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OBJECTIVE: To evaluate the voiding phase before and 1 year after surgery in women who underwent a tension-free vaginal tape (TVT) procedure for stress incontinence. PATIENTS AND METHODS: The study comprised 45 women with genuine stress urinary incontinence. To assess the voiding phase, patients were asked if their voiding had changed after surgery, and objectively the uroflowmetry, residual urine measurements and pressure-flow data were compared. RESULTS: At 1 year after surgery 39 women (87%) were subjectively cured and six (13%) improved. The objective cure rate was 88%; the pad-test leakage and the number of leakage episodes decreased significantly after surgery. Subjectively, 78% of the patients reported that the voiding phase had become more difficult, and the spontaneous flow curve changed to a more obstructive pattern in 40%, with the mean urinary peak flow rate (Q(max)), the corrected Q(max) and the mean average flow rate decreasing significantly. The residual urine volume increased significantly, although no patient had volumes of > 25% of their bladder capacity. During the pressure-flow study the Q(max) decreased and the urethral resistance factor increased significantly. However, only one patient could be classified as obstructed. Two patients had clinical problems and used self-catheterization once daily 1 year after surgery. CONCLUSION: There were subjective and objective changes in the voiding phase 1 year after the TVT procedure. The significance of these findings remains to be determined. Longitudinal studies are warranted to clarify whether the patients at risk can be characterized from subjective and objective findings.

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The aim of this article was to investigate septal branches of the right coronary artery in order to create both their typologies and to evaluate the usefulness of the vessels mentioned above for revascularisation procedures on the interventricular heart septum. The clinical studies were performed on 58 human hearts aged 28-80. Technical method of direct preparation, corrosive preparation and coronarographic picture assessment. The tests showed that the number of septal branches ranged from 5 to 11, their diameter from 0.7 to 1.2 mm. There were no main trunk or vessels with different dimensions than other arteries. Creation of septal vascularisation model was not possible because of rapid changes in studied vessels, their distribution and small diameters (about 1 mm) disqualifying them for direct revascularised operations on interventricular heart septum.

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MATERIAL AND METHODS: In 12 Wistar rats the gross and microscopic structure of haemolymph splenic nodes was assessed after splenectomy and the obtained results were compared with those in the control group. RESULTS: It was found that splenectomy leads to generalised morphological changes of the mentioned nodes, including, among other, their blanching, enlargement, filling with a greater number of morphotic elements and decreased count of erythrocytes and products of their disintegration. The splenic nodes demonstrated no regressive changes, typical of uniorgan nodes. The remaining abdominal non-haemolymph nodes in the rats showed no compensatory changes on gross examination after splenectomy.

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Platform independence is an important issue for a software designed to run across a hospital environment which is practically always heterogeneous one. This paper presents a simple miniPACS solution designed over an existing Intranet (Internet limited to a local area network). Platform independence is achieved with Java programming language which allows resulting code to be executed on virtually all machines. System consists of a server application providing DICOM (Digital Imaging and Communications in Medicine) services and clients that can use these services over a TCP/IP connection. The server application is capable of an image storage and supports a query mechanism to allow access to stored data, thus the clients may perform two major functions: providing image data for archiving or image retrieval for viewing. Presented client application provides both these functions. It retrieves stored images for further processing and returns calculated results to the archive. The parts of the system are connected through a DICOM interface. Consequently the system architecture is open and any devices like scanners or viewing stations supporting specific DICOM services may be attached.

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Analysis software for medical image data tends to be expensive and usable only in a restricted environment. Therefore the aim of the current project was to implement a flexible framework for medical image processing and visualization which is portable among platforms and open to different data formats including DICOM 3.0. The software was designed as a set of tools which encapsulate specialized functionality. The tools are full stand alone applications, but they are also able to present a co-operating environment within which images and other information are communicated in real time. Currently, the emphasis is on quantitative analysis of PET data by kinetic modelling. However, general viewing capabilities are included, and the design is flexible enough that other types of processing can easily be integrated by simply plugging in Java classes. The software is successfully applied to PET data quantitation in clinical research studies and even patient studies. Portability was aimed at by encoding the programs in Java. Experience shows that the implementation of such a complex and computationally demanding Java application is feasible. Although there are major portability issues to consider, configurations can be found on which the software runs stably and at a speed comparable to C code if just-in-time compilation is available.

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The effect of 1,25-dihydroxyvitamin D supplement on glucose metabolism was evaluated in 12 women with gestational diabetes mellitus (GDM). All women had an oral glucose tolerance test (OGTT) performed at inclusion in the study. Thereafter, each patient was instructed to continue their normal diet during the following 2 days, after which they received 2 micrograms/m2 Etalpha i.v. 2 h prior to the second OGTT. During the next 14 days each patient received 0.25 microgram Etalpha orally, after which a third OGTT was performed. On average the level of 1,25-dihydroxyvitamin D3 at inclusion at baseline significantly increased after i.v. 1,25-dihydroxyvitamin D3 (from 92 to 138 ng/l [p < 0.001]), but returned to the baseline level after 2 weeks of oral Etalpha (85 ng/l). Simultaneously, the glucose level decreased from 5.6 to 4.8 mmol/l (p < 0.01) after i.v. treatment with 1,25-dihydroxyvitamin D3, but did not differ significantly from inclusion following 2 weeks of oral Etalpha. There was no difference between the glucose concentrations during OGTT prior to and after i.v. or oral 1,25-dihydroxyvitamin D3, in contrast to the insulin levels which tended to be lower after both i.v. and oral supplementation. In a multiple regression model including 1,25-dihydroxyvitamin D3, insulin, weight and height against glucose, only 1,25-dihydroxyvitamin D3 and insulin were selected for the final model (r2 = 0.73, p < 0.0001). Our results suggest that supplements of 1,25-dihydroxyvitamin D3 influence glucose metabolism in patients with GDM probably by increasing the insulin sensitivity.

