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The purpose of the present study was to evaluate the efficacy and safety of parenteral administration of interferon alpha-2α in the treatment of recurrent herpes genitalis. A total of 97 patients (66 males, 31 females, mean age 34.86 ± 16.74 years), who had at least five recurrences of genital herpes during the previous 12 months, participated in a prospective open study on the effects of treatment with interferon alpha-2α (Roferon-A; Roche). The patients were treated with interferon alpha-2α (3 × 106 IU) by subcutaneous injection, three times weekly for 4 weeks, and the same schedule was repeated after 3 and 6 months. All patients were asymptomatic at the start of the study. After initiation of treatment, all patients reported to the clinic every 3 months for 2 years (the males were submitted to peoscopy and the females to Pap test and colposcopy) at the time of their recurrences. Comparison was made of the number of recurrences, duration of lesions, duration and severity of pain, and itching and burning. Prophylactic administration of interferon alpha-2α prevented recurrences of genital herpes virus infection in 51 patients (20 males and 31 females). Interferon administration shortened the healing time from 8.5 days before treatment to 2.5 days after treatment (p < 0.001). There was a significant reduction in the number of recurrences during the study period, from 7.46 before treatment to 2.64 after treatment (p < 0.001). On the basis of the overall efficacy and adverse effects, this regimen may be of value in the routine treatment of recurrent herpes.

Purpose of the present study was to evaluate the effectiveness of isotretinoin versus interferon alfa-2a plus isotretinoin in the treatment of recurrent condyloma acuminatum in 86 men.Men were randomly assigned to group A (n = 42) who received isotretinoin 1 mg/kg orally daily until remission was achieved, but not more than 3 months, or to group B (n = 44) who received interferon alfa-2a 3 x 10(5) IU subcutaneously three times weekly until remission was achieved, but not more than 8 weeks, plus isotretinoin in the same dosage as in group A.The reduced duration of treatment to achieve remission was statistically significant in group B (2.18 versus 2.5 months; P0.01) and the recurrence rate was less in group B (4 of 44 versus 16 of 42; P0.01).The results of this study are encouraging and demonstrated that the combination of isotretinoin plus interferon alfa-2a achieves higher remission rates and a shorter duration of treatment than isotretinoin alone.

Nine patients with history of hydatid disease have been examined by CT. Localization of the hydatid cysts in the pelvis was established by anatomical criteria. Occasionally, the transverse plane can be confusing for the precise localization of a lesion. A central location, close to the boundaries of the bladder and rectum, can define peritoneal location. Further posterolateral retrovesical location can be considered retroperitoneal. Using these criteria, 8 cysts were situated within the peritoneum and 1 within the retroperitoneum.

Two patients with cardiac involvement of hydatid disease are presented: one with hydatid cyst of the interventricular septum and pulmonary arteries and the other with multiple pulmonary cysts, associated with intracardiac and pericardial cysts. The ability of magnetic resonance imaging (MRI) to provide a global view of cardiac anatomy in any plane with high contrast between flowing blood and soft tissue ensures it an important role in the diagnosis and preoperative assessment of hydatid disease of the heart.

In patients with nasopharyngeal carcinoma, intracranial spread may occur via direct extension from the base of the skull or via perineural spread. Perineural spread usually affects branches of the trigeminal nerve. We describe two patients with recurrent nasopharyngeal carcinoma, who presented with a solitary mass in the cerebellopontine angle without associated bony destruction. MRI findings mimicked those of acoustic schwannoma. The imaging findings and possible pathways of spread are discussed.

