Sulfur Interaction and Regeneration of CaMn0.775Ti0.125Mg0.1O2.9-δ Perovskite as Oxygen Carrier during Combustion of Sour Gas in a 500 Wth Chemical Looping Combustion Unit.

In the present study, the performance of a CaMn0.775Ti0.125Mg0.1O2.9-δ perovskite used as an oxygen carrier to burn sour gas with different H2S concentrations (up to 3000 vppm) in a continuous 500 Wth chemical looping combustion (CLC) prototype was investigated. After 29 h of sour gas combustion, the combustion efficiency had dropped by 18% in comparison with the reference test without sulfur addition. The characterization of the used particles of the perovskite confirmed that the presence of sulfur in the fuel gas had a poisonous effect through the formation of undesired compounds, such as CaSO4. The reactivity with CH4 and oxygen uncoupling capacity decreased, which could explain the decrease in the combustion efficiency. Two regeneration processes, one at high temperature (1273 K) and another one at low temperature (773-873 K), were carried out in a batch fluidized bed reactor to remove the amount of sulfur accumulated in the oxygen carrier particles. The detection of appreciable amounts of gaseous sulfur-based compounds (SO2 and H2S) during the experimentation and the postcharacterization results obtained through different techniques such as X-ray diffraction, ultimate analysis, and thermogravimetric analysis confirmed the effectiveness of both processes. Finally, the feasibility of implementation of the regeneration processes in a commercial CLC unit was thoroughly analyzed.

Prevalence and penetrance of ZFPM2 mutations and deletions causing congenital diaphragmatic hernia.

Zinc finger protein, FOG2 family member 2 (ZFPM2) (previously named FOG2) gene defects result in the highly morbid congenital diaphragmatic hernia (CDH) in humans and animal models. In a cohort of 275 CDH patient exomes, we estimated the prevalence of damaging ZFPM2 mutations to be almost 5%. Genetic analysis of a multigenerational family identified a heritable intragenic ZFPM2 deletion with an estimated penetrance of 37.5%, which has important implications for genetic counseling. Similarly, a low penetrance ZFPM2 frameshift mutation was observed in a second multiplex family. Isolated CDH was the predominant phenotype observed in our ZFPM2 mutation patients. Findings from the patients described herein indicate that ZFPM2 point mutations or deletions are a recurring cause of CDH.

La biopsia pulmonar en el diagnóstico de la enfermedad pulmonar intersticial difusa / Lung biopsy in the diagnosis of diffuse interstitial lung disease

La enfermedad pulmonar intersticial difusa (EPID) representa un grupo heterogéneo de enfermedades que suponen un desafío terapéutico. En muchas ocasiones es necesaria la realización de una biopsia pulmonar quirúrgica para su diagnóstico. El objetivo de este estudio es valorar la eficacia de este tipo de técnica y si tras alcanzar el diagnóstico por este método se produce un cambio en la terapéutica. Material y métodos: estudio descriptivo retrospectivo de los pacientes a los que se les ha realizado una biopsia pulmonar quirúrgica en los últimos 10 años en el Hospital Universitario Virgen Macarena, analizando diferentes variables y comparando el tratamiento pre y postquirúrgico. Resultados: se obtuvo un diagnóstico histopatológico definitivo en el 98% de los casos y un cambio en la actitud terapéutica en el 78,4% (p<0,01) de los casos con una morbilidad del 9% y una mortalidad nula. Conclusiones: la biopsia pulmonar quirúrgica es un método seguro y eficaz que influye en la decisión terapéutica de los pacientes con EPID (AU)

