Dystrophia myotonica

The authors present two cases of myotonic dystrophy (Steinert's disease) with cardiac involvement in young adults. They point out the rareness of this disease, the multisystemic involvement and also the diagnostic problems in the absence of the classic clinical picture.     

A technique of positive-pressure single-lung ventilation via a silicone T-Y stent

Airway control and protection, in any operation, is the first priority. The presence of a T-Y stent in the proximal airway can complicate this fundamental principle. Here we describe an effective and safe technique for positive-pressure single-lung ventilation via a T-Y stent for a lung lobectomy.     

Differential diagnosis and therapy in Adie's syndrome

In general, Adie's syndrome does not represent a serious diagnostic problem. In cases of cerebrospinal syphilis the Argyll-Robertson phenomenon or even absolute pupillary rigidity will be observed. Positive syphilis reactions will clarify these cases. The erroneous diagnosis of brain tumour may arise because of anisocoria. However, if pupillotonia can be ascertained by means of conjunctival instillation of drugs no further invasive diagnostics will be necessary. In some cases of Adie's syndrome concomitant emotional instability may be present. This dysautonomic reaction type of personality will hardly ever be confounded with the psychological disturbances encountered in brain tumours. Therapy is restricted to symptomatic measures. Pupillotonia can be influenced by strychnine and thymoxamine. Headache and facial neuralgia respond to the usual therapeutic schemes. Sweating disorder cannot be influenced. Neuropharmacological treatment may become necessary in periods of acute emotional disturbance.     

Estimation of body fat in rats by whole-body counting

A method for determining body fat in vivo in rats by whole-body counting of 40K is described. The technique utilizes a Nuclear Chicago Corporation TOBOR system with 5-in thallium-activated sodium iodide crystals. To test the method a regression equation was developed using the 40K counts and body weight of young adult rats weighing 333-788 g; the results were compared with those obtained from the gravimetric determination of fat in the carcass. The correlation coefficient between the two methods was 0.945.     

Treatment of antral and duodenal bleeding ulcers by Guevara's catheter

The catheter is based on the principle of compression and tamponage, assuring and guaranteeing hemostasis at the base of the ulcer. This method is suitable for permanently controlling an acute hemorrhage in the event medical treatment fails and surgery is contraindicated. Emergency surgery is changed to elective surgery with all its advantages.     

Microcysts of the permanent adrenal cortex in perinates and infants,

Microscopic cysts in the permanent cortices of adrenal glands were studied in a series of 274 infants, some of whom had been stillborn and none of whom were more than 12 months old. After correction for length of gestation, there were no significant relationships between the occurence and number of microcysts and various maternal, placental, and perinatal diseases. A significant direct correlation was demonstrated statistically with shorter gestational period and shorter survival time after birth. We concluded that the adrenal microcysts are either a developmental feature or the result of a greater susceptibility to stress in the fetus and newborn than in older infants.     

Primary lithiasis of the bile ducts

An analysis is made of 24 cases of primitive lithiasis of the biliary tracts, viz; 10 of diffuse intrahepatic lithiasis, 9 of intrahepatic lithiasis localized in one of the ducts; and 5 of extrahepatic lithiasis. The most common cause were stenosis (14 cases) generally of idiopathic or congenital nature, followed by those of iatrogenic or tumoral origin. There were also cases of isolated or diffuse anomalus dilatation of the biliary ducts. A lithogenetic bile as well as infectious processes are rather considered secondary factors. The diagnosis of the real nature of the condiction was usually established in the postoperative period, this being an explanation why repeated surgery was so common (75%). There was a high postoperative mortality in the diffuse forms owing to severe manifestations of biliary sepsis perpetuated by the stones. Depending upon the individual cases the following procedures are proposed: 1) Biliodigestive anastomosis 2) Sphinteropapilloplasty 3) Dilatation and calibration of the stenosis 4) Postoperative instrumental extraction of calculi. The last-named procedure was carried out in 58% of the cases and result in an improvement in the serious prognosis. Primitive lithiasis should always be borne in mind when undertaking surgery of the biliary tracts in order to avoid additional surgery.