The effectiveness of intraurethral 5-fluorouracil and systemic administration of interferon-alpha 2a in the therapy of condylomata acuminata or flat condylomata of the urethra is assessed. From March 1986 to September 1991, 1,372 male sexual partners of women with condylomata acuminata, flat condylomata or cervical intraepithelial neoplasia underwent urethroscopy and brush cytological examination of the urethra. Of these men 305 (22.23%) had intraepithelial human papillomavirus (confirmed cytologically) and 284 were treated. The best treatment modalities, regardless of the type of lesion, were the combinations of 5-fluorouracil plus high (95.34%) and low (70.58%) dose interferon-alpha 2a. Interferon-alpha 2a can be used as first line treatment with 5-fluorouracil cream in patients with intraurethral condylomata acuminata or flat condylomata.

To describe our experience of percutaneous drainage of intra-abdominal abscesses with large-bore catheters under computed tomographic control.Retrospective study.Teaching hospital, Greece.185 Patients treated for abdominal abscesses during the period 1989-94.Needle aspiration (n = 27), drainage through conventional pigtail catheters (n = 22), and drainage through large-bore (8-16F) Argyle drains (n = 136).Morbidity.The overall success rate was 166/185 (92%). Of the 136 patients for whom the large-bore drains were used, 9 (7%) developed major complications (bowel fistula, n = 5; and pneumothorax and haemorrhage, n = 2 each) and 10 (7%) developed minor complications (obstruction of the tube, n = 4; dislocation of the tube, n = 3; bleeding from the wound, n = 2; and haematoma of the liver, n = 1). There were no deaths.Large-bore Argyle drains are efficient and safe for the percutaneous drainage of certain types of abdominal abscesses.

The aim of the present study was to test the method of urethral cytologic sampling and to assess its results in the cytologic detection of human papillomavirus infection in the male partners of infected women. Cytologic evidence of abnormal epithelium was found in a total of 50 out of 167 cases (29.94%). It is interesting to note that 9 (5.38%) patients with cytological evidence of flat condylomas of the urethra did not have any other lesion. On the basis of the present study, we conclude that cytobrush urethral cytology should be routinely associated with peoscopy in studying the male partners of women affected by human papillomavirus infection, in an effort to diminish the reservoir of a virus strongly associated with cervical and penile neoplasia.

This study was undertaken to assess the effect of CO2 laser vaporization, 5-fluorouracil 5% (5-FU) topical application and Interferon alpha-2a (IFA alpha-2a) in the treatment of C.A. or F.C. of the male genital tract. From March 1986 to September 1991, 1372 men, sexual partners of women with F.C. or C.A. or cervical intraepithelial neoplasia, were submitted to peoscopy. One thousand and nineteen (74.27%) men presented with various penile lesions caused by HPV (histologically confirmed); of these 505 were treated for C.A. or F.C. or a combination of F.C. and C.A. The best treatment modalities, irrespective of the kind of lesion, were found to be the combination of 5-FU plus IFN alpha-2a (high dose) (98.27%), the combination of CO2 laser vaporization plus 5-FU plus IFN alpha-2a (high dose) (93.93%) and the combination of CO2 laser vaporization plus 5-FU (87.23%). In conclusion we believe that IFN alpha-2a can be used with excellent results as first line treatment in combination with CO2 laser vaporization or/plus 5-FU in patients with C.A. or F.C. or combined condylomata.

Twenty patients were investigated with MR imaging of the abdomen before and after the administration of oral magnetic particles in the form of a per os solution for opacification of the gastrointestinal lumen. The parameters which were evaluated were a) distribution of the contrast medium in the gastrointestinal tract, b) delineation with the contrast medium of the region of interest c) image quality of general contract effect of the contrast medium d) diagnostic accuracy compared with CT and plain MRI of the same region. At a concentration of 0.5 mg/oral magnetic particles produced a constant negative signal from the gastro- intestinal tract in all spin echo sequences (T1 weighted, T2 weighted, proton density). Its diagnostic accuracy was similar to CT but better than plain MR examination of the same region in 70% of the cases. The diagnostic accuracy was inferior in the lower abdomen because of underdistension of the bowel. Perhaps the solution to the problem would be the combined per os and per rectum administration of the contrast medium.

