1/7. Evidence of patent ductus arteriosus and right-to-left shunt by finger pulse oxymetry and Doppler signals of agitated saline in abdominal aorta.The diagnosis of patent ductus arteriosus (PDA) with right-to-left shunt in the adult by using transthoracic echocardiography (TTE) is difficult because of limited windows. We report a case of a 23-year-old woman who was referred for treatment of primary pulmonary hypertension but was found to have a PDA with a right-to-left shunt. On examination she had asymmetric hypoxia of the upper extremities on finger pulse oxymetry. Transthoracic echocardiography revealed a large right atrium and no atrial or ventricular septal wall defects. The diagnosis of PDA with Eisenmenger's syndrome was made after evidence of a right-to-left shunt was confirmed by Doppler signals of intravenous agitated saline in the abdominal aorta. This case illustrates the utility of Doppler signals from agitated saline in the abdominal aorta and finger pulse oxymetry, in addition to physical examination, in the diagnosis of PDA with right-to-left shunt.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/7. subcutaneous fat necrosis in an infant, occurring after hypothermic cardiac surgery. Case report and analysis of etiologic factors.A female infant developed extensive subcutaneous fat necrosis 3 weeks following induced hypothermia used as an adjuvant in cardiac surgery. All lesions resolved without sequelae within 4 months. In this article we discuss the various causes of panniculitis in infants and the relevance of each cause to our patient. We believe that an underlying defect in composition and metabolism of fat, coupled with a variety of exogenous and endogenous stresses, can precipitate subcutaneous fat necrosis in infants. These stresses include physical trauma (e.g., hypothermia), poor nutrition, infection, and metabolic abnormalities.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
3/7. Coarctation of the aorta of unusual morphology.Three unusual types of coarctation of the aorta are presented together with long-term follow up covering a period of 8-12 years, after successful operative reconstruction. In one case there were two constrictive lesions, one proximal to the left subclavian artery and the other at the typical location, while in another the coarctation was located between two common carotids, with associated congenital hypoplasia of the left subclavian artery, resulting in a steal syndrome. In the last case, there was evidence of a supradiaphragmatic coarctation. In all cases surgical reconstruction was accomplished by means of a Dacron graft. Even unusually located coarctations are highly likely where physical examination reveals, either in one or both limbs hypertension with concomitant weakness of femoral pulsations. However aortography is mandatory for adequate delineation of the disease and precise surgical orientation. All three patients live a normal life today.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
4/7. iridium- 191 angiocardiography for the detection and quantitation of left-to-right shunting.An osmium- 191 leads to iridium- 191 generator that can deliver multiple doses of Ir- 191m for first-pass radionuclide angiography has been developed. iridium- 191m has a physical half-life of 4.96 sec and decays with emission of 65-keV and 129-keV photons in 58 and 30% abundance, respectively. Using a gamma camera, Ir- 191m radionuclide angiography was carried out, in dogs and ten patients, for the detection and quantitation of left-to-right shunting. In a one-year-old patients, 25 mCi of Ir- 191m results in a whole-body radiation absorbed dose of 35 mrad. Multiple Ir- 191m angiograms can be performed, seconds to minutes apart, without interference from background. The 15.4-day half-life of Os- 191 permits transportation of the generator to centers far from the production facility. With the low radiation dose, high information density, and the ability to repeat studies with Ir- 191m, clinical use of radionuclide angiography should be expanded.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
5/7. Three cases of trisomy 13 mosaicism and a review of the literature.We describe three cases of trisomy 13 mosaicism and review the literature. The phenotype ranges from a severe form similar to Patau syndrome, through to physical and mental normality. This range presumably reflects the proportion and tissue distribution of the trisomic cell line. The percentage of trisomic cells in lymphocytes correlates poorly with the observed phenotype.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
6/7. A case of Duane's retraction syndrome with multiple congenital malformations.Duane's retraction syndrome is associated with various ocular and systemic abnormalities. We report a case with bilateral Duane's retraction syndrome type I accompanied by renal agenesis, vesico-ureteral reflux, patent ductus arteriosus, and external ear malpositioning. Because of disabling consequences, we recommend a thorough physical examination and screening for renal and cardiac abnormalities in all patients presenting with Duane's reaction syndrome.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
7/7. The intermittent ductus revisited: echocardiographic evidence and successful coil occlusion: a case report and review of literature.Intermittent occurrence of a large ductal shunt by physical examination and Doppler echocardiography is reported. cineangiography confirmed a tubular ductus arteriosus with an angulated, narrow, pulmonary end. Presumably this angulation intermittently caused functional closure of the ductus. Trans-arterial delivery of coils resulted in complete occlusion.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |