Bizarre Changes Research Articles

A BIZZARE ECG

Abstract Electrocardiographic artifacts are common and may interfere with interpretation. We describe a clinical case where a limb lead electrode was placed near the pulsation of the radial artery, which created an artery pulse tapping artifact also called Aslanger‘s sign or electromechanical association. This is a very unique physiological type of electrocardiogram (ECG) artifact generated by the movement of the electrode placed near the pulsatile artery, particularly in hyperdynamic state such as hyperthyroidism, severe anemia, liver cirrhosis and arteriovenous fistula, including dialysis fistula of end–stage renal disease. These kind of artifacts may imitate primary repolarization changes characteristic for acute coronary syndrome, arrhythmias or electrolyte abnormalities; thus, they have the potential to trigger unnecessary tests. Careful inspection of the ECG in Fig.1 revealed that the coupling interval of the QRS complex and the artifact is identical, which signifies that the artifact is synchronous with cardiac cycle. In the given ECG, bizarre changes were seen in all limb leads except lead III, suggesting that the artifact arose from right arm limb electrode. The repeat ECG in Fig.2 was taken such that the electrode was not directly on the pulse, showed disappearance of the artifact. When ecountering unexpected electrocardiographic findings, inspection of the ECG and lead placement may identify the cause. Recognizing such intimidating ECG artifacts is very important to avoid unnecessary interventions in a benign condition.

Latent toxoplasmosis impairs learning and memory yet strengthens short-term and long-term hippocampal synaptic plasticity at perforant pathway-dentate gyrus, and Schaffer collatterals-CA1 synapses

Investigating long-term potentiation (LTP) in disease models provides essential mechanistic insight into synaptic dysfunction and relevant behavioral changes in many neuropsychiatric and neurological diseases. Toxoplasma (T) gondii is an intracellular parasite causing bizarre changes in host’s mind including losing inherent fear of life-threatening situations. We examined hippocampal-dependent behavior as well as in vivo short- and long-term synaptic plasticity (STP and LTP) in rats with latent toxoplasmosis. Rats were infected by T. gondii cysts. Existence of REP-529 genomic sequence of the parasite in the brain was detected by RT-qPCR. Four and eight weeks after infection, spatial, and inhibitory memories of rats were assessed by Morris water maze and shuttle box tests, respectively. Eight weeks after infection, STP was assessed in dentate gyrus (DG) and CA1 by double pulse stimulation of perforant pathway and Shaffer collaterals, respectively. High frequency stimulation (HFS) was applied to induce LTP in entorhinal cortex-DG (400 Hz), and CA3-CA1 (200 Hz) synapses. T. gondii infection retarded spatial learning and memory performance at eight weeks post-infection period, whereas inhibitory memory was not changed. Unlike uninfected rats that normally showed paired-pulse depression, the infected rats developed paired-pulse facilitation, indicating an inhibitory synaptic network disruption. T. gondii-infected rats displayed strengthened LTP of both CA1-pyramidal and DG-granule cell population spikes. These data indicate that T. gondii disrupts inhibition/excitation balance and causes bizarre changes to the post-synaptic neuronal excitability, which may ultimately contribute to the abnormal behavior of the infected host.

First-principle study on the X (X=N, P, As, Sb) doped (9.0) single-walled SiC nanotubes

The structural and electronic properties of N, P, As and Sb doped (9.0) single-walled SiC nanotubes (SWSiCNTs) are investigated by the first-principle theory. The calculated results indicated that one P, As or Sb atom substituted for one C atom, which could be considered as n-type semiconductors. When one N, P, As or Sb replace one Si atom, the model shows the character of semi-metallic, n-type semiconductor, p-type semiconductor respectively. These results indicated that with the addition of atomic radius and reduction of electronegativity, dopant of VA elements will bring bizarre change of electronic properties. These results are expected to give valuable information in building nanoscale electronic devices.

Teaching and Learning Guide for: Recent Work on Propositions

Teaching and Learning Guide for: Recent Work on Propositions

Specular microscopy of the corneal endothelium after liquid silicone injection into the vitreous in complicated retinal detachments.

