Clinicopathological profile of subacute hepatic failure

Sigmoid volvulus is an unusual cause of intestinal obstruction in children. We report two cases of sigmoid volvulus as a complication of segmental dilatation of the colon occurring in two girls (5 years old and 9 years old) previously treated for chronic constipation. In both cases the constipation had been recognised since the neonatal period mimicking a Hirschsprung's disease, a diagnosis which has been excluded after rectal biopsy. The delayed diagnosis of segmental dilatation of the sigmoid colon followed the volvulus. Segmental colonic resection resulted in both cases in the cure of the constipation.     

Toxicity of trichlorobutadiene in subacute experiments

The state of the motor function of individuals who were pedalling a bicycle ergometer in an altitude chamber containing a nitrogen-oxygen atmosphere at 5.0 ata was studied. Maximum isometric force, precision of controlling movement and muscular tension, accuracy and velocity of movements were recorded. The maximum force, precision and velocity of movements varied phasically. The greatest changes were found on the 1st-3rd and 6--7th days of the exposure. These parameters returned to the normal when the atmosphere pressure was reduced to 1.0 ata. During exercises at an elevated pressure the muscular force, accuracy and velocity of movements decreased. During exercises at a normal pressure similar changes were less distinct and consistent.     

A case of subacute necrotizing fasciitis

We report a 48-year-old woman who developed necrotizing groin fasciitis with insidious onset. Before she visited us, she had been unsuccessfully treated with several kinds of antibiotics by other doctors for one month, because of a small ulcer covered by blackish necrotic tissue. She was referred to us because of high fever, an ulcer on the left labium majus, and a cellulitis-like lesion with severe pain on the lower abdomen. Methicillin-resistant Staphylococcus aureus (MRSA), Streptococcus intermedius, and Bacteroides uniformis were isolated from the wound. After aggressive debridement on the eighth day after admission of the whole indurated area and the fascia of the underlying muscle, healthy granulation tissue covered the defect, and the wound was finally closed with a skin graft Long-term administration of antibiotics along with insufficient and delayed surgical treatment were considered to have caused the full development of this disease.     

Can frontal sinus development be used for the prediction of skeletal maturity at puberty?

The precision of a new procedure predicting skeletal maturity on the basis of frontal sinus development was tested in 59 boys with an Angle class-II division-1 malocclusion. Lateral head films were used for the analysis of frontal sinus development, and handwrist radiographs were used for the assessment of skeletal maturity. The results showed that skeletal maturity could be predicted with a certainty of about 85% when using a 1-year prediction interval and with a certainty of about 75% when using a 2-year prediction interval. In conclusion, the study showed that skeletal maturity can be predicted with rather high accuracy by means of the analysis of frontal sinus development as imaged on lateral headfilms.     

Rupture of a sinus of Valsalva aneurysm into the right ventricle. A case report in the cardiology clinic at the University Hospital Center of Dakar]

Human cytolytic T lymphocytes specific for autologous Burkitt's lymphoma express the gamma, delta T cell receptor and recognize immunoglobulin idiotype in an MHC-unrestricted manner. Antibodies against a member of the heat shock protein 70 family inhibit this specific cytotoxicity, implicating these molecules in tumor recognition and antigen presentation. Such data is relevant to the design of novel immunotherapies for cancer and provides new insights into target recognition by gamma, delta T cells.     

Effects of functional endoscopic sinus surgery on maxillary sinus mucosa

OBJECTIVE: To compare the preoperative and postoperative changes on ciliary surface of maxillary sinus mucosa in patients treated with functional endoscopic sinus surgery. DESIGN: The maxillary mucosa of both the superolateral wall and the ostium were sampled during the operation and 6 to 12 months (mean duration, 7.6 months) after the operation. Ciliary surface was determined using scanning electron microscopy in combination with an image analyzer and was expressed in terms of ciliary area, which is the percentage of mucosal surface occupied by cilia. SETTING: The samples were taken at a hospital-based clinic. An electron microscopic study was performed at Mie University School of Medicine, Mie, Japan. PATIENTS: Sixteen patients (20 maxillary sinuses) undergoing functional endoscopic sinus surgery for treatment of chronic sinusitis. RESULTS: The mean (+/-SD) ciliary area before the surgery was 60.7%+/-28.8% and 39.9%+/-21.5% in the superolateral wall of the maxillary sinus and the ostium of the maxillary sinus, respectively. The ciliary area of the superolateral wall was significantly higher than that of the ostium (P<.001). The mean (+/-SD) postoperative ciliary area value was 74.3%+/-22.6% in the superolateral wall and 51.3%+/-16.1% in the ostium. These postoperative values were significantly higher than the preoperative values (P<.001). CONCLUSIONS: This study showed that the maxillary sinus mucosa in chronic sinusitis is capable of regeneration, and the damaged ciliated epithelium could return toward normal with the improvement of ventilation and drainage of the maxillary sinus following functional endoscopic sinus surgery.     

Murine typhus presenting as subacute meningoencephalitis

Murine typhus is a febrile systemic illness, presenting with headache and undulating fever. Neurological involvement is considered a rare complication. During 1994 and 1995, 34 patients admitted to our hospital were diagnosed as having murine typhus. Five of these patients presented with a syndrome of subacute "aseptic" meningitis or meningoencephalitis. Three had bilateral papilloedema and 2 had focal neurological signs. None had a rash or other systemic findings suggestive of rickettsial disease. The diagnosis was based on serum and cerebrospinal fluid serology and on prompt response to doxycycline therapy. These cases suggest that neurological involvement in murine typhus is more common than previously suspected and that murine typhus should be included in the differential diagnosis of subacute meningitis in endemic areas.     

Rupture of the diaphragm in the horse

Four cases of fatal diaphragmatic rupture in the horse are described. In 2 cases there was no history of injury but the other 2 animals had sustained recent thoracic trauma. Three of the horses had signs of colic and bowel obstruction complicated, in 2 cases, by respiratory embarrassment; the fourth died rapidly, presumably of shock. Previously published cases are reviewed and the causes, clinical effects, diagnosis and treatment of the disorder are discussed.     

Treatment of subacute cardiac rupture after myocardial infarction

Five successfully treated cases of subacute cardiac rupture after myocardial infarction are described. There were 4 men and 1 woman, ranging in age from 51 to 71 years. Two patients had systemic hypertension. Rupture occurred during the first myocardial infarction in all patients. The interval from the onset of myocardial infarction to cardiac rupture ranged from 1 to 6 days (mean 4 days). In one patient, the rupture was repaired under cardiopulmonary bypass using an autologous pericardial patch over the infarcted myocardium. Two patients underwent sutureless repair with fibrin glue; one of them developed a left ventricular pseudoaneurysm 2 years after the operation, requiring resection. These three patients were operated on through a median sternotomy. The remaining two patients were treated for cardiac tamponade by pericardial drainage through a subxiphoid incision; one died 38 days after the operation due to congestive heart failure. The four surviving patients are currently well 22, 39, 41 and 60 months after surgery. In summary, a conservative approach may be effective for treatment of subacute cardiac rupture.