Solitary fibrous tumor of the adrenal gland

Solitary fibrous tumors are rare neoplasms, most commonly involving the pleura, recently described in various other locations. We report a solitary fibrous tumor of the right adrenal gland in a 42-year-old woman, discovered incidentally during abdominopelvic ultrasonographic examination. Pathologic and immunohistologic features of the tumor were identical to those of other solitary fibrous tumors. Three-quarters of this unencapsulated infiltrating tumoral mass presented foci of hemorrhage and were made of small, round, epithelioid-like cells that expressed the CD34 antigen more weakly than do the typical spindle cells usually observed in solitary fibrous tumors. Despite hemorrhage and poor limitation, the tumor behaved in a innocuous manner; the mass remaining unchanged for more than 5 years before the patient agreed to surgical intervention, which was recommended because of a sudden enlargement of the mass.     

The effect of nerve injury on the incidence and distribution of branched pulpal axons in the ferret

In a previous electrophysiological study in ferrets, we demonstrated that some axons in the inferior alveolar nerve branch to supply the pulps of two teeth. We have now investigated the incidence and distribution of branched pulpal axons at various intervals after nerve injury and subsequent regeneration, to study the extent to which the innervation of the teeth returns to normal. In adult male ferrets under anesthesia, the left inferior alveolar nerve was either sectioned (31 animals) or crushed (10 animals). Following recovery periods of six weeks, three months, or one year after nerve section and three months after nerve crush, electrophysiological recordings were made by insertion of pairs of Ag/AgCl electrodes into cavities cut into left mandibular teeth. Electrical stimuli were applied to each tooth in turn, and averaged responses were recorded individually from the other teeth. Latency and amplitude of the action potentials were used to characterize responses from branched pulpal axons. For some branched units, the point of branching was established by determination of the site of the inferior alveolar nerve section which abolished the response. When compared with controls, the results indicated that, following short recovery periods after nerve section, there was an increase in the number of branched pulpal axons supplying non adjacent teeth, and this branching had occurred at the initial site of nerve injury. Following long recovery periods, there were fewer branched axons than at earlier stages of recovery, but this apparent remodeling had not selectively eliminated axons which branched at the injury site to supply widely separated targets. Nerve crush injury resulted in no increase in the incidence of branched pulpal axons, and branching at the injury site was rare.(ABSTRACT TRUNCATED AT 250 WORDS)     

Age-related changes in the autonomic ganglia

Debridement of nonviable tissue is crucial to optimal wound healing, which can be impaired unless all necrotic tissue, exudate, and metabolic wastes have been removed from the wound. Debridement methods are classified as sharp, mechanical, chemical, and autolytic. This article describes methods of debridement and their outcomes.     

Rigid fixation with teeth in the line of mandibular fractures

The condition of acute cholangitis of severe type (ACST) develops very rapidly and the prognosis is poor. The main clinical feature is that there is an obvious dynamic variation, which is the principal factor for the early occurrence of shock and death. In this study the Japanese long ear rabbits were used and biliary tract pressure increasing and splanchnic nervous plexus blocking experiments were conducted. Our results indicate that 0.6% of lidocaine can be used to block the right celiac plexus. It can avoid the decrease of blood pressure due to the pressure increase of the biliary tract, and the decrease of blood pressure due to the pressure increase of the biliary tract can be corrected by local anesthesia. 8 cases in conformity with the ACST diagnostic standards received the right renal capsule block injection for the purpose of stopping the celiac plexus, 6 cases of whom had a return of blood pressure to various extent, suggesting that the splanchnic nervous activity in the occurrence of ACST is of great significance. The technique may provide a new approach for the clinical treatment of ACST.     

Intraperitoneal chemo-hyperthermia with mitomycin C in cancer of the stomach with peritoneal carcinosis

We report 42 cases of gastric cancer with peritoneal carcinosis treated with intraperitoneal chemohyperthermia. Intraperitoneal chemohyperthermia was achieved with a closed sterile circuit containing mitomycin C, 10 mg/l producing an input temperature varying from 46 to 49 degrees C for 90 minutes. There were three postoperative deaths: one pulmonary embolism at day 4, one multiple organ failure et day 4, and one septic shock at day 25 due to a colonic fistula. Two patients suffered complications: one opening of the duodenal stump requiring reoperation on day 5, and one prolonged postoperative ileus lasting to day 10. Of the 12 patients with ascites, resorption was achieved in 8. In patients with early-stage peritoneal carcinosis (granulations less than 5 mm) survival at 1, 2 and 3 years was 90%, 61% and 41% respectively. For those with more extensive carcinosis, survival at 1 year was 10%. Five patients survived more than 30 months, three have survived to 34, 43 and 73 months. Intraperitoneal chemohyperthermia is a new treatment for carcinosis of gastric origin. These early results must be assessed further with larger controlled.