A primary intravascular synovial sarcoma causing deep-vein thrombosis and pulmonary embolism in a 20-year-old woman.

Primary intravascular synovial sarcoma is a rare malignancy with only a few cases documented in the literature. On presentation, this tumour usually resembles a deep venous thrombosis (dvt) or pulmonary embolism (pe). Here, we report the case of a 20-year-old woman complaining of shortness of breath who had a history of dvt 6 weeks before presentation at our institution. Vascular ultrasound detected a suspicious mass in the right groin, which was identified as a monophasic synovial sarcoma by surgical biopsy. The tumour extended from the right superficial femoral vein into the common iliac vein, profound femoral vein, and great saphenous vein. It caused pe with near-total occlusion of the right pulmonary artery. After initial treatment on the cardiac intensive care unit, the patient was referred to the oncology department for neoadjuvant radiochemotherapy with doxorubicin-ifosfamide according to the Interdisziplinäre Arbeitsgemeinschaft Weichteilsarkome [Interdisciplinary AG Sarcomas] protocol and surgical resection of the tumour. No signs of tumour recurrence were found during the subsequent course of the disease, but the patient died from treatment complications approximately 15 months after initial presentation. This case underlines the importance of screening for malignancies even in young patients presenting with dvt or pe. We also recommend whole-leg compression ultrasonography in patients with suspected dvt or pe (as opposed to venography or simple four-point ultrasound examination in the groin and popliteal fossa) to detect possible underlying causes for thrombosis.

[Management of cardiac high risk pregnancy. Caesarean section in a primagravida with cyanotic cardiac defect]. / Management bei kardialer Hochrisikoschwangerschaft. Sectio bei einer I. Gravida mit zyanotischem Vitium.

A 37-year-old gravida I with cyanotic heart disease presented for caesarean section in the 31st week of gestation. Caesarean section was performed uneventfully with the patient under epidural anaesthesia accompanied by invasive monitoring. Postoperative echocardiography showed no change in the shunt fraction, volumes or the ventricular function. Every patient with complex comorbidities has to be managed according to individual prerequisites and the experiences and preferences of the team. For such high risk pregnancies regional anaesthesia seems to be a possible option although no clear evidence can be found in the literature.

Extraction of antimony with tertiary amines.

The extractability of antimony(III) and (V) with tridodecylamine from various aqueous solutions is reported. Extraction from nitric and hydrofluoric acid solutions is low, but extraction from sulphuric, hydrochloric and hydrobromic solutions is high. Antimony-(III) can be separated from antimony(V) in 7M nitric acid or 0.64M hydrobromic acid. The extraction of antimony from hydrochloric acid solutions in methanol, ethanol, and acetone-water mixtures is greater than from pure aqueous solutions of the same acidity. The elements from which antimony can be separated with tertiary amines are given.

Extraction of certain elements from aqueous methanol, ethanol and acetone by tridodecylamine and tributyl phosphate.

The extraction of silver, mercury, selenium, zinc, cobalt and iron with tridodecylamine (TDA) and tributyl phosphate (TBP) from hydrochloric acid solutions in aqueous methanol, ethanol and acetone is reported. The presence of these additives increases extraction for some elements and decreases it for others. The effect is generally greater with TDA than with TBP.

Extraction of protactinium from mineral acid-alcohol media.

The extraction of protactinium with organic solvents has been investigated in the presence of water-miscible alcohols and acetone. These additives were found to increase considerably the extraction of protactinium in the cases of trilaurylamine, tributyl phosphate and isobutyl methyl ketone. The influence was less in the case of thenoyltrifluoroacetone. In mixtures of an acid with various alcohols, the influence depended on the alcohol concentration, the acidity and on the chain lengths and dielectric constants of the alcohol introduced into the extraction system.

Neutron-activation analysis by standard addition and solvent extraction Determination of traces of antimony.

The application of neutron activation analysis by standard addition and solvent extraction to the determination of traces of antimony in aluminium and rocks is reported. Three simple extraction procedures, using isopropyl ether, hexone, and tributyl phosphate, are described for the selective separation of radioantimony from interfering radionuclides. Antimony concentration is measured by counting the activities of the (122)Sb and (124)Sb photopeaks at 0.564 and 0.603 MeV.