Seminal vesicle cyst: an unusual cause of hematospermia--a case report

Seminal vesicle cyst is a rare disease. The traditional diagnostic method is the vasoseminal vesiculography. We present one case detected by transrectal ultrasonography during examination for hematospermia. He was treated with transperineal aspiration and sclerotherapy under guidance of ultrasonography. The patient had an uneventful clinical course after treatment, but long term follow up is necessary. Literature about seminal vesicle cyst and hematospermia will be reviewed.

Pseudomonas septicemia in infants and children: a retrospective analysis of 49 cases

Reviewed 49 cases of Pseudomonas bacteremia which occurred in pediatric patients during an 8-year period showed the annual rate, per 1000 discharges, was 1.7. In most of the patients (73.5%), the disease was hospital-acquired. Male to female distribution was about 3 to 2. The average age of the 49 patients was 1.29 years, and 55.1% were infected at less than 2 months old. Overall mortality was 44.9%; among the mortalities, 63.6% were under two months of age. Clinical features were not characteristic, but the most common sign associated with this infection was fever (42.9%). Ecthyma gangrenosum occurred in only one patient. Respiratory tract and skin were the most frequent sources of the bacteremia. Polymicrobial bacteremia occurred in 18.4%. Patients with shock, pneumonia, inadequate antibiotic therapy or persistent neutropenia had a substantially poorer prognosis. Administration of combination therapy to patients with Pseudomonas bacteremia seemed to be superior to monotherapy for positive outcome.

Candidemia in the neonatal intensive care unit

The hospital records of 18 infants (9 males & 9 females) with one or more positive cultures for Candida species were studied retrospectively in an attempt to define the characteristics, associated factors and treatment for candidemia in the neonatal intensive care unit. The number of patients have increased recently and the mortality rate is 56% (10/18). The Candida species isolated from blood were Candida albicans in 16 cases and Candida parapsilosis in 2 cases. Fever, not-doing-well, and abdominal distention were the most common presentations, prompting us to the initial impression of bacterial sepsis and/or necrotizing enterocolitis. Eleven associated factors for candidemia were relating to the measures and therapy in the neonatal intensive care unit, such as prolonged use of broad-spectrum antibiotics, parenteral hyperalimentation etc. All of these 18 patients were treated with intravenous amphotericin B. Six patients were given adequate total dose (> 25 mg/Kg), while 12 patients underwent inadequate treatment (3.7 +/- 2.9 mg/Kg). The 10 fatal patients belonged to the inadequate treatment group. As there is continual progress in neonatal intensive care units, candidemia is becoming an increasing common problem and which deserves attention.

Intraventricular hemorrhage in preterm neonates--a two year experience

A prospective brain sonograph study was performed on 134 preterm neonates with birth weight of less than 2500 gm. Ten (7.5%) infants had intraventricular hemorrhage (IVH). The incidence of IVH in preterm neonates weighing less than 1500 gm was 13% and in neonates of less than 32 weeks gestation was 11.27%. Ninety percent of the IVH occurred within the first 72 hours of life. Prematurity, and hypoxia were considered as significant contributing factors for neonatal IVH. Six of the 7 infants with IVH grade I have a favorable neurological outcome. One of the 3 infants with IVH grade III has psychomotor delay. Routine brain sonograph study is considered practical and invaluable for diagnosis of IVH in preterm neonates.

Congenital syphilis: report of twelve cases

Between 1983 and 1992 at the Taichung Veterans General Hospital, twelve congenital syphilis patients were diagnosed, according to the Centers for Disease Control (CDC) criteria. For the five boys and seven girls, ages at diagnosis ranged from 1 day to 8 months, with an average of 23 days. Among these 12 patients, four (33%) were premature. Seven patients (58%) were diagnosed in the past three years. These 12 patients were divided into inborn and outborn patient groups. Serological tests for syphilis were done in all inborn patients, but none in the outborns. All five outborn patients were symptomatic. In comparison, only one of seven inborn infants showed clinical evidence of congenital syphilis. The mean age at diagnosis was obviously older in the outborn patient group (53 days vs. 1 day). Six of ten patients (60%) had cerebrospinal fluid (CSF) abnormalities, while four of nine (44%) showed radiological abnormalities of bones. The hematologic and biochemical abnormalities compatible with congenital syphilis were also described. Penicillin was the drug of choice in ten patients. Despite adequate treatment, one patient died of respiratory failure. There has been no evidence of any signs of late congenital syphilis in those patients who survive. Congenital syphilis, a serious but preventable disease, is best treated adequately and early for minimal sequelae.

