[Use of pleuro-peritoneal shunt in the treatment of chronic chylothorax]. / Zastosowanie zastawki oplucnowo-otrzewnowej do leczenia przewleklego chlonkotoku do jamy oplucnej.

Persistent chylothorax is usually treated by frequent aspirations or intercostal-tube drainage with interpleural installation of chemical or mechanical irritants. In 1986 Denver pleuroperitoneal shunt has been introduced. This is a single-unit silicone rubber conduit consisting of unidirectional valved pumping chamber located between pleural and peritoneal catheters. Manual compression of the shunt is required to achieve active pumping. The described unit is implanted subcutaneously in the lover thoracic and upper abdominal region in the anterior axillary line. We present a 38 year old patient with persistent chylothorax treated successfully by implantation of the described device.

Aqua(benzene-1,3-dicarboxylato)zinc(II).

The title compound, poly[[aquazinc(II)]-mu-benzene-1,3-dicarboxylato-O1:O1':O2], [Zn(C8H4O4)(H2O)]n, forms a metal-organic coordination network that consists of tetrahedral Zn atoms bonded to one water molecule and three carboxylate groups. Isophthalate groups bridge the four-coordinate Zn centers to generate two-dimensional architectures in the ac plane. These planar zinc isophthalate motifs are linked by infinite C=O...H-O-H interactions along the a axis to form a chiral framework. The observed polar structural pattern originates due to the distorted tetrahedral Zn centers [O-Zn-O 100.7 (2)-136.0 (1) degrees ] and the alignment of the water molecules. Bridging isophthalate groups align to form approximate centrosymmetric motifs.

Surgical treatment for myasthenia gravis.

A new surgical technique for thymectomy is presented. Three hundred and seventeen patients with myasthenia gravis and 20 with thymomas who had myasthenic symptoms were operated on. The new surgical approach--a small transverse sternotomy--was used in 257 cases (in 240 patients with myasthenia gravis and 17 with thymomas) and conventional median sternotomy in 80. In myasthenic patients small transverse sternotomy enabled radical thymectomy to be performed with an uneventful postoperative course and very good cosmetic results. There were no hospital deaths among patients with myasthenia gravis after thymectomy. The long term results, assessed after 18-24 months, were good: the total remission rate was 39.5%, and there was a great improvement in 48.5% and an improvement in 9%. After thymectomy about 30% of patients received supplementary treatment with prednisone. A correlation between the duration of symptoms and the result of thymectomy was established: the shorter the duration of myasthenia gravis the better the results. In the small group of 20 patients with thymomas two died in hospital. In 12 patients with encapsulated thymic tumours the long term results were similar to those in patients with myasthenia gravis, whereas in patients with infiltrating thymic tumours the results were unsatisfactory.

[Experience with mediastinoscopy (author's transl)]. / Erfahrungen mit der Mediastinoskopie

Results of 330 mediastinoscopies are presented. Mediastinoscopy showed to be a safe and reliable method in the diagnosis of systemic lymphatic disorders. Mediastinoscopy was not performed as a routine method. Therefore it is difficult to evaluate its significance in the qualification for surgical treatment in the carcinoma of the lungs. Nevertheless the use of this method may spare unnecessary explorative thoracotomy in many patients. Possibilities of therapeutic use of mediastinoscopy are presented.

Hypocalcemia and "toxic" syndrome associated with streptococcal fasciitis.

A 35-year-old man suffered a small puncture wound of the right hand and within four days had acute fasciitis of the right upper extremity. Cultures of wound and blood grew a group A beta-hemolytic Streptococcus. Persistent hypocalcemia was recognized daily, and he died ten days after the injury in cardiac failure. Preliminary studies have shown that the organism elaborated two streptococcal pyrogenic exotoxins (SPE-C and a new exotoxin, SPE-D). It is suggested but not proven that the cause of the patient's "toxic" illness may have resulted from the action of these exotoxins.