Anomalous Communication Research Articles

Does psi exist? Comments on Milton and Wiseman's (1999) meta-analysis of ganzfeld research.

J. Milton and R. Wiseman (1999) attempted to replicate D. Bem and C. Honorton's (1994) meta-analysis, which yielded evidence that the ganzfeld is a suitable method for demonstrating anomalous communication. Using a database of 30 ganzfeld and autoganzfeld studies, Milton and Wiseman's meta-analysis yielded an effect size (ES) of only 0.013 (Stouffer Z = 0.70, p = .24, one-tailed). Thus they failed to replicate Bem and Honorton's finding (ES = 0.162, Stouffer Z = 2.52, p = 5.90 x 10(-3), one-tailed). The authors conducted stepwise performance comparisons between all available databases of ganzfeld research, which were argued not to be lacking in quality. Larger aggregates of such studies were formed, including a database comprising 79 ganzfeld-autoganzfeld studies (ES = 0.138, Stouffer Z = 5.66, p = 7.78 x 10(-9)). Thus Bem and Honorton's positive conclusion was confirmed. More accurate population parameters for the ganzfeld and autoganzfeld domains were calculated. Significant bidirectional psi effects were also found in all databases. The ganzfeld appears to be a replicable technique for producing psi effects in the laboratory.

Identification of an arteriovenous fistula during free tissue transfer despite negative preoperative angiography: a potentially correctable cause of venous thrombosis

Although refinements in microvascular technique have resulted in great success with free tissue transfer, long-term anastomotic patency, particularly venous, is less predictable in patients with a history of intravenous drug abuse or other causes of intimal damage and/or venous hypertension. We report an unusual case in which an arteriovenous fistula was identified intraoperatively as the cause of pulsatile venous backflow despite a normal preoperative angiogram. A flow disturbance at the site of venous anastomosis and subsequent development of a venous thrombosis prompted more proximal venous exposure and the identification of an arteriovenous fistula. Once ligated, pulsatile venous backflow resolved and successful revision of the venous anastomosis was performed. This case illustrates that an anomalous arteriovenous communication must be considered when high-pressure venous backflow is observed intraoperatively, despite no evidence of an arteriovenous fistula on preoperative angiography, because, if identified and ligated, an arteriovenous fistula may represent a treatable cause of venous thrombosis. © 1998 Wiley-Liss, Inc. MICROSURGERY 18:72-75 1998

Aberrant external jugular vein phlebectasia with tongue pain

We have not encountered any other report of phlebectasia with tongue pain in the literature. The pain disappeared after the anomalous venous communication was excised.

The all ulnar motor hand without forearm anastomosis

Anomalous ulnar innervation of intrinsic hand muscles, inferred in a number of clinical series, has been documented only rarely in electrophysiological studies. Using near-nerve and standard conduction studies we evaluated 2 cases with nearly exclusive ulnar innervation of hand muscles. There was no evidence of anomalous communication in the forearm. Digital sensory fibers were normally distributed in median and ulnar nerves. The anomalous motor innervation most likely results from palmar communication between ulnar and median branches (Riche-Cannieu anastomoses). The normal distribution of digital afferents suggests that such anastomoses are formed primarily by motor axons.

Systemic to pulmonary vascular malformation

A case is reported of life-threatening haemoptysis as a result of an anomalous communication between a bronchial artery and pulmonary vein, demonstrated by angiography. The patient recovered following bilobectomy of the right lower and middle lobes. When a systemic artery is involved in an arteriovenous malformation of the lung, haemodynamics are different compared with those present in malformations fed by the pulmonary artery. This implicates other clinical features, options for surgical intervention and prognosis. In reviewing the literature, a relationship with Rendu-Osler-Weber disease is absent in these specific malformations.

