23 research outputs found
Imaging and localization of pancreatic insulinomas
For pancreatic insulinomas, the treatment of choice is surgical
excision, which when successful is curative. Intraoperative palpation
combined with ultrasonography theoretically depict almost all tumors,
however the accuracy of palpation is improved by preoperative
localization. All recent advances in imaging have improved the likely
hood for curative surgical resection. Our purpose is to demonstrate the
characteristics of all modalities, which may be used in the preoperative
localization algorithm. (C) 2001 Elsevier Science Inc. All rights
reserved
Selecting distending medium for out-patient hysteroscopy. Does it really matter?
NoThe aim of this prospective randomized study was to evaluate the role of carbon dioxide (CO2) and normal saline for diagnostic accuracy in out-patient hysteroscopy. Women admitted to our Department in order to undergo total abdominal hysterectomy also underwent diagnostic hysteroscopy, 12¿24 h prior to surgery. The selection of distending medium was made after randomization. Two groups of patients were formed, group A (CO2; n=39) and group B (normal saline; n=35). More than half of the women in the study population were post-menopausal. Post-hysteroscopy, all women were asked to rank any symptom that they felt during the procedure on a 4-point scale (0 = none; 1 = mild; 2 = severe; 3 = inability to perform hysteroscopy). The hysteroscopic diagnosis was compared with the macroscopic findings and the histological examination of the surgical specimen after hysterectomy. The percentage who completed hysteroscopy was 89.74% within group A and 97.14% within group B. Most patients of both groups felt some pain of mild intensity. The diagnostic accuracy of hysteroscopy was similar for both media when major pathology [large polyps (group A 91.7%; group B 92.7%), myomas (group A 81.25%; group B 92.7%) and/or hyperplasia (group A 87.5%; group B 90.2%)] of the endometrial cavity was detected. In contrast, in cases of minor pathology (small polyps, mucosal elevations, crypts, hypervascularization), hysteroscopy with saline presented with significantly higher diagnostic accuracy (85.4%) compared with hysteroscopy with CO2 (64.6%). In out-patient hysteroscopy, CO2 and normal saline were comparable with regard to patient discomfort and for the detection of major pathology of the endometrial cavity. Normal saline seems to be the most appropriate medium for the detection of minor pathology of the endometrial cavity
Cryptorchidism: seasonal variations in Greece do not support the theory of light
To examine seasonal trends of cryptorchidism in Greece, 583 males with
true isolated cryptorchidism were analyzed. All 208 912 live-born boys
born during the same period were used as a comparison group. Seasonality
by month of birth was evaluated using both Edwards’ model with adjusted
frequencies and exact theta(i), and Walter-Elwood method with exact
theta(i). Both tests resulted in consistent findings. The incidence of
cryptorchid births in Greece follows a documented cyclic pattern of
simple harmonic type with spring being the season of statistical
predominance (peak in March with a second, almost equivalent, peak in
May). In contrast, in autumn the incidence of cryptorchid births was
considerably lower (trough in September). Given the fact that no
significant differences in daylight length are found among seasons in
Greece. the detection of a significant seasonal variation suggests that
factors other than light are involved in the pathogenesis of
cryptorchidsm. Low environmental temperature is proposed as a causative
factor negatively influencing the maternal hCG profiles and the
inguinoscrotal phase of testicular descent. This is further supported
by: (i) the similarity of our results to those reported by other
European countries of different longitude and geographical width and
(ii) our data showing significantly smaller maternal hCG profiles at the
26th week of gestation during winter compared with summer.
‘...Whoever wishes to investigate medicine properly should proceed thus:
In the first place to consider seasons of the year and what effect of
them produces...’ Hippocrates: Airs, Waters and Places