[Menstrual cycle and surgery of breast cancer. Point of time for the surgery of primary breast cancer in connection with menstrual cycle is without prognostic significance]. / Menstruationscyklus og operation for mammacancer. Tidspunktet for operation for primoer mammacancer i forhold til menstruationscyklus er uden prognostisk betydning.

From 1977 to 1989 6488 patients under fifty years with primary breast cancer were registered in the nationwide Danish Breast Cancer Cooperative Group (DBCG). Among these information on last menstrual period prior to surgery was available in 1635 cases which constitute the study group of the present analysis. The group was representative of the total group with regard to prognostic factors and survival. In the study group time of surgery in relation to last menstrual period was found to have no influence on five- and ten year survival.

[Bladder leukoplakia]. / Blaereleukoplaki.

Leukoplakia of the bladder is a rare condition. It is characterized by squamous metaplasia of the transitional epithelium and keratinization. The etiology and possible pathogenetic factors are discussed. Up to 42% develop carcinoma which makes early diagnosis important. The clinical diagnosis is difficult. The patients present with symptoms of vesical irritation and the passage of flakes is pathognomonic. Diagnosis is made by cystoscopy with biopsies. Characteristic cystoscopic findings are described. Treatment and a follow-up programme are outlined. As conservative treatment remains unsatisfactory radical extirpation or cystectomy is recommended for extensive lesions.

Trigger finger: report of an unusual case.

Locking of a finger is a common condition usually caused by tightness of the fibrous sheaths around the flexor tendons. A case of a locking finger with an unusual traumatic cause and perioperative findings is presented. Different causes of trigger fingers, especially traumatic, reported in the literature are briefly discussed, and the importance of differing between traumatic and nontraumatic causes for locking phenomena is emphasized.

A case of vesical leukoplakia.

A 54-year-old woman who had earlier been treated for cervical dysplasia complained of recurrent cystitis, urgency and frequency, but without signs of genital prolapse. At cystoscopy with biopsies, leukoplakia of the bladder was diagnosed. We describe how the condition is distinguished from squamous metaplasia of the trigone as seen in normal premenopausal women. An association between leukoplakia and cancer is widely accepted. Against this background, a follow-up program is outlined. The possibility of leukoplakia as a multicentric disorder of the genito-urinary tract is briefly discussed.

[Peptic ulcer in children]. / Ulcus pepticum hos børn.

Peptic ulceration in children is a rare condition. Primary ulcers, representing 70% of ulcers in children greater than 6 years are predominantly duodenal in location. A positive family history for peptic ulcers is common. Immunosuppressive therapy, severe infections and intracranial lesions are important etiologic factors associated with secondary ulcers. The mortality is approximately 80%. The clinical characteristics of both groups are described. Treatment of children's ulcers and associated complications are described with emphasis on reserving surgical treatment for ulcers not responding to medical therapy and complicated ulcers. We recommend increased attention to this notoriously difficult diagnosis and increasing use of upper gastrointestinal fiberoptic endoscopy.

[Fatal acute stomach ulcer perforation in a 4-year-old child]. / Akut ventrikelulcus med perforation og letal udgang hos 4-årigt barn.

A fatal case of perforation of a gastric ulcer in a 4 1/2-year-old child is presented and discussed.

[Recurrent secondary stomach ulcer in a boy 3 months of age with osteogenesis imperfecta]. / Recidiverende sekundaert ulcus ventriculi hos en tre måneder gammel dreng med osteogenesis imperfecta.

A case is described where a 3-month-old boy who had osteogenesis imperfecta with multiple fractures presented with vomiting and bleeding. A gastric ulcer was diagnosed by endoscopy but could not be visualized by repeated radiography. In spite of adequate treatment with H2-antagonists and antacids the bleeding recurred three months later. Development of hypertrophic pyloric stenosis was diagnosed and pyloromyotomy was performed after which the patient recovered without further recurrences. This case suggests that multiple ulcerogenic factors should considered and treated in pediatric patients with recurrent secondary ulcers in spite of appropriate treatment.

Abdominal abscess following asymptomatic pelvic osteomyelitis. Case report.

In a 23-year-old woman, an intramuscular abscess of the ventral abdominal wall in the right iliac fossa was found to have an extraperitoneal fistula to a focus of asymptomatic osteomyelitis of the iliac ala. Pelvic osteomyelitis should be suspected in cases of abdominal wall abscess without pathologic intra-abdominal findings.

Rhabdomyolysis and acute renal failure following an overdose of doxepine and nitrazepam.

A 50-year-old woman developed rhabdomyolysis and myoglobinuric renal impairment after an oral dose of 250 mg nitrazepam and 1,250 mg doxepin. Serum creatinine increased from 70 mumol/l to 472 mumol/l in two days. Serum creatine phosphokinase reached a maximal level of 391 mu kat/l (reference range less than 2.5 mu kat/l) on the third day and serum myoglobin was maximally 910 nmol/l (reference range less than 4.5 nmol/l) on the fourth day after the overdose. Passive and active movements of the knees and ankles became increasingly restricted, but the patient felt no muscle pain. Diuresis decreased to 20-22 ml/hour in spite of repetitive doses of furosemide, but was enforced to greater than 100 ml/hour by vigorous infusion of saline. Haemodialysis was avoided on this regimen. It is suggested that in patients intoxicated with nitrazepam and/or doxepin, rhabdomyolysis should be suspected when a rapidly increasing serum concentration of creatinine is found, even in the absence of muscle pain.