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[Suppurative pseudarthrosis treated by closed, irrigated corticospongious grafts. New technique derived from Papineau's procedure (author's transl)].

The treatment of suppurative pseudarthrosis, particularly in the leg after extensive tibial resection, remains very difficult and exceedingly slow. In the new technique described--which derives from, and improves upon Papineau's procedure--granular micrografts of cortical and spongious bone tissues are laid under a tightly closed sterile tent, and continuous irrigation and aspiration are applied. In 10 patients treated by this technique highly satisfactory results were obtained, bone consolidation being achieved within 8 months on average.

Bone Transplantation↗

[Treatment experience with acute suppurative lactation mastitis].

Results of the treatment of 518 patients with acute suppurative lactation mastitis are analyzed. Lactastasis and nipple cracks are found to be responsible for the appearance and development of the disease. The infiltrative form of mastitis was found in 1,2% of patients, abscess formation in 69,2%, phlegmonous form in 27,2% and gangrenous form in 2%. Sepsis was found to develop in 9,4% of patients. Complex therapy including antibiotics of wide spectrum of effect, infusive therapy with forced diuresis, immunologic drugs are recommended.

Acute Disease↗

Electron microscopy of liver lesions in primary biliary cirrhosis. II. A bile duct with chronic non-suppurative destructive cholangitis.

An 80 micrometers bile duct with typical features of chronic non-suppurative destructive cholangitis was examined by electron microscopy. Many inflammatory cells, including lymphocytes, macrophages and plasma cells infiltrated among epithelial cells of the bile duct. Epithelial cells were compressed and deformed by infiltrating lymphocytes. These lymphocytes were in contact with epithelial cells at small points or large areas. The intercellular distance was about 10 or 20 nm at the contact areas. The mode of contact and intercellular distance coincided with the results of in vitro experiments on lymphocyte cytotoxicity against target cells. Some epithelial cells in contact with lymphocytes showed degenerative changes. Necrotic changes were observed in bile duct epithelial cells undergoing emperipolesis. The invading lymphocyte in the epithelial cell had osmiophilic substances on the surface. These sites of emperipolesis seem to be the areas of lymphocyte cytotoxicity against epithelial cells.

Basement Membrane↗

[Pathology of the umbilicus: case report of a suppurative cyst of the urachus in a 12-year-old girl].

After having illustrated the varied pathology of the umbilical region, the A.A. describe a case of a suppurated cyst of the urachus (pyourachus) in a 12 years old girl. They underline the many types of onset as well as of evolution of the urachal cysts and the differential diagnosis of them. Fistolography, when possible, is the decisive examination. Obviously the treatment may be only surgical. The premonitory signs for a precocious diagnosis are indicated.

Child↗

[Verneuil's disease in the differential diagnosis of suppuration of the ano-perineo-buttock region].

Verneuil's disease or hidradenitis suppurativa is not frequent. Nevertheless since VERNEUIL's classic description in 1854, many cases have been reported. It is a disease of the apocrine sweat glands, that may arise on each of their localizations: axilla, breast areolae, umbilicus, perineum, groin, buttocks. The chronic suppurative disease of these glands give rise to multiple fistulous constantly infected tracts. The typical appearance usually allows a clinical diagnosis. Other disease may nevertheless look like hidradenitis suppurativa. We present two cases and discuss the differential diagnosis between the hidradenitis suppurativa and the chronic infection of a pilonidal cyst.

Buttocks↗

[Meniscus and sequestrum images during pulmonary suppuration. A case of pulmonary gangrene (author's transl)].

Pulmonary gangrene, a rare form of suppurative lung lesion, is the result of bacterial infection associated with vascular thromboses. It is one of the few affections that produce a meniscus image delimiting the pulmonary sequestrum. A case is reported of a woman with pulmonary venous hypertension from mitral disease who developed gangrene limited to Fowler's segment. Recovery occurred after antibiotic therapy and percutaneous drainage.

