El sulcus lunatus en el hombre. (Estudio morfologico). / Sulcus lunatus in human brain (Morphologic study)

Los autores presentan una investigacion casuistica sobre la incidencia y predominancia del sulcus lunatus en el cerebro del hombre. Tomando como punto de partida las incongruencias bibliograficas encontradas, se enfoca el trabajo desde un punto de vista estrictamente morfologico y macroscopico. La metodologia empleada consistio en observaciones directas del lobulo occipital, secciones en diferentes planos, mediciones de longitud y diagramacion de los casos examinados. A traves de los resultados obtenidos se arriba a conclusiones de alta significacion con respecto a incidencia, predominancia y bilateralidad. Se senala, ademas, que la diversidad del sulcus lunatus en cuanto a su conformacion anatomica ha obligado a dividir los casos positivos en un grupo con caracteres tipicos y otro con diferentes grados de atipia

Effects of amiodarone on cardiac and coronary hemodynamics and on myocardial metabolism in patients with coronary artery disease.

While the antiarrhythmic effects of amiodarone are well-documented, its hemodynamic effects are not. We injected 5 mg/kg amiodarone i.v. in 16 patients undergoing coronary arteriography. Heart rate did not change. Aortic (systolic, diastolic and mean) and left ventricular (systolic and end-diastolic) pressures decreased significantly (p less than 0.01) at 5 and 15 minutes; systemic vascular resistance also fell significantly (p less than 0.05), while cardiac index increased slightly but significantly (p less than 0.05). Coronary vascular resistance decreased significantly (p less than 0.01) and coronary sinus blood flow rose in most patients, from a mean of 138 ml/min to 153 ml/min at 5 minutes (p less than 0.02); it then returned toward the control value at 15 minutes (mean 145 ml/min). Myocardial metabolism of O2 was normal and unchanged. Metabolism of lactate improved in five patients, remained unchanged in seven and deteriorated transiently in four. No undesirable hemodynamic and clinical side effects occurred when the drug was administered slowly. We conclude that amiodarone is a powerful systemic and coronary vasodilator. In addition to its present indications in the treatment of angina pectoris and arrhythmias, the drug might be very useful as an afterload-reducing agent.

[Significance of spontaneous reduction of long term auricular fibrillation. Apropos of a case followed by subtotal auricular paralysis]. / Signification de la réduction spontanée de fibrillations auriculaires anciennes. A propos d'un cas suivi de paralysie auriculaire subtotale

The authors report the case of a female patient with mitro-aortic valve disease, whose atrial fibrillation had been recorded over a period of 13 years. There was then a conversion to sinus rhythm, followed by the appearance of a junctional rhythm with retrograde atrial conduction. Intracavitory investigation revealed that the electrical activity of the right atrium could be recorded only from a limited area, and that atrial stimulation was effective only over that area. This subtotal atrial paralysis suggests that the spontaneous conversion from atrial fibrillation was a sign of deterioration in the condition rather than of a "paradoxical improvement".

[Intermediate and long-term results of multivalve prostheses]. / Rsultats des prothèses pluri-valvulaires a moyen et long termes

Over a period of observation of 4 years maximum, there is no significant difference between the estimated survival time (by actuarial calculation) for patients with single and for those with double prostheses. Wihin the year following operation there is not significant difference between single and double prostheses as regards: the incidence of bacterial endocarditis, of pyrexias of unknown origin, of hepatitis, of haemolytic anaemia, of bleeding complications or incidents, of coronary of peripheral ischaemic episodes, or of reduced cardiac volume. On the other hand, there is a significant difference in the incidence of neurological defects (21% for the double prosthesis group, and 5% for the single prosthesis group, p less than 0.005 and or right ventricular failure (18% and 7% respectively, p less than 0.05) in the two groups.

[Recurrent ventricular tachycardia due to hydatic cyst of the heart. Recovery after surgical resection. Report of one case]. / Tachycardie ventriculaire récidivante par kyste hydatique du coeur. Guérison après résection chirurgicale. Rapport d'un cas

Report of the case-history of a 66 year-old woman in whom the diagnosis of ventricular aneurysm was reached in 1958 during a systematic X-ray examination, while the electrocardiogram suggested a lateral-wall infarction with no anginal pain. After fifteen years of a practically asymptomatic course there were practically uninterrupted attacks of ventricular tachycardia. Coronary angiography and left ventriculography excluded the hypothesis of an aneurysm and suggested the diagnosis to cystic tumour of the left ventricle. A voluminous hydatic cyst was removed surgically. Ventricular arrhythmia did not recur since.

[Major deficiency in serum lactate dehydrogenase 1 and 2 isoenzymes: a possible pathogenesis for angina pectoris with normal coronarography]. / Le déficit majeur en isoenzymes 1 et 2 de la lacticodéshydrogénase; une pathogénie possible de l'angine de poitrine à coronarographie normale

Sometimes angina pectoris with normal coronarography can be explained by several enzymatic disturbances. These are as follow: -- a marked decrease of serum lactate-deshydrogenase 1 and 2 isoenzymes, -- the absence of myocardial lactate-deshydrogenase isoenzymes, --the decreased affinity for substrate lactate of residual lactate-deshydrogenase in serum, -- the increased production of 2,3 diphosphoglycreate.

[Biopsy of the pericardium. Diagnostic value in subacute and chronic pericarditis, apropos of 70 cases]. / La biopsie du péricarde. Intérét diagnostique dans les péricardites subaiguës et chroniques, à propos de 70 cas

The aetiology of pericarditis is often difficult to assess. To try to clear up this problem, a pericardial biopsy through a left lateral thoracotomy was performed in 70 cases in which the cause could not be established by the usual means (including pericardial paracenthesis in 32 cases). They included either subacute pericarditis, dry or with effusion (biopsy being undertaken as an average 45 days after the clinical onset), or chronic pericarditis with effusion. Tuberculosis was thus demonstrated in 14 cases (8 of which were aged more than 60 years), inaugural pericardial tumours in 8 and suppuration in 3 cases. Microscopical examination gave support to pathogenic hypotheses concerning cholesterol pericarditis (5 cases) and multi-recurrent pericartitides (6 cases). By elimination with a high probability) of tuberculosis and tumours, it demonstrated definitely the diagnosis of post-radiotherapy pericarditis with effusion (4 cases) pericarditis with normal serous membrane (4 cases) and "idiopathic" forms (23 cases of common sclerogenous subacute inflammation). The inocuity of this method, its more accurate results than those obtained by cytological and bacteriological examination of the pericardial fluid obtained by paracenthesis, should induce to consider this procedure more often in the cases of pericarditis when the aetiology remains doubtful; not to mention the benefit derived from surgical drainage which results in a quicker and more complete cure than repeated paracentheses of chronic and subacute pericardial effusions.