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The objective of this study was to estimate the prevalence of erectile dysfunction (ED) and its health-related correlates among Danish men, to evaluate the influence of age, tobacco smoking, educational level and medication and the needs for treatment and willingness to be treated. A validated questionnaire was sent to 4310 noninstitutionalized Danish men, aged 40-80 y. The men selected constituted all male patients aged 40-80 y in 12 general practitioner practices in a county of Zealand, representing both the urban and rural population. Besides age, education, marital status and International Index of Erectile Function, the questionnaire included the duration of sexual problems (ED, premature ejaculation, penile curvature), comorbidity, medication, risk factors and the effect of prior treatment and willingness to seek treatment for sexual problems. A total of 2210 men responded, giving a response rate of 51.3%. No difference in the response rate by age groups was noted. The prevalence of complete ED increased with increasing age: 40-45 y, ED: 4.5%; 50-55 y, ED: 11.1%; and 75-80 y ED: 52%. The frequency of ED increased three-fold from men without comedication to men having some kind of medical treatment. Risk factors included tobacco smoking and low educational level. Only 9% suffering from ED had received some kind of treatment. Of the treated men, 75% were satisfied with the treatment. Willingness to discuss sexual matters depended both upon the age of the man and his actual erectile function. Taboos were seen more frequently among elderly people. ED increases with age, but only 10% of the men with sexual problems seek advice. Medication predisposes to ED.

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Problem Based Learning (PBL) has not yet been instituted systematically at medical schools in Denmark. We therefore introduced the method in a 10th term course in internal medicine and surgery, eighteen months before graduation, and evaluated the experience after two terms with a total of 93 students and 15 tutors. Compared with traditional education such as bed-side clinics and lectures etc., PBL was the preferred method by 67% of the students, while 28% found the methods equally good and only 2% discredited PBL. The main advantage of PBL was ascribed to motivation and activation, the students finding themselves as being part of the problem-solving situation. The tutors estimated PBL highly when teaching clinical coping strategies, stressing the need for a realistic and appropriate setting. This experience supports the decision to introduce PBL throughout the new medical curriculum in Copenhagen.

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The effect of initial elective arterial reconstructive surgery was evaluated in relation to employment and social status. Ninety patients with intermittent claudication were followed for a period of 3.5 years. The male to female ratio was 1:12. At the time of operation, all the patients were under the age of 60 years and potentially professionally active. The indication for operation in fifty-nine patients was intermittent claudication. For thirty-one patients, the indication for operation was ischaemic rest pain, gangrene or ulcer. Fifty-six patients (74%) returned to active employment following vascular reconstructive surgery. It is concluded that reconstructive vascular surgery is of great importance for rehabilitation and in the success of resumption of active employment.

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Fifty-six patients with renal or ureteric colic were entered into a randomised, prospective, double-blind investigation of the analgesic efficacy and tolerance of Voltaren versus Ketogan, both administered intramuscularly. There were no significant differences regarding pain-relief but side effects were fewer in patients treated with Voltaren.

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During the period 1979-85, 22 patients underwent operation for hydronephrosis. The surgical method chosen was the Anderson-Hynes pyeloplasty. Nine patients out of 15 with impaired function of the affected kidney showed an improvement in function after surgery. Seventy-seven per cent of the patients were totally free of symptoms, 18% improved following operation. The Anderson-Hynes pyeloplasty is recommended for patients with symptoms of hydronephrosis.

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Internal abdominal hernias are uncommon. A case of sigmoid mesocolic hernia involving cystadenoma of the uterine adnexa is described. Symptoms from internal hernias are vague and uncharacteristic. Most cases are diagnosed at laparotomy for ileus.

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To evaluate the use of papaverine-induced erection as a diagnostic test in men with erectile dysfunction, 24 patients had papaverine injected into the corpus cavernosum. The results of the papaverine test in combination with the tentative diagnosis, based upon patient history, clinical examination and peno-brachial pressure index, gave in most cases sufficient information about the function of the penile vessels to decide in which patients a selective arteriography or a cavernosography was indicated. Two patients developed priapism after the papaverine injection.

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The epidemiology of occupational burns injuries in a well-defined population is analysed. Although a total of 371 persons sustained an injury, only a few were inpatients and just one required anti-shock treatment. The mean burn surface area was 0.66 per cent and 14 patients had full thickness burn injuries. There were no deaths. Men were found to be more prone than women to injury, especially young workers. The distribution by categories of work and causes of burn are illustrated. Scalds and contact burns were dominant, particularly in restaurants. The work by the National Labour Inspection is acknowledged.

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Metastasis to the testis is rare. The site of primary tumor may be the lungs, the prostate or the large bowel. The clinical parameter is illustrated by a case history. The immunohistochemical method is taken into account.

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During the period 1 September 1982 to 31 August 1983 the total number of burn injuries in the municipality of Copenhagen was recorded prospectively. The social changes and the constitution of the population are illustrated. The total number of burn injuries showed a decrease of 33 per cent compared to the investigation in 1974/75. Scalds are still the most frequent cause of burn accidents, small children are especially vulnerable. Seventy-two per cent of all accidents occurred at home. Only a few patients required 'antishock' therapy. No patients with work-related burn injuries died. Preventive measures have eliminated or reduced the number of some types of thermal injury.

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The epidemiology of severe burns is analysed. From 1 September 1982 to 31 August 1983 75 patients, 27 females and 48 males were admitted to the Burns Unit in Copenhagen. The majority of burns were domestic and fire was the predominant cause. The most vulnerable areas were the arms and the legs, and small children still have the highest incidence of thermal injury. As predisposing factors were of significance in several accidents, the importance of further prevention is stressed.

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The epidemiology of scalds to children aged 0-5 years is reviewed. More than two-thirds were below 2 years of age. Most accidents took place in the dining/living room and most were caused by coffee. Awareness by the parents may reduce the number of scalds.

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Voiding disturbances following anal surgery are a well known but often ignored condition. Thirty-seven patients were investigated before and after operation for hemorrhoids by uroflowmetry and measurement of residual urine. Sixteen patients showed a decreased peak flow after operation, 13 patients had residual urine of more than 100 ml and 5 patients developed urinary retention. Five of the 13 patients complained of stranguria, incontinence, nocturia and frequency during the following months. We suggest that patients with urological problems after anal surgery should have their bladder controlled at regular intervals.

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