Recurrent carcinosarcoma of the renal pelvis. Case report

Carcinosarcoma is a malignancy that occurs very rarely in the renal pelvis; thus, only a very limited number of cases has been documented. These tumors are composed of both carcinomatous and sarcomatous elements. We report here a case of a carcinosarcoma composed of well-differentiated, keratinizing, squamous carcinoma cells and high-grade sarcoma cells. Differently from the cases described so far, this carcinosarcoma of the renal pelvis was characterized by the quick recurrence, following complete surgical resection, as a highly disseminated high-grade sarcoma.     

Electrical burns causing a urinary bladder fistula. Case report.

We present a patient with electrical burns which resulted in loss of the right upper arm and a urinary bladder fistula. A jump flap was used to cover the repaired bladder, and also to cover the stump of the amputated right arm.     

Technique of definition and diagnostic criteria of a state of blood flow of pelvis minor in woman with pelvis minor varicosis

The aim of the research: the examination of the state of woven blood flow in women with pelvis minor varicosis. The study of woven blood flow by the method of radioisotope clearance in 72 women of reproductive age is carry ouied. In patients with the varicose expansion of the veins of pelvis minor was revealed significant reduction in the indices of blood flow in the organs of pelvis minor, which plays the leading part in the genesis of painful sidroma.     

Trigeminal neuralgia in a patient with multiple sclerosis treated with high cervical spinal cord stimulation. Case report

A 42-year-old male with advanced multiple sclerosis had severe left-sided trigeminal neuralgia in the maxillary and mandibular divisions that was extremely difficult to control with medications. Glycerol injection in the gasserian cystern provided only temporary results. Two electrodes were implanted epidurally at the C1-2 level, one in the midline and the other to the left of midline. Electrical stimulation produced complete relief from the painful paroxysms.     

Diverticulum of the urinary bladder in a woman

In the two cases of congenital absence of the vagina reported herein, the embryologic point of arrest of development of the mullerian ducts was identical. Both patients had a rudimentary uterus, and one had a fibroid tumor on the rudimentary uterus. As a part of operation to construct a vagina in such cases, exploratory pelvic laparotomy appears to be a desirable step in order to determine the status of the internal genital organs. The use of a split thickness skin graft sewn around a vaginal mold and inserted into the dissected vaginal space results in more rapid healing, less scar tissue and a vagina that is soft, pliable and normal in appearance, even to the extent of having rugal folds.     

Relapsed follicular lymphoma sequentially treated with rituximab and 90Y-ibritumomab tiuxetan. Case report

BACKGROUND: Monoclonal antibodies have dramatically changed the treatment possibilities for follicular lymphoma. (90)Y-ibritumomab tiuxetan (Zevalin) is the first radioimmunotherapy agent approved for the treatment of relapsed and resistant follicular lymphoma patients. Long-term benefit was observed especially for patients achieving CR after radioimmunotherapy. METHODS AND RESULTS: A 65-year-old female patient with the second relapse of CD20 positive follicular lymphoma and multiple concomitant diseases was treated with four weekly doses of rituximab (375 mg/m(2)). (18)F-fluoro-deoxyglucose positron emission tomography combined with computed tomography (PET-CT) demonstrated only partial response to therapy with persistent PET scan positivity in enlarged abdominal lymph nodes. Therefore, it was decided to treat her with a 1200-MBq (32-mCi) dose of (90)Y-ibritumomab tiuxetan radioimmunotherapy. No acute complications were noted afterwards. Hematological nadirs were reached 4 weeks later, with a platelet count of 24 x 10(9)/l that normalized within the next 2 weeks. The patient had neither infection nor bleeding complications. Eight weeks after radioimmunotherapy, the PET-CT scans documented only 3 lymph nodes around the abdominal aorta, maximum size 2 x 1 cm. The PET scan analysis proved no accumulation of (18)F-fluoro-deoxy-glucose in any lymph nodes or other organs and tissues. CONCLUSIONS: Sequential treatment with rituximab and (90)Y-ibritumomab tiuxetan may be an interesting alternative in cases of relapsed follicular or other indolent lymphomas in pretreated or older patients with other concomitant diseases.     