Evidence for reduced cancellous bone mass in the spontaneously hypertensive rat

The histomorphometric changes in the proximal tibial metaphysis and epiphyseal growth plate and midtibial shaft of 26-week-old spontaneously hypertensive rats (SHR) compared with those of the corresponding normotensive Wistar-Kyoto (WKY) rats were studied. A decrease in body weight, growth plate thickness, and longitudinal growth rate of the proximal tibial epiphysis, trabecular bone volume, trabecular thickness and number, the number of osteoblasts and osteoprogenitor cells per millimeter square surface of the proximal tibial metaphysis, periosteal and endocortical apposition rate and bone formation rate of the tibial diaphysis were observed in the SHR. Additionally, systolic blood pressure, the number of osteoclasts per millimeter square surface and average number of nuclei per osteoclast of the proximal tibial metaphysis were significantly increased. Thus, osteoclastic activity is dominant over osteoblastic and chondroblastic activity in the SHR that results in a cancellous bone deficit in the skeleton. It will require additional work to ascertain the underlying cause for this condition as several factors in the SHR with a potential for causing this change are present, including elevated parathyroid hormone (PTH), depressed 1,25-(OH)2D3, low calcium absorption, reduced body weight (reduced loading) elevated blood pressure and possibly other direct cell differences in the mutant strain. At present elevated PTH and adaptation to underloading from reduced weight are postulated to be a likely cause, but additional studies are required to test this interpretation.

Neonatal Candida albicans meningitis: report of one case

Candida meningitis is a growing problem today. We report a 21-day-old male baby who was a victim of Candida albicans meningitis with the initial presentations of fever, mild stiff neck, poor feeding and activity. He had been treated with intravenous antibiotics and ventilator therapy prior to admission Initially, he was treated as a case of bacterial sepsis after admission with intravenous antibiotics. Due to positive cultures of cerebrospinal fluid for Candida albicans twice, intravenous amphotericin B was started from the 13th hospital day and was continued for 38 days. The successive three sets of CSF fungus culture yielded negative results and the patient was doing well without fever. Meanwhile, the brain sonogram revealed normal findings and he was discharged in a stable condition. We report this case and review some literature in an attempt to know more about this unusual disease, which is becoming more frequent as progress in intensive care grows.

Morphometric variations of the lumbar vertebrae between Chinese and Indian adults

A morphometric study of the lumbar vertebrae of 126 adult skeletons, 90 Chinese and 36 Indian, of both sexes without marginal osteophytes were performed. In each lumbar vertebra, the cephalad and caudad midsagittal diameters, the interpedicular diameter of the spinal canal as well as the midsagittal and transverse diameters and the height of the vertebral body were measured. The results showed that the midsagittal and transverse diameters, the heights of the lumbar vertebral bodies and the interpedicular diameters of the lumbar spinal canals increased progressively from L1 to L5, while the midsagittal diameters of the lumbar spinal canals decreased progressively from L1 to L5 in both Chinese and Indian adult skeletons. The lowest mean values of the cephalad and caudad midsagittal and the interpedicular diameters of the spinal canals in Chinese were found to be 5.04 +/- 0.15 mm at L5, 4.67 +/- 0.09 mm at L5 and 25.92 +/- 0.20 mm at L2, respectively, while in Indians they were found to be 4.54 +/- 0.18 mm at L5, 4.25 +/- 0.10 mm at L5 and 25.42 +/- 0.22 mm at L1, respectively. In addition, the mean diameters of the spinal canal and the vertebral body (except the height of the vertebral body) were significantly greater in the Chinese than in the Indian skeletons. The above findings indicate that the mean diameters of both the lumbar spinal canal and the vertebral body vary greatly between Chinese and Indian adults, i.e. there are no mean values of the vertebral dimensions that are valid for all populations.(ABSTRACT TRUNCATED AT 250 WORDS)

[Double aortic arch associated with severe left ventricular dysfunction--a case report]

A case of a 3-month-old male infant with severe LV dysfunction and a complete double aortic arch (both arches patient) is reported. The right dominant aortic arch runs retroesophageally to the right and joins with the left smaller arch to form the descending thoracic aorta on the right side while the ligamentum arteriosum was located in its normal position (the left side). Through a left thoracotomy, the smaller left arch and the ligamentum were divided to relieve the obstruction of the trachea from compression of the vascular ring. Postoperative convalescence was good. Further follow up of this patient after 9 months showed that there was neither any respiratory failure nor any heart failure sign present, though severe LV dysfunction persisted.

