Estimation of global left ventricular function from the velocity of longitudinal shortening

AIMS: To determine if global ventricular function can be assessed from the long-axis contraction of the left ventricle, we compared pulsed-wave Doppler myocardial imaging of mitral annular motion to radionuclide ventriculography. METHODS AND RESULTS: We studied 51 patients (56 +/- 10 years, 11 women) with a radionuclide ejection fraction of 52 +/- 13% (15%-70%). Peak systolic velocities of medial and lateral mitral annular motion correlated with ejection fraction (0.55 and 0.54, respectively; P < 0.001), as did the time-velocity integrals (0.57 and 0.58, respectively; P < 0.001). Correlations were higher in normal ventricles (0.62-0.69) than in patients with previous myocardial infarction (0.39-0.64). Patients with anterior myocardial infarction had the lowest correlations (0.39-0.46). The best differentiation of normal (> or = 50%) from abnormal (< 50%) ejection fraction was provided by peak systolic velocity > or = 8 cm/sec for the medial (sensitivity 80%, specificity 89%) or lateral (sensitivity 80%, specificity 92%) mitral annulus. CONCLUSION: Global left ventricular function can be estimated by recording mitral annular velocity. The implementation of a cutoff limit of 8 cm/sec gave a simple guide for differentiating between normal and abnormal left ventricular systolic function that might be useful clinically in patients without regional wall-motion abnormalities. However, in patients with important segmental wall-motion abnormalities during systole, left ventricular longitudinal shortening is an imperfect surrogate for ejection fraction.     

Digoxin and Mortality in Patients With Atrial Fibrillation

Background

Digoxin is widely used in patients with atrial fibrillation (AF).

Cardiovascular involvement in inflammatory bowel disease: dangerous liaisons

Increasing evidence of a link between inflammatory bowel disease(IBD) and adverse cardiovascular events has emerged during the last decade.In 2014,an important number of meta-analyses and cohort studies clarified the subtle dangerous liaisons between gut inflammation and cardiovascular pathology.The evidence suggests that patients with IBD have a significantly increased risk of myocardial infarction,stroke,and cardiovascular mortality,especially during periods of IBD activity.Some populations(e.g.,women,young patients) may have an even greater risk.Current effective treatment of IBD is aimed at disease remission and seems to reduce cardiovascular risk in these patients.A beneficial effect was demonstrated for salicylates,but not for steroids or azathioprine.tumor necrosis factor-α antagonists,which are highly effective in the reduction of inflammation and in the restoration of the digestive mucosa,lead to conflicting cardiovascular effects,as they seem to reduce the risk for ischemic heart disease but increase the rate of cerebrovascular events.Future supplemental treatment strategies that may reduce the atherothrombotic risk during periods of IBD activity should be explored.     

Successful epilepsy surgery in frontal lobe epilepsy with startle seizures: a SEEG studyFrontal epilepsy with startle seizures

Pre‐surgical assessment and surgical management of frontal epilepsy with normal MRI is often challenging. We present a case of a 33‐year‐old, right‐handed, educated male. During childhood, his seizures presented with mandibular myoclonus and no particular trigger. As a young adult, he developed seizures with a startle component, triggered by unexpected noises. During his ictal episodes, he felt fear and grimaced with sudden head flexion and tonic axial posturing. Similar seizures also occurred without startle. Neuropsychological assessment showed executive dysfunction and verbal memory deficit. The cerebral MRI was normal. Electro‐clinical reasoning, investigations performed, the results obtained and follow‐up are discussed in detail. [Published with video sequence]     

Algorithm for mapping cutaneous tissue oxygen concentration using hyperspectral imaging

