Polyarteritis nodosa confined to calf muscles

Two patients who developed pain and tenderness in their calf muscles, without other organ system involvement, are described. A gastrocnemius biopsy disclosed necrotizing muscular arteritis. Five other reported cases are reviewed and we conclude that there is a limited form of polyarteritis nodosa localized to calf muscles, with a differentiated and more benign clinical course, a differential diagnosis restricted to local pathological processes and prompt response to treatment with corticosteroids alone.

Immune response to hepatitis B vaccine in parenteral drug abusers

Responsiveness was assessed to a programme of vaccination of hepatitis B vaccine in a cohort of 197 intravenous drug addicts (mean age, 23.7 years) and their antibody response was compared with that of 271 healthy controls (mean age, 24.2 years). All participants were seronegative for hepatitis B surface antigen (HBsAg) and antibody to HBsAg (anti-HBs). The vaccination schedule consisted of three intramuscular injections (deltoid area) at months 0, 1 and 2. Although 70% of parenteral drug abusers received the three doses of vaccination, only 43.6% were evaluable for immune response. Fifty-eight per cent of heroin addicts and 80% of controls had evidence of anti-HBs seroconversion at 1 month after vaccination (chi 2 = 15.52, p less than 0.001). Geometric mean antibody titres were also significantly higher in controls (69.1 IU l-1; confidence interval 95%, 56.83 and 84.04) than in parenteral drug abusers (18.2 IU l-1; confidence interval 95%, 12.85 and 25.73) (F = 20.951, p less than 0.0001). The anti-HBs response was not influenced by coexistent anti-HBc, HCV antibody or HIV antibody seropositivity.

[Prolonged erections after diagnostic injection of papaverine chlorhydrate]

We analyzed the incidence of prolonged erection (PE) in 495 impotent subjects following intracavernous papaverine chlorhydrate injection to evaluate sexual dysfunction. Patient course was individually assessed. The overall the incidence of PE was 5.05%. The etiology of sexual dysfunction was psychogenic in all cases. No evidence of dose- or age-related PE was observed. Fibrosis of the corpus cavernosum, although more prevalent in PEs greater than 6 hours, was also observed in PEs of a shorter duration. This suggests that a probable predisposing factor might previously be present in some patients. None of the different methods utilized to achieve penile detumescence appears to afford any significant advantage.

Streptococcal myositis as a complication of juvenile dermatomyositis

The infection of muscle is an infrequent condition. We report on a patient with a juvenile form of dermatomyositis who developed infectious myositis caused by Streptococcus pyogenes. The inflammatory myopathy probably favoured the colonization of muscle during a bacteremia related to the skin lesions. The main forms of streptococcal myositis, which can currently be differentiated by means of imaging techniques, are discussed in addition to its treatment and prognosis.

Carcinoma of prostatic ducts

Carcinoma of prostatic ducts is a rare clinical feature. We have reviewed 398 histories of patients with histologic diagnosis of prostatic carcinoma and found 10 patients with the ductal variety (2.51%). Four had pure ductal transitional cell carcinoma, 5 had mixed acinar adenocarcinoma plus ductal transitional cell carcinoma, and the last one had mixed acinar and ductal adenocarcinoma. Age, symptoms, physical findings, and imaging diagnoses were similar to those of acinar carcinoma. Rectal examination disclosed hard prostate in 9 patients. The metastatic way depended on the histologic elements present in each patient. Cystoscopy showed a malignant-resembling image in 4 cases. The mean survival (23 months) was lower than that of patients with acinar carcinoma. Early diagnosis and radical surgery still are the only way to increase the expectation of life of patients affected by this pathology.

[Findings of computed tomography in the acute form of Marchiafava-Bignami disease]

We report a case of Marchiafava-Bignami's disease with acute evolution. Pathological examination was carried out and a cavitary lesion with discontinuous longitudinal extension was found throughout the corpus callosum. CT had shown a narrow hypodense area symmetrically localized just anterior to the frontal horns of the lateral ventricles, corresponding to the genus of the corpus callosum. The literature is reviewed, the anatomical-radiological correlations are discussed, and the possibility of the diagnosis of this condition during life is commented.

