Epididymal sarcoidosis: a case report]

A rare case of epididymal sarcoidosis is reported. A 52-year-old man was admitted with a painless mass in the left scrotum. An operation revealed that a 1-cm mass was located at the epididymal head and well demarcated from the testis and the surrounding tissue. Epididymectomy was performed. Histopathological diagnosis was noncaseating granulomas consistent with sarcoidosis. Systemic examination showed bilateral hilar lymphadenopathy and bilateral peripheral anterior synechiae, but these lesions were diagnosed as inactive. Serum level of angiotensin-converting enzyme was normal.     

Microscopic polyangiitis. Delineation of a cutaneous-limited variant associated with antimyeloperoxidase autoantibody

Identification of inexpensive and technically simple immunological tests useful in predicting the progression to AIDS in human immunodeficiency virus (HIV)-infected patients would be especially welcome in developing countries, in which 80% of HIV-infected patients reside and health budgets are low. In the current study, we evaluated CD4+ and total lymphocyte counts and the concentrations in serum of beta 2-microglobulin, p24 antigen, and immunoglobulin A (IgA) as predictors of disease progression in 74 Panamanian HIV-positive patients and 50 HIV-negative healthy individuals. Total lymphocyte and CD4(+)-cell counts for AIDS patients (1,451 +/- 811 cells/microliters, P < 0.001, and 238 +/- 392 cells/microliters, P < 0.0001, respectively and asymptomatic patients (2,393 +/- 664 cells/microliters, P > 0.05, and 784 +/- 475 cells/microliters, P < 0.001, respectively) were lower than those observed for healthy subjects (2,596 +/- 631 cells/microliters and 1,120 +/- 296 cells/microliters, respectively). The levels of beta 2-microglobulin and IgA in serum were significantly elevated in patients with AIDS (5.7 +/- 3.6mg/liter, P < 0.001, and 541 +/- 265 mg/dl, P < 0.0002, respectively) and asymptomatic infected subjects (3.4 +/- 2.1 mg/liter, P = 0.001, and 436 +/- 216 mg/dl, P < 0.0001, respectively) compared with the levels in healthy subjects (2.2 +/- 0.7 mg/liter and 204 +/- 113 mg/dl, respectively). Nonstatistically significant differences (P > 0.05) for concentrations of p24 antigen between asymptomatic infected patients (29 +/- 13 pg/ml) and AIDS patients (40 +/- 23 pg/ml) were observed. Total lymphocyte counts of 1,750 cells/microliters or less, CD4 counts of 200 cells/microliters or less, beta 2-microglobulin concentrations in serum of 4 mg/liter or higher, concentrations of IgA in serum of 450 mg/dl or higher, and the presence in serum of p24 antigen were correlated with elevated risks for developing AIDS. Monitoring both total lymphocytes and beta 2-microglobulin identified 91% of the AIDS patients; these assays may allow reductions in the annual number of CD4(+)-cell evaluations and the costs associated with monitoring both total lymphocytes and beta 2-microglobulin identified 91% of the AIDS patients; these assays may allow reductions in the annual number of CD4(+)-cell evaluations and the costs associated with monitoring the immune status of HIV-positive patients.     

Microscopic foci of urachal carcinoma in an incidentally detected urachal cyst: a case report

A 33-year-old man who had been treated for chronic prostatitis was diagnosed to have urachal cysts by transabdominal ultrasonography. Cystoscopy revealed protuberance at the dome of the bladder. Computerized tomography scan and magnetic resonance imaging showed the mass to be mostly cystic but partly solid. Resection of the urachal cysts and partial cystectomy were performed. Histopathologically, most cysts had a normal cylindrical epithelium with retention of mucinous substance. However, several small cysts contained epithelial cells resembling tubulo-villous adenoma and showing mitotic figures. This case was concluded as urachal carcinoma detected in its very early stage.     

A case of polyangiitis overlap syndrome

PURPOSE: To examine the quality of life after repair of esophageal atresia, follow-up studies were performed in 58 of 71 surviving patients (81.7%). METHODS: Fifty patients with primary anastomosis and all eight surviving patients with colon interposition were seen. The mean age was 25.3 years (range, 20 to 31). Symptoms were evaluated by a standardized interview. Quality of life assessment was performed using a visual analogue scale (0 to 100 points), the Spitzer Index (5 dimensions, 10 points), and the Gastrointestinal Quality of Life Index (GIQLI, 5 dimensions, 128 points). RESULTS: After primary anastomosis the estimated meal capacity was unrestricted in 46 patients (92%), but numerous symptoms such as recidivating cough (60%), hold up (48%), and short breath (30%) were reported. All symptoms except cough were seen more frequently in patients with colon interposition, and all of these patients suffered from periods of short breath. Quality of life scores were higher in patients with primary anastomosis compared with colon interposition. The difference in the visual analogue scale score did not reach statistical significance, but the mean Spitzer Index was 9.7 compared with 8.8 after colon interposition (P < .05). The GIQLI after primary anastomosis was similar to that in healthy controls and was significantly lower in patients with colon interposition. This was because of specific symptoms, which scored 49.3 after colon interposition compared with 61.7 after primary anastomosis (P < .05) and to 54.8 (SD 5) in healthy controls (P < .05). Physical and social functions, emotions, and inconvenience of a medical treatment scored similar in patients with primary anastomosis, colon interposition, and healthy volunteers. CONCLUSIONS: The long-term quality of life after primary anastomosis was excellent. Patients with colon interposition suffer more frequently from various gastrointestinal and respiratory symptoms, but they lead an otherwise normal life.     

