[Evaluation of the validity of "M-mode" echocardiographic studies in the diagnosis of "univentricular heart"].
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Biomedical subjects
Publications and source records attributed to M Rossi.
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The authors report the angiographic demonstration of arteriovenous fistulas in three patients. The fistula was believed to be spontaneous in one case, related to abdominal surgery and to abdominal trauma in the other two cases. The importance of angiography in the diagnosis and evaluation of this disease has been emphasized in the literature. Early diagnosis is valuable, either to prevent hepatic damage or to give an opportunity for recovery once it has taken place. Follow-up of the three patients has shown that hepatic function notably improved after surgery.
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A case of bilateral pheochromocytoma presenting as primarily cystic suprarenal masses is reported. The computed tomographic manifestations, possible etiology, and differential diagnosis of these cystic suprarenal lesions are discussed.
We present three aged female patients who fulfil the criteria of a syndrome that we call "amiloride hyponatremia". They became hyponatremic during amiloride + hydrochlorothiazide therapy. They needed diuretic therapy and tolerated well hydrochlorothiazide with potassium supplementation as potassium chloride. Patients with hyponatremia during diuretic therapy for cardiovascular diseases can be allocated to three groups: 1) Patients with edema and water retention due to severe impairment of cardiac function and decreased water clearance. They need diuretic therapy and water restriction. 2) Patients with "normal diuretic hyponatremia". Hypokalemia and extracellular volume contraction seem to be associated with this phenomenon, and the therapy involves discontinuing the necessary diuretic treatment. 3) Patients with "amiloride hyponatremia". They need diuretic treatment and tolerated thiazide therapy, but the hyponatremia can be corrected by changing amiloride to potassium supplementation. "Amiloride hyponatremia" is suggested to be due to a direct effect of amiloride + hydrochlorothiazide on the distal nephrons. The combination amiloride + hydrochlorothiazide must be used cautiously in elderly patients and the possibility of hyponatremia should be born in mind cases of vague symptoms and CNS disturbances.
223 cases with chronic lymphoid leukemia (CLL) were subjected to a prospective study on the presence of adeno- and splenomegaly at diagnosis and their subsequent variation. Subjects with no initial organ involvement were usually female (76%) and of old age (mean 69.2 years). Adenopathy or combined lymph node and spleen enlargement were inversely proportional to the mean age at diagnosis. Subsequent organ enlargement was noted in 11.7% of patients with no initial organomegaly, splenomegaly in 15% of patients with adenopathy only and adenopathy in 15% of patients with splenomegaly only. Except in the few cases with leukopenia, particularly high leuklocyte levels were noted in patients with splenomegaly (with or without adenopathy). Anemia at diagnosis was not related to the degree of organ enlargement. It is suggested that qualitative and also quantitative differences in organomegaly in CLL merit further study to establish their underlying mechanisms. CLL must be seen as something more complex than the simple mechanical expression of progressive lymphocyte accumulation.
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The crystal and molecular structures of two isomeric inhibitors of carcinogenesis by certain polycyclic aromatic hydrocarbons are described. The two compounds are 7,8-benzoflavone and 5,6-benzoflavone, which are shown by X-ray crystallographic studies to differ appreciably in their three-dimensional structures. Polycyclic aromatic hydrocarbons are metabolically activated by an enzyme system that is responsibe for the detoxification of many chemicals that enter the body. The two benzoflavones described here differ in their effect towards specific enzymes in the metabolizing system. Potential energy calculations predict that a nonplanar conformation is most probable for these flavone derivatives, as a result of the presence of a biphenyl-like system. Such a conformation is found for 7,8-benzoflavone with a torsion angle of 23 degrees between the phenyl group and the rest of the molecule. The isomeric 5,6-benzoflavone is, in contrast, found to be a predominantly flat molecule. There is an interaction between O(4) and a neighboring -C-H group which may explain the planarity of 5,6-benzoflavone. A comparison is made with structures of some common carcinogenic polycyclic aromatic hydrocarbons, the activities of which these two benzoflavones inhibit.
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A case of torsion of the spleen complicated by bowel occlusion occurred in a 3 1/2-yr-old boy is reviewed. Pathogenesis, symptoms and diagnostics are discussed. The rarity of the lesion in childhood is underlined together with the utility, in diagnostics, of plain films of the abdomen taken some hours one from the others.