Natural history of rheumatic carditis. A follow-up of more than 20 years

In this retrospective study of 43 patients of the National Institute of Cardiology of Mexico, 20 to 35 years after the first attack of rheumatic carditis shows that the prognosis of the heart valve disease is directly influenced by the number of attacks of rheumatic fever. In fact, when patients had only one rheumatic attack the secuelae was mild mitral regurgitation (19%), without hemodynamic significance, with less proportion of mitral stenosis (15%), or aortic regurgitation (7.6%), less plurivalvular lesions (16%), or required heart surgery (15%). In the other hand, when the patients suffered three rheumatic attacks had more proportion of mitral stenosis (33%), aortic regurgitation (41%), pluryvalvular lesions (38%) and required more heart (50%). We conclude that prophylactic treatment is important in patients with chronic rheumatic heart disease.     

Aneurysm of the interauricular septum and Klinefelter's syndrome

Atrial septal aneurysms are reported secondary to congenital cardiopathies with an increased gradient between the two atrial chambers or primary, usually associated with an alteration in the connective tissues of the heart. We describe a patient with an atrial septal aneurysm and Klinefelter's syndrome, an association not previously reported, that reinforces the relationship of this aneurysm to a connective tissue abnormality.     

Correlation of scintigraphy and angiography for ventricular volume determinations using realistic cardiac phantoms: the unimportance of self-attenuation

The volumes of the left ventricle (LV) and right ventricle (RV) were determined by scintigraphy, radiography, and weight, using hollow, morphologically accurate cardiac phantoms that ranged from 99-415 ml (RV) and 72-364 ml (LV). Self-attenuation within these simulated ventricles appeared negligible in view of the nearly linear correlation between scintigraphic and weight determined volumes. Scintigraphy compared favorably with radiography for estimating clinically encountered volumes of the RV and LV.     

Frontal eye field as defined by intracortical microstimulation in squirrel monkeys, owl monkeys, and macaque monkeys: I. Subcortical connections

Intracortical microstimulation was used to define the borders of the frontal eye fields in squirrel, owl, and macaque monkeys. The borders were marked with electrolytic lesions, and horseradish peroxidase conjugated to wheat germ agglutinin was injected within the field. Following tetramethyl benzidine histochemistry, afferent and efferent connections of the frontal eye field with subcortical structures were studied. Most connections were ipsilateral and were similar in all primates studied. These include reciprocal connections with the following nuclei: medial dorsal (lateral parts), ventral anterior (especially with pars magnocellularis), central lateral, paracentral, ventral lateral, parafascicular, medial pulvinar, limitans, and suprageniculate. The frontal eye field also projects to the ipsilateral pretectal nuclei, subthalamic nucleus, nucleus of the posterior commissure, superior colliculus (especially layer four), zona incerta, rostral interstitial nucleus of the medial longitudinal fasciculus, nucleus Darkschewitsch, dorsomedial parvocellular red nucleus, interstitial nucleus of Cajal, basilar pontine nuclei, and bilaterally to the paramedian pontine reticular formation and the nucleus reticularis tegmenti pontis. Many of these structures also receive input from deeper layers of the superior colliculus and are known to participate in visuomotor function. These results reveal connections that account for the parallel influence of the superior colliculus and the frontal eye field on visuomotor function; suggest that there has been little evolutionary change in subcortical connections, and therefore function, of the frontal eye fields since the time that these lines of primates diverged; and support the conclusion that the frontal eye fields are homologous in New and Old World monkeys.