It has been reported that large cranial osteonecrotic areas can heal. It was hypothesized that optimal healing is possible by the synchronized contribution of the osteogenic structures (periosteum, dura, and adjacent bone) that envelop the necrotic cranium. This hypothesis was tested by preserving or isolating the contribution of these osteogenic tissues. A total of 37 4-old-month rats were included in the study. Twelve animals were killed immediately, and cranial bone samples were taken and processed for examination (from 6 animals as fresh samples [Group A] and from the rest as autoclaved samples [Group B]). Group B was created to test if the bone was completely nonviable. In Group C (n = 25), cranial bone disks 8 mm in diameter were taken from 4-month-old rats, autoclaved, and put back onto the defect area. This group was further divided into the four Subgroups C1 through C4 (n = 7 in C3; n = 6 in C1, C2, and C4). Dura mater was isolated from the overlying bone disk with a polytetrafluoroethylene sheet in Subgroups C1 and C2, whereas the bone contacted the dura in the rest. The bone samples were covered with healthy periosteum in Subgroups C1 and C3 and with skin in Subgroups C3 and C4. These animals were killed after a healing period of 12 weeks, and the relevant bone disks were obtained. Surrounding healthy bone was also harvested from the same animals after they were killed to create Group D. The data of Group A and D were compared with those of the experimental group to comment on the degree of bone healing in the latter group. Quantitative and qualitative assessment was performed by mammography, bone densitometry, computed tomography, and histological examinations to find out the density and cellular content (osteocytes and vessels) of the samples. Examination of Group B samples showed nonviable tissue with a preserved microstructure. Analysis of other samples showed that both the periosteum and, mainly, the dura play an important role in cranial bone healing. The periosteal reaction was observed to be more evident when the dura was not separated. Cellular repopulation was more evident when both structures contributed to the healing process. Newly formed bone progressed centripetally; however, adjacent bone without the support of the dura and periosteum was capable of producing limited neovascularization and bone formation.

We report the radiologic presentations of two cases of peritoneal-pelvic tuberculosis. The initial interpretation based on the adnexal masses, ascites, omental and peritoneal thickening, and elevated serum CA-125 levels led to an erroneous preliminary diagnosis of disseminated ovarian cancer. In both patients, histologic examination showed tuberculosis. The clinical and radiologic findings resolved significantly after several months of multidrug antituberculosis treatment.

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Downhill esophageal varices", classically defined as those that develop in the upper region of the esophagus, are less common than the "uphill" type, which is usually produced by portal hypertension. Various causes of downhill varices have been reported, but mediastinal tumor is the most common responsible lesion. Castleman's disease, or angiofollicular lymph node hyperplasia, is a rare pathological process of unknown etiology that usually develops in the mediastinum. We report the case of a 60-year-old woman whose large esophageal varices were detected incidentally. The cause was a mediastinal mass which was diagnosed as Castleman's disease on histopathological examination of a surgical specimen. This patient's varices most likely formed as a result of copious blood drainage from the tumor into the esophageal veins. Evidence for this was the lack of the classic downhill pattern, the absence of superior vena cava obstruction, and the fact that the varices resolved after the tumor was removed. It is our opinion that this type of varices should be renamed, and we suggest that "overflow varices" would be an appropriate term.