A patient with back pain and fever

A case is reported of life-threatening haemoptysis as a result of an anomalous communication between a bronchial artery and pulmonary vein, demonstrated by angiography. The patient recovered following bilobectomy of the right lower and middle lobes. When a systemic artery is involved in an arteriovenous malformation of the lung, haemodynamics are different compared with those present in malformations fed by the pulmonary artery. This implicates other clinical features, options for surgical intervention and prognosis

The double uterus associated with an obstructed hemivagina: Clinical management

The clinical management of It) patients, 9 with uterus didelphys and 1 with complete septate uterus associated with an obstructed hemivagina, is described. The diagnostic evaluation revealed a complete unilateral obstruction in four patients, and an anomalous communication between the two uterovaginal channels in six. In all such patients, the presence of regular menses is frequently misleading, perhaps resulting in unnecessary laparotomy and inadequate or extirpative surgery with negative reproductive consequences. However, diagnosis is simplified if the gynecologist is aware of the malformation. Recommended treatment consists of evacuation of the retained menstruum and excision of the vaginal wall. It is a simple, safe, and effective procedure but must be performed immediately following diagnosis in order to prevent or treat the related pelvic pathology (such as endometriosis or pelvic inflammatory disease). Drainage of the retained menstruum must be complete, otherwise infectious sequelae often occur. Fertility after therapy can well be preserved; however, reproductive success depends on the associated uterine malformation. Therefore, early establishment of the correct diagnosis followed by conservative treatment is mandatory in order to prevent pelvic pathology and to preserve reproductive potential.

A case of anomalous communication between coronary artery and main pulmonary trunk complicated with acute myocardial infarction

A case of anomalous communication between coronary artery and main pulmonary trunk complicated with acute myocardial infarction

A case of combined valvular heart disease with left ventricular diverticulum and anomalous coronary artery-pulmonary artery communication

A case of combined valvular heart disease with left ventricular diverticulum and anomalous coronary artery-pulmonary artery communication

Chronic Relapsing Pancreatitis in Childhood Caused by Pancreaticobiliary Ductal Anomaly

Chronic relapsing pancreatitis is a rare childhood disease. Although various obstructive phenomena have been implicated in its etiology, few reports have described the role played by anomalies of the pancreaticobiliary ductal system. Recently, a patient with a complex anomalous ductal communication was treated by us for chronic relapsing pancreatitis. This particular anomaly, and its clinical presentation, has not previously appeared in the literature. The problems associated with the diagnosis and surgical management of this patient have prompted this report.

Chronic Relapsing Pancreatitis in Childhood Caused by Pancreaticobiliary Ductal Anomaly

SummaryChronic relapsing pancreatitis is a rare childhood disease. Although various obstructive phenomena have been implicated in its etiology, few reports have described the role played by anomalies of the pancreaticobiliary ductal system. Recently, a patient with a complex anomalous ductal communication was treated by us for chronic relapsing pancreatitis. This particular anomaly, and its clinical presentation, has not previously appeared in the literature. The problems associated with the diagnosis and surgical management of this patient have prompted this report.

Ischemic heart attack related to anomalous communication between coronary artery and main pulmonary trunk

Ischemic heart attack related to anomalous communication between coronary artery and main pulmonary trunk

Anomalous communication between coronary artery and pulmonary artery complicated with combined valvular disease

Anomalous communication between coronary artery and pulmonary artery complicated with combined valvular disease

Anomalous Communication of the Left Coronary Artery with a Peripheral Branch of the Right Pulmonary Artery

A 64-year old man had a history of two myocardial infarctions recurrent episodes of paroxysmal ventricular tachycardia and hemoptysis. Cineangiocardiographic studies showed an anomalous vessel connecting the left coronary artery with a peripheral branch of the right pulmonary artery. Although several coronary obstructive lesions and abnormalities in the distribution of the circumflex branches were found, the anomaly apparently produced a real "pulmonary steal" and, thereby a worsening of the coronary insufficiency. We believe that this is the first reported case in the literature with such a coronary-pulmonary fistula. The angiographic findings are presented in detail, and the possible factors in the development of myocardial ischemia are discussed.

