Anterior sacral meningocele: two case reports and discussion of surgical approach

The kinetic properties of the N-hydroxylation of 2-acetylaminofluorene (2-AAF) are studied with microsomal preparations of livers from both control and 3-methylcholanthrene (3-MC)-pretreated rats and hamsters. The level of basal enzymatic activity is higher in hamster than in rat liver; 3-MC induces the activity in both animals. When added in vitro to incubation mixture, 3-MC competitively inhibits the N-hydroxylase activity. When fed to rats simultaneously with 2-AAF, 3-MC suppresses the carcinogenicity of the acetylated arylamine by inhibiting the first step in its activation pathway. Hamster tissues are not protected by this pretreatment because the level of N-hydroxylase activity is too high.     

Retro-iliac ureter. Report of a case lumbosacral agenesis

The authors report a case of retro-iliac ureter associated with a lumbo-sacral agenesis. Retro-iliac ureter seems in relation with abnormal constitution of aortic division and/or ilio-cava confluence when the metanephros migrates. Lumbosacral agenesis is the most severe state of sacral agenesis and is a part of the syndrome of caudal regression. The association of the two malformations have never been described and could be fortuitous. Nevertheless, the vertebral malformation could induce a perturbation in the formation of vascular structures and so an abnormal migration of the metanephros.     

The role of the anterior commissure in callosal agenesis.

Two individuals with callosal agenesis (J.P. and M.M.) and 10 neurologically normal participants were tested on tasks requiring interhemispheric visual integration. M.M., whose anterior commissure was within normal limits, was much worse at matching colors and letters between visual fields than within visual fields, whereas J.P., whose anterior commissure was greatly enlarged, showed no evidence of interhemispheric disconnection. This suggests that in some cases of callosal agenesis, probably a minority, an enlarged anterior commissure may compensate for the lack of the corpus callosum. Neither acallosal participant showed interhemispheric disconnection on tasks requiring integration of location and orientation, however, suggesting that the anterior commissure plays no role in such tasks. These tasks may depend on subcortical commissures, such as the intertectal commissure. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Twenty-eight-year follow-up of anterior and posterior fusion for congenital kyphosis. A case report

STUDY DESIGN: Case report and long-term follow-up. OBJECTIVES: To answer the question of whether the operation performed was worthwhile and lasting. SUMMARY OF BACKGROUND DATA: Congenital kyphosis due to defects of vertebral body formation has a high incidence of paraplegia if not surgically stabilized. Traditional posterior spine fusion failed for such problems. METHODS: Radiographic and photographic evidence of the patients's problem, the combined anterior and posterior surgery, and at a 28-year follow-up available. RESULTS: Surgery at age 13 prevented paraplegia, but also gave correction of deformity and permitted a normal life. CONCLUSIONS: Combined anterior and posterior spinal fusion is a good operation with lasting value for this condition.     

Stroke and meningitis in a case of SLE with anti-phospholipid antibodies

Anti-phospholipid antibodies (aPL) are concerned with many central nervous system diseases in systemic lupus erythematosus (SLE). However, no report has described the relationship between aseptic meningitis and aPL in SLE. We report a case of SLE with aPL, presenting cerebral infarction and aseptic meningitis. A 14 year old female with SLE with aPL experienced cerebral infarction and recurrent aseptic meningitis. Combination therapy with steroids and aspirin improved the condition and prevented relapses. The aPL are associated with cerebral infarction, even in young patients with SLE. In addition, aPL may induce aseptic meningitis in SLE.     

Leucinosis--a case of congenital metabolic disease in a child

Trasditional Chinese medicine is based on inductive-synthetic reasoning with regard to all life processes, in contrast to the causal-analytic orientation in our Western medicine. This philosophical approach is based on a system of comparisons (equivalents), referred to as Yin and Yang. Vital functions are seen as "energizing" processes, whereby the acupuncture points and the system of meridians are seen as a means of regulation for this "energy". A disturbed balance in this energy results in illness. The therapy according to the acupuncture method is to acheive a balance in the disturbed flow of energy by means of acupuncture points. By utilizing biophysical methods of measurement, it is possible to prove that a change in this energy takes place. The complex active principle which results in the effectiveness of acupuncture includes neurophysiological, biochemical and biophysical functional processes.     