Interstitial lung disease (ILD) is a heterogeneous group of diseases that involve a therapeutic challenge. Frequently, a surgical biopsy is needed to obtain a definitive diagnosis. The aim of this study was to assess the accuracy of surgical lung biopsy in the diagnosis of ILD, and to what extent, such a biopsy leads to changes in treatment options. Patients and methods: all patients undergoing a surgical lung biopsy for suspected ILD at the Virgen Mararena University Hospital over the last 10 years were retrospectively analysed. Several pre- and post-operative variables were collected. Differences between pre- and post-lung biopsy treatments were assessed. Results: a definitive diagnosis was obtained in 98% of cases. The lung biopsy led to changes in medical treatment in 78,4% of patients (p<0,01). Morbidity of the series was 9%, with no cases mortality. Conclusions: the surgical lung biopsy is a safe and effective method to guide the therapeutic decision in patients with ILD (AU)

Localización de nódulos pulmonares mediante arpón guiado por TAC para su resección videotoracoscópica / No disponible

El objetivo de este estudio es la valoración de la técnica de localización de nódulos pulmonares periféricos con arpón guiado con TAC para su posterior resección por cirugía video toracoscópica. Se realizó un estudio retrospectivo con 60 pacientes obteniendo el diagnóstico de certeza en el 100% de los casos, representando los procesos malignos el 71,6% de los nódulos estudiados y el28,4% correspondieron a procesos benignos. La localización de nódulos pulmonares mediante aguja con arpón es un método sencillo y seguro para la localización del nódulo y la obtención de un diagnóstico, previa extirpación video toracoscópica de los mismos, aunque a veces, sean lesiones de difícil abordaje (AU)

The aim of this paper is to study the technique of solitary pulmonary nodule’s localization using CT guided hook wire in the way to make it possible to be resected by VATS. We performed a retrospective study of 60 patients. In all of them a certain diagnosis was obtained. There were 71.6% malignant diseases and 28.4% benign nodules. Localization of solitary pulmonary nodules using hook wire is an easy and safe method to identify this kind of lesion and to get a true diagnosis due VATS resection even in small and central nodules (AU)

Hemotórax espontáneo como forma de presentación de carcinoma de pulmón / Spontaneous haemothorax as a form of presentation oflung cancer

El hemotórax espontáneo como forma de presentación de uncarcinoma de pulmón es extremadamente raro, siendo muy pocos los casos reflejados en la literatura. Hemos tenido la oportunidad de tratar a una paciente de 64 años, no fumadora, cuyo ingreso hospitalario fue debido a un hemotórax masivo izquierdo que estaba originado por un carcinoma de células gigantes en lóbulo inferior, como se comprobó en la intervención, y a la que se le pudo realizar una lobectomía inferior izquierda y linfadenectomía

Haemothorax as a form of presentation of lung cancer isextremely rare, and very few cases have been reported in the literature. We have had the opportunity to treat a 64 year old, nonsmoker patient, whose hospital admission was due to a massive left haemothorax that was originated by a giant cell carcinoma in the lower lobe and confirmed in the intervention. A left lower lobectomyand lymphadenectomy was completed

Hemotórax espontáneo como forma de presentación de carcinoma de pulmón / Spontaneous haemothoraz as a form of pesentation of lung cancer

El hemotórax espontáneo como forma de presentación de uncarcinoma de pulmón es extremadamente raro, siendo muy pocoslos casos reflejados en la literatura. Hemos tenido la oportunidadde tratar a una paciente de 64 años, no fumadora, cuyo ingresohospitalario fue debido a un hemotórax masivo izquierdo queestaba originado por un carcinoma de células gigantes en lóbuloinferior, como se comprobó en la intervención, y a la que se le pudorealizar una lobectomía inferior izquierda y linfadenectomía (AU)

Haemothorax as a form of presentation of lung cancer isextremely rare, and very few cases have been reported in the literature.We have had the opportunity to treat a 64 year old, nonsmokerpatient, whose hospital admission was due to a massive lefthaemothorax that was originated by a giant cell carcinoma in thelower lobe and confirmed in the intervention. A left lower lobectomyand lymphadenectomy was completed (AU)

Tratamiento de la hiperhidrosis palmar por simpatectomía torácica. Resultados inmediatos y calidad de vida postoperatoria / Thoracoscopic sympathectomy for palmar hyperhidrosis. Immediate results and postoperative quality of life

