Search

The AA. present 2 cases of esophageal perforation due to foreign bodies among 179 esophagoscopies done for removal of other intruders, which required the endoscopic procedure, during a lapse of 4 years. Considerations regarding the treatment and the evolutive course.

Fixed subvalvular aortic stenosis is an uncommon cause of left ventricular outflow obstruction which occasionally can be found in association with dynamic muscular obstruction. In the past, the diagnosis of this association has been difficult and relied upon cardiac catheterization and angiography. To our knowledge, no case of this pathology diagnosed by echo and Doppler has previously been reported. We present a case of double subvalvular aortic stenosis in a 35 years old patient which illustrates the feasibility of detection with echo and Doppler of both types of subvalvular aortic obstruction.

To extend to the crustacean class the information concerning the genomic organization of the mitochondrial DNA (mtDNA) a double strategy has been used: Southern blot analysis with cloned Drosophila mtDNA probes and sequence comparison to the Drosophila mtDNA of the sequenced termini of different subclones along the Artemia mitochondrial genome, probably the smallest mtDNA studied at this level to date. These approaches have allowed us to localize the 16S rRNA gene, two tRNA genes and eleven protein genes. The genome organization is surprisingly similar to the Drosophila mtDNA, with the 16S rRNA and the protein genes located in the same positions and orientations as their Drosophila counterparts. The only changes detected are at the level of tRNA genes, although the position and orientation of some of these are also conserved. These results contrast with the important rearrangements detected among other invertebrates mtDNAs and suggest that the genome organization of the mitochondrial DNA may be more conserved in the arthropods than in other invertebrate phyla.

From our series of 72 patients with severe valvular aortic stenosis, we identified 19 showing features of left ventricular systolic disfunction (ventriculographic ejection fraction less than 55% and/or fractional shortening less than 30% at M-mode echocardiography). In these patients, we found a significant inverse correlation between the fractional shortening and the systolic wall stress (r = 0.79, p less than 0.001). Clinically, 18 of the 19 patients were in NYHA class III (n = 11) or IV (n = 5), and two died before they could be operated upon. The remaining 17 had their aortic valve replaced (coronary artery bypass surgery was simultaneously performed in 2 patients). After a mean follow-up of 18 months, all patients are alive and show substantial symptomatic improvement (15 patients in class I and 2 patients in class II). Cardiothoracic index was reduced (61 +/- 5% preoperatively versus 52 +/- 5% postoperatively), and fractional shortening changed from 21 +/- 5% to 30 +/- 5%. The latter remains under normal limits in two thirds of the patients. Our results lend support to the idea that the systolic left ventricular dysfunction in aortic stenosis is due to the increased afterload, rather than to an intrinsic contractility defect. This explains the great functional improvement after the reduction of the systolic wall stress achieved by surgery.

Congenital diverticulum of the heart is an unusual malformation. It is frequently associated with thoracic or abdominal midline alterations and also with various types of congenital heart disease. Complications of this anomaly are rupture, peripheral embolism and heart failure. Surgical management consists of resection of the diverticulum either as an isolated operation or at the time of correction of accompanying malformations. We present six cases of congenital diverticulum of the heart, four on the right ventricle and two on the left. In one patient with Fallot's tetralogy a diverticulum was found at necropsy; in two cases the underlying malformation was double outlet ventricle; one case had pulmonary artery stenosis and two did not have associated malformations.

We present clinical and postmortem examination of a child who presented in life with severe obstruction to the left ventricular outflow tract. The heart was right-sided with usual atrial arrangement. The right atrioventricular connexion was absent. There was straddling of the left atrioventricular valve which had a double orifice. Each orifice was connected to a well-differentiated ventricle, the left ventricle being dominant and right-sided (left-hand topology). An inlet ventricular septal defect was restricted by the leaflet tissue of the straddling valve.

The results obtained during the last successful flight of the Challenger Shuttle, in early November 1985, indicate that oogenesis and embryonic development of Drosophila melanogaster are altered in the absence of gravity. Two hundred forty females and ninety males, wild type Oregon R Drosophila melanogaster flies were flown in the Spaceshuttle during the 7-day D-1 mission and the embryos laid during the spaceflight were recovered and studied. Although some eggs developed into normal 1st instar larvae and many into late embryos in the 23 +/- 2 h collection periods throughout the flight, several interesting differences from the parallel ground and in-flight centrifuge controls were observed: 1) There was an increase in oocyte production and size. 2) There was a significant decrease in the number of larvae hatched from the embryonic cuticles in microgravity. 3) The majority of embryos were normally fertilized and at late stages of development, except in the space-flown containers in microgravity where a percentage of earlier stage embryos were recovered showing alterations in the deposition of yolk. 4) In correspondence with these results, at least 25% of the living embryos recovered from space failed to develop into adults. 5) Studies of the larval cuticles and those of the late embryos indicate the existence of alterations in the anterior, head and thoracic regions of the animals. 6) There was a delay in the development into adults of the embryos and larvae that had been subjected to microgravity and recovered from the space shuttle at the end of the flight. No significant accumulation of lethal mutations in any of the experimental conditions was detected as measured through the male to female ratio in the descendant generation. It seems that Drosophila melanogaster flies are able to sense and respond to the absence of gravity, changing several developmental processes even in very short space flights. The results suggest an interference with the distribution and/or deposition of the maternal components involved in the specification of the anterioposterior axis of the embryo.