Twenty-one patients were followed up for at least 6 months after pars plana vitrectomy and liquid silicone injection into the vitreous for complicated retinal detachment by means of specular microscopy. In 17 eyes without silicone penetration into the anterior chamber, only insignificant changes were observed. In contrast, in 4 eyes, where a large drop of liquid silicone penetrated into the anterior chamber, the cell densities rapidly decreased to critical values and a marked pleomorphism of large endothelial cells with abnormal intracellular details indicated serious damage of the surviving cells. A characteristic structureless reflecting layer with contourlike lines in some areas of the specular image was a newly observed bizarre change that was caused by the replacement of the anterior chamber fluid by liquid silicone with markedly different optical properties.

Ovarian sex cord-stromal tumors with bizarre nuclei: a clinicopathologic analysis of 17 cases.

Seventeen ovarian sex cord-stromal tumors that contained bizarre nuclei are reported. The patients, two of whom were pregnant, ranged in age from 14 to 72 years (average, 47 years). The tumors, two of which had ruptured, were all Stage Ia. On microscopical examination, all the tumors had areas typical of one of the subtypes of ovarian sex cord-stromal tumors but, in addition, had foci where the cells had enlarged bizarre nuclei. Multinucleated giant cells were present in 12 cases and were of the floret-type in five of them. Apart from the presence of the bizarre nuclei and giant cells, the microscopical appearance and the mitotic rate of the tumors were similar to those of sex cord-stromal tumors in general. Eight tumors were classified as granulosa cell tumors, seven as Sertoli-Leydig cell tumors, and two as thecomas. Eleven patients who have been followed for 3-21 years (average, 9.7 years) postoperatively are alive and free of disease. Two patients have been lost to follow-up, and four have been treated too recently for a meaningful follow-up. The bizarre changes in these tumors resemble those seen in the uterine leiomyoma with bizarre nuclei and, like them, are probably degenerative. Their presence does not appear to alter the prognosis of the underlying tumor in view of the results of this small series.

Vertical Folds of Central Retina and Choroid in Sudden Ocular Decompression

Sudden and limited decompression of an eye due to corneal rupture has four days later allowed for the histopathological demonstration of an interesting combination of a vertical retinal fold, cystoid macular edema, degeneration of foveal cones, a vertical choroidal fold with loss of pigment epithelium and papilledema. The rather bizarre changes in this case may be helpful for the understanding of the much more subtle histopathological findings in typical cystoid macular edema.

On the role of tortuous coronary arteries in billowing mitral leaflet syndrome. A hypothesis

Sixty three male patients with billowing mitral leaflet syndrome (BML) and forty one age and sex match controls were studied with emphasis on the cineangiographic features of coronary arteries. In the BML group, the coronary arteries were considered normal in five and abnormal in fifty eight. In fifty eight with abnormal coronary arteries, twelve showed atherosclerotic occlusive lesions, fifteen showed combined occlusive lesions and nonocclusive abnormalities and thirty one showed nonocclusive abnormalities alone. The non-atherosclerotic abnormalities consisted of redundancy of the coronary arteries manifested by bizarre changes in configruation and motion. These abnormalities were present in only five patients in the Control Group. On the basis of our observations and corroborative evidence in the literature, a hypothesis is presented; the salient features of which are that: (1) the spectrum of BML may be considerably more complex than hitherto suspected, (2) a combination of BML and tortuous coronary arteries may form a distinct subset of this spectrum and (3) the increased tortuousity may result in impaired coronary perfusion causing myocardial ischemia thus offering a possible explanation for some of the symptoms — such as chest pain, arrhythmias and even sudden death seen in this syndrome.

HISTOPATHOLOGICAL STUDIES ON RADIATION PNEUMONITIS.

