Right postpneumonectomy gained dextrocardia

The negative pressure realized into the hemi thorax with lung pneumonectomy has consequences upon the mediastinum organ statics. This aspect results in expansion of the other lung. These changes are usual but limited in the adult lung pneumonectomy. In the right lung pneumonectomy, the mediastinum moves to the operated part and disturbs the function of the vessels and cavities with thin wall or low pressure (vena cava, right atrium). These aspects are not described in the left lung pneumonectomy. Taking into consideration the previous factors, we present a particular case of a young woman with right lung pneumonectomy; this intervention was made in childhood, at ten years of age. After sixteen years of evolution it was realized a real mediastinum reshuffle, the heart was moved in the right hemi thorax, with dextrocardia-like aspect. This case is interesting because it involves the positive and differential diagnosis problems--dextrocardia, associated disorders, real complications.     

Metachronous primary cancers of the colon and stomach

We report herein a case of 69 years old woman who, in the course of 11 years, developed two cancers: carcinoma of the colon fistulization in duodenum and adenocarcinoma of the stomach. No polyposis has been found. This patient successfully underwent a right hemicolectomy with pancreaticoduodenectomy (Traverso-Longmire procedure). A decade later, she suffered a total gastrectomy with distal pancreatectomy for gastric adenocarcinoma. The patient made an uneventful postoperative recovery. Although patients with primary multiple cancers are not common, it is nonetheless important for clinicians to consider the possibility of metachronous cancers in patients who were treated for a primary malignant tumor.     

Synthesis and analytical characteristics of new progesterone skeleton haptens

This article describes the synthesis of new conjugated progesterone-bovine serum albumin substances, used to obtain specific antisera toward this hormone and for progesterone assay kits. In general, these kits are designed to be used on the farm or at the local veterinary clinics.     

The prevalence of the owner of serologic markers for the hepatitis C virus,in a north-eastern territory of Romania

The paper describes aspects in the natural evolution of hepatitis C virus (HCV) infection with severe outcomes induced by the typical or atypical clinical manifestations or chronic carrier state. In the interval 1995-1999 in the Iasi district morbidity from all types of viral hepatitis ranged from 153.4 cases per 100,000 inhabitants in 1995 to 66.6 in 1999. The features of A viral hepatitis epidemiological process was the multiannual cyclic pattern. From estimating the circulation of HCV in the population of Iasi district, several population categories have been screened for the presence of HCV antibodies (anti-HCV). Testing 87,894 blood samples assessed the prevalence of anti-HCV in blood donors. Different annual values resulted: 1.5% in 1997 and as a result of routine screening, only 0.3% in 1999. The cases of posttransfusion hepatitis (PTH) admitted to the Clinic of Infectious Diseases of Iasi, the diagnosis of which was supported by epidemiological history and confirmed serologically by the presence of anti-HCV were of 12 in 1995 (36.4% of all PTH), 20 in the interval 1996-1999, with an average for the 4 study years of 7.5%. Anti-HCV was found in 24.4% of series of 4,594 patients with viral hepatitis, in 32.1% of 582 individuals with various disorders or at risk, of which those with liver cirrhosis accounted for 37%, and in 9.6% of 94 patients with neurological disorders. Of the 1083 tested physicians and nurses working in health care settings at risk 6.6% were anti-HCV-positive.     

Extrapulmonary translocation of ultrafine carbon particles following whole-body inhalation exposure of rats

Studies with intravenously injected ultrafine particles have shown that the liver is the major organ of their uptake from the blood circulation. Measuring translocation of inhaled ultrafine particles to extrapulmonary organs via the blood compartment is hampered by methodological difficulties (i.e., label may come off, partial solubilization) and analytical limitations (measurement of very small amounts). The objective of our pilot study was to determine whether ultrafine elemental carbon particles translocate to the liver and other extrapulmonary organs following inhalation as singlet particles by rats. We generated ultrafine (13)C particles as an aerosol with count median diameters (CMDs) of 20-29 nm (GSD 1.7) using electric spark discharge of (13)C graphite electrodes in argon. Nine Fischer 344 rats were exposed to these particles for 6 h. in whole-body inhalation chambers at concentrations of 180 and 80 microg/m(3); 3 animals each were killed at 0.5, 18, and 24 h postexposure. Six unexposed rats served as controls. Lung lobes, liver, heart, brain, olfactory bulb, and kidney were excised, homogenized, and freeze-dried for analysis of the added (13)C by isotope ratio mass spectrometry. Organic (13)C was not detected in the (13)C particles. The (13)C retained in the lung at 0.5 h postexposure was about 70% less than predicted by rat deposition models for ultrafine particles, and did not change significantly during the 24-h postexposure period. Normalized to exposure concentration, the added (13)C per gram of lung on average in the postexposure period was approximately 9 ng/g organ/microg/m(3). Significant amounts of (13)C had accumulated in the liver by 0.5 h postinhalation only at the high exposure concentration, whereas by 18 and 24 h postexposure the (13)C amount of the livers of all exposed rats was about fivefold greater than the (13)C burden retained in the lung. No significant increase in (13)C was detected in the other organs which were examined. These results demonstrate effective translocation of ultrafine elemental carbon particles to the liver by 1 d after inhalation exposure. Translocation pathways include direct input into the blood compartment from ultrafine carbon particles deposited throughout the respiratory tract. However, since predictive particle deposition models indicate that respiratory tract deposits alone may not fully account for the hepatic (13)C burden, input from ultrafine particles present in the GI tract needs to be considered as well. Such translocation to blood and extrapulmonary tissues may well be different between ultrafine carbon and other insoluble (metal) ultrafine particles.     

Efficacy of benfluorex in combination with sulfonylurea in type 2 diabetic patients: an 18-week, randomized, double-blind study

OBJECTIVE: The aim of this study was to demonstrate the superiority of benfluorex over placebo as an add-on therapy in type 2 diabetic patients in whom diabetes is insufficiently controlled by sulfonylurea monotherapy and who have a limitation for the use of metformin. RESEARCH DESIGN AND METHODS: Type 2 diabetic patients with HbA(1c) (A1C) (7-10%) who were receiving the maximum tolerated sulfonylurea dose and had a contraindication to or poor tolerance of metformin were randomly assigned (double blind) to receive benfluorex 450 mg/day (n = 165) or placebo (n = 160) for 18 weeks. The main efficacy criterion was A1C, analyzed as the change from baseline to the end of treatment using ANCOVA with baseline and country as covariates. Secondary criteria were fasting plasma glucose (FPG), insulin resistance, and plasma lipid level. RESULTS: Both groups were similar at baseline in the intention-to-treat population. A1C significantly decreased with benfluorex from 8.34 +/- 0.83 to 7.52 +/- 1.04% (P < 0.001) and tended to increase with placebo from 8.33 +/- 0.87 to 8.52 +/- 1.36% (NS), resulting in a mean adjusted difference between groups of -1.01% (95% CI -1.26 to -0.76; P < 0.001). The target A1C (< or =7%) was achieved in 34% of patients receiving benfluorex versus 12% of patients receiving placebo. Significant between-group differences in favor of benfluorex were observed for mean FPG (-1.65 mmol/l) (P < 0.001) and for homeostasis model assessment of insulin resistance. Overall tolerance was similar in both groups. Serious adverse events were more frequent in the benfluorex group, without evidence of causality relationship. CONCLUSIONS: Benfluorex as an add-on therapy was superior to placebo in lowering A1C with a between-group difference of 1% in type 2 diabetic patients whose disease was insufficiently controlled with sulfonylurea alone and in whom metformin was contraindicated or not tolerated.