[Treatment of chronic anal fissure with lateral sphincterotomy]. / Lécení chronické anální fisury laterální sfinkterotomií.

This paper presents a group of 134 patients, who underwent treatment of chronic anal fissure by internal lateral sphincterotomy (ILS) within the period of 12 years (1985-1996). This number of patients where those in whom conservative treatment (anal divulsion) was not successful. From the total number of 134 patients 110 were treated successfully by surgery (82.08%). In 19 patients even after fissure healing slight discomfort persisted. Moderate and more severe complaints were reported in 5 patients. In 4 cases the chronic anal fissure failed to heal, in 1 patient due to ILS perianal fistula developed. No other complications, like incontinency etc., were found within the short time interval of follow-up. ILS is a simple and safe surgical procedure performed under general anaesthesia after precise differentitation of the internal sphincter. The results of surgical treatment are very satisfactory, marked painfulness relieves immediately after operation, the fissure heals rapidly after relaxation of the internal sphincter spasm. Postoperative treatment is simple, the percentage of complications is low. None of the patients operated on in the authors department developed incontinence. (Tab. 3, Ref. 25.)

Attitudes of hospital executives toward product line management: a pilot survey.

This article reports results of a pilot survey of hospital executive attitudes toward product line management (PLM). Results indicate that the majority of respondents feel the concept is applicable to hospitals in general as well as to their own institutions. However, the respondents have not really internalized some of the key attributes of the concept and the likelihood of adopting PLM is higher for large, for-profit, and urban hospitals.