- Email: [email protected]
Alleged Resection of the Vas Deferens: Medicolegal Implications
215 ffiUSt
n;c;'l'flC'HHffP
and government methodologies. 2 13 references
in the development of assurance standards and
Robert M.D. Cleveland, Ohio
16: 43-47 (Jan.) 1988
A rat model with extravaginal 540-degree torsion of the right testicle for 6 or 12 hours, or permanently was used and a sham operated group of animals served as controls. Spermiography and plasma hormone levels in each individual animal were determined before and 9 weeks after torsion. The luteinizing hormone levels increased significantly 18 weeks after torsion. Morphometry of the contralateral testicle revealed no alterations except a significant increase in Leydig and interstitial cells. The simultaneous findings of normal histology of the contralateral testes, normal plasma folliclestimulating hormone values and undisturbed spermatogenesis 2 months after torsion indicates that in the rat damage to l testis does not necessarily result in a permanent lesion on the contralateral side. 4 figures, 2 26 references Pramod R. Rege, M.D. Ohio
Alleged Resection of the Vas Deferens: Medicolegal Implicatio:ns F. TOLETE-VELCEK, E. LEDDOMADO, F. HANSBROUGH AND W. L. THELMO, Division of Pediatric and Downstate J\!ledical of New J. Ped. Surg., 23: 21-23
1988
A 7-month-old male infant bilateral inguinal herni.orrhaphy with segments of the vas deferens in the m•,o<,am,·on and the ramifications are discussed. In law requires notification of the risk management uv.o,.,,•om administration and State of Health. Notification was na,·sn.~r,wn this chief of service and surgeon at1ter1cl1ng date. Two noninvolved that the :sxcised ductal structures were consistent v;,ith onic :remnants or this report are The 2 issues the medical aspects, different. One the unusual condition of vas usually are or partial agenesis. of the vas deferens has been "'°'~,..,,,u,.,.., of whom 4 had and 5 had incomplete duplication. Also, the pathological specimen should correlate with the clinical impression at operation. In the case reported the surgeons dearly inspected and protected the vas during the operation and believed it virtually impossible that the vas was part of the surgical specimen. Subsequent exploration confirmed their intraoperative observations. The second issue is that of the intertwining of the medical and legal systems in this country. The authors note that laws, rules and regulations may unjustifiably damage the reputation of the physician and institution, and that the med~u+•L•C~U.VLCnL,
vv,,u,.,•av,N
A:ncrectal MaJformatfons: Evaluation of Associated Spinal Dysraphi.c Syndromes
F. M. KARRER, A. M. FLANNERY, M. D. NELSON, JR., D. G. McLONE AND J. G. RAFFENSPERGER, Departments of Surgery and Radiology, The Children's Memorial Hospital, Chicago, Illinois J. Ped. Surg., 23: 45-48 (Jan.) 1988
It is well established that anorectal malformations may be associated with bony spinal deformities and subsequent neurological deficits. Of 14 patients with spinal dysraphism reviewed 4 had a low imperforate anus, 4 a high lesion and 6 cloacal exstrophy. Spinal dysraphism was diagnosed by ultrasonography in 8 patients, magnetic resonance imaging (MRI) in 7 and computerized axial tomography (CT) in 13. All patients had tethered cords with varying associations with lipomeningoceles, meningoceles, myelocystoceles and lipomas. Three patients had hydromyelia. Thirteen patients underwent an operation with no deteriorating neurologically. Three patients have had significant improvement in the neurological symptoms. Four patients are unchanged and 6 who were normal preoperatively have remained normal neurologically. The diagnosis of spinal dysraphism associated with anorectal malformations begins with a suggestion plain sacral films demonstrating abnormalities. These abnormalities may range from spina bifida to hemivertebra to an abnormal spinal curve. Although the authors used ultrasonography for diagnosis, they acknowledged that CT scanning with metrizamide is the gold standard with MRI recently replacing the CT scan. The authors recommend that all patients with an imperforate anus undergo of the lumbosacral spine in the neonatal They recommend intervention in asymptomatic patients, since the natural history of a tethered cord is one of deterioration to a fixed neurological deficit. 2 tables, 28 references Robert Kay, M.D. Ohio
RADIOLOGY, NUCLEAR MEDICINE AND SONOGR.APHY Compa:rfaon of In.travenous Digital SubtEaction Angiography and Cm.1J.ve1.1tional Arte:riography in. Defining Renal Anatomy
