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PubMedDate not supplied

[Effects of amiodarone on atrio-ventricular and ventriculo-atrial conduction in the Wolff-Parkinson-White syndrome (author's transl)].

In 10 patients with the Kent's bundle W.P.W. syndrome, the action of amiodarone (5 mg/kg i.v.) on conduction along the normal and anomalous pathways was studied. The drug actions were: 1) constant increase of the anomalous pathway E.R.P., in one case with antegrade functional block; 2) constant reduction of antegrade conduction velocity along the anomalous pathway, in one case with antegrade functional block; 3) reduction of retrograde conduction velocity along the anomalous pathway in 6 cases out of 8, including one with retrograde functional block; 4) constant increase of the A-V node E.R.P.; 5) reduction of sub Hisian A-V conduction velocity in 3 cases out of 7. Episodes of reciprocating tachycardia could be initiated by atrial electrostimulation in 5 patients before administration and in 3 following administration of the drug. In connection with the electrophysiological properties of the two atrio-ventricular pathways and on the mechanism of tachycardia, the use of this drug in prevention of the circus movement tachycardia in patients with the W.P.W. syndrome is discussed.

Adolescent↗
PubMedDate not supplied

Let first-level supervisors do their job.

Performing well as a first-level supervisor is like walking the circus high wire. In both positions, the ability to maintain one's balance when shifting forces pull in opposite directions is a measure of one's success. First-level supervisors must be able to harmonize the demands of management, the demands of the collective work force (often represented by unions), and the demands of workers with the requirements for doing the tasks at hand. These needs are more often than not conflicting and even at times mutually exclusive. First-level supervisors usually have mixed emotions about their situation and often lose their sense of identity as they try to perform this precarious balancing act. Today these supervisors are part of management, but chances are they were once among the employees they are now trying to supervise. Although first-level supervisors have the responsibility for implementing the goals of upper management, their organizational authority to carry out the necessary actions is frequently unclear and often insufficient. By allowing these lowest-level managers to use the levers of influence inherent in their position, higher-level managers will be improving the performance of the whole organization.

Administrative Personnel↗
PubMed1976

[A proposed hepatic pie chart].

The AA. have chosen 12 tests to organize an "hepatic flash" after a selection out of 180 cases scheduled as the table no. I through a set of tests showing step by step any modifications in compliance with the sensibility, reliability, statistical clinical and physio-pathological meaning of each test. The 12 tests are set out by circular abscissae of a circus according to the pathogenetic mechanisms leading to their modifications. By the radial ordinates, instead, it is shown the decreasing and increasing values which every test may assume. An hypothetic line (hepatogram) links then the values set out during the process of the disease in such a manner that the particular shapes assumed by the line itself show quickly and visually the spreading rate of the disease process.

Bilirubin↗
PubMed2000

[The flea in cultural history and first effects of its control].

The knowledge about the biology and the origin of fleas from different periods of time as well as different geographical regions are described, starting from antiquity. Among this, the role of fleas in literature and art, for example in fairy tales and legends, proverbs and fables, painting and music and also the so called "circus of fleas" are covered. In connection with those aspects of cultural history the first efforts of control of flea plagues are mentioned. In addition to magic spells, these also include more or less complicated fleatraps for fleas and attempts of chemical control.

Animals↗
PubMed1975

Disturbances of transmembrane ionic fluxes and their role in the pathogenesis of cardiac dysrhythmias.

Abnormalities of cardiac rhythm are due either to disorders of impulse propagation (delay or block of conduction, re-entry, circus movement, etc.), or to disturbances of impulse formation (dysfunction of ordinary pacemakers and induction of focal activity). In most instances certain disturbances of transmembrane movements of Na or K ions may be considered to be involved basically in the genesis of dysrhythmic cardiac activity. By means of intracellular recordings as well as of voltage clamp measurements and of analogical computations it is demonstrated that characteristic changes of the membrane potential might result from entirely different ionic mechanisms. Furthermore, an attempt is made to present a detailed analysis of permeability changes underlying normal pacemaker activity in Purkinje fibers as compared with the sinus node or with focal activity induced in myocardial fibers by different influences (aconitine, barium ions, stretch, and strong currents).

Aconitine↗
PubMed1997

[Man and animal from the ethical view]

This review over the books, articles in Journals and newspapers in 1996 and 1997 reports about the development in the field of man-animal- and man-nature-relations. The review considers the following themes: development, trends and perspectives, philosophy, theology, eco-ethics, legal questions, animal experimentation, freedom of research, teaching and conscience, farm animals, hunting and fishing, zoo and circus, bio-technology, violence, killing, vegetarism and dignity of creatures. The review includes a bibliography with about 300 quatoations.