Recurrent osteoblastoma of the mandible: a case report

Amiodarone decreases plasma and tissue triiodothyronine (T3) and increases plasma cholesterol levels resembling changes seen during hypothyroidism. To elucidate the mechanism of amiodarone-induced hypercholesterolemia we investigated gene expression of three key proteins in cholesterol metabolism (cholesterol 7 alpha-hydroxylase, LDL receptor, HMG-CoA reductase) in livers of rats. Animals were treated with amiodarone or propylthiouracil (to induce mild hypothyroidism). The LDL receptor mRNA was downregulated (approximately 50%) in both amiodarone-treated and hypothyroid animals, while the other mRNA remained unchanged after 14-day treatment. The results suggest that amiodarone-induced hypercholesterolemia is associated with decreased LDL receptor mRNA levels.     

Ultrastructural analysis of the liver with portal vein agenesis: a case report

Multiple myeloma is a rare neoplasm in cats. Common presenting signs (e.g., lethargy, anorexia, weight loss) usually are nonspecific. Two cats with multiple myeloma were presented with primary complaints of lameness; one had femoral osteolytic lesions, and the other likely had hyperviscosity syndrome. The cat with osteolytic lesions was treated with chemotherapy; the primary lesion responded, but the neoplasia metastasized.     

Recurrent purulent meningitis in traumatic lesions of the ethmoid (author's transl)

A report is presented of two cases of recurrent meningitis (mainly pneumococcal meningitis with different serotypes). The different possible causes of recurrent meningitis are discussed. The key to diagnosis in recurrent meningitis caused by forgotten traumatic fracture of the ethmoid bone is X-ray investigation including tomography of this region. The prognosis is poor in infancy, but improves with increasing age of the child and is dependent on early diagnosis of the underlying causative process.     

Listeria meningitis presenting as enteritis in a previously healthy infant: a case report

In two hundred and twenty-five healthy volunteers not receiving any treatment the occurrence of drug-like factors in blood serum was studied. The examinations were carried out with the use of the fluorescence-polarization-immunoassay (FPIA)-TDx Abbott. The presence of endogenous phenytoin-like, theophylline-like and cyclosporin-like factors has been demonstrated.     

Surgical therapy in a case of congenital mitral valve insufficiency]

Using sheep erythrocytes (SRBC) as the antigen, two subpopulations of spleen antigen-binding lymphocytes could be distinguished by a marked difference in the susceptibility of their receptors to trypsin. In unimmunized animals, 30% of the antigen-binding cells were trypsin-resistant, whereas at 5 days after immunization, 80-90% were trypsin-resistant, indicating an increase of about 50-fold in trypsin-resistant antigen-binding cells per spleen. In contrast, trypsin-sensitive cells per spleen were only 4-fold higher on day 5 than before immunization. The rise in % trypsin sensitivity preceded the increase in rosettes per spleen, implying that immunization produced a preferential increase in trypsin-resistant antigen binding cells partly by converting sensitive cells to resistant cells. After the 5th day, the trypsin sensitivity of antigen-binding cells slowly returned toward the unimmunized level, but a booster injection of SRBC restored trypsin resistance. Trypsin resistance was not lost in the presence of sodium azide or protein synthesis inhibitors. But a slightly increased trypsin susceptibility was conferred by 2-deoxyglucose, implying that glycolysis or the glycosylation of protein may be involved in maintaining trypsin resistance.     

