Treatment of relapsing-remitting multiple sclerosis with interferon beta type 1-b

Interferon-beta-1b was the first drug found to slow the progression of relapsing-remitting multiple sclerosis, with a reported decrease in the relapse rate of up to 34%. The present study involved 35 patients treated with interferon-beta-1b for one year. The aims of the study were: a) to compare the changes in the relapse rate and the number of days of hospitalization with other data, b) to compare the steroid needs required to treat relapses for one year before and in the year of interferon-beta-1b treatment. Our data indicated that the relapse rate may decrease as much as 77% following the introduction of interferon-beta-1b treatment. The adverse effects and the changes in the EDSS grades were similar to the published data. The duration of hospitalization decreased by 84% and the amount of methylprednisolone needed for remission by 78%. This data suggest that the impairment of the condition of the patients may be delayed considerably, while some of them can continue to work for a longer period, the standard of life of these patients therefore being more tolerable.     

Primary posterior chest wall echinococcosis

Hydatid cyst is not mentioned among the chest wall tumours in areas not known to harbour echinococcosis. One of the uncommon sites for echinococcosis even in endemic countries is the chest wall. The striking resemblance between neoplasm and hydatid cysts forms a diagnostic dilemma and makes the correct diagnosis essential before surgery.     

Subtotal duodenal necrosis as a surgical complication (A case successfully treated with multiple-stage surgery)

A 53 year-old woman was admitted to our Department with serious sepsis, biliary-, fecal peritonitis, and subtotal duodenal necrosis following 5 previous operations. The first surgical intervention ceased the insufficiency of the small intestine anastomosis, and the marsupialization of Vater's papilla was achieved. After the sepsis and peritonitis ceased the authors performed a successful reconstruction. For two and a half years the patient has been free from complaints.     

Esophago-pericardial fistula caused by recurrent esophageal tumor

The esophago-pericardial fistula is a rare disease that causes a rather high mortality. Up to now less than 70 cases were published in the literature. The authors report an esophago-pericardial fistula caused by recurrent esophageal tumor one year after resection in the lower third esophagus for esophageal cancer. With conservative treatment the patient was kept alive for a month. No case report can be found in the literature of an esophago-pericardial fistula of the same etiology.     

Liesegang's rings resembling helminthiasis

So called Liesegang's rings are lamellar corpuscles which develop after periodical precipitation of oversaturated solutions in gel medium. They can occur in cysts, closed cavities, inflammatory exudates and necroses. They resemble parasitic eggs, larvae or adult forms. A case of 28-year-old woman is presented with many Liesegang's rings in a stuff from dilated renal calyx. Their preliminary evaluation considered helminths, especially Dioctophyma renale.     

Interim report in humans of a previously described technique in an animal model: closure of bladder exstrophy with rectus abdominis muscle flap

The aim of this study was to present the results of a new bladder closure and augmentation technique in children born with bladder exstrophy where primary surgical closure was impossible. The technique was performed in four children with small, noncompliant, inelastic bladders in which secondary changes such as squamous epithelial metaplasia and polypoid transformation had developed. During the opration, a full-thickness rectus abdominis muscle island flap with an intact neurovascular pedicle was prepared from the left abdominal quadrant and rotated to cover the bladder defect and aid in augmentation. The inner layer formed by peritoneum was sutured to the edges of the bladder defect. Postoperative endoscopic and histopathologic investigations revealed the inner, peritoneal layer of the flap to be completely covered by transitional urinary bladder epithelium. Considering the advantages of the technique from this limited experience, the evidence suggests that there is no need for a major gastrointestinal operation for bladder augmentation. A reasonable bladder capacity was available, there was no mucus production from the inner layer of the flap, and metabolic and electrolyte disturbances were reduced.     

Dead-time correction in dynamic radionuclide studies by computer

Several methods for the measurement of dead time and for evaluation of the dependencies required to correct dynamic studies for dead-time losses are described. Two program variants were written to produce time-activity curves in the selected areas of interest of the dynamic studies with computer's correction of dead-time losses; these variants are part of the system of programs for complex processing of scintigraphic studies set up for a Clincom instrument. The first variant performs correction on the basis of the registered count rate in the whole image, while the second variant makes use of the additional reference source positioned on the periphery of the camera visual field.     

Phacoemulsification. The method of choice in cataract surgery]

Complications and problems in the first 300 patients operated on by phacoemulsification technique are described. In the first 100 cases the procedure began with the creation of the corneoscleral incision and the anterior capsule was opened in a "can opener" fashion. In the second group of 200 patients we preferred the scleral incision, and the anterior capsule was opened mainly by capsulorhexis. The phacoemulsification was predominantly performed in the capsular bag or in the iris plane. The wound was closed with interrupted sutures. The most common and the most serious complication as well in the first 100 cases was posterior capsule rupture (11%). Then the percentage of this most common complication was diminished significantly with increasing experience of the surgeon (2.5% in 200 cases). The same problems which the authors had in their first operations appeared again, though in a smaller amount as soon as they started to work with phacoemulsification as a method of choice of cataract surgery.