Bacterial Infections↗

[Ultrasonic diagnosis of acute suppurative appendicitis: a case report (author's transl)].

In a patient, 87 years of age, with typical symptoms and clinical signs of acute appendicitis we were able to demonstrate the swollen and fluid-filled appendix by sonography. The suspected diagnosis of a suppurative appendicitis was confirmed at operation. This is the first report, to our knowledge, of the use of sonography in establishing the diagnosis of acute appendicitis.

Acute Disease↗

Neonatal enterobacter suppurative arthritis and osteomyelitis.

Suppurative arthritis of the right knee and osteomyelitis of the adjacent femur complicated a urinary tract infection in an 18-day-old infant with a posterior urethral valve causing urinary flow obstruction. Initially cephalosporine sensitive Enterobacter caused the urinary tract infection. Shortly following cephazolin therapy, cephalosporine resistant Enterobacter microorganisms were isolated both from the urine and the knee joint fluid. These two infections were successfully treated with a combination of gentamicin and Co-trimoxazole. Gram-negative bacteria should be considered among the pathogens in neonatal osteoarticular infections, particularly if a urinary tract infection co-exists.

Arthritis, Infectious↗

Suppurative arthritis in an infant orangutan.

A 12-day-old male orangutan (Pongo pygmaeus) was removed from its mother because of oral ulcers and reluctance to suckle. Close examination revealed ulcerations extended to the mandibular bone. Staphylococcus aureus was cultured from the oral lesions. Despite intensive antibiotic therapy, the infection progressed to septicemia, with suppurative arthritis of the left coxofemoral and right radiohumeral joints. Treatment included removal of synovial exudate by aspiration, indwelling drains, and arthrotomy. Antibiotics were administered systemically and by joint irrigation. The infant responded well to the treatment, which lasted for approximately 2 months.

Ampicillin↗

[Complex treatment of acute suppurative lung diseases].

Immediate and remote results of treatment of 48 patients with complicated acute suppurations of lungs give the estimation of different types of complex treatment. The method unites an isolated and associated microtracheostomy, external drainage of the cavities in the lung and empyemas of the chest, flowing sanitation of the pleural cavity with active aspiration of the exudate. Remote results were followed in 25 patients, in 3 patients lung abscess was found to change into a chronic stage.

Adolescent↗

[Immediate implantation of preserved cartilage in suppurative perichondritis of the auricle (author's transl)].

Following satisfactory experiences in the treatment of abscesses of the nasal septum, preserved rib cartilage without its perichondrium was used in the immediate reconstruction of the pinna following the excision of all diseased cartilage and granulation tissue in patients with suppurative perichondritis, according to the technique of Herrmann and Boenninghaus. This prevents shrinkage and the inevitable deformity of the auricle and is demonstrated in three typical cases. In one child the graft induced a partial regeneration of autogenous fibrous cartilage, and later preserved auricular cartilage was successfully transplanted.

Abscess↗

[The prevention of hemorrhagic and suppurative complications in the abdominoperineal extirpation of the rectum].

A special two-walled latex balloon on a draining tube was introduced into the perineal wound in the abdomino-perineal extirpation for locally spread tumor in 36 of 68 patients. This tamponing device allowed to make simultaneous hemostasis, irrigation of the wound with antiseptics and its valuable drainage. As a result, postoperative blood loss was greatly reduced (up to 80-100 ml) as well as the amount of suppurations (from 56.3 to 5.6%). The average postoperative stay at the hospital became shortened from 38 to 22 days.

Abdomen↗

[The early diagnosis of postoperative suppuration in endoprosthesis of the hip joint].

The authors describe the method of control of the course of an early wound process in patients with endoprosthesis of the hip joint in early postoperative period, which is based on determination of the level of lysozyme in the wound. The method allows detection of the development of suppuration and start of antibacterial therapy in the early postoperative period, before the appearance of the clinical symptoms.

