1/15. Clinical treatment with the Begg appliance.In a series of three articles, clinical treatment with the Begg appliance has been discussed. In the March, 1973 article, the standard procedures in the three stages commonly used in the Begg method were illustrated in a series of eight cases showing the wide range of orthodontic treatment possibilities of this method. The February, 1974 article contained a case report that illustrated some of the problems connected with orthodontic observation, diagnosis, Begg treatment, and retention. In this third article, due attention has been given to common problems of the chairside worker as encountered in daily practice. Certain comments have been offered, particularly with regard to child dental care and orthodontic guidance procedures of the growing child. A treatment approach, based on an individual optimum for each patient is discussed, following the course of treatment of three cases (Figs. 1, 2, and 4) with unfavorable jaw patterns and dental problems. These are compared with others having better anatomic proportions (Figs. 3 and 5). In the last case (Fig. 5) diagnosis and treatment planning are once again reviewed. The essential decision to be made for each orthodontic treatment, namely, whether and which teeth must be removed, is discussed and illustrated. In all cases, attention has been given to the portrayal of methods and technical details through the three stages of Begg treatment.- - - - - - - - - - ranking = 1keywords = comment (Clic here for more details about this article) |
2/15. Ureterorectal fistula: a rare cause of recurrent bacteriuria.The differential diagnosis of recurrent bacteriuria includes a host of conditions very familiar to urologists. Ureterorectal fistula represents an unusual clinical entity that can cause recurrent bacteriuria. We present a patient who ultimately proved to have such a fistula. We review the available literature and comment on the significance of this condition.- - - - - - - - - - ranking = 1keywords = comment (Clic here for more details about this article) |
3/15. Iatrogenesis or bad luck? relapse of an LMP1-positive follicular lymphoma after immunosuppression for hepatitis-associated aplastic anaemia.A 55-year-old man suffered a cutaneous relapse of an LMP1-positive follicular lymphoma after treatment with antithymocyte globulin and cyclosporine A (CSA) for a hepatitis-associated aplastic anaemia (AA). Rituximab was not effective, so CSA was tapered off. lymphoma masses did not regress but AA relapsed. A second remission of both lymphoma and AA was achieved with high-dose cyclophosphamide, but the patient died of a bilateral pneumonia. The relationships between immunosuppression, viral reactivation and tumour growth are discussed. The use of rituximab and lamivudine in immunodepressed patients is also commented.- - - - - - - - - - ranking = 1keywords = comment (Clic here for more details about this article) |
4/15. Eosinophilic pustulosis of the scalp in childhood.BACKGROUND: Among sterile pustulosis in childhood, a pruritic relapsing eosinophilic variant beginning in infancy and located mostly in the scalp was first described as eosinophilic pustular folliculitis in infancy by Lucky and colleagues in 1984. OBJECTIVE: Our purpose is to describe such a condition in five boys and one girl and comment on differential diagnosis and relation with Ofuji's disease. METHOD: This is a clinicopathologic study. RESULTS: All patients had scalp pustules beginning in infancy or early childhood that were unresponsive to antibiotic therapy. Lesions also occurred on other areas but the scalp was the major site of involvement. Although secondary infection was demonstrated in one case, the lesions were primarily sterile. Smears of pustules showed a variable proportion of eosinophils. Histopathologic findings suggested a major role for eosinophils in this disorder because dermal eosinophilia was noted in all patients. The inflammatory pattern was not similar to Ofuji's disease. Transient blood eosinophilia was recorded in five patients. Topical steroids relieved inflammatory episodes. dapsone was tried in one case with apparent benefit. CONCLUSION: Eosinophilic pustulosis of the scalp in childhood is a self-limited disease that can be relieved by topical steroids.- - - - - - - - - - ranking = 1keywords = comment (Clic here for more details about this article) |
5/15. Preventing recurrence of focal segmental glomerulosclerosis following renal transplantation: a case report.While the recurrence of FSGS in a primary renal transplant has been well studied, strategies to prevent subsequent recurrence in later transplants, has not been well formulated. This is important considering that one center's experience with adults reported an initial recurrence rate of 57% with reoccurrence of 37% in subsequent transplants. However, renal function was maintained in 62% (1). In pediatrics, data from a single-center reported 100% recurrence of FSGS in the second allograft after an initial recurrence of 52% (2). Two commentaries reviewing such data, one each in adults and pediatrics, suggested that the benefits of living-related donation might not be realized in patients with FSGS because of this frequent recurrence (3, 4). Here, we report a patient who was considered to be at very high risk for post-transplant recurrence of FSGS, because of the established risk factors, who was successfully retransplanted after a course of pretransplant plasmapheresis, followed by post-transplant plasmapheresis and the use of cyclosporine. Eighteen months post-transplant, he has no proteinuria and his serum creatinine is 1.2 mg/dL.- - - - - - - - - - ranking = 1keywords = comment (Clic here for more details about this article) |
