Fatal acute left ventricular outflow obstruction due to interventricular septal haematoma -- diagnosis by transoesophageal echocardiography

We describe a case of fatal left ventricular outflow obstructiondetected by intraoperative transoesophageal echocardiography.This resulted from acute haematoma formation within the interventricularseptum follow–ing internal mammary artery grafting tothe left anterior descending coronary artery. This unusual casehighlights the emerging role of transoesophageal echocardiographyin the diagnosis and management of the complications of cardiacsurgery.     

INTER-RELATIONSHIP BETWEEN CHANGING PATTERNS OF LHRH AND GONADOTROPHINS IN THE MENSTRUAL CYCLE

Optimum conditions for a sensitive and highly precise radioimmunoassay of LHRH were established. Precipitation and removal of interfering substances and concentration of the resultant LHRH extracts from peripheral plasma were also achieved. Using these methods, daily plasma LHRH levels in females with normal menstrual cycles were measured and correlated with the corresponding LH and FSH levels. The levels of LHRH in the peripheral plasma of postmenopausal females, as well as eugonadal males, were also determined. The LHRH profile in normal cycling women was found to be cyclic but the peak LHRH levels were observed at the beginning of the rise in LH and FSH levels and preceded the midcycle surge of gonadotrophins. The LHRH levels in the luteal phase (19·8 ± 1·1 pg/ml, mean ± SEM) were significantly (P < 0·01) higher than those in the follicular phase (16·5 ± 0·5 pg/ml) of the menstrual cycle. A high degree of correlation (r = 0·91) was seen between the immunoreactivity and biological activity of the extracted LHRH.     

Protection by ipratropium bromide and metaproterenol against methacholine and histamine bronchoconstriction

To establish relative protection against methacholine and histamine, 40 μg of ipratropium bromide, an anticholinergic compound, 1.3 mg of metaproterenol or placebo aerosols were administered by metered-dose inhaler prior lo inhalation challenge with methacholine or histamine in nine asthmatic subjects. Double-blind, randomized challenges were performed. Subjects required a mean methacholine dose of l.72 ± 0.73 and 2.46 ± 0.72 (Ln inhalation units), and mean histamine dose of 2.l6 ± 0.65 and 2.68 ± 0.49, to cause a drop of 20% and 35% respectively in the FEV₁ following the placebo. In the methacholine challenges, both ipratropium bromide and metaproterenol had significant protection as compared to placebo (P<0.001). There was no statistical difference in the degree of protection against methacholine between ipratropium bromide and metaproterenol. In histamine challenges, metaproterenol had significant protection as compared to the placebo, while ipratropium bromide did not protect against histamine.     

Erythrokeratoderma Variabilis Responding to Low-Dose Isotretinoin

Abstract:  A 2-year-old male child was diagnosed with erythrokeratoderma variabilis, and showed an excellent response to low-dose isotretinoin, with remarkable improvement in all the affected areas within just 2 weeks of treatment.