MDCT evaluation of the cardiac venous system.

PURPOSE: This study was undertaken to evaluate the usefulness of electrocardiographically (ECG)-gated multidetector-row computed tomography (MDCT) for the assessment of the coronary venous system and detection of its anatomical variants, in order to identify those suitable for lead placement in cardiac resynchronisation therapy (CRT). MATERIALS AND METHODS: We retrospectively examined the coronary MDCT studies of 89 patients (73 males, 16 females, average age 62.5 years, range 31-79) referred for suspected coronary artery disease. The cardiac venous system was assessed in all patients using three-dimensional (3D) postprocessing on a dedicated Vitrea workstation (five patients were excluded from the analysis). RESULTS: The coronary sinus, the great cardiac vein, the anterior interventricular vein and the middle cardiac vein were visualised in all cases. The lateral cardiac vein was visualised in 56/84 patients (67%) and the posterior cardiac vein in 63/84 patients (75%), never both missing. Along the postero-lateral wall of the left ventricle, only one branch was present in 44 cases, two branches in 21 cases and three or more branches in 19/84 cases (22%). Evaluation of the maximum diameter revealed that the lateral vein was dominant over the posterior vein in 20/40 cases. The small cardiac vein was visualised in 11/84 cases. CONCLUSIONS: MDCT provides good depiction of the cardiac venous system, enabling the study of the vessel course and the identification of anatomical variants. Hence, this imaging technique could be proposed for the preoperative planning of CRT in selected patients.

[Follow-up of 151 pregnant women exposed to antidepressant treatment (MAOI excluded) during organogenesis]. / Suivi de 151 grossesses exposées à un traitement antidépresseur (IMAO exclus) au cours de l'organogenèse.

The Pharmacovigilance and Poisons Center in Lyon undertook an analysis of their data on antidepressant (MAOI excluded) exposure during the first trimester of pregnancy. From 1986 to 1991, 151 prospective enquiries were collected of which 145 exposures occurred during the first trimester of pregnancy. The outcome of pregnancy was known for 114 of these cases. Voluntary or medical abortion was decided in 24 cases, spontaneous abortion occurred in 11 patients and fetal death, unrelated to drug exposure, was noted in one case. Delivery was reported in 78 cases including 69 (88.5%) normal infants, with obstetrical complications not related to the treatment in 7 of these cases. Neonatal complications were noted in 5 (6.4%) cases, including withdrawal symptoms possibly related to the treatment in 3 cases. Congenital abnormalities were identified in 4 cases (5.1%) with one case of major malformation (membranous ventricular septal defect). Such a study is not an exhaustive survey of antidepressant exposure during pregnancy, but a collection of inquiries received by our centre. Even though our study's ability to detect an overall increase in the risk of malformations is too low and limited the extent of our conclusion, our results are in agreement with the literature data as no important increased in major birth defect was observed.

First-trimester in utero exposure to anorectics: a French collaborative study with special reference to dexfenfluramine.

A collaborative study with 8 Teratology Information Centres was undertaken to collect data on anorectic exposures (amfepramone, clobenzorex, dexfenfluramine, fenfluramine, fenproporex) during pregnancy. Two hundred and ninety seven prospective enquiries were analysed of which 285 exposures occurred during the first trimester. Outcome of pregnancy was known for 164 of these cases. Voluntary or medical abortion was decided in 30 cases (18%), spontaneous abortion occurred in 14 cases (8.5%), extrauterine pregnancy in 1 patient and fetal death following drug abuse in another. A normal infant was delivered in 111 cases (68%). Low birthweight was identified in 1 case and neonatal complications in 2 cases. Various congenital abnormalities were noted in 4 cases (1 minor and 3 major), with no clear cause-effect relationship (2 amfepramone, 1 fenproporex and 1 dexfenfluramine). Although the number of exposed pregnancies in this cohort was too small to rule out any increase in teratogenic effects of anorectics, the results of this survey suggest that the risk for malformations, especially for dexfenfluramine is probably not greater than the 2-3% risk for pregnancies in the general population. Morover, these results provide substantial information for future enquiries about exposure to such medication during organogenesis.

The polymorphism of red cell uridine monophosphate kinase in two samples of the Italian population.

Red cell uridine monophosphate kinase polymorphism has been studied on a total of 915 individuals from two different areas of Italy (Milan and Rome). The two groups of about the same size show very similar gene frequencies. The UMPK2 allele in the pooled sample has a frequency of 2.8% which is significantly lower than those observed in the two other Caucasian populations so far examined.

An analysis of red cell enzymatic markers in the province of Bologna (Italy).

About 280 unrelated individuals living in the province of Bologna (Northern Italy) have been studied for the following red cell enzymatic markers: phosphoglucomutase (PGM), adenylate kinase (AK), adenosine deaminase (ADA) and phosphohexose isomerase (PHI). 116 subjects from the same sample have also been analysed for red cell acid phosphatase (ACP). The observed gene frequencies are PGM21 = 0.280; AK2 = 0.030; ADA2 = 0.091; ACPa = 0.297; ACPb = 0.647; ACPc = 0.056. In the PHI system two individuals with the variant PHI 3-1 phenotype have been found.