Atypical cat-scratch disease: a case report of splenic granulomatosis]

Two paediatric cases of patent urachus are reported. In one of these cases, the anomaly was isolated whereas in the other case an omphalocele was also noted. Radical excision of the urachus with segmental resection of the bladder was easy and highly effective. Anatomy, complications and therapeutic aspects of this rare condition are discussed.     

Small cell carcinoma of the prostate: a case report]

In many cell types, Ca2+ signals are organized in the form of repetitive spikes. The frequency of these intracellular Ca2+ oscillations increases with the level of stimulation, suggesting the existence of a frequency encoding phenomenon. The question arises as to how the frequency of Ca2+ oscillations can be decoded inside the cell. Ca2+/calmodulin kinase II has long been proposed as an attractive candidate, as it is a key target of Ca2+ signals. By immobilizing the Ca2+/calmodulin kinase II and subjecting it to pulses of Ca2+ of variable amplitude, duration, and frequency, De Koninck and Schulman have shown for the first time that the autonomous activity of Ca2+/calmodulin kinase II is highly sensitive to the temporal pattern of Ca2+ oscillations.     

Gerstmann-Straussler syndrome clinical and neuromorphofunctional diagnosis: a case report]

The Syndrome of Gerstmann-Straussler is a constellation of typical symptoms that affects the parietotemporal crossroad and also involves the contiguous parts of the occipital lobe of the dominant hemisphere. Is a family ailment that starts with an espinocerebellar ataxy followed by dementia. Diagnosis options such as EEG, TC, RM and brain SPECT-99mTc-HMPAO have been carried out in an adult with Gerstmann Syndrome. RESULTS: The brain SPECT disclosed a disminution of the flow at the parietotemporooccipital areas of both hemispheres. The results revealed a clinical and a neuromorphofunctional correlation. CONCLUSION: Brain SPECT is a complementary test to the structural neuroradiological examinations, such as TC and RM, that occasionally is useful not only to clarify but also to widen the information that these offer.     

MALT lymphoma of the bladder: report of a case]

Laryngeal metastases from remote primary tumours are uncommon. They derive mostly from melanomas or renal cell carcinomas. The generally rare laryngeal adenocarcinomas can only be classified as metastatic tumours in the presence of a distant primary of the same histology. Only five cases of a laryngeal secondary originating from adenocarcinoma of the large bowel have been reported in the world literature. A further case is presented which to our knowledge is the first to arise from the rectum, a site which suggests haematogenous tumour spread. This paper emphasizes the need for the search of synchronous metastatic disease and discusses the therapeutic options on the grounds of current management of singular colorectal secondaries.     

Persecution syndrome after the use of interferon: a case report]

The interferon has been used for fifteen years as a viral and carcinomatous pathology treatment, however it has some spychiatric secondary effects. In this paper we present a psychotic reaction in a patient without any psychiatric history. A depression with specific characteristics was also detected. It appears just after injection and goes away quickly forming an interesting "on-off" depression model.     

Thoracoscopic decortication for chronic empyema thoracis: report of a case]

A clinical case of a woman with AIDS who developed lymphoma of the nasopharynx and paralysis of the VII, IX and XII cranial nerves is reported. The probable origin of the paralysis in relation to AIDS and lymphoma is discussed.     

Microscopic polyarteritis]

Microscopic polyarteritis is a type of vasculitis that shows similar characteristics to other illnesses from the same group. This group presents a common clinical fact: a rapidly progressive glomerulonephritis. We specially point out among this group of illnesses the Wegener granulomatosis. The anti-neutrophil cytoplasmic antibodies is important for two different reasons. The fact that sometimes they have allowed to make differential diagnosis and that they represents so far the only serologic marking of such vasculitis. The ANCA antimieloperoxidasa (p-ANCA) can be found in a greater level in microscopic poliarteritis as well as the antiproteinasa-3 (c-ANCA) in the Wegener granulomatosis. The current revision tries to clarify the differential diagnosis of the microscopic poliarteritis, which nowadays is still quite vague. This lack can be compensated thanks to the fact that the therapeutic treatment of this group of illnesses is very similar.     

Endoscopic treatment of a gastric phytobezoar using electrohydraulic lithotripsy: a case report]

The Authors report a case of spontaneous large gastric phytobezoar in an unoperated stomach and describe this pathology especially with regards to pathogenesis, diagnosis and endoscopic treatment.     

Hemangiopericytoma: a case report

We describe one case of hemangiopericytoma touching a 44-year-old man. It is a rare vascular tumor originating from pericytes surrounding capillaries. The main typical features of it are the difficulty in doing an histologic diagnosis and the impossibility to make out a reliable prognosis. The therapy of choice is a surgical procedure sometimes in combination with radio- and/or chemotherapy.     

Pseudopneumoperitoneum: a case report

A case of post-traumatic pseudocyst of the pancreas is presented. The elevated and compressed stomach showed an appearance on X-ray film which might be interpreted as free peritoneal air. The term pseudopneumoperitoneum is defined and other causes of this condition are mentioned.     

Ruptured aortic arch aneurysm with hemorrhagic cardiac tamponade: report a case]

The ruptured thoracic aortic aneurysm has had severely high mortality. A 71-year-old male who suddenly fainted away was admitted to our hospital. He was in shock on arrival. Computed tomography and echo cardiogram demonstrated ruptured aortic arch aneurysm with hemorrhagic cardiac tamponade. Aortic arch replacement was performed using the selective cerebral perfusion under deep hypothermia. The recovery of his consciousness was delayed, and he had right hemiplegia postoperatively, but his state was improved gradually. Finally he complained only slight degree of aphasia, paralysis. An immediate and aggressive emergency operation is a only method to salvage the patient who has ruptured aneurysm of the thoracic aorta.