Subarachnoid-pleural fistula after resection of a pancoast tumor with hyponatremia

Resection of superior sulcus neoplasms is associated with a number of complications resulting from the extensive nature of the resection and the necessity to sacrifice certain adjacent structures. One of the complications of resection is the development of subarachnoid-pleural fistula, with the subsequent appearance of air in the cerebrospinal fluid circulation. We report a case in which a subarachnoid-pleural fistula led to persistent pneumocephaly in a patient who exhibited postoperative hyponatremia, confusion, and gait disturbance.     

Cognitive complaints in closed-head injury: relationship to memory test performance and emotional disturbance

Self-appraisal of cognitive difficulties by a sample of 63 male patients with closed-head injury (CHI) was examined in relation to their performance on the Wechsler Memory Scale - Revised (WMS-R; Wechsler, 1987), WAIS-R Digit Span (Wechsler, 1981), and to their scores on MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) measures of anxiety and depression. In an initial step, the Cognitive Difficulties Scale (CDS; McNair & Kahn, 1983), consisting of 39 self-report items, was factor analyzed using a sample of 255 consecutive neuropsychological referrals with documented brain impairment. Seven orthogonal dimensions emerged: Attention and Concentration, Orientation and Memory, Praxis, Domestic Activities, Facial Recognition, Task Efficiency, and Errand and Name Recall. Within a sample subset consisting of 63 patients with CHI, subjective complaints on the CDS were predictive of WMS-R Logical Memory performance (r = -.51, p < .0005). In contrast, CDS scores were generally poor predictors of Digit Span and Visual Reproduction scores (rs < .31). Cognitive complaints were also associated with emotional distress on the MMPI-2. The CDS appears to be a useful measure of self-appraised cognitive difficulties in patients with CHI, and may assist in the assessment of their self-reflective insight.     

Analysis of suckling-induced changes in adenohypophyseal prolactin concentration in the lactating rat by three assay methods

Suckling-induced changes in adenohypophyseal prolactin (PRL) concentrations in lactating rats were measured in two experiments by three assays: a disc electrophoretic assay (DEA), a bioassay (BA) and a radioimmunoassay (RIA). Substantial discrepancies among the three assays were found in the absolute amounts of pituitary PRL measured and in the changes in adenohypophyseal PRL concentration that were recorded between suckling intervals. The results indicate that in dynamic states of secretory activity the correspondence among BA, RIA and DEA estimates of pituitary PRL concentration is poor.     

Quantification and identification of particle movement in epidermis after thermal injury

Skin samples from a rabbit hind limb were taken from controls and at 5 min, 2 and 6 hr after a mild thermal injury (60 degrees C for 1 min). Large aggregates of intercellular particles, usually ribosomal in appearance, were seen in 6 hr samples and were accompanied by some peripheral aggregates of particles and by granule-coated vesicles. These structures were present in earlier samples to a lesser extent and were absent from control material. Quantitative assessment showed that intercellular particles apparently increased up to 6 hr whereas peripheral aggregation was maximum at 2 hr. Histochemical analysis confirmed that the particles contained ribonucleoprotein. Other larger particles were seen occasionally and contained carbohydrate. Lymph draining the site showed cellular changes, little change in enzyme activities, and no aggregates of particles.