A case of paradoxical presentation of a postural postdural puncture headache after combined spinal-epidural anesthesia.

We report a case of paradoxical presentation of a postural postdural puncture headache secondary to dural puncture with a 25-gauge Whitacre needle for combined spinal-epidural anesthesia. This 27-year-old female patient presented to the emergency department with elevated blood pressure and a global headache 9 days after administration of epidural anesthesia for a spontaneous vaginal delivery after an uncomplicated pregnancy. The patient reported that the headache was more intense when lying down and immediately improved when she sat or stood up from a recumbent position.

[Cosmetic surgery of the female genitalia].

Introduction: This review studies rationale and outcome of vulvovaginal aesthetic surgery.

Method: Medline search of the existing literature utilizing terms labiaplasty, clitoral hood reduction, hymenoplasty, vaginoplasty, perineoplasty, female genital surgery, sexual satisfaction/body image, and anterior/posterior colporrhaphy; references from bibliographies of papers found through the literature search and in the author's reading of available literature until January 2012. Clinicians who receive requests from patients for such procedures should discuss with the patient the reason for request and perform an evaluation for any physical signs or symptoms that may indicate the need for surgical intervention.

Reconstructive surgery after female genital mutilation: a prospective cohort study.

Background: Women who have undergone female genital mutilation rarely have access to the reconstructive surgery that is now available. Our objective was to assess the immediate and long-term outcomes of this surgery.

Methods: Between 1998 and 2009, we included consecutive patients with female genital mutilation aged 18 years or older who had consulted a urologist at Poissy-St Germain Hospital, France.

Triple-blind randomized clinical trial of time until sensory change using 1.5% mepivacaine with epinephrine, 0.5% bupivacaine, or an equal mixture of both for infraclavicular block.

Background And Objectives: Practitioners mix faster-onset, intermediate-duration local anesthetics (LAs) with slower-onset, long-duration LAs to get fast peripheral nerve block (PNB) onset and long duration. We hypothesized that 1.5% mepivacaine (with epinephrine) (mepivacaine) or 1.

Coitus as revealed by ultrasound in one volunteer couple.

Introduction: The anatomy and function of the G-spot remain highly controversial. Ultrasound studies of the clitoral complex during intercourse have been conducted to gain insight into the role of the clitoris and its relation to vagina and urethra during arousal and penetration.

Aim: Our task was to visualize the anterior vaginal wall and its relationship to the clitoris during intercourse.

Who's afraid of the G-spot?

Introduction: No controversy can be more controversial than that regarding the existence of the G-spot, an anatomical and physiological entity for women and many scientists, yet a gynecological UFO for others.

Methods: The pros and cons data have been carefully reviewed by six scientists with different opinions on the G-spot. This controversy roughly follows the Journal of Sexual Medicine Debate held during the International Society for the Study of Women's Sexual Health Congress in Florence in the February of 2009.

The clitoral complex: a dynamic sonographic study.

Introduction: The existence of the G-spot remains controversial partly because no appropriate structure and innervation have been clearly demonstrated in this pleasurable vaginal area. Using sonography, we wanted to visualize the movements of the clitoris and its anatomical relationship with the anterior wall of the vagina during voluntary perineal contraction and vaginal penetration without sexual stimulation.

Aim: The aim of this presentation is to provide a dynamic sonographic study of the clitoris and to describe the movements of the quiescent clitoral complex during a voluntary perineal contraction.

Sonography of the clitoris.

Introduction: The prevalence of invasive procedures in diagnosing female sexual dysfunctions and pathologies is high. There is a need for a less invasive evaluation tool and medical imaging of the clitoris may be a solution. The clitoris has already been studied with nuclear magnetic resonance but there are very few sonographic 2D and 3D studies despite the fact that it is a simple, noninvasive, and inexpensive method.

[Results of surgical clitoral repair after ritual excision: 453 cases].

