OBJECTIVES: To determine the effect of propofol on pulmonary short circuit or shunt (Qs/Qt). PATIENTS AND METHODS: Nine patients undergoing scheduled thoracic surgery with single lung ventilation were studied. All patients were anesthesized with 2 mg/kg propofol followed by a continuous infusion of 4-6 mg/kg/h; fentanyl 0.3 mg followed by bolus as needed; and relaxed with atracurium 0.5 mg/kg followed by bolus of 0.1-0.2 mg/kg as needed. The ratio Qs/Qt was calculated with an FiO2 of 1 and patients in lateral decubitus. RESULTS: During double-lung ventilation Qs/Qt was 17.4 +/- 5.4% and PO2 was 430 +/- 16 mmHg, while shunt increased to 27.8 +/- 8.4% and PO2 decreased to 258 +/- 127 mmHg during single-lung ventilation. Change was significant in both cases. CONCLUSIONS: Continuous infusion of propofol produces a significant increase of Qs/Qt and a significant decrease of PaO2 during single-lung ventilation for thoracic surgery.

Adult↗

PubMedDate not supplied

CNS complications in acute malaria: MR findings.

MR showed a small, acute hemorrhage adjacent to an area of infarction in the parieto-occipital lobe in a man with acute malaria.

Acute Disease↗

PubMedDate not supplied

Isolation and axenization of two entamoeba histolytica strains.

We describe the isolation and axenization of two E. histolytica strains, obtained from the stools of two patients with the clinical diagnosis of dysentery. We used Pavlova's medium for initial polixenic culture, and TYI-S-33 (Diamond's) medium for monoxenic and axenic cultures. In order to eliminate the microorganism contaminating the stools the following antibiotics were used: penicillin, streptomycin, ampicillin, chloramphenicol, kanamycin, nistatin, ceftriaxone and amphoterycin B. Both strains grew in similar culture conditions with a yield of 2 x 10(6) microorganism per tube of 15 ml. Both strains belong to pathogenic zymodemes, and virulence was determined by the capacity for producing hepatic abscesses in 100% of the hamsters inoculated intrahepatically.

Animals↗

PubMedDate not supplied

C-erbB-2 oncoprotein in the sera and tissue of patients with breast cancer. Utility in prognosis.

C-erbB-2 serum levels were studied in the sera of 50 healthy subjects, 56 patients with benign breast diseases and 412 patients with breast cancer. Using 15 U/ml as the cut-off, no healthy subjects, patients with benign disease and only 2.4% of patients with no-evidence of disease had serum levels higher than this cut-off point. Abnormal c-erbB-2 levels were found in 9.2% of the patients with locoregional breast carcinoma and in 45.4% of those with advanced disease. C-erbB-2 serum levels in patients with locoregional breast cancer were not related to tumor size or nodal involvement. By contrast, significantly higher c-erbB-2 serum levels were found in ER- or PgR- tumors than in those ER+ or PgR+ tumors, in both locoregional or metastatic tumors. The correlation between serum and tissue levels of C-erbB-2 was studied in the tumors of 161 patients. Significantly higher c-erbB-2 serum levels were found in patients with overexpression in tissue by immunohistochemistry, in both locoregional and advanced disease (p = 0.0001). In patients with C-erbB-2 overexpression in tissue, c-erbB-2 serum levels were related to tumor size and nodes, with higher values in tumors greater than 5 cm or in those with more than 3 nodes involved. When the prognostic value of this oncoprotein was evaluated, patients with abnormally high presurgical c-erbB-2 had a worse prognosis than those patients with normal values, in both node-negative and node-positive patients. Serum concentrations in patients with advanced disease, were related to the site of recurrence with significantly higher values in patients with metastases (mainly in those with liver metastases) than in those with locoregional recurrence. In summary, c-erbB-2 serum level seem to be a useful tumor marker in the prognosis of patients with breast cancer.

Breast Neoplasms↗

PubMedDate not supplied

[Acute myocardial infarction related to cocaine use. Report of a case].

Cocaine use has been associated with ischemic syndromes, especially angor pectoris, myocardial infarction, cardiac arrhythmias and sudden death. A significant number of persons suffering from myocardial infarction associated with cocaine abuse do not have significant coronary atherosclerosis, and the mechanism for infarction in these patients have remained obscure. This report describes a young man with angiographically normal coronary arteries in whom cocaine abuse probably produced coronary artery spasm leading to coronary thrombosis and infarction.

