Paratesticular desmoid tumor

A primary intrascrotal mass clinically mimicking a testicular tumor was found to be a desmoid tumor originating from the spermatic cord. To our knowledge, this is the first reported case of a paratesticular desmoid tumor.     

Strategies to avoid unnecessary cesarean sections

Because there is a 35 to 50 percent incidence of false-positive prediction of fetal compromise on fetal heart-rate monitoring patterns, many unnecessary cesarean sections are performed. To reduce the number of unnecessary cesarean sections, the physician is urged to consider the following: (1) fetal heart-rate monitoring is associated with higher rates of cesarean sections than in those not monitored; (2) only high-risk patients should be monitored provided the low-risk patient is at term, with a normal-sized infant, and does not convert to a high-risk patient while in labor; (3) maintenance of variability is a better predictor of absence of acidosis than is fetal scalp pH; (4) fetal scalp stimulation by firm digital pressure or gentle nontraumatic clamping of scalp tissue or acoustic stimulation obviates the need for fetal scalp pH confirmation of acidosis in 50 percent of cases; (5) monetary considerations may unconsciously lead to increased cesarean sections, since insurance companies remunerate at a higher level for those as compared with vaginal deliveries; and (6) more patients with prior cesarean section should be given a trial of labor, since the initial reason for cesarean section often is not a recurring one and many could successfully be delivered vaginally. Ultimately there is a risk inherent in any decision regarding method of delivery. The patient must understand this risk and share in the decision-making process as a knowledgeable person, aware of the limitation of her physician.     

Assessing hospital nursing staff retention and turnover. A life table approach.

This research applied the life table technique to nursing personnel data in two types of hospitals to illustrate how administrators can examine patterns of continued employment. Although a large proportion of nurses were short-stay employees, the teaching hospital was found to have a higher retention rate than the community hospital corporation. The retention patterns are examined by personal and professional characteristics, as well as by reason for termination. Implications of our findings are discussed with respect to policy concerns related to hiring, retention, productivity, and staff development.     

A portion of the human surfactant protein A (SP-A) gene locus consists of a pseudogene

SP-A is the most abundant, surfactant-associated protein isolated from lung lavage. Genomic blot analysis of total human cellular DNA with SP-A cDNA demonstrated the presence of multiple hybridizing fragments that are not accounted for by available SP-A gene sequences. In this report, we have cloned and characterized human genomic DNA fragments that account for some of the other hybridizing fragments. These clones contain nucleotide sequences that are highly homologous to the fourth intron and fifth exon of the human SP-A gene. Sequences upstream from these SP-A-like sequences are not detectable by Northern blot hybridization of SP-A-expressing cells and the SP-A-like sequences contain premature stop codons, consistent with the interpretation that these clones represent an SP-A pseudogene. Restriction fragments consistent with this pseudogene and the functional SP-A gene are present in a human chromosome 10 genomic library made from a single chromosome, showing that the functional SP-A gene and the pseudogene are syntenic.