Preload-dependent variation of the propagation velocity in patients with congestive heart failure.

BACKGROUND: Although color Doppler M-mode propagation velocity (Vp) is preload-independent, the variation in Vp with the temporal variation of preload in the clinical setting has not been evaluated. Because left ventricular filling pressure changes dramatically with treatment of congestive heart failure (CHF), we hypothesized that preload-dependent variations in Vp occur with treatment of CHF. METHODS: We performed Doppler echocardiographic and hemodynamic evaluation in 24 patients with CHF (15 men, 62 +/- 10 years) at initial presentation (baseline study) and after CHF had improved with therapy (second study). RESULTS: The interval between the baseline and the second study was 48.6 +/- 21.5 hours. Vp decreased between the baseline study (41 +/- 5 cm/s) and the second study (28 +/- 5 cm/s, P <.0001). Only the change in pulmonary capillary wedge pressure (-8.3 +/- 3.3 mm Hg) between the baseline and second study was an independent predictor of the change in Vp (-12.5 +/- 5.9 cm/s) by stepwise linear regression (r = 0.68, P =.0002). CONCLUSIONS: Vp decreases significantly with decreases in pulmonary capillary wedge pressure with the treatment of CHF. The preload-dependent variation should be taken into account in the assessment of Vp in patients with CHF.     

Intestinal neuronal dysplasia]

Intestinal neuronal dysplasia (IND) type B is a disease of the submucosal plexus of intestine manifesting chronic intestinal obstruction or severe chronic constipation. IND is one of intestinal dysganglionoses and clinically closely associated with Hirschsprung's disease. Until recently, it is not fully clear whether IND is a congenital malformation or an acquired secondary condition related to some gastrointestinal problems. However, recently published data and consensus reports have enhanced our understanding of the pathogenesis and management of IND. The aim of this paper was to review the current state of knowledge regarding the controversial issues of IND including the etiology, classification, diagnostic criteria, and available therapeutic intervention.     

Characteristics of pain following intracavernous injection of prostaglandin E1.

The aim of this study was to determine the incidence and characteristics of pain following intracavernous injection of prostaglandin E1 (PGE). We injected PGE into the cavernous tissues of 156 patients with erectile dysfunction who had never previously been injected with PGE. The incidence and characteristics of pain after injection were evaluated by the patients'' response to a questionnaire. The intensity of pain was determined by the degree of impediment to intercourse, verbal rating scale (VRS), numerical rating scale (NRS), and visual analogue scale (VAS). Patients scoring ''no pain'' on the VRS, NRS, and VAS were 11.5%, 7.7%, and 7.7%, respectively. Overall incidence of pain was 91%. There was ''much'' or ''very much'' impediment to intercourse because of pain in 14 (9.1%) patients. The most common kind of pain was ''heavy pain'' in 90% of the patients followed by ''throbbing'' in 38%, ''aching'' in 21%, ''tightening'' in 18%, and ''shooting'' in 13%. The mean duration of pain was 101.2 +/- 63.7 minutes and it lasted during the entire erection period in 71(50.4%) patients. There were significant correlations among the degree of impediment to intercourse, VRS, NRS, and VAS scores (all p < 0.01). However, no association was noted between pain intensity and both erectile response to PGE and injected dose. The higher incidence of intracavernous PGE-induced pain reported here compared to other studies might be related to difference in pain thresholds among races. The high incidence of pain but low frequency of much impediment to intercourse would be related to the pain characteristics as well as the intensity of pain.     

