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On the basis of a critical review of 936 inguinal hernioplasties performed in 8 years, the authors present their good long-term results with tension-free techniques including the original Lichtenstein technique, Lichtenstein with a sutured mesh and annulorrhaphy of the deep inguinal ring, and Lichtenstein with plug. The only two recurrences in this case series occurred with the original technique. Suturing of the mesh and deep inguinal ring annulorrhaphy proved to be reliable and inexpensive. Results were equivalent with the use of the plug, despite the presence of an additional foreign body. In conclusion, the results obtained with the three variants are practically equivalent, and the choice of technique may depend on the preference and experience of the surgeon. [ABSTRACT FROM AUTHOR]

The case history of a 67-year-old man who underwent a subtotal sternectomy for a tumour of the manubrium and left clavicle is reported. Histological examination revealed a highly undifferentiated metastatic carcinoma: the original tumour was not discovered but the patient was in good condition 10 months after operation. Adequate replacement and stabilization of the chest wall was obtained with autotransplantation of the tibia and muscle flaps. [ABSTRACT FROM AUTHOR]

Purpose. The study determined the pharmacokinetics of urinary human follicle stimulating hormone (u-hFSH) in 12 down-regulated healthy female volunteers. Methods. Following pituitary desensitization, baseline FSH serum levels were measured over a 24-hour period. Then each subject received, in random order, single doses of u-hFSH (Metrodin), 75 IU, 150 IU and 300 IU iv, and 150 IU im on four occasions separated by washout periods of one week. Blood and urine samples were collected at preset times. FSH levels were measured by a immuno-radiometric assay and an in vitro rat granulosa cells aromatase bioassay. Results. All doses of u-hFSH were well tolerated. After an iv bolus, the pharmacokinetics of FSH were well described by a two-compartment open model. Immunoassay data showed that the total exposure to FSH was proportional to the administered dose. Mean total clearance of FSH was approximately 0.5 L·h and renal clearance was 0.14 L·h. The volume of distribution at steady-state was around 8 liters. The distribution half-life was 2 h and the terminal half-life nearly one day. After im injection, almost two thirds of the administered dose was available systemically. The in vitro bioassay confirmed this pharmacokinetic analysis. Conclusions. The estimation of the elimination half-life of around one day indicates that the maximal effect of a given dose of u-hFSH administered daily cannot be observed until 3 to 4 days of repeated administration. This indicates that, on a pure pharmacokinetic basis, physicians should wait at least 4 days to assess the efficacy of a given dose of u-hFSH and that they should not modify dosage too frequently. [ABSTRACT FROM AUTHOR]

These studies were designed to compare the pharmacokinetic characteristics of a very highly purified urinary human follicle stimulating hormone (FSH-HP) preparation (sp. act. approximately 9000 IU FSH/mg of protein), Metrodin HP, with a standard urinary FSH preparation Metrodin (FSH). The two preparations were administered in a balanced, random-order, cross-over sequence as single doses of 150 IU, separated by 1 week of washout to 12 female volunteers by i.v. injection and to 12 male volunteers by i.m. and s.c. routes. FSH concentrations were measured by immunoradiometric assay and by an in-vitro rat granulosa cell aromatase bioassay. After an i.v. bolus, the pharmacokinetics of the two FSH preparations were identical. Total clearance was 0.5 and 0.15 l/h respectively for immunoassay and bioassay data. Immunoassay showed that the two preparations were similar for renal clearance (0.1 l/h), volumes of distribution at steady state (9 l), distribution and terminal half-lives (2 and 17 h, respectively). After parenteral administrations, the absorption half-life of FSH was approximately 3 h and the apparent terminal half-life was approximately 1.5 days. Both preparations had relative bioavailabilities close to 100% for i.m. and s.c. administrations. Immunopurification, which results in a very highly purified FSH-HP, does not modify the pharmacokinetic properties of FSH. This study also confirmed that s.c. and i.m. doses of FSH-HP are equivalent from the pharmacokinetic and pharmacodynamic points of view. [ABSTRACT FROM AUTHOR]

The treatment of chest wall injuries with severe paradoxical movement remains controversial. Intermittent positive-pressure respiration may be appropriate, but in some, especially those requiring exploratory thoracotomy for a visceral lesion, surgical fixation is desirable. We present a simple method using two or three stainless Kirschner wires placed in the chest wall. Results in five cases have been good. [ABSTRACT FROM PUBLISHER]