Right hematocolpos and hematometra with left renal agenesis. A rare association. Apropos a case

Although this anomaly is seen more frequently, the present case is unique in that the genital anomaly (imperforate vagina with the subsequent hematocolpos and hematometra) was associated with contralateral renal agenesis, whereas the cases reported in the literature have all been ipsilateral. Like most of the cases, the presenting symptom was acute urinary retention arising from extrinsic compression of the genital mass on the lower urinary tract. The embryological aspects of the genitourinary system concerning the present case are discussed, as well as some of the hypotheses that have been put forward to explain the etiology of these anomalies, although these have been developed on the basis of the associated ipsilateral anomalies observed.     

Recurrent cutaneous necrotizing vasculitis in a patient with Kikuchi's disease: case report

Kikuchi's disease or histiocytic necrotizing lymphadenitis without granulocytic infilteration, is a clinico-pathologic entity well described in developed countries. We report a case of this disorder presenting with recurrent cutaneous necrotizing vasculitis, with the dual objective of highlighting this condition in developing countries and presenting an uncommon manifestation of this disorder.     

Surgery in congenital heart defects: current developments and a few case examples

Congenital heart surgery includes the palliative treatment and surgical complete repair of cardiac malformations in newborns, children and adolescents. Palliative surgery allows early or long-term survival, depending on the primary malformation and the condition of the patient. Confection of a systemic-to-pulmonary shunt (the modified Blalock-Taussig shunt) allows in general recovery from severe cyanosis and leads to development of the hypoplastic pulmonary vascular tree in newborns with severe pulmonary stenosis. Longterm palliation can be applied to all patients in whom establishment of a biventricular heart can not be realized. The total cavo-pulmonary connection represents one possibility to bypass a single ventricle in these complex cases. Total repair allows the restitution of a completely normal anatomy and physiology after surgery; usually, this type of surgery is followed by a normalization of life expectancy with minimal pharmacotherapy. Preoperative diagnosis of congenital heart disease is reasonably performed by transthoracic echocardiography in the majority of cases. Cardiac catheterism is reserved for complex cases and those in which full hemodynamic evaluation is required for proper planning of surgery. Continuous improvement has been realized in the fields of cardiac anesthesiology and pediatric intensive care during the last decade; hence more and more complex cases have been accepted without any negative effect on the operative mortality. Additionally there has been a number of improvements in surgical and perfusion techniques, thus allowing open heart surgery in newborns with a minimal weight of 2000 g. Intraoperative transesophageal echocardiography is performed routinely and allows the proper control of surgical repair; furthermore this examination may be helpful during the weaning period from the extracorporeal circulation. There is a number of interesting topics that will take importance or will be developed in the near future: the role of interventional cardiology in pediatric patients gains more and more importance. There is a potential for minimally-invasive surgery and the number of potential candidates for heart transplantation may increase, due to the fate of long-term survivors after palliative surgery.     

Delayed cerebrospinal fluid leakage after head and facial trauma resulting in meningitis: a case report

BACKGROUND: Several years ago, a successful surgical technique for treating depigmentation resulting from burn injuries was developed. OBJECTIVE: The purpose of this study was to investigate results of dermabrasion with melanocyte transplantation using new modifications of the technique in patients with vitiligo. METHODS: We performed 17 procedures on 12 patients with stable vitiligo. The epithelium of the vitiliginous areas was removed by dermabrasion. The dermabraded area was then reepithelialized with ultra-thin sheet grafts, which more recently were meshed and partially expanded. RESULTS: Good to excellent repigmentation was observed in 88% of the procedures. Scarring did not develop in the repigmented or donor site regions. The final color match has been good to excellent. CONCLUSIONS: This technique has proven beneficial in 88% of the procedures on our patients. Both our patients and we feel that this provides a valuable treatment option in patients who have failed medical management.     

Recurrent ameloblastoma in an autogenous bone graft after 28 years: a case report

The growth characteristics of ameloblastoma is such that recurrence can occur regardless of treatment method, although recurrence rates following a block resection are considerably less than that following enucleation and curettage. A small number of recurrences in autogenous bone grafts have been reported in the literature. This report describes a recurrent ameloblastoma in an autogenous bone graft occurring 28 years following resection and reconstruction.