Interaction of crosslinked poly(4-vinylpyridine) with methyl orange

Various crosslinked poly(4-vinylpyridine)s ( 3 ) having different degrees of crosslinking were prepared by the radical copolymerization of 4-vinylpyridine ( 1 ) with N,N′-hexamethylenediacrylamide ( 2 ) as a crosslinker. These crosslinked polymers were examined for their ability to bind methyl orange at various temperatures in a buffer solution of pH 7. The first binding constants (K₁) and thermodynamic parameters that accompany the binding were evaluated. The values of K₁ show bell-shaped curves against both the binding temperature and the degree of crosslinking of 3 . Lower temperature and higher degree of crosslinking for the maximum binding in the bell-shaped phenomenon of this binding system were observed, when they were compared with those of the previously reported binding systems, 1 /N,N′-methylenediacrylamide copolymers-methyl orange and 1 /N,N′-tetramethylenediacrylamide copolymers-methyl orange. The values of enthalpy change and entropy change increase with increasing degree of crosslinking of 3 , whereas the absolute magnitude of free energy change is not increased. These results could be accounted for in terms of the temperature dependence of the hole size of 3 rather than the hydrophobic interaction in the binding process.     

Antiepileptic effects of low-frequency repetitive transcranial magnetic stimulation by different stimulation durations and locations.

OBJECTIVE: To evaluate the antiepileptic effect of low-frequency rTMS (repetitive transcranial magnetic stimulation) in the patients with intractable epilepsy. METHODS: We enrolled 35 patients with localization-related epilepsy who had experienced at least one complex partial seizure or a secondarily generalized seizure per week on a constant antiepileptic drug regimen over an 8-week period. rTMS was administered using a Rapid(2) magnetic stimulator with an air-cooled coil at 0.5Hz for 5 consecutive days at 100% of rMT (resting motor threshold). Patients were divided into a focal stimulation group with a localized epileptic focus, or a non-focal stimulation group with a non-localized or multifocal epileptic focus. These two groups were then randomly subdivided into four subgroups depending on the total number of stimulations administered, i.e., 3000 pulse and 1500 pulse subgroups. Weekly seizure frequencies were determined for 8 weeks before and after rTMS. To compare the number of interictal spikes before and after rTMS, EEG was recorded twice before (1st day) and after rTMS (5th day). RESULTS: Mean weekly seizure frequency was non-significantly decreased after rTMS (8.4-->6.8/week, -13.9%). Longer stimulation subgroups (3000 pulses, -23.0%) tended to have fewer seizures than shorter stimulation subgroups (1500 pulses, -3.0%), without statistical significance. TMS stimulation site and structural brain lesions did not influence seizure outcome. However, interictal spikes significantly decreased (-54.9%, P=0.012) after rTMS and they totally disappeared in 6 patients (17.1%, 6/35). CONCLUSIONS: Low-frequency rTMS reduced interictal spikes, but its effect on seizure outcome was not significant. Focal stimulation for a longer duration tended to further reduce seizure frequency. SIGNIFICANCE: These findings may help clinicians to further investigate the therapeutic potential of the rTMS for patients with intractable epilepsy.     

Primary Mucinous Adenocarcinoma of a Seminal Vesicle Cyst Associated with Ectopic Ureter and Ipsilateral Renal Agenesis: a Case Report

Primary adenocarcinoma of the seminal vesicles is a rare neoplasm. Congenital seminal vesicle cysts are commonly associated with unilateral renal agenesis or dysgenesis. To the best of our knowledge, mucinous adenocarcinoma of the seminal vesicle cyst that''s associated with an ectopic ureter opening into the seminal vesicle and ipsilateral renal agenesis has not been described in the radiological literature. We report here on the radiological findings of a primary adenocarcinoma of a seminal vesicle cyst in this condition.     

Pilomotor seizures in frontal lobe epilepsy: case report.

We report a 27-year-old man with pilomotor seizures originating in the right frontal lobe. Subtracted ictal SPECT coregistered with MRI showed multifocal hyperperfused areas in the anterior medial frontal area, mainly involving the cingulate gyrus. Chronic electrocorticography with subdural electrode arrays during the piloerection demonstrated that the pilomotor seizures were originating in the anterior medial frontal region. After resection of the focus, the patient became seizure free.