OBJETIVO: La hiperhidrosis palmar primaria localizada es un trastorno en la producción del sudor que resulta social y laboralmente incapacitante. El propósito de este estudio es evaluar los resultados, complicaciones y grado de satisfacción de los pacientes con hiperhidrosis palmar primaria tratados con simpatectomía videotoracoscópica T2-T3 bilateral en el Servicio de Cirugía General y Torácica del Hospital Universitario Virgen Macarena de Sevilla. MATERIAL Y MÉTODO: Se ha realizado un estudio clínico prospectivo histórico de 226 simpatectomías torácicas. La muestra la componen 113 pacientes (47 varones y 66 mujeres) de 14 a 50 años años de edad con hiperhidrosis palmar y axilar primaria, en algunos severa. A todos ellos se les intervino bajo anestesia general practicándoseles simpatectomía videotoracoscópica T2-T3 bilateral. Se presenta un seguimiento mediante cuestionario en relación con la calidad de vida y grado de satisfacción pre y postoperatoria. Se han efectuado análisis de frecuencia y descriptivos de los datos obtenidos sobre la técnica quirúrgica, calidad de vida y cambios posteriores a la cirugía y una prueba no paramétrica de Wilcoxon para dos variables relacionadas para contrastar diferencias significativas entre la calidad de vida pre y postoperatoria con relación a la hiperhidrosis y sus complicaciones. RESULTADOS: El porcentaje de éxito terapéutico ha sido del 100 por ciento. La tasa de complicaciones del procedimiento fue del 14,2 por ciento e incluyó hemotórax en dos pacientes, hemoneumotórax en tres, derrame pleural en dos y mínima cámara aérea apical en 9. De los 106 pacientes a los que se les realizó seguimiento entre 6 y 12 meses mediante entrevista y cuestionario, un 67 por ciento de ellos desarrollaron sudación compensatoria. Un 95 por ciento de estos pacientes refirió mejoría de su calidad de vida, y un 4 por ciento no experimentó ningún cambio en ella, sobre todo al considerar la aparición de la sudación compensatoria. El 97,2 por ciento de los pacientes entrevistados respondieron afirmativamente a la cuestión de si se volverían a operar. CONCLUSIÓN: La simpatectomía videotoracoscópica es un método efectivo para el tratamiento de la hiperhidrosis palmar primaria con bajas tasas de morbilidad y nulas de mortalidad. A pesar de la aparición de cambios posteriores como la sudación compensatoria, presenta una alta tasa de satisfacción y mejora de la calidad de vida de los pacientes (AU)

[Thoracoscopic sympathectomy for palmar hyperhidrosis. Immediate results and postoperative quality of life]. / Tratamiento de la hiperhidrosis palmar por simpatectomía torácica. Resultados inmediatos y calidad de vida postoperatoria.

OBJECTIVE: Primary palmar hyperhidrosis is a socially and occupationally debilitating disorder characterized by excessive sweating. The purpose of this study was to evaluate the results, complications, and degree of satisfaction among patients who underwent video-assisted bilateral thoracoscopic sympathectomy of the second and third ganglia (T2-T3) to treat primary palmar hyperhidrosis at the Department of General and Thoracic Surgery of the Hospital Universitario Virgen Macarena in Seville, Spain. MATERIAL AND METHOD: A study of 226 thoracoscopic sympathectomies was undertaken based on case histories and a prospective pre- and postoperative questionnaire survey. The sample was composed of 113 patients (47 males and 66 females), ranging in age from 14 to 50 years, with primary palmar and axillary hyperhidrosis, in some cases severe. Bilateral video-assisted thoracoscopic T2-T3 sympathectomy was performed under general anesthesia in all cases. Follow up included a questionnaire on pre- and postoperative quality of life and degree of satisfaction. Descriptive statistics on the surgical procedure, quality of life, and postoperative changes were compiled and frequency analyzed. A nonparametric Wilcoxon test for paired variables was performed to contrast significant differences between pre- and postoperative quality of life related to hyperhidrosis and its complications. RESULTS: The therapeutic success rate was 100%. Complications were seen in 14.2% of the cases and included hemothorax in two, hemopneumothorax in three, pleural hemorrhage in two, and minimal apical airspace in nine. Of the 106 patients who were monitored over a period of 6 to 12 months through follow-up interviews and questionnaires, 67% developed compensatory sweating, 95% reported improvement in quality of life, and 4% experienced no change in quality of life, mainly because of the emergence of compensatory sweating. Of the patients interviewed, 97.2% said that they would undergo the operation again. CONCLUSION: Video-assisted thoracoscopic sympathectomy for the treatment of primary palmar hyperhidrosis is effective, with low rates of morbidity and no mortality. Despite the appearance of postoperative changes such as compensatory sweating, patient satisfaction with the procedure is high and their quality of life improves.