Journal Article↗
PubMed1975

New manifestations of dual A-V nodal pathways.

Electrophysiological studies with extrastimulus technique demonstrated evidence of dual A-V pathways in two patients with paroxysmal supraventricular tachycardia (PSVT). In case one, the second P of paced Wenckebach sequences was followed by two conducted QRS complexes without an intervening P wave. The A-H of the first and second QRS were consistent with the fast and slow pathway conduction times. The second QRS was followed by an atrial echo and PSVT, suggesting that the first pathway was available for retrograde propagation following the second QRS. In case two, PSVT was induced with atrial extrastimulus, followed by development of A-V dissociation. The two cases suggest the following conclusions: (1) dual A-V nodal pathways may allow the occurrence of double antegrade conduction of one P; (2) the atria are not necessary for A-V nodal circus movements in "dual pathway" A-V nodal reentrant PSVT.

Animals↗
PubMed2001

Esophageal perforation in a sword swallower.

We present the case of a 59-year-old man who sustained an esophageal perforation as a result of sword swallowing. An esophagogram established the diagnosis, and surgical repair was attempted. However, 19 days later, a persistent leak and deterioration of the patient's condition necessitated a transhiatal esophagectomy with a left cervical esophagogastrostomy. The patient recovered and has resumed his daily activities at the circus, with the exception of sword swallowing. This case report presents an unusual mechanism for a potentially lethal injury. Our search of the English-language medical literature revealed no other report of esophageal perforation resulting from sword swallowing. Management of such an injury is often difficult, and a favorable outcome is dependent on prompt diagnosis and treatment.

Accidents, Occupational↗
PubMed1975

The effects of ajmaline in experimental and clinical arrhythmias and their relation to some electrophysiological parameters of the heart.

The antiarrhythmic efficacy of ajmaline has been evaluated in three experimental models of cardiac arrhythmias in the dog. These data have been related to the actions of the compound on several parameters of heart function and compared to results obtained in various clinical arrhythmias. Ajmaline was more effective in arrhythmias of the ectopic focus type than in the circus movement model. These results agreed with the pattern of clinical activity. The compound produced decreases in excitability and conduction and increased the functional refractory period in all heart tissues. These effects were most marked in the atrium. The drug also showed a moderate degree of anticholinergic activity. Both in the dogs and in the clinical cases, the agent showed an important hypotensive effect. In a group of experiments in which transmembrane potentials were recorded, the compound produced in all tissues a decrease in upstroke velocity and amplitude of the action potential; it also increased the duration of the action potential in atrial and ventricular muscle, but it decreased it in Purkinje fibers. The possible mechanism(s) of action of the drug is discussed in terms of the different hypotheses for cardiac arrhythmias.

Action Potentials↗
PubMed2001

[Cardiac arrhythmias in pregnancy].

Atrial premature beats are frequently diagnosed during pregnancy (PR), supraventricular tachycardia (SVT; atrial tachycardia, AV nodal reentrant tachycardia, circus movement tachycardia) less frequently. For acute therapy, electrical cardioversion with 50-100 J is indicated in all unstable patients (pts). In stable SVT the initial therapy includes the vagal maneuver to terminate breakthrough tachycardias. For short-term management, when the vagal maneuver fails, intravenous adenosine is the first-choice drug and may safely terminate the arrhythmia. For long-term therapy, beta-blocking agents with beta 1 selectivity are first-line drugs; class Ic agents or the class III drug sotalol (sot) are effective and therapeutic alternatives. Ventricular premature beats are also frequently present during PR and benign in most pts; however, malignant ventricular tachyarrhythmias (sustained ventricular tachycardia [VT], ventricular flutter [VFlut], ventricular fibrillation [VF]) were observed less frequently. Electrical cardioversion is necessary in all pts with a hemodynamically unstable situation and life-threatening ventricular tachyarrhythmias; in hemodynamically stable pts, initial therapy with ajmaline, procainamide or lidocaine is indicated. If prophylactic therapy is needed, beta-blocking agents with beta 1 selectivity are considered as first-choice drugs. If this therapy is ineffective, class Ic agents or sot can be considered. In pts with syncopal VT, VF, VFlut or aborted sudden death an implantable cardioverter-defibrillator is indicated. In pts with symptomatic bradycardia, a pacemaker can be implanted using echocardiography at any stage of PR. The treatment of the pregnant patient with cardiac arrhythmias requires important modification of the standard practice of arrhythmia management. The goal of therapy is to protect the patient and fetus through delivery, after which chronic or definitive therapy can be administered.

Anti-Arrhythmia Agents↗
PubMed1975

[Electrocardiographic features and vectorial analysis of cardiac potentials in electric shock-induced ventricular fibrillation (author's transl)].

