Chest
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Intralobar pulmonary sequestration (ILS) has generally been considered a congenital malformation, mainly because of the presence of one or more systemic arteries to the sequestered portion of lung. We performed a study of the pulmonary ligaments in children without congenital pulmonary or vascular disease that demonstrated systemic arteries in ten of 11 cases, with as many as five arteries present in a single case. These arteries arose from the thoracic aorta, contributed to the esophageal plexus, and traversed the pulmonary ligament to ramify in the visceral pleura. A sequence of events including bronchial obstruction, pneumonia, pulmonary artery occlusion, pleuritis, and parasitization of pulmonary ligament (or diaphragmatic) arteries leading to the "creation" of an ILS is proposed.
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Randomized Controlled Trial Comparative Study Clinical Trial
Lorcainide. A comparative trial with quinidine gluconate in patients with previously untreated ventricular arrhythmias.
The efficacy of a new antiarrhythmic agent, lorcainide, was compared with that of quinidine gluconate in a fixed-dose, randomized, crossover trial. Of 26 previously untreated patients with frequent ventricular ectopic beats documented by 24-hour ambulatory monitoring, 17 completed four weeks of therapy with quinidine and 12 with lorcainide. ⋯ We conclude that in a dose of 100 mg twice or three times daily, lorcainide is as effective as quinidine gluconate, 324 mg three times daily, for the suppression of chronic ventricular arrhythmias. However, the high incidence of adverse reactions experienced with lorcainide make it an unacceptable agent for first-line antiarrhythmic therapy.