Implications of amalgam in general health.
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Biomedical subjects
Publications and source records attributed to P Kertesz.
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This study reports five cases of Merkel-cell carcinoma of the skin. Then the authors review the present state of the art from the data already available in the literature concerning this malignant primary skin tumor. A part from local excision, no standard procedures are described. The literature provides a lot of discrepancies concerning the additional treatments such as lymph mode excision, radio and chemotherapy. The prognosis of this tumor remains poor because of a high incidence of local recurrence, a frequent spread to regional lymph modes and the development metastases.
The brown bear is one of the most persecuted animals in the world. In Greece, Turkey, Pakistan and India they are used as dancing spectacles by gypsies. The mother is killed so that the cubs can be captured at a very early age and subjected to training that involves extreme cruelty: starvation, beatings and red-hot metal plates, as well as rings and chains through their noses and lips, are used to make the animals stand on their hind feet and mimic a dance routine so that their handlers can collect money in the streets. The author describes the treatment of the first bears to benefit from the facilities at the new Bear Protection Centre set up by Arcturos.
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An unusual association of a secreting renal oncocytoma and a parathyroid adenoma is described. The high level of hypercalcemia and of blood parathormone (PTH 44-68), partially reduced by nephrectomy and totally normalized by parathyroidectomy, as well as the renal tumor PTH evaluation and the ultrastructural features showing secretory granules in oncocytic cells of kidney, advocate for a double site of PTH secretion. Removal of both tumors permits a complete recovering.
A case of mucinous cystadenocarcinoma discovered into a voluminous benign mucocele of the appendix, is presented. The clinical feature is a tumor of the right iliac fossa. The identification of a limited area of epithelial degenerescence in the cyst wall--by peroperative microscopic examination--permits immediate enlargement of the cystectomy by a right hemicolectomy. The prognosis of the tumor is generally excellent as soon as the diagnosis is early and the removal large enough.
A better understanding of the vascular anatomy of the breast has drastically reduced the risk of postoperative necrosis in breast reduction. Scars however remain a major concern, and techniques to reduce these have often been considered to be less satisfactory in terms of the shape and stability of the result. Our experience with more than 1,000 breasts operated on between 1984 and 1989 with a short inframammary scar technique has proved the contrary. The next step was to eliminate the inframammary scar, as proposed by Lassus, and to leave just a periareolar scar and a lower vertical scar which does not cross the inframammary fold. One hundred and four breasts, in sixty four patients--17 to 60 years old--have been operated on according to this vertical technique between April and September 1989. Twenty seven cases of ptosis correction in seventeen patients, and seventy seven reductions in forty seven patients, with a median excision weight of 460g, have been performed. By means of an individualized preoperative drawing and several technical devices, the results have proved that vertical mammaplasty is an excellent technique particularly indicated for women with elastic skin and a firm gland. Recent experience with liposuction at the beginning of the operation, has given new possibilities for breast modelling. In fatty juvenile hypertrophies, liposuction alone may even be adequate to reduce the volume, retaining a satisfactory shape for the breast with minimal scarring.
The specificity of abnormal radiomorphological patterns in the endoscopic retrograde pancreatogram (ERCP) has been studied. Out of 3,000 ERCPs 381 contained pathological findings in the pancreatic duct, all of which was subsequently checked by histology. Comparison of the radiomorphologic data and the histologic abnormalities has revealed that ductal abnormalities are not specific to the underlying pancreatic disease. There are, however, changes in the radiomorphologic appearance which, owing to their greater incidence, may be regarded as characteristic to some pathologic process. Solitary stenosis or complete obstruction indicate the presence of tumour, nonsegmental extended dilatation points to papillary stenosis, filling of cavities reveals cysts, while diffuse abnormalities occur most frequently in chronic pancreatitis. Opacification of the bile ducts may yield complementary data, although their specificity is not absolute either. Nonsegmental stenosis of the intrapancreatic bile duct indicate chronic inflammation, while irregular narrowing supports the diagnosis of pancreatic tumours. Arc-shaped dislocation of the bile duct is frequently observed in response to cysts, stenosis confined to the ampullary segment and associated with dilated biliary system are characteristic findings in papillary stenosis. Thus the diagnostic value of the abnormal pancreatogram may be enhanced by simultaneous study of the biliary morphology
Clinical experience of 73 cases of necrobacillosis in red-necked wallabies (Macropus rufogriseus) over a 6-year period is reviewed. Diagnostic methods and the medical and surgical treatment options are detailed. It is suggested that survival curves are necessary to assess the outcome of treatment.
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