Morphological comparison of processus vaginalis from boys with undescended testis and hernia sacs from boys with inguinal hernia.

INTRODUCTION: The aim of this study was to compare the morphological features of processus vaginalis (PV) and hernia sacs obtained from boys with undescended testis and inguinal hernia, respectively, in order to investigate whether these structures have similar histology. MATERIAL AND METHODS: Samples of PV (n=61) and hernia sacs (n=68) obtained from boys operated for undescended testis (n=58) and inguinal hernia (n=64), respectively, were stained with hematoxylin-eosin for optical qualitative microscopy analysis. The histological structures of each group of samples were compared by a pathologist blinded to the specific pathology. RESULTS: The most prevalent histological findings were connective tissue, smooth muscle, mesothelium, nervous elements, striated muscle and mesonephric remnants with no statistical differences between the groups. The amount of smooth muscle was greater in the hernia sac group where it appeared as a layer. In contrast, the smooth muscle present in the form of sparse bundles around the connective tissue in the PV. CONCLUSIONS: Sacs obtained from boys with inguinal hernia and PV obtained from boys with undescended testis shares a similar histology except for the amount of smooth muscle when analyzed qualitatively by optical microscopy using hematoxylin-eosin stain.

Patency of the "third inguinal ring" in children with unilateral cryptorchidism: fact or fiction?

BACKGROUND: The entrance to the scrotum, or the so-called "third inguinal ring" (3rd IGR), was thought to be an important finding and etiological factor for cryptorchidism at the beginning of the 20th century. Historical reports of its association with undescended testis suggest that it was considered by many to be a true anatomical entity. As the understanding of testicular descent has changed, the description of this anatomical passage has vanished from textbooks and publications. In order to evaluate the findings that led to its original report, we sought to assess the patency of the expected testicular path of descent into the scrotum in children with unilateral cryptorchidism. METHODS: Two hundred consecutive children who underwent unilateral orchidopexy were prospectively evaluated at the time of surgery to determine the anatomical patency of the area thought to represent the 3rd IGR. We also evaluated its association with the patient's age at surgery, the affected side, position of the undescended testis, macroscopic epididymal anomalies (MEA), and the patency of the processus vaginalis (PV). RESULTS: The mean age at surgery was 5.2 +/- 3.0 years, ranging from 1 to 13 years. The 3rd IGR was closed in 118 boys (59.0 %) and open in 82 (41.0 %). A closed 3rd IGR was found significantly more frequently in patients with intra-abdominal testes (p < 0.01). No significant association was observed between patency of the 3rd IGR and other evaluated factors. CONCLUSION: Our results suggest that the so-called 3rd IGR may represent the passage point of the testicle into the scrotum, which was not patent during the intraoperative examination in (2/3) of children with unilateral cryptorchidism. This observation by surgeons at the beginning of the 20th century may represent an anatomical curiosity rather than an important factor in the pathogenesis of cryptorchidism.

Biliary ascariasis after Roux-en-Y hepaticojejunostomy.

The authors report on a 6-year-old girl with biliary ascariasis after surgical treatment of a choledochal cyst and biliary-digestive tract reconstruction by Roux-en-Y hepaticojejunostomy. A precise diagnosis can be obtained by ultrasonography. Surgical treatment is required when clinical and endoscopic treatments fail. In countries in which this disease is endemic, biliary ascariasis should be considered in the differential diagnosis of cholangitis after surgery for hepaticojejunostomy.

Use of a plastic hemoderivative bag in the treatment of gastroschisis.

The authors report their experience with the use of a polyvinyl chloride (PVC) bag for blood-derivative transfer as a prosthesis for the creation of a silo for surgical treatment of gastroschisis (GS) in seven newborn infants. The bag is sterile, impermeable to micro-organisms, transparent, flexible, resistant, internally smooth, does not adhere to the bowel loops, readily available, and inexpensive, properties that make it an excellent alternative as a prosthesis for staged surgical treatment of congenital anomalies of the abdominal wall such as GS and omphalocele. The importance of a multidisciplinary team for the care of newborns with GS is also emphasized for a good postoperative outcome.

Quiste del colédoco en niños: experiencia en 15 casos / Choledocal cyst in children: 15 years experience

Presentamos la experiencia del Servicio de Cirugía Pediátrica del Hospital de Clínicas de la universidadFederal de Minas Gerais en quistes colédoco,con 19 niños tratados en el período de 1984 a 1998,ocho eranmenores de 2 años de edad,7 de los cuales presentaban ictericia obstructiva y acolia.A partir de los dosaños solamente 3 de los 11 niños manifestaban la tríada sintomática de ictericia,dolor y masa abdominal.En 18 pacientes se realizó la estirpación de la vesícula,del quiste y una hepaticoyeyunostomía en Y de Roux.En dos de ellos con severa inflamación periquística,fue realizada la resección intramural del quistey en otro paciente,con inflamación periquística se realizó una quisteyeyunostomía en Y de Roux y colecistectomía

Quiste del colédoco en niños: experiencia en 15 casos / Choledocal cyst in children: 15 years experience

Presentamos la experiencia del Servicio de Cirugía Pediátrica del Hospital de Clínicas de la universidadFederal de Minas Gerais en quistes colédoco,con 19 niños tratados en el período de 1984 a 1998,ocho eranmenores de 2 años de edad,7 de los cuales presentaban ictericia obstructiva y acolia.A partir de los dosaños solamente 3 de los 11 niños manifestaban la tríada sintomática de ictericia,dolor y masa abdominal.En 18 pacientes se realizó la estirpación de la vesícula,del quiste y una hepaticoyeyunostomía en Y de Roux.En dos de ellos con severa inflamación periquística,fue realizada la resección intramural del quistey en otro paciente,con inflamación periquística se realizó una quisteyeyunostomía en Y de Roux y colecistectomía '

Change in erythrocyte shape induced by cyclosporine administration.

In order to estimate the effect of the long term administration of cyclosporine (CsA) on the shape change of erythrocytes, erythrocyte shapes which are observed with a scanning electron microscope were classified according to the nomenclature of Bessis for stomatocyte-echinocyte shape transformation. As a result of observing the erythrocyte shape of fifty-six patients with kidney transplantation treated with CsA, the morphological index of the erythrocytes of patients significantly increased to 0.0835+/-0.0085*** in comparison with 0.0004+/-0.0051 of those from healthy volunteers (control) (***: p<0.001, ANOVA). Such transformations had no relation to the subjects' sex or age. On the other hand, the erythrocytes of patients administered more than 100 ng/ml of CsA and posttransplanted within less than two years were transformed by CsA from the state of discocyte to echinocyte. In rats, the morphological index of erythrocytes of rats treated with 3 mg/kg/d or 5 mg/kg/d of CsA significantly increased in comparison with rats treated with saline (control). Furthermore, the erythrocytes of two patients were observed in terms of shape before the treatment with CsA. In both patients, the echinocyte type of erythrocyte increased by treatment with CsA. In vitro, the morphological index of the erythrocytes incubated with plasma containing CsA significantly increased, to 0.459+/-0.066*** in comparison with 0.064+/-0.029 of the control. It is suggested from these results that CsA treatment induces the echinocyte type of erythrocyte.