Inflammatory cloacogenic polyp of anus: report of three cases

The term of "cloacogenic anal carcinoma", "cloacogenic zone" and "cloacal membrane" have been widely used, but the term of "inflammatory cloacogenic polyp" (ICP) was first applied and published by Lobert PF and Henry DA in 1981. Here we present three cases of ICP to stress its inflammatory property, predilection to invade cloacogenic zone of anus and polypoid shape, and to differentiate it from its related lesions as concise as possible.     

Comparison of dynamic compression plating and reamed intramedullary nailing in the treatment of aseptic tibial shaft nonunions

Among 105 tibial shaft aseptic nonunions followed for a mean of 32 months, 30 were treated with dynamic compression plating and 75 were treated with either Küntscher or Grosse-Kempf interlocking intramedullary nailing. With the plating technique, the union rate was 90.0% (27/30), the period of time to union was 5.2 +/- 1.7 months, the complication rate was 16.7% (5/30), the infection rate was 13.3% (4/30), and the surgical time was 110 +/- 30 minutes. With the intramedullary nailing technique, the union rate was 93.3% (70/75), the period of time to union was 5.0 +/- 1.6 months, the complication rate was 17.3% (13/75), the infection rate was 13.3% (10/75), and the surgical time was 70 +/- 30 minutes. Thus, while the union rate was high with both techniques, the complication rate also was high, especially deep infection. However, the technique for nailing was simpler and required less surgical time than plating (p less than 0.001). With open reamed intramedullary nailing, a higher infection rate was noted in the cases initially treated with an external fixator than for cases in which other forms of treatment initially were used (p less than 0.05).     

Detection of methyl ethyl ketone in urine using headspace solid phase microextraction and gas chromatography

Headspace solid-phase microextraction coupled with gas chromatography/flame ionization detection was developed to measure urinary methyl ethyl ketone (MEK). A fused silica fiber coated with 75 microns carboxen/polydimethylsiloxane was used to extract urinary MEK. The optimal extraction conditions were obtained when temperature was 50 degrees C, extraction time was 15 minutes, and ammonium sulfate concentration was 0.5 g/mL. The optimal desorption temperature and time were 200 degrees C and 5 minutes, respectively. The concentration range of calibration curves was 27 to 8000 ng/mL of MEK. The within-day and between-day pooled coefficients of variation (9 concentrations, triplicate samples) were 5.4% and 8.8%, respectively. The limit of detection and limit of quantitation were 4.2 ng/mL and 21.6 ng/mL, respectively. The recovery (+/- standard deviation) of MEK was 100.2% +/- 8.6% (n = 3). MEK in urine was stable for at least 1 month when stored at -20 degrees C. This method proved to be applicable for the analysis of urinary MEK of exposed workers in a plastic material printing plant. We concluded that this new method is sensitive, inexpensive, simple, and reliable for measuring the occupational exposure of MEK.     

Testicular lymphoma with bone/bone marrow metastases illustrated by scrotal sonography, spinal MRI, and total body Tc-99m HMDP and Tc-99m MIBI imagines

An 83-year-old man with testicular lymphoma demonstrated progressive scrotal enlargement with non-homogeneity sonographically and abnormally increased uptake in the scrotum of Tc-99m HMDP and Tc-99m MIBI scintigraphically. Extensive bone/bone marrow metastases were exhibited by Tc-99m MIBI and Tc-99m HMDP scintigraphies and MRI of the spine. In addition, focal/tubular activity of the femoral bone marrow on Tc-99m MIBI imaging was consistent with skeletal scintigraphic findings. It is emphasized that Tc-99m MIBI total body imaging enabled the demonstration of testicular lymphoma as increased uptake and the illustration of skeletal/bone marrow metastases as diffuse and/or focal increased uptake, especially focal/tubular MIBI activity of the femoral marrow.     

Benefit of bilateral pallidotomy in the treatment of generalized dystonia. Case report

This 29-year-old man with cerebral palsy complicated by generalized dystonia was treated by simultaneous bilateral posteroventral pallidotomy. Postoperatively, there was slow, but steady, improvement in the patient's dystonia and disability. However, the improvement in abnormal movements was only prominent for cervical dystonia and oromandibular dyskinesia. The patient's Burke-Fahn-Marsden dystonia scores were 51 preoperatively and 37, 33.5 and 33.5, at 3, 6, and 12 months postoperatively, respectively, demonstrating a maximum improvement of 34%. These results suggest that pallidotomy can be an alternative therapy for those patients suffering from intractable generalized dystonia.     

Diaschisis in chronic viral encephalitis with Koshevnikov syndrome.

The authors report a 61-year-old man with chronic viral encephalitis and Koshevnikov syndrome occurring 42 months after initial symptom of right hemiparesis. Serial computed tomography of the brain showed changes in the attenuation of the left temporal lobe lesion over time. Magnetic resonance images of the brain showed enlargement of left temporoparietooccipital lobes with cortical gyral enhancement on T1-weighted images following intravenous administration of gadolinium-DTPA. 99mTc-HMPAO single-photon emission computerized tomography showed increased radioactivity and hyperperfusion in the left temporoparietal region with paradoxically decreased local tissue perfusion at the contralateral right hemisphere. Follow-up magnetic resonance images of the brain 4 years later showed atrophy of bilateral cerebral hemispheres. We postulate that a "transcallosal diaschisis" with subsequent degeneration is a possible mechanism. A brain biopsy from the left temporal lobe lesion showed pictures compatible with viral encephalitis probably herpes simplex encephalitis.