Radiofrequency catheter ablation of accessory pathways. Outcome and use of antiarrhythmic drugs during follow-up.

AIMS: The purpose of this study was to assess the acute and long-term success of accessory pathway ablation in a single large-volume centre, concentrating on long-term recurrences and the clinical use of antiarrhythmic drugs. METHODS AND RESULTS: A total of 519 consecutive patients (mean age 40+/-14 years) underwent radiofrequency ablation of manifest or concealed accessory pathways. The patients were seen in the hospital or by the referring physician at 6 and 12 months. Long-term follow-up information was obtained by questionnaire. Pathway conduction was abolished in 476 cases (91.7%). 'Redo' procedures, due to recurrence, were performed in 38 patients (7.3%) and were successful in 30 (78.9%). Follow-up data were obtained from 454 patients (87.5%) with a follow-up duration of 22. 6+/-12.4 months. Among the 398 patients with successful ablations who responded to the questionnaire, 340 (85.4%) were asymptomatic with only 10.6% taking antiarrhythmic drugs. An additional 20 patients (5.0%) had symptoms suspicious of recurrence. In total, 66 out of 398 successfully treated patients (16.6%) were taking antiarrhythmic drugs. Twenty-three out of 56 (41.1%) patients with failed ablations were asymptomatic, 12 of whom (21.4% of patients with failed ablations) had not been administered antiarrhythmic drugs. In the total group of 454 patients with ablation attempts and available follow-up data, 99 (21.8%) were still taking antiarrhythmic drugs during follow-up. CONCLUSIONS: Patients with successful ablation of accessory pathways show excellent long-term results. However, 17% of successfully treated patients were still taking antiarrhythmic drugs during the period of long-term follow-up. On the other hand, 21% of patients with failed ablations were symptom-free without antiarrhythmic drugs. On an intention-to-treat basis, 22% of the patients with ablation attempts were still taking antiarrhythmic drugs during follow-up.     

Chlamydia trachomatis in Andrologic Patients – Direct and Indirect Detection

Background: Chlamydia trachomatis is considered to be the most common sexually transmitted disease in Germany. It is currently unclear whether chlamydial infection causes pathological conditions of the male accessory glands with consequences for male infertility. Patients and Methods: Within the framework of several prospective studies the association between sperm quality, male accessory gland function and infection with C. trachomatis was investigated in men of couples with unexplained infertility. Chlamydial infection was determined by serologic methods and by proof of Chlamydia-specific DNA. As a marker of infection the direct determination of granulocytes in the ejaculate or the measurement of the polymorphonuclear (PMN) elastase concentration was used. The male accessory gland function was evaluated using the markers fructose, citric acid and α-glucosidase in the seminal plasma. Results: Chlamydia-specific DNA in the ejaculate was present in between 3–5% of the subjects, which corresponds to it s prevalence in the normal population. Chlamydia IgA antibodies were demonstrated with a frequency of 38% in seminal plasma (n = 834) using a genus-specific test (rELISA). Using other species-specific tests (MIF, SeroCT, IgA pELISA and ImmunoComb), Chlamydia IgA antibodies were found at frequencies of between 8 and 22%. Conclusion: Only in a few individual cases was it possible to show a connection between reduced sperm quality, disturbed male accessory gland function and indication of infection with Chlamydia, bacteria or Ureaplasma. Received: May 23, 2000 · Revision accepted: December 20, 2000     

体表电位标测判定预激综合征旁路的评价

目的 评价体电位标测在房室旁路定位中的准确性和可行性。方法 ５２例常规行身频导管消融（ＲＦＣＡ）的显性激综合征（Ｗｏｌｆｆ－Ｐａｒｋｉｎｎｏｎ－Ｗｈｉｔｅ ｓｙｎｄｒｏｍｅ，ＷＰＷ）病人，订前后体表电位标测（Ｂｏｄｙ Ｓｕｒｆａｃｅ Ｐｏｔｅｎｉｔａｌ Ｍａｐｐｉｎｇ，ＢＳＰＭ）。旁路定位采用：（１）等电位图：除极４０ｍｓ后，稳定持续１０ｍｓ以上的极上值位置。（２）等积分图，等积分图中极小值的位置     

The Location of Maxillary Sinus Ostium and Its Clinical Application

The endoscopic sinus surgeons must have a detailed knowledge of inconsistent location of maxillary sinus openings in any interventional maxillary sinus surgeries as it relates to the orbital floor, ethmoid infundibulum and the nasolacrimal duct. Forty cadaver head and neck specimens had been cut sagittally through the nose, such that the lateral nasal wall had been preserved. The findings were documented with an emphasis on location of the maxillary sinus openings. In the present study maxillary sinus ostium opened more commonly into posterior third of the hiatus semilunaris. Accessory maxillary ostium was another variation seen in nearly three-fourths of the cases which opened into membranous meatus inferior to the uncinate process.     