Clinical Enzyme Tests↗

[Clinical studies of an experimental suppurative surgical infection in cattle caused by Cornynebacterium pyogenes].

Studied were clinically and paraclinically six cattle manifesting an experimental suppurative surgery infection caused by Cornebacterium pyogenes, strain 1056. It was established that the infection assumes the course of septicaemia with metastases in the viscera, causing severe disturbances in the general condition and leading to death in most cases. Found were also anemia, leukopenia, that alternated with leukocytosis presenting nuclear shift to left, changes in the erythrocyte sedimentation rate in terms of more rapid settling out of r. b. c. The urine presented protein and sediment consisting of 8 to 10 or numerous erythrocytes, 5 to 6 or 10 to 15 leukocytes, single to 8-10 kidney epithelium cells. The rumen content became alkaline, and the infusoria count dropped.

Animals↗

[The combined-action preparation Sipralinat in the treatment of suppurative diseases of the soft tissues and osteomyelitis of the bones of the foot].

Sipralynate is a powder containing the broad spectrum antibiotic sisomicin, the enzyme protease C and the polymer carrier sodium alginate with a drainage capacity promoting wound regeneration. The clinical trials with sipralynate showed that it was highly efficient in the treatment of patients with suppurative infections of the soft tissues and ossa pedis osteomyelitis. The tolerance was good.

Administration, Topical↗

Risk factors with contact lens related suppurative keratitis.

Risk factors in contact lens related suppurative keratitis were investigated. Over 12 months, sixty contact lens wearers presented with presumed microbial keratitis and 147 presented with presumed sterile keratitis. The control group consisted of contact lens wearers without lens related disorders (n = 507). The relative risk of microbial keratitis for extended wear soft contact lens users were 36.8 times (12.6-107.6) that of rigid gas permeable (RGP) contact lens users; while the relative risk of sterile keratitis among extended wear soft lens users was 4.6 times (2.2-9.9) that of RGP lens users. For daily wear soft contact lens users, the relative risk of microbial keratitis was 4.2 times (1.1-16.0) that of RGP lens wearers; for sterile keratitis the relative risk was 2.3 times (1.3-4.3) greater than RGP contact lens users. A multivariable logistic regression analysis was used to examine associated risk factors for daily and extended wear soft lens users. The type of disinfection system and its frequency of use were associated with both microbial keratitis and sterile keratitis in daily wear users. Duration of overnight wear and gender were associated with microbial keratitis, while a patient's age and socioeconomic class were associated with sterile keratitis. Different relative risks and risk factors for microbial keratitis and sterile keratitis support the use of a clinical definition to differentiate the diseases.

Adult↗

[Suppurative complications in acute pancreatitis].

The authors examining suppurative complications caused by acute necrotizing pancreatitis point out how such complications can arise early at the same time of acute pancreatitis with large spread in peripancreatic tissues and spaces and with worse prognosis or have a late appearance with a trend to localize and circumscribe. Four cases of pancreatic abscess, three of which largely diffused brought to death in spite of surgery, are reported.

Acute Disease↗

The management of chronic suppurative otitis media with acid media solution.

An organism must maintain a fairly constant balance of pH to survive. Most bacteria grow the best in a narrow range of pH from 6.5 to 7.5. Ninety-six patients with chronic suppurative otitis media were selected. Two weeks before the treatment they were instructed to stop taking any antibiotics; then a sterile swab culture was taken from auditory canal secretions and at the same time the pH of the secretions were measured. Otomicroscopic examination of the ear with cleaning of purulent debris was done. All patients received ear irrigation with 2% acetic acid solution three times per week for the maximum of 3 weeks without antibiotic therapy. Any patients with cholesteatoma, polyp, granulation and otomycosis were excluded. Patients were followed for up to 3 years. Fifty-five patients (57%) had resolution of their original otorrhen, whereas 19 patients (20%) developed healed ear drum perforation. The remaining 14 patients (15%) showed recurrence and 8 of them (8%) had no response to the treatment.

Acetates↗