Left atrial appendage function in patients with nonrheumatic atrial fibrillation

In this study, 36 patients with non-rheumatic AF and 10 healthy subjects were investigated. The patients were subjected to thorough history taking, thorough clinical examination, plain X-ray chest to assess the cardiothoracic ratio and pulmonary vasculature, 12-lead surface ECG to define the patient's rhythm, rate and type of AF [course or fine], transthoracic echocardiographic examination and transesophageal echocardiography. The flow pattern of all patients and normal subjects was assessed by transesophageal pulsed wave and color Doppler and two distinct flow patterns were recorded [low flow pattern in 18 patients and high flow pattern in 18 patients]. This study confirmed that LAA is a highly contractile dynamic pump with a pattern of contraction that is quite distinct from that of the main body of the LA. LAA thrombus formation is associated with LAA dilatation, decreased LAA EF percentage and slow forward and backward velocity

nails - a review

In this part of "The Nails -A Review", the anatomy of the nail is demonstrated. Some nails affection is discussed. To start with, we covered in short, some main topics as abnormal nail discoloration which included most leukonychial nail affections and some causes of melanonychia, subungual melanoma, yellow nail syndrome and nail discoloration from drugs as well as some rare congenital causes of nail discoloration. Hereditary diseases involving the nails especially those associated with atrophic changes, total and partial absence of nails, hypertrophic congenital nail changes and periungual involvement were briefly discussed. We tried to illustrate these conditions by available photographs. This could help as a quick short reference to these nails changes. To start with, it is important to know clearly the anatomy of the nail unit in order to understand the nail affection in disease

Telangiectasia macularis eruptiva perstans [TMEP] case report with review of the literature

The most frequently affected organ in any form of mastocytosis is the skin [1]. Cutaneous lesions tend to appear early in life and include urticaria pigmentosa, mastocytoma, diffuse and erythematous Cutaneous mastocytosis and Telangiectasia Macularis Eruptiva perstans [2, 3]. Telangiectasia Macularis Eruptiva Perstans is observed in less than 1 % of cases of mastocytosis [4]. Although cutaneous mastocytosis appears to occur sporadic, yet familial incidence was reported as four cases of telangiectasia macularis eruptiva perstans appearing in three generations of one family with an autosomal dominant mode of transmission with incomplete penetrance [5]. Telangiectasia macularis eruptiva perstans is characterized by telangiectatic reddish brown macules usually on the trunk, pruritus [6] with little tendency to urticate [7]. Telangiectasia macularis eruptiva perstans is mostly seen in adults and is occasionally seen in children or infants[8] The classic symptoms in Telangiectasia macularis eruptiva perstans include episodic flushing, gastrointestinal complaints, heart palpitation, syncope and may be confused with carcinoid [8]. We present a case of telangiectasia macularis eruptiva perstans in an adult and discuss its diagnosis and mastocytosis in general and its management