Late onset of Leber's hereditary optic neuropathy in HIV infection.
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Biomedical subjects
Publications and source records attributed to E Lehrer.
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Child mortality may affect spacing through biological and behavioral channels. The death of a child may elicit a desire to have another one soon; further, it may interrupt breastfeeding and shorten the sterile period following childbirth. The hypothesis that the child mortality-spacing linkage varies across parities, being strongest in the middle parities, is examined using microdata from Malaysia and the Cox-regression technique. The empirical results lend support to the hypothesis.
A 13-month-old infant developed acute hemiparesis in the course of myocarditis. Cranial CT suggested occlusion of the right middle cerebral artery, and it is believed that an embolus arising from a mural thrombus is the most likely cause of the cerebral vascular accident. Anticoagulant therapy should be considered in myocarditis when myocardial ischemic damage or an intracavitary thrombus are suspected.
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An electron microscopic study of the coronary terminal circulation (starting with the small coronary arteries) was carried out on small pieces of myocardium operatively resected from the left ventricle on 11 patients with coarctation of the aorta. The patients were 4 to 20 years of age. Structural modifications were found in the small coronary arteries and arterioles. Two patterns of morphologic alterations were noted in these small resistance vessels. In the first pattern, seen in most of the children, the components of the arterial wall were still distinguishable, and well represented portions of smooth muscle layers were visualized together with muscle cells showing signs of degeneration and more or less widespread collagenous islets. The second pattern, seen in young adults, was characterized by a total collagenous transformation of the arterial wall. In contrast, the smaller microvessels (precapillary sphincter, metarterioles and capillaries) appeared free of pathologic change. It is postulated that the precapillary sphincters play a special protecting and regulating role in the coronary microcirculation in such cases with elevated coronary pressure. It is suggested that surgery should be performed at an early age to prevent further development of structural changes in the microvessels. The microcirculatory damage may contribute to the increased surgical mortality in patients with coarctation of the aorta operated on at a later age. These findings should trigger further research on the small coronary vessels in systemic hypertension.
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During a 12-mth period 162 consecutive patients with mitral stenosis underwent examination by M-mode as well as cross-sectional echocardiography. The mitral valve area was measured by cross-sectional echocardiography ad the severity of mitral stenosis by M-mode echocardiography. Out of the total, 69 patients underwent left and right heart catheterization and in 53 of these the mitral valve area was calculated. A correlation of r=0.92 for the mitral valve area was found between sector scan echocardiography and cardiac catheterization, whereas the correlation between M-mode echocardiography and catheterization yielded a result of only r=0.38. Thus the assessment of the severity of mitral stenosis by cross-sectional echocardiography is a reliable alternative to cardiac catheterization.
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A new apexcardiographic recording system has been developed which is free of certain technical limitations. This noncontact magnetic transducer was tested alternately with a commonly used pneumatic piezoelectric transducer in a comparative study on ten normal subjects. The magnetic registration offered a more accurate timing and configuration of the ACG. Signal distortion, such as peaked waves and an early fall of the systolic wave, was eliminated. The magnetic transducer was capable of recording directional apex point tracings, as well as pulsations of a larger apical area. The new system proved to possess definite advantages and eliminated some of the inconveniences inherent in the pneumatically coupled system.
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