The effect of copper ions in vivo on specific hormonal endometrial receptors

A comparative randomized study was made of three intrauterine contraceptive devices: the Nova-T, MLCu250 Short and MLCu375. An endometrial biopsy was performed on the 25th day of the menstrual cycle before and after IUD insertion. The tissue obtained was analyzed to determine estrogen and progesterone receptor concentration and endometrial morphology patterns in IUD users. Both estrogen and progesterone receptors decreased proportionally to the increased amount of copper in the IUD. The histologic study showed changes in endometria relative to the amount of copper, but these changes were transitory and disappeared after a year of IUD use.

[Fetal rhabdomyomatous nephroblastoma: study of 2 cases and review of the literature]

Report of two cases of Fetal Rhabdomyomatous Nephroblastoma, a cytodifferentiated variant of Wilms' tumor. The incidence of this rare variant is of 2.10% in our material (88 nephroblastomas in a sixteen years period). The patients were ten months and two years old. Bilateral tumors were discovered in both patients. Preoperative radiotherapy was given but no reduction of the tumors size was obtained. Microscopically, benign looking striated muscle is the predominant component of the tumors, with scare foci of epithelial elements. The low age of presentation, high incidence of bilaterality and the peculiar intrapelvic renal growth are three relevant characteristics in the 35 cases previously reported as well as in these two new cases, that distinguish Fetal Rhabdomyomatous Nephroblastoma from conventional Wilms' tumor.

[Clinical aspects and therapy of congenital cystic livers]

Thirty patients with congenital cystic disease of the liver are reported. Expansion with pain, jaundice, cholangitis and suspicion of malignancy are indications for surgical intervention. Operation is chosen according to localization, size, quantity of cysts and their fluid content. Resection, fenestration, punction, anastomosis and hemihepatectomy were performed. Postoperative mortality was about 3%, prognosis is well, but worsened by associated diseases like polycystic kidneys or intramural aneurysms.

[Duodenal hematoma in acute alcoholic hepatitis]

Hematoma of the duodenal wall usually occurs after traumata. A case report is given of such a patient who suffered in addition from acute alcoholic hepatitis. The hematoma had led to complete obstruction of the duodenum and compression of the common bile duct. After endoscopy surgery was done and the hematoma removed.

Postoperative assessment of below-knee bypass grafts

Our results seem to demonstrate that, even when healthy or arteriosclerotic arteries tolerate knee flexion without any impairment of blood flow, all bypass materials, to a certain extent, have a tendency toward morphologic changes, such as kinking, looping, stenosis and decrease of peripheral blood flow. Reocclusion in below-knee reconstruction, which cannot be explained by poor outflow situation or technical faults, might be related to the graft material used as well as hemodynamic changes caused by flexion of the knee joint. With the use of ASV grafts, these changes are minimal and of little or no clinical importance; when HUV is used, these changes are more distinctive and might, in some instances, be the cause of reocclusion. This could explain the difference in the late results with the use of ASV or HUV. The results of reinforced PTFE still await evaluation. However, it should be kept in mind that the results in addition to the already mentioned influences are also caused by neointima proliferation and progression of the disease.

[The PTFE plastic prosthesis as an arterial replacement: experiences over a 5-year period]

Unilateral iliac femoral reconstructions with PTFE are yielding good results-similar to those with Dacron, with patency rates of 75, 67, and 65% at 1, 2 and 3 years, respectively (Kaplan-Meier). PTFE has additional advantages compared with other materials: a) no need of preclotting; b) smooth inner surface-easy thrombectomy in case of thrombosis and c) good handling characteristics. In view of the above-mentioned facts PTFE can be recommended without restriction for unilateral pelvic reconstructions. The functional early results of bilateral aorto-femoral Goretex-Y bifurcation grafts in 50 cases after 2 years are encouraging. Long-term results are still pending. Reports of other groups using this material as aorto-bifemoral substitute are not yet available. The functional results with PTFE for femoro-popliteal grafts are not satisfactory: 35% after 2.5 years. Extra-anatomical bypasses yielded 70% one-year functioning rate. Especially the ring-or spiral-armoured PTFE grafts seem to be suitable for these reconstruction procedures.

