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Congenital pulmonary venous stenosis (CPVS) has been previously described in older infants and children, typically manifesting as failure to thrive with congestive heart failure and subsequent respiratory deterioration. We report on 2 cases of CPVS which presented during the immediate newborn period as severe persistent pulmonary hypertension of the newborn.

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Previous measurements of fetal hepatic blood flow have relied on microsphere methodology. Estimates of fetal hepatic oxygen consumption (VO2), based on these measurements and the oxygen content difference across the fetal hepatic circulation, have been quite variable. To estimate hepatic VO2 in the fetal lamb by a different methodology, we applied the Fick principle using the steady-state uptake of indocyanine green (ICG) by the fetal liver to measure left hepatic blood flow in 10 pregnant ewes. Sampling catheters were inserted into the fetal external iliac artery, left hepatic vein, and umbilical vein. ICG was infused to steady state (for approximately 60 min) through a fetal brachial vein. Four sets of ICG concentration differences across the circulation of the left hepatic lobe were determined for each animal, and left hepatic lobe blood flow calculated. The oxygen concentration difference was measured simultaneously and VO2 of the left hepatic lobe calculated. In addition, we measured fetal VO2 and calculated the ratio of hepatic to fetal VO2. Left hepatic lobe blood flow was 382.30 ml/min/100 g tissue (COV = 0.32), a result statistically no different than in 4 animals with an independent measurement of hepatic blood flow using an ethanol equilibration method. Hepatic VO2 was 1.74 micromol/min/g tissue (COV = 0.13), and hepatic to fetal VO2 ratio was 18.23% (COV = 0.19). Our results indicate that normal fetal hepatic oxygen uptake per gram of tissue is less variable than previously suggested, and that ICG can be applied in the fetus for the purpose of hepatic blood flow measurement.

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PURPOSE: The computer generated recordings for 2 nights in 40 patients studied with the RigiScan device were reevaluated using the new RigiScan Plus software to test its value in improving the discrimination between psychogenic and organic erectile dysfunction. MATERIALS AND METHODS: Each man was evaluated for erectile dysfunction with a detailed medical and sexual history, physical examination, biothesiometry, plethysmography, 2 nights of ambulatory RigiScan monitoring and a psychological evaluation that usually included a private interview with the sexual partner. At the conclusion of evaluation each patient was broadly classified as having organic or psychogenic erectile dysfunction. The RigiScan reports were initially independently analyzed without the investigator's knowledge of the final diagnosis by determining the single best erectile event, with a minimal cutoff value of 60% erection for 5 minutes as necessary to be considered normal and the sum of measurements from the 2 nights. The original reading and final diagnosis were correlated. At this point the data were processed with the new RigiScan Plus software using 2 new measurements: 1) rigidity activity units and 2) tumescence activity units at the base and tip of the penis, and the results were correlated with the final diagnosis. RESULTS: Evaluation of the single best event again showed that tip rigidity was the best single predictor if the diagnostic criteria were modified to 70% tip rigidity for 5 minutes with an estimate of correct classification of 92.5%. Nearly the same accuracy was obtained by base single event rigidity, tip rigidity and base tumescence activity units (each 90%). The summary analysis of all erectile events during the 2 nights of evaluation that had a low correlation with the final diagnosis using the original software showed that the best overall predictor of final diagnosis was tip tumescence activity units (92.5%), followed by base rigidity and tumescence activity units (each 90%). CONCLUSIONS: The RigiScan Plus software introduced 4 new parameters that facilitate interpretation of the RigiScan data. The new software did not improve the correlation with the final diagnosis compared to the subjective single best event analysis but added new objective parameters, measured and displayed by the software, that facilitate use of the data by the physician.

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PURPOSE: Information was collected during the first 2 years of an ongoing, prospective, multi-institutional evaluation of the Dura-II penile prosthesis. Evaluation included data on clinical outcomes and a patient satisfaction survey, and will continue for 5 years after implantation for each patient. MATERIALS AND METHODS: To date 196 patients have been evaluated. Surgical data, adverse events and information from satisfaction surveys are reported. RESULTS: At a followup of 13.4 +/- 8.4 months postoperatively, adverse events occurred in 8.2% of the patients, resulting in reoperation in 5.1%. There have been no mechanical failures. Overall satisfaction rates were 85% at 3 months, 83% at 1 year and 91% at 2 years after implantation, and levels of sexual functioning were correspondingly high. A majority of patients assigned high scores to rigidity, concealability, ability to have intercourse and erection size, although satisfaction with erection size ranked lower than the other measures. CONCLUSIONS: The Dura-II penile prosthesis provides a satisfactory result and has an acceptable level of complications associated with its use. Further followup will assess temporal changes in satisfaction rates and sexual functioning for these patients.

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Swelled cans were collected over a 17-month period from outlets of two supermarket food chains. Each swelled can was classified by product and the probable cause of the swelled condition. Using weekly sales volume data for each outlet, the incidence rate of swelled cans for each type of food was estimated. The incidence rates ranged from 2.1 to 78.4 swelled cans per 100,000 units sold, depending upon the type of food. Of the 1.104 swelled cans collected, 314 (28.4%) were found to have major container defects which were assumed to have resulted in the swelled condition. Microbiological analyses were performed on the products in the remaining 790 cans; the following results were obtained: (a) typical leaker spoilage, 86%; (b) typical underprocessing spoilage, 7%; (c) thermophilic spoilage, 1% and (d) nonmicrobial swells, 6%. Using vacuum testing and double seam measurements, the causes of the leakage were determined as follows: (a) poor or questionable quality canner's end double seam, 51%; (b) leaks at locations other than the double seam, 26% and (c) poor or questionable quality manufacturer's end double seam, 4%. It was concluded that examining swelled cans of low-acid foods at the retail level is a valid method for evaluating the canning operation of commercial food processing.

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