Successful use of sirolimus for refractory atrial ectopic tachycardia in a child with cardiac rhabdomyoma.

Cardiac rhabdomyomas are common in tuberous sclerosis. We report a child who developed rhabdomyoma related arrhythmia refractory to antiarrhythmic drug therapy. Reversion of the atrial ectopic tachycardia was achieved with mammalian target of rapamycin pathway (mTOR) inhibitor sirolimus. As per our knowledge, this is the first time that sirolimus has been successfully used in this setting.

Occipital sulci of the human brain: variability and morphometry.

The external morphology of the occipital lobe was investigated in 15 human post-mortem brains (30 hemispheres) fixed in formalin. We identified, described and measured the lengths of nine major human occipital sulci and five variable ones, comparing both types between individuals and hemispheres. Morphological variability of human occipital sulci is related to interindividual and interhemispheric differences in their presence, origin, type, segmentation, intersection and length. The major occipital sulci, particularly the parieto-occipital, the calcarine, the inferior lateral occipital and the anterior occipital sulci, as well as two points of their intersections (cuneal point and intersection of the transverse occipital and superior occipital sulcus) may be used as reliable anatomical landmarks for the location of architectonically and functionally defined human visual areas (V1, V2, V3, V3A, V5/MT+, LO1 and LO2) and during less invasive neurosurgical procedures in the cases of focal lesions within the occipital lobe. Two lateral occipital sulci (inferior and superior) were defined on the lateral surface of the occipital lobe. The variable lunate sulcus was studied and combining our results with those from histological and functional imaging studies, we suggest that the lunate sulci of human and nonhuman primates are not homologous.