Clinicopathological features of cutaneous histoplasmosis in human immunodeficiency virus-infected patients in Zimbabwe.

Reports of disseminated Histoplasma infection in African AIDS patients are scanty. In Zimbabwe, 12 patients presented in 1994-2000 with facial nodular/papular cutaneous lesions, which became umbilicated and finally ulcerated. Histology revealed non-granulomatous inflammation and macrophages stuffed with Histoplasma. Recognition of these clinical features may lead to more rapid diagnosis of disseminated histoplasmosis in Africa.

An unusual complication of oesophageal stent deployment.

Insertion of a self-expanding metal stent is commonly used to palliate dysphagia secondary to oesophageal carcinoma. Displacement of the stent itself is a recognized complication which can result in perforation of the upper gastrointestinal tract. We report the first case of bowel obstruction and perforation resulting from the olive of the deployment system. This was probably due to peritoneal deposits on the small intestine obstructing passage of the olive.

[The influence of adrenaline on the effects of halothane and enflurane on the myocardium. Papillary muscle of the cat (author's transl)]. / Der Einfluss von Adrenalin auf die Myokardwirkung von Halothan und Enfluran. Papillarmuskel der Katze.

In this paper the influence of epinephrine on the isolated papillary muscle has been investigated with respect to the myocardial effects of enflurane and halothane. The contractile properties have been described under isotonic conditions by the parameters "muscle length change", "velocity of shortening and under isometric conditions by the parameters "peak tension" and "maximum rate of tension development". The studies led to the following results: 1. Halothane and enflurane cause a dose-dependent decrease of the contractile properties of the cat papillary muscle. Averaged for all parameters the mycocardial depressant effect of halothane is 2.6 times higher than that of enflurane, referring to equal concentrations. 2. Epinephrine has a positive inotropic effect which is most pronounced under isotonic mode of contraction for "velocity of shortening" and during isometric conditions for "maximum rate of tension development". 3. The positive inotropic effect of epinephrine is partially neutralized by halothane and enflurane. There is, however, evidence that the relative decrease of contractility due to halothane and enflurane is diminished by epinephrine. This finding shows that the myocardial effects of inhalation anaesthetics are overestimated in in-vitro-experiments (because of the lack of exogenous epinephrine) in contrast to experiments with intact animals. As this finding is referring to both halothane and enflurane, there is no specific difference to be found concerning the myocardial effects in comparative studies, including both in-vitro and in-vivo conditions.

Trisomy 14 mosaicism leading to cytogenetic discrepancies in chorionic villi sampled at different times.

Short- and long-term cultures of chorionic villi obtained in the 11th week of pregnancy revealed trisomy 14. After induced abortion trisomy 14 mosaicism was established in fetal skin and umbilical cord tissue while a second long-term culture of chorionic villi exhibited a normal karyotype. The results of the pathological investigations are discussed with respect to the cytogenetic findings.

Transvenous double-balloon occlusion of the persistent ductus arteriosus: an experimental study.

A new method of transvenous catheter closure has been developed for closure of a persistent ductus arteriosus (PDA), especially in infants and children. The device consists of a 5F or 6F triple-lumen catheter which carries a detachable silicone double-balloon at the tip. After expanding the distal positioning balloon, the proximal occlusion balloon is placed in the PDA and filled to the required size with radiopaque silicone. As the silicone cures inside the balloon, a solid plug occludes the PDA after it is detached from the catheter. In 21 beagles a short segment of subclavian artery was interposed between the main pulmonary artery and the descending aorta, simulating a PDA. The procedure was tested on these models and proved to be suitable. Within one month the plug was covered with fibrous tissue at the pulmonary and aortic ends, thus ensuring permanent occlusion. The long-term follow-up extended for up to two years and confirmed the biocompatibility of the silicone plug.