Split cord malformation and neurenteric cyst--case report and a theory of embryogenesis

A rare case of split cord malformation with neurenteric cyst is presented. The clinical, radiological and surgical findings are presented, and the possible embryological basis is discussed. To our knowledge, only seven such cases have been reported in the literature.     

Fourth ventricle ependymoma in father and son

A father and son presented ten years apart with a fourth ventricle ependymoma. The history, imaging and pathology are presented and the aetiology of familial ependymoma discussed.     

Hirschsprung disease associated with total colonic agenesis and imperforate anus—case report and review of the literature

We report a case of Hirschsprung disease associated with total colonic agenesis and high-type imperforate anus in a newborn girl. The patient also presented with uterus bicornis and a single kidney. The treatment procedure is presented together with a review of literature. The presented combination of pathologies has never been described before.     

Complications of distraction-compression osteogenesis and their prophylaxis--a clinical report]

The authors present a historical overview of various classifications of distraction osteogenesis complications. Paley's classification as well as the authors' own classification also presented. Basing on the authors' own 10 year experiences with the Ilizarov method, selected complications at different stages of diagnostics, treatment and rehabilitation are presented. The most effective forms of prophylaxis are presented, with special attention given to the surgeon's own experience with the Ilizarov method.     

Rapid, massive and unphysiological breast enlargement

Two cases of gigantomastia are presented, one is non-gravid and the other occurred during pregnancy. This is probably more common than has been reported but the cause remains unknown. The medical and surgical treatment of the disorder is presented.     

Management of extracranial carotid stenosis and intracranial aneurysms.

Twenty patients with extracranial carotid stenosis and intracranial aneurysms are reviewed. Fifteen of these patients had transient ischemic attacks (TIA's) and incidental aneurysms. The other five presented with symptoms referrable to an aneurysm, and angiography revealed significant carotid stenosis. None of the patients who presented with TIA's and underwent endarterectomy suffered subarachnoid hemorrhage. However, those patients who presented with symptoms referrable to an aneurysm and underwent endarterectomy seem to be at greater risk for subarachnoid hemorrhage.     

Coarctation and coarctation syndrome. A 5-year review

The management of and results of treatment in 57 children with coarctation of the aorta are presented. In this series, 75% of the patients presented in the 1st year of life and 51% presented as neonates. Among the 50 patients who underwent surgery the total surgical mortality rate was 14%. The higher mortality in young infants is closely related to associated cardiac anomalies. We suggest that neonates with coarctation presenting with heart failure should be operated on early, as this significantly reduces the mortality.     

Burn Scar Carcinoma and Hypercalcemia

A case of a patient with burn scar carcinoma of an extremity associated with hypercalcemia and without bone metastasis is presented. From the data presented, it seems reasonable to assume that this squamous cell carcinoma of a burn scar secreted some type of parathyroid hormone-like substance or substances which posessed calcium-increasing biological activity resulting in hypercalcemia.     

Association of paranasal sinus osteoma and intracranial mucocele--two case reports

Two young adult males presented with paranasal sinus osteoma associated with mucocele. A 20-year-old man presented with headache and seizure, and another 20-year-old man presented with headache, frontal deformity, and visual disturbances. Both patients underwent surgery and satisfactory results were obtained. Isolated paranasal sinus osteomas are benign and slow-growing tumors, but may become more aggressive in association with mucoceles. The higher aggressiveness of the lesions may be due to the presence of the mucocele. Calcification and ossification of the mucocele probably contributes to the unexpected enlargement of the osteoma.     

Renal Failure,Paraproteinemia, and Lung Squamous Cell Carcinoma

A 66-year-old man presented with gastrointestinal symptoms and acute renal failure. He had paraproteinemia and tested positive for antinuclear antibodies. There was no evidence for autoimmune disorder or amyloidosis, and bone marrow biopsy was not consistent with multiple myeloma. Three months later he presented with diffuse lymphadenopathy and right lung mass, and lymph node histology revealed metastatic squamous cell carcinoma. This association of paraproteinemia and nonlymphatic neoplasia is unusual and still very rare. A review of the literature is presented.     

Normal and abnormal arthroscopic anatomy of the ankle joint

Normal and abnormal intraarticular anatomy of the ankle is presented from an arthroscopist's perspective. Pathologic anatomy including synovitis, transchondral fracture, impingement lesions, osteochondral bodies, and erosions are described. A classification of chondromalacia and current concepts of its pathogenesis are presented.     

