Duplication of the cervical esophagus in children

True duplication of the cervical esophagus is rare. An 18-month-old girl presented with a large asymptomatic neck mass, which was found to be an intramural duplication of the esophagus. The evaluation and treatment of this patient is presented as well as a review of the six previously reported cases.     

Incomplete Boerhaave syndrome of the cervical esophagus

It is known that an acute postemetic injury may evoke a spontaneous rupture of the oesophagus. This spontaneous rupture may produce an intramural hematoma or a laceration of the oesophagus wall. The intramural hematoma is restricted to the esophageal wall and may produce a fistula into the lumen of the oesophagus (with creation of a double lumen) or into the mediastinum (haematoma of the mediastinum). On the other hand the rupture may extend from the mucosa (lesion of Mallory-Weiss) into the complete wall of the oesophagus (Boerhaave's Syndrome). There are reports on a lesion of the exterior muscular layer of the third distal half of the oesophagus, which had evoked an acute haemorrhage into the mediastinum and has been defined as a variant of Boerhaave's syndrome. We now describe a similar case which is confined to the cervical oesophagus and has been treated without surgical intervention.     

Ultrasonographic imaging of neoplasms of the cervical esophagus

BACKGROUND/AIMS: We studied the effectiveness of ultrasonography in evaluating the cervical esophagus for the presence of large masses arising from the esophageal wall and consequently, the modifications of the visceral lumen. MATERIALS AND METHODS: The cervical esophagus can be evaluated by ultrasound with longitudinal and axial scans, using the left thyroid lobe as an acoustic window. The cervical esophagus can be visualized from the C5 to D2 vertebrae. From November 1992 to July 1996, 220 patients with esophageal cancer and 120 subjects without esophageal disease (control group) were examined with ultrasonography. Examination of the cervical esophagus was performed with a linear high definition small parts probe with a frequency of 7.5-10 Mhz. RESULTS: In all 31 patients with cancer of the cervical esophagus, ultrasonography of the cervical region showed the presence of an expanding mass from the esophageal wall as well as the modifications in the visceral lumen. The neoplasm of the cervical esophagus was visualized when its diameter exceeded 5 mm. CONCLUSIONS: The experience of the authors shows that, during ultrasound examination of the cervical region, it is possible to accurately evaluate the cervical esophagus, either morphologically or functionally.     

Reflex reversal of apnoeic episodes by electrical stimulation of upper airway in cats

Respiratory effects of electrical stimulation of the upper airways (UAW) before and during apnoeic episodes induced by nitrogen inhalation were studied in 9 anaesthetized cats. In eupnoeic animals these electrically-evoked reflexes comprise rapid and powerful inspiratory efforts characterized by strong maximal airway occlusion pressures (Pmax = 635 +/- 39 mm H2O) and rapid peak inspiratory flow rates (PIF = 536 +/- 36 ml.sec-1) similar to the sniff-like aspiration reflex elicited mechanically. Electrical stimulation of the UAW mucosa can elicit reflex inspirations and sniff-like aspiration reflexes even during reversible hypoxic apnoea but their intensity and reproducibility are transiently reduced. When repeated adequately, the electrically-induced reflexes can increase the reactivity of respiratory centre and interrupt or terminate apnoeic episodes as do other types of UAW stimulation. Reflex mechanisms and respiratory centre activations seem to be involved in these effects. The results suggest that electrical stimulation of UAW could be useful for testing the respiratory centre reactivity as well as for reflex reversal of apnoeic episodes and restoration of normal breathing in animal experiments and clinico-physiological studies. Such investigation of the role of UAW reflexes in the pathogenesis and therapy of apnoeic syndromes might also be possible by using a cardiostimulator adapted as respiratory pacemaker.     

