30 patients with urethral strictures treated with internal urethrotomy with the Sachse urethrotome were followed from 2-25 months postoperatively. Reexamination included retrograde urethrography and flow studies. One half of the patients were fully satisfied, one fourth reasonably so, whereas the remaining patients were dissatisfied. Urethrography and flow study revealed a considerably higher rate of recurrence than the clinical results.
A follow-up study was performed in 82 patients in whom a diagnosis of isolated pulmonary stenosis was established by cardiac catheterization in this laboratory between 1947 and 1961. Only patients who did not have intervening cardiac surgery during the first 5 years were included. The follow-up time was 5–21 years (mean 12.3 years). 51 of the patients had a mild stenosis with a right ventricular systolic pressure of 60 mm Hg or below. Serial heart catheterizations were performed in 36 patients, 20 of whom had mild stenosis. Clinical and hemodynamic progression was found to be limited. It occurred only among those patients with an initial right ventricular systolic pressure of more than 80 mm Hg. In the relatively large group of patients with mild stenosis, no clinical, electrocardiographic, or roentgenographic progression could be detected; the pressure gradients also remained small, though a minor increase in right ventricular systolic pressure was encountered in two children.
The syndrome of periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis (PFAPA) is an autoinflammatory disorder of unknown aetiology. Tonsillectomy may cause a prompt resolution of the syndrome. The aim was to study the histologic and immunological aspects of the palatine tonsils in PFAPA, to help understand the pathophysiology of the syndrome. Tonsils from children with PFAPA (n = 11) and children with tonsillar hypertrophy (n = 16) were evaluated histologically after haematoxylin and eosin staining. The number of different cell types was identified immunohistochemically by cluster of differentiation (CD) markers: CD3 (T cells), CD4 (T helper cells), CD8 (cytotoxic T cells), CD15 (neutrophils), CD20 (B cells), CD45 (all leucocytes), CD57 (NK cells) and CD163 (monocytes and macrophages). Tonsils from children with PFAPA showed reactive lymphoid hyperplasia dominated by welldeveloped germinal centres with many tingible body macrophages. The histologic findings were unspecific, and a similar morphologic appearance was also found in the tonsils from controls. The number of CD8+ cells in germinal centres differed between children with PFAPA [median 9 cells (quartiles: 5, 15)] and controls [18 cells (12, 33) (P = 0.001)] and between children with PFAPA with (median 14 cells; 9, 16) and without (4 cells; 3, 8) aphthous stomatitis (P = 0.015). For the other cell types, no differences in germinal centres were found between children with PFAPA and controls. In conclusion, a lower number of CD8+ cells were found in germinal centres of tonsils in children with PFAPA compared to controls, which may be a feature linked to the aetiology of the syndrome.
In 20 male patients with urethral strictures, urethral pressure profile was compared with retrograde urethrography. There was good accordance between the two methods with only minor discrepancies in multiple or very distal strictures. Urethral profile did not provide more exact information than did urethrography.
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