6/15. aneurysm of the median artery causing recurrent carpal tunnel syndrome and anatomic review.A patient is presented who had recurrent carpal tunnel syndrome symptoms in his left hand 1 year after having undergone release of the transverse carpal ligament. On exploration, this was found to be due to an aneurysm of a median artery and possibly scarring due to this compression around the branches of the bifurcated median nerve. This represents the first case in the literature to comment on (1) the absence of bilaterality of the anatomic finding and (2) carpal tunnel syndrome relative to median artery aneurysm. With this in mind, a plea is made for careful exploration of the carpal tunnel, maintaining an incision as far to the ulnar side of the median nerve as technically possible with thorough visualization of the contents of the tunnel and any anatomic variance involved. The incidence of the combination of aberrant median artery with high bifurcation of the median nerve is unknown, as is the incidence of aneurysm of the median artery.- - - - - - - - - - ranking = 1keywords = comment (Clic here for more details about this article) |
7/15. Recurrent bladder perforation in chronic irradiation cystitis.Chronic irradiation cystitis may cause fibrosis and weakening of the detrusor, with greater susceptibility of the bladder wall to endoscopic trauma. We lately treated a patient with chronic irradiation cystitis who sustained recurrent bladder perforation, one after electrohydraulic lithotripsy and the other--following cystoscopy. The first event was handled surgically and the second one in a conservative approach. We hereby report on the case and comment on the etiology.- - - - - - - - - - ranking = 1keywords = comment (Clic here for more details about this article) |
8/15. Acquired deficiency of the inhibitor of the first component of complement: report of five additional cases with commentary on the syndrome.The association of late onset recurrent angioedema with a deficiency of the inhibitor of the first component of complement (C1INH) and of the binding subunit of the first component, Clq, defines the syndrome of acquired C1INH deficiency. The description of five new cases, along with the original two and the 18 others in the literature, brings the total reported cases to 25 and highlights the associated B cell abnormalities that are present in 23 and are of a malignant nature in 19 cases. In three of the five newly reported cases, the occurrence of angioedema, which prompted recognition of the acquired deficiency of C1INH, C1q, and C4, preceded the delineation of the underlying B cell malignancy by 2 to 3 yr despite efforts to recognize neoplastic disease in two of these patients throughout the interval. Because the acquired C1INH deficiency reflects increased catabolism rather than impaired biosynthesis, only high-dose attenuated androgens elicit a measurable increment in serum C1INH. The occurrence of the syndrome with multiple myeloma is noted for the first time.- - - - - - - - - - ranking = 4keywords = comment (Clic here for more details about this article) |
9/15. Fate of ovary transposed during treatment of Hodgkin's disease.Although successful transposition of the ovaries at the time of staging laparotomy for Hodgkin's disease is well documented, little comment has been made on potential complications. This case report of a primary ovarian neoplasm (benign) developing in a transposed ovary serves to alert physicians as to possible ovarian problems in such patients. ultrasonography or computed tomography is invaluable in following up the patient with laterally transposed ovaries no longer accessible to routine bimanual clinical evaluation.- - - - - - - - - - ranking = 1keywords = comment (Clic here for more details about this article) |
10/15. Longterm results in cholesteatoma surgery.From the results of 689 cases of cholesteatoma operated and followed over a period of 9 years, are discussed the respective indications of opened and closed techniques. The intact canal wall tympanoplasty with mastoidectomy is the preferred technique. It is undertaken on the understanding that it will be done in 2 stages over a 1-year interval. From the revised 460 cases, the presence of residual cholesteatoma was found in one out of 2 cases. Cause of high incidence are analyzed and commented. Retraction pockets or true recurrence of cholesteatoma whose incidence was 11% at the beginning of the series have practically disappeared since it was started to repair the tympanic frame with cartilage. Open techniques, modified radical mastoidectomy, with or without obliteration, are done when a 2-stage procedure is not possible. They are also indicated in particular cases related to the nature of the disease, mastoid pneumatization, condition of the attic wall or the patient's age. Auditory results do not show any significant difference between the open and closed techniques when the ossicular chain is complete or the stapes intact. However, in cases of subtotal ossicular defects, preservation of the tympanic frame provided the most favourable conditions for a functional restoration.- - - - - - - - - - ranking = 1keywords = comment (Clic here for more details about this article) |
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