Acute Myocardial Infarction in a Discrete Coronary Artery Aneurysm Without Obstruction

We report an unusual case of acute myocardial infarction attributable to obstruction of a discrete coronary aneurysm in a 54-year-old man. Although coronary angioplasty and thrombolysis were unsuccessful, serial arteriography showed spontaneous recanalization, and no spasm was induced by ergonovine. We discuss its mechanism.     

Efficacy of a Novel Prophylactic Barbiturate Therapy for Severe Traumatic Brain Injuries: Step-down Infusion of a Barbiturate with Normothermia

This study aimed to examine the beneficial effects of a novel prophylactic barbiturate therapy, step-down infusion of barbiturates, using thiamylal with normothermia (NOR+sdB), on the poor outcome in the patients with severe traumatic brain injuries (sTBI), in comparison with mild hypothermia (MD-HYPO). From January 2000 to March 2019, 4133 patients with TBI were admitted to our hospital. The inclusion criteria were: a Glasgow coma scale (GCS) score of ≤8 on admission, age between 20 and 80 years, intracranial hematoma requiring surgical evacuation of the hematoma with craniotomy and/or external decompression, and patients who underwent management of body temperature and assessed their outcome at 6–12 months. Finally, 43 patients were included in the MD-HYPO (n = 29) and NOR+sdB (n = 14) groups. sdB was initiated intraoperatively or immediately after the surgical treatment. There were no significant differences in patient characteristics, including age, sex, past medical history, GCS on admission, type of intracranial hematoma, and length of hospitalization between the two groups. Although NOR+sdB could not improve the patient’s poor outcome either at discharge from the intensive care unit (ICU) or at 6–12 months after admission, the treatment inhibited composite death at discharge from the ICU. The mean value of the maximum intracranial pressure (ICP) in the NOR+sdB group was <20 mmHg throughout the first 120 h. NOR+sdB prevented composite death in the ICU in patients with sTBI, and we may obtain novel insights into the beneficial role of prophylactic barbiturate therapy from suppression of the elevated ICP during the first 120 h.     

Coronary Artery Spasm Induced by Ergonovine in an Infarct Related Coronary Artery Late After Primary Angioplasty

We report two cases with induced coronary spasm of the culprit lesion in the infarct related coronary artery in the chronic phase after primary percutaneous transluminal coronary angioplasty (PTCA). To our knowledge, there are few data on the response of the angioplasty site to ergonovine in human coronary arteries after primary PTCA. It is important to note that chest pain recurring after successful primary PTCA is not automatically related to restenosis, and coronary spasm in patients with previous myocardial infarction, should also be considered . (J Interven Cardiol 2000;31–34)     

The delay time of tooth vibration signal recorded at facial skin surface

The onset of a tooth vibration signal with a mini acceleration pickup attached to the skin on the forehead was delayed by 0.1788 ms on average after the actual tooth impact. When the signal was recorded at the zygomatic arch, the delay time was 0.1008 ms on average, which was significantly shorter than that obtained from the forehead (P < 0.001). The difference due to a transposition of the vibrated tooth was also smaller (0.025 < P < 0.05) and had almost no effect on the intensities of the tooth flipping force. The delay time was even more prolonged when a poor frequency specification pickup and/or low pass filter were applied.     

An excitatory response preceding the silent period in masseter electromyographs

A masseteric excitatory reflex response preceding the silent period which appears following tapping movement of the jaw, was investigated in order to evaluate its origin. In the pre-anaesthetic state, the latency of response did not change with the intensity of tapping. However, its amplitude increased depending on the intensity of tapping. The response did not disappear even after the anaesthesia. After the anaesthesia the lighter the intensity of tapping was, the longer the latency of the response, coming up to that of the jaw-jerk reflex. The pre-anaesthetic response had an intricate wave form comparing with the post-anaesthetic one. From the above findings it was concluded that the response must be a complex one in nature originating in the muscle spindle of jaw closing muscles and in a certain receptor of the structures surrounding the tooth.