Acute pericarditis presenting with sinus bradycardia: A case report

Acute pericarditis is almost invariably associated with sinus tachycardia. Recent-onset chest pain in the presence of (sinus) bradycardia is considered to be associated with an acute ischemic syndrome rather than acute pericarditis. This report describes a patient with acute pericarditis initially presenting with sinus bradycardia, probably due to a vasovagal response to (chest) pain.     

Radiologic identification of disaster victims: a simple and reliable method using CT of the paranasal sinuses

Objective

To assess the reliability of radiologic identification using visual comparison of ante and post mortem paranasal sinus computed tomography (CT).

Subjects and methods

The study was approved by the responsible justice department and university ethics committee. Four blinded readers with varying radiological experience separately compared 100 post mortem to 25 ante mortem head CTs with the goal to identify as many matching pairs as possible (out of 23 possible matches). Sensitivity, specificity, positive and negative predictive values were calculated for all readers. The chi-square test was applied to establish if there was significant difference in sensitivity between radiologists and non-radiologists.

Results

For all readers, sensitivity was 83.7%, specificity was 100.0%, negative predictive value (NPV) was 95.4%, positive predictive value (PPV) was 100.0%, and accuracy was 96.3%. For radiologists, sensitivity was 97.8%, NPV was 99.4%, and accuracy was 99.5%. For non-radiologists, average sensitivity was 69.6%, negative predictive value (NPV) was 91.7%, and accuracy was 93.0%. Radiologists achieved a significantly higher sensitivity (p < 0.01) than non-radiologists.

Conclusions

Visual comparison of ante mortem and post mortem CT of the head is a robust and reliable method for identifying unknown decedents, particularly in regard to positive matches. The sensitivity and NPV of the method depend on the reader's experience.     

内镜引导下的鼻窦窦口球囊扩张术

鼻窦窦口球囊扩张术是近年来发展的一种新的微创手术方法.该方法在内镜引导下,经导管将球囊管放置于相应的鼻窦口处,球囊管注水充盈后致鼻窦口及邻近组织扩张,起到扩张鼻窦口促进鼻窦引流的作用,以达到治疗目的.由于整个手术过程中,无撕、拉、切、割组织的动作,相对于其他鼻腔鼻窦手术方法而言,可称为真正意义上的微创手术.本文就鼻窦窦口球囊扩张术的原理、手术方法、临床应用、手术适应证与禁忌证,以及目前对该术式的认识等进行概要介绍.     

Electrophysiological effect of overdrive suppression and combined autonomic blockade with propranolol and atropine in patients with sinus node dysfunction

The phenomenon of sinus node depression and recovery after rapidatrial pacing was studied in 36 patients before and after thecombined administration of atropine and propranolol. Sinus noderecovery time was measured, and the first 10 cycles followingcessation of atrial pacing (‘secondary phase’) wereevaluated. During the pharmacological test, the observed intrinsicheart rate was compared with theoretical values. Altered electrophysiological parameters were observed duringthe post-stimulation sinus node depression in all patients havingan abnormal intrinsic heart rate. In patients with a normal intrinsic heart rate the electrophysiologicalstudy of the sinus node gave either normal or abnormal results.In the latter case, the possibility that altered electrophysiologicalparameters could result from functional' sinus node dysfunctionis to be considered. Although the intrinsic heart rate may benormal, pacemaker cells could have disorders of their intrinsicelectrophysiological mechanisms. Abnormalities observed duringthe secondary phase after autonomic blockade in patients witha previously unaltered post-stimulation recovery phase stronglysupport such a view. This study emphasises the diagnostic valueof the behaviour of the secondary phase to distinguish betweenfunctional sinus node disorders and organic changes of the pacemakercells.     

