Green lasers are beyond power limits mandated by safety standards.

There has been an increasing number of reports of people losing vision from laser exposure from pocket laser pointers despite the safety limit of 1 milliwatt (1mW) imposed by the Australian government. We hypothesize that this is because commercially available red and green laser pointers are exceeding their labeled power outputs. We tested the power outputs of 4 red and 4 green lasers which were purchased for less than AUD$30 each. The average of 10 measurements was recorded for each laser. We found that 3 out of 4 red lasers conformed to the 1mW safety standard; in contrast, all of the green lasers exceeded this limit, with one of the lasers recording an output of 127.9 mW. This contrast in compliance is explained by the construction of these lasers - green lasers are typically Diode Pumped Solid State (DPSS) lasers that can emit excessive infrared (IR) radiation with poor workmanship or inconsistent adherence to practices of safe design and quality control; red lasers are diode lasers which have limited power outputs due to `Catastrophic Optical Damage' (COD). Relevant professional bodies ought to advocate more strongly for stringent testing, quality control and licensing of DPSS lasers with a view towards government intervention to banning green laser pointer use.

High uterosacral vaginal vault suspension with fascial reconstruction for vaginal repair of enterocele and vaginal vault prolapse.

OBJECTIVE: The purpose of this study was to review retrospectively the functional and anatomic outcomes of women who underwent vaginal repair of enterocele and vault prolapse with the use of an intraperitoneal suspension of the vaginal vault to the uterosacral ligaments in conjunction with fascial reconstruction of the anterior and posterior vaginal wall. STUDY DESIGN: Two hundred two women with advanced symptomatic uterovaginal prolapse or posthysterectomy vault prolapse underwent a standard transvaginal procedure to correct their prolapse between January 1997 and June 2000. Anatomic results were assessed by standardized examination from 6 months to 3 years after the operation. Functional results were assessed subjectively and with standard quality of life questionnaires. The average age of the women was 60.3 years. Follow-up data were available for 168 of the 202 women. Fifty-three percent of the women had their uterus in place and underwent a vaginal hysterectomy. The prolapse repair was a primary procedure in 45.2% of the women and was performed for a recurrence or persistence in 54.8% of the women. Sixty percent and 78.6% of women underwent anterior and posterior repair, respectively. Thirty-five percent of the women underwent an anti-incontinence procedure. RESULTS: Eighty-nine percent of the women expressed satisfaction with the results of the procedure. Ten women (5.5%) underwent a repeat operation (by the authors) for recurrence of prolapse in one or more segments of the pelvic floor. Quality of life assessment revealed a significant reduction in all aspects of daily living, when the short forms of the incontinence impact questionnaire and urogenital distress inventory were evaluated before and after the operation. Major intraoperative complications included 5 cases (2.4%) of ureteral injury, 1 case of a small bowel injury, and 1 case of a pelvic abscess that required abdominal exploratory operation and diversion of the colon. CONCLUSION: High uterosacral ligament vaginal vault suspension with fascial reconstruction would seem to provide a durable anatomic repair with good functional improvement in patients with significant complex uterine or vaginal vault prolapse.

Suprapubic bladder drainage after extraperitoneal cystotomy.

OBJECTIVE: To observe the effects of cessation of continuous bladder drainage after short-term catheterization in women who had extraperitoneal cystotomies. METHODS: The study population included 84 women, 78 of whom had retropubic urethropexies and six of whom had retropubic paravaginal repairs. Intentional cystotomy was done intraoperatively to assure ureteral patency, bladder integrity, and no inadvertent suture penetration into the bladder. All cystotomies were closed in two layers with 3-0 chromic suture. Suprapubic catheters were placed intraoperatively in all cases. In all women except four with gross hematuria, continuous bladder drainage was stopped and voiding trials were started within 24 hours after surgery. Suprapubic catheters were removed when women spontaneously voided 80% of total bladder volume. RESULTS: Suprapubic catheters were discontinued on average 4.1 days after surgery (range 2.7-14.1 days). Average bladder volume at initial clamping of the suprapubic catheter was 382 mL (range 224-510 mL). At this volume the integrity of the cystotomy should have been challenged appropriately. The women were observed for a minimum of 3 months with no immediate or long-term complications. CONCLUSION: Extraperitoneal cystotomy in a nondependent portion of the bladder does not require continuous bladder drainage for more than 24 hours. This information should allow pelvic surgeons to be more liberal with intraoperative cystotomies if bladder integrity or ureteral patency needs to be confirmed.

A randomized comparison of oral misoprostol versus Foley catheter and oxytocin for induction of labor at term.

OBJECTIVE: We sought to compare the efficacy and safety of oral misoprostol administered to patients with the efficacy and safety in a control group treated with a Foley catheter and oxytocin for induction of labor. STUDY DESIGN: Two hundred patients requiring induction of labor at term with a Bishop score of

Techniques for the rapid display and manipulation of 3-D biomedical data.

The use of fully interactive 3-D workstations with true real-time performance will become increasingly common as technology matures and economical commercial systems become available. This paper provides a comprehensive introduction to high speed approaches to the display and manipulation of 3-D medical objects obtained from tomographic data acquisition systems such as CT, MR, and PET. A variety of techniques are outlined including the use of software on conventional minicomputers, hardware assist devices such as array processors and programmable frame buffers, and special purpose computer architecture for dedicated high performance systems. While both algorithms and architectures are addressed, the major theme centers around the utilization of hardware-based approaches including parallel processors for the implementation of true real-time systems.