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Biomedical subjects

P Nicolai

Publications and source records attributed to P Nicolai.

10 recordsLinked to original sources
PubMed1977

[Auricular fibrillation with ventricular tachycardia. Surgical section of a left lateral bundle of Kent].

The authors report the case of a man of 22 years, with no previous cardiac history, in whom a Wolff-Parkinson-White syndrome was discovered during the course of this first episode of atrial fibrillation with a ventricular rate of 300-350/mn; investigation (vecto-cardiogram, intra-cavitory ECG) showed the presence of a short circuit of the Kent type, with a high permeability, and localised in the left lateral position; this was confirmed by pericardial cartography. After the surgical division of the accessory pathway, the electrical phenomenon of pre-excitation disappeared. The current possibilities of operating on cases of a Wolff-Parkinson-White syndrome justify carrying out a scrupulous electrophysiological study of each case, so that any accessory pathway can be precisely localised, and its refractory period determined; thus a pathway of preexcitation localised in the left lateral position, and having a short refractory period leading to a high ventricular rate under atrial fibrillation conditions, constitutes an indication for operation which may be urgent.

Adult↗
PubMed1976

[Gap phenomenon and supranormal conduction during intermittent left bundle-branch block].

The mechanism of intermittent bundle branch block, whether spontaneous or as a result of vagal stimulation, can be studied by reference to the known facts of atrial stimulation. Three cases with intermittent left bundle branch block were studied by means of an intracavitary electrode, which allowed the potential of the bundle of His to be measured, and was also used for the extrastimulus method of study. In case 1, in which the block was independent of the cardiac rate, a type 1 "Gap" phenomenon (of nodal origin) was demonstrated; the coupling zone in which the extrastimulus overcame the block was situated in two areas, one being late, and the other earlier in a region where the conduction was normal. In case 2, in which the block was dependent upon the heart rate, the "recovery" of the blocked branch after early coupling of the extrastimulus seemed to be associated with the phenomenon of "supra-normal" conduction. In case 3, in which the block was again dependent upon heart rate, the two phenomena of "Gap" and "suppranormality" seemed to act successively when the coupling of the extrastimulus is decreased progressively. These observations allow us to distinguish two types of intermittent left bundle branch block; one, which is not related to heart rate, is characterised by a prolonged refractory period of the left bundle branch, which becomes progressively shorter as the heart rate increases; the other, which is dependent upon tachycardia, is characterised on the one hand by an increased left bundle branch refractory period which does not shorten as the heart rate increases, and on the other by the phenomenon of supranormal conduction.

Bundle of His↗
PubMed1975

[Study of sinus node function. Preliminary results].

Direct exploration of the sinus node remains experimental. Indirect techniques have been put forward to assess the sinus function in man: high frequency atrial pacing; premature atrial pacing; pharmacodynamic tests using atropin and isoproterenol injection. 68 patients were so explored: in 10 of them were ECG signs suggestive of "sinus disease" or "atrium disease" (group I); 14 subjects had only a sinus bradycardia with a rate of 55/mn or below (group II); in 16 cases, the ECG tracing was normal, but there was the notion of paroxysmal tachycardia or various disturbances (group IIIa); finally, in 28 cases the ECG demonstrated atrio-ventricular or inter-ventricular conduction disturbances (group IIIb). The preliminary results reported here should be interpreted carefully; nevertheless, correlation of the data obtained by the various techniques used, seems to be able to allow a correct assessment of sinus automatism, and of sino-atrial conduction.

Adult↗
PubMedDate not supplied

Sphenoid mucocele with intracranial invasion secondary to nasopharyngeal acinic cell carcinoma.

We present a case of sphenoid mucocele with large invasion of the middle cranial fossa, secondary to a nasopharyngeal acinic cell carcinoma, occurring in a 52-year-old man. To the best of our knowledge, this association has not been reported so far. We discuss the importance of imaging techniques in delineating the relationship between the two lesions, as long as the clinical and therapeutic problems related both to sphenoid mucocele and acinic cell carcinoma.

Carcinoma↗