Superior vena cava syndrome: Case report: A complication of permanent transvenous endocardial cardiac pacing requiring surgical correction

Superior vena cava syndrome developed in a patient in whom an endocardial transvenous pacemaker had been inserted five years previously. Venography demonstrated an obstructing lesion at the junction of the superior vena cava and right atrium. Balloon catheter dilatation failed to afford any relief from her progressive symptoms. Exploration of the area revealed a benign fibrotic lesion encircling the pacemaker lead within the right atrium. Excision of the lesion, removal of the lead, and patching the right atrium with pericardium resulted in rapid cure.     

Intermyofibrillar and nuclear-myofibrillar connections in human and canine myocardium. An ultrastructural study

Cytoplasmic filaments, which measure 100 Å in diameter, and which differ morphologically from actin and myosin filaments, are described in normal canine myocardium and in normal and hypertrophied human myocardium. These filaments were found between Z bands, near the sarcolemma, in regions of intercalated discs, and in the vicinity of nuclear membranes. The 100 Å filaments appeared to form transverse connections between adjacent Z bands and between Z bands and outer nuclear membranes. These filaments probably function as a cytoskeleton.     

Direct effects of the hyperglycemic factor of the freshwater snail Lymnaea stagnalis on isolated glycogen cells

In the freshwater pulmonate snail Lymnaea stagnalis special cells, the glycogen cells (GC) are present for the storage of glycogen reserves. These cells occur in large numbers in the anterior mantle region. In a previous paper in vitro experiments with intact anterior mantle tissue indicated that a hyperglycemic factor is released from the central nervous system (CNS) which stimulates glycogen mobilization in mantle tissue (M. A. Hemminga, J. J. Maaskant, W. Koomen, and J. Joosse (1985). Neuroendocrine control of glycogen mobilization in the freshwater snail Lymnaea stagnalis. Gen. Comp. Endocrinol. 57, 117-123). In the present study the question of whether this factor affects glycogen metabolism of GC isolated from mantle tissue was investigated. It is reported that in high-K+ Ringers the CNS is stimulated to release a factor which, in a dose-dependent way, inhibits glycogen synthesis in isolated GC (measured as a decreased incorporation of [14C]glucose into glycogen). Simultaneous with this glycogen synthesis-inhibiting effect, stimulation of glycogen degradation is found (measured as a decreased retention of prelabeled glycogen). It is concluded that (1) the factor released by the CNS having these effects on isolated GC is the same as the hyperglycemic factor which was reported to stimulate glycogen mobilization in intact mantle tissue, and (2) GC after isolation from mantle tissue have retained their ability to respond to this factor.(ABSTRACT TRUNCATED AT 250 WORDS)     

Conduction system examination in a case of spontaneous heart block in a dog

This is a serial-section study of the conduction system in a 2-year-old boxer with electrocardiographic evidence of complete A-V block. The following findings were present: a lack of communication between the atria and the A-V node, atrophy of the A-V node, and tenuous connections between the A-V node and the A-V bundle. These were accompanied by acute degenerative changes in the conduction system. These changes are considered to be the result of arteriolosclerotic heart disease.     

Baroreflex dysfunction in patients with adult-onset diabetes and hypertension

Ten patients with adult-onset diabetes in whom diabetes antedated the appearance of hypertension were evaluated. These patients had evidence of diabetic autonomic neuropathy, including significant orthostatic hypotension (four patients), impotence (three patients), and evidence of diabetic peripheral sensorimotor neuropathy (nine patients) in clinical testing and nerve conduction study results. Baroreflex function was evaluated by multiple hemodynamic tests, including inhalation of amyl nitrite and intravenous administration of phenylephrine, before and after parasympathetic blockade with atropine, and the cold presser test; results were compared with results in normal control subjects, patients with essential hypertension, and two subgroups of uremie patients undergoing maintenance hemodialysis. Baroreflex function was significantly abnormal in the diabetic patients and was consistent with combined parasympathetic and sympathetic motor nerve (efferent) dysfunction in the baroreflex arc. There was a significant inverse correlation between the degree of orthostatic hypotension in the diabetic patients and their baroreflex responsc to phenylephrine (r = ?0.680, p < 0.05). There was no significant correlation between supine hypertension in the patients with diabetes and any of the hemodynamic or biochemical parameters examined. The results suggest that orthostatic hypotension in these patients is related to baroreflex dysfunction. However, baroreflex dysfunction does not appear to be a factor in the development of hypertension in these patients, although more studies with normotensive diabetic patients are needed to confirm this point.     

