Hedgehog and beyond

The authors describe a case of an epidermoidal cyst of the spleen, which they were able to observe in an emergency case, due to suppuration of the cyst. Primary cysts of the spleen represent a rare dysontegenetic pathological condition which is, for this reason, often underestimated. The general clinical summary is related here, with particular reference to supporative complications, which cause problema of differential diagnosis with patients suffering from abscess of the spleen. The diagnosis can be made as a result of standard X-ray procedures and computed tomography and above all, following a simple scan. The treatment recommended in this case is an open splenectomy, in order to check the allarming clinical symptoms of the patient, which can deteriorate. The use of laparoscopical techniques or trans-cutaneous draining is reserved for salected cases.     

Endodontic therapy in a maxillary second molar with three buccal roots

In this study, we report a case of a four-rooted maxillary second molar in which three well-separated buccal roots were located. This case demonstrated that even though it is not common, an extra root containing an independent root canal may occur.     

Malignant oncocytoma

A case of malignant oncocytoma of the parotid gland in a 32-year-old male is presented. Ten months after parotidectomy an undifferentiated carcinoma, in which oncocytes still could be recognized, developed in the operated area. According to the literature available to us, this is the second reported case in which malignant transformation in a benign oncocytoma of the salivary gland has been observed.     

The case described by Alois Alzheimer in 1911. Historical and conceptual perspectives based on the clinical record and neurohistological sections

In 1906, Alzheimer presented the first case of the disease which was later named Alzheimer's disease by Kraeplin. While the publication on this case in 1907 is only a relatively short communication, Alzheimer published a very comprehensive paper in 1911 in which he discussed the concept of the disease in detail. This publication focusses on the report of a second patient suffering from Alzheimer's disease, the case of Johann F. The detection of neurohistopathological sections from this patient found among archives at the Institute of Neuropathology of the University of Munich enabled us to reinvestigate this case using modern methods. Neurohistopathologically, the case of Johann F. is "plaque-only" Alzheimer's disease. There is a controversy in the modern literature as to whether these "plaque-only" cases belong to the modern concept of Alzheimer's disease. A careful analysis of all pros and contras in the literature led to the conclusion that plaque-only cases are also an integrative part of the modern Alzheimer disease concept.     

Gastric involvement with Anisakis sp. larva in a Belgian patient after consumption of cod

A case of acute episode of gastric anisakiasis in a patient, which was acquired through the consumption of infected cod meat and could be successfully resolved by endoscopic extraction, is described and discussed. This is the first report of cod as infection source as well as an authentic case of gastric anisakiasis in Belgium.     

Tumor-associated hypophosphatemic osteomalacia: case report and literature review

Despite the great number of neoplastic entities, which are able to cause this disease, "oncogenous osteomalacia" is hardly known as a paraneoplastic phenomenon. Without removing the not constantly malignant tumor as the underlying cause recovery is not possible. Until now pathogenesis is unknown. Together with a review of the literature a case report is presented, in which a malignant fibrous histiocytoma of soft tissue caused an untreatable osteomalacia. Because of failure of local tumor control prognosis in this case must be considered fatal.     

Unusual electrocardiographic finding--bifascicular block due to hyperkalemia

A unique case in which the patient had bifascicular block consisting of right bundle branch block and left posterior hemiblock as a result of marked hyperkalemia is presented. To our knowledge, this is the first reported case in which such unusual electrocardiographic abnormalities due to hyperkalemia were demonstrated. The electrocardiographic abnormalities produced by hyperkalemia in this case disappeared promptly by hemodialysis, as the serum potassium level returned to normal. It has been stressed that hyperkalemia should be considered as an important etiologic factor in the differential diagnosis of bundle branch block, hemiblocks and bifascicular block, particularly when these intraventricular blocks are produced suddenly.     

Tuberculosis in Shelby County and Tennessee correctional facilities

A case is presented which highlights the problems encountered when using an implant-stabilised overdenture in an edentulous upper jaw, opposed by a natural dentition.     

