Neonatal Volkmann's compartment syndrome. A report of two cases

Neonatal Volkmann's compartment syndrome is a rare entity. This diagnosis may be suspected when a case presents cutaneous damage associated with poor hand and wrist function after delivery. We present two such cases of neonatal Volkmann compartment syndrome with long term clinical and x-ray follow-up. In our patients, a hand surgeon was not consulted in the perinatal period and early fasciotomy was not performed. No particular aetiology or associated cerebrovascular accident was found. A series of operations was necessary in order to improve function of the hand. Neonatal Volkmann compartment syndrome must be recognised early in order to enable further investigation of any underlying condition and to perform early surgical decompression. Long term clinical and x-ray follow-up is necessary to prevent and treat wrist deformation and finger contractures.     

Eccrine duct carcinoma of the eyelid mimicking meibomian carcinoma: clinicopathological study of a case

Eccrine duct carcinoma belongs to a group of malignant sweat gland tumors showing de novo eccrine differentiation, but without features of benign adnexal counterparts. They are therefore likely to be confused with visceral adenocarcinomas that have metastasized to the lid. These tumors require important diagnostic considerations when adenocarcinoma is encountered in the lid in the absence of a known primary tumor. We present the case of a 60-year-old man with a nodule in the right upper eyelid that was histopathologically diagnosed as eccrine duct carcinoma of the lid. The differential diagnosis of eccrine carcinomas based on light microscopy, enzyme histochemistry, and immunohistochemistry is discussed, and a list of the various malignant eccrine tumors reported in the lid is presented.     

HLA class II antigen expression in conjunctival precancerous lesions and squamous cell carcinomas

PURPOSE: The expression of human leukocyte antigen (HLA) class II molecules on the cell surface is necessary for the presentation of peptide antigens to helper CD4 T lymphocytes of the immune system. We studied the immunoexpression of HLA class II antigen in conjunctival precursor lesions and conjunctival squamous cell carcinomas. METHODS: HLA class II antigen expression was analyzed in 8 conjunctival dysplasias, 6 carcinomas in situ and in 7 conjunctival squamous cell carcinomas, by immunoperoxidase staining with monoclonal antibody to HLA class II antigen on the archival clinical samples. Immunoanalysis was done by a semi quantitative method based on the intensity of staining and the percentage of stained cells. RESULTS: HLA class II antigen immunoexpression was heterogeneous in 8 conjunctival dysplasias and in 6 carcinoma in situ and negative in 7 conjunctival squamous cell carcinomas. CONCLUSIONS: Human leukocyte class II antigen immunoexpression is decreased in conjunctival precancerous and squamous cell carcinomas.     

Myxoma of the orbit

Myxomas are rare, benign neoplasms of mesenchymal origin that usually develop in soft tissues. As the clinical manifestations are non-specific, it is difficult to diagnose the tumour without biopsy and histopathological examination. We report a case of orbital myxoma with histopathological correlation.     

Enhancement of circulatory antioxidants by alpha-ketoglutarate during sodium valproate treatment in Wistar rats

The effects of alpha-ketoglutarate (alpha-KG) on sodium valproate-induced hyperammonemia and hepatotoxicity were studied in biochemical experiments in rats. The levels of ammonia, urea, serum transaminases, hydroperoxides and thiobarbituric acid reactive substances were significantly increased in sodium valproate-treated rats. These levels were significantly decreased in alpha-KG- and sodium valproate-treated rats. Further, non-enzymatic (vitamins C and E) and enzymatic (superoxide dismutase and catalase) antioxidants were significantly decreased in sodium valproate-treated rats and were increased in alpha-KG- and sodium valproate-treated rats. These biochemical alterations during alpha-KG treatment could be due to (i) its ability to act as an ubiquitous collector of amino groups in body tissues, (ii) the participation of alpha-KG in the non-enzymatic oxidative decarboxylation in the hydrogen peroxide decomposition process and (iii) enhancing the proper metabolism of fats which could suppress oxygen radical generation and, thus, prevent the lipid peroxidative damages in rats.     

Does the type of suture material used for ligation of the vas deferens affect vasectomy success?

OBJECTIVES: To determine retrospectively, the outcome of vasectomies performed by five urologists over a six year period in terms of achievement of azoospermia on post vasectomy semen analysis (PVSA) and to compare the effect of the type of suture material used for ligation of the vas deferens on the vasectomy success. METHODS: Review of PVSA results of 3005 consecutive vasectomies done in a district general hospital between November 1998 and October 2004. Patient records and vasectomy logs were reviewed and data analysed. The main outcome measure was achievement of azoospermia on PVSA. RESULTS: The age distribution of men between the two study groups was similar. Overall compliance to provide at least two semen samples for PVSA was 73.8% and was similar between the two groups. Failure to achieve azoospermia on PVSA was seen in 3.5% men (36/1038) in the chromic catgut group and 10.1% men (110/1088) in the Vicryl group (p < 0.0001). Also, the vasectomy failure rates for individual urologists increased significantly following introduction of Vicryl. CONCLUSIONS: In our study we noticed a three fold increase in failure to achieve azoospermia on PVSA with Vicryl as compared to chromic catgut. This study demonstrates that the type of suture material used for ligation of the vas deferens does affect the vasectomy success.     

Epstein-Barr Virus-associated Smooth Muscle Tumor of the Basal Ganglia in an HIV+ Child: Case Report and Review of the Literature

We describe the clinicopathologic features of an Epstein-Barr virus (EBV)-associated smooth muscle tumor arising in the basal ganglia of a 10-year-old human immunodeficiency virus (HIV)-positive child. Only a few cases of intracranial smooth muscle tumors are reported in the literature and virtually all of these have been extra-axial, involving the dura or sinuses in HIV+ adults. Our case underscores the need to include an EBV-associated smooth muscle tumor in the differential diagnosis when evaluating intracranial mass lesions in immunodeficient children.Corresponding author, e-mail: