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Biomedical subjects

C Brechenmacher

Publications and source records attributed to C Brechenmacher.

At least 73 records · Page 4Linked to original sources
PubMed1983

[Electrocardiographic criteria of left ventricular hypertrophy and unipolar aVR lead].

The introduction of data processing techniques into the interpretation of electrocardiograms and the rapid progress towards automatization require a multiplication of the criteria of decision and an exact evaluation of their performance. The ECG diagnosis of left ventricular hypertrophy depends on a large number of parameters. Only the aVR lead has not been fully exploited to date. This study proposes a corrected measurement of S in aVR, with an amplitude of S aVRc greater than or equal to 11 mm being the parameter with the best performance and the best predictability.

Adult↗
PubMed1983

[Application of endocavitary mapping to the study of auricular flutter].

Many in vitro and animal experimental studies seem to support the hypothesis of reentry as the physiopathological mechanism of atrial flutter. Clinically, these studies are much more difficult because of problems in determining the different sequences of atrial depolarisation. In this study, the authors attempted to improve the technique of endocavitary atrial mapping. Three or four multi-recording electrodes were positioned in the atria using biplane 30 degrees RAO and 60 degrees LAO incidences. Right atrial angiocardiography showed up the atrial borders and enabled the recording catheters to be more accurately positioned. Thirty to 47 recordings points were thereby determined within the atrial cavities, the left atrium being studied via the coronary sinus, right pulmonary artery, patent foramen ovale or by the endooesophageal approach. This method of spatial orientation of the catheters associated with recording of the endocavitary potentials allowed the construction of an isochronic map of atrial depolarisation, which was then analysed for each case of flutter. The study confirmed two hypotheses: the asynchronism of right and left atrial depolarisation, and the circus motion of depolarisation. Three types of flutter were observed: --The first two types were similar with cirus motion within the right atrium. The wave front ascended in part or all of the septum and descended in the external free wall of the right atrium. There was a transitional zone, possibly reentrant, in the groove located anterior to the inferior vena cava. --The third type of flutter was atypical and was associated with cirus motion in the left atrium. Two transitional zones, similar to those encountered in the right atrium, were detected in one patient between the orifices of the pulmonary veins, and, in another patient, on the anterior part of the roof of the left atrium. These transitional zones seem to be at the basis of the physiopathological mechanism of flutter. Unfortunately, their small size makes their analysis by endocavitary mapping difficult.

Atrial Flutter↗
PubMed1982

Abnormal proliferation of intraergastoplasmic microfilaments in myelinated schwann cells: ultrastructural study of two cases.

We report the ultrastructural findings in superficial peroneal nerve biopsies in two patients, one with idiopathic sensory neuropathy and the other with the Guillain-Barré syndrome and Hodgkin's disease. In addition to demyelination, there was an intense proliferation of microfilaments within numerous vesicles of the endoplasmic reticulum of a great number of myelinated Schwann cells. This abnormality does not appear to have been previously reported in the literature. The mechanisms responsible for this finding are unknown.

Aged↗
PubMed1981

Ultrastructural study of peripheral nerve in Guillain-Barré syndrome presence of mononuclear cells in axons.

As has been shown during the course of experimental allergic neuritis, in the Guillain-Barré syndrome there is an invasion of the myelin sheath in certain fibres by a mononuclear cell, with an intact axon. In a series of 45 cases we have been able to show this feature in 31 cases. In certain cases the cytoplasm prolongation of the invading cell was seen in the myelin sheath, forcing apart two neighbouring layers. In five cases we have furthermore observed the presence of mononuclear cells located either between the myelin and the axon which is deformed, or on the inside of the axon. Such an anomaly was frequent in one recent case and was occasionally found in four other cases.

Axons↗
PubMed1981

[Wolff-Parkinson-White syndrome and longitudinal dissociation of the atrioventricular node. Anatomical and electrophysiological correlates].

A 58 year old man who died of metastatic carcinoma had undergone electrophysiological investigation 4 years previously for a Wolff-Parkinson-White syndrome (Rosenbaum Type A, Frank and Boineau Type IV) associated with supraventricular tachycardia (SVT) at 180/mn, atrial fibrillation and flutter and slow junctional (or low atrial) rhythm at 70-80/mn. Atrial extrasystoles or appropriate atrial stimulation not only induced and terminated the SVT but also the junctional rhythm and allowed passage from one arrhythmia to another. These studies showed the presence of a left lateral Kent bundle responsible for orthodromic SVT with retrograde conduction through the accessory pathway, and suggested that the junctional rhythm might be due to longitudinal dissociation of the AV node. Autopsy findings confirmed the presence of the left posterolateral Kent bundle in an almost horizontal position, parallel to the mitral annulus (it might therefore have escaped eventual surgical section) and the longitudinal dissociation of the AV node.

