Peyronie curvature treated by plication of the penile fasciae.

OBJECTIVE: To evaluate the results of plication of the penile fascia in patients with penile curvature secondary to Peyronie's disease. PATIENTS AND METHODS: Twenty-eight men with Peyronie curvature underwent plication of the penile fascia. Before operation, the deviation of the penis was so severe (median 60 degrees) in 24 men that they were unable to perform sexual intercourse. Follow-up was based on hospital records, one postal questionnaire sent to all patients and a clinical evaluation of the men in the out-patient clinic. RESULTS: After an uncomplicated operation and a median follow-up of 34 months, 20 of the 28 men were able to perform sexual intercourse and 23 were satisfied with the result of the operation. The most frequent reasons for dissatisfaction with the outcome of the operation were insufficient straightening, pain from sutures and uncharacteristic pain related to the penis and/or scrotum. CONCLUSION: The technique is simple to perform and the method gives functional and cosmetic results equal to those of more invasive procedures. The provision of adequate information to patients before the operation is important to ensure their satisfaction with the outcome.

[Chylous ascites after surgery on the abdominal aorta]. / Kyløs ascites efter abdominalaortakirurgi.

Chylous ascites is a rare clinical condition and especially rare as a complication of surgical intervention. Its pathophysiology is poorly understood. We report a case of chylous ascites following aortic femoral bypass managed by conservative approaches involving multiple paracenteses, dietary restriction of fat and parenteral nutrition. We suggest that cases of surgically induced chylous ascites which do not respond to conservative treatment within a few weeks should have a laparatomy to close the fistula.

The effect of hyaluronic acid on cartilage in the immobilized rabbit knee.

Out of 30 adult rabbits, 20 had one knee immobilized with a plaster of Paris cast for 6 or 12 weeks, and 10 rabbits were used as untreated controls. Prior to immobilization, 10 knees were injected with high-molecular weight hyaluronic acid. The articular cartilage of the femoral condyles was studied by light microscopy, whereas that of the patella and tibia was analyzed biochemically. Degenerative changes of the articular cartilage similar to those seen in arthrosis were observed after 6 weeks. The intraarticular injection of hyaluronic acid did not prevent these changes; instead, the reparative processes seemed inhibited.

Monteggia lesions in children and adults: an analysis of etiology and long-term results of treatment.

The mechanism of trauma and late results of treatment were analyzed in 17 pediatric and 16 adult Monteggia lesions. Pediatric Monteggia lesions were almost entirely found to be the result of low energy trauma leading to a closed, noncomminuted fracture in an otherwise noninjured child. In the adult cases, however, these lesions were most often found to be the result of high energy trauma leading to open and comminuted fractures. Furthermore, 62% of the adults had other, and often more serious, injuries. Results at follow up (average 7 years) were excellent in the pediatric cases, whereas all adults had sequelae, especially regarding range of motion. The results of this study clearly suggest that a Monteggia lesion represents a more severe injury in the adult.

Congenital bilateral eventration of the diaphragm in a pair of male twins.

We present a case of congenital bilateral eventration of the diaphragm in a pair of male twins. The case is associated with severe pulmonary hypoplasia. Both infants died in the neonatal period. An exposure to Thiotepa in the first trimester of the pregnancy is a possible etiologic factor.

Bacteraemia following orotracheal intubation and oesophageal balloon dilatation.

Asymptomatic bacteraemia following balloon dilatation was assessed in 20 adults with oesophageal stricture. Asymptomatic bacteraemia occurred in 12 of 19 patients. The source of the bacteraemia appeared to be the patients' oropharyngeal flora. The bacteraemia was not of clinical importance in our patients, but might lead to endocarditis in predisposed individuals.