Résumé
BACKGROUND: Patients with chronic glomerulonephritis(CGN) have several risk factors for atherosclerosis including hypertension, renal functional disturbance, and lipid abnormality. The purpose of this study was to evaluate the intima-media thickness of carotid arteries and its association with a number of known risk factors for atherosclerosis in patients with CGN. METHODS: Twenty four patients with CGN underwent B-mode ultrasound of the carotid arteries with 10 MHZ linear array probe. The intima-media thickness(IMT) was measured at two sites of far(posterior) wall of both common carotid artery and bifurcation, and the incidence of atherosclerotic plaque was examined. According to renal function, patients with CGN were divided into two groups, one group with normal renal function and the other group with decreased renal function. Normal control consisted of 36 healthy persons. RESULTS: Intima-media thickness of left bifurcation of carotid artery in CGN group with decreased renal function was significantly thicker than those of CGN group with normal renal function and normal control group(p<0.05). Multiple regression analysis showed that increased intima-media thickness of carotid artery in CGN group was positively correlated to only age. CONCLUSION: The results suggest that intima- media thickness of carotid artery in patients with CGN is thicker as renal function decrease and other risk factors of atherosclerosis as well as age may influence intima-media thickness of carotid arteries.
Sujets)
Humains , Athérosclérose , Artères carotides , Artère carotide commune , Glomérulonéphrite , Hypertension rénale , Incidence , Plaque d'athérosclérose , Facteurs de risque , ÉchographieRésumé
The diagnosis of dilated cardiomyopathy associated with pheochromocytoma was made in a 24 year old male on the basis of symptoms and signs, measurements of metabolites of catecholamine,echocardiography and radionuclide ventriculography were preformed and demonstrated. The presence of a tumor on both adrenal glands without definite distant metastasis was demonstrated by abdominal ultrasonography, CT scanning and 131I-MIBC scintigraphy. Surgical removal was performed after proper preoperative preparation with a-adrenergic blocker. During the surgery, neither significant arrhythmia nor severe change of blood pressure was observed. After surgery, cardiac function of the patient improved slowly and progressively.
Sujets)
Humains , Mâle , Jeune adulte , Glandes surrénales , Troubles du rythme cardiaque , Pression sanguine , Cardiomyopathie dilatée , Diagnostic , Métastase tumorale , Phéochromocytome , Scintigraphie , Ventriculographie isotopique , Chirurgie thoracique , Tomodensitométrie , ÉchographieRésumé
Cardiovascular changes has been reported eating and digestion. Experimental studies showed an early rise in cardiac output during eating which was attributable to an increased heart rate. This changes reverted to baseline valuse at the end of eating. To investigate postprandial cardiac functional change, we studied 20 healthy young men(average age 27 years) nonivasively with BP measurement, electrocardiography and M-mode echocardiohrapy before, 30 minutes and 3 hours after a lunch(600 Kcal). There was no significant changes in mean blood pressure after eating. On echocardiography, diastolic and systolic left ventricular internal dimensions were 4.9+/-0.4 and 3.1+/-0.4cm before meal and 4.9+/-0.4 and 2.9+/-0.3cm 30 minutes after eating. There was an average increase of 9% in cardiac output 30 minutes after meal. Fractional shortening was 36.4+/-6.4% before meal and 40.4+/-6.1(p<0.05) 30 minutes after eating. Ejection fraction changed from 73.5+/-7.9% to 78.2+/-6.3%(p<0.05) at postprandial 30 minutes. Myocardial contractility index assessed by the ratio of systolic BP to end-systolic volume was 4.3+/-1.6mgHg/ml before and 5.3+/-2.2mmHg/ml 30 minutes after eating. Peripheral resistance index as the ratio of mean blood pressure divided by cardiac index changed from 2,536+/-1,120dynesdSdcm-5/m2 to 2,048+/-472dynesdSdcm-5/m2 at postprandial 30 minutes. Electorcardiographic study revealed no changes in ST SE segment, T wave and heart rate after a meal. In conclusion, the increase of cardiac output after a moderate meal in healthy young men was associated with an increase in myocardial contractility and a decrease in peripheral vascular resistance.
Sujets)
Humains , Mâle , Pression sanguine , Débit cardiaque , Digestion , Consommation alimentaire , Échocardiographie , Électrocardiographie , Rythme cardiaque , Repas , Résistance vasculaireRésumé
Multiple level laminectomies are a destructive procedure complicating kyphosis, anterior subluxation and instability of the spine in children. The surgical procedure of multiple level osteoplastic laminotomies was proposed as an alternative by Raimondi et al in 1976. The goal is preservation of the normal architecture of the spine in patients who are still developing. We have experienced a case of multiple level laminotomies(T4-T11) for removal of epidural neuroblastoma in a 3-month old baby. The technical points of surgical procedure were discussed.
Sujets)
Enfant , Humains , Nourrisson , Cyphose , Laminectomie , Neuroblastome , Canal vertébral , RachisRésumé
A soft ruptured thoracic disc herniation is very rare. We have experienced a ruptured T5-6 disc herniation which was migrated into spinal canal and compressed spinal cord posteriorly. It was difficult to differentiate it from cord tumor. Posterior laminectomy offers a better chance of removal than does the anterolateral or posterolateral approach this case.