Introduction to problems of plastic surgery of the eyelids (author's transl)

The qualities of the plastic surgeon and the basic principles of plastic surgery are briefly described, particularly in relation to the reconstruction of wounded eyelids.     

Histological studies in the developing eyelids of congenital microphthalmic (Cts) mice

The Cts mouse is a mutant of the Jcl:ICR strain with congenital cataract and small eyes in homozygotes. In the present study, attempts were made to measure postnatally the palpebral fissure and to examine the process of eyelid development by light microscopy in both normal (+/+) and homozygous (Cts/Cts) mice. The width of the palpebral fissure in homozygotes was significantly smaller than in unaffected mice. To investigate the process of eyelid development, tissue specimens from normal and Cts homozygous mice were prepared with hematoxylin and eosin, and observed by light microscopy on days 14, 16, and 18 of gestation and on days 0, 7, and 14 after birth. In both groups, the eyelid fused on day 16 of gestation and opened completely on day 14 after birth. The primordium of the orbicularis oculi muscle was defined on day 16 of gestation, and the primordia of hair follicles and Meibomian glands were detected on day 18 of gestation. In the present study, there were no significant differences in the process of eyelid development between normal and homozygous mice. Eyelid development has thus far been thought to be self-determining and not affected by tissue interaction, and the present findings support this line of thought.     

Microbiological investigation of Bartholin's gland abscesses and cysts

Percutaneous aspirates from intact Bartholin's gland cysts (12) and abscesses (34) were examined for bacteria and genital mycoplasmas. Aspirates from 10 of the 12 patients with Bartholin's gland cysts were sterile. Aspirates from the other two cysts contained organisms that are part of the vaginal microbial flora. Of the 34 abscesses, 24 (70.6 per cent) contained bacteria. Eight abscesses contained gram-negative rods in pure culture and four contained gonococci in pure culture. Twelve abscesses contained one or more vaginal organisms including anaerobic gram-negative rods (eight isolates), anaerobic gram-positive cocci (eight), Staphylococcus epidermidis (four), and microaerophilic streptococci (three). Although most of the patients had genital mycoplasmas isolated from vaginal cultures, Mycoplasma hominis was isolated from only one and Ureaplasma urealyticum from none of the aspirates.     

Median raphe (parameatal) cysts of the penis

PURPOSE: Although median raphe cysts of the penis have been widely reported the pathogenesis is obscure. We describe the microstructural detection of 3 cases of median raphe to study the true pathogenesis. MATERIALS AND METHODS: Three patients presented to our clinic of plastic surgery complaining of abnormal shape of the penis or mass recurrence. High magnification light microscopy and electron microscopy were performed. RESULTS: Microstructural study revealed that all 3 cases had similar findings to those of the common urethral mucosa. CONCLUSIONS: Median raphe cysts are derived from the external paraurethral ducts and contain features that to our knowledge have not been previously reported.     

Multiple hepatic cysts along the intrahepatic bile duct--case report

A case of multiple hepatic cysts of the periductal gland located along the left intrahepatic bile duct is described. Ultrasonography and computed tomography disclosed many cystic lesions along the left portal vein in the left lateral segment of the liver. Percutaneous transhepatic cholangiography showed many compressed lesions. The resected specimen revealed multiple cysts of 2-7mm in diameter along the intrahepatic bile duct. Microscopically, cysts within the large Glisson's capsule were intermixed with lobuli of the periductal glands, thus suggesting periductal gland origin. Histopathological features of these cysts were similar to those of "multiple hilar cysts" reported by Nakanuma, but lack of portal hypertension and underlying chronic liver disease is the significant characteristics in this case which is different from "multiple hilar cysts".     

Multiple neoplasms of the salivary gland and the lung

Intracranial adenoid cystic carcinoma is uncommon. We report two unusual cases of intracranial adenoid cystic carcinoma. The first patient presented with a steroid-responsive optic neuropathy from an orbital mass that simulated orbital pseudotumor, and subsequently developed intracranial involvement, presumably by contiguous perineural spread. The second patient presented with proptosis of the left eye, right facial weakness and numbness, and an intracranial mass, presumably from hematogenous metastatic spread.     

Surgery of the eyelids

This article reviews the most common pediatric oculoplastic conditions and addresses clinical evaluation as well as medical and surgical management. The complex issues of amblyopia and special considerations for eyelid surgery in children are discussed. A step-by-step approach is used in the treatment of many common pediatric oculoplastic conditions, including congenital blepharoptosis and lid margin defects. Surgical options are explored and clinical examples are provided.     

