主动脉窦动脉瘤破裂10例临床分析

本文分析10例主动脉窦动脉瘤破裂的临床表现,提出早期诊断要点。多数患者为突起胸痛、心悸、气促、相继出现心力衰竭,并在胸骨左缘3～4肋间可闻及连续性机器样杂音。超声心动图、X线、心电图等检查异常,必要时心导管或心脏造影检查,便能确诊。且应与动脉导管未闭、主动脉肺动脉间隔缺损,空间隔缺损并主动脉瓣闭锁不全相鉴别。     

鼻窦肿瘤的CT诊断与临床对照分析

由于鼻窦解剖部位隐蔽，鼻窦良恶性肿瘤早期临床表现较少，除一般炎症症状外少特异性，但它们的治疗方法尤其是手术方式却截然不同。CT检查具有密度分辨力高、解剖关系明确等特点，能早期对鼻窦肿瘤作定位诊断。本文报告的42例鼻窦肿瘤病者，定位正确者为38例，占90.48％。在肿瘤定性方面，CT对肿瘤良恶性的鉴别力也较高。但是由于各种肿瘤CT表现无明显特点，故定性诊断仍较困难。且对于体积小肿瘤及微小的骨质破坏，CT也有局限性。因此CT检查要结合临床特点，体格检查及其他辅助检查，以提高CT的诊断准确率。     

Ruptured sinus of Valsalva aneurysm in children: Report of two cases and literature review

Two children with ruptured sinus of Valsalva aneurysm are described, each with a ventricular septal defect, and in one there was also an associated discrete subvalvular aortic stenosis. The diagnostic appearance of two-dimensional echocardiography and axial angiocardiography are emphasized to allow early diagnosis and surgical repair. A literature review of recent reports in English disclosed that 13 patients under age 20 had been reported to have ruptured sinus of Valsalva aneurysm.     

Electrical activity in canine sinus node cells during arrest produced by acetylcholine

Acetylcholine (ACh) in concentrations above 0.1 μg/ml causes temporary arrest of the heart since it (1) suppresses sinus node automaticity and (2) blocks sino-atrial conduction. These two factors appear simultaneously and it has been difficult to decide if one or if both of them remain in force throughout the period of atrial arrest. By using microelectrodes in the isolated, perfused canine sinus node we recorded transmembrane potentials during normal sinus rhythm, atrial pacing, and atrial arrest. Automaticity (the rate of subthreshold impulse generation) recovered within the first minute after ACh but sinoatrial conduction of the impulses remained suppressed; action potential amplitude was less than 30 mV. Sinoatrial conduction was restored 1 ± 0.5 min later as the sinus node action potentials reached amplitudes exceeding 30 mV. Therefore, the chronotropic and dromotropic effects of ACh appear to be two separate changes, each being demonstrated independently.     

Reversible bilateral thalamic lesions caused by primary internal cerebral vein thrombosis: a case report

Summary The case is reported of a patient with primary thrombosis of the internal cerebral veins who presented initially with unilateral and later developed bilateral thalamic lesions revealed by computed tomography. Magnetic resonance imaging and angiography confirmed the diagnosis. Upon anti-coagulation the patient recovered nearly completely.     

Cardiac Response to Simple Stimuli as a Function of Phase of the Respiratory Cycle

To evaluate respiratory effects on the cardiac response to simple stimuli, 10 female subjects were presented with a series of 20 100 dB tones with stimulus onset occurring at either peak expiration or peak inspiration. The heart rate response at peak inspiration is quartic in form (deceleration-acceleration-deceleration- acceleration) and differs significantly from that obtained at peak expiration which is cubic in form (acceleration-deceleration -deceleration-acceleration). These differences can be eliminated, however, by subtracting heart rate values obtained during control periods from the heart rate response to stimulation.     

MYO-MAP—a fast recording system for epicardial mapping

A low cost device for epicardial mapping, ‘MYO-MAP’ has been developed in order to shorten the mapping procedure time. It was designed using a relatively simple analogue network, combined with a spring loaded bioelectrode. The MYO-MAP can be used in the operating room to locate a reentry circuit, causing ventricular or supra-ventricular tachycardia. Initial results indicate that the reentry front can be rapidly detected using this technique.     

Primary intracranial germ cell tumours

Summary A histological study has been made of a retrospective series of 17 primary intracranial germ cell tumours found in a collection of 3550 intracranial neoplasms (incidence of 0.48%). All, except for two differentiated teratomas (one extracerebral in a neonate and another in the lateral ventricle), were situated in the midline in persons aged 5 to 37 years (13 males, 4 females). 12 tumours were located in or originated from the (para)pineal region, two of them also invaded the hypothalamus, while three germinomas occupied the retrochiasmal (supra/intrasellar) region without pineal involvement. There were 11 rather pure tumours (7 germinomas, 4 teratomas of various differentiation) and six mixed neoplasms (2 germinomas with teratoid areas, 3 embryonal carcinomas containing elements of endodermal sinus tumour, choriocarcinoma and germinoma, and one teratocarcinoma with endodermal sinuses). Only one case showed prominent features of endodermal sinus tumour, but characteristic elements of this type were present in four other mixed tumours. All germinomas and germinomatous parts of mixed neoplasms showed an inflammatory reaction of varying intensity, in 6 cases associated with multinucleated giant cells, which may be related to the prognosis of these tumours (one patient with hypothalamic germinoma is alive 6 years after radiotherapy). The close structural similarities between the various types of intracranial and gonadal dysgerminomas and their frequent combination within the same tumour support the concept of a common histogenesis of germ cell tumours regardless of their site of origin. Difficulties of classification may arise from the rather frequent occurrence of mixed germ cell neoplasms.Dedicated to E. Frauchiger, on the occasion of his 70th anniversary.     

Proptosis secondary to pneumocele of the maxillary sinus

Summary The third known case of a pneumocele of the maxillary sinus is reported. Radiographic findings included hyperlucency of a maxillary sinus with generalized expansion of its borders. Bone dehiscence was also visible with tomography. The present case emphasizes a gradual onset of clinical signs manifested primarily by proptosis. Possible mechanisms in the production of this deformity are discussed.