Neural respiratory responses to cortically induced seizures in cats

Seizure activity can lead to profound respiratory stimulation in spontaneously breathing animals with intact respiratory feedback mechanisms (Paydarfar et al., Am. J. Physiol. 260, R934, 1991). The present study was designed to test the hypothesis that peripheral respiratory feedback mechanisms are not important for the genesis of seizure-induced hyperpnea. Studies were performed in 16 anesthetized, vagotomized, glomectomized cats whose end-tidal PCO2 (PETCO2) was kept constant. Integrated phrenic nerve activity was used to represent respiration. Seizures were induced by injection of penicillin into the parietal cortex and electrocorticographic (ECoG) and biceps femoris nerve activities, arterial pressure, airway PCO2 and brain temperature were recorded continuously. Progressive seizure activity was associated with progressive increases of respiratory frequency and peak phrenic activity, despite constancy of PETCO2 and brain temperature. Patterns of entrainment were identified among ECoG spikes, biceps femoris nerve and phrenic nerve activities. Phrenic nerve activity became highly irregular during generalized ictal seizures and ceased to respond to changes of PETCO2. Acute intercollicular decerebration in all experiments resulted in normalization of respiratory rhythm even while ictal ECoG activity continued. We conclude that stimulation of breathing during seizures occurs in the absence of respiratory feedback mechanisms. The findings suggest that an important cause of the respiratory response is a feedforward mechanism, whereby activation of subcortical structures above medulla and pons results in stimulation of breathing.     

Phase relationships in the Al-Ta system

Phase relationships have been investigated in the Al-Ta system in the region between Al and AlTa₂. Al-Ta alloys with compositions between 20 and 60 at. pct Ta were prepared using different processing routes. Following appropriate heat treatments, the alloys were characterized microstructurally, by quantitative electron probe microanalyses, X-ray diffraction, and differential thermal analysis. Based on our observations, a revised Al-Ta phase diagram is proposed. Significant revisions include the verification of Al₃Ta as a line compound, the absence of a eutectic transformation in the region between Al₃Ta and AlTa₂, and the conclusive identification of a phase designated as AlTa near the equiatomic composition.     

Antioxidants in the respiratory system

BACKGROUND: Reactive oxygen species can participate in the airways reactivity changes after oxidants. The authors have observed an increase in airways reactivity after an exposure to toluene in guinea-pigs and cats in previous experiments. There literature data provide information on the prevention or the delay of free radical damage by antioxidants. MAIN PURPOSE: The aim of our study was to evaluate the effect of nonenzymatic antioxidants--vitamin C and vitamin E on the airways reactivity changes after the exposure to toluene vapours. METHODS: After a one-month-lasting pretreatment with 500 mg/kg/day vitamin C and 50 mg/kg/day vitamin E the guinea-pigs were exposed to toluene for 3 days 2 hours. Then the reactivity of trachea and lung strip smooth muscle to histamine was evaluated. RESULTS: The pretreatment with vitamin C did not evoke statistical significant changes of trachea and lung strip smooth muscles reactivity when compared with the control group. The pretreatment with vitamin E produced a statistically non-significant decrease in trachea smooth muscle reactivity, but an increase in contraction amplitude of lung strip smooth muscle. Trachea was without expressive histological changes. The lung showed granulomatous inflammation with lymphocytes and eosinophils. SUMMARY: Antioxidants in used doses did not prevent the reactivity changes evoked by toluene exposure. (Fig. 2, Tab. 4, Ref. 14.)     

胃食管反流病误诊为呼吸道疾病分析

胃食管反流病(gastroesophageal reflux disease,GERD)常出现呼吸系统症状,使临床诊断困难,甚至误诊为呼吸道疾病.常因误诊而延误诊治,我院2006年6月～2010年7月共收治GERD35例,其中以呼吸道症状为突出表现者18例,均曾在外院或本院误诊为呼吸道疾病,现分析误诊原因如下.     

Reflex sympathetic dystrophy: is the immune system involved?