[Usefulness of video-assisted thoracoscopy for the diagnosis of solitary pulmonary nodules]. / Utilidad de la cirugía videotoracoscópica en el diagnóstico de los nódulos pulmonares solitarios.

OBJECTIVES: Various approaches are used for the diagnosis and treatment of solitary pulmonary nodules (SPN) of unknown origin. New imaging techniques and nuclear medicine have provided more information about SPN, but surgical removal is still the most sensitive and specific way to obtain a correct analysis of the lesion. With video-assisted thoracic surgery (VATS), a histological diagnosis can be obtained without resorting to thoracotomy. In the present study we describe our experience with the diagnosis and treatment of SPN using VATS. MATERIAL AND METHODS: From July 1992 through April 2001, 182 patients were operated on for SPN in our department. DESIGN: Retrospective study. Mean age: 59.2 years (12-78). Sex: 39 women and 143 men. Localization: Visual or instrumental exploration in 102 patients, with palpation in 52 cases and using a hookwire guided by preoperative computed tomography in 25 (with failure in 4 of those cases). Tissue was biopsied during surgery and when the lesion was malignant, oncological excision was performed during the same operation. RESULTS: A firm diagnosis was obtained by VATS for 178 patients (98.3%). For three other patients the surgeon had to take a needle biopsy (Tru-cut) during surgery, and in one case conversion to open surgery was necessary. Histopathology: hamartoma: 11; fibrous nodule: 10; bronchiolitis obliterans: 1; pneumoconiosis: 1; mesenchymal tumor: 3; inflammatory pseudotumor: 14; mucormycosis: 1; tuberculoma:17; lymphoma: 1; carcinoid tumor: 6; metastasis: 22; bronchogenic carcinoma: 95. Mortality was 0.55%, with 1 patient dying from massive pulmonary thromboembolism. Morbidity was 5%, from 9 minor complications. CONCLUSIONS: VATS is an effective approach, with low morbidity and mortality. We consider it to be the technique of choice for the diagnosis of all SPN and for the treatment of some, such as benign nodules and solitary metastases.

Utilidad de la cirugía videotoracoscópica en el diagnóstico de los nódulos pulmonares solitarios / Usefulness of video-assisted thoracoscopy for the diagnosis of solitary pulmonary nodules

