MITRAL REGURGITATION SIMULATING AORTIC STENOSIS

Serial determinations of serum lactic-acid dehydrogenase (LDH), phosphohexose isomerase (PHI), alkaline phosphatase (AP), and glutamic oxaloacetic transaminase (GOT) were carried out in 30 patients with primary and four with secondary neoplasms of the lung. Enzyme values were correlated with the stage of illness, with tumour histology, with chemotherapy and with the extent and site of metastases as determined at autopsy. The activity of the enzymes LDH and PHI was most frequently elevated; their values correlated closely. AP and GOT tended to become elevated only shortly before death. Although, in general, enzyme activity increased with tumour extension and often in relation to chemotherapy, assays provided little assistance in early diagnosis or prognosis except that, in most instances, elevated values of any of the four enzymes indicated the presence of metastases.     

ECHO-PHONOCARDIOGRAPHIC CHARACTERISTICS OF THE NORMALLY FUNCTIONING COOLEY-CUTTER MITRAL VALVE PROSTHESIS

Echocardiographic and phonocardiographic records of 19 patients with a normally functioning Cooley-Cutter mitral valve were analyzed in order to provide quantitative baseline values for this prosthesis. The average duration between the second heart sound and peak opening of the valve (A(2)-OC interval) was 83 +/- 4 (standard error of the mean) msec. The Q-CC interval (from the electrocardiographic Q wave to closure of the valve) was 71 +/- 2 msec. Mean opening and closing velocities of the disc were similar (396 +/- 11 mm/sec and 393 +/- 12 mm/sec, respectively). Amplitude of disc excursion ranged from 6 to 9 mm, but this measurement was not possible in all patients due to the presence of spurious echoes. Early onset of prosthetic valve closure was a relatively common finding in patients with atrial fibrillation or with various forms of atrioventricular block, and frequently resulted in a variety of phonocardiographic alterations. Except for the A(2)-OC interval and amplitude of disc excursion, there was no significant correlation between valve size and echo-phonocardiographic measurements. Results of this study are compared with values previously reported for other types of caged disc valves, and the usefulness and limitations of echo-phonocardiographic assessment of prosthetic valve function are briefly discussed.     

ECHOCARDIOGRAPHIC ABNORMALITIES OF THE MITRAL VALVE ASSOCIATED WITH A LARGE PERICARDIAL EFFUSION

Features of mitral stenosis and systolic anterior motion of the mitral valve were observed on the echocardiogram of a patient with a large posterior pericardial effusion. The abnormal findings disappeared with resolution of the fluid. Because pericardial effusion may result in the echocardiographic alteration of cardiac structures, repeat study is necessary after the effusion has cleared.     

不同月龄大鼠椎间盘退变与多效生长因子表达的关系

目的观察不同月龄大鼠椎间盘的形态学变化并检测椎间盘中多效生长因子（pleiotrophin,PTN）的表达,探讨PTN与椎间盘退变的关系。方法取Wistar大鼠50只,以1,3,6,12,18个月龄不同分为5组,每组10只。采用苏木精-伊红染色观察椎间盘的形态学变化。采用SABC免疫组织化学方法,检测椎间盘中PTN的表达情况;结果（1）随着月龄的增加,椎间盘组织结构紊乱的程度逐渐增加,髓核内基质降解、正中出现空腔,胶原纤维增生、粗大、排列紊乱、并可见纤维断裂或缺失。（2）随着大鼠月龄的增加（1-12月龄）,椎间盘细胞中PTN的表达有逐渐减低的趋势,但至18月龄,PTN表达又有所增加;6和12月龄组椎间盘细胞中PTN的表达显著低于1月龄组,而18月龄组PTN的表达显著高于12月龄组。同月龄组椎间盘细胞中,PTN在终板的表达高于髓核和纤维环,髓核和纤维环中PTN的表达未见明显差异。结论大鼠椎间盘结构随月龄增加发生退行性变,PTN参与了大鼠椎间盘的退变,并可能通过促进椎间盘组织中新生血管的形成,延缓椎间盘的退变。     

THE SURGICAL TREATMENT OF MITRAL STENOSIS

A surgical procedure known as commissurotomy, devised by Bailey for the relief of certain cases of mitral stenosis, gives promise of considerable benefit to a large number of patients who have the disease. The technique of the operation involves the introduction of the right index finger and an especially designed valvulotome through the left auricular appendage into the left auricle. The mitral valve commissures are then divided. Twentyfive cases of mitral stenosis in which this operation was performed are discussed.