High-dose etoposide enables the collection of peripheral blood stem cells in patients who failed cyclophosphamide-induced mobilization

A case of an intracranial cavernous angioma, which presented with headaches and seizures in a pregnant patient, is described. Diagnosis was established with magnetic resonance imaging. A computer-assisted literature search uncovered no previously reported case of intracranial cavernous angioma initially presenting during pregnancy.     

Eutectic growth: A modification of the Jackson and Hunt theory

The Jackson and Hunt theory of eutectic growth is modified in order to get a better understanding of the physical mechanisms driving the solidification process. The density difference between the eutectic phases is taken into account when calculating the diffusion field, and the isothermal interface coupling condition is replaced by an equilibrium criterion for the three-phase junction. Although the problem can be solved in the general case, a simpler solution is derived for the case of nearly isothermal interface, which differs from that of Jackson and Hunt only by a corrective factor reflecting the density differences between the phases, the correction being quite large in the case of cast iron. The volume fractions of the eutectic phases are shown to be adjusted by the movement of the three-phase junctions. The boundary layer composition, which depends on this mechanism, is shown to be responsible for the well-known occurrence of austenite halos surrounding the primary graphites in cast iron. The curvature undercooling is written as the ratio of the volumetric interface energy contained in the eutectic microstructure to an average volumetric entropy of melting, which allows a quantitative evaluation of the effect of an anistropy in the α/β interface energy. Reliable values of the relevant physical constants are provided for several important eutectic alloys.     

Implications of empirical Bayes meta-analysis for test validation.

Empirical Bayes meta-analysis provides a useful framework for examining test validation. The fixed-effects case in which ρ has a single value corresponds to the inference that the situational specificity hypothesis can be rejected in a validity generalization study. A Bayesian analysis of such a case provides a simple and powerful test of ρ?=?0; such a test has practical implications for significance testing in test validation. The random-effects case in which ?2 ρ ?>?0 provides an explicit method with which to assess the relative importance of local validity studies and previous meta-analyses. Simulated data are used to illustrate both cases. Results of published meta-analyses are used to show that local validation becomes increasingly important as ?2 ρ increases. The meaning of the term validity generalization is explored, and the problem of what can be inferred about test transportability in the random-effects case is described. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A gonadotrophin dependent stromal luteoma: a rare cause of post-menopausal virilization

A stromal luteoma is an uncommon ovarian tumour in post-menopausal women, which presents rarely with hyperandrogenism and virilization. We present the case of a 64-year-old woman referred for evaluation of virilization which had developed over 5 years. Testosterone, FSH and LH were markedly inhibited following the administration of a GnRH analogue, suggesting a gonadotrophin dependent, testosterone secreting ovarian tumour, which could not be localized with imaging techniques. Surgery revealed normal sized ovaries with no apparent lesions, but microscopic examination showed a small stromal luteoma in the right ovary and severe stromal hyperthecosis in the adjacent and contralateral ovarian stroma. We conclude that stromal luteoma is an uncommon cause of virilization in post-menopausal women. This case illustrates, to our knowledge for the first time, that a stromal luteoma is not autonomous but is gonadotrophin dependent.     

An ecological study of intersubjectivity and the opening of closed minds.

Two interpretive case studies are reported that investigate the intentionality of defensiveness versus open-mindedness in persons who hold flawed ideological beliefs. The 1st analyzes an academic authority's resistance to information that disconfirms a therapeutic intervention that he has been successfully promoting. His dissociation and narcissistic withdrawal contrasts with the 2nd case in which a neo-Nazi accepts shaming information about himself and his political ideology that leads him to forge a more integrated persona. The content and scenes of instruction in both cases are formally similar, but in the 2nd case there is an identification with the teacher and an interpersonal and philosophical vitality to their conversation that is credited as conducive to moral culpability, realism, and experiential enlightenment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Chronic viral diseases of the liver--systemic infections?

