Left Bochdalek hernia with delayed presentation: report of two cases

Left Bochdalek hernia is a serious and complex condition with high mortality. In most cases, it presents in the neonatal period and is seldom found later in life when symptomatology, usually after an asymptomatic period, is quite different and the prognosis excellent. The embryological development of left Bochdalek hernia suggests the presence of abdominal content in the left pleural cavity before birth. The type of clinical presentation and the prognosis depend on the time of visceral herniation. This study presents two cases of left Bochdalek hernia with delayed presentation. In both cases, after surgical reposition of the hernia, a small congenital diaphragmatic defect was found hidden between the rims of diaphragm. This indicates the possibility for the abdominal content to enter the left pleural cavity at the time of presentation.     

115In as a probe for the characterization of therapy bremsstrahlung beams and the detection of photoneutrons

Variation of the photoactivation rate across radiation fields of three different bremsstrahlung beams of two medical accelerators has been measured, making use of the photonuclear reactions in natural indium probes: 115In(y,y')115mIn and 115In(y,n)114mIn. The third nuclear reaction, 115In(n,y)116mIn, was used to detect the presence of neutrons in the photon beam and to estimate the spatial distribution of thermal and fast neutrons in the patient plane as a function of collimator opening.     

Linear parameters of normal and abnormal cava septi pellucidi: a post-mortem study

Anatomical variations in the dimensions of different brain structures have been correlated with clinical syndromes. This study on the parameters of normal and abnormal cavum septi pellucidi (CSP) can be of clinical significance. We obtained 479 brains from autopsied persons (310 males and 169 females, 377 normal or asymptomatic and 102 abnormal or symptomatic persons, aged 22-89 years) and observed that 110 brains (75 males and 35 females) had CSP. These cava were classified into two groups depending on the past medical histories of the autopsied person: 40 asymptomatic and 70 symptomatic cava. We have defined symptomatic cava as those in autopsied persons who had known past medical history of psychiatric or neurological disease. Asymptomatic cava were in autopsied persons who had no known past medical history of psychiatric or neurological disease. The CSP parameters (length, width, depth) of the symptomatic and asymptomatic groups were measured and were statistically analyzed. Analysis showed that the cava in the symptomatic group were significantly longer and wider. Discriminant function analysis was used to derive a mathematical formula to classify CSP into an asymptomatic or symptomatic group based on length and width measurements of the cavum.     

Recurrent posterior dislocation following primary posterior-stabilized total knee arthroplasty

In our series of 136 patients with primary total knee arthroplasty using posterior-stabilized prosthesis, a female patient with Parkinson disease developed posterior dislocation of the knee 9 months after surgery. Eventually, the dislocation became recurrent, occurring several times a day. The patient made the reposition always by herself. Two months after the first dislocation, we performed the revision of the polyethylene tibial insert and found wearing of the tibial insert's cam as an hitherto unreported cause of the mechanical instability of the total knee prosthesis.