Multifocal kaposiform haemangioendothelioma.

Kaposiform haemangioendothelioma (KHE) is a rare, locally aggressive vascular spindle cell proliferation, with resemblance to Kaposi's sarcoma. This tumour usually occurs in skin and retroperitoneum of infants and young children and is often complicated by the Kasabach-Merritt phenomenon (KMP). A 3-year-old boy presented with a right submandibular swelling due to lymphadenopathies, a violaceous skin lesion at the left commissure of the lips and an ill-defined lesion in the right thyroid lobe.

Laryngeal repair after resection of advanced cancer: an optimal reconstructive protocol.

Tracheal autotransplantation allows for reconstruction of extended hemilaryngectomy defects after resection of laryngeal cancer. With this technique, optimal functional results were obtained after a learning curve of more than 50 patients. The objective of this paper is to present the final reconstructive concept with the typical indications.

Immunophenotype and possible origin of nevi with phenotypical heterogeneity.

Biphenotypical nevi or nevi with phenotypical heterogeneity consist of phenotypically different cell populations in a pattern other than that observed in classical combined nevi or in various maturation stages of banal nevocellular nevi. Besides several well-known entities such as deep penetrating nevi and plexiform spindle cell nevi, this category of pigment cell lesions also harbors fewer delineated lesions such as nevi with atypical dermal nodules (N-ADN) and nevi with a focal atypical epithelioid cell component (N-FAECC). Their worrisome histology may result in a wrong diagnosis of malignancy.

Torsional diplopia in Graves' orbitopathy. Three case reports.

Torsional diplopia may frequently accompany Graves' orbitopathy and is often not recognized. Some patients with manifest cyclotorsion do not complain of torsional diplopia because it is concealed by the large vertical and/or horizontal deviation. Torsional diplopia can occur spontaneously or appear after decompression or strabismus surgery.

Tracheal autotransplantation as a new and reliable technique for the functional treatment of advanced laryngeal cancer.

Objectives/hypothesis: Tracheal autotransplantation allows for reconstruction of extended hemilaryngectomy defects (including half of the cricoid cartilage) after resection of laryngeal or hypopharyngeal cancer. A series of 38 patients underwent the operation. The technique involved a two-stage procedure (stage 1, tracheal revascularization; stage 2, hemilaryngectomy and tracheal autotransplantation) because the trachea requires at least 2 weeks for revascularization.

Lipoblastoma in a 23-year-old male: distinction from atypical lipomatous tumor using cytogenetic and fluorescence in-situ hybridization analysis.

Lipoblastoma is a rare benign tumor that occurs primarily in infancy and early childhood. We present the rare presentation of a 12 cm sized intramuscular lipoblastoma of the thigh in a 23-year-old patient. On histology, the tumor strongly resembled an atypical lipomatous tumor due to the presence of lipoblasts and atypical stromal nuclei.

Short-term intra-individual variability in heidelberg retina tomograph II.

We determined the short-term intra-individual variability for each parameter of the Heidelberg Retina Tomograph II (HRT II). Therefore we examined prospectively 20 healthy volunteers 3 times within 2 weeks. The variability was expressed as the coefficient of variation for each parameter.

Long-term lansoprazole treatment for gastro-oesophageal reflux disease: clinical efficacy and influence on gastric mucosa.

Background: Long-term acid suppression is believed to accelerate atrophic gastritis in Helicobacter pylori-positive patients. The influence of long-term therapy with lansoprazole has not been examined.

Aim: To study the clinical and endoscopic efficacy and histological evolution of gastric mucosa during 5 years of maintenance treatment with lansoprazole, 30 mg.

An investigation of airway wound healing using a novel in vivo model.

Objective: To study the amount of wound contraction and reepithelialization occurring in the healing process of full-thickness mucosal defects treated with and without mitomycin.

Study Design: A new wound healing model was developed in which the tracheal mucosa was exteriorized without interference with the blood supply or with the cartilage support of the trachea. This was done by: 1) orthotopic tracheal revascularization in vascularized fascia; 2) isolation of revascularized segment after 14 days; 3) posterior longitudinal incision of revascularized segment; 4) exteriorization of tracheal mucosa with formation of anterior full-thickness mucosal defect; and 5) closure of posterior tracheal incision and reimplantation in the airway.