L. P.
N. R. DUNNICK, T. M. COFFMAN, S. L R. BOLLINGER, R. L. MCCANN, R. H. S. D. BRAUN, G. E. NEWMAN, R. H. COHAN AND P. E. KLOTMAN, Duke University Medical Center and the Durham Veterans Administration Medical Center, Durham, North Carolina SVETKEY,
HIMMELSTEIN, R. WILKINSON, JR.,
Transplantation, 45: 56-58 (Jan.) 1988 The true accuracy of intravenous digital subtraction renal angiography in detecting anomalies and abnormalities of renal
n;c;'l'flC'HHffP
and government methodologies. 2 13 references
in the development of assurance standards and
Robert M.D. Cleveland, Ohio
16: 43-47 (Jan.) 1988
A rat model with extravaginal 540-degree torsion of the right testicle for 6 or 12 hours, or permanently was used and a sham operated group of animals served as controls. Spermiography and plasma hormone levels in each individual animal were determined before and 9 weeks after torsion. The luteinizing hormone levels increased significantly 18 weeks after torsion. Morphometry of the contralateral testicle revealed no alterations except a significant increase in Leydig and interstitial cells. The simultaneous findings of normal histology of the contralateral testes, normal plasma folliclestimulating hormone values and undisturbed spermatogenesis 2 months after torsion indicates that in the rat damage to l testis does not necessarily result in a permanent lesion on the contralateral side. 4 figures, 2 26 references Pramod R. Rege, M.D. Ohio
Alleged Resection of the Vas Deferens: Medicolegal Implicatio:ns F. TOLETE-VELCEK, E. LEDDOMADO, F. HANSBROUGH AND W. L. THELMO, Division of Pediatric and Downstate J\!ledical of New J. Ped. Surg., 23: 21-23
1988
A 7-month-old male infant bilateral inguinal herni.orrhaphy with segments of the vas deferens in the m•,o<,am,·on and the ramifications are discussed. In law requires notification of the risk management uv.o,.,,•om administration and State of Health. Notification was na,·sn.~r,wn this chief of service and surgeon at1ter1cl1ng date. Two noninvolved that the :sxcised ductal structures were consistent v;,ith onic :remnants or this report are The 2 issues the medical aspects, different. One the unusual condition of vas usually are or partial agenesis. of the vas deferens has been "'°'~,..,,,u,.,.., of whom 4 had and 5 had incomplete duplication. Also, the pathological specimen should correlate with the clinical impression at operation. In the case reported the surgeons dearly inspected and protected the vas during the operation and believed it virtually impossible that the vas was part of the surgical specimen. Subsequent exploration confirmed their intraoperative observations. The second issue is that of the intertwining of the medical and legal systems in this country. The authors note that laws, rules and regulations may unjustifiably damage the reputation of the physician and institution, and that the med~u+•L•C~U.VLCnL,
vv,,u,.,•av,N
A:ncrectal MaJformatfons: Evaluation of Associated Spinal Dysraphi.c Syndromes
F. M. KARRER, A. M. FLANNERY, M. D. NELSON, JR., D. G. McLONE AND J. G. RAFFENSPERGER, Departments of Surgery and Radiology, The Children's Memorial Hospital, Chicago, Illinois J. Ped. Surg., 23: 45-48 (Jan.) 1988
It is well established that anorectal malformations may be associated with bony spinal deformities and subsequent neurological deficits. Of 14 patients with spinal dysraphism reviewed 4 had a low imperforate anus, 4 a high lesion and 6 cloacal exstrophy. Spinal dysraphism was diagnosed by ultrasonography in 8 patients, magnetic resonance imaging (MRI) in 7 and computerized axial tomography (CT) in 13. All patients had tethered cords with varying associations with lipomeningoceles, meningoceles, myelocystoceles and lipomas. Three patients had hydromyelia. Thirteen patients underwent an operation with no deteriorating neurologically. Three patients have had significant improvement in the neurological symptoms. Four patients are unchanged and 6 who were normal preoperatively have remained normal neurologically. The diagnosis of spinal dysraphism associated with anorectal malformations begins with a suggestion plain sacral films demonstrating abnormalities. These abnormalities may range from spina bifida to hemivertebra to an abnormal spinal curve. Although the authors used ultrasonography for diagnosis, they acknowledged that CT scanning with metrizamide is the gold standard with MRI recently replacing the CT scan. The authors recommend that all patients with an imperforate anus undergo of the lumbosacral spine in the neonatal They recommend intervention in asymptomatic patients, since the natural history of a tethered cord is one of deterioration to a fixed neurological deficit. 2 tables, 28 references Robert Kay, M.D. Ohio
RADIOLOGY, NUCLEAR MEDICINE AND SONOGR.APHY Compa:rfaon of In.travenous Digital SubtEaction Angiography and Cm.1J.ve1.1tional Arte:riography in. Defining Renal Anatomy
L. P.
N. R. DUNNICK, T. M. COFFMAN, S. L R. BOLLINGER, R. L. MCCANN, R. H. S. D. BRAUN, G. E. NEWMAN, R. H. COHAN AND P. E. KLOTMAN, Duke University Medical Center and the Durham Veterans Administration Medical Center, Durham, North Carolina SVETKEY,
HIMMELSTEIN, R. WILKINSON, JR.,
Transplantation, 45: 56-58 (Jan.) 1988 The true accuracy of intravenous digital subtraction renal angiography in detecting anomalies and abnormalities of renal