Surgical anatomy of the mandibular ramus of the facial nerve in Chinese adults

One hundred and twenty Chinese adults' facial halves were selected for this study. The description of the mandibular ramus of the facial nerve was presented under 4 items: (1) the relationship with the lower border of the mandible, (2) the number of its rami, (3) the relationship with the retromandibular vein, the facial vein or the facial artery, and (4) its anastomoses with the buccal ramus and/or the cervical ramus. In these specimens, anterior to the facial artery, 90% of the mandibular rami ran above the lower border of the mandible, and 10% of the mandibular rami ran below the lower border of the mandible. Posterior to the facial artery, 67% of the mandibular rami ran above the lower border of the mandible, and 33% of the lowest mandibular rami passed in an arc with an average of 0.95 cm (the lowest point being 3 cm or less) below the lower border of the mandible. In 32% of the specimens, the mandibular ramus had no branch and in 68% of the specimens, the mandibular ramus had two or more rami. There were 100% of the mandibular rami lying superficially to the retromandibular vein and the facial vein, while in 5% of the specimens, some other mandibular rami ran deeply to the facial vein. In 83% of the specimens, the mandibular rami lay only superficially to the facial artery and in only 2% deeply to the facial artery. The remaining 15% ran both deeply and superficially to the facial artery. There were 60% of the specimens in which the mandibular rami had one or more anastomoses with the buccal rami.(ABSTRACT TRUNCATED AT 250 WORDS)

Assessment of the relative locations of the greater palatine foramen in adult Chinese skulls

One hundred dry skulls of adult Chinese of both sexes were studied. They were homogeneous in the form of maxillary arch and having full eruption of the upper third molar, without missing teeth and malposition of teeth. Our findings revealed that the mean distance from the center of the greater palatine foramen (GPF) to the midsagittal plane of the hard palate was 16.00 mm, and to the posterior border of the hard palate, 4.11 mm. The location of the GPF related to the maxillary molars was expressed as percentage in 5 relations. We found that the most common location of the GPF was between the maxillary second and third molars (relation III: 48%), and less common was lingual to the maxillary third molar (relation IV: 33.5%). The usually accepted description of the GPF location was lingual to the second molar (relation II), but in our study this relative position occurred in only 17% of the skulls. The long axis of the greater palatine canal directing to the GPF in the oral cavity was found to be directed anteriorly in 181 openings (90.5%) of the 200 GPF, and only 19 openings (9.5%) directed vertically. The bilateral symmetry of GPF on both sides of each skull was remarkable. The discrepancy of our observations on the Chinese skulls from those on other ethnic groups was discussed. Our findings suggest, therefore, the existence of an ethnic variation and the necessity of a more accurate method of locating the GPF in clinical practice.

Effects of prostaglandin E2 on alveolar bone resorption during orthodontic tooth movement

Twenty Sprague-Dawley rats weighing 280-300 g were divided into two groups of ten animals each. They were treated by daily submucosal injections of 50 micrograms prostaglandin E2 (PGE2) per kilogram body weight into the region below the apex of the left first maxillary molar (experimental), or vehicle into the region below the apex of the right first molar (control), for a period of 5 days. The animals of the first group were sacrificed immediately following the treatment period, while those of the second group were sacrificed 5 days after the treatment period. Twenty-two hours prior to sacrifice, a piece of latex orthodontic elastic was secured to the adjacent area between the first and second maxillary molars of both sides of each rat by using two mosquito hemostats. The periodontal ligament (PDL) mesial to the mesiobuccal root of the first maxillary molar was assayed for changes in PDL cell factors. The results showed that immediately following the 5-day treatment period the left PDL had a significant decrease in the total number of fibroblasts and a significant increase in the total number of both osteoclasts and nuclei per osteoclast, while no significant changes in the osteoblasts when compared with those of the right control PDL. The left PDL of animals which were sacrificed 5 days after the treatment period revealed a significant decrease in the number of total fibroblasts and only a slight decrease in both numbers of total osteoclasts and total nuclei per osteoclast, but again no significant changes in osteoblasts when compared with those of the right control PDL.(ABSTRACT TRUNCATED AT 250 WORDS)

Study of histomorphometric changes of the mandibular condyles in neonatal and juvenile rats after administration of cyclophosphamide