Acral myxoinflammatory fibroblastic sarcoma with unique clonal chromosomal changes.

Acral myxoinflammatory fibroblastic sarcoma is a rare tumor of the distal extremities. We present the hitherto unreported karyotypic abnormalities of this new entity. The tumor presented as a mass in the dorsum of the foot in a 53-year-old woman and showed the typical virocyte-like and lipoblast-like cells in a myxoid and inflammatory background.

Minimizing the risks of missing a contact allergy.

The diagnosis of a contact allergy can be missed in the various stages of the allergological investigation: the clinical examination of the patients, the anamnesis, the skin testing as well as the determination of the relevance of a positive test. This is illustrated by means of examples from the literature.

Acute manifestation of LHON and coincidental finding of a pituitary adenoma: a case report.

A patient with Leber Hereditary Opticus Neuropathy (LHON) and a pituitary adenoma is presented. The different ophthalmological signs of LHON are described and illustrated. A definite diagnosis is made by detecting a mitochondrial mutation.

Assessing the developmental level in Rett syndrome: an alternative approach?

Reviewing the literature concerning the developmental level of Rett Syndrome (RS) girls, one is confronted with important difficulties in interpreting the meaning of the results of these studies. Anecdotal evidence from parents suggests that RS girls might understand more than these studies indicate. Analyses of these examples suggests that there are other learning mechanisms than those assessed in classical developmental tests, which are important for RS girls in order to learn to know and understand their world.

Results of larynx preservation surgery for advanced laryngeal cancer through tracheal autotransplantation.

Objective: To evaluate the use of tracheal autotransplantation for reconstruction of the hemilaryngectomy defect that includes the hemicricoid cartilage and results from resection of laryngeal or hypopharyngeal cancer.

Design: The clinical records of 28 patients undergoing primary or salvage hemicrico-hemilaryngectomy for laryngeal (26 patients) and pyriform sinus (2 patients) cancer were analyzed for function and local control.

Setting: Academic center.

Expression of the inducible isoform of nitric oxide synthase in pigment cell lesions of the skin.

Nitric oxide (NO) is a small molecule produced during the conversion of L-arginine to L-citrulline by NO synthase (NOS). Several isoforms of NOS exist, of which the Ca2+-independent, inducible NOS (iNOS or NOS2) is most prominently expressed by macrophages. iNOS activity and increased levels of iNOS have been found in various tumours and tumour cell lines but not in normal tissues; however, the precise role of NO in tumour progression has yet to be elucidated.

From concept to clinical reality: implementing tracheal autotransplantation in conservation laryngectomy.

The implementation of tracheal autotransplantation in conservation laryngectomy is an illustration of how surgical research on laryngotracheal reconstruction was taken from the bedside to the laboratory and back. The study started in 1989 in an effort to improve laryngeal reconstructive methods because a total laryngectomy seemed unnecessary radical for unilateral fixed-cord glottic lesions. The clinical problem we chose for investigation was taken to the laboratory and a rabbit model allowing tracheal revascularization and transplantation was developed.

Limbal transplantation after chemical injuries of the eye.

Purpose: To illustrate the benefit of limbal stem cell transplantation in three eyes with severe ocular surface failure due to chemical burns.

Methods: In two patients with monocular corneal scarring and vascularization after chronic chemical burns, a limbal tissue autograft was transferred from the unaffected fellow eye. A complete superficial keratectomy was performed on the host eye.

Expression of the neuronal isoform of nitric oxide synthase (nNOS) and its inhibitor, protein inhibitor of nNOS, in pigment cell lesions of the skin.

Nitric oxide (NO) is involved in many physiological processes. In cancer, low levels of NO are thought to enhance tumour progression and metastasis. NO is generated from arginine by NO synthase (NOS); the Ca2+-dependent neuronal isoform or nNOS (expressed by neurones and inhibited by the protein inhibitor of nNOS, PIN), is also expressed by cultured normal melanocytes and by all malignant melanoma (MM) cell lines.