Orbital venous drainage into the anterior cavernous sinus space: microanatomic relationships.

OBJECTIVE: Microsurgical anatomy and relationships in the region of the superior orbital fissure and anterior part of the cavernous sinus were studied, with special attention to the venous structures. METHODS: Microanatomic dissections were performed in 24 specimens from human cadavers, fixed in formalin, with the aid of a microdrill and operating microscope. RESULTS: A protocol of dissection was developed, enabling plane-by-plane exposure of the cranial nerves passing from the cavernous sinus to the superior orbital fissure and farther, on disclosure of the junction between the ophthalmic veins and the anterior cavernous sinus space. The main draining vessel was the superior ophthalmic vein. The inferior ophthalmic vein was much thinner and it was identified in 91.7% of cases. These two vessels fused together to form a common venous confluence approximately 5 mm in length that entered the anterior cavernous sinus space in its anterior or anteroinferior aspect. The shape of this venous drain varied greatly, from that of a typical vein to that of a venous lake. The latter was characterized by a relatively narrow opening into the anterior cavernous sinus space and lacunar widening of the vessel in its central part. No case of a separate entrance of the superior and inferior ophthalmic veins into the anterior cavernous sinus space was encountered. The anterior cavernous sinus space was described as a slit-like venous chamber located in front of the anterior genu of the intracavernous segment of the internal carotid artery. The anteroposterior diameter of this space was 3.2 +/- 0.4 mm; it was filled with blood, and no venous structures inside this space were observed. CONCLUSION: The knowledge of the anatomic details described may be useful for elaborating surgical approaches to this region and for planning the treatment of carotid-cavernous fistulas.

[Pathogenesis and clinical features of various forms of pulmonary emphysema in children]. / Patogeneza i klinika niektórych postaci rozedmy pluc u dzieci.

On the basis of the views of Lynne Reid 4 principal pathological mechanisms of pulmonary emphysema development are discussed. The clinical manifestations of the most frequent forms of emphysema characteristic of childhood are presented.

[Magnesium status in children and adolescents with celiac disease]. / Stan odzywienia magnezem u dzieci i mlodziezy z celiakia.

UNLABELLED: Magnesium deficiency has been reported in patients with classical coeliac disease. Classical coeliac disease has been recently very rare, but the frequency of the silent or latent form has increased. The aim of the study was to evaluate the magnesium status in patients with coeliac disease diagnosed according to ESPGAN criteria. 41 GFD(+) patients aged 6-18 years, who were on a gluten-free diet (GFD) for 2.8 to 17.3 years (mean 11 years); with normal villous structure and IgAEmA(-), and 32 GFD(-) patients aged 5-17 years, with villous atrophy and IgAEmA(+): 8--after 7/12-13/12 of gluten challenge, 4--with late onset of coeliac disease, 20--with silent coeliac disease. All of the children did not have any other disorders. Magnesium status was examined by using: an i.v. Mg-loading test (30 mmol/1.73 m2); Mg urinary excretion and Mg concentration in serum, erythrocytes, and in hair. Abnormal values in GFD(+) and GFD(-) patients were found in: Mg i.v. loading test (retention > 40%) in 20 vs 34%, serum Mg (< 0.7 mmol/l) in 7 vs 3%, erythrocytes Mg (< 1.8 mmol/l) in 20 vs 25%. The reversed statistically significant correlation was found between Mg retention and Mg urinary excretion (R = -0.293, p = 0.009). No other statistically significant correlations were found. CONCLUSION: The magnesium deficiency was present in all patients with classical coeliac disease, but only in 1/5 of patients with coeliac disease on a gluten-free diet and in 1/5 of patients with silent coeliac disease.

[Sex chromatin in sex determination and the diagnosis of gonadal differentiation disorders in children]. / Chromatyna plciowa w diagnostyce zaburzen determinacji plci i róznicowania gonad u dzieci

PIP: 350 children, aged from 1 day to 20 years, were given determinations of the level of sex chromatin as a preliminary determination of sex and gonadal differentiation. 150 were initially diagnosed with Turner's syndrome, 114 with Klinefelter's syndrome, 50 cases with hermaphroditism, and 27 with suspected aberration X. Discrepancies between the content of sex chromatin and the accepted sex were found in 47 of the cases of Turner's syndrome, in 21 cases of Klinefelter's syndrome, and in 3 cases of androgenital syndrome, 3 of Morris's syndrome, 3 of testicular dysgenesia, and in 1 case of scrotal hypospadia. Determination of sex chromatin was found useful for the diagnosis of height deficiency and delayed maturation, of eunuchoid physique in boys, for infants with abnormal external genitals, and in hormonally unexplained (extra adrenal) virilization syndromes in females.^ieng

[Use of droperidol and seduxen for preanesthetic medication in surgical treatment of mitral valve stenosis]. / Ispol'zovanie droperidola i seduksena dlia premedikatsii i vvedeniia v narkoz bol'nykh s mitral'nym stenozom.

According to the authors' data, droperidol (5-10 mg.) or seduxen (15-25 mg.), injected intramuscularly 90-120 minutes before operation, are more efficient than the premedication by traditional scheme (barbamil, pipolphene, promedol and atropine).

[Prolonged peridural block for postoperative analgesia in heart surgery patients]. / Dlitel'naia peridural'naia blokada dlia posleoperatsionnogo obezbolivaniia u kardiokhirurgicheskikh bol'nykh.

Prolonged peridural blockade with trimekain used in 1000 cardiosurgical patients is shown to be an effective prophylactic measure against postoperative complications. This method should not be widely used in patients with blood circulation insufficiency.