Significance of ST-segment and T wave changes in the resting electrocardiograms of patients with exertional angina, studied by exercise radionuclide angiocardiograms

In order to investigate the clinical significance of ST-T changes in resting ECG in angina pectoris, symptom-limited ergometer exercise radionuclide angiocardiography with ECG was performed in 60 patients with exertional angina. In those with normal ECG at rest (Group N), left ventricular ejection fraction (EF) did not change during exercise (71 +/- 5% to 71 +/- 6%). In those with only ST change at rest (Group ST) and those with only T change at rest (Group T), EF decreased significantly during exercise (68 +/- 5% to 63 +/- 7%, p less than 0.01; 68 +/- 6% to 61 +/- 7%, p less than 0.001). In those with ST and T changes at rest (Group ST + T), EF was low at rest (58 +/- 11%) and decreased further at exercise (52 +/- 8%, p less than 0.001). In those whose negative or flat T wave became more negative during exercise, EF was low both at rest and at exercise. In conclusion, ST and T changes at rest in patients with exertional angina might suggest a depressed reserve of myocardial function for exercise.     

Relationship between the extent of the hypoperfused zone of the myocardium and the occurrence of ventricular fibrillation

Ventricular fibrillation and subsequent death frequently occur so soon after coronary artery occlusion that infarct size cannot be determined; thus the systematic study of their relationship is impossible. Recently, however, a technique has been developed that permits the assessment, in vivo, of the extent of the myocardial hypoperfused zone (HZ). Accordingly, in 55 open-chest dogs, 99mTc-labeled (8 mCi) albumin microspheres (15 microns in diameter) were injected into the left atrium 1 minute after coronary artery occlusion. The zone of hypoperfusion was analyzed in 28 dogs that had ventricular fibrillation (group A) and 27 dogs that had no ventricular fibrillation (group B). In group B, the HZ was 26.3 +/- 1.7% of the left ventricle vs 31.6 +/- 1.3% of the left ventricle in group A (p less than 0.05), showing that ventricular fibrillation occurred in dogs with larger zones of hypoperfusion.     

Transesophageal cross-sectional echocardiography

A transesophageal cardiac imaging system is described. This system employs hand-held mechanical sector and linear scanners each having a flexible tube and a small ultrasonic transducer contained within a small oil bag easily swallowed by adults. In the sector scanner, a small transducer in the esophagus rotates alternately and horizontal heart images are displayed. In the linear scanner, a small transducer in the esophagus moves up and down and vertical heart images are displayed. The system was evaluated in 31 adult subjects. In all subjects, stable high quality heart images were observed continuously from base to apex as the transducer was being withdrawn or advanced in the esophagus. In horizontal scans, entire heart images were observed at the level of the atrioventricular valves. In vertical scans, the bifurcation of the pulmonary artery could be observed clearly. There was little difference in the image quality among subjects.     

Identification of estradiol in the ovaries of the silkworm, Bombyx mori

Estradiol was extracted and partially purified from the ovaries of the silkworm, Bombyx mori. Identification of estradiol was done by use of radioimmunoassay (RIA) and by gas chromatography-mass spectrometry (GC-MS) after derivatization into the ethyldimethylsilyl derivative. Concentration of estradiol in the ovaries was estimated to be 176 pg/g (RIA) and 63 pg/g (GC-MS).