Sinus histiocytosis with massive lymphadenopathy (Rosai-Dorfman disease): report of a patient with isolated renotesticular involvement after cure of non-Hodgkin's lymphoma

 Sinus histiocytosis with massive lymphadenopathy (SHML) – Rosai-Dorfman disease – is a rare but well-defined benign histiocytic proliferative disorder. We report an unusual patient, cured of non-Hodgkin's lymphoma, who presented 12 years later with renotesticular SHML associated with IgA monoclonal gammopathy, but without any evidence of relapsed lymphoma. The genitourinary manifestations of this disorder with massive lymphadenopathy and its rare association with malignant lymphoma are reviewed. Received: 4 July 1996 / Accepted: 25 September 1996     

国产封堵器介入治疗主动脉窦瘤破裂四例

自从1840年Thumam报道了第1例主动脉窦瘤破裂（rupturedsinusofvalsalvaaneurysm,RSVA）以来,外科手术曾是治疗RSVA的主要方法。随着介入治疗的发展,一些RSVA也成功进行了介入封堵治疗。由于病例有限,RSVA介入封堵的适应证仍在探讨之中,远期疗效也有待于观察。我们近年来成功使用过程封堵器对4例伴或不伴室间隔缺损的RSVA患者成功进行介入封堵,现报告如下。     

抑郁对心绞痛型冠心病患者心率震荡的影响

目的：探讨抑郁对心绞痛型冠心病患者心率震荡（HRT）的影响。方法纳入2008年1月~2012年2月苏州市吴江第一人民医院心绞痛型冠心病患者78例,应用Zung抑郁自评量表（SDS）评定抑郁状况,其中不合并抑郁（SDS评价＜50）的40例患者作为对照组,合并抑郁患者38例作为观察组,并根据SDS评分将观察组进一步分为轻度抑郁组（50≤SDS评分＜60,n=14）、中度抑郁组（60≤SDS评分＜70,n=14）、重度抑郁组（SDS评分≥70,n=10）。所有入选患者均于入组时接受动态心电图检查,测量窦性HRT的参数,包括震荡起始（heart rate turbulance onset,TO）和震荡斜率（heart rate turbulence slope,TS）,比较两组之间的差异。结果观察组TO较对照组显著升高[（2.16±1.06）%vs.（1.54±0.68）%,P=0.027],TS较对照组患者显著降低[（2.33±1.95）ms/RRIvs.（4.47±3.89）ms/RRI, P=0.014]。观察组亚组分析显示,随着抑郁程度加重,TO逐渐升高而TS逐渐降低。结论抑郁可导致冠心病患者心率震荡明显减弱,抑郁程度越重,HRT减弱越明显。     

乳兔窦房结细胞的分离及鉴定

目的 乳兔窦房结细胞（sinus node cell,SNC）的分离、纯化、培养与鉴定.方法 选用新生新西兰乳兔5只,采用双酶解法对细胞进行消化分离,差速贴壁结合5-BrdU对分离的细胞进行纯化培养,观察SNC形态变化并采用全细胞膜片钳技术对SNC进行动作电位的记录.结果 培养得到的SNC主要有3种形态：梭形、三角形与不规则形,而梭形细胞最多,搏动频率最快,符合窦房结细胞的特征.采用膜片钳技术记录10个梭形细胞的动作电位中,平均最大舒张电位为（-50.9±5.3）mV,动作电位幅度为（61.9±4.8）mV.结论 采用双酶解、差速贴壁及BrdU对乳兔窦房结细胞进行消化、分离可得到纯化的SNC,此种方法得到的SNC状态活性良好,且具有典型特征的动作电位.     

Association of Left Ventricular Diverticula and Sinus Venosus Atrial Septal Defect

Left ventricular diverticula are congenital anomalies and are not as rare as previously thought. In adults, cardiac diverticula are generally accidental findings during imaging modalities, but concomitant disorders might frequently coexist. The pathophysiology, management, prognosis, and natural history of cardiac diverticula remain poorly understood and controversial. Definite diagnosis is often challenging due to similarities in appearance to other more common anomalies such as aneurysms, pseudoaneurysms, endocarditis, cysts, and hypertrophied trabeculations. We herein report a rare case of an adolescent presenting with sinus venosus atrial septal defect, partial anomalous venous connection, and left ventricular diverticula.     

不同频率电刺激内脏大神经传入纤维的血压效应

内脏大神经含有丰富的传入纤维,它在传导腹腔内脏器官活动信息方面起着重要的作用。用固定的刺激强度或频率电刺激不同动物的内脏大神经中枢端,可引起血压降低或升高。另外,动脉压力感受器传入可抑制刺激躯体神经传入纤维所致的交感神经传出冲动。切断狗双侧窦神经和主动脉神经(或颈