Coronary artery motion and cardiac phases: dependency on heart rate -- implications for CT image reconstruction

This study had institutional review board approval; written informed consent was obtained. The purpose was to prospectively determine the heart rate (HR) dependency of three-dimensional (3D) coronary artery motion by incorporating into analysis the durations of systole and diastole. Thirty patients (seven women, 23 men; mean age, 56.6 years +/- 12.7 [standard deviation]; HR: 45-100 beats per minute) underwent electrocardiographically gated 64-section computed tomographic (CT) coronary angiography to determine coronary motion velocities at bifurcation points. Significance of velocity differences (P < .05) was determined by using analysis of variance for repeated measures and Bonferroni post hoc tests. HR dependency was determined by using linear regression analysis. HR significantly affected 3D coronary motion (r = 0.47, P < .009) through nonproportional shortening of systole and diastole (r = -0.82, P < .001), leading to percentage reconstruction interval shifts of coronary velocity troughs and peaks (P < .01). Results suggest that image reconstruction algorithms at CT coronary angiography be adapted to the individual patient's HR.     

Diastolic Function Study with Conventional and Pulsed Tissue Doppler Echocardiography Imaging in Acromegalic Patients

Acromegaly is associated with myocardial hypertrophy and it can progress to diastolic and systolic dysfunction. Purpose: To evaluate diastolic function in acromegalic patients through conventional echocardiography (CD) and tissue Doppler imaging (TDI). Methods: Seventeen acromegalic patients were submitted to CD and TDI, and early (E) and atriogenic (A) transmitral flow were evaluated in mitral, septal, and tricuspid regions. Results: In comparison with controls the means of conventional (1.06), septal (1.01), and tricuspid (0.98) E/A ratio were significantly lower in acromegalic patients. E/A ratio <1.0 was demonstrated in 41% and 49% of acromegalics by DC and TDI, respectively, with no statistical difference among the two methods. An inverse linear correlation was shown between mitral E/A ratio and acromegalic age (r =−0.7). Conclusion: In this study, DC and TDI were equally effective in demonstrating diastolic dysfunction, a common finding in acromegalic patients.     

Identification of multiple nonprimary motor cortical areas with simple movements

The human cortex reportedly contains at least five nonprimary motor areas: in the frontolateral convexity, the dorsal and ventral premotor cortex (PMd and PMv), and in the frontomesial wall, the presupplementary and supplementary motor areas (pre-SMA and SMA), and the rostral, dorsal and ventral cingulate areas (CMAr, CMAd, and CMAv). Activation of these regions in neuroimaging studies has been generally associated either with the performance of complex motor tasks or with reorganization occurring with motor recovery in the presence of pathology. Recent evidence from neuroimaging studies suggests that the same areas are activated with well controlled simple movements in healthy subjects providing support to the observation that their contribution may be more quantitative rather than exclusively specific to a certain aspect of motor behaviour. An important consequence of this observation is that activation of multiple nonprimary motor areas during simple motor tasks should not be considered unique to patients with upper or lower motoneuron lesions but rather as a normal physiological process.     

Value of early systematic transoesophageal ultrasonography after mitral valve replacement by Saint-Jude prosthesis

The aim of this study was to assess the value of the routine multiplane transoesophageal echocardiography (TEE) in the early postoperative period after mitral valve replacement with a Saint Jude Médical (SJM) mechanical prosthesis. This prospective work enrolled 56 patients who have been operated between September 1999 and September 2001, all these patients had a multiplan TEE after 14.7 days (8-29 days) of post-operative. The effect of peri-prosthetic leaks was 59%. They were always minimal and asymptomatic. 68% of them disappeared at the late exam. An asymptomatic intermittent blockage of an leaflet had been noted in one patient. It appears to us today indispensable to achieve a systematic TEE in the early post operative period after mitral valve replacement. This exam remains little aggressive and comfortably supportable by the patient in look of information brought.     

Bullous pemphigoid in children. Report of three cases

Bullous pemphigo?d (BP) is an acquired immunobullous disease that usually affects adults and rarely children. About 60 cases of infant PB have been reported. Diagnosis is based on immunofluorescence investigations. Clinical, histological and immunopathological findings in childhood PB appear to be not different from the adult. Nevertheless, oral mucosal and palm and sole lesions seem to occur more frequently. We report 3 cases of children BP in one girl and 2 boys, aged respectively of 7.2 and 3 years. Palm and sole were affected in 1 case, and no oral mucosal lesion was noted. Recovery was reached in all cases under dapsone. Characteristics of BP in children are discussed with comparison to literature data.     

Embolization of head and neck hypervascular lesions. A retrospective study of 5 cases

Embolisation of head and neck hypervascular tumours and arterioveinous malformations (AVMs) is now a well-established therapeutic procedure. The purpose of this study was to analyse the technique and to evaluate the safety and value of preoperative embolization of hypervascular lesions. We retrospectively reviewed the records of 5 patients, agged between 14 and 47 years, with hypervascular tumours and AVMs in the head and neck. Lesions were distributed as follow: nasal angiofibroma (n = I), nasal angioleiomyoma (n = I), nasopharyngeal angiofibroma (n = I), aneurysmal bone cyst in the posterior element of the second cervical vertebra (n = I) and AVM of the inferior lip (n = I). Angiography and embolization were carried out at the same time. Complete exclusion of lesions was obtained without any complications. Complementary surgical resection was performed with not notable blood loss.     

Painful traumatic neuroma after a finger stick

In this case report we present a patient with a painful traumatic neuroma after a finger stick by lancet. The patient benefited from surgical excision of the lesion, and her symptoms were completely abolished with additional sympathetic nerve blocks.