Adult↗

PubMedDate not supplied

Stability of vinblastine sulphate in 0.9% sodium chloride in polypropylene syringes.

The stability of vinblastine sulphate diluted in 0.9% sodium chloride solution for injection was studied. Vinblastine sulphate was reconstituted with 0.9% sodium chloride solution for injection to concentration of 1.0 mg/mL and stored in polypropylene syringes at 25 degrees C +/- 1 degree C protected from light. On different days the solutions were analysed and the vinblastine concentration was determined by high-performance liquid chromatography. An high-pressure liquid chromatographic method is described for the quantitative determination of vinblastine in the presence of its degradation products. The degradation of vinblastine was studied by examining the percentage changes from the theoretical concentrations for each solution. The results of these studies indicate that vinblastine solutions in 0.9% sodium chloride solution for injection (1 mg/mL) in polypropylene syringes at 25 degrees C +/- 1 degree C protected from light are stable for up to one month.

Antineoplastic Agents, Phytogenic↗

PubMedDate not supplied

Middle term intestinal adaptation after massive distal small bowel resection in oral feeding dogs.

Intestinal adaptation (IA) consists mainly in a increase of the normal cell proliferative rate in the crypts of the intestinal mucosa. Histidine- and ornithine-decarboxylase (HDC and ODC, respectively) are always involved in the rapid growing tissue process. The present experiment studies the relation of HDC and ODC, the morpho-functional changes of the jejunal mucosa remnant and the nutritive state 2, 3 and 4 weeks after performing a 75% distal small bowel resection (DMSBR) in dogs fed with a standard chow. Each animal was its own control measure in a healthy state measured before provoking the DMSBR. The results demonstrated that 14 days after DMSBR, the mucosa of the jejunal remnant showed a loose of the normal characteristics of the villi and enterocyte morphology ("mucosal microinjuries"), accompanied by an increase in the depth of the crypt and in the HDC and ODC levels, while the D-glucose and L-phenylalanine absorptive capacity did not vary compared with that of the mucosa of the same animals in a healthy state. This correspond with a statistically significant altered nutritive state parameters. However, 21 days after DMSBR, the intestinal remnant mucosa initiates a structural recovery process. It was also observed a significant increase in the HDC and ODC enzymatic levels accompanied by an increased absorptive capacity and an improvement in the nutritive state parameters. Twenty eight days after DMSBR, the findings revealed a similar trend. In conclusion, in our model, between the second and fourth week the IA process is accompanied by a progressively increased HDC and ODC activities and an improvement of the nutritive state. The significance of the "mucosal microinjuries" described needs further investigation.

Adaptation, Physiological↗

PubMedDate not supplied

[Radiofrequency ablation of type I atrial flutter: combination of electrophysiological and anatomical techniques].

Atrial flutter type I (FLA) is one of the most common arrhythmias found in clinical practice. Reentry into the right atrium (AD) is the mechanism of this arrhythmia. The reentry mechanism has critical sites where radiofrequency (RF) can act blocking the circuit. Both, electrophysiological and anatomical approaches using RF to FLA have demonstrated a success rate above 80%. Our group combined both techniques treating 35 patients with FLA type I (22 men and 13 women), with mean age of 40.8 +/- 15 years old (range 9-70). In 21 patients (60%) this arrhythmia was associated with cardiopathy. All patients had failed to respond to different antiarrhythmic therapy. The success rate was 82.8% (29/35). When compared failure vs success we observed that patients who failed were older (51.8 vs 38.5 years old, p < 0.05), had structural cardiopathy (83.3% vs 55.1%, p = NS), had FLA type I with P waves with shorter cycle length (195 vs 254 ms, p = 0.052), had the arrhythmia chronically (129.6 vs 68.1 month, p = NS), had great left atrium diameter (41.2 vs 36.7 mm, p = 0.052) and frequently had been associated with atrial fibrillation (33.3% vs 3.4%, p = 0.02). There were no complications. Six (20.6%) patients reverted to FLA. We followed our patients during mean time 8.37 +/- 8.8 months (1-36). Our results support the notion that FLA type I can be treated with high percentage of success and low risk of complications when both RF techniques are combined. Our predictors of failure were: gender and associated atrial fibrillation (p < 0.05). We conclude that RF is the treatment of choice in every patient with FLA type I who had failed to antiarrhythmic therapy. We recommend RF as soon as FLA has been diagnosed because the probability of success is higher in such instances.

Adolescent↗