Local argyrosis of oral mucosa or amalgam tattoo. A problem in diagnosis and treatment

The authors, basing on three cases published by different authors in the years 1995-2003, discuss the problem of diagnosis and treatment of local gingival argyrosis and amalgam tattoo. Treatment methods carried out consisted of the following procedures free gingival graft, subepithelial connective tissue graft in a two-step procedure and subepithelial connective tissue graft without flap coverage. In the authors opinion in some cases a connective tissue graft does not need flap coverage, therefore a dual blood supply is not necessary.     

Eosinophilic granulomatous hepatitis. Apropos of 3 cases

The authors report three cases of eosinophilic granulomatous hepatitis observed among 325 liver puncture biopsies. The patients had urinary bilharziasis and had just been treated with oltipraz. These cases were probably due to eosinophilic reactions which sometimes follow treatment of schistosomiasis.     

Focal fibrous disease of breast

Summary The study concerns a problem of practical importance in the daily routine work. 218 cases of focal fibrous disease of the breast were classified into three types with conventional methods of pathohistology and statistics. The peak incidence between 20 and 25 years is considerably lower than the incidence figures reported by other authors. The authors postulate the progressive evolutive nature of the lesion.     

Changes in the small biliary passages in the hepatic localization of Hodgkin's disease

Summary The authors have investigated the behaviour of the small biliary passages in the liver biopsies of six patients suffering from untreated Hodgkin's disease with hepatic localization. No obstruction of the major bile ducts was demonstrated in any patient. Three of the patients were anicteric, while the three others presented with jaundice. In the first three cases typical Hodgkin's granulation tissue appears to be limited to portal tracts and collagen reaction is virtually absent. The three cases with cholestasis showed granulomatous tissue associated with heavy connective tissue rearrangement invading and dissociating the lobular structure. They also show a conspicuous bile-duct proliferation, which is not observed in the three anicteric patients. In these latter cases, however, the small bile ducts running within or near the granulomatous tissue present various morphologic changes, including basal membrane thickening, dilation or constriction of the lumen and alterations of the biliary epithelial lining. Complete disappearance of the bile duct may occur.The authors are indebted to Professor Valeer J. Desmet, Chief of the Department of Pathology II, Leuven, Belgium, for his appreciation and valuable suggestions     

5 new cases of entomophthoromycosis observed in Cameroon. Role of immunofluorescence in thr diagnosis]

The authors present five new cases of entomophthoromycosis observed during three years of histopathology in Cameroon. Three classic cases of rhinoentomophthoromycosis. In one case, Conidiobolus coronatus was isolated. Two cases of subcutaneous entomophthoromycosis, without isolation of the germ. In one observation, the clinical and histological aspect suggested mucormycosis post entomophthoromycosis. An immunofluorescence technique showed the Basidiobolus haptosporus to be the real cause.     

Encephalitis Epidemica Japonica in Horses Occurring In a Non-Epidemic Year

The authors have carried out investigations on horses with cerebral symptoms clinically, pathologically, and epidemiologically which were obtained in various areas in Hokkaido in non-epidemic years—1955, 1956 and 1957. Among cases investigated, there were three cases in which the authors could certainly prove the existence of encephalitic changes histopathologically in addition to two cases, one being positive to the complement-fixation test and the other in virus isolation. In five out of eighteen cases investigation, slight leucocyte emigration was observed in the brain tissue. Comparing such facts with the judgement from the viewpoint of epidemiology and differential diagnosis, the authors have concluded that all of the cases with encephalitic symptoms were infected with Japanese encephalitis ( Encephalitis epidemica japonica ). They have also added considerations pertaining to the infection-pathology of Japanese encephalitis based upon the discrepancies in infected horses between epidemic and non-epidemic years.     

T6 monoclonal antibody reacts with blasts from cases of common antigen acute lymphocytic leukemia

The expression of the T6 antigen on malignant lymphoid cells has been considered strong evidence in support of T-cell lineage and thymic stage of differentiation of the neoplastic cells. Thus, the authors have used the T6 monoclonal antibody for the last three years in the immunophenotyping of blasts from 60 consecutive cases of acute lymphocytic leukemia (ALL) and 8 cases of T-cell lymphoma. Blasts from 12 of 46 (26%) cases of common type ALL, 4 of 7 (57%) cases of T-cell ALL, 2 of 3 (66%) cases of lymphoblastic lymphoma, and 1 of 5 (20%) cases of peripheral (postthymic) T-cell lymphoma were positive for the T6 antigen. The authors conclude that the expression of T6 antigen on malignant lymphoid cells may not always indicate T-cell lineage.     

