Massive Cystic Hepatomegaly in a Female Patient with Polycystic Kidney Disease Treated by Combined Hepatic and Renal Transplantation

A patient with cystic kidney disease of adult onset and severecystic hepatomegaly is presented. The patient was severely disabledsolely by her abdominal bulk. Simultaneous liver and renal transplantationwas undertaken successfully.     

Stem curvature and load angle influence the initial relative bone-implant motion of cementless femoral stems

A 6 df measurement system was used to investigate the initial relative bone-implant motion of two types of cementless total hip replacement femoral components—a straight stem and a curved stem. Five pairs of fresh frozen femurs from human cadavers were tested with loads applied to the femoral head at angles characteristic of level walking, stair-climbing, and rising from a chair. The most important findings were that (a) the resultant proximal translations were twice as high with the straight stem as with the curved stem at load angles encountered in stair-climbing and rising from a chair, (b) both stem types had more motion at load angles encountered in stair-climbing and rising from a chair than in level walking, with the increases ranging from 3 to 14-fold, (c) there was as much as 66-fold more motion distally than proximally, and (d) the amount of interface motion varied by 5-fold between the medial and lateral surfaces of the distal part of the implant because of the combined effects of translation and rotation. The amount of initial bone-implant motion of the femoral component was found to be particularly sensitive to off-axis loading; this suggests that stair-climbing and rising from a chair should be avoided in the early postoperative period when a cementless porous-coated femoral stem has been used.     

Thymic cysts in mediastinal Hodgkin disease

Three cases of proved thymic cysts associated with mediastinal Hodgkin disease are presented. Two illustrate regression of lymphoma with chemotherapy but persistence of thymic cysts. The third case demonstrates a thymic cyst in untreated Hodgkin disease. These cases suggest that such cysts are probably neither coincidental with nor a consequence of therapy but are probably related to initial thymic involvement by Hodgkin disease.     

Sonolucencies in fetal and infant abdomen: implications for management

The increased use of prenatal and antenatal ultrasonography will detect predictably abnormalities of fetal and infant anatomy not assessed or suspected previously. Three cases are presented illustrating similar ultrasonographic findings with different diagnoses and prognoses, and comparisons are made with other cases reported in the literature. Caution should be used in interpreting sonolucencies in fetal and infant abdomen to be diagnostic of a particular defect since further studies are required to define properly the specific abnormality so that proper treatment can be instituted.     

The transcutaneous measurement of the elastic properties of the human saphenous vein femoropopliteal bypass graft.

The pressure-strain elastic modulus and compliance of 20 reversed saphenous femoropopliteal vein grafts have been measured by a noninvasive, ultrasonic method. The grafts had been in place for an average of 33.6 months, 11 days to 128 months. In this study no correlation was demonstrated between wall stiffness and duration of implantation. It is concluded that the elastic properties of vein grafts may remain stable for considerable periods of time.