OBJETIVOS: Varios tipos de estrategias se emplean para el diagnóstico y tratamiento de los nódulos pulmonares solitarios indeterminados (NPS). Las nuevas técnicas de imagen y de medicina nuclear parecen añadir más información a esta afección, pero aún es la exéresis quirúrgica el método más sensible y específico para obtener un correcto análisis de la lesión. Con la cirugía videotoracoscópica (CVT) se puede conseguir un diagnóstico histológico sin la necesidad de realizar una toracotomía. En este estudio se expone nuestra experiencia en el diagnóstico y tratamiento de los NPS con la CVT. MATERIAL Y MÉTODOS: Desde julio de 1992 a abril de 2001 se ha intervenido a 182 pacientes afectados de NPS en nuestro servicio. Diseño: estudio retrospectivo. Edad media: 59,2 años (límites, 12-78). Sexo: un total de 39 mujeres y 143 varones. Localización: exploración visual o instrumental en 102 pacientes, con palpación en 52 casos y con arpón guiado por tomografía computarizada (TC) preoperatoriamente en 25 (cuatro de ellos fallaron). A todos ellos se les realizó una biopsia intraoperatoria y cuando la lesión fue maligna se les practicó una exéresis oncológica en la misma operación. RESULTADOS: Se ha obtenido un diagnóstico de certeza, por CVT en 178 pacientes (98,3 per cent). En otros 3 pacientes fue necesario practicar biopsia con aguja Tru-cut® durante la CVT y un caso más hubo de convertirse a cirugía abierta. Histopatología: hamartoma, 11; nódulo fibroso, 10; bronquiolitis obliterante, 1; neumoconiosis, 1; tumor mesenquimal, 3; seudotumor inflamatorio, 14; mucormicosis, 1; tuberculoma, 17; linfoma, 1; tumor carcinoide, 6; metástasis, 22, y carcinoma broncogénico, 95. Mortalidad: 0,55 per cent, un paciente por tromboembolia pulmonar masiva. Morbilidad: 5 per cent, nueve complicaciones menores. CONCLUSIONES: La CVT es un abordaje muy efectivo, con baja morbilidad y mortalidad, y en nuestra opinión debe ser la técnica de elección para el diagnóstico de todos los NPS y el tratamiento de algunos, como los nódulos benignos y las metástasis solitarias (AU)

Human papillomavirus genotypes in rural Mozambique.

We studied the genotype distribution of cervical human papillomavirus (HPV) infections in an age-stratified sample of 262 women in Mozambique using the PGMYO9-PGMY11 primer system in a reverse line-blot strip-based assay with high sensitivity in type-specific amplification. Despite the low precision of the estimates, we found that HPV-16 was not the dominant type. Instead, HPV 35 was the most commonly identified genotype among HPV-positive women (16/96 [17%]) and women with cervical neoplasia (7/23 [30%]). Certain genotypes might have been under-detected in previous studies, and type-specific HPV distributions might vary across populations. Therefore, the estimated proportion of cervical neoplasia that could be prevented by an HPV-16-based vaccine could be lower than expected.

Extramuscular soft tissue myxoma of the lateral neck.

Myxomas are rare benign connective tissue tumours of unclear histogenesis. In this case a lateral neck tumour initially behaved, both clinically and radiographically as a lipoma, and was therefore managed conservatively. Subsequently the lesion caused pressure symptoms and therefore a surgical approach was taken with subsequent histology confirming a myxoma. Only five cases of soft tissue myxoma of the lateral neck have been reported in the English literature of which two were extramuscular. This is the largest reported myxoma of the head and neck region and was treated with simple enucleation. There has been no evidence of recurrence five years after surgery.

Videopericardioscopia: una nueva exploración para valorar la resecabilidad de los cánceres de pulmón CT4 por invasión vascular / Video-pericardioscopy: a new way to assess resectability of cT4 lung cancers by vascular invasion

