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We report a case of Morgagni hernia occupying the anterior mediastinum and right hemithorax in a male infant with Down syndrome, who also had a perimembranous ventricular septal defect. Through a median sternotomy, the hernia sac was freed from the right pleura, and the pericardium was opened to reduce its contents (colon) into the abdomen. The diaphragmatic defect was closed with Prolene mesh and the hernia sac was used to reinforce the diaphragmatic defect. Finally, the pericardium was opened and the ventricular septal defect was closed with a polytetrafluoroethylene patch through a right atriotomy after instituting cardiopulmonary bypass.

A 76-year-old man with metastatic adenocarcinoma of the prostate presented with increasing dyspnea. After being treated initially with drainage and afterwards with pleurodesis, he was referred for Ga-prostate-specific membrane antigen 11 PET/CT imaging for restaging purposes. PET/CT demonstrated extensive Ga-prostate-specific membrane antigen 11 uptake in the right pleura. Histopathology confirmed the rare case of malignant pleural effusion from metastatic prostate cancer.

PURPOSE: To evaluate macro and microscopically, changes following the use of the aqueous extract of babassu (Orbignya phalerata) in the lung parenchyma and pleura of rats. METHODS: Sixty adult male rats with average weight of 350 g, were randomized into two groups of 30 animals (experimental and control) further divided into sub-groups of 10 to be sacrificed at 48 h, 72 h and 21 days. The substance was injected into the right pleura of the animals. RESULTS: There was intense pleuropulmonary macroscopic reaction with statistically significant differences between groups respectively (p0.05). CONCLUSION: The aqueous extract of babassu (Orbignya phalerata) was found to be highly irritating to the pleura and lung of rats, evidenced macroscopically by numerous adhesions and inflammation while no major changes were evident microscopically.

A 21-year-old male patient had sustained a blunt chest and abdominal trauma during a traffic accident. All the major injuries were on the left side. On the second day, a massive shift of the mediastinum to the right was noted. Further investigations raised the suspicion of herniation of the heart into the right pleural cavity. However, the patient's hemodynamic stability did not fit into the picture. Echocardiography and CT scan helped reinforce our suspicion. Herniation was confirmed at the operation, which was performed through median sternotomy. The patient recovered well without complications.

A 30-year-old woman with a 6-year history of cryptogenic polyserositis was hospitalized for paracentesis of slowly progressing chylous ascites. She was referred for lymphoscintigraphy to identify possible lymph leak. Conventional Tc-99m sulfur colloid lymphoscintigraphy revealed asymmetric lymphatic drainage from the lower limbs, with a normal course up to the kidney level. Then the migration was abnormal with visualization of the right pleural space and secondary radiotracer uptake in the mediastinal and subclavicular lymph nodes before lymph entered the venous circulation. This examination allowed the authors to distinguish a chylous effusion with extravasation of tracer in the peritoneum and right pleura from a photopenic pericardial exudate.

This case report summarizes our experience with a 19-year-old male patient who suffered a blunt chest trauma during a traffic accident. On admission no serious injuries could be detected, but 12 hours later displacement of the heart to the right side combined with sudden cardiac failure appeared. Emergency operation showed a right-sided rupture of the pericardium with complete herniation of the heart into the right pleural cavity and consequent strangulation by the pericardial margin.

A case of spontaneous rupture of the oesophagus occurring in the right wall of the midoesophagus is reported. The treatment, conservative in the primary stage of the disease, is described. This consisted of per-oesophageal drainage of the mediastinum, effected endoscopically. In spite of complications—an empyema in the right pleura and an oesophagocutaneous fistula—the treatment was successful, resulting in a complete cure about two years after the accident. The patient has remained in good health since then.

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When air gains access to the pleural cavity a displacement of the mediastinum frequently takes place. This mobility of the mediastinum depends on the flexibility of its tissues, the lack of pleural or pleuro-pericardial adhesions, the pressure created within the pleural space and the size or volume of the pneumothorax. The entire mediastinum may be shifted or a part of it. Thus, only the upper or only the lower portion of it may be displaced. Besides these variations in the position of the mediastinum, a protrusion of the pneumothorax cavity through the mediastinum into the sound, or untreated, side, occasionally takes place, thus forming a culdesac, or hernia. The most frequent point for a hernia of this nature to occur is in the upper anterior part of the mediastinum between the first and third ribs. Here the right pleura and the left pleura come in closest contact and are separated

In an article recently published inThe Journal, I1reported the discovery that it was possible to abolish all breath sounds as heard over the larynx and the chest by a voluntary separation of the vocal cords. The discovery was entirely original on my part, yet it seemed incredible that so simple and easy a procedure as the voluntary widening of the rima glottidis should never have occurred to any one until the present time. A search through the literature now shows that I had been anticipated by nearly a century. At the session of the Academie royale de medecine, June 10, 1834, Beau2described a case in which he heard a very marked bronchial souffle at the level of the subspinous fossa, in a patient with "effusion of the right pleura" who was breathing noisily. Wishing to know how much the noise of respiration contributed to produce

The problem of differentiating grossly bloody fluid in the pericardiac sac from intracardiac blood during a pericardicentesis may sometimes be difficult. Fortunately, this situation seldom occurs, but, when it does, it is usually in a patient who is acutely ill and can poorly tolerate loss of an appreciable quantity of blood as the result of unintentional aspiration of blood from the heart. In the following abridged case report, such a distinction was rendered difficult by the anatomic changes caused by the underlying disease and the effects of therapy. The use of the procedure described below as an aid in determining the source of the blood obtained at pericardicentesis was arrived at by fortuitous circumstances, and its simplicity was sufficiently appealing to warrant publication. REPORT OF A CASE A 17-year-old white boy had an extensive lymphoblastic lymphoma of the mediastinum and right pleura of three months' duration at the time of