Bone scintigraphy is a highly sensitive method for the detection of fractures. In case a trauma and clear clinical signs are evident, but the radiography is inconspicuous, bone scintigraphy may lead to the final diagnosis. In the present case of an occult fracture in the proximal femur only scintigraphy indicated the fracture, which then was proved topographically by magnetic resonance imaging.     

Photosensitivity reaction to intravenously administered fluorescein

Sodium fluorescein is an organic dye widely used as a diagnostic aid. This article reports a case of a photosensitivity reaction associated with intravenous administration in a healthy volunteer. To our knowledge, this is the 1st case of a photosensitivity reaction of the immediate type due to fluorescein reported in the literature, which probably indicates its very low incidence. The literature on photosensitization to fluorescein is reviewed.     

Fracture of the penis: two new cases. Review of the literature. Usefulness of echography

OBJECTIVE: To analyze the diagnostic and therapeutic difficulties in rupture of the albuginea penis and review the literature. METHODS/RESULTS: Two additional cases of penile rupture are described. Penile ultrasound evaluation disclosed a hematoma in the corpus cavernosum in one case and hematoma and a probable rupture of the albuginea penis in the other case. Treatment was by immediate surgery which achieved good cosmetic and functional results. CONCLUSIONS: Penile fracture is an uncommon condition which occurs when the penis is in erection. Ultrasound is useful in its diagnosis, but MRI is more precise. Treatment is by immediate surgery to avoid sequelae, which are common in cases treated conservatively.     

Enlargement of cisterna magna as an indicator of chromosomal abnormalities in a low-risk Asian population

BACKGROUND: Segmental hyperhidrosis is an uncommon finding which is usually associated with irritation or infiltration of pre-ganglionic sympathetic fibres or the sympathetic chain. METHODS: We report two cases of segmental hyperhidrosis with striking clinical features. RESULTS: In one case, a mesothelioma produced ipsilateral simultaneous underactivity and overactivity of sympathetic outflow and in the other case a thoracic central disc herniation was probably responsible for a band of sweating which clearly extended beyond the segmental level of injury. CONCLUSION: Segmental hyperhidrosis should trigger a search for structural disease in the spinal and paraspinal region.     

Gastric inflammatory myofibroblastic proliferation in children

Gastric inflammatory myofibroblastic proliferation (IMP) is an extremely rare entity in children, which to our knowledge has only been mentioned in case reports. We describe the ninth pediatric case and review the literature concerning the etiology, clinical and laboratory features, pathology, treatment, and outcome. There has been a predominance in preschool females. Abdominal pain, upper gastrointestinal hemorrhage, and an abdominal mass, either isolated or associated, have been the main clinical features. Iron-deficiency anemia has been a constant finding. Lesions are elevated and involve the full thickness of the gastric wall, usually with ulceration of the luminal surface; extragastric extension suggesting malignancy is frequent. Diagnosis is made by histology after surgical excision. There was no mortality directly related to gastric IMP, and only one case recurred after surgical excision. The pathogenesis is controversial, but the finding of Helicobacter pylori in our case may indicate an inflammatory origin. Awareness of this benign lesion and its mimicry of malignancy is important so that inappropriately aggressive therapy can be avoided.     

Drug-induced myopia: a case report

A case report is presented in which an acute, transient myopia of 3 diopters is induced by Hygroton (chlorthalidone), a monosulfamyl diuretic and antihypertensive drug.     

A case of intestinal trichobezoar

Report is made of a case of an unusual localization of a trichobezoar in a 12 year-old girl, who presented vomiting and abdominal pain as chief complaints. She was found to have an 18 X 5 cm palpable abdominal mass, which upon surgery was localized in terminal ileum and in the pathology report was found to be a trichobezoar. The interest of this case is the unusual localization of a single bezoar and the fact that a resection of 25 cm. of small bowel had to be done, as it was found necrotic at the time of surgery.