Spontaneous expulsion of a bullet via the urethra

The rare clinical occurrence of the spontaneous passage of bullet which was not found during an operation after a gunshot wound to the bladder in a 28-year-old man is described.     

Case report: Liver function abnormalities in a severe case of hyperreactio luteinalis

Rare causes of liver dysfunction in pregnancy may pose a challenge to the consulting gastroenterologist or hepatologist from both the diagnostic and therapeutic standpoints. We describe here liver function abnormalities in a case of hyperreactio luteinalis with light and electron microscopic findings.     

Evidence for a Leukocyte Adhesion Factor Produced by the Early Embryo

PROBLEM : To determine if the embryo may induce adhesive molecules needed for implantation. METHOD : Determination of whether platelet rosetting around lymphocytes might occur when exposed to sera from pregnant, but not nonpregnant patients and from culture fluid from embryos but not oocytes. RESULTS : 90.2% of women with positive sera beta human chorionic gonadotropin (P-hCG) levels taken at least 12 days postovulation demonstrated platelet rosette factor (PRF) vs only 18.7% when β-hCG was negative. Using mid-luteal phase sera in women receiving hCG injection 1 wk before, 64.7% had positive PRF when serial β-hCG levels were positive as did 100% of samples taken from in vitro fertilization (IVF) patients; however, only 15.3% were positive with negative serial hCG levels. Culture media from fertilized oocytes and embryos tested positive for PRF, but follicular fluid and media from unfertilized oocytes were negative. CONCLUSION : The early embryo secretes a factor(s) that gains access to maternal serum and promotes increased lymphocyte/platelet adhesiveness.     

Histopathological Changes of the Placenta in Diabetes Induced by Maternal Administration of Streptozotocin during Pregnancy in the Rat

Abstract The objective of this investigation was to find out the histopathological changes of the placenta and to correlate them with fetal malformations and growth retardation in experimental diabetes. Diabetes was induced in Wistar rats at different stages of gestation by intraperitoneal injection of streptozotocin (STZ). The controls were either buffer treated or injected with STZ followed by 2–6 IU insulin until term. All fetuses and placentae were collected on day 20 of gestation. Fetuses of diabetic rats were significantly growth retarded. Maxillary hypoplasia, edema, gastroschisis, exencephaly and septal defects of the heart were the major malformations. Most of the experimental placentae weighed heavier relative to their body mass. Toluidine blue stained sections of the placentae revealed severe histological abnormalities. The unusually large sized placentae had extensive cystic degeneration, often with an increased population of leucocytes. Giant cells were very numerous. Perivascular fibrosis, persistence of fetal mesenchyme, edema, infarcts and vacuolisation were observed in the labyrinths. In the small placentae, the glycogen cells were fewer and the glycogen in them remained unutilized. Reduction of labyrinthine zone, hypovascularity, constriction of vessels, perivascular edema and platelet aggregation characterized these placentae. The placentae of externally malformed fetuses showed cystic degeneration; their labyrinths contained constricted and less extensive vascular network. Phagocytic giant cells, polymorphs and platelet aggregation were also marked. Placentae of externally normal looking fetuses also presented cystic degeneration, reduction in fetal vasculature, dilated maternal sinusoids and giant cell proliferation. Insulin treatment resulted in the preservation of most of the normal histology of the placenta which correlated well with the reduced fetal malformations.     

Blockade of neuronal tryptamine receptors by metoclopramide

The variations with age and blood pressure in the cyclic nucleotide phosphodiesterase activator content of rat aorta were studied. Activator content increased with age and was less in mineralocorticoid-hypertensive than in control rats. These variations were more pronounced in the particulate than in the soluble fraction of aorta. The data do not demonstrate any relationship between the activator level and blood pressure, but they suggest that the activator may modulate cyclic nucleotide metabolism in rat aorta.     

Alternating Current Electrocution Detection and Termination by an Implantable Cardioverter Defibrillator

A patient with an ICD accidentally grasped a power line and was electrocuted. He was unable to release the cable during electrocution though he remained conscious. After receiving a shock from his ICD. the powerline was released. ICD interrogation revealed inappropriate detection of alternating current and delivery of a shock.     

QUANTITATIVE ASSESSMENT OF RESIDUAL ANTIDEPOLARIZING BLOCK (PART I)

A method is presented for the assessment of residual curarizationafter the use of anti-depolarizing muscle relaxants which doesnot involve the necessity for establishing control observations.The ulnar nerve at the elbow was stimulated with a train offour pulses repeated intermittently. The muscle response tothis train of four stimuli was recorded and analyzed using threeratios of twitch height (or electromyographic responses). Ratio(a) was taken as the height of the first response of the trainto the height of the control response (i.e. the response beforemuscle relaxant was given), ratio (b) as the height of the secondresponse to the height of the first response, and ratio (c)as the height of the fourth response to the height of the firstresponse. There was a highly significant positive linear associationbetween ratio (a), which involves the use of a control response,and the other two ratios, (b) and (c), which do not involvea control response.