[Biliary calculi in th golden hamster (M. a. auratus). XXXV. Effect of the hydrogenation of Polifat KA-02 on its preventive activity against pigment cholelithiasis]

It has been previously reported that Polifat KA-02 (fatty acids derived from safflower oil) prevents the pigment cholelithiasis produced by vitamin A in the golden hamster. In order to establish whether the saturation or the unsaturation of Polifat is directly related with its preventive action, in the present study the effect of the hydrogenation of the derivative on this preventive action was tested. Two experiments were carried out in which the animals received the different experimental diets ad libitum during 70 days. In the 1st. experiment the effect of the additions to the lithogenic diet (Rodents Chow + 25,000 UI% of retinol acetate) of 18% of crude safflower oil, or 15% Polifat, or 15% hydrogenated Polifat (approx. 80% saturation) were assayed. In the 2nd. experiment the effect of a more hydrogenated Polifat KA-02 (greater than 99%) was tested. The results of the 1st. experiment showed that the lithogenic diet produced a high incidence (90.5%) of animals with gallstones, which was very similar (100%) to that produced by the crude safflower oil, whereas the additions of normal and hydrogenated Polifat completely prevented the formation of gallstones. The 2 forms of Polifat produced a considerable hepatomegaly. The absorption of vitamin A, measured as total hepatic vitamin A, was higher in the 3 groups that received extra lipids in their diets. The results of the 2nd. experiment fully confirmed the findings related to the hydrogenated Polifat. It is concluded that hydrogenated Polifat KA-02 prevents, as normal Polifat does it, the pigment cholelithiasis in the golden hamster produced by vitamin A.

[Vasculo-renal arterial hypertension. Apropos of 2 very representative cases]

Authors's presents two clinical cases representatives of vasculo-renal hypertension, as much by its etiology and physiopathological mechanisms, as the therapeutics solutions successfully applied.

The quality and extension of nerve fibre regeneration in the centrocentral anastomosis of the peripheral nerve

Centro central anastomosis (CCA) is the connection created by means of a nerve autograft placed between the fascicles of the proximal stump of a sectioned nerve. We have used this technique in the laboratory and in the human to avoid the formation of a terminal neuroma after amputation of a limb. The aim of the present study is to know what is the quality and how long is the progression of the regenerating nerve fibers coming from a fascicle and growing inside the nerve graft and into the other central fascicle. 56 male, adult, Sprague-Dawley rats were operated on. The 4 rats of Group I were used for control: the right sciatic nerve was exposed and dissected in its four branches. One piece of 10 mm was taken of each of the sural and the peroneal branches for hystological and histomorphometric studies. In the 16 rats of Group II, after the section of the sural and peroneal branches a terminoterminal suture between their proximal stumps was made. In the 16 rats of Group III a CCA with an interposed nerve graft of 7 mm was achieved. 5.5 and 6 rats of Groups II and III were sacrificed at 10, 40 and 365 days after the operation and the entire graft was taken for histological analysis. In the 20 rats of Group IV, 60 days after CCA, the graft was sectioned at its center to produce wallerian degeneration of nerve fibers. 10 days after this second operation the animals were sacrificed and the nerve specimens were taken for histological study.(ABSTRACT TRUNCATED AT 250 WORDS)

[Primary pulmonary lymphoma. Radiologic manifestations of well-differentiated lymphocytic lymphoma]

Two cases of primary lymphoma of lung, a rare pulmonary neoplasm, are presented. The radiologic findings are described. One patient showed an interstitial pattern on chest film. In our knowledge, this finding has not been previously reported.

Os penis in a hemodialysis patient

A case of os penis in a patient on chronic hemodialysis is described for the first time. Bilateral involvement of the corpora cavernosa was present, covered by an ossification plate.

Iron content and distribution in Japanese quail

Determination of blood haematocrit and haemoglobin, plasma iron content, total iron binding capacity and phosphoprotein (vitellogenin), and the iron content of different organs (pectoral muscle, liver, spleen, intestine, femur bone marrow, blood, gonad and eggs, and feathers) were carried out in prelaying, onset of laying and full laying females, as well as in adult males. The whole iron content was also determined on incinerated specimens giving these results: 53.7 parts per million (p.p.m.) iron in the prelaying group, 54.5 p.p.m. iron at the onset of laying, 64.3 p.p.m. iron in full laying and 53.5 p.p.m. iron in males. The plumage represented 5-8% of the total body weight, and its iron content oscillated between 152-163 p.p.m. iron in males and non-laying females and 177.3 p.p.m. iron at full laying. The laying period induced important variations in plasma levels and in organ distribution, but not in haematological values. The first eggs laid were smaller (9.2 g) and richer in iron (427 micrograms iron) than those laid by older layers (11.8 g and 305 micrograms iron). The percentage distribution of the total iron content of organs was, in prelaying females: feathers, 21.9; blood, 56.6; pectoral muscle 8.1; liver, 9.7; intestine, 2.7. In laying females: 29.1; 46.6; 11.5; 7.4; 4.2. In males: 17.4; 59.6; 11.4; 7.9; 2.3. The increase in intestinal iron content in laying quails coincided with a double intake of food. This distribution differs from the mammalian model, as egg production (where each egg represented 2.5-5.5% of the total iron) and the great inert iron deposits in the plumage require an elaborate iron metabolism control system to cover all the iron needs in birds.