Traumatic lung cyst

We report a patient with a traumatic lung cyst, documenting its radiological evolution: the formation of the pneumatocele, the appearance posteriorly of an intracavitary hematoma, and the spontaneous resolution of the radiological abnormalities.

Simultaneous determination of benzodiazepines by ultraviolet--visible spectrophotometry in micellar media

A method for the simultaneous determination of benzodiazepines in binary mixtures is proposed, based on the acid hydrolysis of benzodiazepines to benzophenones and the spectrophotometric determination of the latter in the presence of Nemol K 1030, a non-ionic surfactant condensate of ethylene oxide with nonylphenol. The experimental conditions for the hydrolysis of several benzodiazepines in sealed Pyrex tubes were determined. The addition of Nemol K 1030 to acidic solutions of benzophenones modified the positions of the absorption bands and made possible the simultaneous analysis of binary mixtures of benzodiazepines.

Two-dimensional echocardiographic features of echinococcosis of the heart and great blood vessels. Clinical and surgical implications

Echocardiographic findings in cardiac echinococcosis have been previously described in isolated cases, but no detailed account of the various echocardiographic aspects and their clinical and surgical implications have ever been reported. We present a retrospective analysis of the two-dimensional echocardiograms of 15 patients with hydatid cysts affecting the heart or great blood vessels. Two-dimensional echocardiogram features were compared with the main clinical syndromes. Surgical confirmation of the echocardiogram findings was available in 12 patients. The cyst sizes ranged from 0.5 to 12 cm in diameter. Eleven patients had single cysts, three patients had two cysts, and one patient had multiple cysts. Cysts were located in the intramyocardial region in nine patients, the pericardial in three, and the paracardial in another three. All intramyocardial cysts protruded into the adjacent cardiac chamber, but in only two patients was there significant tricuspid valvular dysfunction. Pericardial and mediastinal cysts showed compression of cardiac chambers or great blood vessels, and two cysts had ruptured into the descendent thoracic aorta or inferior vena cava. In most patients, two-dimensional echocardiographic images of hydatid cysts were those of a cystic mass having well-defined edges and internal trabeculations corresponding to daughter membranes. However, in four patients, two-dimensional echocardiographic images showed a "solid" mass instead of a cystic mass, and in one patient with the multivesicular variety of echinococcosis, the images showed a large mass with poorly defined edges having a honeycombed appearance causing lysis of the anterior arch of the second and third left ribs. The two-dimensional echocardiographic finding showed good correlation with main clinical syndromes, but anaphylactic reactions occurred in every cyst location. In one patient, postoperative two-dimensional echocardiography showed two small intramyocardial cysts that had not been noticed during preoperative two-dimensional echocardiography or during surgical examination. Pathological examination in the four patients with a solid mass showed replacement of the hydatid liquid by necrotic matter containing membrane residues with a foreign-body inflammatory reaction of a granulomatous type. In conclusion, two-dimensional echocardiography is a very useful tool for diagnosis and management of patients with cardiac echinococcosis, but the great diversity of findings regarding number, size, location, and appearance of cysts must be borne in mind to interpret correctly the two-dimensional echocardiograms.

Differential effects of calcium channel blocking agents on pancuronium- and suxamethonium-induced neuromuscular blockade

The effects were studied of several calcium channel blocking agents on muscle twitch, and possible interactions between these drugs and pancuronium and suxamethonium, using a rat phrenic-hemidiaphragm preparation. Nicardipine, verapamil and diltiazem each caused a concentration-related depression of muscle response. Nicardipine had the most, and diltiazem the least, potent effect. Verapamil and diltiazem 5 and 10 mumol litre-1 caused a concentration-dependent enhancement of suxamethonium-induced neuromuscular blockade, but increased the effect of pancuronium only at 10 mumol litre-1. Nicardipine 10 mumol litre-1 significantly enhanced pancuronium-induced neuromuscular blockade, but not that produced by suxamethonium.

Myocardial depression in septic shock caused by meningococcal infection

Comparative hemodynamic measurements recorded in 19 cases of septic shock associated with Neisseria meningitidis bacteremia and in 20 shock cases associated with bacteremia due to other Gram-negative bacilli showed a significantly higher incidence of early myocardial depression in the cases with meningococcal infection. Echocardiographic, ECG, and serum enzyme (CK-MB isoenzyme) studies closely correlated with impaired myocardial contractility and development of cardiogenic shock in patients with meningococcal bacteremia. Autopsy of the heart from three patients who succumbed to shock confirmed the presence of myocarditis with intracellular Gram-negative diplococci. Our observations suggest that the onset of cardiac dysfunction precedes clinical manifestations of shock.

[Capgras syndrome. Clinical aspects and organic problems: a re-evaluation]

Capgras Syndrome or Illusion of the Doubles is studied from a personal case. Its clinical and organic cerebral aspects are emphasized. We think that the occurrence of Capgras Syndrome should incite the clinician to look for a cerebral lesion, even in a definite psychopathological situation.

De novo partial 2p duplication with postmortem description

An unbalanced karyotype most likely consisting of a partial duplication of the short arm of chromosome 2 (p13 leads to pter) was found in a newborn infant with intrauterine growth retardation, facial, skeletal, and cardiac abnormalities. There was no evidence of a translocation in either parent. At autopsy, striking histopathologic abnormalities were detected in the central nervous system and ovaries.