Sexual dimorphism in shape and size of the neurocranium

International Journal of Legal Medicine - Sex identification is a primary step in forensic analysis of skeletal remains. The accuracy of sex estimation methods greatly depends on the sexual...     

Office-based surgery and anesthesia: Where are we now?

At the time of publication of this journal, the Center for Urinary Control in Memphis, Tennessee, has performed eight office-based surgical procedures using anesthesia. Patients were aged between 56 and 80 years, and all were ASA I–III class. The procedures involved either cystoscopy with collagen injection into the bladder neck or cystoscopy with indigo laser treatment of the prostate. All patients were prepared by the anesthesiologist prior to the day of surgery, and appropriate laboratory tests were ordered and evaluated. All patients did very well, the surgical field was quiet, and each procedure went very smoothly. Each patient tolerated anesthesia without any adverse effect, was recovered in an adjacent examination room, and was extremely satisfied upon discharge from the office. Anesthesia was induced with Propofol (Diprivan) and sublimaze, maintained with a Propofol infusion and oxygen. The surgeon performed a periprostatic block on the patient having the Indigo laser treatment.     

Histaminergic and dopaminergic traits in the human carotid body

Carotid body (CB) chemoreceptors are the main sensors detecting systemic hypoxia. Studies in animals revealed that dopamine and histamine may serve as transmitters between the chemoreceptor cells and the afferent nerve. To gain insight whether histamine and dopamine could play a role in the human CB and thus be important for the understanding of breathing disorders, we have investigated the chemosensory traits in human CBs from nine subjects of different ages obtained at autopsy. Immunohistochemistry revealed expression of histidine decarboxylase, vesicular monoamine transporter 2, histamine receptors 1 and 3 in virtually all chemosensory cells within the glomeruli of different ages. By contrast, catecholaminergic traits (tyrosine hydroxylase and vesicular monoamine transporter 1) were only detected in a subset of CB chemosensory cells at each age group while dopamine D2 receptors were expressed in the great majority of them. Our data suggest that histamine along with catecholamines may serve as transmitters between chemoreceptor cells and the afferent nerve in humans as well.     

Combined treatment of large head and neck capillaro-venous malformation by a fibrosing agent

We report our experience of seven cases suffering from capillaro-venous malformation localized in the head and neck area, treated preoperatively by a fibrosing agent--ETHIBLOC. Four of the cases are presented and analysed. We suggest the pre-operative injection of Ethibloc as the treatment of choice for capillaro-venous malformations in the head and neck region.     

Paediatric Behçet disease manifested as recurrent myositis: from an incomplete to a full-blown form

A 12-year-old boy presented with a limp and findings suggesting localised myositis of his right calf and a working diagnosis of Behçet disease was made. During 3 years of follow-up, he had another three episodes of calf myositis, all responsive to corticosteroids within days. Conclusion A case of recurrent localised myositis as a main manifestation of Behçet disease is reported. The evolution of incomplete Behçet disease, which is common in children, to the full blown form, with the emphasis on muscle involvement and the importance of early diagnosis of Behçet disease, is discussed.     

The metabolic and structural changes of the liver in experimental animals after administration of isoprenaline.

Application to rats and rabbits of higher doses of isoprenaline (IP) results in derangement of glycid metabolism, manifested by the decrease of free glycogen (free-GL), and in an even more significant impairment of lipid metabolism, evidenced by an earlier increase of non-esterified fatty acids (NEFA) followed by an increase of esterified fatty acids (EFA) and a concomitant development of fatty infiltration, all indicators of marked lipomobilization. Histograms obtained from hypersensitive individuals show besides fatty infiltrations also necrobiotic processes and structural changes, seen as distinctly marked liver cell membranes. It is perhaps relevant to draw attention to the fact that there are both individual and species differences in the metabolic changes ensuing on application of IP.     

Premenstrual syndrome and associated skin diseases related to hypersensitivity to female sex hormones

OBJECTIVE: To study skin diseases and hypersensitivity to female sex hormones in patients with the premenstrual syndrome (PMS). STUDY DESIGN: Thirty women answered a questionnaire related to PMS and underwent gynecologic, dermatologic and laboratory examinations. Intradermal testing was performed with estradiol valerate, progesterone and placebo. Desensitization treatment was instituted in 15 patients. RESULTS: Ten patients were diagnosed with PMS and concomitant skin disease, including pruritus vulvae, hyperpigmentation, papular eruption and acne vulgaris (group A). Ten patients diagnosed with PMS but without skin disease served as the first control group (group B). The second control group consisted of 10 healthy women (group C). Immediate and delayed hypersensitivity reactions to sex hormones were observed in all patients with PMS and PMS-related skin diseases (groups A and B) but not in healthy women (group C). Desensitization produced a decrease in PMS symptoms and improvement in the skin disease related to PMS. CONCLUSION: Skin diseases may be a part of PMS. Demonstration of a delayed allergic reaction tofemale sex hormones may uncover a significant pathogenetic mechanism in patients with recurrent skin disease and PMS.     

Testicular torsion can also be present in adult men

Five adult men, aged 34, 33, 31, 56 and 52 years respectively, were admitted with acute scrotal pain. Testicular torsion was eventually diagnosed in all the patients. Two of the patients were initially treated with antibiotics due to a suspected epididymitis. One of them required orchidectomy due to necrosis. The remaining patients underwent orchidofixation and their testicles could be preserved. The most important different diagnosis for acute pain and swelling of the testicle is either acute epididymitis or testicular torsion. The latter is uncommon in adult men. Using a physical examination to distinguish epididymitis from testicular torsion can be difficult. Doppler ultrasound is a reliable diagnostic tool for confirming testicular ischaemia. If the intratesticular flow is diminished or absent, then testicular torsion should be considered and this should be followed by immediate surgical exploration.