The carotid bodies in a case of ventricular septal defect

A woman of 62 years with Turner's syndrome died in congestive cardiac failure secondary to a large ventricular septal defect with biventricular hypertrophy. During her last few months the lifelong left-to-right shunt underwent reversal exposing her carotid bodies to hypoxaemia. The carotid bodies were not enlarged, thus demonstrating that hyperplasia of glomic tissue is not brought about by increased myocardial mass per se. They were, however, abnormally cellular with more dark cells ( a variant of chief cells), many of which were abnormally large and showed ultrastructural features of metabolic activity. These changes may represent the earliest histological response of the carotid body to hypoxaemia and later, the dark cells may mature into the more familiar and common light variant. It seems likely that this dark cell activity precedes, probably by a long period, the sustentacular cell hyperplasia and proliferation of nerve axons which we have reported elsewhere as the chronic reaction of the carotid bodies to hypoxaemia.     

Amiodarone-induced torsades de pointes

Five cases of amiodarone-induced syncope due to torsades depointes or ventricular fibrillation are described. Amiodaronewas used for recurrent supraventricular tachycardia in fourcases and frequent ventricular extra systoles complicating congenitalQT prolongation in the remaining case. Each was associated witha marked prolongation in the QTc interval following amiodarone.Three cases had had a previous history of life-threatening ventriculararrhythmias secondary to anti-arrhythmic drugs. Hypokalemiamay have been a contributory factor in two. The clinical features,predisposing factors, and treatment are discussed.     

Morphine compared with diamorphine

The dose requirements and side effects of morphine were compared with those of diamorphine administered by patient-controlled analgesia in 40 patients following elective total hip replacement. Patients were allocated randomly to receive in a double-blind manner either morphine or diamorphine for postoperative pain relief. There were no significant differences between the two groups with regard to postoperative sedation, nausea, well-being, pain relief and requirements for antiemetic drugs. The dose requirement for diamorphine was approximately 50% of that for morphine.     

重齿毛当归(独活)中异当归醇、毛当归醇及其它香豆素的分离与鉴定

Nine coumarins were isolated from dichloromethane extract of the roots of Angelica pubescens Maxim. Seven of them were identified as osthol (Ⅰ), columbianetin acetate (Ⅱ), columbianetin (Ⅲ), bergapten (Ⅳ), angelol (Ⅴ),xanthotoxin (Ⅵ) and isoimperatorin (Ⅶ). (Ⅵ) and (Ⅶ) were isolated for the first time from this plant. Two new coumarins were elucidated as isoangelol (Ⅷ), a geometric isomer of angelol C₂₀H₂₄O₇ [α]_D²⁰-133.5 and anpubesol C₂₀H₂₆O₇ [α]_D²⁰ -72.5 on the basis of spectral evidences.     

The comparative anatomy of the pig middle ear cavity: a model for middle ear inflammation in the human?

This study was undertaken to develop a functional model of otitis media with effusion (OME) in the pig ( Sus scrofa ), with the purpose of investigating the origin of lymphocytes populating the middle ear during the course of an inflammatory process. The relevance of the model to the human condition of OME is to a large extent dependent on the anatomical and physiological similarities between the middle ear cavity and the pharyngeal lymphoid tissue of the pig and man. Anatomical specimens were collected from 7 young Large White pigs to determine the gross anatomy of the middle ear cavity and the histological characteristics of the middle ear mucosa. It was found that the anatomy of the 3 parts of the middle ear cavity in man and in the pig is broadly similar, although some minor differences were observed. The porcine eustachian tube was seen to be cartilaginous throughout its length in contrast to the part osseous, part cartilaginous structure found in man; the porcine ossicles were slightly different in shape to those of man and the air cell system was situated inferior to the tympanic cavity in the pig as opposed to posteriorly in man. This paper describes the structure and morphology of the pig middle ear cavity and compares and contrasts it with that of man. The minor differences observed are of anatomical importance but do not diminish the usefulness of the pig middle ear cleft as a potential model for human middle ear disorders.     

The diagnosis of partial intestinal obstruction by surface vibration analysis (SVA)

Abstract Surface vibration analysis is a non-invasive test of gastrointestinal activity, which shows an 'obstructive' pattern of hyperactivity and quiescence, corresponding to cluster contractions, in experimental obstruction. This study has evaluated surface vibration analysis against clinical and operative diagnosis in suspected partial intestinal obstruction. Forty-six patients and 18 volunteers underwent surface vibration analysis tests. On clinical grounds, 28 patients were considered likely to have partial intestinal obstruction and underwent laparotomy. Only 14 of these were found to have dilated bowel proximal and normal or collapsed bowel distal to a potentially obstructive lesion, such as adhesions. Surface vibration analysis showed an 'obstructive' pattern in 12/14 patients with obstruction compared to only 3/14 without operative evidence of any obstruction. Surface vibration analysis amplitude values were also significantly higher in the obstruction group. Surface vibration analysis may provide a useful adjunct in the diagnosis of partial intestinal obstruction.