The influence of some non-steroidal anti-inflammatory drugs on the retraction of collagen lattices.

The effects of some antirheumatics on the formation and retraction of collagen lattices seeded with fibroblasts have been studied. Among the antirheumatics, diclofenac was the most active inhibitor of lattice retraction, then tropesin and to a lesser extent indomethacin. Ibuprofen which is known as a very slight inhibitor of protein synthesis was able to significantly enhance lattice retraction when 10 micrograms/ml (48.5 microM) and 50 micrograms/ml (242 microM) were used.     

Misdiagnosis of hysteria

The diagnosis of hysteria is often incorrect and must be made with great caution. A retrospective study demonstrates that an erroneous diagnosis of hysteria is most likely to be given to females, the psychiatrically ill, patients who embellish and patients who present plausible psychogenic explanations for their illness. Movement disorders and paralysis are the neurologic disorders most frequently mislabeled as hysteria.     

Scar sign of renal oncocytoma: Magnetic resonance imaging appearance and lack of specificity

This case report illustrates the magnetic resonance imaging (MRI) appearance of a typically asymptomatic renal oncocytoma as a homogeneous mass of medium signal with a stellate central region of decreased signal, representing the central scar. The MRI was correlated with computed tomography (CT), ultrasound (US), and gross pathologic appearance. The appearance of a central scar is not specific for oncocytoma and does not exclude renal cell carcinoma, as illustrated by a second case.     

Cryptococcal meningoencephalitis. Case report and review of Italian literature

A case of cryptococcal meningoencephalitis, as presented by a hypertensive hydrocephalus, is described. To our knowledge, this is the 24th case described in Italy since 1953. The diagnosis was made with ventricular fluid examination: the patient was successfully treated with amphotericin B and 5-fluorocytosine, thus avoiding the risks of surgical treatment of hydrocephalus. Early diagnosis and proper therapy are necessary in order to decrease the high lethality of cryptococcosis.     

A case of giant hydronephrosis caused by renal fibrosarcoma

The presented report is fibrosarcoma arising from renal capsule in a 64-year-old woman. The tumor is very rare and is the 25th case in Japan. The patient visited our hospital with the complaint of macroscopic hematuria for several days. Abdominal examination revealed a painless lump from the left lumbar region to para-median abdomen. A diagnosis of hydronephrosis caused by neoplasma or tuberculosis was considered by CT, AG, etc., and transperitoneal nephrectomy was performed on 6-July-1984. Pathology of the tumor was fibrosarcoma arising from the renal capsule. Three months later, the tumor was growing on the peritoneal surface from the left renal region and she died on Nov. 10, 1984.     

Priapism: a refined approach to diagnosis and treatment

The recent introduction of intracorporeal injections of papaverine and phentolamine for the diagnosis and treatment of impotence has resulted in an increased incidence of iatrogenic priapism. Based on our research into penile hemodynamics we propose a refined approach to all types of priapism. Intracorporeal blood gas and pressure monitoring should be used to differentiate ischemic (low flow) from nonischemic (high flow) types. Most cases of papaverine-induced or phentolamine-induced priapism will respond to aspiration alone or in combination with intracorporeal instillation of a diluted alpha-adrenergic agent. In spontaneous priapism alpha-adrenergic agents can be tried first if patients have only mild or no ischemia. In patients with severe ischemia stagnant blood should be evacuated and a shunt procedure should be performed to allow metabolic replenishment of tissue. Intracorporeal pressure monitoring will help to determine the size and number of shunts needed to re-establish corporeal circulation.     

Surgery of Dupuytren's disease: a review of the open palm method

Experience with 49 cases of Dupuytren's disease treated by the open palm method and followed for an average of 5 years is reported. This method permits excision of the involved fascia while minimizing early postoperative morbidity associated with the surgical management of this condition. There were no cases of wound necrosis, hematoma, or infection with this technique, and all wounds closed spontaneously within 3 to 5 weeks. Long-term follow-up, however, revealed a significant rate of recurrence (32%) and extension (48%), as well as flexion loss at one or more joints in 41% of involved hands. While helpful in the early care of these patients, the open palm method does not modify the long-term results in Dupuytren's disease, which is a pervasive condition without simple surgical solution.