Anomalous communication between coronary and pulmonary arteries

Anomalous communication between coronary and pulmonary arteries

Communication between right pulmonary artery and left atrium

The 12th case of a direct communication between the right pulmonary artery and the left atrium is reported, with special emphasis on the clinical and hemodynamic findings. The anatomic differences in the 12 cases are categorized into three general types: an anomalous vessel connecting the posterior aspect of the right pulmonary artery and draining into the left atrium with (1) normal pulmonary venous connections or (2) the pulmonary vein draining into the anomalous vessel; and (3) an anomalous communication draining into the left atrium in place of the absent right lower pulmonary vein. In patients with this anomaly, surgery should result in complete cure; early intervention is recommended because the mortality rate is higher for patients who are older at operation and because there is an increased chance that cerebral and Systemic emboli will occur if surgery is not performed.

Pathology of angina pectoris.

Among the wide variety of causes of angina pectoris, two major categories may be recognized: the anatomic, causing arterial obstruction, and the functional. The anatomic causes may be divided according to anatomic sites as follows: (1) the major coronary arterial trunks and their epicardial branches, (2) the coronary ostia at the aorta, and (3) the intramyocardial "small" arteries. The major coronary arteries are by far the most common sites for anatomic lesions. Atherosclerosis in its various anatomic manifestations is responsible for about 90% of the cases of angina. Commonly, hypertension and, less commonly, valvular disease are associated. The balance of cases of angina result from various states given below. Nonatheromatous diseases of the major coronary arteries include embolism, primary dissecting aneurysm of a coronary artery, arteritis, and anomalous communication of a coronary artery. Coronary ostial narrowing results from various diseases of the aorta including atherosclerosis, saccular and dissecting aneurysm, inflammation, and calcification of the aorta in relation to origin of a coronary artery. Lesions causing obstruction of the intramyocardial arteries are commonly part of systemic diseases such as hematologic, embolic, metabolic, and degenerative. Functional causes of angina pectoris include aortic valvular disease and functionally related conditions, thyroid disease, and pulmonary hypertension.

Atrioventricular communication in the Wolff-Parkinson-White syndrome.

Congenital anomalous muscular connections between atrium and ventricle allow electrical activity to bypass the normal cardiac conduction system. The resultant acceleration of electrical conductivity from atrium to ventricle is recorded in the electrocardiogram as the Wolff-Parkinson-White (WPW) syndrome. Although usually benign, the WPW syndrome carries a low mortality rate, attributed to the frequently associated paroxysmal atrial tachycardia. Postmortem examinations of the hearts of two patients with congenital heart disease and the WPW syndrome included multiple sections of the normal conduction system and the tricuspid and mitral valve rings. In each specimen, the A-V node and bundle of His were normal. An anomalous communication between the right atrium and the right ventricle was identified in each case and interpreted as the morphologic basis of the WPW syndrome.

Spontaneous arteriovenous fistula between dural branches of the internal maxillary artery and the posterior cavernous sinus.

