Coronary artery fistula after cardiac transplantation

A cardiac transplant recipient with multiple coronary artery fistulae draining into the right ventricle is described. These fistulae presumably resulted from repeated endomyocardial biopsies. The diagnosis of coronary artery fistulae was made at the annual coronary arteriography. The magnitude of the shunt remained small over eight years of follow-up.     

Ability of methanolic seed extracts of pawpaw (Asiminatriloba) to inhibit n-3 fatty acid oxidation initiated by peroxyl radicals and reactive oxygen,nitrogen, and sulfur

Methanolic extracts from underripe, ripe, and ripe then dried pawpaw seeds (PPSE) were tested for antioxidative effectiveness. Underripe seeds contained more total phenolic compounds than ripe seeds, but ripe seeds showed the highest reducing potential. PPSE samples effectively scavenged DPPH (>86%). PPSE (0–26.8 μM gallic acid) effectively inhibited lipid oxidation biomarkers in 22:6 phosphatidylcholine (PC) liposome suspensions over 7 day’s incubation at room temperature. PPSE inhibited TBARS in 22:6 PC liposome suspensions induced by peroxyl radical generators, free radical generators that produce reactive oxygen, reactive nitrogen, and reactive sulfur species. After 120 min of storage TBARS inhibition by PPSE was in the order of H₂O₂ ? SIN-1 = DSSO = AAPH ? Sulfite > ONOO = MMb > iron/ascorbate. PPSE inhibited lipid oxidation biomarkers in skeletal muscle homogenates induced by iron/ascorbate. The development of value added products from pawpaw seeds may lead to successful commercialisation of this underutilised fruit.     

Air caloric test: irrigation technique

The technique of using air to perform the caloric test is discussed. Greater temperature differences and larger volumes of air are needed to achieve stimulations equal to those caused by water irrigations. Special consideration must be given to the design and operation of air irrigation equipment. The effects of irrigating a wet canal and of misdirecting the air jet are discussed. A new air irrigation apparatus is described.     

Bioethics: occupational therapy attitudes toward the prolongation of life

Two cases of massive pulmonary embolism, confirmed by angiographic or necropsy findings, were remarkable by the absence of arterial hypoxaemia. The various mechanisms responsible for arterial hypoxaemia in pulmonary embolism are discussed. It is suggested that in patients with massive pulmonary embolism a markedly decreased cardiac output might account for the absence of arterial hypoxaemia. In the light of these two cases the finding of a normal PaO2 does not rule out the diagnosis of pulmonary embolism.     

Thoracoscopic T2-sympathetic block by clipping--a better and reversible operation for treatment of hyperhidrosis palmaris: experience with 326 cases

Although thoracoscopic sympathectomy or sympathicotomy is the best treatment for hyperhidrosis palmaris, a new approach of clipping only without transection of T2-sympathetic trunk is just as effective. Aside from the guaranteed cure of hyperhidrosis, this new method has fewer complications and has the advantage of recovery of the sympathetic tone in the hands if the procedure is reversed by the removal of the clips. Between March 18 and September 30 of 1996, 326 patients (190 female and 136 male with a mean age of 20.5 years) underwent thoracoscopic T2-sympathetic block by clipping to treat hyperhidrosis. Good results and few complications were noted during follow up six months to one year postoperatively. Five of the 326 patients, all female, had the operation reversed because of intolerable compensatory sweating. Three recovered from the compensatory sweating within two months and had less palmar sweating than before their sympathetic block; the fourth achieved relief of compensatory sweating after nine months, and the fifth reported no improvement.