Magnetic Resonance (MR) imaging features of pineal region tumors were analyzed in 14 oncologic cases. The tumors were classified as germ-cell tumors, glial tumors, pineal parenchymal tumors, meningiomas, and cysts. They demonstrated different MR signal characteristics on precontrast scans and nodular or ring type enhancement with occasional central lucencies, except for benign cysts, which have not shown enhancement. MR images were useful in defining the relationship of the tumor to the posterior third ventricle, sylvian aqueduct, vein of Galen, and tentorium. Although CT can demonstrate in more evident fashion displacement of the original pineal calcification as well as tumor calcifications, MR imaging demonstrates different signal characteristics in germinomas and pineoblastomas which can be a useful adjunct in the evaluation and differential diagnosis of these tumors.

A case of a single inflamed mastoid air cell is described. This was initially interpreted as a facial nerve schwannoma on MRI examination. Careful evaluation of the signal characteristics and additional findings from the high resolution CT examination helped to establish the correct diagnosis.

A patient suffering from thalassaemia, with extreme osteoporosis, coarse trabeculation and cortical thinning of the bones, developed a pathological fracture of the left hip. This was treated by a single dose of radiotherapy. It is suggested that the radiotherapy facilitated the healing process by eliminating the causative factor of the fracture, which was the expanding and over-proliferating bone marrow.

We report the computed tomographic (CT) findings in a case of radiation therapy of the abdomen which affected the left lobe of the liver. The post-radiotherapy CT demonstrated a low density area involving the left lobe of the liver. One month later in a new CT this finding disappeared. We conclude that low density areas in the liver parenchyma following radiotherapy should be analysed with caution, especially when secondary deposits are considered in the differential diagnosis.

Sperm penetration through bovine cervical mucus was determined and correlated with the sperm characteristics in three fractions of the split ejaculate and in the whole ejaculate from 40 men of infertile couples in which a female cause of infertility had been ruled out. Sperm concentration and motility were found to be significantly higher in the first fraction (n = 40) as compared with the rest of the fractions and the whole ejaculate, whereas normal sperm morphology was not significantly different among the various fractions and the whole ejaculate. The bovine mucus penetration (BCMP) test was found to be normal in a significantly high percentage (58%) of samples of the first fraction as compared with the other two fractions (32% and 17%, respectively) and the whole ejaculate (35%) (n = 17). Moreover, in the first fraction of the split ejaculate, the results of the BCMP test were correlated significantly with sperm concentration (P less than 0.01), motility (P less than 0.0001), and morphology (P less than 0.02). The data demonstrate the superiority of the first fraction of the split ejaculate in terms of cervical mucus penetrability and sperm characteristics.

Rapidly growing cytotrophoblasts were isolated from early human chorionic villi and the Papanicolaou method was used to characterize their cytology and transformation into syncytiotrophoblasts. Cytotrophoblasts fused and formed binucleated cells or mononucleated intermediate cells. Syncytial cells were formed by fusion of small cytotrophoblasts or intermediate cells and cytotrophoblasts. Glycosaminoglycans were produced in cytotrophoblasts and released extracellularly. Here they were accumulated and/or diffused into a continuous layer covering the cells. Glycosaminoglycans in syncytial cells were contained in well defined membranous sacs. Cytotrophoblasts only grown beyond confluence differentiated into villi with a villus-like histology.

The clinical efficacy of the prophylactic use of cephradine was evaluated prospectively in 118 women who underwent cesarean section. The patients of the cephradine group had a significantly lower (p less than 0.01) postoperative morbidity rate (17.79%) as compared with the control group (51.06%). The mean hospitalization time was also significantly shorter (p less than 0.01) in the cephradine group (7.2 +/- 0.13) than in the control group (10.9 +/- 0.23). Cephradine was proved to be an effective antimicrobial agent for chemoprophylaxis, due to its wide antimicrobial spectrum, beta-lactamase resistance, low percentage protein binding, large volume of distribution and non metabolic degradation.