CNS metastasis secondary to malignant-mixed Müllerian tumor: case report and review of therapeutics.

This paper reviews CNS involvement secondary to malignant-mixed Müllerian tumor or uterine carcinosarcoma, a rare aggressive biphasic Müllerian tumor. We report a cerebellar metastasis with epithelial and mesenchymal components, demonstrating heterologous rhabdomyogenic and chondroblastic differentiation. The patient had undergone total abdominal hysterectomy and bilateral salpingo-oophorectomy for palliation of symptomatic chemotherapy-resistant node-positive disease.

Learning From Experience: Development of a Cognitive Task List to Perform a Caesarean Section in the Second Stage of Labour.

Objective: Caesarean section at full cervical dilatation is a challenging procedure with a higher risk of fetal and maternal morbidity. We wished to elicit the essential clinical components of a CS at full dilatation performed skilfully and safely.

Methods: We conducted a prospective study with both qualitative (individual interviews) and quantitative (questionnaire) components.

Infection-induced lung injury is worsened after renal buffering of hypercapnic acidosis.

Objective: Prolonged hypercapnia is commonly encountered during the treatment of acute respiratory distress syndrome and acute respiratory failure attributable to other causes with protective ventilation strategies. In these circumstances, compensatory renal buffering returns pH to normal establishing a condition of buffered hypercapnia. It is also common intensive care practice to correct the pH more rapidly using bicarbonate infusions.

Sustained hypercapnic acidosis during pulmonary infection increases bacterial load and worsens lung injury.

Objective: Hypercapnic acidosis is commonly permitted in patients with acute respiratory distress syndrome during the use of protective ventilation strategies. Hypercapnic acidosis is also a common complication of multiple lung diseases and is associated with a poor prognosis, although the mechanisms by which it leads to increased mortality is not known. Previous studies using noninfective models of lung injury show that acute (<6 hrs) hypercapnic acidosis reduced lung damage by an anti-inflammatory effect.

Implications for repetitive application of acetylcholine in the determination of the mechanisms of endothelium-dependent relaxation.

The influence of repetitive vasodilator concentration response curve determination was investigated in rat mesenteric and femoral small arteries. Arteries were precontracted with noradrenaline and relaxed with acetylcholine (ACh) or K+. Mesenteric arteries exhibited attenuation of ACh-stimulated relaxations during repetitive precontraction/relaxation cycles that was not prevented by SQ29548.