Mesenteric fibromatosis.

Two rare cases of mesenteric fibromatosis are presented. The first patient had a right upper quadrant mass and colicky abdominal pain. The tumor originated from the mesentery of the colon and it infiltrated the gallbladder, cystic duct, and the liver. The second patient had severe hematemesis and melena. The origin of the tumor, which infiltrated 3/4 part of the stomach, the gastrohepatic ligament, the first part of the duodenum, and the liver could not be determined. In the first patient, partial colectomy and cholecystectomy were performed and the liver lesion was completely excised. The second patient underwent subtotal gastrectomy and left lobectomy of the liver. The first part of the duodenum was excised. Gastrojejunostomy was performed. No recurrence was recorded in either patients during 16 and 13 months follow-up, respectively. In this report, diagnostic aids, differential diagnosis and treatment of this rare disease are discussed.

Infantile myofibromatosis. A case report.

Infantile myofibromatosis is a rare mesenchymal disorder of infancy characterized by the formation of tumors in the skin, muscle, viscera, bone and subcutaneous tissue. The etiology of the disorder is unknown. We describe here a newborn with multiple infantile myofibromatosis, peritonitis and intestinal perforation. Surgery revealed multiple intestinal obstructions and jejunal perforation due to intestinal tumors; consequently, a jejunostomy was performed. The patient was maintained on total parenteral nutrition and oral semiliquid infant formula for two months, however, he died due to multiple attacks of diarrhea and septicemia.

A case of neurenteric cyst.

An eight-month-old female infant with a neurenteric cyst situated in the lumbar region is presented because of its rarity and because it can mimic other neurological malformations which occur on the same site. Microscopic examination of the surgically excised cyst revealed Water-Paccini corpuscles, lymphoid follicles, intestinal mucosa and meningeal tissue which originated from two ectoderm and endoderm-germ layers.

Treatment of osteochondral defects with tendon autografts in a dog knee model.

Tendon autograft was used for the treatment of osteochondral defects induced experimentally in dogs' knees. Osteochondral defects were created on the femoral condyles in both knees of five dogs. The tendon was harvested from the anterior cruris, and a knot was tied in the middle. Then two tunnels were bored in the medial condyle. The free ends of the tendon were individually inserted into the tunnels and pulled from the openings on the medial recessus side so that the knot itself sat within the osteochondral defect. The lateral condyle was left untreated for comparison. At 24 weeks postoperatively, the dogs were killed and macroscopical and histological examinations were performed. A congruous articular surface had formed, and the grafted tendon was bonded into the defect. The tendon was not degraded, and was covered with reparative tissue as seen microscopically. Despite weight-bearing being allowed in the early stages after the operation, no sign of degradation was noted in the tendon.

Role of diltiazem in ischemia-reperfusion injury of the intestine.

It is well recognized that reperfusion causes tissue damage in excess of that produced by ischemia alone. The present study was designed to test this and to evaluate the role of the calcium antagonist, diltiazem (400 micrograms/kg body weight administered intravenously over 95 min), in ischemia-reperfusion injury of the intestine. Intestinal ischemia was produced by occlusion of the superior mesenteric artery (SMA) with interruption of the collateral flow for 30 min. Reperfusion was established by declamping the SMA for 1 h, and mucosal injury was assessed using a grading scale from 0 to 5. The severity of mucosal damage increased significantly after 1 h of reperfusion, from a mean grade of 2.1 in the ischemia group to 3.8 in the ischemia-reperfusion group (p < 0.01). Diltiazem was effective in the amelioration of histologic changes of reperfusion injury and reduced the degree of mucosal injury from a mean grade of 3.8 in the ischemia-reperfusion group to 2.5 in the diltiazem group (p < 0.05). This study strongly suggests that calcium ions are involved in the pathogenesis of ischemia-reperfusion injury and that diltiazem attenuates this injury by preventing the intracellular calcium influx that occurs during reperfusion.