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An unusual cause of renal colic: Hydatiduria

Hydatid disease of the urinary tract is seen rarely. Hydatiduria may be a finding of renal involvement, but it is a rare cause of renal colic. A case is reported of renal hydatid disease that was diagnosed during the investigation of renal colic. A 38‐year‐old woman presented with renal colic. She had a history of episodes of renal colic and occasional voiding of grape‐like material. No calculus was found in the urinary tract by plain film or ultrasonographic examination. The histopathologic examination of this material revealed daughter cysts that are pathognomonic for hydatid disease. Ultrasound and computed tomography confirmed this diagnosis and right nephrectomy was performed without cyst perforation or any spilling of cyst content. Albendazole, 10 mg/kg per day, was given for 4 weeks (2 weeks preoperatively and 2 weeks postoperatively).

Island rat groin flaps with twisted pedicles.

Clinical attempts are made to avoid rotating a flap and twisting the pedicle for fear of perfusion compromise. Torsion of an island rat groin flap pedicle is not a well-recognized experimental entity. The authors describe the results of island flap rotation with pedicle twisting in the rat groin flap model. Forty male Wistar rats were randomly divided into four groups of 10 animals each. In each group, bilateral groin flaps were elevated; one flap was sutured in place without rotation and the contralateral flap was subjected to 180, 270, 360, or 720 degrees of rotation. Blood flow within the flaps was assessed by laser Doppler flowmetry, and flap edema and necrosis were determined 10 days postoperatively. No differences were noted between control flaps and those subjected to 180 and 270 degrees of rotation. Although flaps subjected to 360 degrees of rotation demonstrated a large amount of postoperative edema and congestion of the subcutaneous tissue with some histologic changes, all flaps in this group survived. Measured flap weights at death were different from those of controls. All flaps subjected to 720 degrees of rotation underwent ischemic necrosis. Because of the differences between human skin architecture and rat skin architecture it cannot be concluded that similar results would be observed in any human skin flap. There might be three important points arising from this study of unknowingly twisted island groin flap pedicles in the rat model: (1) twisting of less than 360 degrees has no effect on flap survival; (2) twisting of 720 degrees is always associated with skin flap necrosis; (3) twisting of 360 degrees, although associated with some changes, does not cause skin flap necrosis.

Surgical management of penoscrotal lymphangioma circumscriptum.

Lymphangioma circumscriptum of the penis and scrotum is an unusual entity that may be indistinguishable from genital warts. After confirmation of the diagnosis, a treatment plan consisting of wide excision should be outlined. To lower the chance of recurrence, not only the affected skin but all the subjacent subcutaneous tissue, including the deeper components of the lymphatic malformation just above the deep fascia, should be removed.

Prognostic importance of tumor angiogenesis in breast carcinoma with adjuvant chemotherapy.

Tumor angiogenesis is believed to be related to prognostic factors involved in tumor development and metastasis. Using immunohistochemical methods, we evaluated tumor angiogenesis in 42 early invasive breast cancer patients (T1-2, NO-1-2, M0). Four patients received tamoxifen, 25 patients received CAF or CA, and 15 patients received CMF as adjuvant therapy. The median follow-up was 47 (range 24-119) months. Ten patients (43.5%) in the node-positive group and 2 patients (10.5%) in the node-negative group relapsed (p = 0.019). The mean microvessel count (MVC) was 60.3 3.05 per 200x field (range: 16-95). MVCs of postmenopausal and premenopausal patients were 50.13 +/- 5.74 and 68.64 +/- 4.11, respectively, in the axillary lymph node (ALN)-negative patient group (p = 0.04). Staining was moderate to strong in 13 (68%) ALN-negative and in 17 (74%) ALN-positive patients (p > 0.05), and was also moderate to strong in 82% of premenopausal patients and in 50% of postmenopausal patients (p = 0.037). There was no significant relationship between angiogenesis and p53, nor was angiogenesis significantly associated with the patient ER status and tumor size. No significant correlations were found between OS/DFS and Factor VIII staining or p53 (log rank test, p > 0.05). Of all ALN-negative patients with increased angiogenesis, one patient of the CMF group relapsed, but no recurrence occurred in patients undergoing anthracycline-based chemotherapy (p > 0.05). On the other hand, of all ALN-positive patients with increased angiogenesis, 5/14 patients treated with anthracylcine and 2/2 CMF-treated patients relapsed (p = 0.175). Despite the statistical insignificance, anthracycline-based adjuvant chemotherapy appears to be more effective than CMF as regards relapse prevention particularly in early ALN-positive breast cancer patients with increased angiogenesis. Additional studies are necessary to demonstrate the clinical importance of angiogenesis.

Extensive lymphatic malformation of penis and scrotum.

Lymphangioma circumscriptum is an uncommon condition of the skin and subcutaneous tissues characterized by localized patches of vesicles. The penoscrotal region is a rare site for its development. We present a case with an extensive onset of lymphatic malformation of the pubis and penoscrotal region that we treated with wide excision. Reconstruction was achieved with a split-thickness skin graft combined with residual scrotal skin advancement.

Symptomatic renal metastasis 5 years after the management of a squamous cell carcinoma of the lung.

A case of solitary renal metastasis five years after the management of a primary squamous cell carcinoma of the lung is presented.

Effect of amrinone on mucosal permeability in experimental intestinal ischaemia/reperfusion injury

Background:u2003 The preventive effect of amrinone on ischaemia/reperfusion (I/R) injury has been shown in the medical literature. The purpose of the present study was to investigate the preventive effect of amrinone on I/R injury of the small bowel of the rat.

Condyloma acuminatum of the penis and the role of molecular biology in diagnosis

Abstractu2002The diagnosis of condyloma acuminatum generally relies on the presence of characteristic clinical features. However, atypical cases can cause diagnostic problems. With the development of the molecular biological techniques, the disease can be readily diagnosed. A case of atypical condyloma acuminatum in a 25-year-old male is reported, he presented with midpenile hypospadias and a mass extending from the scrotum to the corona through the chordee deformity. The clinical diagnosis was condyloma acuminatum. A tissue specimen was obtained for histopathological analysis and in-situ hybridization assay for human papilloma virus. Histopathological analysis showed papilloma. The immunohistochemical assay was negative for human papilloma virus. However, in-situ hybridization for human papilloma virus was strongly positive. Condyloma acuminatum should be suspected in hypospadias patients with atypical papillomatous lesions on the chordee deformity. In-situ hybridization is extremely useful in establishing the diagnosis. Since condyloma acuminatum is the cause of viral contamination and malignant transformation, it is worth considering histopathological examination and molecular biological techniques to protect both the patient and the sexual partner.