Coronary Artery Embolism: Two Case Reports and a Review of the Literature

Coronary embolism (CE) is an uncommon and unique cause of acute myocardial infarction. In this report, we review 216 cases of CE including 2 new cases from our institution. The mean patient age was 52.5 years and 62% of the patients were males. Chest pain was the most common presenting symptom followed by dyspnea, and the most commonly affected vessel was the left anterior descending artery. Leading etiologies of the embolus were atrial fibrillation, septic emboli, and iatrogenic causes. Treatment approaches varied with thrombus aspiration being used in 30% of cases. In-hospital mortality rate was 36% and 13% of the cases were complicated by cerebrovascular accident. CE is a unique pathology that leads to acute myocardial infarction. It portends a high mortality rate and requires a high level of suspicion as symptoms may be misleading. Further research is needed in order to improve recognition and management and to lower associated mortality.     

The Presence of Portal Vein Thrombosis Alters the Classic Enhancement Associated with Diagnosis of Hepatocellular Carcinoma

Digestive Diseases and Sciences - To determine whether the presence of portal vein thrombosis (PVT) where venous flow within the liver may be altered may delay the diagnosis of HCC and be...     

维吾尔药玫瑰花口服液结合西药治疗44例心血管疾病的疗效观察

冠心病、高血压、心律失常等心血管疾病作为现代社会的多发病和常见病，已经引起医学界的广泛关注和高度重视。维吾尔医药基于维吾尔医药的特有理论和丰富的经验，借助现代医学先进的诊疗技术和科学手段，对部分常见的心血管疾病进行了大量的临床观察和深入的研究，取得了许多独具特色的成功经验和科研成果。我院在临床上自1991年开始应用玫瑰花口服液治疗心血管疾病，疗效显著。现仅在2005年治疗心血管疾病中随机抽样进行疗效观察。     

新疆维吾尔族慢性胃炎患者HLA-DRB1等位基因与幽门螺杆菌感染的关系

目的研究新疆维吾尔族慢性胃炎患者HLA-DRB1等位基因与幽门螺杆菌（Hp）感染的关系。方法采用幽门螺杆菌分离培养技术检测33例维吾尔族慢性胃炎患者幽门螺杆菌感染情况,采用PCR-SSP检测HLA-DRB1＊0405、HLA-DRB1＊08、HLA-DRB1＊12等位基因,并与36例汉族慢性胃炎患者进行比较。结果1）新疆维吾尔族慢性胃炎患者Hp阳性率（78.8%）显著高于汉族慢性胃炎患者（58.3%）（P〈0.05）;2）维吾尔族、汉族慢性胃炎患者Hp感染与HLA-DRB1＊0405、HLA-DRB1＊08、HLA-DRB1＊12等位基因无相关性（P〉0.05）。结论1）维吾尔族慢性胃炎患者Hp感染率高于汉族慢性胃炎患者;2）维吾尔族、汉族慢性胃炎患者Hp感染与HLA-DRB1＊0405、HLA-DRB1＊08、HLA-DRB1＊12等位基因无关。     

A role of insular cortex in cardiovascular function

We sought to determine whether the insular cortex contributes to the regulation of arterial blood pressure (AP). Responses to electrical and chemical stimulation of the cortex were studied in the anesthetized, paralyzed, and artificially ventilated Sprague-Dawley rat. The insular cortex was initially defined, anatomically, by the distributions of retrogradely labeled perikarya following injections of wheat germ agglutinin-horseradish peroxidase (WGA-HRP) into the nucleus tractus solitarii (NTS). Injections of WGA-HRP into the insular cortex anterogradely labeled terminals in cardiopulmonary and other divisions of the NTS and confirmed projections revealed by retrograde tracing experiments. Electrical stimulation of the insular cortex elicited elevations of AP (less than or equal to 50 mm Hg) and cardioacceleration (less than or equal to 40 bpm). The locations of the most active pressor sites corresponded closely to the locations of retrogradely labeled cells in layer V of granular and posterior agranular areas of the insular cortex (areas 14 and 13) and the extreme capsule. Maximal pressor responses were obtained at a stimulus intensity of three to five times threshold current of 20-30 microA. Responses elicited mostly with higher-threshold currents were also mapped in areas 2a and 5lb and the claustrum and within the corpus callosum. Unilateral injections into the insular pressor area of the excitatory amino acid monosodium glutamate (L-Glu; 0.05 nmol to 10 nmol) or the rigid structural analogue of L-Glu, kainic acid (KA) (0.4 nmol) (which specifically excite perikarya), caused topographically specific elevations in AP and tachycardia. During the course of the anatomical transport studies, new findings were obtained on the organization and characteristics of the cortical innervation of the NTS and the nucleus reticularis parvocellularis. Topographic relationships between the cortex and the NTS were organized in a more complex manner than previously thought. Cells projecting to caudal cardiopulmonary segments of the NTS were fewer and generally located ventrally and caudally and in a more restricted area than cells projecting rostrally or to the parvicellular reticular formation. Anterograde transport data revealed new presumptive terminal fields in dorsolateral, ventral, periventricular, and commissural regions of the NTS, including an area overlapping the terminal field of the aortic baroreceptor nerve. We conclude that neurons within an area of the insular cortex projecting to multiple brainstem autonomic nuclei, including a region of the NTS innervated by baroreceptor afferents, increase arterial blood pressure and heart rate.(ABSTRACT TRUNCATED AT 400 WORDS)     

The surgical removal of mandibular third molars: a study in decision making.

OBJECTIVE: The aim of this study was to investigate and analyze the angulation of and the various indications for removal of mandibular third molars in Jordanians as a representative Arab sample. METHOD AND MATERIALS: The data included in this retrospective study were obtained from the clinical and radiographic records of 1,282 patients undergoing mandibular third molar surgery during a 5-year period from 1994 to 1999. The indications for removal of the mandibular third molars were classified in accordance with age and gender. The angular position of mandibular third molars was registered. RESULTS: A total of 2,252 mandibular third molars were removed from 740 male patients (57.7%) and 542 female patients (42.3%) aged 14 to 67 years. Pericoronitis was the most common indication for surgery, affecting 1,055 teeth (46.8%). Caries was observed in 519 third molars (23.0%). The vertical angular position was most commonly found (1,383 teeth; 61.4%) followed by the mesioangular position (407 teeth; 18.1%). CONCLUSION: The results obtained in this study are similar to those reported in earlier studies carried out elsewhere, although the incidence of periodontitis among Jordanians was significantly higher and occurred in older patients, and prophylactic removal was performed less frequently than has been reported in other countries.