Objective: Ritual excision is responsible for urologic, gynaecologic and obstetrical complications, whose surgical treatment has been fully described. Sexual sequelae deserve the same attention. We describe and analyze the results of a surgical procedure for clitoral rehabilitation.

General anesthesia for ophthalmic surgery.

Skillful anesthetic management is integral to optimal outcomes after ophthalmic surgery. Although the majority of ophthalmic operations in the United States are performed with local anesthetic techniques, nonetheless general anesthesia may be either necessary or advisable in several challenging circumstances. Ophthalmic patients are often at the extremes of age, and not uncommonly have extensive associated systemic or metabolic diseases.

[Reconstructive plastic surgery of the clitoris after sexual mutilation].

This article describes a clitoris reconstruction technique after ritual excision. After resection of the scar, the angle and the body of the clitoris are then released by preserving the innervation. A clitoral glans is reconstituted by wedge plasty, then reimplanted in an anatomical position.

Minimal operative mortality in patients undergoing coronary artery bypass with significant left ventricular dysfunction by maximization of metabolic and mechanical support.

Between January 1, 1992, and January 23, 1996, 111 consecutive patients with severe left ventricular dysfunction underwent isolated coronary artery bypass grafting. The ejection fraction in these patients ranged from 10% to 34% (mean 27.9% +/- 5.

Clinical, EEG mapping and psychometric studies in negative schizophrenia: comparative trials with amisulpride and fluphenazine.

Based on recent quantitative EEG findings of increased slow activity in negative schizophrenia indicating organicity, it was hypothesized that neuroleptics decreasing delta/theta activity should be beneficial for schizophrenics with predominantly negative symptoms. Thus, a double-blind, clinical, psychometric and neurophysiological study was carried out in 40 hospitalized patients with unproductive schizophrenia (mean age: 31 years; ICD diagnoses: 295.0, 295.

Premorbid adjustment of schizophrenic criminal offenders.

The premorbid psychosocial adjustment of 28 schizophrenic criminal offenders, 23 non-criminal-offender schizophrenics (ICD-9) and 14 nonpsychotic criminals was compared by means of the Premorbid Adjustment Scale (PAS). The schizophrenic groups did not differ regarding age, marital status, diagnostic subgroup or length of illness. PAS scores showed highly significant differences between the schizophrenic groups and the controls on every subscale and on average scores.

Smooth pursuit eye movements in schizophrenia: influences of neuroleptic treatment and the question of specificity.

The authors investigated smooth pursuit eye movements (SPEMs) in 66 schizophrenic and 40 major affective patients and 39 healthy controls. The results showed significant differences of both patient groups as compared to the controls. Schizophrenics with neuroleptic treatment in the preceding 2 years were significantly more disturbed than the controls, the affective patients and the untreated schizophrenics.

[Extensive nephrectomy in severe forms of cancer of the kidney in the adult].

Resection of renal tumours may be useless when the staging procedures reveal that the disease is too far advanced. A retrospective study of 100 radical nephrectomies for renal cell carcinoma distinguished the following groups: advanced cancers in young patients; cancers in patients over the age of 70 years. Despite the limited follow-up of this series, the study of survival demonstrates the following points: the difficulty of predicting the degree of lymph node involvement on pre-operative staging, the value of an anterior sub-costal and abdominal approach which facilitates radical nephrectomy in elderly and fragile patients, the poor prognosis of lymph node invasion and metastases, although some patients have survived for 12 months after resection of metastatic tumours.

[Biopsy of the internal mammary lymph node by anterior thoracotomy (author's transl)].

The authors suggest a new technique of biopsy of the internal mammary lymph node by anterior thoracotomy, through the large pectoral respecting entirely the costal presentation. After a presentation of different operating cycles, they report their results.

[Bronchial conservative surgical procedure without any pulmonary resection (author's transl)].

The authors report a study of 3 cases of bronchial tumors treated by conservative surgical procedures, without any pulmonary resection. This treatment is applied in 3 different cases: a bronchial carcinoid tumor; an inflammatory granuloma; an epidermoid carcinoma.