[Reticulovascular radiologic pattern in primary arterial pulmonary hypertension]

We tested the value of the radiographic indexes in 16 patients with the diagnosis of pulmonary hypertension of unknown etiology. The index PL/T (lung-lobe-thoracic) was abnormal in 62.5%, the Osawa-Kanemoto index (DPA(T/2] was also abnormal in 62.5% of the cases, the r/h index (which measures the ratio right pulmonary artery thickness/right lung field) was abnormal in 81% of the cases. There was no relationship between the above mention indexes and the pulmonary artery pressure. Seven of the 16 patients displayed a new radiographic image that we have named "reticulo-vascular pattern", this radiographic sign may be important in the diagnosis of primary pulmonary hypertension.

[Pathogenic factors and therapeutic criteria in 82 newborn infants with necrotizing enterocolitis]

Sixty newborn infants with necrotizing enterocolitis (NEC) were retrospectively studied in 1979. The incidence was 0,49/1.000 living newborns: 81% were under 2,500 g and 30% under 1.500 g. We found a very low incidence of the so-called pathogenic factors. Feeding started in this group on the 24 h of life, with adapted formulas; 28% underwent surgery with a postoperative mortality of 62% and an overall mortality of 28%. Ten out of the 17 deceased were under 1.500 g. From 1979 with a similar medical treatment we introduced a prospective study consisting of a protocol of 10 different parameters including clinical, radiological and analytical values, the aim being a more objective way of indicating when to operate the patient. Special meticulous care of the nutrition of the low-weight babies was taken; 22 patients were treated til 1982, only 4,5% were under 1.500 g. The initial feeding time in all high risk babies under 1.250 g being 7 days with gastric gavage and elementary diets. All the infants with more than 60% values in the protocol underwent surgery (38%). The postoperative mortality was 37% with an overall mortality of 19%. A look back to our series suggests a clear usefulness of the protocol and the suspicion that the delay on feeding with intragastric continuous perfusion in low weight babies reduces NEC.

[Neuronal ceroid-lipofuscinosis. Diagnosis by skin biopsy. Physiopathology (author's transl)]

Authors report a case of Batten's disease (neuronal ceroid-lipofuscinosis), in its late infantile form (Jansky-Bielschowsky), so as the ability to identify the process by ultrastructural study of the skin.

[The normal pulmonary angiogram]

The experience obtained from the study of 151 normal pulmonary angiograms is presented. It was found, that is possible to identify most if not all the segmental arteries in the anteroposterior view, but the lateral view let identify the segmental arteries that arise perpendicular to the frontalplane. The role of the byplane pulmonary angiography in order to identify the segmental pulmonary arteries is emphasized. Must of the normal variation patterns of the segmental pulmonary arteries were found and only two differents patterns were seen, type IV in the right upper lobe and probably type II for the left lower lobe. It was also found that the arterial patterns of the middle lobe and right lower lobe were observed in different percentages that would be expected.

[Coexistence of aorto-pulmonary calcification]

The importance of finding in chest roentgenograms the coexistence of aortic and pulmonary artery calcification in emphasized. This radiologic feature is useful in patients which offered difficulty in the clinical diagnosis, it should suggest as a first possibility in the diagnosis patent ductus arteriosus.

Protective effect of steroids on liver ischemia

Occlusion of the afferent liver circulation for variable periods of time would be advantageous to temporarily control bleeding from profound lacerations or during extensive resections. Because of its low tolerance to ischemia we attempted to protect the liver with steroids during inflow occlusion. Total hepatic ischemia was produced in rabbits by ligating the portal triad and gastrohepatic ligament for 30 minutes. A 10 per cent survival was obtained in untreated controls whereas pre-treatment with methylprednisolone improved survival to 100 per cent. Methylprednisolone injection after occlusion improved survival only to 57 per cent. There were profound pathohistologic and electron microscopic changes in untreated controls. In animals treated with methylprednisolone either before or after occlusion changes were minimal or absent. This treatment was used in four trauma patients in whom occlusion of the liver inflow was carried out for various periods of time. Even though no significant statement can be made from such small group, the early postoperative course was remarkably smooth and stable. Methylprednisoline protects the liver during warm ischemia, especially if given before occlusion, and decreases the mortality from this maneuver in experimental animals.

Effects of some sympathomimetic drugs and their antagonists on afterdischarges elicited in chronically isolated slabs of cerebral cortex

1. The role of sympathomimetic agents in the maintenance and termination of induced cortical epileptiform activity was studied in chronically neuronally isolated slabs of cerebral cortex in the suprasylvian gyrus of unanaesthetized, unrestrained cats.2. The administration of the sympathomimetic agents (+)-amphetamine, methamphetamine, tyramine, and ephedrine resulted in a highly significant decrease in the duration of epileptiform afterdischarge (EADs).3. The alpha-adrenoceptor blocking drugs phenoxybenzamine, phentolamine and tolazoline did not significantly alter the duration of EADs but prevented the decrease in duration of EADs produced by the sympathomimetic drugs.4. The effect of atropine and arecoline on the duration of EADs, previously described, were not modified by the alpha-adrenoceptor blocking drugs, but atropine prevented and reversed the inhibitory action of amphetamine.5. It is suggested that (1) in the chronically neuronally isolated cortical slab there is normally no spontaneous adrenergic activity, (2) a cortical, cholinergic inhibitory mechanism, previously described, is modulated by ascending adrenergic influences, (3) adrenergic cholinergic linkages might be arranged in the cortex in an alternating network, as proposed by Feldberg.