[Anesthesia for thymectomy in patients with myasthenia gravis]. / Anestezioloski pristup za timektomiju kod bolesnika sa miastenijom gravis.

INTRODUCTION: Anesthetic approach to patients with myasthenia gravis requires preoperative treatment with anticholinesterase drugs, corticosteroids, plasmapheresis and mechanical ventilation support, either before or immediately after the surgical procedure. MATERIAL AND METHODS: During the period of 10 years, 41 patients with myasthenia gravis (71.42% female and 28.57% male, aged between 9 and 69 years) underwent surgical procedures. All the patients were preoperatively treated with anticholinesterase drugs and corticosteroids and were in remission. Considering the fact that barbiturates and succinylcholine should be avoided during induction of anesthesia, halothane was used. The induction into the surgical stage of anesthesia was pronged. RESULTS: Intubation, as well as the surgical procedure, were successfully completed in all patients. All, except three patients, started breathing spontaneously. Two patients required respiratory support during the immediate postoperative period and one patient died. After the surgical procedure one patient had manifested gastrointestinal bleeding and three patients had pneumothorax (one iatrogenic and two during mechanical ventilation). Mechanical ventilation in postoperative period indicates inadequate respiratory function in patients with myasthenia gravis, whereas thymectomy is a therapy of choice. Volatile inhalation anesthetic with pre and postoperative anticholinesterase drugs and corticosteroids resulted in complete remission.

Effects of ethane dimethanesulfonate on the structure of adult male rat adrenal cortex.

The influence of ethane dimethanesulfonate (EDS), a specific toxicant for Leydig cells, on the morphometric characteristic of adult male rat adrenal cortex was examined on day 15 after administration. As expected, the dose of 75 mg kg-1 of EDS produced drastic reduction in serum testosterone levels followed by a decrease in testis and seminal vesicle weight. However, a considerable drop (over 50%) in adrenal weight was also found. Stereological analysis of the adrenal cortex, performed under light microscope, revealed atrophy of all adrenocortical zones. The changes were most prominent in the inner zones. Thus, in the zona fasciculata the number of parenchymal cells was markedly decreased. In the zona reticularis a layer consisting mostly of atrophic parenchymal cells was localised at the border between zona reticularis and zona fasciculata. The remaining small number of cortical cells in this zone displayed a notable hypertrophy. It is concluded that EDS at a dose that destroys Leydig cells has a strong deleterious effect on steroidogenic cells of adult male rat adrenal cortex.

[Exogenous lipoid pneumonia with abscess mimicking a lung tumor]. / Apscedirajuca egzogena lipoidna pneumonija pod slikom plucnog tumora.

A case of abscessing exogenous lipoid pneumonia is reported. After the onset of respiratory symptoms, 68-year-old male was admitted to our hospital. Physical and X-ray examination suggested malignant lung tumor. After false positive finding of fine needle transthoracic biopsy, the right middle lobectomy was performed. Histological examination showed an unexpected finding of lipoid pneumonia and thereafter information of accidental petroleum aspiration was obtained.

[Sudden death due to dysplasia of the right ventricle]. / Nagla smrt izazvana displazijom desne komore.

The authors present two cases of arrhythmogenic right ventricular dysplasia in two young males, who had died by sudden death. A brief presentation is given of the clinical manifestation, uninvasive and invasive diagnostic possibilities, of the pathoanatomic finding and the pathohistological presentation, and the possibilities of treatment.

[Nodular amyloidosis of the lungs associated with Sjögren's syndrome]. / Nodulusna amiloidoza pluca udruzena sa Sjögrenovim sindromom.

Pulmonary amyloidosis can develop together with both primary or secondary amyloidosis, isolated or associated with amyloidosis of other organs. In the study a case of a 59 year old female with multiple nodules and diffuse amyloid infiltration in pulmonary parenchyma associated with Sjörgen's syndrome is presented. Amyloid deposits were also found in the surgically removed parotid salivary gland, mostly in its blood vessel walls.

[2 cases of ovarian struma]. / Povodom dva slucaja strume ovarija.

The authors present two patients, aged 48 and 54 respectively, treated surgically for the alleged tumor of the ovary which histologically proved to be the struma of the ovary. In one patient the tumor behave as a benign one, while in the other there was also ascites--simpto mof malignant tumour. After surgery all disorders disappeared in both patients.

[The quality of preserved blood]. / Kvalitet konzervisane krvi.

The examinations of 30 blood samples each preserved with three Yugoslav different ACD-solutions were performed. The blood samples were stored at 2-6 degrees C and examinations were performed at the day of blood donation and after on the 7th, 14th and 21st day during the storage. Differences in hematocrit (well known dilution effect of the ACD-solutions used) and intensive morphological and chemical changes were found in all blood samples regardless the type of ACD-solution used. It was shown that the permanently increasing number morphologically altered erythrocytes (echinocytes and spherocytes) and the excessive release of hemoglobin and potassium from erythrocytes were occurred during the storage of blood samles. Too, there were noticed significant decrease of pH values enormous accumulation of ammoniac and other metabolic producta.