[Lethal osteogenesis imperfecta. Anatomopathologic (optical and structural) study of 8 autopsy cases]

A pathologic review of lethal osteogenesis imperfecta was performed based in nine cases and mainly concerning eight cases with total postmortem study. One of the cases was classified as type III while all other were of type II. Emphasis is made on the high rate of prematurity, small for date and podalic presentation at birth. In those six cases of lower age lung hypoplasia was present. Well known findings in membranous or enchondral bones were confirmed in this series. Long bones showed characteristic bowings related to the nutrient artery point of entry. Among bone collagen fibres some of them were anomalous in shape or thickness but with normal striation. The only anomaly detected at the cartilaginous epiphysis was the increased wideness of the vascular channels because the existence of loose connective tissue and multivacuolated cells of unknown significance. At the growth plates the vascular channels were too much widened and of abnormal distribution. The proliferative and columnar zones showed poor cellular population and some condrocytes were abnormally vacuolated. The perichondrial ossification groove of Ranvier was absent or underdeveloped in all bones studied coexisting with epiphyseal-metaphyseal deformities. In our present cases, ocular, dental, dermal, cardiac valves and hepatic alterations have been detected. The weight increase and haematopoiesis of the liver was correlated to the hyperplasia and fibrosis of the bone marrow.

Bilateral, congenital, dermis-like choristomas overlying corneal staphylomas

Two unrelated patients with diffuse, bilateral, congenital tumefactions overlying the corneas were seen. The tumors were protuberant, fleshy masses that partially concealed underlying corneal staphylomas. Spontaneous rupture was suspected in one eye. Histopathologic study of three specimens disclosed dermis-like tumors. In one specimen, an apocrine gland was identified, thus supporting the diagnosis of choristoma. An evisceration specimen from a ruptured globe confirmed that the ectatic cornea was an anterior staphyloma. The posterior pole seemed grossly normal. This disorder may have a genetic basis or it may result from a developmental or inflammatory insult in utero. Preoperative diagnosis is important because the associated anterior staphylomas complicate management.

Ring dermoid syndrome. A new syndrome of autosomal dominantly inherited, bilateral, annular limbal dermoids with corneal and conjunctival extension

A new hereditary syndrome of bilateral ocular dermoids is described in five patients from three generations of a single family. There were no associated extraocular anomalies. The choristomas involved the limbus for 360 degrees, extended anteriorly onto the cornea, and extended posteriorly about 5 mm within the conjunctiva for 360 degrees. Additional clinical findings of diagnostic value were conjunctival plaques of keratinization, hairs, and corneal lipid deposition. An irregular corneal astigmatism, amblyopia, and concomitant strabismus were secondary features. The unique bilateral, annular configuration of the dermoids is pathognomonic of this syndrome. Early surgical intervention is indicated to try to improve the visual prognosis and cosmesis. At surgery, the conjunctival portion of one case was easily resected in toto, but the limbal portion required partial excision. Histopathological examination confirmed the clinical diagnosis of dermoid choristoma.

Endogenous and exogenous ocular and systemic silver deposition

The ocular distribution of particulate silver after prolonged ingestion and the topical application of an organic silver compound (argyrol) are described and compared with the distribution after long-term occupational contact with refined silver. The deposits appear to be inert and to cause no functional visual deficit.

Congenital syphilis of the eye with lens involvement

Pathological examination of a girl with congenital syphilis revealed a focal granulomatous reaction involving the anterior uvea and lens. Krajian's (silver) stain exhibited spiral forms that were morphologically compatible with Treponema pallidum within the lens cortex. These findings have been rarely reported in early congenital lues.

[Congenital monomorph adenoma of the parotid gland (author's transl)]

Congenital monomorph tubular adenoma is a very infrequent tumor. Usually diagnosis is an operative finding. Together with its' infrequency, rapid rate of growth, differential diagnosis with other vascular tumors, specially cystic lymphangioma, and its surgical excision avoiding lesion of the facial nerve, account for this publication.

Adenomatoid tumour of the epididymis: histochemical and ultrastructural study of 2 cases

Two cases of adenomatoid tumour of the epididymis are described. Both the histochemical and ultrastructural studied support the concept that it is of mesothelial origin. The histochemical study showed the presence of acid mucopolysaccharides in the lumen of the tubular structures. The epithelial cells presented numerous microvilli in the free surface, junction complexes, wide intercellular channels and a well-developed Golgi complex. Abundant bundles of microfilaments and intracellular spaces were observed in the cytoplasm. Lymphocytes and histiocytes were identified both in the tubular lumen and between the epithelial cells. The stroma of the tumour was made up of dense connective tissue with abundant bundles of elastic fibres. The presence of intracytoplasmic spaces in the epithelial cells and elastic fibres in the stroma had not been previously observed in this tumour.