Newborn infant with maternal anti-SSA antibody-induced complete heart block accompanying cardiomyopathy.

Newborn case of maternal anti-SSA antibody-induced congenital complete heart block (CCHB) accompanying cardiomyopathy is presented. Unexpectedly, she died of ventricular tachycardia, not bradycardia, 6 days after birth. Autopsy revealed left ventricular cardiomyopathy with endocardial fibroelastosis. Thus, when evaluating fetal cardiac performance in cases of maternal anti-SSA antibody-induced CCHB, it is necessary to pay attention to myocardial attributes such as endocardial hyperplasia.     

Adaptational changes in cone electroretinograms in man

Changes of amplitude and implicit time of human cone electroretinogram (ERG) were studied during dark adaptation and succeeding light adaptation. Dark-adapted cone ERG was isolated by subtracting scotopic blue response from matched scotopic red response. The former represented the rod-mediated b-wave, while the latter consisted of both rod-mediated b-wave and cone-mediated b-wave or x-wave. The b-wave amplitude of dark-adapted cone ERG remained unchanged during dark adaptation, while the implicit time increased systematically, reaching a plateau. Light-adapted cone ERG was obtained by red stimulus lights under a bright background light. The amplitude of light-adapted cone ERG was markedly suppressed through dark adaptation but it recovered gradually during light adaptation, reaching the base line level. The implicit time was unchanged during light adaptation.     

Thyroplasty Type I with Ceramic Shim

Abstract: To prevent side effects from a silicone shim in Isshiki thyroplasty type I, we used a ceramic shim in 10 patients with unilateral recurrent laryngeal nerve paralysis. No published reports have described the use of ceramic in this type of surgery. According to the degree of glottic insufficiency, ceramic shims of various heights were inserted into the fenestration made in the thyroid ala. All patients experienced subjective improvement of voice postoperatively. Laryngoscopies in most cases showed that glottic insufficiency improved postoperatively. In the postoperative examination, the maximum phonation time improved an average of 3.7 s, and the mean flow rate improved an average of 331 ml/s. We have analyzed the relationship of these improvements to the degree of glottic insufficiency and have compared our results with those of other investigators.     

The sites of origin of dopaminergic afferent fibers to the lateral habenular nucleus in the rat

The lateral habenular nucleus of the rat contains a dense plexus of dopaminergic fibers, which are more marked in the medial part of the lateral habenular nucleus than in its lateral counterpart. Employing a combination of fluorescent retrograde axonal tracing with fluorogold and tyrosine hydroxylase immunofluorescence histochemistry, we investigated the distribution of cells of origin of the dopaminergic afferent fibers to the lateral habenular nucleus in the rat. The cells double-labeled with both fluorogold injected into the lateral habenular nucleus and tyrosine hydroxylase antisera were seen in a variety of fore- and midbrain regions, including the bed nucleus of the stria terminalis, medial preoptic area, periventricular, ventromedial, and dorsomedial hypothalamic nuclei, ventral tegmental area, interfascicular nucleus, substantia nigra pars compacta, ventrolateral division of the midbrain periaqueductal gray, and dorsal raphe nucleus. The double-labeled cells were located bilaterally with an ipsilateral predominance, and constituted approximately 10% of the total fluorogold-positive cell population. We have further observed by anterograde axonal tracing with Phaseolus vulgaris–leucoagglutinin that projection fibers arising from the sites of origin of the dopaminergic afferent fibers to the lateral habenular nucleus terminate mainly in the medial part of the lateral habenular nucleus, and to a lesser extent in its lateral conterpart. Thus, we have found in the present study that the dopaminergic neurons sending their axons to the lateral habenular nucleus are widely distributed in the A9, A10, A14, and A15 dopaminergic cell groups. Such dopaminergic neurons may exert regulatory influences upon many limbic-associated brain regions via the lateral habenular nucleus. © 1993 Wiley-Liss, Inc.     

Improvement in the Treatment of Childhood Cancer: Analysis of Survival Data from the National Children's Hospital (1965-1987)

Developments in the treatment of childhood cancer have beenevaluated in patients who had been treated in the National Children'sHospital from 1965 to 1987. The total number of patients was867, of which leukemia accounted for 376, malignant lymphoma61, neuroblastoma 174, Wilms' tumor 55, yolk sac tumor 29, rhabdomyosarcoma36 and hepatoblastoma 30. Patients were divided into three timeintervals: the 1960s, 1970s and 1980s. A marked improvementin five-year survival was recognized in Wilms' tumor and yolksac tumor, amounting to 80%, followed by rhabdomyosarcoma, acutelymphoblastic leukemia and malignant lymphoma. There was noimprovement in patients with acute non-lymphoblastic leukemia,neuroblastoma and hepatoblastoma. Prognostic factors for neuroblastomawere further analyzed, and the age of onset and stage of diseasewere found to have remained constant for 23 years. Factors relatingto the improvement of survival were discussed.