Malignant course of a benign anomaly: myocardial bridging

A 35-year-old man, with recent onset angina, developed recurrent episodes of syncope due to ventricular tachycardia. His coronary angiogram showed normal coronary arteries and myocardial bridging of the left anterior descending causing severe systolic milking effect. Extensive invasive and noninvasive investigations did not reveal cardiac pathology other than the myocardial bridging. Electrophysiologic studies, not previously reported in myocardial bridging, demonstrated inducible sustained ventricular tachycardia at a rate of 280 beats/min. The possible relationship between the arrhythmia and the myocardial bridge is suggested. Combined medical treatment with amiodarone and diltiazem proved to be an effective alternative to surgical myotomy of the bridge.     

Acute myocardial infarction: thrombotic complications of nephrotic syndrome

Thrombotic complications are common in patients with nephrotic syndrome. We report a case of acute inferior wall myocardial infarction in a nephrotic patient secondary to a thrombotic occlusion of the right coronary artery which was subsequently documented to be free from any significant atherosclerotic disease.     

OXYGEN FREE RADICAL IN HUMAN OSTEOARTHRITIS

The xanthine oxidase catalysed release of superoxide free radicals (O2-) from endogenous hypoxanthine was determined in homogenates of synovium obtained from three groups of patients, those undergoing primary or revision total hip replacement (THR) for osteoarthritis and those undergoing arthroscopy of the knee for semilunar disc injuries. The concentrations of hypoxanthine in homogenates obtained during THR were found to be significantly higher than those in the group with semilunar disc injuries. The results suggest that there is a greater predisposition to free radical release and tissue damage in osteoarthritis.     

Aging in Nigeria

Following the presentation of demographic data concerning the situation of the elderly in Nigeria, the government's policy with regard to the aged is described. One aim is to strengthen the traditional system of the extended family. Reference is made to the difficulties involved in gerontological research.     

Importance of electrogastrography and pharmacological tests in assessing gastric motor function in vagotomy

The effect of 6 pharmacological drugs on the motor function of the stomach in patients with ulcer disease was studied. It was established that Cerucal was the best modulator of gastric motor activity. There were three types of reaction of electrogastrogram to the administration of Cerucal. It was noted that in the first type there was a real danger of the development of postvagotomic kinetic disorders. In the second and third types such a danger was as a rule absent. This method of prognosis of motor disorders after vagotomy was successfully used in 81 patients with ulcer disease of the duodenum treated with the help of vagotomy.     

Tears of the medial meniscus associated with increased radionuclide activity of the proximal tibia

Summary Three patients who presented with long-standing medial knee pain and normal radiographs had an isotope bone scan in an attempt to arrive at a diagnosis. In each case there was a well-defined area of increased uptake over the medial tibial condyle and arthroscopy subsequently revealed meniscal damage. After arthroscopic menisectomy each patient became asymptomatic and the bone scan returned to normal. We suggest that patients with incapacitating knee pain, normal radiographs and a positive bone scan undergo an arthroscopy even in the absence of clinical signs of meniscal damage.

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Résumé Trois malades qui présentaient depuis longtemps des douleurs de la partie interne du genou et dont les radiographies étaient normales ont bénéficié d'une scintigraphie afin d'essayer d'ðablir un diagnostic. Dans tous les cas il y avait une zone bien limitée d'hyperfixation au niveau de la partie interne de l'extrémité supérieure du tibia, et l'arthroscopie ultérieure découvrit une lésion méniscale. Après méniscectomie arthroscopique tous les malades furent soulagés et la scintigraphie redevint normale. Nous proposons que l'on pratique une arthroscopie, même en l'absence de signes cliniques d'atteinte méniscale, chez les sujets présentant des douleurs notables du genou, avec des radiographies normales et une scintigraphie positive.