Search

The Rapunzel Syndrome is a rare form of gastric trichobezoar extending throughout the bowel. A 8-year-old girl was admitted to our institution with a six months history of vomiting and astenia. Upper gastrointestinal contrast study showed a lot of filling defects in stomach and the first bowel loops. At laparotomy a large intraluminal mass is observed. Gastrotomy revealed a large tricobezoar with intestinal extension to jejunum, that were extracted. In rare instances, this syndrome presents with a confusing clinical picture. A detailed medical history is an essential point in the diagnosis.

The effects of water activity (aw, 0.994-0.90 identical to 0.4-14.0 (-)MPa water potential), temperature (4-45 degrees C), and pH (3.6, 5.5, 7.0), and their interactions on growth of isolates of Fusarium moniliforme and Fusarium proliferatum were determined in vitro on a maize extract agar medium. Growth of two isolates of F. moniliforme and four isolates of F. proliferatum were significantly influenced by water activity regardless of solute type used (NaCl, glycerol, or glucose). However, at steady-state aw levels, growth was optimum at 0.994-0.98 aw and reduced significantly at 0.92 aw. Further detailed studies with one isolate of F. moniliforme (25N) and two isolates of F. proliferatum (73N, 131N) showed that growth occurred over the range of 0.994-0.90 aw in the temperature range 20-35 degrees C with slight differences between species. Growth did occur at 4 degrees C and 0.994-0.96 aw, but no growth was recorded at 40 and 45 degrees C regardless of aw. Profiles of aw x temperature relations for growth of these two species were constructed from these data for the first time. Optimum pH and temperature for growth was 5.5 and 25 degrees C for both isolates of F. proliferatum, and pH 7.0 and 30 degrees C for the isolate of F. moniliforme. However, for the latter isolate at < 0.98 aw, optimum pH and temperature for growth changed. The effects of pH, temperature, and aw for single, two-way and three-way interactions were all found to be statistically significant for these three isolates. The ecological significance of this information for understanding these important fumonisin-producing fungi is discussed.

Objective: To evaluate the profile of the patient admitted to hospital with pulmonary tuberculosis and the clinical-radiological signs and symptoms of the illness., Design: A descriptive, retrospective study., Setting: The study was carried out in the Miguel Servet Hospital in Zaragoza., Patients and Other Participants: Patients over 14 who were admitted for pulmonary tuberculosis between 1985 and june 1990 and who fulfilled the requisite diagnostic criteria., Measurements and Main Results: Out of the 423 patients studied, 75.17% were male. Average age of the whole sample was 45.9. 31% were retired. 55% (232 cases) had factors predisposing to tuberculosis. The 12% were infected by HIV (human immunodeficiency virus). The most common presentation symptoms were coughing and the radiological semeiology of condensation. In 22.7% there was extrapulmonary tubercular infection, most commonly in ganglia. Delay in diagnosis was over three months in 19.8% of the cases., Conclusions: Tuberculosis is a common illness in our ambit and particularly affects those patients with underlying pathology. Given that there are still important delays in diagnosis, doctors need to be highly aware of the possibility.

Gastric mucosa is not found often in the proximal and medial esophagus. Hematemesis and dysphagia are the most frequent symptoms. We report a six year-old child who complained of difficulty in swallowing. A filling defect was detect in the esophagogram. We biopsied the suspected area, through an endoscopy and the pathological examination informed of ectopic gastric mucosa. We performed a 99Tc isotopic study. The child is on ambulatory controls and at the moment is asymptomatic.

The day-to-day reproducibility of planned radiotherapy treatment is an important precondition for achieving good clinical results and reducing toxic effects. This reproducibility is difficult to achieve in the irradiation of head and neck malignancies because of the mobility of this anatomical area. This paper presents a dosimetric study and analysis of the utility of a facial mask immobilization system prepared from an orthopedic glass-fiber bandage. The dosimetric study conducted on a lucite phantom shows that the interposition of one, two, or three layers of the bandage reduces the deep absorbed dose by about 1% at 0.5 cm2, while increasing the absorbed surface dose by 12% (for a field of 15 X 15 cm2 and one layer of bandage) to 46% (for a field of 5 X 5 cm and three layers of bandage). The dosimetric study conducted on a Rando Anderson manikin shows an average increase in the skin dose of about 8% and a maximum increase of about 20%. The good dosimetric results and the practicality of this system of immobilization have persuaded us to propose it as an alternative to the systems currently on the market, which, although rather more sophisticated, are also more expensive.

Background: Pelvic radiation therapy is usually associated with intestinal symptoms, especially diarrhea. Sucralfate has been demonstrated to be effective in peptic ulcers, and seems to provide some benefits in chemotherapy induced mucositis and radiogenic rectitis and enteritis., Methods: Thirty-four patients between 20-80 years of age, without diarrea and with a Karnofsky index greater than 60%, undergoing whole pelvic irradiation (46 Gy total dose, 2 Gy/day, 5 days/week) have been randomized to receive: sucralfate (1g/6h) (18 patients) or placebo (16 patients) during the treatment period and 3 weeks later., Results: The statistical analysis of the clinical records show that patients receiving sucralfate do better during the whole treatment period (p = 0.03), and they need other complementary measures against diarrhea, as diet (p = 0.03) or pharmacologic support (p = 0.002), later in the course of the radiotherapy. Nevertheless, the incidence and severity of diarrea and other associated simptoms show no differences between both groups., Conclusions: Sucralfate increases the enteric tolerance during pelvic irradiation in cancer patients.

Authors report nine cases of asymmetric crying facies related to congenital aplasia or hypoplasia of depressor anguli oris muscle (DAOM). The interest of this abnormality consists in the frequently associated malformations (over 50%), specifically, congenital heart disease, urogenital, musculoskeletal and cervicofacial. This association occurs in five of our cases. Its genetical condition is significant: 22% in our own series. The paper emphasizes the easiness of diagnosis (merely observing the baby crying) and also its frequency, higher than usually thought.

The paper deals with the experience gained by the AA (Hospital "La Fe", Valencia) through 49 glottic cancers treated with x-ray therapy. The results are very gratifying since the percentage of survivals and cures at 10 years accounts for 96 and 92 per cent, respectively. Five failures (10%) underwent salvage surgery (T. laryngectomy), 3 with good outcome. With regard to the prognostic factors it is important to recall the great number of recurrences among the cordectomy patients (preceding the x-ray therapy) with seeded borders (4 among 10) than in the rest of the group (1 among 39).