Cystic renal masses: Usefulness of the bosniak classification

To determine the usefulness of the Bosniak classification of cystic renal masses, the computed tomographic (CT) and ultrasound findings of 16 pathologically proven cystic renal masses were retrospectively reviewed. All imaging studies were reviewed and categorized utilizing the Bosniak classification without knowledge of the final pathologic diagnosis. There were no category I lesions (classical simple cyst), four category II (minimally complicated), seven category III lesions (more complicated), and five category IV lesions (probable malignant). All category II lesions were benign, all category IV lesions were malignant. Of the seven category III lesions, three were benign and four were malignant. We conclude that the Bosniak classification is extremely useful in the management of cystic renal masses. The opinions expressed herein are those of the authors and are not to be construed as official or as reflecting the views of the Uniformed Services University of the Health Sciences, the Department of Defense, or the United States Navy     

New Developments in High Pressure Living

The hazard of carbon monoxide (CO) exposure in dense traffic was examined in policemen by analysis of the carboxyhemoglobin (COHb) in blood, after they had controlled the traffic during rush hours. The mean COHb levels in smokers were from three to five times higher than in nonsmokers who had a normal, or only slightly increased, COHb concentration in blood. The COHb in smokers tended to decrease when their hours of traffic duty increased. Since the increase of COHb, due to smoking, conceals the effect exerted on COHb by exposure to air in crowded city streets, the biologically significant CO exposure, due to urban air pollution, ought to be evaluated on the basis of the COHb levels in nonsmokers.     

ACUTE ZINC DEPLETION SYNDROME DURING PARENTERAL HYPERALIMENTATION

ABSTRACT: Zinc is an essential trace element whose malabsorption in early childhood may result in a skin disorder known as acrodermatitis enteropathica. Cutaneous lesions typical of acrodermatitis enteropathica have been described during total parenteral nutrition on zinc-deficient intravenous solutions in both adults and children. This condition has been named the “acute zinc depletion syndrome.” A case is described in which a patient, despite a zinc intake of double the daily requirement, manifested the acute zinc depletion syndrome during therapy with combined liquid diet plus parenteral hyperalimentation. Predisposing factors in this individual included a short bowel syndrome and a large oral load of calcium lactate. Zinc metabolism is reviewed with attention to alterations in disease and during hyperalimentation. The clinical manifestations, predisposing factors, therapy and prevention of the acute zinc depletion syndrome are discussed.     

Congenital coronary aneurysms with angina pectoris and myocardial infarction treated with saphenous vein bypass graft

A young woman with bilateral congenital coronary arterial aneurysms associated with myocardial infarction and angina pectoris was successfully treated with a saphenous vein bypass graft. Possible clinical and laboratory manifestations of such aneurysms are discussed, and possible complications of saphenous vein graft surgery in treatment of this lesion are noted. The finding of coronary arterial aneurysms during coronary arteriography warrants close follow-up study since in many patients the lesion appears to progress to myocardial infarction.     

Cholecystitis due to granular cell myoblastoma of the cystic duct

Summary 1. Benign tumors of the extrahepatic biliary system are rare.2. An unusual case of chronic cholecystitis due to obstruction of the cystic duct by a granular cell myoblastoma has been presented.