OBJECTIVE: Evaluation of immune system function in patients with reflex sympathetic dystrophy (RSD). DESIGN: Survey on blood samples obtained from RSD patients and from a randomly selected control group. The lymphocyte populations (T, B, NK cells), and the activated T cells (CD25, and HLA-Dr-positive CD4 and CD8 cells) were analyzed by flow cytometry with dual-color direct immunofluorescence after whole-blood lysis. Clinical chemistry parameters were analyzed in additional serum samples. SETTING: Tertiary care center (outpatient rehabilitation clinic). SUBJECTS: Thirteen patients (nine women) with RSD and a control group of 21 healthy individuals. MAIN OUTCOME MEASURES: The results of the flow cytometry analysis of RSD patients were related to those of the control subjects. Means were analyzed, and confidence intervals for differences of the means were calculated. The means of the clinical chemical analysis were related to local reference values. RESULTS: The flow cytometry analysis did not differ between RSD patients and healthy controls. Although in some patients an individual parameter of clinical chemical analysis differed from its reference value, all of the mean values were within reference limits. Stratification on medications with immunomodulatory effects and on probability of a definite diagnosis of RSD had no influence on the results. CONCLUSION: No association between immunologic indices and RSD was found. This finding is relevant, because recent theories stress that it is not the sympathetic nervous system but a local inflammatory reaction that is fundamental in the pathogenesis of RSD. The results of this study do not support this theory.     

Motility determinations on the esophagus and its sphincter system

The authors report the case of a large pelvic tumour compressing the bladder, the ureters and the recto-sigmoid junction. Its sudden rupture into the peritoneum led to an emergency operation and the discovery of a hydatid cyst ruptured into the pouch of Douglas and a hepatic cyst. The most frequent presentation of peritoneal echinococcosis, peritoneal cysts are metastases from a hepatic or splenic cyst which has ruptured into the peritoneum. They are usually multiple. Single pelvic lesions are rare, their hydatid nature is in the absence of a past history of hydatid disease difficult to suspect before operation. The object of the latter is to treat in one stage the primary cyst and its peritoneal metastases. The narrow vascular connections of the pelvic cysts render cystectomy dangerous and make one prefer removal of the germinal membrane followed by marsupialisation or drainage of the remaining cavity. In the long term, the frequency of peritoneal recurrences makes prolonged supervision necessary.     

Phase relationships in the neodymium-magnesium alloy system

The Nd-Mg system was studied using differential thermal analysis (DTA), X-ray examination, metallography, and microprobe analysis. The following intermetallic compounds were found to exist and their crystal structures confirmed or determined: NdMg (cubic, cP2 CsCl type, melting point 800 °C), NdMg₂ (cubic, cF24 MgCu₂ type, peritectic formation ∼755 °C), NdMg₃ (cubic, cF16 BiF₃ type, melting point 780 °C), and Nd₅Mg₄₁ (tetragonal, tI92 Ce₅Mg₄₁ type, decomposes peritectically at 560 °C). The NdMg₂ phase undergoes a eutectoidal decomposition at 660 °C. Three eutectic equilibria were observed to occur at 42.5 at. pct Mg and 775 °C, 64.5 at. pct Mg and 750 °C, and 92.5 at. pct Mg and 545 °C, respectively. In the Nd-rich alloys, previously determined data^[15] concerning the Mg solubility in α-Nd (8.2 at. pct Mg, ≈550 °C) were accepted. The Mg solubility in β-Nd was evaluated as 34 at. pct Mg at 775 °C. The β-Nd phase was observed to decompose eutectoidally at 17 at. pct Mg and 545 °C. Moreover, in the Mgrich alloys, a metastable NdMg₁₂ phase (tetragonal, tI26 ThMn₁₂ type) was observed in samples quenched from the liquid. The general properties of the Nd-Mg phases are compared with those of the R-Mg compounds and briefly discussed.     