Postmortem findings in 25 patients who had received radiotherapv for cancers of the thoracic region are reported. The local x-ray or Co/sup 60/ gamma -ray doses varied up to 30,500 rad. Several other systems of classification of radiation pneumonitis were rejected and a new scheme is proposed which classifies this disease into four types from a pathologic standpoint according to the degree of damage to tissue components: alveolar exudative type (11 cases); interstitial proliferative type (2 cases); mixed type (5 cases); and fibroatelectatic type (7 cases). The alveolar exudative type is characterized by the exudation caused by irradiation and its organization, which occur in the alveoli. This finding is predominant, and edema, hyaline membrane formation, fibrin deposition, and intra-alveolar fibrosis are observed, In the interstitial proliferative type the major finding is fibrous thickening of the interstitial tissue including the alvelolar septa; the elastic fibers degenerate and rupture. The changes of alveolar epithelium are observed in both of these types, with proliferation and bizarre changes. In the mixed type these changes exist in the same specimen. These three types can be classified into three stages; i.e., early,, middle, and late. The fibroatelectatic type represents a late stage; the lungs are atelectaticmore » and abnormal proliferation of elastic fibers is observed in the alveolar wall which shows hyaline thickening. Macroscopically, this may be subdivided into localized and diffuse forms according to the extent of lesions. In the latter form, the whole lung becomes contracted to fist-size. Intra-alveolar edema was observed in 13 of 25 cases, frequently complicating in the early and midille stages. In seven of 25 cases, hyaline membrane formation was noted, mostly in the alveolar exudative type and only in cases with severe edema. Fibrin deposition occurred in 14 cases, mostly in alveolar exudative or mixed types. In the alveolar epithelium, regardless of the type of lesion, swelling and proliferation were both observed. Frequently, it assumed a bizarre form, the nuclei showing atypical forms and sometimes a multinuclear giant cell with two to three nuclei. The cytoplasm was darkly stained with eosin and was PAS-positive. Proliferating alveolar epithelium desquamated into the alveoli, and showed a tendency to fatty degeneration. In the late stage, a gland-like metaplasia with proliferation of alveolar epithelium was observed in six cases. Thickening of the alveolar septa was one of the most significant changes in radiation pneumonitis. Similar changes were seen in animal experiments with rats and rabbits. In these animals, however, marked changes could not be induced, which might be due to low sensitivity of endothelium of the alveolar capillary in comparison to the human. But in rabbits the same kind of changes as seen in human cases were noted in the alveolar septa in a few cases which received 10,000 r in divided doses (500 r, 20 times). This produced a marked change on the 140th day, and in an extensive area, fibrous thickening of the alveolar septa was observed, four to five times the normal thickness. In the human cases there was no difference in reactions between x-ray and Co/sup 60/ irradiation. In the pathogenesis of this disease, the increase of capillary permeability of the alveolar wall seems to play the most important role. In addition to it, the lesion is characterized by abnormal metabolism of alveolar epithelium and new growth of connective tissue. The diagnostic criteria of this disease are discussed. (BBB)« less

The Artificial Kidney

The first so-called artificial kidney used in this country was an ingenious device containing a collodion membrane as the filter and hirudin, the active anticoagulant principle of the leech, to prevent blood clotting. It was used in experiments to remove salicylate from the blood of dogs by extracorporeal circulation.1Almost 50 years later the same basic technique is used to treat salicylate poisoning in the human.2In spite of some radical and occasional bizarre changes in design, only one fundamental modification has been made in the apparatus proposed by Abel in 1913.1This is the substitution of a cellophane membrane for the collodion membrane laboriously hand poured by Abel and his collaborators. The necessity for grinding leech heads to extract its anticoagulant substance has been obviated by the development of heparin. With this exception, little change has occurred in the fundamental operating principle of hemodialysis. As the

Dystrophia unguium mediana canaliformis.

Dystrophia unguium mediana canaliformis is a very rare and rather bizarre change affecting one or more nails, usually the thumb nails, in which a central, longitudinal, dark-colored streak appears for no apparent reason. Robinson and Weidman1reported a case in 1948 and listed the few previously reported cases back to the original one described in 1928 by Heller,2who named the condition. The following case seems worth recording because of its curious periodicity and the exact symmetry of the lesions in the two thumbs. REPORT OF A CASE The patient was a fit, slightly built man of 33. He presented himself complaining of an abnormality of both thumb nails, illustrated in figure 1. About seven weeks before I saw him he had noticed a defect at the base of each thumb nail. There was no discomfort and no apparent inflammation of the perionychial tissues. As the nails grew

VESTIBULAR REACTIVITY IN SCHIZOPHRENIA

In a series of papers, 1 Angyal has described a syndrome occurring in a certain form of schizophrenia and consisting essentially of a particular type of dissociation, which has been called loss of ego reference. An outstanding feature of the syndrome is the constant occurrence of paresthesias: bizarre changes in the experience of the body—a subjective impression of excessive lightness or heaviness, of changes in the size of the body and other distortions of the body image. According to Angyal, these paresthesias are due to changes in the muscle tonus, which become dissociated in conjunction with the dissociation of complex behavior tendencies. The explanation of these paresthesias on the basis of changes in the muscle tonus was supported also by the fact that it was possible to produce experimentally similar changes in the experience of the body in normal subjects by introducing passive changes in muscle tonus. Such experimentally produced