Objetivos: Manifestar la utilidad de la exploración intrapericárdica de los vasos pulmonares por videotoracoscopia, para demostrar si su invasión sospechada en la tomografía axial computarizada o resonancia magnética es cierta o no. Pacientes y método: Desde 1993 utilizamos la videotoracoscopia exploradora (VTE) como método de estadificación final y valoración de la resecabilidad en el cáncer de pulmón. La exploración vascular intrapericárdica (videopericardioscopia [VPC]) es el complemento para valorar la resecabilidad en casos cT4. Hemos realizado 20 videopericardioscopias entre 460 videotoracoscopias exploradoras, ante la sospecha de invasión intrapericárdica de vasos pulmonares (19 varones, una mujer; edad media 64,6 años; rango 50-77). En 11 pacientes se sospechaba previamente por la tomografía axial computarizada la invasión hiliar y vascular; en los nueve restantes se comprobó esta invasión en la videotoracoscopia exploradora de valoración de la resecabilidad. La videotoracoscopia exploradora-videopericardioscopia se realiza a través de tres puertas de entrada, ocasionalmente cuatro, por las que se exploran fácilmente los vasos intrapericárdicamente. Resultados: Cinco casos fueron irresecables: cuatro por invasión de la arteria pulmonar hasta su origen y uno por gran invasión de venas pulmonares y aurícula izquierda. Los 15 restantes fueron resecables, y fueron operados por toracotomía posterolateral con disección y ligadura intrapericárdica de los vasos. Cinco de ellos habían sido considerados irresecables en otros hospitales por considerarlos cT4 avanzados en exploraciones de imagen. El tiempo medio de duración de la videopericardioscopia fue de 23 min (rango 16-33); la estancia media postoperatoria, de 48 h en los no resecados, que fueron enviados al tercer día para terapia neoadyuvante. En estos casos sometidos sólo a videopericardioscopia no existieron complicaciones ni mortalidad, y se evitaron 5 toracotomías innecesarias. Conclusiones: La videopericardioscopia permite la correcta estadificación del parámetro T, en aquellos casos en que se sospecha T4, evitando toracotomías innecesarias en los casos irresecables y permitiendo rescatar para cirugía casos dudosos en la tomografía axial computarizada o resonancia magnética. (AU)

[Videocardioscopy: a new way to assess resectability of cT4 lung cancer by vascular invasion]. / Videopericardioscopia: una nueva exploración para valorar la resecabilidad de los cánceres de pulmón cT4 por invasión vascular.

OBJECTIVES: To demonstrate the usefulness of intrapericardial inspection of pulmonary vessels by video assisted thoracoscopy (VAT), for determining whether suspicion indicated by computed axial tomography (CAT) or magnetic resonance (MR) scanning is justified or not. PATIENTS AND METHOD: Since 1993 we have used exploratory VAT for final staging and assessment of lung cancer resectability. Intrapericardial vascular exploration (IVE) is a complementary method of assessing resectability in cT4 cases. We have performed 20 IVE among 460 VAT when intrapericardial involvement of pulmonary vessels has been suspected (19 men, 1 woman, mean age 64.6 years, range 50-77). VAT demonstrated invasion for 11 patients with previous suspicion based on hilar and vascular invasion shown by CAT scan; in 9 others such involvement was found during IVE for assessing resectability. VAT-IVE was performed through three or sometimes four entrance approaches, from which intrapericardial vessels were explored easily. RESULTS: Five cases were non-resectable: four due to invasion of the pulmonary artery to its point of origin and one due to extensive invasion of pulmonary veins and the left auricle. The remaining 15 cases were resectable and lesions were removed by posterolateral thoracotomy with intrapericardial dissection and ligature of the vessels. Five had been considered non-resectable by teams at other hospitals where they were classified as advanced cT4 cancers after imaging. The mean duration of IVE was 23 minutes (range 16 to 33); mean postprocedural stay was 48 h in non-resected patients, who were sent for neoadjuvant therapy on the third day. These patients, who underwent only IVE, had no complications and there were no deaths, with five unnecessary thoracotomies avoided. CONCLUSIONS: IVE allows correct staging of the T parameter in patients for whom T4 classification is suspected, avoiding unnecessary thoracotomies in non-resectable cases and allowing for surgical removal in cases where CAT or MR imaging results are unclear.

Opposite effects on NCAM expression in the rat frontal cortex induced by acute vs. chronic corticosterone treatments.