Results and prognosis following surgery for malignant tumors of the skull base

A series of 155 malignant craniofacial tumors referred to a specialized craniofacial center for surgical treatment are presented. One quarter of these were primary and three quarters recurrent. The statistics of long-term follow-up are presented, and it is concluded that this type of surgery for these difficult problems is worthwhile. The increasing experience gained from operating on and following up these patients is presented.     

Elective resection of the spleen--overview of resection technics and description of a new technic based on radiofrequency coagulation and dessication

The authors present a short overview of the development of elective splenic resections. Past and present indications are presented. Contemporary hemostatic technique for elective splenic resection are discussed. An original new technique for transsegmental partial splenic resection using RF generator Radionic Cool Tip(without any aditional hemostatic procedures is presented. This technique is inovative and when use properly it is a practically zero blood loos technique. A patient with transsegmental splenic resection using RF generator is presented. Further clinical application of the technique is necessary.     

Microassay of drugs and modern measurement techniques

Details of the development of conventional analytical methods for the determination of drugs in pediatric plasma/serum samples via microassays are presented. Examples of the development of small-volume sampling and the use of the newer detection systems such as LC/MS/MS for enhanced detection are presented. Dried blood spot sampling has conventionally been used for the study of inborn errors of metabolism using Guthrie cards. Limited applications in the area of drug-level determination, for example, in therapeutic drug monitoring had been reported but the methodology had not been widely used up until relatively recently. In the last few years, there has been a resurgence of interest in this methodology for drug-level determinations, and examples of drug analysis in pediatric and neonatal patients where the small-volume samples are particularly useful are presented. The application of the methodology in pharmacokinetic/pharmacodynamic studies is discussed. The utilization of solid-phase microextraction and stir bar sorptive extraction in drug analysis is presented. Clinical applications of these methodologies are reported including the development of in vivo solid-phase microextraction.     

Oncoplastic surgery of the breast: rationale and experience of 30 cases

A definition of oncoplastic surgery of the breast is presented, and its objectives and advantages over the usual conservative procedures are discussed. The oncological safety of these procedures are demonstrated, especially in surgery of larger tumors. Technical possibilities are discussed and a classification of the procedures presented. Data from 30 cases operated in our institution are depicted. The need for better training of the breast surgeon is discussed and the advantages of the same surgeon to perform the whole procedure presented.     

Extensive aneurysm of the aortic arch and descending aorta Extra-anatomical reconstruction and exclusion of the aneurysmal sac

A new technique for repair of extensive aneurysm reaching from the ascending aorta to the diaphragm is presented. The operation consists of the reconstruction of the aortic arch and descending aorta and the exclusion of the aneurysmal sac in a single operation. Two successful cases are presented.     

Renal hamartoma. Current concepts of diagnosis and surgical management

Five new cases of renal hamartomas are presented. Diagnostic methods, including ultrasound, and a plan of management are discussed. An unusual documentation of growth of a solitary hamartoma over a five-year period is presented.     

Anatomy and microanatomy of peripheral nerve.

The anatomy of the peripheral nervous system is presented, with special emphasis on the connective tissue sheaths and their relationship to the nerves' blood supply. The microanatomy of nerve fibers is also presented, with a focus on pathologic changes caused by compression and ischemic injuries. The article highlights neuropathologic findings relevant to the surgical management of peripheral nerve injury and entrapment.     

Imaging and Management of Breast Masses During Pregnancy and Lactation

▪ Abstract: Detection and management of breast abnormalities that develop during pregnancy and lactation is difficult for both the clinician and the radiologist. This article reviews the hormonal and physiologic effects on the breast during pregnancy and lactation. Breast masses that occur in pregnant or lactating patients, including pregnancy-associated breast cancer, are discussed and the corresponding ultrasound and mammographic findings are presented. Finally, a rationale for the imaging evaluation and management of the pregnant or lactating patient with a breast mass are presented. ▪     

Unique ureteropelvic junction obstruction in father and daughter

The cases of a father and daughter with a unique ureteropelvic junction obstruction which suggested genetic transmission are presented. The previously reported pedigrees of patients with a familial occurrence of ureteropelvic junction obstruction are presented.