Fallibility of persistent blood return for confirmation of intravascular catheter placement in patients with hemorrhagic thoracic effusions

Two patients are described with hemorrhagic thoracic effusions who required central venous catheterization. Presumed subclavian and internal jugular vein cannulation, ipsilateral to the hemorrhagic thoracic effusions, was confirmed by the operators in each case by the persistent aspiration of blood. Subsequent clinical and radiologic evaluation revealed that the vascular catheters were introduced into the pleural space. In both individuals, the persistent aspiration of extravascular hemorrhagic fluid mimicked intravascular catheter positioning. Physicians treating patients with hemorrhagic thoracic effusions need to be aware of this potential complication that can result in the delayed resuscitation of hemodynamically unstable patients.     

Hereditary macular dystrophies

BACKGROUND: Orthostatic hypotension is a common phenomenon in the elderly. Hormonal changes during orthostatic stress have been described in elderly normotensive people and in those with essential hypertension. However, the hormonal response in elderly people who have systolic hypertension during orthostasis has not yet been quantified. METHODS: In this study we investigated 14 non-diabetic men, aged 60 to 75 years, with untreated systolic hypertension who were subjected to 45 degrees passive head-up incline on a tilt table for 15 min. Their hormonal profile and hemodynamic changes were analyzed before and after the stress. RESULTS: In the supine position, plasma levels of norepinephrine, atrial natriuretic peptide and aldosterone were in the normal range, while the plasma renin activity was low. Immediately upon tilt the systolic blood pressure fell but it reverted to baseline values after 15 min of orthostasis. At that time the cardiac output decreased while the systemic vascular resistance and the plasma norepinephrine concentration rose. The atrial natriuretic peptide appeared to fall, and the renin-aldosterone level did not change. CONCLUSION: The physiologic response to orthostatic stress in elderly people with systolic hypertension is comparable to that of elderly normotensive people and those with essential hypertension, i.e. a decrease in cardiac output and an increase in plasma norepinephrine levels. The atrial natriuretic peptide appeared to fall appropriately. The response of the renin-aldosterone system mimicked that in elderly patients with low renin essential isolated hypertension. These observations may have a bearing on the management of elderly people with systolic hypertension who also have orthostatic symptoms; they may not require a different approach from that needed for others of the same age group.     

THE INFLUENCE OF ENTEROBACTER AGGLOMERANS ON BEER FLAVOUR

The influence of Enterobacter agglomerans (Erwinia herbicola) on the fermentation process and beer flavour was studied. The presence of E. agglomerans gave rise to increased levels of acetaldehyde, methyl acetate, diacetyl, 2,3-pentanedione and dimethyl sulphide in the final product. The concentration of these compounds was affected by the number of bacterial cells inoculated into the pitched wort.     

Surface changes of the rat embryo before implantation

Study of the rat embryo surface under the scanning electron microscope shows the superficial structure of the pellucid membrane as a perforated network cover which does not change throughout the preimplantation period (1 to 41/2 days). Dissolution of the pellucid membrane by brief ATP treatment reveals a zygotic surface which changes from day to day. The number and length of microvilli increase with development. At the early blastula stage there is a great heterogeneity of microvilli of different size and shape as well as large membranous ruffles mainly located at one pole of the embryo. The significance of these structures may relate to the changing metabolic requirements of the developing embryo and to the invasive properties of the trophoblast.     

Dermatoglyphic patterns in patients with mitral valve prolapse: a clue to pathogenesis

Fingerprints were obtained from 100 patients with mitral valve prolapse and compared with those of 100 control subjects matched for sex and race. Arches were found in 16.8 percent of all digital patterns in patients with mitral valve prolapse but in only 2.5 percent of all digits in the control group. Whereas no patient in the control group had four or more arches, 19 percent of patients with mitral valve prolapse had this finding. In addition, arches were found on 16 and 9 percent, respectively, of digits IV and V in patients with mitral valve prolapse but were not found on these digits in the control group. The finding of four or more arches or arches on digits IV or V may be important supportive evidence of mitral valve prolapse when evaluating patients with atypical chest pain and palpitations. Antenatal factors may be involved in the pathogenesis of mitral valve prolapse since it is possible that a genetic or environmental factor that interferes with the development of the mitral valve may also influence epidermal ridge patterns.     

Action potential fatigue in nonmyelinated nerve fibers: garfish olfactory and rabbit vagus nerve

With the new method the fecal flora of 13 clinically healthy dogs aged 3 to 42 months was analysed qualitatively and quantitatively. It was characterized by that bacteroidaceae constituted the most prodominant flora, catenabacteria, streptococci, peptostreptococci, lactobacilli and bifidobacteria were the next most numerous, enterobacteria consisted the accompanying flora. The numbers of Clostridium perfringens were remarkably fluctuated and seem to be influenced by the composition of the food ingested by the host. The total cultivable counts averaged log 10.8 +/- 0.2/g. The composition of the Lactobacillus flora and Bifidobacterium flora in the feces of 34 dogs from 3 different age groups was analysed. In the feces of all age groups L. acidophilus, L. salivarius and L. fermenti with 9 different types were found. Within the lactobacilli L. acidophilus type VI c, L. salivarius type VI a and L. fermenti type IV b were most frequently found. L. acidophilus types VI c and XI, L. salivarius types VI a and VI b could not be placed in any established types of each species, and were described as new types. Bifidobacteria were regularly found in large numbers in the feces of dogs aged 2 to 24 months. B. adolescentis and B. pseudolongum consisted the main Bifidobacterium flora.