Pancoast's syndrome due to Pseudomonas aeruginosa infection of the lung apex.

A case of Pancoast's syndrome was caused by Pseudomonas aeruginosa infection of the lung apex. The infection extended to extrapleural structures of the thoracic inlet.

[Deletion of the long arm of chromosome 18, primary hypothyroidism, Biermer's anemia and IgM hypogammaglobulinemia]. / Délétion du bras long du chromosome 18, hypothyroïdie primaire, anémie de Biermer et hypogammaglobulinémie de type IgM.

We report the case of an adolescent girl who presents with the 18q-syndrome, primary hypothyroidism, pernicious anemia and IgM hypogammaglobulinemia. Her karyotype was performed during infancy because of malformations and showed deletion of the long arm of chromosome 18. The patient had been treated with levothyroxine (Elthyrone) since age 13 when primary hypothyroidism was documented. A close hematological follow-up was then undertaken due to the presence of anti-parietal cell antibodies. A megaloblastic anemia of sudden offset led to the diagnosis of pernicious anemia by age 16, which was confirmed by a positive Shilling's test. Recently, the patient was found to have antimicrosome antibodies and moderate IgM hypogammaglobulinemia.

Influence of the respiratory route on the resting breathing pattern in humans.

It has been shown that the pattern of breathing is modified when breathing through a mouthpiece (MP) with a noseclip (NC), although the reasons for this are not clear. We studied 14 healthy naïve subjects during unrestrained breathing, while connected to a spirometer without NC, and while connected to a spirometer with NC. Breathing pattern, studied with an inductive plethysmograph (Respitrace), was recorded during 4 min in each case, once a steady state was attained. During unrestrained breathing, all subjects breathed exclusively through the nose. During spirometric testing without NC, 9 of 14 subjects still breathed through the nose only (since the oropharynx is closed by the soft palate and the tongue, and flow proceeds through the nose). Tidal volume (VT), frequency (f), minute ventilation (VE), inspiratory time, mean inspiratory flow, and duty cycle (Tl/Ttot) were not different during the first 2 procedures (p greater than 0.1 by analysis of variance). By contrast, during spirometric testing with NC, mean VT increased from 530 (during unrestrained breathing) to 700 ml (p less than 0.02), whereas f decreased from 14.9 to 13.6 breaths X min-1 (p greater than 0.05), VE did not change, and Tl/Tot increased from 37 to 41% (p less than 0.05). These data suggest that the change in the pattern of breathing depends on the breathing route. To further confirm this, we asked 8 separate subjects to simply breathe through either the nose or the mouth (half of them starting with mouth breathing, half with nose breathing) while respiration was monitored with the Respitrace without any connection to the airways.(ABSTRACT TRUNCATED AT 250 WORDS)