The adult Tillaux fracture: one not to miss.

This case is a rare adult type Tillaux fracture. This fracture should be diagnosed in the emergency department. The fracture requires careful evaluation with awareness of associated injury.

Acute isolated cerebral mucormycosis in a patient with high grade non-Hodgkins lymphoma.

A 57-year-old female in complete remission of grade IV non-Hodgkin lymphoma whilst on intensive chemotherapy, suddenly developed unilateral hemispheric stroke with a fatal outcome in 3 days. She was apyrexial and had received antifungal prophylaxis during her treatment. Post-mortem examination showed complete thrombosis of the internal carotid artery leading to infarction in the territory of the middle and anterior cerebral arteries.

An assessment of Gd-DTPA as a CT contrast agent in the renal tract.

Intravenous gadolinium diethylene triamine penta-acetic acid (Gadopentetate dimeglumine, Gd-DTPA) is visualized as a radiographic contrast agent in the renal tract on computed tomography (CT). In this study the CT appearance of this contrast agent within the renal collecting systems of 12 patients is described following a Gd-DTPA enhanced magnetic resonance imaging (MRI) study. The CT appearances are variable and not predictable on the basis of time from injection, age, sex or indices of renal function.

Gallbladder wall thickening (congestive cholecystopathy) in chronic liver disease: a sign of portal hypertension.

A thickened gallbladder wall is often seen with ultrasound in alcoholic cirrhosis. Hypoalbuminaemia is thought to be the cause since there is a strong association between bowel wall thickening and low serum albumin. To determine the role of portal hypertension in producing gallbladder wall thickening we studied 40 consecutive stable patients-37 with cirrhosis and three with portal hypertension due to primary biliary cirrhosis.

The left ascending lumbar vein: a potential pitfall in CT diagnosis.

A communication between the left ascending lumbar vein and the left renal vein may be mistaken for a para-aortic mass on abdominal computed tomography due to a localised dilatation at the confluence of these veins. The use of contiguous closely collimated sections and the injection of intravenous contrast medium overcomes this potential pitfall which may be particularly important in the staging of patients with testicular neoplasms.

A potential pitfall of pelvic computed tomography.

The cross-sectional areas of the common iliac veins were measured by pelvic computed tomography (CT) in 51 patients. The left common iliac vein was significantly larger than the right (p less than 0.01) and in 35% of patients there was at least a two-fold difference between the cross-sectional areas of the veins.

Fluid balance and secretion of antidiuretic hormone following transsphenoidal pituitary surgery. A preliminary series.

Hyponatremia developing some days after transsphenoidal pituitary adenectomy is a treacherous complication of uncertain cause. Of 19 patients monitored in a pilot study at the Wessex Neurological Centre, plasma sodium fell below 125 mmol/liter in three patients at times ranging from 6 to 9 days postoperatively. One patient had evidence of inappropriate secretion of arginine vasopressin (AVP), and the other two probably had steroid insufficiency despite apparently adequate steroid cover.

The assessment of nocturnal oxygen saturation.

Existing methods of assessing nocturnal episodic hypoxaemia are either insensitive or ignore the majority of the available data. We describe a method of analysis using off-line digital processing. A distribution of oxygen saturation (SaO2) with time is produced from all the available data, and subjected to moment analysis to produce a simple index which describes an entire night's SaO2.

Evaluation of the respiratory inductive plethysmograph in man.

We evaluated the respiratory inductive plethysmograph, (RIP), during tidal breathing in eight men and seven women. This device measures movements of the rib cage and abdomen during breathing and adds the signals to produce an indirect record of ventilation. We recorded on magnetic tape, the rib and abdominal signals separately, with a simultaneous ventilation measurement from a pneumotachograph, and analysed them later using a digital computer.

Influence of the vagus nerve on changes in heart rate during sleep apnoea in man.

1. The changes in heart rate surrounding a period of apnoeic asphyxia, produced by either central or obstructive sleep apnoea, are characteristically a progressive bradycardia during the apnoeic period followed by an abrupt reversal to tachycardia with resumption of lung inflation. 2.

A case of prenylamine toxicity showing the torsade de pointes phenomenon in sinus rhythm?

A case of torsade de pointes attributed to prenylamine is described. In addition, the authors show QRS axis variation of a similar nature in sinus rhythm. It is postulated that these changes of QRS axis direction, seen in ventricular tachycardia and sinus rhythm, are both manifestations of partial refractoriness, within the ventricle, producing gross changes in the mean QRS vector.