Tumors of the ampulla of Vater treated by local resection: a report of five cases.

The clinical features, diagnostic work-up and difficulties in establishing a diagnosis on endoscopic biopsy specimens were retrospectively analysed in five patients with ampullary tumors. In addition, the technique of local papillary resection is reported. Indications for local resection are: elderly patients with severe co-existing diseases, patients with benign ampullary tumors which are either adenomatous or show epithelial dysplasia or patients with inconclusive preoperative endoscopic biopsy or peroperative frozen sections.

The incidence, multiple presentation and recurrence of aggressive cysts of the jaws.

The incidence, multiple presentation and recurrence rate of aggressive cysts of the jaws is discussed, based on a study of 677 cysts in 651 patients. Cysts that are considered aggressive include: cysts in which carcinoma develops, unicystic ameloblastoma, keratocysts and calcifying odontogenic cysts. Based on literature studies and on our own material, the incidence and multiplicity of these lesions is calculated.

A protocol for the treatment of hypertrophic scars and keloids.

Hypertrophic scars and keloids still present problems in both white and pigmented skin. A treatment protocol is proposed: Hypertrophic scars are primarily treated with intralesional injections of corticosteroids or with compression therapy. Surgical scar revision is only secondarily indicated.

Glafenine-associated hepatic injury. Analysis of 38 cases and review of the literature.

Glafenine was associated with hepatic injury in 38 cases. The causal relationship was assessed on the basis of the temporal relationship with drug use, course and exclusion of other causes. In 27 cases a causal relationship was considered likely, i.

Ketoconazole-associated hepatic injury. A clinicopathological study of 55 cases.

Fifty-five cases of ketoconazole-associated hepatic injury, reported to the Netherlands Centre for Monitoring of Adverse Reactions to Drugs, were analysed in detail. In 50 cases a causal relationship was considered likely, i.e.

Hepatitis B virus DNA detected in formalin-fixed liver specimens and its relation to serologic markers and histopathologic features in chronic liver disease.

To examine the relationship of hepatitis B virus (HBV) DNA sequences in the liver with histopathologic features and antigenic markers, the authors determined the hepatocytic status of viral DNA by in situ hybridization in formalin-fixed liver sections using a biotinylated probe in 45 patients with various chronic liver diseases. The results were compared retrospectively with the HBV serologic markers and histopathologic features including the presence of ground-glass cells or Shikata staining positivity. The specificity of this in situ detection of HBV DNA has been proven excellent in a double-blind control study in 18 patients in whom liver HBV DNA was also determined by DNA extraction, gel electrophoresis, and the Southern blotting technique.

An anatomic investigation of radical resection of tumor in the hepatic duct confluence.

The fetal umbilical vein in the ligamentum teres can be reopened to provide a 10 centimeter long vein, as wide as the left portal vein or the central splenic vein, that gives access to the left portal vein in the umbilical fissure of the liver. By cutting the ligamentum teres, this potential autologous venous graft is lost and, therefore, the ligamentum teres should never be sacrificed without reason. The umbilical side of the reopened umbilical vein can be anastomosed with the splenic vein to form a portal vein bypassing conduit that enters the liver in the umbilical fissure and take over function of the portal vein.

Anovulation presumably due to the gonadotrophin-resistant ovary syndrome.

The clinical syndrome of the resistant ovary is described in a 24-yr-old woman (XX genotype) with secondary amenorrhea and primary infertility. She presented an increased secretion of gonadotrophins with a decreased secretion of estrogens. In the ovarian tissue only primary ovarian follicles and a thickened tunica albuginea were found.

Chondrosarcoma of mandible misdiagnosed as chondromyxoid fibroma.

The diagnosis of chondrosarcoma of the jaws is often difficult due to the often indistinct boundaries between benign and malignant chondromatous tumors. In view of the often considerable variation in histological characteristics within a tumor, repeated biopsies and step sections through a specimen are recommended in difficult cases. This paper is a follow-up of the case described by DAVIS & TIDEMAN (1978) in this journal.