Forty 1-week-old Sprague-Dawley rats were divided into 4 groups of 10 animals each. Five rats of each group served as the controls, and another 5 were given weekly intraperitoneal injections of 20 mg cyclophosphamide (CTX, Endoxan, Cytoxan) per kg of body weight. The animals of each group were sacrificed either at 1, 3, 5, or 7 weeks after initial intraperitoneal injection of CTX or water. The mandibular condyles of all rats were assayed histomorphometrically for changes on cartilage and bone cells, and other elements. The results showed a decreasing tendency in the thickness of the cartilage layer, the number of prechondroblasts, the number of chondrocytes, the percentage of cartilage matrix, the percentage of hard tissue, the bone surface perimeter, the number of osteoblasts, the number of osteoclasts, and the average number of nuclei per osteoclast in the condyles at 1 or 3 weeks after initial CTX treatment. After 7 weeks of treatment with CTX there was a significant decrease in the thickness of the cartilage layer, the number of prechondroblasts, and the numbers of both osteoblasts and osteoclasts per square millimeter of bone surface in the condyles, when compared with those of the control groups. In addition, after 5 or 7 weeks of CTX treatment there was a significant decrease in the percentage of hard tissue, the number of osteoblasts and the number of osteoclasts. Furthermore, changes in the morphology and size of the bone cells were also observed in all the rats.(ABSTRACT TRUNCATED AT 250 WORDS)

A clinical and anatomical study of the location of the mental foramen in adult Chinese mandibles

One hundred mandibles of adult Chinese cadavers of both sexes without missing teeth, alveolar bone resorption and malposition of teeth were studied. The anatomical location of each mandibular mental foramen was measured by using a combination of three previous methods. Our results showed that the location of the mental foramen below the apex of the lower second premolar (relation IV: 58.98%) was the most common. On average, the distance between the most anterior portion of the anterior border of the mental foramen and the mandibular symphysis was 28.06 mm, between the most anterior portion of the anterior border of the mental foramen and the posterior border of the ramus 74.14 mm, between the inferior border of the mental foramen and the lower border of the mandibular body 14.70 mm, between the superior border of the mental foramen and the bottom of the lower second premolar socket 2.50 mm. The distance across the mental foramen between the alveolar crest and the lower border of the mandibular body was 30.29 mm. Our results were compared with those of other investigators. The significance of identifying the anatomical location of the mental foramen in dental practice is discussed.

Craniopagus parasiticus: a case report of a parasitic head protruding from the right side of the face

An extremely rare case of parasitic head protruding from the right side of the face is presented. It differs from all the other cases previously reported in the literature. The patient had a parasitic head with an abnormal brain, two eyebrows, two underdeveloped eyes, nose, mouth, 12 teeth, a tongue and plenty of hair. The parasitic head was excised. The nature of the embryological abnormalities is discussed and the literature of polygnathism reviewed.

Effects of phytohemagglutinin-P (PHA-P) on bone of the growing rat

The effects of phytohemagglutinin-P, (PHA-P), a mitogen known to selectively stimulate cells of hematogenous or lymphoid monocytic origin, 25 and 50 mg/kg/day administered for 15 days on proximal tibiae of growing male Sprague-Dawley rats, were studied. The general effect of PHA-P was to decrease the amount of cartilage, hard tissue, and longitudinal growth in the proximal tibial metaphysis. A decrease in longitudinal bone growth, in the number of chondrocytes, in the thickness of cartilage plate, in the metaphyseal mass of hard tissue, in the percentage of calcified cartilage core, and in the number of osteoblasts per mm of bone surface was observed. Additionally, PHA-P increased the number of osteoclasts, the number of labeled osteoclastic nuclei, and the average number of nuclei per osteoclast. There was a significant decrease in the time to the first appearance of labeled osteoclastic nuclei as the dose of PHA-P increased. Thus, PHA-P treatment leads to the dominance of osteoclastic over chondroblastic and osteoblastic activity and results in a hard tissue deficit in a growing skeleton. The data indicate that PHA-P administration selectively increases osteoclast numbers by elevating osteoclastic progenitor cell proliferation and enhancing their fusion and differentiation to osteoclasts.

Harvester ant sensitivity: in vitro and in vivo studies using whole body extracts and venom

Harvester ant stings by Pogonomyrmex maricopa (Pm) or Pogonomyrmex rugosus (Pr) resulted in serious reactions in 8 patients, 4 with generalized reactions and 1 with large local reactions. Exposure to one species in the genus Pogonomyrmex (P) appeared to cross-sensitize ant-sensitive patients to other species in the same genus as evidenced by skin testing and leukocyte histamine release, but these patients were less sensitive to extracts from other stinging Hymenoptera, including bee, wasp, yellow jacket, hornet, and Formica ant. Pr ant venom was obtained by electrical stimulation of live ants for leukocyte histamine release studies. The venom preparation was considerably more effective in inducing histamine release than a body extract derived from gasters, the posterior abdominal segments. Rabbits immunized with an extract from one species produced precipitating antibodies against the injected extract withich cross-reacted with extracts from other species of harvester ant, but not with other stinging Hymenoptera. Humans and rabbits appear to react to certain genus-specific antigens present in Pogonomyrmex whole body extracts. Proper identification of the offending ant is crucial for proper testing and treatment of ant-sensitive patients.