Phase relationships and thermodynamic properties in the Mn-Ni-C system

In the present work, phase relationships in selected phase regions of the Mn-Ni-C system have been investigated at 1073 and 1223 K by use of an equilibration technique. Alloys of Mn-Ni-C were prepared from pure Mn, Ni, and C powders by the powder metallurgy method. The phase identification of the heat-treated samples was carried out by scanning electron microscope (SEM) and transmission electron microscope (TEM). The main phase compositions of the alloys have been analyzed by X-ray diffraction (XRD). The experimental results show that the site fraction of Ni in the metallic sublattice of the carbides M₂₃C₆, M₇C₃, and M₅C₂ is quite low and the value is around 0.02 to 0.03. The thermodynamic activities of manganese in 16 different Mn-Ni-C alloys have been studied by solid-state galvanic cell technique with single-crystal CaF₂ as the solid electrolyte in the temperature range 940 to 1165 K. The results are discussed in light of the available thermochemical information.     

Associations between body condition and disease in cats

OBJECTIVE: To determine the association between body condition and disease in cats. DESIGN: Prospective study. SAMPLE POPULATION: Information on 1,457 cats without major illnesses from 27 veterinary hospitals in the northeastern United States. PROCEDURE: Cats that had body conditions determined from 1991 to 1992, using a set of 6 body condition silhouettes, had their health experiences and body conditions assessed for the subsequent 4.5 years. Cats were described by the following 6 body conditions: cachectic, lean, optimally lean, optimal weight, heavy, and obese. Data obtained from medical records and owner interviews were collected, using standard forms. Associations between body condition and specific diseases were analyzed. Findings in cats with body conditions other than optimal were compared with findings in cats with optimal body condition. RESULTS: Compared with optimal weight cats, heavy cats were 2.9 times as likely to be taken to veterinarians because of lameness not associated with cat bite abscesses. Obese cats were also 3.9 times as likely to develop diabetes mellitus, 2.3 times as likely to develop nonallergic skin conditions, and 4.9 times as likely to develop lameness requiring veterinary care. Cats considered thin (cachectic and lean) were 1.7 times as likely to be presented to veterinary hospitals for diarrhea. CLINICAL IMPLICATIONS: Results of this study substantiate reports of health risks associated with excess body weight in cats. Efforts to reduce weight in heavy and obese cats can lead to reduced risks of diabetes mellitus, lameness (presumably related to osteoarthritis and soft-tissue injuries), and skin problems unrelated to allergies. Cachectic and lean cats are more likely to have diarrhea that is not associated with a definitive diagnosis.     

Extirpation of the thoracic part of the esophagus using left lateral thoracoabdominal and cervical approach

The article presents data on follow-up of 7 patients having occupational argyria. Signs and symptoms of the disease are shown. Skin and mucous membranes are the main sites involved. Conclusions on diagnosis and treatment of the disease are given.     

Phase stability relationships and glass formation in the system Cu-Ag-In

Details are presented of phase relationships in the ternary system Cu-Ag-ln. Isothermal sections have been determined at 505 and 676 °C, and a most likely projected surface of primary crystallization is proposed. The phase relationships in this system are dominated by an extensive γ-phase (a Hume-Rothery “electron phase”) which extends approximately along a line of 30 at. pct In between the respective binary phases. The stability of the γ-phase follows approximately constant electron concentration lines and appears to be also enhanced by size relationships in the ternary system. The glassforming ability (GFA) in the Cu-Ag-ln system is poor, being limited to only a narrow region in the vicinity of alloy Cu₅₁Ag₃₁In₁₈. This behavior appears to be directly related to the stability of the γ-phase. An attempt has been made to interpret the GFA in terms of the most likely behavior of the T₀ surfaces.     

Direction-of-wording effects in the relationships between scales.

The effect of direction of wording in attitude and personality scales has been investigated in its effect upon the relationship between scales, demonstrating a dependable effect in all studies examined, including MMPI studies. This approach makes possible the demonstration of a strong direction-of-wording effect for the original F scale measure of authoritarianism even if all reversal efforts are rejected as inappropriate. The effect is small for some variables and larger for others. Rarely, however, does the direction-of-wording factor exceed shared trait factors in magnitude. (PsycINFO Database Record (c) 2010 APA, all rights reserved)