Pregnancy rates, LH and progesterone concentrations in mares treated with a GnRH agonist

The aim of the study was to investigate the effect of the GnRH agonist Buserelin given on day 10 after ovulation on pregnancy rate and concentrations of progesterone and LH. Altogether 191 warmblood mares were used for two trials. Fresh or frozen/thawed semen from 27 stallions was used for A.I. In trial A 171 mares received either Buserelin (Receptal, Hoechst, Germany, 40 microg/animal) or 10 ml 0.9% NaCl (placebo). On day 16 after A.I. pregnancy diagnosis was performed by ultrasound scanning of the uterus. For statistical analysis, data were analyzed by a mixed model, with four fixed factors (treatment, type of spermatozoa, A.I. number, reproductive status of the mare) and a random factor (stallion). Least Square Means (LSM) for pregnancy rate were 46.0% in GnRH agonist treated mares and 36.4% in the control group (P=0.22). In trial B 20 lactating and cycling mares were used for endocrine studies. Blood samples were recovered for analyses of progesterone and LH from days 0 to 11. The mean progesterone concentrations increased continuously from days 0 to 8 after ovulation in both groups (GnRH group: from 0.81+/-0.48 to 5.47+/-0.48 ng/ml, control group: from 0.63+/-0.68 to 5.83+/-0.68 ng/ml). Moreover, the progesterone concentrations from days 9 to 11 were not different between the GnRH and the control group. In contrast to this LH concentrations were markedly influenced by the GnRH agonist. On day 10 LH concentrations were significantly higher in GnRH agonist treated than in placebo treated animals. From the data obtained from individual animals it can be concluded that GnRH agonist, given during luteal phase may have different effect on luteal function.     

Case report: a case of intractable Meniere's disease treated with autogenic training

Aims  

The purpose of this study was to examine HRQOL depending on whether the participants have family members with disabilities or not. In addition, we examined the relationship between HRQOL and social networks among family caregivers in Japan.     

Myeloschisis in a six weeks embryo of a leukemic woman treated by busulfan.

A case of myeloschisis in a six weeks old human embryo is reported. The 39-year-old mother was treated by busulfan before and during the early stages of gestation for chronic lymphatic leukemia. Additional histological findings consisted in a decrease of mesenchymal elements together with a somitic disorganisation in the affected area of the embryo. In spite of the well known experience that this drug is well tolerated by leukemic pregnant women, a possible interference of busulfan with the oocyte differentiation in this elderly primipara is proposed.     

Sexual dimorphism in the human bony pelvis, with a consideration of the Neandertal pelvis from Kebara Cave, Israel.

Sexual dimorphism of the human pelvis is inferentially related to obstetrics. However, researchers disagree in the identification and obstetric significance of pelvic dimorphisms. This study addresses three issues. First, common patterns in dimorphism are identified by analysis of pelvimetrics from six independent samples (Whites and Blacks of known sex and four Amerindian samples of unknown sex). Second, an hypothesis is tested that the index of pelvic dimorphism (female mean x 100/male mean) is inversely related to pelvic variability. Third, the pelvic dimensions of the Neandertal male from Kebara cave, Israel are compared with those of the males in this study. The results show that the pelvic inlet is the plane of least dimorphism in humans. The reason that reports often differ in the identification of dimorphisms for this pelvic plane is that both the length of the pubis and the shape of the inlet are related to nutrition. The dimensions of the pelvis that are most dimorphic (that is, female larger than male) are the measures of posterior space, angulation of sacrum, biischial breadth, and subpubic angle. Interestingly, these dimensions are also the most variable. The hypothesis that variability and dimorphism are inversely related fails to be supported. The factors that influence pelvic variability are discussed. The Kebara 2 pelvis has a spacious inlet and a confined outlet relative to modern males, though the circumferences of both planes in the Neandertal are within the range of variation of modern males. The inference is that outlet circumference in Neandertal females is also small in size, but within the range of variation of modern females. Arguments that Neandertal newborns were larger in size than those of modern humans necessarily imply that birth was more difficult in Neandertals.     

Successful pregnancy in a woman with congenital factor XIII deficiency treated with substitutive therapy. Report of a second case

A syndrome of marked fetal wastage is associated with congenital factor XIII deficiency in adult women. A previously unreported case of a woman with factor XIII deficiency is described, in which substitutive treatment with normal plasma or placental factor XIII concentrate permitted two normal pregnancies. Factor XIII activity was maintained above 1-2% with intermittent infusion of 300 ml to 450 ml of plasma every 14 days or of 500 units of concentrate every 21 days. This case confirms the only other case so far reported in which factor XIII substitutive therapy was able to permit a normal pregnancy in a woman with factor XIII deficiency and seems to suggest factor XIII to be involved in the process of annidation.