Is Chronic Atrial Stimulation a Reliable Method for Single Chamber Pacing in Sick Sinus Syndrome?

To evaluate the feasibility of chronic atrial pacing (AAI) in sick sinus syndrome (SSS), 22 patients (pts) with bradytachycardia syndrome (BTS) and 17 patients with only bradyarrhythmias (BA) were studied on the incidence of supraventricular tachycardias (SVT) and occurring AV block. A scoring system based on symptoms of SVT was developed (grade 0–5). All patients had proven normal AV conduction before PM implantation. In the BTS-group, nine patients (41%) had symptomatic SVT at the end of follow-up (mean 53 months), despite drug therapy. These patients had a high SVT score on entry (mean 3.2). High degree AV block occurred in three patients. Although in the BA-group SVT arose in six patients (35%), there was only one symptomatic patient at the end of follow-up (mean 36 months). In this group, only one patient developed high degree AV block. Atrial stimulation should be considered as a reliable therapy in patients with SSS and low SVT score before PM implantation when normal AV conduction is present.     

A first episode of mania after age 80.

The case of a patient whose first episode of mania (DSM-III-R diagnosis) occurred after age 80 is presented; the patient had no previous psychiatric illness. Diagnostic and therapeutic issues are discussed with special regard to features of mania in old age, secondary mania (organic mood syndrome), pseudodementia, MHPG excretion and carbamazepine treatment.     

Changes in work performances in obstructive sleep apnea patients after dental appliance therapy

Abstract The effects of dental appliances on work performances of obstructive sleep apnea syndrome (OSAS) is not well examined. This study evaluated the polysomnographic and psychological findings before and after therapy. Nine patients were diagnosed OSAS by nocturnal polysomnography. The psychological battery was performed from 13:00 to 14:00, which consisted of Uchida-Kraepelin psychodiagnostic test (U-K's test) and Bourdon's cancellation test (Bourdon's test). Approximately 3 months after the treatment, the examinations were performed. Apnea and desaturation index decreased significantly after the therapy. In addition, sleep architecture improved after the therapy compared with that before the therapy. Dysfunction of task performances, such as mean level of work amounts in U-K's test, mean error, mean performance time and mean deviation in Bourdon's test improved after therapy. We conclude that dental appliances therapy is effective not only to apnea but also to work performance in OSAS.     

Intrahepatic bile duct and portal vein anatomy revisited

Seventeen normal cadaver livers were studied to assess the anatomic relationship of bile ducts to portal veins. The common bile duct, main portal vein, and hepatic artery were cannulated and injected with air, dilute contrast medium, and mineral oil, respectively. The livers were placed in anatomic position and examined with computed tomography. In the lateral segment of the left hepatic lobe, the bile ducts were anterior to the portal vein in seven cases, posterior in seven, and tortuous (ie, both anterior and posterior) in three. In the medial segment of the left lobe, the bile ducts were anterior in four cases, posterior in four, tortuous in three, and not seen in six. In the right lobe, the bile ducts were anterior in nine cases, posterior in five, tortuous in one, and not seen in two. In the porta hepatis, the bile ducts were anterior in ten cases, posterior in one, tortuous in five, and not seen in one. Histologic findings confirmed the anterior and posterior location of the bile ducts relative to the portal veins. These findings contradict the commonly held view of intrahepatic bile ducts being anterior to the portal vein and are clinically significant for techniques such as bile duct drainage.     

朝藿素D的分离和结构

从朝鲜淫羊藿(Epimedium koreanum)地上部分分离得到一新黄酮成分(I)和一已知化合物(II)。经光谱解析,证明I的结构为5,7,3',4'-tetrahydroxy-5'-prenylflavone,命名为朝藿素D(epimedokoreanin D);II为2-hydroxy-3,4,6,7-tetramethoxy-9,10-dihydrophenanthren。