Volvulus of the cecum

Twenty-six cases are reported of ileo-cecal volvulus admitted to three community hospitals over a period of six years. The operative management of ileo-cecal volvulus is discussed. Based on the results and review of the literature the authors recommend a right hemicolectomy in the presence of gangrene or perforation, in other cases a cecopexia with fixation in combination with intestinal tube decompression when needed.     

Exogenous lipoid pneumonia (oil granulomas of the lung)

The authors observed three cases of exogenous lipid pneumonia clinically suspected of lung carcinoma. Histological examination of material after thoracotomy gave the possibility of correct diagnosis. The lesions in lungs were characteristic granulomas around lipid material and with surrounding advanced fibrosis.     

Acute basophilic leukemia. A clinical, morphologic, and cytogenetic study of eight cases

The authors describe eight cases of acute basophilic leukemia. In six of the eight cases, basophilic involvement was not apparent by light microscopic examination. The cases were identified on the basis of ultrastructural evidence for basophil/mast cell differentiation of the blasts with little or no differentiation into other lineages. Ultrastructural analysis revealed immature basophil granules in blasts in all eight cases and theta granules in blasts in four cases. In three cases, ultrastructural evidence of mast cell differentiation also was present, with rare cells showing evidence for both basophil and mast cell differentiation. No clinical features distinguished this group of patients from others with acute myeloid leukemia. Cytogenetically, the cases were heterogeneous. Three had a Philadelphia chromosome; none had a t(6;9). The authors conclude that ultrastructural analysis usually must be used to diagnose acute basophilic leukemia, that acute basophilic leukemia is associated frequently with the Philadelphia chromosome, and that the ultrastructural findings provide evidence for a common origin of basophils and mast cells.     

The influence of “biorhythm” on the incidence of injuries among forest workers

Summary The paper investigates effects of the three basic cyclic rhythms including a 23-day physical cycle, a 28-day emotional cycle and a 33-day intellectual cycle on the incidence of injuries among 322 forest workers, using the mathematical system of Khalil and Kurucz (1977). Results of the present work based on the examination of samples representing another sphere of human activity in two out of five cases studied support the conclusions of the above mentioned authors. In the remaining three cases the application of the method neither confirmed nor disproved the statement that biorhythms do not affect the incidence of injuries.     

Isolated and syndromic cryptophthalmos

The association between cryptophthalmos and multiple congenital malformations has been well documented over the last century. Numerous authors have described cases as the cryptophthalmos syndrome, but recently reports of cases without cryptophthalmos have led several authors to use the eponymic designation Fraser syndrome. We have seen seven cases of cryptophthalmos syndrome, including three sib pairs. All presented with cryptophthalmos and bilateral renal agenesis in addition to other characteristic associated malformations. A literature review showed 124 cases in which 27 demonstrated isolated cryptophthalmos, while 97 showed a pattern of multiple congenital malformations. We selected four major and eight minor criteria which enabled us to classify 86 of those cases as having cryptophthalmos syndrome with 11 remaining unclassified. Cryptophthalmos demonstrates equal sex distribution, occurrence in sibs, consanguinity in families with more than one affected child, and lack of vertical transmission--strongly suggesting autosomal recessive inheritance. Isolated cryptophthalmos or cryptophthalmos sequence was sporadic in 16 cases and familial in 11. The familial cases occurred in three families and demonstrated vertical transmission. The pathogenesis of this syndrome is unknown. There are similarities to animal models of maternal vitamin A deprivation and defects in programmed cell death. Cryptophthalmos syndrome should be considered in the differential diagnosis of cases with multiple congenital malformations, especially when they are associated with renal agenesis, even in the absence of cryptophthalmos.     

Stroke like presentation of Creutzfeldt Jakob disease: an unusual variant

Creutzfeldt-Jakob disease (CJD) is a degenerative process of the brain, induced by novel infectious agent or prion, and is usually characterized by a rapidly progressive dementia in association with myoclonus. However different patterns of disease presentation have been identified. The authors describe three probable cases of CJD. None of them had positive family history or any known modes of iatrogenic transmission. Interestingly, all the cases presented like a stroke. This is the first series of CJD cases from this part of country.     

Fine-needle aspiration cytology and flow cytometry of intracystic papillary carcinoma of breast

To define criteria for cytologic diagnosis of intracystic papillary carcinoma (ICPC), the authors retrospectively reviewed the fine-needle aspiration (FNA) cytologic specimens of eight cases of histologically proven ICPC of breast. The patients were five black and three white women, 56-87 years of age. The FNA specimen was cyst fluid in four cases (bloody in three, clear in one). All the aspirates showed cellular smears with small and large clusters of cells with papillary and/or cribriform configurations and numerous single epithelial cells. The cells were cuboidal to columnar with minimal atypia. ICPC was suggested by FNA in each case, and all the patients underwent surgical excision or mastectomy. Flow cytometry, performed on fresh FNA specimen in one case and on paraffin-embedded surgical tissue in all eight cases, showed seven tumors to be aneuploid and one to be diploid. The authors contend that ICPCs of breast have distinct cytomorphologic features that can be recognized by FNA. Because ICPC may present in cyst fluid, either bloody or clear, all breast cyst fluids from postmenopausal women should be examined cytologically. Flow cytometric demonstration of an aneuploid population may assist in confirming malignancy in this lesion.     

