The canal of Nuck is the portion of the processus vaginalis within the inguinal canal in women. A hydrocele of the canal of Nuck is equivalent to an encysted hydrocele of the cord in men. The literature reveals very little about this rare condition in the adult female patient. In this paper, we report a case of hydrocele of the canal of Nuck in a young female. The diagnosis was made with ultrasound and magnetic resonance imaging and then confirmed preoperatively and by histopathology. Although rare, a hydrocele of the canal of Nuck has to be included in the differential diagnosis of a groin lump in female patients.

We examined the relationship between skin test reactivity and level of FEV1 in a stratified random sample of U.S. children 6 to 12 yr of age with asthma or frequent wheezing, studied as part of the Second National Health and Nutrition Survey (NHANES II). Subjects were considered symptomatic if they reported asthma or wheezing. Spirometry was performed according to ATS standards. Skin test reactivity to Alternaria, Bermuda grass, cat, dog, house dust, mixed long and short ragweed, oak, and rye grass allergens was determined. House dust mite (-17% FEV1; 95% CI, -9 to -25), dog (-28% FEV1; 95% CI, -11 to -42), and oak (-26% FEV1, 95% CI, -16 to -35) were associated with the greatest decrements in FEV1. In general, indoor allergens (-13% FEV1; 95% CI, -6 to -20) were associated with greater effects than outdoor allergens (-5% FEV1; 95% CI, -2 to -13). The association of indoor allergens with reduced FEV1 was greater in girls (-16% FEV1; 95% CI, -5 to -25) than in boys (-8% FEV1; 95% CI, -3 to -13). Sensitization to indoor allergens among symptomatic children 6 to 12 yr of age was associated with decrements in level of FEV1.

We examined how chronic respiratory symptoms, reported in a questionnaire, and results of skin prick tests and spirometry predicted variability in peak expiratory flow (PEF) among 6-12-yr-old children (n = 1,854). After characterization with skin tests and spirometry, children were followed for 2-3 mo during the winter of 1993-1994. Peak expiratory flow was measured daily in the morning and evenings. Children with asthmatic symptoms (wheeze and/or attacks of shortness of breath with wheeze in the past 12 mo and/or ever doctor diagnosed asthma) had a greater variation in PEF than children with dry nocturnal cough as their only chronic respiratory symptom. Similarly, doctor-diagnosed asthma was associated with a greater variation in PEF, also among children with asthmatic symptoms. Peak flow variability increased with an increasing number of symptoms reported in the questionnaire. Atopy, positive skin test reactions to house dust mite and cat and lowered level (as % of predicted) in FEV1 and in MMEF were also associated with an increased variation in PEF. All the differences were observed in both diurnal and day-to-day variation in PEF. In conclusion, chronic respiratory symptoms reported in a questionnaire, spirometric lung function and skin prick test results among asthmatic children predicted variation in PEF measured during a 2-3 mo follow-up. The difference in morning PEF coefficient of variation (CV) between children with asthmatic symptoms and children with cough only was somewhat bigger in girls than in boys. The effect of atopy on morning PEF CV was somewhat bigger in young than in older children.

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We investigated determinants of change in bronchial reactivity in the Swiss Cohort Study on Air Pollution and Lung Diseases in Adults (SAPALDIA), a population-based cohort with wide age range (29-72 yrs at follow-up).The role of sex, age, atopic status, smoking and body mass index (BMI) on percentage change in bronchial reactivity slope from the baseline value was analysed in 3,005 participants with methacholine tests in 1991 and 2002, and complete covariate data. Slope was defined as percentage decline in forced expiratory volume in 1 s from its maximal value per micromole of methacholine.Bronchial hyperreactivity prevalence fell from 14.3 to 12.5% during follow-up. Baseline age was nonlinearly associated with change in reactivity slope: participants aged ,50 yrs experienced a decline and those above an increase during follow-up. Atopy was not associated with change, but accentuated the age pattern (p-value for interaction50.038). Smoking significantly increased slope by 21.2%, as did weight gain (2.7% increase per BMI unit). Compared with persistent smokers, those who ceased smoking before baseline or during follow-up experienced a significant decrease in slope (-27.7 and -23.9%, respectively). Differing, but not statistically different, age relationships and effect sizes for smoking and BMI between sexes were found.Mean bronchial reactivity increases after 50 yrs of age, possibly due to airway remodelling or ventilation-perfusion disturbances related to cumulative lifetime exposures.