[Randomized trial on the value of diagnostic laparoscopy before appendectomy]. / Randomiseret studie over vaerdien af diagnostisk laparoskopi før appendektomi.

Two groups of 30 women with clinical signs of appendicitis were randomized to immediate appendicectomy or diagnostic laparoscopy. In the latter group, appendicectomy was performed if a diagnosis of acute appendicitis was established or if the appendix could not be visualized. Eleven patients who underwent immediate operation had unnecessary appendicectomy, compared with two who underwent laparoscopy. This difference of 30% (95% confidence interval 11-49%) was significant (p = 0.01). There was no significant difference in postoperative morbidity rate in the two groups. Diagnostic laparoscopy is a useful preliminary investigation in women with clinical signs of acute appendicitis.

Randomized study of the value of laparoscopy before appendicectomy.

Two groups of 30 women with clinical signs of appendicitis were randomized to immediate appendicectomy or diagnostic laparoscopy. In the latter group, appendicectomy was performed if a diagnosis of acute appendicitis was established or if the appendix could not be visualized. Eleven patients undergoing immediate operation had unnecessary appendicectomy, compared with two having laparoscopy. This difference of 30 per cent (95 per cent confidence interval 11-49 per cent) was significant (P = 0.01). There was no significant difference in postoperative morbidity rate in the two groups. Diagnostic laparoscopy is a useful preliminary investigation in women with clinical signs of acute appendicitis.

Balloon dilatation of ureteral strictures.

Balloon catheter dilatation is now an accepted method for treating strictures of the upper urinary tract. A successful result was obtained in 34 (85%) of 40 patients with symptomatic stricture. The number of dilatations required for improved runoff from the kidney was one in 26 cases, two in six cases and three in one case. One patient had a permanent stent and six required a conventional operation. There were seven recurrences of stricture, all within 4 months after the dilatation. One of these patients required nephrectomy because of nonfunctioning kidney.

Microvascular transposition of the arterial supply to the testis of the boar.

The origin of the arterial supply to a testis was changed in 7 boars with a microsurgical technique. A. testicularis was connected, end to side, to a branch of the femoral artery. The capillary blood flow was unchanged, indicating viable transplants. The temperature difference between testis and body disappeared after the surgery, indicating an interruption of the heat transfer in the pampiniform plexus. The lower values of the histological score and the possibly lower peripheral plasma concentration of testosterone after the arterial by-pass may indicate a physiological importance of the counter current exchange.

[Pseudoaneurysm of the deep femoral artery after osteosynthesis of a pertrochanteric fracture of the femur]. / Psudoaneurysme fra arteria profunda femoris efter osteosyntese af pertrokantaer femurfraktur.

A woman aged 66 years developed a pseudoaneurysm from the deep femoral artery after osteosynthesis of a pertrochanteric fracture of the femur. During operation, it is important to avoid boring into the soft tissues on the medial aspect of the thigh and a screw of the correct length should be chosen.

The physiology of the testes in the Göttingen mini pig.

Capillary blood flow (133xenon clearance), deep testicular and muscle temperature (needle thermistor) and androgenic hormone concentrations in peripheral blood samples (RIA) were measured and the histology (needle biopsies) evaluated in 16 anaesthetized, mature Göttingen mini pigs. The blood flow was 0.26 +/- 0.10 ml x g-1 x min-1. The testicular temperature was 33.6 +/- 1.4 degrees C, and the body temperature 37.2 +/- 0.9 degrees C. The plasma levels of testosterone were 15.2 +/- 10.1 nmol x l-1, of dihydrotestosterone 0.99 +/- 0.98 nmol x l-1, dehydro-epi-androsterone sulphate 441 +/- 333, nmol x l-1, and the delta-4 androstenedione level was 9.2 +/- 7.0 nmol x l-1. Sexual-hormone-binding-globulin was immeasurable. The histological appearance was judged to 7.8 +/- 1.0 by a testicular biopsy score (scale 10-1). The results from the present investigation are in the same range of order as in other mammals and it is concluded that the mature, male Göttingen mini pig is a useful model for reproductive research.

Functional results after ileocystoplasty.

The functional results after ileocystoplasty were studied in seven patients with interstitial cystitis, irradiated bladder and neurogenic bladder dysfunction. None of the patients had had symptomatic improvement by medical or surgical means. All patients were suffering from urinary frequency and five patients had severe urge incontinence or suprapubic pains. Postoperatively the patients were followed from 8 to 66 months and evaluated by urodynamic examinations and interviews. Urinary frequency was improved in all patients but one with interstitial cystitis who had persisting suprapubic pains. None had residual urine volume greater than 30 ml postoperatively. It is concluded that bladder augmentation by ileocystoplasty is an excellent method of treatment for patients with contracted bladder secondary to interstitial cystitis, irradiated bladder, and detrusor hyperreflexia and sphincter dyssynergia.

Somatostatin in the treatment of persisting pancreatic fistula--a report of two cases.

In two patients with persisting pancreatic fistula not responding to conventional treatment, definitive closure of the fistula was achieved when somatostatin was added to the treatment.

Vaginal absorption of oestradiol and progesterone.

The vaginal absorption of micronized oestradiol/progesterone from a hydrophilic matrix system was investigated before and after 10 days of treatment in 7 post-menopausal women with an average age of 56.1 yr. Oestradiol and progesterone levels were measured on days 1 and 11 before administration and 0.5, 1, 2, 3, 4, 6, 8, 12, and 24 h afterwards by radioimmunoassay. Peak values were seen 6-12 h after administration. This finding differs from those of other investigations. Sex hormone binding globulin (SHBG) and androgen concentrations were unchanged after 10 days of treatment.