Cystic Dysplasia of the Testis: A Report of Three Cases and Review of the Literature

We describe the clinical and pathologic findings in three cases of cystic dysplasia of the testis and compare our findings to others in the English literature. The condition is characterized by dilatation of the rete testis with or without similarly affected adjacent structures. It is important to recognize this lesion for two reasons. First, it is associated with a high frequency of ipsilateral renal anomalies. Second, it is important to consider this condition in the differential diagnosis of cystic testicular mass in a neonate or a child. The management of this condition is quite different from the management of other testicular masses such as a hydrocele, testicular germ cell tumor, or infiltrative disorder (e.g., lymphoma, inflammation, torsion, or hematoma). Testicular cystic dysplasia is benign and the lesion can be removed surgically, leaving the rest of the testis intact. A discussion of the lesion's possible pathogenesis is also presented.     

Chronic fall risk among aged individuals with type 2 diabetes

Falls in the elderly are common and a frequent source of injury. Chronic fall risk factors were evaluated in aging individuals with type 2 diabetes from two different settings--an urban day care center (age range: 57 to 83 years) and a rural community center (age range: 62 to 97 years). Six fall-related risk factors were studied: client history/subjective assessment of fall history, daily medication intake, number of medical diagnoses, balance (Tinetti Balance and Gait Tool), lower extremity protective sensation (Semmes-Weinstein monofilament testing), and relaxed gait velocity (timed functional walk test). Both groups demonstrated a high risk for chronic falling with a mean of 4.8 and 4.0 risk factors present in individuals from the urban day care center and the rural community center, respectively. No differences between clients in the two centers with respect to number of medications and comorbidities were found. In both groups, > 50% of individuals reported a history of falling. Loss of protective sensation was detected in 100% of the individuals from the urban day care center compared to 67% in the rural community center. Similarly, 40% of the individuals from the urban day care center demonstrated impaired balance as compared to 29% from the rural community center. A similar ratio of impaired balance to loss of lower extremity protective sensation was demonstrated across the two groups. These data indicate a potential relationship between loss of protective sensation and impaired balance. These findings also indicate that individuals in urban and rural community settings share similar risk factors for chronic falling.     

Endogenous endophthalmitis following disseminated fungemia due to Fusarium solani in a patient with acute myeloid leukemia

We report the case of a young man with a resistant acute myeloid leukemia (AML) who developed a disseminated fungemia due to Fusarium solani involving the skin and lungs, during the neutropenic phase following a chemotherapy course. Despite continuous therapy with liposomal amphotericin B, he developed a bilateral endophthalmitis that rapidly evolved to complete blindness. The patient underwent two procedures of vitrectomy, with detection of F. solani in the vitreous fluid, and continued antifungal therapy, without any recovery of visual acuity. When he eventually died due to recurrence of leukemia and hemorrhagic shock, autopsy revealed a diffuse fusarial involvement of the central nervous system.     

Transesophageal echocardiography in the diagnosis of acute aortic syndrome

In recent years, technological advances in echocardiography have led to improvements in the diagnosis of acute aortic disease. With transesophageal echocardiography (TEE) and, particularly, bi- and multiplane probes, the physiopathologic understanding of these diseases has widened. Thus, new entities such as penetrating ulcer and intramural hematoma have been described and differentiated from classical aortic dissection.     

Retrobulbar chlorpromazine injections for the management of blind and seeing painful eyes

PURPOSE: To report the efficacy of primary retrobulbar chlorpromazine injections for the management of blind and seeing painful eyes. PATIENTS AND METHODS: Retrospective case series from three university hospitals was done. Twenty eyes of 20 patients with at least 3 months of follow-up are reported. Ten of these 20 eyes did not receive any other ophthalmic medications either 2 weeks before chlorpromazine injection or at any time point after injection. Treatment was considered successful if pain control lasted for at least 3 months, without the need for reinjection or enucleation. RESULTS: Sixteen of 20 (80.0%) eyes achieved successful pain control. There were no permanent complications in any patient. CONCLUSIONS: Retrobulbar chlorpromazine appears to be safe and effective for the management of pain in blind eyes.     

Determination of active substances in antiallergic and antiphlogistic multicomponent preparations by high performance liquid chromatography (HPLC)

The aim of the present study was the elaboration of an HPLC method enabling the identification and determination of the content of selected compounds occurring in multicomponent preparations applied in allergic and non-allergic diseases of upper respiratory tracts. These compounds include: buzepide methyl iodide, clocinizine dihydrochloride, phenylpropanolamine hydrochloride, pseudoephedrine sulfate and dexbrompheniramine maleate. The elaborated HPLC method shows that a good separation of the mentioned compounds is feasible. The regression analysis has demonstrated linearity of the method in concentration range suitable for the intended experiments. The determination of the compounds in pharmaceutical preparations and the statistical evaluation of the results indicate that both the selectivity and precision of the method are good.