Cardiac tamponade in a preterm neonate secondary to a chest tube

In a preterm infant, chest tubes were inserted for treatment of bilateral pneumothoraces. Hemorrhagic pericardial effusion with cardiac tamponade developed, probably resulting from traumatic injury by the left chest tube. The infant survived due to timely diagnostic and therapeutic intervention. No recurrence of pericardial effusion was seen and follow-up showed normal psychomotor development.     

Kinetics and bioavailability of N-nitrosodiethanolamine after intravenous and cutaneous administration to rats

Male CD-COBS rats were given N-nitrosodiethanolamine (NDELA) by intravenous or cutaneous administration at a dose of 5 mg/kg. Blood and liver were analysed for NDELA at various times after administration. The excretion of unchanged NDELA and its acidic metabolite N-(2-hydroxyethyl)-N-carboxymethylnitrosamine (ECMN) was determined in urine for 24 hr after treatment. The semilogarithmic blood concentration-time plot after iv injection showed a triphasic profile indicating that a three-compartment model may adequately describe the kinetics of this compound. After cutaneous application NDELA was rapidly absorbed through the skin, and the absolute bioavailability was calculated to be 27% from blood data, and to be 32% (NDELA + ECMN) from urine data. Hepatic NDELA levels reflected blood levels after both treatments, indicating that this organ does not accumulate NDELA to a significant extent. Urinary excretion of unchanged NDELA after iv and cutaneous administration was 83 and 25% of the administered dose, respectively. ECMN excretion was 4.9 and 2.5% of the administered dose after iv and cutaneous administration, respectively.     

Inhibition by indomethacin of increased estradiol extraction by the IUD-containing rat uterine horn

The role of prostaglandins on the extraction of estradiol (E2) by the rat uterine horn in the presence of the intrauterine device (IUD) was evaluated. Increased extraction of E2 by the IUD horn compared to the contralateral control horn was consistently observed irrespective of the estrogen status of the animals. This increased extraction was abolished by indomethacin, an inhibitor of prostaglandin synthesis, suggesting a role of prostaglandin in this process.     

Synthesized MR images: comparison with acquired images

Synthesized and directly acquired spin-echo images were compared in order to assess the validity of magnetic resonance (MR) image synthesis as a method enabling retrospective formation of images by interactive manipulation of scan parameters. Synthetic images subjectively compared favorably in both accuracy and precision with acquired images when formed for the same values of echo (TE) and repetition times (TR) and for interpolated and extrapolated values of both TE and TR. Plots of synthetic and acquired signals within the same pixel sectors quantitatively showed comparable values for several regions of interest in the brain. Percent error and noise-normalized differences between acquired and synthetic images were tested as a quantitative measure of accuracy. Percent error was consistently less than 5% for brain parenchyma, and synthetic signals were accurate to within four times the noise level at acquisition. The apparent signal-to-noise ratio of synthetic images was comparable, superior, or inferior to similar acquired images, depending on the values of TE and TR. Total acquisition time required for synthetic formation of images for arbitrary values of TE and TR was equivalent to that of a single direct acquisition with a TR of 2,500 msec.     

Complex fractures of the clivus: diagnosis with CT and clinical outcome in 11 patients

During a 20-month period, fractures of the clivus occurring after craniocerebral trauma were diagnosed with computed tomography (CT) in 11 patients. Five patients had longitudinally oriented fractures; these were fatal in four patients due to either vertebral-basilar artery occlusion, brain stem trauma, or both. Six other patients had transversely oriented fractures that extended through the carotid canal and petrous temporal bone. While less frequently contributing directly to mortality, transverse fractures were also associated with cerebrospinal fluid leaks (two patients) and a cavernous sinus-carotid fistula (one patient). They were not as frequently associated with Horner syndrome or cranial nerve deficits as suggested in the current literature. This retrospective evaluation reveals two distinct injury patterns that demonstrate a difference in related morbidity and mortality.