Cough and inhibitors of the angiotensin-converting enzyme

Regarding 5 recent cases of cough induced by inhibitors of angiotensin conversion enzyme (CEI), the authors emphasize the still underestimated frequency of this annoying and sometimes disabling side-effect (10 to 15% of cases). They remind of their clinical and evolutive characteristics: dry cough, predominantly at night, often occurring rapidly, sometimes delayed (up to 17 months) after introduction of the CEI and unrelated to the dosage. The cough usually disappears in two to three days (up to 8 days) upon discontinuation of the treatment. The test of discontinuation-reintroduction, possibly crossed (captopril/enalapril) is used in questionable cases as a diagnostic test. Besides, this diagnosis must be made rapidly in order to avoid costly, unnecessary laboratory tests which are sometimes unpleasant for the patient. The cough could be explained by an irritation of the bronchial mucosa secondary to bradykinin and pulmonary E2 prostaglandins elevation, under CEI.     

Influence of age on the transparency of the lens in normals: a population study with help of the Lens Opacity Meter 701

The Lens Opacity Meter 701 measures the lens density quantifying the back light scatter of the lens. The instrument emits a modulated dark-red beam which runs along the optic axis of the lens. The stray light is converted into an electrical impulse which is displayed and printed using a numerical scale. The lens density in a normal population was investigated with this instrument in order to study the influence of age on the opacification process.     

On the structure of the mesomorphic form of syndiotactic polystyrene

In this contribution, the X-ray diffraction (XRD) pattern of a highly oriented sample of syndiotactic polystyrene in the mesomorphic form, collected by an automatic diffractometer, is presented, thus providing quantitative and more complete information relative to the diffracted intensity. The structural changes induced by annealing procedures in mesomorphic samples are shown through the analysis of the XRD patterns: both unoriented and oriented mesomorphic samples are transformed gradually into α-form crystals. On the basis of these evidences and of preliminary comparisons between the calculated Fourier transform of simplified models and the experimental diffraction intensity, it is suggested that the local organization in triplets of trans-planar chains, typical of the different modifications of the α-form, would be largely present also in the disordered chain agglomerates of the mesomorphic form.     

Auriculotemporal syndrome (Frey's syndrome) presenting as tic douloureux. Report of two cases.

Two cases of auriculotemporal nerve syndrome (Frey's syndrome) presenting as trigeminal tic douloureux are reported. This condition, characterized by gustatory sweating and facial hyperemia, is occasionally associated with pain, which is usually described as aching or burning, and long-lasting. In these two cases, however, a tantalizing gustatory pain occurred in excruciating brief paroxysms. The pathophysiology of the syndrome, with particular reference to pain, and possible treatment modalities are discussed.     

A new technique for the division of syndactyly

Summary This paper describes a new technique for the division of syndactyly. The commissure is reconstructed by a dorsal trilobed flap and a zig zag incision which produces triangular flaps for the side of the digits. This technique does not require use of a skin graft. Seventeen syndactylies in fourteen children, nine incomplete (six congenital and three secondary to burn) and eight complete syndactylies were treated by this technique. The results after a maximum of twelve months follow-up and the advantages of the technique are discussed.[/ab]     

HMPAO Single-Photon Emission Computed Tomography in Posterior Circulation Infarcts

The sensitivity of single-photon emission computed tomography (SPECT) in evaluating posterior mculation infarcts compared with that of computed tomography (CT) or magnetic resonance imaging (MRI) remains unknown. In a hospital-based population, the authors studied SPECT, CT, and MRI in 35 consecutive patients presentmg with acute infarction clinically localized in the thalamus (7), posterior cerebral artery (PCA) territory (15), bramtem (19), and cerebellum (3) Multiple infarcts were noted m 8 patients. Overall, the SPECT sensitivity was lower than that of MRI (21% vs 93%, p ~ 0 004) and CT (42% vs 65%, p = 0 046) The SPECT and CT sensitivities were not Significantly different (67% vs 73%) for PCA Infarcts. Performed within 24 hours, SPECT showed a relevant hypoperfusion in all PCA mfarcts. For brainstem infarcts, CT (33%, p = 0 074) and MRI (91 %, p = 0.004) were more sensitive than SPECT, which showed no hemispheric hypoperfusion. The sensitivity of the three imaging techniques was 100% for large cerebellar infarcts. For the small group of thalamic infarcts, the SPECT, CT, and MRI sensitivities were 14, 71, and 100%, respectively. Thus, SPECT compared to CT and MRI is not helpful in the subacute phase to localize PCA and cerebellar infarcts and is of limited value for thalamic infarcts. In the first hours, the absence of cerebral hypoperfusion in brainstem mfarcts may help to differentiate them from hemispheric infarcts usually associated with profound hypoperfusion.