Assuntos
Neoplasias das Glândulas Suprarrenais/diagnóstico , Feocromocitoma/diagnóstico , Neoplasias das Glândulas Suprarrenais/patologia , Arritmias Cardíacas/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Feocromocitoma/patologia , Tomografia Computadorizada por Raios X , Vômito/etiologiaRESUMO
In the crystal structure of a semi-synthetic opioid drug buprenorphine, C29H41NO4 {systematic name: (2S)-2-[(5R,6R,7R,14S)-9α-cyclo-propyl-methyl-3-hy-droxy-6-meth-oxy-4,5-ep-oxy-6,14-ethano-morphinan-7-yl]-3,3-di-methyl-butan-2-ol}, the cyclo-propyl-methyl group is disordered over two sites with an occupancy factor of 0.611â (3) for the major component. One of the hy-droxy groups is involved in intra-molecular O-Hâ¯O hydrogen bond. The other hy-droxy group acts as a proton donor in an inter-molecular O-Hâ¯O inter-action that connects mol-ecules into a zigzag chain along the b axis.
RESUMO
The presence of congenital tracheobronchial abnormalities remain rare and have been reported to range from 0.1% to 2% in the literature. The most commonly described abnormalities are the tracheal bronchus and the accessory cardiac bronchus. We present the case of a 67-year-old man presenting for evaluation of interstitial lung disease, on computed tomography found to have presence of both the anomalies; the findings later confirmed on bronchoscopy. We believe this report is important as it adds more descriptive information regarding this unusual presentation, including bronchoscopic and computed tomographic images. We believe that it is imperative that bronchoscopists are cognizant of these congenital abnormalities and their combinations. Inability to properly characterize these abnormalities has a potential leading to unnecessary investigations of these relatively benign entities.