Cytomegalovirus encephalitis in an HIV positive patient presenting with a cerebral mass lesion.

Cytomegalovirus (CMV) encephalitis typically occurs as a diffuse cerebral infection in patients with advanced AIDS. This is a case report of a patient who presented with right-sided weakness and subsequently was found to have a cerebral mass lesion due to CMV. Only four similar cases are described in the literature. Though uncommon, CMV encephalitis must be considered in the differential diagnosis of cerebral mass lesions in patients with advanced AIDS.

Correlation of cross-linked fibrin degradation products (D-dimer) with coronary angiographic lesion morphology.

We tested the hypothesis that complex irregular coronary lesions are "active" lesions and thus associated with ongoing fibrinolysis by measuring the degradation products of cross-linked fibrin (D-dimer) in 136 patients undergoing coronary arteriography. Blood samples obtained before catheterization were assayed by an enzyme linked immunosorbent assay (ELISA) using specific monoclonal antibodies for D-dimer particles. In the four groups with complex coronary morphologies (filling defects, extrinsic lesions with irregular borders and total occlusions with or without staining) the majority of patients (64%) had normal D-dimer levels. The incidence of abnormal D-dimer levels was not significantly higher in any of these four groups than in the two groups with normal coronaries or with smooth lesions. In the same patients, however, the clinical diagnosis was predictive of the presence of elevated D-dimer levels. These findings suggest that complex coronary lesions are often not associated with ongoing fibrinolysis and that endogenous fibrinolysis frequently ceases in the presence of persistent clot.

Morphology of coronary lesions in the prediction of early PTCA outcome.

The coronary lesions in 164 patients who underwent 194 PTCA procedures were analyzed in an effort to define if there were morphological characteristics that would predict thrombotic problems following percutaneous transluminal angioplasty (PTCA). Patients with smooth and concentric or eccentric lesions rarely had difficulty at PTCA, whereas those with filling defects or with eccentric and irregular lesions frequently had postprocedure thrombi. Total occlusions were amenable to angioplasty when there was lesion staining present, but the success rate was significantly less in patients in whom there was no staining. These findings suggest that the acute outcome of PTCA can be predicted on the basis of the morphology of coronary lesions on preprocedure angiography.

Real time processing and analysis of fetal phonocardiographic signals.

The monitoring of fetal heart rate (FHR) is commonly used in assessing the general health of the fetus. Although certain periodic cycles may be indicative of fetal problems, only short term observations are routinely employed in clinical practice. This is due to cost considerations, inconvenience to the patient and concern about long term ultrasonic monitoring. Therefore only a low confidence assessment can be established between detected rhythms and the health of the fetus. The technique advocated in this paper makes use of an inexpensive, non-invasive phonocardiographic (phono) transducer which facilitates safe long-term patient monitoring. A variable comb filter applied to the frequency domain is used in order to take full advantage of the harmonic content of fetal heart signals. Real time estimation of FHR has been achieved on pre-recorded phono signals lasting eight hours. Recordings with a reasonable signal quality were analysed and some of the results are given. Advanced signal processing techniques followed by Artificial Intelligence (AI) algorithms reduce the number of erroneous estimates during periods of low signal to noise ration (SNR). The resulting FHR time series is stored on the host computer for further processing, display and parameter extraction. This paper outlines the processing steps involved.