High-performance liquid chromatography in the diagnosis of hemoglobinopathies and thalassemias. Report of three cases

High-performance liquid chromatography is a technic that has recently been applied to the diagnosis of hemoglobinopathies and thalassemias. Its advantages over other methods include increased sensitivity, resolution and simplicity, as well as speed. In this report, the authors present an HPLC procedure that uses a weak cation exchange column and a gradient elution system for the diagnosis of hemoglobinopathies and thalassemias. The authors illustrate the utility of this procedure by reporting three cases in which the technic enabled them to make the correct diagnosis, which by traditional methods would have been missed or equivocal.     

Traumatic diaphragmatic hernias: analysis of six cases.

During three years, from January 1975 through December 1977, the authors saw six cases of traumatic left diaphragmatic hernias, all of whom survived. All were males aged 17 to 56 years, with an average age of 30 years. Four (67 percent) of the cases resulted from blunt abdominal trauma while two (33 percent) were due to stab wounds of the left lower chest. Admitting chest x-ray findings were diagnostic for all acute hernias due to blunt trauma and for all hernias presenting with a delayed interval. Digital exploration of all penetrating lower chest wounds is recommended by some authors if exploratory laparotomy is not contemplated. Our preferred approach for the repair of the hernias includes (1) laparotomy for all acute cases, (2) thoracotomy for delayed cases, and (3) separate abdominal thoracic incisions whenever a combined approach is considered necessary. The repair should be carried out in two layers with nonabsorbable sutures.     

Anatomical study of triple renal arteries

Within an 8 year study of the renal blood supply, the authors assessed 14 cases of triple renal arteries, 2 of them bilaterally (both on human fetuses), so a total of 16 triple renal arteries. Among the 14 cases of unilateral triple renal arteries, 8 were placed on the left side. In what concerns the caliber, the renal artery that enters the kidney through the hilum is usually greater than the others; in only three fetal samples the triple renal arteries were almost equal in caliber. Concerning the arterial traject, in 5 of the cases, two of the three renal arteries crossed one another; this aspect was assessed in first two arteries (2 cases) and last two arteries (3 cases). In 3 cases, the triple renal arteries were accompanied by double renal arteries on the opposite side. The almost parallel traject of the triple renal arteries was assessed in only 3 cases.     

事故后飞行人员的心理治疗与康复

飞行人员在其职业生涯中，不可避免地耳闻目睹或亲身经历飞行事故。对当事机组人员产生严重的心理问题应给予及时矫治。笔者采用音乐治疗、生物反馈放松训练、系统脱敏、成功表象飞行训练、空中特殊情况表象训练等一系列方法，分别对三位事故后产生创伤后应激障碍的空中乘务员、飞行驾驶员进行治疗，取得了较好的疗效。     

Parathyroid hormone (PTH) assay of parathyroid cysts examined by fine-needle aspiration biopsy

The authors report three cases of parathyroid cysts examined by the fine-needle aspiration biopsy technic. A presumptive diagnosis of parathyroid cyst was made when characteristic water-clear fluid was aspirated. The diagnosis was then confirmed by parathyroid hormone (PTH) assay. The authors believe that the C-terminal/midmolecule determination should be the assay of choice, because the N-terminal-specific assay gave normal or slightly elevated results in all the cases studied. If only an N-terminal-specific PTH assay is obtained, potential for a false negative diagnosis exists. With a correct PTH assay, a specific diagnosis of parathyroid cyst can be rendered, which enables appropriate treatment of total fluid aspiration, which thereby eliminates the need for thyroid hormone treatment or surgery in most cases. A discussion of PTH assays is presented along with speculations concerning the secretion of PTH by the parathyroid gland. The previous literature detailing cytologic findings and the PTH assays of parathyroid cysts diagnosed by the fine-needle aspiration biopsy are reviewed.     

Autopsy findings in patients with acquired immunodeficiency syndrome

We have evaluated the autopsies of 11 patients with HTLV III/LAV-infection. The clinical diagnosis was AIDS in 10 cases and AIDS related complex (ARC) in one case. The most common infectious disease was pneumocystis carinii pneumonia, occurring in 5 cases. 3 patients showed evidence of mycobacterial infections and another three showed cytomegalovirus infections. Kaposi's sarcoma was found in 4 and other malignancies in 3 cases. Our results are in agreement with the findings of other authors.