Assessment of Left Ventricular Volumes and Function by Real Time Three‐Dimensional Echocardiography in a Pediatric Population: A TomTec versus QLAB Comparison

Background: Three‐dimensional echocardiography (3DE) allows accurate calculation of ventricular volumes despite a remaining geometric assumption on the ventricular shape. Few studies involving full volume reconstruction software have been performed on children. Our aim was to compare the left ventricular (LV) volume measurements obtained with the most used 3D analysis software in a pediatric population. Methods: Fifty patients (median age: 9.5 years) without cardiac disease were included in the study. 3DE was performed with the X4–2 or X7–2 matrix probe (ie33, Philips). The LV volume analysis was performed with QLAB 6.0 (semiautomated border detection) and TomTec 4D LV (primary manual tracking with semiautomated border detection). Results: TomTec analysis feasibility amounted to 94% whereas QLAB analysis feasibility only reached 80% (P = 0.037). The analysis time was shorter with QLAB than TomTec (5 ± 2 versus 6 ± 3 minutes, P < 0.05). The stroke volume, end diastolic and end systolic LV volume measurements performed on the 40 patients were strongly correlated (r > 0.97; P < 0.0001) with minimal bias. The LV ejection fraction was well correlated (r = 0.79; P < 0.0001). Conclusion: 3D LV volume quantification is feasible either by using manual or automated reconstruction software in a normal pediatric population. LV Measurements are well correlated. Differences in volume reconstruction algorithms provide specific software performance characteristics. TomTec is a more feasible method but requires a longer analysis time. Further studies are needed to validate the accuracy of the method to calculate enlarged LV volumes in patients with congenital heart diseases. (Echocardiography 2010;27:1263‐1273)     

Benign non-specific ulcer of the colon. 3 new cases

Three cases of solitaries ulcers of the colon verified by an anatomo-pathological examination of the excision piece are presented. The accent is put on the research of an etiologic factor. The part of a vascular pathology appears probable without been proved. In the ignorance in which we are, for the while, of the natural history of these ulcers, the treatment by surgical excision is justified to prevent acute complications.     

Postural challenge and adaptation to vibration-induced disturbances

The described experiment investigated whether adaptation to successive Achilles tendon vibration depends on the postural challenge. In phase 1, thirty-six participants were divided into three groups, each with a different postural challenge. After being blindfolded, participants received 15 trials of Achilles tendon vibration (10 s–90 Hz) while standing upright in either a free-standing condition (FS group), a light finger touch condition (LFT group), or a restrained-standing condition (RS group) in which a dorsal stand prevented body displacement. In phase 2, all participants were freely standing and received 15 additional trials of vibration. Antero-posterior trunk tilt was measured at the level of the trunk (C7). Although there were limited postural readjustments in LFT, adaptation was observed in phase 1 in both FS and LFT groups. In phase 2, the evoked postural displacement was greater in the RS group than in the other two groups. We concluded that although the absence of any postural challenge concomitant to the sensory stimulation prevented adaptation to occur, a minimal challenge was sufficient.     

Zollinger-Ellison syndrome of ovarian origin. Apropos of a case with a review of the literature

We report a case of Zollinger-Ellison syndrome due to secretory G and D cells in an ovarian mucinous cystadenoma. Surgical resection of the tumour led to disappearance of clinical symptomatology and laboratory signs. Four other cases were found in the literature. The prognosis of the Zollinger-Ellison syndrome, due to a secretory ovarian tumour, appears to be favourable after oophorectomy.     

EMMPRIN/CD147 is an independent prognostic biomarker in cutaneous melanoma

CD147 has been implicated in melanoma invasion and metastasis mainly through increasing metalloproteinase synthesis and regulating VEGF/VEGFR signalling. In this study, the prognostic value of CD147 expression was investigated in a cohort of 196 cutaneous melanomas including 136 consecutive primary malignant melanomas, 30 lymph nodes, 16 in‐transit and 14 visceral metastases. A series of 10 normal skin, 10 blue nevi and 10 dermal nevi was used as control. CD147 expression was assessed by immunohistochemistry, and the association of its expression with the clinicopathological characteristics of patients and survival was evaluated using univariate and multivariate statistical analyses. Univariate analysis showed that high CD147 expression was significantly associated with metastatic potential and with a reduced overall survival (P < 0.05 for both) in primary melanoma patients. CD147 expression level was correlated with histological factors which were associated with prognosis: Clark level, ulceration status and more particularly with Breslow index (r = 0.7, P < 10^?8). Multivariate analysis retained CD147 expression level and ulceration status as predicting factors for metastasis and overall survival (P < 0.05 for both). CD147 emerges as an important factor in the aggressive behaviour of melanoma and deserves further evaluation as an independent prognostic biomarker.