[Cystic mesenchimal hamartoma of the liver in two-year-old patient--case report].

Mesenchymal hamartoma is an uncommon benign hepatic tumor arising from the mesenchyme of the portal triad. This lesion is relatively uncommon, representing 5% of all primary hepatic pediatric tumors. This form of hamartoma usually presents before the age of 2 years, typically with abdominal swelling as the initial symptom. The classic management of these lesions has been excision either by hepatic lobectomy or wedge resection. We present a case of 2-year-old girl with a right hepatic lobe tumor, 66 x 57 x 71 in diameter that was completely removed by right hepatic lobectomy.

A short vas deferens limiting successful laparoscopic testicular descent.

OBJECTIVE: To highlight the problem of the short vas deferens in a single stage or staged laparoscopic orchidopexy. PATIENTS AND METHODS: From October 1992 to February 1996, 23 patients (mean age 4.9 years, range 12 months to 12 years) underwent a laparoscopic staged Fowler-Stephens orchidopexy. During the second stage (open surgery), a short vas deferens was found in three patients; two testes were located retrovesically and one was in the internal inguinal ring. Two testes could not be brought into the scrotum, but only to the inguinal region, and one testis was placed in the scrotum but under tension. RESULTS: The patients were followed for 12, 19 and 28 months; the testis under tension became fully atrophic. One of the two testes that could not be placed further than the inguinal canal developed marked hypotrophy, while the other "survived'. CONCLUSIONS: A laparoscopic staged Fowler-Stephens orchidopexy should not used in patients with a very short vas deferens; patients with such a short vas deferens are extremely rare.

Laparoscopy in the diagnosis of non-palpable testes.

OBJECTIVE: To determine whether laparoscopy is a reliable method for the diagnosis of non-palpable testes. PATIENTS AND METHODS: From January 1991 to February 1993 laparoscopy was performed in 126 patients, aged 6 months to 29 years (mean 5.2 years), with non-palpable testes. Of these, 98 had unilateral and 16 bilateral non-palpable testis, and 12 had previously undergone corrective surgery. Within the same period, 1163 patients underwent surgery for undescended testes. RESULTS: In the group of 126 patients, 146 testes were searched for. The testes were laparoscopically diagnosed in 70 instances (48%). Of these, 46 were unilateral, 18 bilateral, and six testes were in children who had previously undergone surgery. Non-palpable testes were predominantly on the left side. All testes located were situated between the external iliac vessels and the internal inguinal ring or within the inguinal ring. Of the 146 testes searched for, 76 (52%) were absent. CONCLUSION: Laparoscopy is the most satisfactory method for the diagnosis of non-palpable testes, when carried out by an experienced endoscopist.

[An expert system for differentiation of viral meningitis]. / Ekspertni sistem za differenciranje virusnih meningitisa.

The LOSTI system for viral meningitis differentiation, by using promptly accessible attributes, has been described. It is based on attribute values (averages and percentages). Logical principles on similarities and diversities are used. The system is dynamic for its ability to make itself permanently adjusted by using new cases and their attribute values. Through the possibility of prompt data processing according to a certain methodology, the system is able to take part in medical decision making. Its intention is not to make any definite decisions, just to "substitute" aetiologic diagnostics of viral meningitis in case it has not been successful or has not been done. It can also be used in epidemiological and statistical studies so long as the fact still stands that over half of the cases of serous meningitis remain aetiologically undiagnosed.