Atrioventricular Node↗
PubMed1980

Guillain-Barré syndrome and Hodgkin's disease--ultrastructural study of a peripheral nerve.

A 46-year-old male patient developed the Guillain-Barre syndrome and recovered completely within 3 months. He had been treated 5 years previously for Hodgkin's disease, and during the neurological syndrome, relapse of the malignant lymphoma was discovered. On neuro-muscular biopsy, lymphocytes were observed penetrating Schwann cells. These neuropathological aspects confirm the auto-immune character of the nervous involvement.

Hodgkin Disease↗
PubMed1980

[Association of nodoventricular and atrioventricular fibers with the origin of reciprocating tachycardia. Electrophysiological and anatomopathological aspect].

A 25 year old patient presented with several types of paroxysmal tachycardia. Analysis of the recordings and the results of endocavitary electrophysiological investigation suggest the presence of nodoventricular and atrio-ventricular fibres. These two accessory pathways were latent in sinus rhythm but formed part of reentry loops. The reciprocating rhythms used the Kent bundle in the retrograde direction, and either the normal nodo-hisian or the Mahaim fibres in the anterograde direction. Simple echos ascending by the nodo-hisian pathway and descending by the nodo-ventricular pathway were also observed. The patient died of an unassociated cause and a pathological examination of the heart was performed. This confirmed the presence of a left posterior paraseptal Kent bundle and the presence of fibres relaying the inferior part of the atrioventricular node to the septal ventricular myocardium, this being made possible by a dehiscence of the central fibrous body.

Adult↗
PubMed1980

Persistent fetal dispersion of the atrioventricular node. Association with the Wolff-Parkinson-White syndrome.

Symptomatic supraventricular tachycardias developed in a 58-year-old man not long before he also was found to have metastatic cancer. During electrophysiological studies, type A Wolff-Parkinson-White syndrome was defined and at least four different forms of supraventricular tachycardias were documented. When he died of his cancer, autopsy studies included special examination of his heart and its conduction system. There was a slender connection between the left atrium and left ventricle posterior to the margo obtusus, composed of ordinary working myocardial cells. There was also persistent fetal dispersion of the atrioventricular (AV) node within the central fibrous body, forming a suitable anatomical substrate for reentrant tachycardias originating entirely there. The anatomical and electrophysiological findings are discussed relative to the question of surgery in such patients, since cutting the lateral AV connections might eliminate the delta wave but not the supraventricular tachycardias.

Atrioventricular Node↗
PubMed1978

Relapsing polyradiculitis after portocaval anastomosis.

A case of relapsing polyneuritis in a cirrhotic woman with a surgical splenorenal shunt is reported. The ultrastructural study of the nerve biopsy shows widespread segmental demyelinization with total myelin breakdown in most fibers; some Schwann cells are invaded by mononuclear cell processes. Such histological changes are characteristic of the Guillain-Barré syndrome. Alcohol and diabetes are unlikely to be the causative factors of the nerve damage. The possible role of unidentified toxic metabolites such as those which cause portosystemic encephalopathy, also present in our patient, is discussed.

Female↗
PubMed1977

XXII. Intractable paroxysmal tachycardias which proved fatal in type A Wolff-Parkinson-White syndrome.

Paroxysmal tachycardias proved fatal in a middle-aged man with type A Wolff-Parkinson-White syndrome. Efforts to control his arrhythmias included a surgical incision into the left atrium, based on discovery of early left ventricular activation during epicardial mapping. The incision did not alter any electrocardiographic or clinical feature; at later necropsy examination it was found that the incision had not cut a nearby left atrioventricular (A-V) connection. Serial section study of the entire A-V rings and septal junction of this heart also demonstrated a second unusual A-V connection, between the atrial septum and the region of the His bundle. This latter connection was anatomically eccentric to the normal organization of this region and may have caused an alteration in the local electrophysiological behavior. The left lateral A-V connection may have been of no electrophysiological significance since it was composed of ordinary working myocardial cells. These and other possible correlations are discussed in the context of the clinical features, numerous electrophysiological observations, and the meticulously determined anatomical findings.

Atrioventricular Node↗