The temporal pattern of exposure to glucocorticoids has been reported to be a critical factor in determining the outcome of glucocorticoid actions at the brain. In this work, the effects of different regimes of subcutaneous corticosterone administration (acute-single injection-vs. chronic-daily injection for 21 days) on the expression of the neural cell adhesion molecule (NCAM) were evaluated in different rat brain regions (CA1-CA4, dentate gyrus, frontal cortex, striatum, and hypothalamus). The treatments were selected according to previous studies in which we showed biphasic effects of corticosterone on memory formation, with acute corticosterone effects being facilitating and chronic effects being deleterious. In addition, the chronic treatment was shown by others to result in structural alterations at the hippocampus. NCAM was evaluated given its cell-cell recognition and adhesion properties, and the involvement on synaptic stabilisation subserving long-term memory formation. The results showed a biphasic modulation of NCAM levels at the frontal cortex, with acute corticosterone resulting in enhanced NCAM levels at 8 h and 24 h posttraining, and the chronic treatment decreasing its expression. None of the other brain areas examined showed significant changes in NCAM expression with corticosterone treatments, except for the hypothalamus that showed reduced NCAM levels after the chronic corticosterone regime. These results support the view that NCAM regulation at the frontal cortex might be a mechanism by which corticosterone treatments influence memory formation. They also highlight the hypothalamus as a brain area particularly sensitive to NCAM regulation by prolonged exposure to elevated glucocorticoids.

[The treatment of myasthenia gravis by video thoracoscopic thymectomy. The technic and the initial results]. / Tratamiento de la miastenia grave mediante timectomía videotoracoscópica. Técnica y resultados iniciales.

The primary role of thymectomy for the treatment of myasthenia gravis is currently undisputed. Traditionally, the approach of choice has been sternotomy, although a transcervical route has also been advocated because of its lower rate of associated morbidity. Our department performed thymectomy using a video-assisted thoracoscopic technique in 7 patients (2 men and 5 women) between March 1993 and October 1995. The patients' mean age was 43.4 years (range 20 to 66 years). Complications were few, consisting of 2 cases of pneumothorax due to contralateral opening of the pleura, resolved by pleural drainage. No deaths occurred. Clinical results over periods of observation ranging from 14 to 44 months were excellent in 2 cases of complete remission; good in 3 patients with considerable reduction in drug requirements; and fair in 2 patients who continued to need the same doses of medication throughout the 14 months after thymectomy. The technique we propose is less aggressive than mid-sternotomy, offering incontrovertible advantages and leading to faster. No patient required assisted ventilation for longer than 4 hours and the maximum time spent in the intensive care unit was 24 hours. We therefore suggest that thymectomy to treat myasthenia gravis be performed by thoracoscopy.

Piracetam facilitates long-term memory for a passive avoidance task in chicks through a mechanism that requires a brain corticosteroid action.

We investigated the effects of piracetam, a nootropic, on learning and memory formation for a passive avoidance task in day-old chicks. To test for the possible cognitive-enhancing properties of piracetam, a weak learning version of this task--whereby chicks maintain a memory to avoid pecking at a bead coated in a diluted aversant for up to 10 h--was used. Post-training (5, 30 or 60 min), but not pretraining, injections of piracetam (10 or 50 mg/kg, i.p.) increased recall for the task when the chicks were tested 24 h later. Because previous studies showed that long-term memory for the passive avoidance task is dependent upon a brain corticosteroid action, and because the efficacy of piracetam-like compounds is also modulated by corticosteroids, we tested whether the facilitating effect of piracetam was dependent upon a corticosteroid action through specific brain receptors (mineralocorticoid receptor and glucocorticoid receptor). First, increased plasma levels of corticosterone were found 5 min after piracetam injection. In addition, intracerebral administration of antagonists for each receptor type (RU28318, for mineralocorticoid receptors, and RU38486 for glucocorticoid receptors; i.c.) given before the nootropic inhibited the facilitative effect of piracetam on memory consolidation. These results give further support to a modulatory action of piracetam on the mechanisms involved in long-term memory formation through a neural action that, in this learning model, requires the activation of the two types of intracellular corticosteroid receptors.