Intubation of the Pericardial Sac

A 22-year-old male was admitted to casualty with a penetrating injury to his left ventricle following a stabbing to his chest. Penetrating injuries to major organs that originate or pass through the relatively narrow mediastinal corridor may have catastrophic consequences with little in the way of external signs to indicate the severity of the injury. Clinically, patients with penetrating cardiac injuries may present with cardiac shock due to either volume loss or pericardial tamponade. However, expeditious recognition, resuscitation and surgical treatment of these injuries are imperative if one wishes to reduce their inherently high mortality. Simple methods in trauma resuscitation, often being carried out in less than optimum conditions, are vital in order to save an injured patient's life. Decompression of the pericardial sac by intubation is described as a new and relatively simple method in the initial resuscitation of a patient with sharp cardiac injury, prior to definitive surgery

Malignant myoepithelioma (myoepithelial carcinoma) of the breast: a detailed cytokeratin study.

AIMS--To study the expression of a range of cytokeratins by malignant myoepithelioma of the breast. METHODS--Immunophenotyping was carried out using a panel of antibodies on paraffin wax embedded and frozen material using immunohistochemistry and double-labelled immunofluorescence. Electron microscopy was also performed. RESULTS--The tumour cells were positive for CAM 5.2, actin, vimentin, and cytokeratin 14 and negative for cytokeratins 18 and 19. Electron microscopy showed well formed desmosomes and hemidesmosomes together with pinocytic vesicles, plentiful rough endoplasmic reticulum and 6 nM microfilaments with focal densities. CONCLUSIONS--The pattern of cytokeratin expression provides further evidence that tumours with a specific myoepithelial phenotype occur rarely in the breast