Combined form of chronic aggressive hepatitis primary biliary cirrhosis

15 patients with primary biliary cirrhosis (PBC) and 109 patients with chronic aggressive hepatitis (CAH) have been followed. Features of PBC, namely the generalized pruritus, massive rise in alkaline phosphatase, antimitochondrial antibodies and high levels of IgM-globulins, were present in 7 patients with CAH. This group was treated with immunosuppressive drugs for 1-2 years. Clinical, biochemical, immunological and histological parameters were used to assess the therapeutic effect. The pruritus improved and there was a statistically significant reduction in the IgG-hyperglobulinemia. Some resolution of the piecemeal necroses was seen. However, in judging these changes the sampling error must be taken into account. The unknown agent attacks both the hepatocytes and the epithelial cells of the bile ducts. The immunosuppressive treatment protects the liver cells from further damage while the progressive destruction of the bile ducts remains uninfluenced. The results suggest that the smallest possible dose sufficient to suppress the activity of CAH must be selected.     

Waiting lists for men with benign urinary disorders]

This paper reflects the problems in having a large non-specific waiting-list. One hundred and twenty-eight patients were on a waiting-list under the main diagnosis of prostatism. This diagnosis revealed seven patients with cancer in the urinary tract system. Only two-thirds of the patients on the waiting-list were interested in further examination and treatment. This paper emphasizes the need for a more specific referral, when dealing with symptoms from the lower urinary tract system.     

Two cases of metastasizing benign leiomyomatosis from myoma uteri]

Case 1. A 50-year-old woman was referred to our hospital because of multiple bilateral small round lesion on chest radiography. She had undergone total hysterectomy for myoma uteri at the age of 33. She underwent thoracoscopic tumor excision at left lung. The lesion was proved benign. Right side lesions were laterly excised using thoracotomy. Case 2. A 49-year-old woman was referred to us because of two ovoid lesion at left lung area of chest radiography. She also had undergone total hysterectomy for myoma uteri at the age of 37. She underwent tumor extirpation using thoracotomy. All samples of two patients revealed, pathologically, lesions were consisted of benign spindle-like calls similar to those of myoma uteri. Therefore, we consider these lesions were pulmonary metastasis of myoma uteri. Myoma uteri has certain potential of metastasizing to the lung, in spite of benign disease.     

Extra-articular manifestations of chronic polyarthritis]

Although the chronic destructive joint processes dominate the clinical picture of chronic rheumatoid arthritis, it must not been forgotten that the disease is a systemic one, whereby certain organs or organ systems are affected either clinically or subclinically. The various possible pathogenetic mechanisms are discussed and the particular type of patient with rheumatoid arthritis who appears to be prone to extra-articular manifestations is described. Subsequently, the individual organic manifestations and the clinical picture are discussed, as well as the incidence and significance of these features.     

A benign form of isolated angiitis of the central nervous system in puerperium: an identical disorder to postpartum cerebral angiopathy?

A case of isolated angiitis of the central nervous system (IACNS) in puerperium with a clinical presentation of bilateral frontal lobe hemorrhage is described. Her symptoms and arteriographic abnormalities were resolved by institution of corticosteroid. After cessation of steroid treatment she showed no evidence of relapse. This case indicates that there appears to be a benign form of IACNS, although the etiology of postpartum IACNS is not known. The postpartum cerebral angiopathy described in the literature may be an identical disorder, since there are no clinical points of specific distinction between them.