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Biomedical subjects

S Pollak

Publications and source records attributed to S Pollak.

At least 91 records · Page 5Linked to original sources

[Detection of diphenhydramine in autolytic brain tissue in poison-induced brain death syndrome].

A case of accidental monointoxication caused by diphenhydramine is reported. Having taken 12 dragées of Neo-Emedyl (50 mg diphenhydramine), an 18-month-old girl showed the following symptoms: generalized erythema, dyspnoea, vomiting, hyperpyrexia, tremor, convulsions, coma, respiratory arrest and absence of reflexes. Computed tomography (CT) suggested a massive cerebral oedema. Her electroencephalogram was abnormally diffused at first; later on, it flattened significantly and became isoelectric between the 14th day and the final stoppage of circulation (after 5 weeks). Autopsy revealed total necrosis of the brain, with the venous cerebral blood vessels being thrombosed (the morphological basis for dissociated cerebral death). In autolysed brain tissue, diphenhydramine was detected at a concentration of 30 ng/g by GC/MS (gas chromatography, mass spectrometry); the concentration of the substance was less than 10 ng/g in the liver. The relatively high concentration in the brain was due to the previous blocking of the circulation. Cerebral death syndrome caused by intoxication offers the chance of detecting measurable amounts of the unchanged drug in autolysed brain tissue.

Autolysis↗

[2-stage rupture of the liver as a complication of external heart massage].

A delayed rupture of the liver after resuscitation is reported. In the case of a 27-year-old woman, pulmonary embolism was followed by asystolia, which was remedied by external cardiac massage. This procedure caused ruptures of the liver, which first led to the formation of a subcapsular hematoma and 5 1/2 hours later, due to a secondary rupture of the capsule, led to internal bleeding and death. Degenerative changes of the parenchyma cells in the vicinity of the rupture were recognized, as well as fibrin separations on the detached Glisson's capsule, as signs of a survival period of several hours. Histological investigation of the lungs revealed a hepatocellular embolism and--in the absence of rib or sternum fractures--fat and bone-marrow embolisms. The morphological findings are discussed with reference to pertinent reports in the literature.

Adult↗

Rapid ventricular tachycardia due to His-Purkinje reentry.

Two patients developed rapid His-Purkinje reentrant tachycardia during programmed ventricular stimulation for evaluation of recurrent ventricular tachycardia. In Patient 1, His-Purkinje reentry induced a morphologically distinct ventricular tachycardia which may have been a reentrant circuit operating independently for several cardiac cycles. His-Purkinje reentry was not inducible in Patient 2 until lidocaine was given. Following lidocaine administration, sustained His-Purkinje reentrant tachycardia was initiated by 2 premature ventricular stimuli. The tachycardia was rapid (240 beats per minute) and required cardioversion.

Adult↗

Transient osteoporosis of hip joint with liver cirrhosis.

We describe the association between transient osteoporosis of the hip (TOH) and liver cirrhosis in a female patient. The clinical course, radiographic and scintigraphic features were similar to cases of TOH described previously. The pathogenesis of this syndrome is unknown and we suggest there may be a relationship between the hemodynamic changes common in cirrhotic patients and in pregnant women and the development of TOH.

Adult↗

[Pulmonary lipids in fatal burns (author's transl)].

The pulmonary lipids were investigated at autopsy in 22 deaths from burns (3 scalds among them) by means of histological examination, thin-layer chromatography and gas liquid chromatography. Leaving out of consideration 4 cases with concomitant mechanical trauma 7 out of 18 burned victims showed fat embolism of the lungs, the degree varying from slight (4) to medium (3). Cases surviving for a short period showed fat embolism more frequently than those with a rapidly fatal course. The extracted pulmonary lipids were separated by thin-layer chromatography into 5 fractions (phospholipids, cholesterol, fatty acids, triglycerides, cholesterol esters) and evaluated densitometrically. The triglyceride fraction was increased in cases of fat embolism after burns, as well as in control cases of post-traumatic fat embolism. For further lipid characterisation the fatty acids were determined by gas chromatography. Calculation of the amounts of the individual fatty acids showed that in cases of at least medium intensity the ratio of oleic acid/linoleic acid and oleic acid/stearic acid is shifted towards oleic acid.

Adolescent↗

["Bolt projectiles" discharged from modified humane killers (author's transl)].

Some common types of "humane killers" are supplied with rubber bushings and recoil springs holding back the bolt, which afterwards is rebound into the barrel. Removal of the rubber bush and withdrawal spring before firing can cause the bolt to break and become a free projectile. A suicide case is reported, in which a livestock stunner discharged a steel bolt penetrating the forehead and getting stuck in the skull.

Craniocerebral Trauma↗