The measurement of tissue oxygenation plays an important role in the diagnosis and therapeutic assessment of a large variety of diseases. Many different methods have been developed and are currently applied in clinical practice for the measurement of tissue oxygenation. Unfortunately, each of these methods has its own limitations. In this paper we proposed the use of hyperspectral imaging as new method for the assessment of the tissue oxygenation level. To extract this information from hyperspectral images a new algorithm for mapping cutaneous tissue oxygen concentration was developed. This algorithm takes into account and solves some problems related to setting and calculation of some parameters derived from hyperspectral images. The algorithm was tested with good results on synthetic images and then validated on the fingers of a hand with different blood irrigation states. The results obtained have proved the ability of hyperspectral imaging together with the developed algorithm to map the oxy- and deoxyhemoglobin distribution on the analyzed fingers. These are only preliminary results and other studies should be done before this approach to be used in the clinical setting for the diagnosis and monitoring of various diseases.OCIS codes: (000.2170) Equipment and techniques, (110.4234) Multispectral and hyperspectral imaging, (170.6935) Tissue characterization, (300.6550) Spectroscopy, visible     

Waking-sleep modulation of paroxysmal activities induced by partial cortical deafferentation

We investigated the dependency of electrical seizures produced by cortical undercut upon behavioral states of vigilance in chronically implanted cats. Experiments were performed 1-12 weeks after white matter transection. Multisite field potentials and intracellular activity were recorded from suprasylvian and marginal gyri. Paroxysmal activity developed within days and consisted of spike-wave complexes at 3-4 Hz occurring during the waking state (correlated with eye movements), being enhanced during slow-wave sleep (SWS) and blocked during rapid eye movement (REM) sleep. Prolonged hyperpolarizing events were seen not only during SWS (which is the case in normal animals) but also during both waking and REM, thus resulting in bimodal distribution of the membrane potential in all 3 natural states of vigilance. The increased synchrony of field potential activity expressed by shorter time of propagation over the cortical surface and the tendency toward generalization are ascribed to changes in intrinsic neuronal properties and potential disinhibition following cortical undercut.     

Bilateral osteochondrosis of radial head

Introduction

We present a case of bilateral osteochondrosis of the radial head with a 9-year follow-up. The appearance of the disease in one elbow was related with a trauma-injury; meanwhile the opposite elbow had no relation with it. On the other hand, the traumatic elbow associates a chondral lesion. As far as we know, it is the first case where an osteochondral lesion is associated with this entity.

Case report

Our patient is an 11-year-old male, who struck his right elbow in April 1996 and developed an osteochondrosis of the radial head. In February 1997, an arthroscopy was performed and it was found that a chondral lesion was also associated. Two years later, the child developed the disease in the opposite elbow with no traumatic incident preceding the symptoms. Nine years after, the patient was asymptomatic except for a limitation to the forearm supination of 45°. We proposed a radial head resection but the patient refused it for the moment.

Discussion

The long follow-up of patient allows a good revision of the symptoms and radiological details of the disease. There is a general belief that most of the children with this disease respond well to non-operative treatment. But when symptoms are intense, loose bodies are present or the MRI suggests the association of an important chondral lesion we think an arthroscopy should be performed. Despite the remodelling that generally occurs many of the patients present a limitation in their elbow mobility that, in advanced cases, might need a radial head resection.     

The N-terminal region of reelin regulates postnatal dendritic maturation of cortical pyramidal neurons

Cajal-Retzius cells, located in layer I of the cortex, synthesize and secrete the glycoprotein reelin, which plays a pivotal role in neuronal migration during embryonic development. Cajal-Retzius cells persist after birth, but their postnatal role is unknown. Here we show that Cajal-Retzius cells receive a major excitatory synaptic input via serotonin 5-HT₃ receptors. Blocking this input using pharmacological tools or neutralization of reelin signaling results in hypercomplexity of apical, but not basal, dendrites of cortical layer II/III pyramidal neurons. A similar hypercomplexity is observed in the cortex of the 5-HT_3A receptor knockout mouse. The increased dendritic complexity can be rescued by application of recombinant full-length reelin or its N-terminal fragment, but not by the central fragment of reelin, and involves a signal transduction pathway independent of the activation of the canonical reelin receptors. Taken together, our results reveal a novel role of serotonin, Cajal-Retzius cells, and reelin in the postnatal maturation of the cortex.