Respiratory effects of extradural analgesia after lower abdominal surgery

Blood-gas tensions, FRC and volume of trapped gas (VTG) in the lung were measured in patients on the day before lower abdominal gynaecological surgery, and twice on the day following surgery, before and after establishing lumbar extradural block (EDB) using 0.5% bupivacaine to provide analgesia after operation. FRC and VTG were measured with the closed-circuit helium-dilution technique. Mean VTG was 175 ml before operation and 275 ml after operation. PaO2 decreased significantly after operation, and the changes in FRC and VTG that occurred were related qualitatively. EDB did not significantly alter FRC, VTG or PaO2. Individual changes in FRC could not be related to changes in VTG or PaO2. Although EDB provided effective analgesia, the variables measured did not indicate that EDB conferred an immediate respiratory advantage.     

Granulocytic sarcoma (chloroma) initially seen as acute mastoiditis

Granulocytic sarcoma (chloroma) is a localized tumefaction of immature granulocytes that is typically seen in association with myelogenous leukemia. The primitive cell population seen in biopsy material may be misinterpreted as histiocytic lymphoma or other sarcoma unless additional studies are performed. We saw a 36-year-old woman with promyelocytic leukemia in remission who had the signs and symptoms of an acute coalescent mastoiditis. Histologic examination of the surgical specimen, however, demonstrated a granulocytic sarcoma. Our case exemplifies some of the difficulties that may be encountered in the diagnosis of granulocytic sarcoma and illustrates the point that symptoms of an inflammatory process in a patient with a diagnosis of leukemia must be regarded with a degree of suspicion.     

Preliminary characterization and pathogenicity studies of a virus isolated from ticks (Ornithodoros coriaceus) and from tick-exposed cattle

Several viral isolates from ticks (Ornithodoros coriaceus) and from the blood of cattle which aborted after exposure to these ticks were found to be identical by reciprocal cross serum-neutralization tests. Characterization studies indicate that the virus is a member of the Togaviridae family, although specific identification is still incomplete. Whether its natural host is the tick or bovine animals is also unknown. Pregnant cows inoculated with the agent by all conventional parenteral routes, including intrafetal, delivered healthy calves at term. It was concluded, therefore, that it was not a bovine pathogen and that the abortions which occurred after tick-exposure were due to a 2nd agent in O coriaceus ticks which also harbor the virus. While several ciruses believed to be tick-borne have been isolated from cattle in various parts of the world, it is believed that the present report describes the first isolation in the Western Hemisphere for a viral agent from Argasid ticks which has been demonstrated to replicate in cattle.