直肠末端旋转式瘘修补肛门成形术治疗先天无肛舟状窝瘘的研究

目的:采用直肠末端旋转式瘘修补肛门成形术(简称直肠末端旋转术)治疗先天无肛舟状窝瘘的研究并与几种术式疗效评价。方法:直肠末端旋转术102例。随机完成对照组48例,其中骶会阴、尾路肛门成形术20例,瘘后移肛门成形术28例。对两组患儿进行术后3个月～2年的随访。结果:直肠末端旋转术优97例,良5例,优良率95％,并发症5％对照组:优33例,良6例,差9例,优良率81.2％,并发症31.2％。其中骶会阴、尾路肛门成形术优13例,良3例,差4例;瘘后移肛门成形术优20例,良3例,差5例。研究组与对照组疗效经统计学检查,X~2值=17.16,P<0.001,直肠末端旋转术无瘘复发,对照组瘘复发6例,X~2值=14.81,P<0.001,有极显著性差异。结论:直肠末端旋转术解决了直肠回缩、瘘复发的发病基础,基本上避免了并发症的发生。     

The Accessory Soleus Muscle: A Case Report and Review of the Literature

A case of histologically proven accessory soleus muscle simulating a soft tissue turnour in a young male is reported. The radiological features are demonstrated and reviewed.     

An anomalous digastric muscle with three accessory bellies and one fibrous band

During our routine dissection studies we encountered an anomalous digastric muscle with three accessory bellies and one fibrous band in one embedded cadaver. All of these structures were attached to the mylohyoid raphe. This anomaly should be considered during surgical procedures involving this region.     

Torsion of an accessory lobe of the liver in a child: Report of a case

We report a case of torsion of an accessory lobe of the liver (ALL) in a 14-year-old girl. The patient was admitted for acute abdominal pain and laparotomy revealed an ALL, the pedicle of which was elongated with 180° torsion. The diagnosis was not made preoperatively because of the rarity of this condition. However, a close relationship between omphalocele repair and the development of ALL has been reported; thus, a history of omphalocele repair should alert the doctor to the possibility of this condition, which could be suggested by imaging findings preoperatively. Torsion of an ALL should be included in the differential diagnosis of a patient with a history of omphalocele, who presents with acute abdominal symptoms.     

Hazardous effect of tannery solid waste leachates on development and reproduction in Drosophila melanogaster: 70 kDa heat shock protein as a marker of cellular damage

Rapid industrialization has increased the burden of chemicals in the environment. These chemicals may be harmful to development and reproduction of any organism. We therefore analyzed the adverse effects of leachates from a tannery solid waste on development and reproduction using Drosophila. We show a significant delay in mean emergence of flies observed at the higher concentrations of the leachates, indicating their effect on the organism's development. Significant leachate-induced effect on reproduction of the organism was also observed. Sub-organismal analyses revealed Hsp70 expression and tissue damage in a sex-specific manner. Refractoriness of Hsp70 expression in accessory glands of male flies and ovaries of females was concurrent with tissue damage. Genes encoding certain seminal proteins (Acp70A and Acp36DE) from accessory glands were significantly down-regulated at higher concentrations of the leachates. The study suggests that (i) sub-organismal adverse responses are reflected at organismal level, (ii) tannery waste leachates cause adverse effects on the expression of genes encoding seminal proteins that facilitate normal reproduction and (iii) Hsp70 may be used as a marker of cellular damage for reproductive organs.     

The supernumerary muscles of the leg: a report of two cases

Summary Two cases of supernumerary muscles of the leg reported, which were both inserted on the sides of the calcaneus. The accessory soleus m., adductor of the fore-foot, is a variation of the triceps surae which through hypertrophy on the medial side of the leg can become particularly problematic in athletes. The fourth peroneal m. abductor of the fore-foot, is considered to increase the stability of the ankle and is asymptomatic.

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Les muscles surnuméraires de la jambe : à propos de deux cas

Résumé Les auteurs rapportent 2 cas de muscles surnuméraires de la jambe qui s'insèrent sur les faces du calcanéum. Le m. soléaire accessoire, adducteur de l'arrièrepied, est une variation du triceps sural qui, par son hypertrophie au bord médial de la jambe, peut devenir gênante spécialement chez le sportif. Le m. 4^e péronier, abducteur de l'arrière-pied, est considéré comme un élément progressif améliorant la stabilité de la cheville et restant asymptomatique.