Case Report: Splenic Peliosis (A Rare Complication Following Liver Transplantation)

In this article, we report a rare case of isolated splenic peliosis in an individual who had recently undergone liver transplantation. The disorder had remained clinically and radiologically undiagnosed until he suffered a traumatic rupture of the affected organ. The relevant literature on this topic is briefly reviewed.     

Illicit drug use and liver transplantation: is there a problem and what is the solution?

Liver transplantation is indicated in carefully selected patients with alcohol‐induced liver disease. There has been less debate to date on the issues surrounding assessment of patients with an illicit drug history and outcome post‐transplantation. UK guidelines on assessment and selection have been agreed. Careful assessment and access to treatment should be considered.     

Factors influencing the fate of T cells responding to Mls antigens.

Although T cell tolerance to self antigens is primarily a reflection of clonal deletion in the thymus, recent evidence suggests that mature T cells are subject to negative regulation in the post-thymic environment: Extrathymic tolerance is the result of clonal anergy in some studies and T cell deletion in others. The factors controlling the induction of anergy versus deletion of mature T cells are still poorly understood. This article summarizes evidence that exposure of T cells to Mls superantigens in vivo leads to a sequence of T cell proliferation, anergy and deletion; anergy appears to reflect persistence of antigen. The biochemical consequences of exposing T cells to superantigens in vitro are discussed.     

Nasal bone length throughout gestation: normal ranges based on 3537 fetal ultrasound measurements.

OBJECTIVE: To establish normal ranges for nasal bone length measurements throughout gestation and to compare measurements in two subsets of patients of different race (African-American vs. Caucasian) to determine whether a different normal range should be used in these populations. METHOD: Normal nasal bone length reference ranges were generated using prenatal measurements by a standardized technique in 3537 fetuses. RESULTS: The nasal bone lengths were found to correlate positively with advancing gestation (R(2) = 0.77, second-order polynomial). No statistical difference was found between African-American and Caucasian subjects. CONCLUSION: These reference ranges may prove to be useful in prenatal screening and diagnosis of syndromes known to be associated with nasal hypoplasia. Different normal ranges for African-American and Caucasian women are not required.     

Colloid cyst of the third ventricle

Summary The authors have added 54 new cases to the 200 published in the literature. The clinical manifestations of colloid cysts of the third ventricle are thoroughly analyzed, as are also diagnostic procedures, including EEG and EKG. Photographs of gross specimens illustrate the text.

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Zusammenfassung Die Autoren fügen den 200 in der Literatur bereits beschriebenen Colloidcysten des III. Ventrikels 54 weitere Fälle hinzu.Die klinischen Erscheinungen werden, auch mit diagnostischen Hilfsmitteln, einschließlich EEG und EKG genau analysiert. Photographien der makroskopischen Präparate illustrieren den Text.

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Résumé Les auteurs ajoutent 54 nouveaux cas de kystes colloïdaux du 3e ventricule aux 200 cas déjà publiés dans la littérature.Les manifestations cliniques sont analysées exactement à l'aide des diagnostiques cliniques y compris l'EEG et l'EKG. Des photogrammes des préparations macroscopiques illustrent le texte.

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This article is dedicated to the memory of ProfessorAlbert Kuntz.     

Extracorporeal shockwave lithotripsy, endourology and open surgery: the management and follow-up of 200 patients with urinary calculi

The management and follow up of 200 consecutive patients with renal and ureteric calculi are presented. The primary treatment of 185 (92.5%) was by extracorporeal shockwave lithotripsy (ESWL), of whom three (1.6)%) with large calculi underwent percutaneous nephrolithotripsy (PCNL) prior to ESWL as a planned combined procedure. Twelve (6%) were treated by PCNL or ureterorenoscopy (URS) as their definitive treatment and three (1.5%) by conventional open renal and ureteric surgery. The average in-patient stay was 3.8 days and most returned to normal activity within one day of discharge. Of the 185 patients 102 (55%) required no analgesia after treatment by ESWL, 29 (15.6%) required parenteral analgesia and the rest were comfortable with oral non-narcotic medication. Thirty (16%) required auxillary treatment by percutaneous nephrostomy (PCN), PCNL and URS following ESWL for obstructive complications from stone particles. Two required further ESWL and one PCNL at three months for large fragments. Overall, open surgery was required for only 1% of renal calculi and 13% of ureteric stones. These results are consistant with the extensive West German experience confirming that most urinary calculi are now best managed by ESWL and endoscopic techniques. Where these facilities are available open surgery should only be necessary for less than 5% of upper urinary tract stones.     

Human tolerance to 100% oxygen at 9.5 psia during five daily simulated 8-hour EVA exposures

Extravehicular activity (EVA) currently involves decompression to 4.3 psia. This degree of decompression carries a significant potential for decompression sickness (DCS) which could be alleviated if a pressure of 9.5 psia could be maintained in the pressure suit. Previous studies have not evaluated the potential for oxygen toxicity at 9.5 psia. Twenty-one subjects were exposed to 100% oxygen at 9.5 psia for 5 consecutive days, 8 h.d-1 while performing moderate exercise to simulate a typical work-week in the proposed pressure suit environment. No DCS or venous gas bubbles were detected. Pulmonary function tests, physical exams, blood analyses, arterial oxygen saturation monitoring, and X-rays showed no evidence of oxygen toxicity under these conditions. These results suggest that a 100% oxygen, 9.5 psia pressure suit environment could avoid both DCS and oxygen toxicity during EVAs of comparable duration and physical activity.