Ein Fall Von Albers-Sch$Ounberg'Scher Krankheit (Osteopetrosis) Mit Besonderer R$Uucksicht Auf Die Mundverh$Aultnisse

Following an experimental oro-paranasal communication, the mucous membrane revealed extensive cellular reactions in the different cell layers of the nasolacrimal duct. These cellular reactions as observed histologically were mainly limited to the injured area. However, increased epithelial cell proliferation extended to other areas of the mucosal membrane as revealed by the autoradiographic observations. Fibrosis of the submucosa was a pronounced phenomenon.

The stratified columnar epithelium in an area restricted to the traumatic communication revealed pronounced metaplasia into a non keratinized squamous epithelium.

Due to the limited experimental period (6 hours–14 days) no conclusions were drawn as to the problem if the cellular reactions are reversible or not.     

高渗葡萄糖联合胰岛素局部换药治疗咽瘘的临床研究

目的观察高渗葡萄糖联合胰岛素局部换药治疗咽瘘的临床效果，探讨咽瘘的治疗经验。方法回顾性分析12例全喉切除术后并发咽瘘者应用高渗葡萄糖联合胰岛素治疗的临床资料。12例均于常规清创处理后，以50％葡萄糖注射液10～20ml加精蛋白锌胰岛素10～20U的混合液擦洗伤口2或3次，再使用混合液纱条填寒瘘腔，外覆无菌干纱布，最后对咽瘘周围组织适度加压包扎，并观察创面愈合情况和时间。结果12例创面全部达到痊愈标准，平均痊愈时间19．6d；观察6个月，无一例出现吞咽困难。结论高渗葡萄糖联合胰岛素可通过控制创面感染、清除坏死组织、促进肉芽组织和上皮细胞生长等促进全喉切除术后咽瘘创面愈合，方法简单，值得推广应用。     

Amylase level after pancreaticoduodenectomy in predicting postoperative pancreatic fistula

BackgroundIt is new clinical interest higher serum amylase level with pancreatitis after pancreaticoduodenectomy (PD) correlates with postoperative pancreatic fistula (POPF). Nevertheless, its evidence and study were scarce. We aimed to investigate correlation of serum amylase level immediate after PD and POPF occurrence.MethodsOf 163 patients who underwent PD at between January 2009 and December 2019, retrospective analysis was conducted to identify risk factors including serum amylase level immediate after PD for POPF occurrence.ResultsOverall incidence of POPF (25/163) was 15.3%. The patients occurred a POPF had significantly higher level of serum amylase on POD0 compared to in whom without a POPF (414 vs 253, p < 0.001). In univariate analysis, ASA classification, post pancreatectomy acute pancreatitis (POAP, serum amylase on POD0 >285IU/L) and Fistula Risk Grade were correlated with POPF occurrence. In multivariable analysis, Fistula risk grade and POAP were significantly associated with developing POPF.ConclusionIn patients with higher serum amylase (>285IU/L) on POD0 with higher fistula risk grade, comprehensive management to achieve mitigation of POPF is important.     

A dermoid cyst fistulating with the transverse colon

We present a rare case of fistulation of a dermoid cyst with the transverse colon. We illustrate how an infected dermoid cyst can be diagnosed as an appendix abscess although the management of these is quite different. The general surgeon should be aware of this as a differential diagnosis for an appendix abscess.     

Correction of hypospadias with a vertical preputial island flap: the Göteborg experience of 47 patients

We report the follow-up of 47 patients with penile hypospadias who were treated by the Scuderi procedure between 1988 and 1998 at Sahlgrenska University Hospital, Göteborg, Sweden. Forty of the patients (85%) had had no previous operations, while the remaining seven had had meatotomy with chordectomy only, or an unsuccessful Dennis-Browne procedure. Hypospadias was distal in 35 (74%), mediopenile in 8 (17%), and proximal in 4 (9%); 21 (45%) showed signs of curvature. After a Scuderi urethroplasty one patient developed a fistula (2%) and 4 developed mild stenosis. The early success rate was therefore 42/47 (89%) and this later increased to 46/47 (98%) after non-surgical treatment of the stenoses. The results support the use of the Scuderi procedure for correction of primary and secondary penile hypospadias with a low complication rate.