Intraoperative hypercyanosis in a patient with pulmonary artery band: case report and review of the literature

A case of intraoperative cyanosis in a patient with a common atrioventricular canal palliated with a pulmonary artery (PA) band is presented. The patient's physiology was consistent with cyanosis due to inadequate pulmonary blood flow, and responded quickly to typical interventions used for a hypercyanotic episode in a patient with unrepaired Tetralogy of Fallot. Differences and similarities in the physiology of PA banding compared with Tetralogy of Fallot are presented, including a rationale for treatment options for hemodynamic decompensation occurring in the setting of anesthesia and surgery.     

Angiomyofibroblastoma of the vulva

A 30-year-old female presented with unilateral labial enlargement. The clinical impression was that of a benign cyst. The microscopic features were that of angiomyofibroblastoma showing hyper and hypocellular areas containing spindle and plump stromal cells admixed with blood vessels. This tumour is benign with extremely low rate of recurrence. Surgery is the only treatment as in this case.     

Prevalence of elevated total IgE and food allergies in a consecutive series of ENT pediatric patients.

OBJECTIVE: Food allergies in childhood have been found to vary in frequency from 6% to 8% in the general population. Previous studies indicate milk allergy affects approximately 2.5% of infants and egg allergy has been estimated at 1.6% to 2.6%. Numerous allergists believe that the prevalence of food allergies is rising, similar to the rise in other atopic conditions. Prior studies have demonstrated that food-specific IgE is a useful test for diagnosing symptomatic allergies to certain foods, including milk and eggs, and could decrease the need to perform cumbersome multiple double-blind, placebo-controlled food challenges in children based on history alone. The purpose of this study was to determine the prevalence of food allergies and elevated IgE in a consecutive series of pediatric otolaryngology patients. STUDY DESIGN AND SETTING: ImmunoCap studies were drawn in a 2-year series of children undergoing ENT procedures of bilateral myringotomy with tubes (BMT) with or without adenoidectomy or tonsillectomy or adenoidectomy alone between 2001 and 2003. Sera was analyzed for increased total IgE antibodies, as well as specific IgE antibodies to antigens, including milk, egg, beef, and environmental allergens. A positive patient history or family history of allergy were documented. RESULTS: A total of 242 patients were assessed. Of the study population, milk allergy was found in 10.7%; egg white allergy was found in 5.0%. The prevalence of elevated IgE among participants was 11.2%. The overall food allergy prevalence was 14.5%. CONCLUSIONS: Although we cannot imply causality, the study demonstrated an increased prevalence of food allergy in children undergoing ENT procedures, specifically milk and eggs, than in previous population studies. EBM rating: C-4.     

Norditerpenoid alkaloids from Delphinium nordhagenii

Three new norditerpenoid alkaloids, nordhagenine A (1), nordhagenine B (2), and nordhagenine C (3), along with a known alkaloid, lycoctonine, were isolated from the aerial parts of Delphinium nordhagenii. The structures of the new compounds 1 and 2 were also deduced on the basis of single-crystal X-ray diffraction studies.     

Screening for abdominal aortic aneurysms in cardiovascular patients

BACKGROUND: The objective of the study was to determine the incidence of Abdominal Aortic Aneurysms (AAA) in a population of symptomatic cardiac patients. A retrospective cohort study of investigations was done at the cardiology clinic, Beaumont Hospital, Dublin. MATERIALS AND METHODS: There were 415 men and women recruited by referral to the cardiology clinic. All participants underwent routine ultrasound screening for AAA, and full assessment of all cardiac risk factors. Data were analyzed and correlated with age, sex, and diagnosis. RESULTS: Ultrasonographic diagnosis of aneurysm was based on an anteroposterior diameter of 3 cm or more. Of the 415 patients screened, 47 aneurysms were detected. Total incidence of AAA was 9.9% (male 14.1%, female 3.95%). All aneurysms were detected in patients over 60 years, detection rate 11.7% (male 16.3%, female 3.9%). The incidence of AAA was significantly higher in those who were subsequently proven to have cardiovascular disease, 13.8% (male 18%, female 5.15%). CONCLUSION: Screening the general population for those at risk of AAA is an ongoing debate. This study supports the concept of screening a higher risk population of patients over 60 years with cardiovascular disease.     

Method development and validation for the GC-FID assay of p-cymene in tea tree oil formulation

This paper describes the development and validation of an isothermal gas chromatography-flame ionisation detection (GC-FID) method for the assay of pure tea tree oil. The chromatographic conditions of the method employ a 5% carbowax packed column (20 m x 0.25 mm), isothermal elution with hydrogen at a column flow of 36 ml/min, injector and detector temperature at 220 degrees C and oven temperature at 100 degrees C, and a 1.5 microl injection volume. Samples and standard were diluted in hexane. The calibration curve for p-cymene was linear (r2=0.9995) from 20 to 120% range of the analytical concentration of 100 microg/ml. The precision of this method was calculated as the relative standard deviation (R.S.D.) was 0.66% (n=6). The R.S.D. for intermediate precision study was 0.13 and recovery of the p-cymene ranged between 93.39 and 97.86%. The limits of detection and quantitation were determined to be 2.08 and 10.39 ng/ml, respectively.