SPONTANEOUS arteriovenous communications between the dural branches of the external carotid artery and the cavernous sinus are rare. Such malformations may be associated with cranial bruit, proptosis, conjunctival swelling, and dilated arterialized conjunctival veins. These signs and symptoms are clinically indistinguishable from those of the more common fistula between the internal carotid artery and the cavernous sinus. The differential diagnosis, therefore, depends upon neuroradiologic studies that include selective angiograms of the internal and external carotid systems. An anomalous arteriovenous communication between branches of the internal maxillary artery and the dural veins entering the posterior cavernous sinus is exemplified in the following report. Case Report A 62-year-old woman with systemic hypertension was referred to the University of California Medical Center (San Francisco) in April 1967 with symptoms of painless and progressive proptosis of the right eye, swelling of the right eyelids, and a noise in her head that had been present for two weeks. One year previously she had experienced the sudden onset of horizontal diplopia, the result of a right abducens palsy. Medical examinations and skull roentgenograms did not reveal the cause of the palsy, which, in the months that followed, regressed slowly. In 1962, five years before occurrence of the proptosis, the patient experienced a spontaneous intraocular hemorrhage, attributed to rupture of one of a group of small microaneurysms located in the periphery of the left retina. On examination the patient was alert and, with the exception of marked proptosis of the right eye, appeared healthy. The blood pressure was 200/110. Exophthalmometer readings were 24 mm on the right and 20 mm on the left. The conjunctiva of the right eye contained many bright red, dilated veins (Fig. 1). Moderately dilated veins and a few punctate retinal hemorrhages were seen in the right fundus. Vision in the involved eye was 20/40 and in the left eye 20/20. The right lateral rectus muscle was partially paretic, but other ocular movements were normal. A loud high-pitched systolic bruit was heard over the right eye, temple, and forehead. Digital compression of either carotid artery did not obliterate the bruit. Routine hematologic studies, including tests of blood coagulation, glucose tolerance, and erythrocyte sedimentation, gave normal results. An electrocardiogram showed evidence of a mild left ventricular conduction defect. Neuroradiologic studies are illustrated in Figures 2 and 3. Neurosurgical treatment was not recommended because of the mild symptoms and the technical problems imposed by the multiplicity of the arteries supplying the arteriovenous malformation. Discussion

Arteriovenous communication between the occipital artery and transverse sinus.

Anomalous communications between the occipital artery and the transverse sinus represent unusual arteriovenous malformations involving the dura. The major symptom of such a malformation is a pulsatile tinnitus, with a physical finding of a bruit behind the ear. This condition must be considered in the differential diagnosis of intermittent tinnitus, and can be properly evaluated only by angiography. Three cases are presented in which such a malformation was demonstrated angiographically. Case I : A 58-year-old woman with a pulsatile bruit in the left ear for one year before admission. She was occasionally awakened by this buzzing noise. There was no history of previous trauma or local ear infection. The results of physical examination on admission were normal except for a pulse-synchronous murmur behind the left ear. Hearing and vestibular function were unimpaired. A left common carotid arteriogram (Fig. 1) revealed an anomalous communication between branches of the occipital artery and the transverse sinus as well as between the middle meningeal artery and the transverse sinus. Jugular venography revealed no abnormalities. The right transverse sinus was larger than the left. Case II: A 52-year-old man admitted because of a pulse-synchronous buzzing in the left ear of three years duration. Past history revealed that the patient had fallen from a bicycle at the age of twelve years, which resulted in a cerebral concussion but no known fracture. Physical examination disclosed no abnormalities except for slight, nonspecific hearing loss, bilaterally. Roentgenograms showed a normal skull. Selective left external carotid arteriography disclosed an arteriovenous anastomosis between dilated meningeal branches of the occipital artery and the transverse sinus (Fig. 2). A distinct subjective and objective decrease in bruit was noted shortly after angiography, but the condition once more became pronounced a few weeks later. Case III: A 66-year-old woman with a four-month history of transient pressure sensation in the left occipital region followed by a buzzing sound in and behind the left ear. This noise increased with time and was synchronous with the pulse. The bruit stopped two weeks before admission, but returned suddenly ten days later. At that time the patient also experienced transient vertigo associated with nausea and vomiting. Two years prior to admission otitis in the right ear had been accompanied by spontaneous rupture of the tympanic membrane. Following this, the patient noted a pulsatile sound in the right ear which had persisted. Her past medical history showed several episodes of syncope, but no definite skull injury. On physical examination the blood pressure was 170/100 mm Hg. A pulse-synchronous murmur was heard in the left mastoid and occipital regions. A coarse nystagmus was noted on left lateral gaze.