Vascular anatomy of the eyelids

PURPOSE: The eyelids have a rich vascular supply, and bleeding may compromise both surgical technique and postoperative results. Generally, it is known that the eyelids contain a marginal and peripheral arcade, but detailed anatomic information is not available. This study therefore was undertaken to determine the detailed anatomy of eyelid vascularity. METHOD: The common carotid arteries of six fresh cadaver heads were injected with a compound consisting of a partially polymerized monomer, to which a catalyst and promoter were added to cause hardening. The soft tissue was then digested, using 40% potassium hydroxide, to obtain detailed casts of the eyelid arteries, arterioles, and capillaries. RESULTS: The authors describe the eyelid vascularity and anastomotic network with average distance measurements from clinically relevant soft tissue landmarks in the 12 cadaver eyelids. CONCLUSIONS: Consistent patterns of eyelid vascularity were observed. A better understanding of the eyelid vascularity should allow modification of surgical techniques and reduce postoperative complications after eyelid surgery.     

Treatment of cancer of the eyelids

With a few modifications, the old technique of curettage and electrodesiccation has been successfully applied to the treatment of eyelid cancer.     

Metastatic melanoma of the parotid gland (author''s transl)

An electronic measuring instrument, which automatically calculates the rectal potential difference, has been developed to determine mineralocorticoid activity in patients with primaroid disorders. A special probe with a disposable tip enables measurements to be made on successive patients without prior cleaning of the probe. The technique, results and their clinical implications are discussed. A highly significant correlation between plasma aldosterone and rectal potential difference is demonstrated.     

Multiple angiomyolipomas of the liver (case report)

Angiomyolipoma of the liver is an extremely rare type of tumor and reported cases are few and far between. This case study reports on a 37-year-old woman who suffered from multiple angiomyolipomas of the liver. Ultrasonography (US) and computed tomography (CT) initially revealed the existence of two tumors located in the right lobe of the liver and measuring 20 x 15 mm and 8 x 7 mm in size. The patient underwent partial resections of the liver. Histopathologic examination of both the resected specimens revealed angiomyolipoma. This is the first reported case of multiple angiomyolipomas of the liver. Furthermore, the lesions of our case study were small in size and rich in fat component. Under such conditions, preoperative examination resulting in an angiomyolipoma diagnosis is difficult even with the aid of imaging modality and needle biopsy techniques.     

Data on the pathogenesis of solitary juvenile bone cysts (author's transl)

On the basis of the histologic analysis of 45 solitary (juvenile) bone-cysts the author reveals new aspects of the pathogenesis. I. Data on sex-age-localisation are referred to. II. Due to the hemosiderosis regularly manifesting itself in the loose connective tissue layer lining the cyst and owing to the similarity to the liquified hematomas to be found elsewhere in the organism, as well as on the basis of the specific blood-supply conditions of the spongiosa of the increasing metaphysis the author presumes the intramedullary hemorrhage--possibly occurring also without fracture--to be the primary change. III. In the lining layer of the cyst, as well as in the adjacent bony tissue the author frequently observed capillary stase and to a considerable degree lymphedemas (resorption insufficiency). On the basis of these data the author presumes that the following mechanism might be hold responsible for the persisting of the cyst: The congestive (anoxic) wall of the capillary gets permeable for the proteins. Hence the fluid of high protein content, filling the cyst is constantly replaced. It is emphasized that solely the lymphatic vessels are apt to convey proteins. On the basis, however, of the histologic phenomena (lymphedema) observed, the pericystic lymphatic system is in the stage of relative insufficiency.     

Multiple hydatid cysts of the brain: a case report and review of the literature

Multiple hydatid cysts of the brain are uncommon and may be either primary or secondary. We report a 12-year-old child with multiple hydatid cysts of the brain occurring 1 year after surgical rupture of a primary large and infected cerebral hydatid cyst. Surgical removal of hydatid cysts was successfully performed. Albendazole (10 mg/kg twice daily for 12 weeks) was administered to the patient in the postoperative stage.     

Peri-ano-rectal cysts and tumours of vestigial origin in the adult (author''s transl)

Although the annular dark field detector in the STEM collects a large fraction of the elastically scattered electrons, it does not use all the information carried by these electrons because it ignores the distribution of electrons over its surface. This information can be obtained by dividing the detector into sections. This paper calculates the number of electrons scattered by a single atom onto each side of an annular dark field detector split in half by a line passing through its center. This scattering problem is unusual becuase the incident wave is not a plane wave in the STEM. The sum and difference signals are calculated for a single atom from its scattering amplitude for a STEM limited by primary or secondary spherical aberration operating at 10 kV, 70kV, or 100 kV. All the cases calculated show that a single thorium atom should give an observable difference signal which is very sensitive to the focal conditions of the STEM.