Familial association of intracranial aneurysms and cervical artery dissections.

BACKGROUND AND PURPOSE: The familial occurrence of intracranial aneurysms and cervical artery dissections has been described in different families and supports the hypothesis that a primary arteriopathy may play a role in the pathogenesis of these disorders. Although the basis for this arteriopathy is generally not believed to be similar among cases of intracranial aneurysms and cervical artery dissections, several similarities exist in the epidemiology of these disorders and a common underlying arterial abnormality may be suspected. SUMMARY OF REPORTS: The medical records of all 175 patients with spontaneous dissections of the cervical arteries who were seen at the Mayo Clinic between 1970 and 1989 were reviewed to identify families in which intracranial aneurysms and cervical dissections coexisted. Three families were identified in which intracranial aneurysms and cervical artery dissections were observed among siblings. These families are described in detail. CONCLUSIONS: The familial occurrence of intracranial aneurysms and cervical artery dissections within the same families provides support to the importance of a common underlying arteriopathy in the pathogenesis of both these disorders. The underlying vascular defect may, at least in some cases, be inherited.     

Clinicopathologic correlation of pigmented epiretinal membranes

We performed clinicopathologic correlation on ten surgically removed pigmented epiretinal membranes causing macular pucker. All cases occurred in eyes with existing retinal holes or tears, including eight cases of macular pucker after previous retinal detachment. These cases probably represented a limited form of proliferative vitreoretinopathy. All membranes contained pigment epithelial cells with polarity, basement membrane, and melanosomes. Cytoplasmic melanin granules accounted for the clinical feature of pigmentation in these eyes.     

Messung der psychischen Belastung nach akutem Myokardinfarkt mit Hilfe der SCL-90-R

Zusammenfassung. Ziel: Die psychische Belastung bei Patienten mit akutem Herzinfarkt innerhalb der ersten 48 h auf der Intensivstation des Städtischen Krankenhauses Kiel wird mit Hilfe der Symptom-Checkliste (SCL-90-R) gemessen. Patienten und Methodik: 134 hauptsächlich wegen eines akuten Herzinfarkts aufgenommene Patienten wurden zwischen August 1996 und Juli 1999 randomisiert ausgewählt. Sie füllten einen der Intensivstation angepassten Fragebogen aus, der u. a. neben Fragen zu sozioökonomischen Daten die standardisierten SCL-90-R enthält. Ergebnisse: Erhöhte Mittelwerte zeigten sich vor allem für die Skalen Somatisierung, Ängstlichkeit, Depressivität und GSI (Global Severity Index) bei solchen Patienten, die wenig soziale Unterstützung bekamen und über ein niedriges Einkommen verfügten. Schlussfolgerung: Da für Patienten mit schlechtem sozialen Netzwerk, niedrigem sozialen Status, erhöhter Angst und Depressivität eine schlechtere Prognose hinsichtlich der Mortalität und Wiedereingliederung in den Beruf beschrieben wurde, ist es im prospektiven Verlauf dieser Studie notwendig, gerade diese Patienten hinsichtlich der Entwicklung ihrer Angst zu erfassen und zu behandeln. Abstract. Objective: 134 patients with acute myocardial infarction, who were treated in an intensive care unit (ICU) of a German hospital in Kiel between 1996 and 1999 were selected for the study to examine their psychologic symptoms. Patients and Methods: The patients were asked to fill in the self-report inventory, the Symptom Checklist-90-Revised (SCL-90-R) within the first 48 h after their arrival in the ICU. Results: Patients with a low social status were found to have elevated mean values of the following scales: somatization (0.93), depression (0.66), and anxiety (0.59). The Global Severity Index (GSI) as a global measure of psychologic distress was elevated as well (0.46). Conclusion: Since patients with a limited social network and low social status, increased anxiety and depressive scores have a poor prognosis as to their mortality and their professional reintegration, it it considered necessary for the prospective setting of this study to register particularly those patients in order to treat their anxiety.     

Interdisziplin?re Leitlinien zur Diagnostik und Therapie der extrazerebralen Amyloidosen

Ohne Zusammenfassung     

Organ culture of pig cornea: biochemical analyses of mid-term-stored corneal tissue

Freshly prepared pig corneas were cultured at 22 degrees C in TC 199 medium supplemented with HEPES buffer, antibiotics and 10% sterile pig blood serum. The cultures were maintained in a closed system up to 30 days. The hydration as measured by wet and dry weights increased from 80 to 94% after 2 weeks of storage. Glucose decreased slowly and continuously during the culture time by 0.32 mmol in 30 days. This was equivalent to 11 mumol/day, 0.46 mumol/h and finally 0.264 mumol/h/cm2. Lactate increased in the culture accordingly by 0.34 mumol/h/cm2. In the corneal epithelium of the cultured tissues the glucose levels--normally at about 5 mumol/g--equilibrated with those of the medium during the first 10 days; later the epithelial glucose levels increased up to 20-30 mumol/g. The glycogen content of the epithelium remained constant for the first 10 days of storage. The ATP/ADP ratios in the corneal epithelium initially decreased but later recovered to values of about 12. The pO2 in the culture system decreased from 156 to 120 mm Hg, which is equivalent to an oxygen consumption of 7.41 microliters O2/h/cm2. The CO2 production initiating from a level of 16.6 mm Hg was 4.88 microliters/h/cm2. The data showed that the cornea was viable in this culture system for 30 days.     

Coronary reperfusion with a new catheter in six patients with acute occlusion after angioplasty

A new catheter was used in an attempt to re-establish coronary flow in six patients with acute occlusion after angioplasty and prior to emergency coronary artery bypass surgery. All patients suffered from severe chest pain, and the electrocardiogram showed signs of acute transmural ischemia. A reperfusion catheter manufactured by Advanced Cardiovascular Systems (ACS) has 36 side holes spirally arranged along the distal 10 cm. It is introduced over an exchange wire. After the catheter was positioned across the occlusion, five patients had complete relief of chest pain, and another patient had partial relief. The electrocardiogram normalized in all six patients (in one only initially). Two patients developed a limited myocardial infarction, but four did not. The time between introduction of the reperfusion catheter and aorta cross clamping varied between 1.5 and 6.5 hours, and there were no complications related to its use. We conclude that the ACS reperfusion catheter is useful in re-establishing coronary blood flow after failed angioplasty and prior to emergency coronary artery bypass surgery.     

Predictors of alcoholics' acquisition of treatment-related knowledge

Only modest relationships have been found between cognitive functioning and treatment outcome; there is some indication of better prediction of within-treatment progress. The current study attempted to determine whether either cognitive or sociodemographic/alcohol-related variables were predictive of learning in educational treatment. Eighty-seven male alcoholics were exposed to one hour of instruction on the medical effects of alcohol. Sociodemographic, alcohol-related, and cognitive functioning measures were obtained at the outset of treatment. Knowledge was assessed 24 hours prior to and 24 hours and three weeks after the intervention. Statistically significant increases in knowledge were found both 24 hours and three weeks following the educational intervention; retention of information declined significantly from 24 hours to three weeks post-intervention. Discriminant function analyses using either seven cognitive variables or six alcohol-related/sociodemographic variables significantly discriminated between learners and nonlearners 24 hours after the intervention. The weighted composite of measures in each of the analyses was able to successfully differentiate learners from nonlearners in over 70% of the cases. The findings suggest that the clinician may be able to employ a limited number of variables to differentiate between patients who will and will not be able to acquire knowledge from educational interventions.