A comparative study on the diagnostic sensitivity of rodent sperm and embryos in the detection of endotoxin in earle's balanced salt solution

Purpose The bioassay used by most IVF units to assess culture media is the mouse embryo test. The limitations of this assay are well known. The objective of this study was therefore to evaluate the in vitro bioassay potential of rodent sperm, in terms of relative sensitivities to endotoxins, and to compare the results with the routine mouse embryo and human sperm tests.Results The greater sensitivity of rodent sperm than of mouse embryos was evident in this study. A further advantage in using the mouse sperm test was the time (4–6 hr) in which endotoxins could be detected.Conclusion This rapid sperm test proved to be inexpensive, convenient, and invaluable for detecting potential sources of cytotoxicity.     

Bizarre parosteal osteochondromatous proliferation of a phalanx

Summary A rare proliferative osteochondromatous malformation of a proximal phalanx is described. This malformation may mimic the appearance of a sessile osteochondroma or parosteal osteosarcoma on X-rays and may be mistaken for a low-grade osteosarcoma on histology, with disastrous therapeutic consequences. We found that cryotherapy followed by local excision was adequate to remove the tumour.     

Infectious osteitis pubis. Case reports

Two cases of spontaneous septic osteitis of the pubis in patients who had not previously undergone intrapelvic or abdominal surgery are presented. Early diagnosis and evaluation of the immunological system are discussed. Drainage of the pus and thorough debridement of the affected bone are the hallmarks of correct treatment. The administration of suitable antibiotics with simultaneous correction of immunological deficiencies will result in eventual cure.     

Bladder interposition in traumatic diastasis of the symphysis pubis. A case report

Closed reduction of the symphysis pubis in a patient with an open-book type disruption of the pelvic ring failed because of interposition of the bladder and retroperitoneal fat. The problem of maintaining reduction with an external fixation device is discussed.     

Hand infections--approach and management

Infections of the hand are always very serious conditions and should therefore be treated aggressively. Early diagnosis, adequate anaesthesia, a bloodless field and thorough drainage including debridement, elevation and early active mobilization are the cornerstones of treatment. Antibiotics need not be given routinely, but under certain circumstances (for example in the case of human bites) combination antibiotic treatment is imperative. Management of hand infections along these lines is most rewarding and should prevent a chronic infection or a disastrous osteitis which would result in a permanent lesion and disablement. The management of specific hand infections is discussed.     

Ionogran--an ionomeric micro implant in bone tumour reconstruction. A clinical evaluation

A new implant material, Ionogran (Ionos, Medizinische Produkte GmbH & Co. K.G., Germany), is evaluated in a series of 60 cases requiring augmented bone grafting for major bone defects. The material, an ionomeric porous micro implant (IMI), is stable, non-degradable, osteoconductive and biocompatible. It promotes the formation of osteoid and displays a dynamic surface activity which stimulates the process of repair. In the compromised situation of a large cavity following curettage and cryotherapy, Ionogran when mixed with a mulch of autogenous cancellous bone is a valuable filler, providing a direct osteoid bond with host bone, and a permanent scaffold which maintains shape, length and form of the affected part. It replaces allogenic bone grafts and the problems associated with that technique.     

The prognostic significance of p53, mdm2, c-erbB-2, cathepsin D, and thrombocytosis in stage IB cervical cancer treated by primary radical hysterectomy

de Jonge ETM, Viljoen E, Amant F, Nesland JM, Holm R. The prognostic significance of p53, mdm2, c-erbB-2, cathepsin D, and thrombocytosis in stage IB cervical cancer treated by primary radical hysterectomy. Int J Gynecol Cancer 1999; 9: 198–205.
The objective of this study was to evaluate the value of platelet count, p53, MDM2, c-erbB-2, and cathepsin D immunoreactivity as predictors of lymph node metastasis (LNM) as well as their prognostic significance in patients with stage IB cervical cancer treated by radical hysterectomy between 1991 through 1995. We also report on the outcome of a protocol considering lymph-vascular space invasion (LVSI) in addition to LNM as a strong motivation for adjuvant radiotherapy. A total of 93 patients were the subject of this retrospective study. The incidence of positive nodes was high (30.1%). Thrombocytosis (≥ 400.000/mm³) was present in 6.7% of patients. Positive immunostaining was found for p53 (50.6%), MDM2 (21.7%), c-erbB-2 (14.5%), and cathepsin D (45.8%), but none of them was able to predict LNM. Only thrombocytosis was associated with an unfavorable prognosis: a statistically significant association was shown with relapse-free and overall survival in an univariate analysis ( P = 0.0431 and P = 0.0012, respectively) with a tendency to significance in multivariate analysis ( P = 0.079 and P = 0.0882, respectively). We postulate that thrombocytosis in early stage cervical cancer could be a marker for subclinical tumor burden. LVSI, regarded as an indication for adjuvant radiotherapy, was no longer associated with poor relapse-free or overall survival, but resulted in a 41% postoperative irradiation rate. Further research is needed to establish the value of LVSI in postoperative radiotherapy decision making.     

Uterine carcinosarcoma with melanocytic differentiation.

A 65-year-old black woman was found to have a 3.0 cm endometrial tumor that was a carcinosarcoma with a major epithelial and a less prominent mesenchymal component. The latter was undifferentiated but one focus of chondroid differentiation was noted. The former showed papillary serous differentiation. Melanin pigment was observed in both epithelial and mesenchymal components. Staining with antisera to S100 protein and HMB-45 confirmed the presence of melanocytes. An endocervical focus of tumor also contained melanin. Electron-microscopic studies showed large tumor cells with an irregularly indented nucleus and abnormal giant cytoplasmic melanosomes. Only one case of uterine carcinosarcoma with melanocytic differentiation has been previously reported.