RESUMO
Testicular tumors are very rare in boys, approximately 1.5% of these are Leydig cell tumors. The authors present a 4.5 year-old boy with Leydig cell tumor of left testis, which was associated with increased sex steroid production that caused precocious puberty. These tumors are benign processes in prepubertal children. Beyond the rarity of this case the authors would like to report about its diagnostic difficulties and testis-sparing remove of it. The plasma 17-hydroxyprogesterone levels provide the distinction between congenital adrenal hyperplasia and Leydig cell tumor in patient with precocious puberty.
Assuntos
Tumor de Células de Leydig/complicações , Tumor de Células de Leydig/diagnóstico , Puberdade Precoce/etiologia , Neoplasias Testiculares/complicações , Neoplasias Testiculares/diagnóstico , Hiperplasia Suprarrenal Congênita/diagnóstico , Hormônio Adrenocorticotrópico/sangue , Pré-Escolar , Desidroepiandrosterona/sangue , Diagnóstico Diferencial , Humanos , Tumor de Células de Leydig/sangue , Tumor de Células de Leydig/patologia , Tumor de Células de Leydig/cirurgia , Masculino , Puberdade Precoce/sangue , Puberdade Precoce/patologia , Neoplasias Testiculares/sangue , Neoplasias Testiculares/patologia , Neoplasias Testiculares/cirurgia , Testosterona/sangue , Procedimentos Cirúrgicos Urogenitais/métodosRESUMO
UNLABELLED: During a 15-month period 8 patients (1 male, 7 females, mean age 49 years) admitted from different institutions were treated with bile leaks after laparoscopic cholecystectomy. The diagnosis was established by endoscopic retrograde cholangiography. The site of the leakage was the cystic duct in five cases, the common bile duct in one case, the hepatic "bed" in one case and it was undetectable in one case. Five patients had common bile duct stone and one patients also had common bile duct stricture. Endoscopic sphincterotomy was performed in all cases with stone extraction if needed, and stent insertion (7 or 10 Fr straight endoprosthesis) in six cases. The stents were removed after 4-16 weeks in all cases, except the patients with common bile duct stricture, in whom the stent was exchanged for two other endoprostheses to prevent restricture after three months, she is still under treatment. Endoscopic sphincterotomy, stone removal and stent placement were successful in all cases. Symptoms resolved in hours, and the bile leakage stopped in days. Apart from transient serum amylase level elevation in one patient no other complication was observed. CONCLUSION: The endoscopic treatment of bile leakage after laparoscopic cholecystectomy has proved to be a safe and effective method. It may be considered the method of choice in the management of this complication.
Assuntos
Refluxo Biliar/etiologia , Colecistectomia Laparoscópica/efeitos adversos , Esfinterotomia Endoscópica , Adulto , Refluxo Biliar/diagnóstico , Refluxo Biliar/cirurgia , Colangiografia , Colangiopancreatografia Retrógrada Endoscópica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-OperatóriasRESUMO
An 18 year old male patient is reported with a five year history of mild pain in his right hip. Radiological investigation showed a typical feature for osteoblastoma of iliac bone, with two niduses. En bloc excision was performed. The histological examination's result was also osteoblastoma.
Assuntos
Neoplasias Ósseas/diagnóstico por imagem , Ílio/diagnóstico por imagem , Osteoma Osteoide/diagnóstico por imagem , Adolescente , Neoplasias Ósseas/patologia , Neoplasias Ósseas/cirurgia , Humanos , Ílio/patologia , Ílio/cirurgia , Masculino , Osteoma Osteoide/patologia , Osteoma Osteoide/cirurgia , RadiografiaRESUMO
The ostitis deformans Paget in the metacarpal bone is a rarity. Author presents a case of a 70 year old white man with a single metacarpal alteration.
Assuntos
Metacarpo/diagnóstico por imagem , Osteíte Deformante/diagnóstico por imagem , Idoso , Humanos , Masculino , RadiografiaAssuntos
Articulação do Quadril/diagnóstico por imagem , Prótese de Quadril , Calcinose/diagnóstico por imagem , Calcinose/etiologia , Reação a Corpo Estranho/diagnóstico por imagem , Reação a Corpo Estranho/etiologia , Prótese de Quadril/efeitos adversos , Humanos , Osteólise/diagnóstico por imagem , Osteólise/etiologia , RadiografiaRESUMO
The effect of repeated intravenous administration of 1 mg/kg atropine was studied on the synchronization elicited by low and high frequency electrical stimulation in the olfactory tubercle. The results showed that the synchronization of the cortical electrical activity could also be brought about during atropine administration, moreover, a gradual dose-dependent facilitation of the synchronizing effect was observed. Similar facilitation was obtained in cerveau isolé of the cats. Based on the experimental results it is concluded that the synchronizing effects of basal forebrain stimulation and the arousal effect of the activating system converge at a cortical level.