Intrauterine repair of surgically created defects in mice (lip incision model) with a microclip: preamble to endoscopic intrauterine surgery.

We compared the difference between a nonpenetrating silver microclip and suture on wound healing, inflammatory response, and application time in the repair of surgically created standardized unilateral cleft lip type defects in fetal mice. Excellent lip continuity and dermal reconstitution were achieved by both methods of repair. Furthermore, collagen accumulation did not occur. Occasional mononuclear cells were seen around sutured repairs in contrast to microclipped repairs. The most significant difference, however, was in application time with the microclip requiring an average of 7 seconds (+/- 2) compared to 90 seconds (+/- 15) for suture. We conclude that the microclip offers distinct advantages for intrauterine cleft lip repair: (1) nonpenetrating tissue approximation; (2) less inflammatory response than suture; (3) technically more rapid and less difficult to apply than suture; and (4) can be utilized more readily than suture for endoscopic approaches limiting the risks of fetal surgery for both the mother and the fetus.

Plantar fibromatosis: literature review and a unique case report.

Plantar fibromatosis represents a relatively uncommon benign lesion of soft tissue. It is most often found to invest the central and medial portions of the plantar fascia and commonly occurs in conjunction with other fibrous proliferate disorders. The authors present a detailed review of the literature concerning this usually unencapsulated fibrous growth. A unique case involving a relatively large encapsulated mass found to undergo dorsal extension into the plantar musculature is also presented.

Hydrocephalus following prenatal methylmercury poisoning.

Prenatal methylmercury poisoning of C57BL/6J mice was followed by the development of communicating hydrocephalus in 15% to 25% of surviving offspring. Although examination of the serially sectioned cerebral aqueduct in hydrocephalic animals revealed the presence of stenosis, complete occlusion of the lumen was not observed. The ependymal epithelium of the cerebral aqueduct was preserved, and there was no evidence of periaqueductal inflammation or reactive gliosis. Edema and vacuolar change were, however, observed subependymally. The cerebral white matter, which bore the brunt of the degenerative changes seen in hydrocephalic brains, showed edema, spongy degeneration, gross cystic change and loss of parenchyma. In addition, ependymal cells and choroid plexus epithelial cells in Hg-treated animals contained large amounts of mercury within their cytoplasm, and it is possible that this may have contributed to the development of hydrocephalus by causing disturbances of CSF homeostasis. We believe that the appearance of aqueductal stenosis in Hg-intoxicated animals represents the result rather than the cause of the hydrocephalus.

Hypertrophic mononeuropathy. A report of two cases and review of the literature.

Two cases of hypertrophic mononeuropathy were studied. This entity is characterized grossly by focal enlargement of a single peripheral nerve, and microscopically by loss of nerve fibers, fibrosis, and formation of numerous onion bulbs. Our cases were diagnosed by exploratory surgery, biopsy, and light microscopy. Electron microscopic evaluation was performed in one case. Recognition of this entity by the surgical pathologist is important, so that it can be distinguished from generalized forms of onion bulb neuropathies, most of which give a much less favorable long-term prognosis. Hypertrophic mononeuropathy has usually resulted in irreversible local neurologic deficit but, unlike the polyneuropathies, in all the previously reported cases (as well as in our two cases to date) it has remained a localized process.