A note on the synapses between vesicle containing profiles in the pontine nuclei of the cat

In the cat synapses between vesicle containing profiles were observed in ventral and dorsolateral pontine nuclei. The presynaptic elements consisted of two types of axon terminals: axon terminals characterized by a population of small (38-40 nm) round synaptic vesicles (SSV) and axon terminals containing pleomorphic synaptic vesicles (PSV). The postsynaptic pale elements (PP) had pleomorphic vesicles and some features attributed to dendrites. In the dorsolateral pontine nucleus most of PP profiles took part in serial synapses, usually as an intermediate component, they were rarely observed in triads. On the basis of their electron microscopical appearance and synaptic relations they might be considered to represent a dendritic part of putative interneurons.     

Positive sign of the stenocardia syndrome as a criterion of myocardial ischemia during the treadmill test

Diagnostic validity of the criteria of myocardial ischemia in coronary patients exposed to the treadmill test is assessed. The risk of a false diagnosis of coronary insufficiency on the basis of the pain syndrome was 5 times as high as that of diagnosis based on ischemic electrocardiographic ST depression. In subjective assessment of walking tolerance, patients with severe angina were particularly prone to mistakes. Limitations of angina classifications by severity, based on subjective sensations of coronary patients, are considered.     

Surgical tactics in clotted hemothorax in patients with combined chest injuries

Based on the experience with treatment of 26 patients the authors recommend to use mainly conservative treatment with the intrapleural administration of fibrinolytic drugs. The method was used in 20 patients. All of them recovered.     

Use of endoscopic papillosphincterotomy in the treatment of acute pancreatitis

The authors describe results of using endoscopic papillosphincterotomy in 100 patients with acute pancreatitis. Methods of endoscopic papillosphincterotomy and endoscopic papillosphincterowirsungotomy are presented. The effectiveness of the treatment was 96%. Operative procedures on emergency made up 1%, lethality-1%, complications-3% of the cases.     

Benign intracranial hypertension and recombinant growth hormone therapy in Australia and New Zealand

Benign intracranial hypertension (BIH) is reported in three children from Australia and one from New Zealand, who were being treated with recombinant human growth hormone (rhGH). Three males and one female, aged between 10.5 and 14.2 y, developed intracranial hypertension within 2 weeks to 3 months of starting treatment. A national database, OZGROW, has been prospectively collecting data on all 3332 children treated with rhGH in Australia and New Zealand from January 1986 to 1996. The incidence of BIH in children treated with growth hormone (GH) is small, 1.2 per 1000 cases overall, but appears to be greater with biochemical GHD (<10IUml ^-1), i.e. 6.5/1000 (3 in 465 cases), relative risk 18.4, 95% confidence interval 1.9-176.1, than in all other children on the database. The incidence in patients with Turner's syndrome was 2.3/1000 (1 in 428 cases). No cases in patients with partial GHD (10–20 IUml ^-1) or chronic renal failure were identified. Possible causative mechanisms are discussed. The authors'practice is now to start GH replacement at less than the usual recommended dose of 14IUm-² week^-1 in those children considered to be at high risk of developing BIH. Ophthalmological evaluation is recommended for children before and during the first few months following commencement of rhGH therapy and is mandatory in the event of peripheral or facial oedema, persistent headaches, vomiting or visual symptoms. The absence of papilledema does not exclude the diagnosis.     

Diagnosis and evaluation of the severity of arterial insufficiency of the legs using ultrasonic Doppler flowmetry in the treadmill test

A method of diagnostics and assessment of the severity of arterial insufficiency of lower extremities was developed on the basis of multistep treadmill-test and measuring time of reestablishment of continuous bloodflow in the popliteal artery by the method of ultrasonic doppler flowmetry. An examination of 40 patients with angiographically detected alterations of the vessels and 18 healthy persons was performed. It was found that the diagnostic and assessment criterion of arterial insufficiency in treadmill-test with high parameters of sensitivity and specificity is longer duration of the period of reestablishment of continuous bloodflow over 180 sec. The arterial insufficiency severity is estimated by the value of exercise by the moment of the appearance of the criterion.