Anatomical considerations of selective pudendal neurectomy

The pudendal nerve was examined in 100 cadavers of both sexes. Because of the variable number of trunks of the pudendal nerve, 5 types were distinguished: one-trunked; two-trunked, rectopudendal; two-trunked, pudendo-penile (or-clitoridal); three-trunked, recto-perineo-penile (or-clitoridal); four-trunked, recto-perineo-perineopenile (or-clitoridal). The authors' suggestions make it possible to perform selective pudendectomy, consisting in denervation of the sphincter urethrae muscle by neurectomy of the perineal branches of the pudendal nerve.     

Endoscopic papillosphincterotomy in patients with para-ampullar diverticulosis

It is suggested that the numerous variants of diverticula occurring in the region of the major duodenal papilla should be grouped into four types. Type I--the major duodenal papilla (MDP) is on the floor of the diverticulum; type II--the MDP is in the region of the lower ++semi-circumference of the diverticular orifice while the longitudinal fold runs radially on the wall of the diverticulum; type III--the MDP is in the region of the orifice of the diverticulum while the longitudinal fold does not pass on its wall; type IV--two diverticula located above the MDP to both sides of the longitudinal fold. Endoscopic papillosphincterotomy is considered contraindicated in patients with type I diverticulum. When indicated, the intervention was carried out in patients with types III and IV diverticula. Endoscopic papillosphincterotomy can be conducted in patients with type II diverticulum measuring more than 2 cm.     

Intraportal allogeneic transplantation of the islets of Langerhans cultures in the complex treatment of surgical patients with diabetes mellitus

The article presents results of treatment of 21 patients with a surgical pathology and diabetes mellitus who had intraportal allotransplantation of cultures of islet cells of the pancreas and 316 patients with the similar surgical pathology without such transplantation. It was found that the intraportal introduction of islet cell cultures into the liver can result in an early and considerable drop of the injected insulin dose which is very important in the postoperative period. This method allowed to make the period of treatment at the hospital approximately 15 days shorter.     

Subtypes of the Gc gene (vitamin D binding protein) in the Polish population

Gc subtypes were analyzed by isoelectric focusing on thin-layer polyacrylamide gel. In the sample of the Polish population including 278 persons, six Gc phenotypes were encountered: 1S, 1F-1S, 1F, 2-1S, 2-1F, 2 with the following frequencies: 0.342, 0.151, 0.014, 0.360, 0.072 and 0.061. Frequency of Gc1S was 0.597, Gc1F - 0.126 and Gc2 - 0.277. It was shown that a group system of the Gc protein in the Polish population was in good agreement with Hardy Weinberg equilibrium.     

Risk factors of avascular necrosis in the treatment of congenital dislocation of the hip

We examined the causes of iatrogenic avascular necrosis of the femoral head in 254 hips with congenital dislocation (CDH) treated conservatively. The influence of the age of the child, the height of the displacement of the femoral head, the extent of acetabular dysplasia, and the method of treatment on the frequency and degree of necrosis were estimated. The investigation showed that children are at the highest risk of iatrogenic necrosis in the following cases: (a) age less than 6 months, (b) severe acetabular dysplasia, (c) use of an abduction apparatus such as the Frejka pillow for outpatients, and (d) "frog-leg" position after reduction.     

Angiomyolipoma of the kidneys

59 angiomyolipomas were studied: immunohistochemistry (IHC) was used in 24 cases, electron microscopy (EM) in 6 cases. 57 tumors had a typical structure, 2 did not contain fat component. Premelanosomes were found by EM in one tumor. Smooth muscle actin was found in all tumor cells. Involvement of lymph nodes was observed in 2 patients. Histogenesis of this tumor is discussed.