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In 26 Wistar rats the morphology of 30 renal and 20 splenic lymph nodes were investigated. The left renal nodes are usually singular as compared to multiple right renal nodes. Microscopically they present segmental structure with erythroidal elements located mainly in the medullary cords. The splenic nodes, 1 to 5 in number do not show segmental structure but have uniformly dispersed erythroidal elements.

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Sections were taken from the infrapatellar adipose body of 74 males and females of various ages. In subjects exposed to long-lasting burden of the lower limbs and in older persons the subsynovial lymphocytic infiltration was found.

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A total of 589 women applying for termination of pregnancy (46% of the total number of applicants during a one-year period) completed a questionnaire concerning female anatomy, sexual information and contraceptive habits. Of these, 415 women had their pregnancy terminated at Hvidovre Hospital, Copenhagen (high abortion rate) and 174 in northern Jutland (low abortion rate). The two groups did not differ considerably in their replies. Mean age at the first coitus was on average 15.8 years, where a total of 36% had not used any contraception. Among those who were applying for termination of pregnancy, 34.1% had not used contraception, 13.4% had used unsafe methods and 23% had not used the method correctly, leaving a total of 60% at high risk of pregnancy. Information about contraception was in most cases given by the general practitioner (38%). An increased number of women with a high level of sexual knowledge from Copenhagen had less frequently used contraception as compared with those in Jutland. In conclusion the high discrepancy in abortion rate among the two areas can not be explained by differences in contraceptive habits.

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A total of 589 women applying for termination of pregnancy completed a questionnaire about female anatomy and sexual information (46% replies). Of these 415 women had the pregnancy terminated in Hvidovre Hospital, Copenhagen (high abortion rate) and 174 in Aalborg Hospital in the northern Jutland (low abortion rate). The two groups showed great agreement in the replies. In 14% the sexual information was not acceptable and, especially among women under 20 years, the sexual information was poor. Only 13% of the women with poor sexual information considered that their knowledge should be increased, compared to 26% women with better knowledge. Most women received their first sexual information from their mothers and the general practitioners were the most used for further information. Most women were satisfied with the information given by their mothers and general practitioners. In conclusion, the present study did not explain the observed difference in abortion rate between the two regions.

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At present, magnesium treatment is employed routinely in the treatment of hypertension induced by pregnancy (PIH) and preeclampsia in USA with the object of preventing seizures. In USA the treatment of election consists of intravenous infusion of large doses of magnesium sulphate in order to obtain a therapeutic concentration. The anticonvulsive mode of action of magnesium is only partially understood. Magnesium is presumed to block the neuromuscular transmission but a central effect cannot be excluded. Treatment with magnesium has, in addition, an antihypertensive effect. The effect of magnesium on the blood pressure is probably a direct vasodilatory effect which explains the ability of magnesium to reduce the maternal blood pressure. Probably the same mode of action is responsible for the relaxing effect of magnesium on the vascular tone in the umbilical and placental vessels. This can probably explain the favourable effect of magnesium on the birth weight. Even if magnesium treatment implies a potential risk for neonatal hypermagnesemia and hypocalcaemia, only few side effects have been reported.

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Out of a total of 158 pregnant women, 55 accepted participation in a dietary investigation for seven days with the object of assessing the consumption of milk by pregnant women and the significance of this for the intake of energy-providing dietary constituents and certain minerals. The diet in pregnant women contained more fat (43.2%) and the relationship between polyunsaturated and saturated fatty acids (P/S-relationship) (0.25) was less than that recommended. The daily dietary content of fibre of 20.7 g/day was lower than the recommended intake. Calcium, phosphate and magnesium intakes constituted 180%, 131% and 64% respectively, of the recommended daily intake. The average intake of milk (buttermilk, skim milk, low fat milk and whole milk) was 482 g/day. The calcium content of the milk constituted, on an average, one third of the total calcium intake. The content of fat and saturated fatty acids in the milk constituted 7% and 10%, respectively, of the total intake. Four of the pregnant women had a daily calcium consumption of less than the recommended intake (1,000 mg/day). The same women had the lowest consumption of milk and energy in the group investigated. The results suggest that the dietary consumption is adequate to cover the calcium requirements. Extra calcium supplements should only be recommended for pregnant women with limited consumption of milk and other milk products. Pregnant women should be advised to take increased quantities of magnesium and to reduce the fat intake.

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A case of primary retroperitoneal cyst in a woman aged 21 years is presented. The cyst, which contained 6.5 litres, was treated by total excision. The diagnosis, treatment and classification are briefly described.

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