[Reliability of clinical diagnosis in malignant melanoma]. / A klinikai diagnózis megbízhatósága melanoma malignumban.

During the last 10 years (1981-1990) 14,178 skin tumors were histologically examined in the Department of Dermatology of the University Medical School of Szeged. Of these lesions 520 were diagnosed clinically and histologically as malignant melanoma (true-positive). 104 lesions were clinically diagnosed as malignant melanoma but were found histologically to be other tumors (false-positive). An additional 78 cases diagnosed clinically as other than malignant melanomas, were found histologically to be malignant melanoma (false-negative). The clinical diagnostic accuracy was 74.07%. The index of suspicion was 104.34%, thus demonstrating a slight degree of "overdiagnosis". The sensitivity, specificity and predictive values were consonant with those of the literature.

Clinical characteristics of cutaneous melanoma in southeastern Hungary.

Clinical and histopathologic characteristics and data on the incidence of primary cutaneous melanoma are presented from an area of Hungary with 1.9 million inhabitants. Experiences with delayed elective node dissection on survival are also documented.

Correlates of diuretic renography in experimental hydronephrosis.

We studied the correlations between diuretic renographs and kidney function in experimental hydronephrosis in rabbits. Features of furosemide-stimulated 99mTc-diethylenetriamine-pentaacetic acid renographs were compared to the growth rate, thirst test and endogenous creatinine clearance rate in a chronic solitary-kidney animal model. Intravenous pyelograms, done four weeks after laparotomy, left nephrectomy, bladder resection and constriction of the right pyeloureteric junction, showed signs of obstruction in all the 12 animals of the experimental group. An absent tracer washout after intravenous furosemide, found in five animals, was associated with retarded growth, isosthenuria and an abnormal creatinine clearance. In all of the other seven animals, a distinct tracer washout after intravenous furosemide was accompanied with a normal growth rate and creatinine clearance. However, no one of these seven animals had a normal ability to retain water and concentrate urine in the thirst test. We conclude that, in this experimental model, a furosemide-induced tracer washout from the kidney pelvis cannot be taken as a proof of the absence of any upper urinary tract obstruction.

Keratinocyte grafting: a new means of transplantation for full-thickness wounds.

Twenty adult individuals with chronic leg ulcers caused by venous insufficiency, and 5 patients with full-thickness burns were treated. Twenty of the patients (15 with leg ulcers and 5 with burns) were grafted with separated autologous keratinocytes. In these cases the cells were fixed to the wound bed by a fibrin net. Five other patients (with leg ulcers) were treated with fibrin without keratinocytes. In 16 of the 20 patients grafted with keratinocytes in a fibrin net, the defect healed completely in 14 to 21 days. On the other hand, the fibrin net without keratinocytes failed to significantly accelerate the process of reepithelialization. Our experience suggests that a rapid healing of full-thickness skin defects can be achieved through keratinocyte grafting.

[Closure possibilities for unexpectedly large skin defects in operations on the extremities]. / Veschlussmöglichkeiten für unerwartet grosse Hautdefekte bei Operationen an den Extremitäten.

Five different techniques to close operation wounds are discussed. Burrow-triangles are especially helpful to close defects on the back of the hand. Other methods are stamp-like thin skin grafts, the handcut meshgraft and the synthetic cover with Epigard, especially for outpatients. The triangular subcutaneously flapped graft is an elegant technique but demands a suitable terrain.