Malignant Langerhans' cell histiocytosis of the clavicle: a rare pathological fracture.

Langerhans' cell histiocytosis (LCH) is an extremely heterogeneous disorder which is uncommon, making therapeutic guidelines difficult. The malignant features seen in this case have been described presenting in the skin but not in the bone. Although pathological fractures through bone affected by eosinophilic granuloma have been described, this is the first reported case of LCH with malignant features presenting in such a way.

Extra-renal rhabdoid tumour of the glutei.

A case of an extra-renal malignant rhabdoid tumour of the gluteal muscles in a 12-year-old boy is presented. Such a site has not been reported previously. The literature about this uncommon and aggressive tumour is reviewed.

Uveitis in juvenile chronic arthritis.

About 20% of patients with juvenile chronic arthritis develop uveitis which is frequently bilateral. Risk factors for uveitis are: female gender, pauciarticular onset of arthritis, presence of circulating antinuclear antibodies, and the antigens HLA-DW5 and HLA-DPw2. The visual prognosis in patients with uveitis is good in 25% and fair in 50%.

The use of corium porcine graft for a malignant enterovaginal fistula.

Palliative treatment of an enterovaginal fistula secondary to adenocarcinoma of the rectum in a 65-year-old woman with intraperitoneal corium porcine graft is reported. The patient had previously had a total colectomy for ulcerative colitis followed by excision of the rectal stump, mucosal proctectomy and ileostomy.

Intravenous treosulfan versus intravenous treosulfan plus cisplatinum in advanced ovarian carcinoma.

In a prospective, multicentre, randomized trial, the efficacy and tolerance of treosulfan alone was compared with that of treosulfan plus cisplatinum in 135 women with advanced ovarian carcinoma. No statistically significant difference was found between the two treatments in terms of median survival. Combined treatment was associated with significantly greater side-effects and haematological toxicity.

Diameters, generations, and orders of branches in the bronchial tree.

Studies of bronchial tree data by West et al. (J. Appl.

Neodymium: YAG transscleral cyclocoagulation: a clinical study.

Thirty-seven eyes of 35 patients with uncontrolled glaucoma on maximum medication and after previous failed glaucoma surgery, were treated by transscleral cyclocoagulation using the free running mode of the Lasag Microrupter II Neodymium: YAG (Nd:YAG) laser. The indications, technique and results are discussed in this group of complicated glaucomatous eyes and suggests that Nd:YAG laser cyclocoagulation is a safe and effective method of lowering the intraocular pressure (IOP) and improving glaucoma control. The mean pre-treatment IOP was 41 mmHg, and the mean post-operative IOP was 22.

Juvenile arthritis and uveitis.

The association between juvenile arthritis and uveitis is reviewed. Some children with the HLA-B27 related spondyloarthropathies develop anterior uveitis. About 20% of patients with juvenile rheumatoid arthritis (JRA) who are negative for IgM rheumatoid factor develop a frequently bilateral, nongranulomatous chronic anterior uveitis.

Catamenial pleural pain.

A case of recurrent pleural pain without pneumothorax, thought to be due to pulmonary endometriosis, is presented. The pain was associated with the menstrual periods, remitted when the patient was sterilised, recurred when she was given oestrogens, and finally disappeared when the oestrogen was stopped. The presentation of pulmonary endometriosis, with pleural pain but no pneumothorax, should be added to those previously described in the literature.

Subsidence of the femoral component related to long-term outcome of hip replacement.

We compared the clinical outcome with femoral subsidence and radiographic changes in 102 patients at 9 to 13 years after low friction arthroplasty. In 92 cases with a satisfactory outcome there was an average of 2.3 radiological signs and mean subsidence of less than 5 mm.

Effect of lack of noradrenaline on myocardial oxygen consumption in denervated dog hearts.

Surgical cardiac denervation was carried out in dogs under halothane anaesthesia. In a paired experimental design control biopsy specimens were obtained before surgical denervation. The dogs were allowed to recover and three weeks to elapse before the second biopsy specimen was taken.