The authors examined the electrocardiographic features of ventricular fibrillation and other ventricular paroxysms induced by electric shock in the guinea pig. The analysis of the electrocardiographic patterns, as well as the vectorial study of the cardiac potentials during repeated episodes of ventricular "anarchy" induced in more than forty animals, showed the following data: 1. following electric shock, ventricular paroxysms appear, featuring paroxysmal tachycardia, typical or impure flutter, tachycardia--either "torsade de pointe" or "spindle" type, and typical ventricular fibrillation. Such different electrocardiographic patterns represent evolutive stages of electric activity disorganization, leading to a complete ventricular "anarchy". Such steps may reverse when reorganization of the electric activity and spontaneous defibrillation occur; 2. an attempt can be made at present to classify ventricualr paroxysms, thus eleminating semeiotic and semantic errors, still present in the literature, and providing a standardization of both nomenclature and electrocardiographic interpretation; 3. during fibrillation, the mean ventricular rate decays, featuring an exponential curve. This phenomenon accounts for a metabolic depletion of the myocardium: the higher the number of fibrillation episodes previously induced and subsided (either spontaneously or not) in the same animal, the faster the course of the phenomenon; 4. the vectorial analysis of the fibrillation potentials and, particularly, the graphic construction of "depolarization" and "repolarization" vectorcardiograms, in the differenttypes or variants of ventricular paroxysms, show that the basic mechanisms leading to ventricular electric activity disgregation are the multiple re-entry and the irregular spreading of the activation front; 5. on the basis of the acquired data, the authors believe that the "circus movement" theory (Wiggers) is still the most suitable for explaining the onset and the evolution of ventricualr fibrillation.

Animals↗
PubMedDate not supplied

[Occurrence of parasites in indigenous birds of prey and owls].

In the present paper a general overview on parasites in birds of prey and owls is given. This part is followed by a study investigating the prevalences and species of parasites in free-ranging birds of prey and owls in Berlin and Brandenburg State, Germany. Over a one year period, 84 birds of prey and owls of the following species were examined for the presence of endo- and ectoparasites: Common Buzzard (Buteo buteo) (n = 32), Kestrel (Falco tinnunculus) (n = 20), Sparrowhawk (Accipiter nisus) (n = 9), Goshawk (Accipiter gentilis) (n = 8), Black Kite (Milvus migrans) (n = 4), Peregrine Falcon (Falco peregrinus) (n = 3), Marsh Harrier (Circus aeruginosus) (n = 1), White-tailed-Sea Eagle (Haliaeetus albicilla) (n = 1), Tawny Owl (Strix aluco) (n = 4), Long-eared Owl (Asio otus) (n = 1) and Barn Owl (Tyto alba) (n = 1). In 97.6% of the cases, ectoparasites (feather mites and hippoboscid flies) were found. Especially eyasses (93.3%) were positive for hippoboscid flies. Trichomonas was detected in 28.6% of all birds of prey and owls examined. A prevalence of 100% was established in the Sparrow Hawks as well as Peregrine Falcons. Leucozytozoon sp. and Hemoproteus sp. as blood parasites were found in 26.9% of the birds in total. Common Buzzards showed the highest prevalence (44.8%). 58.3% of birds examined were positive for endoparasites. Flukes were found in 16.7%, tapeworms in 14.3%, round-worms in 48.8% and acanthocephales in 2.4% of the cases. Interestingly, Tylodelphis clavata (in a Common Buzzard) and Hovorkonema variegatum (in a Goshawk) were found for the first time in raptors. The results of this study underline the importance of a parasitological examination in the process of raptor rehabilitation.

Animals↗
PubMedDate not supplied

[Current status of pharmacologic treatment of arrhythmia].

Arrhythmias result from alterations in the electrophysiological properties of the heart: excitability, automatism, conduction, refractory period, and repolarization. These properties depend on the cellular membrane voltage. This voltage is a consequence of macromolecular tunnels permitting the flow of electrical charged particles and the action of the electrogenic pumps against electrochemical gradients. The voltage alterations in the membrane give rise to arrhythmogenic mechanisms resulting of automatism alterations or disorders in conduction, producing re-entry or circus movement. The medical treatment must be based on a correct integral diagnosis, knowledge of the trigger and maintenance mechanisms of the arrhythmia as well as on the pharmacology of the drug. The antiarrhythmic drug classifications are useful for didactic purposes but may be of little use in medical practice. In supraventricular arrhythmias, the mechanisms are known and can be identified; the re-entry pathways are also known and the electrophysiological mechanisms are normal, therefore the response to the drugs is predictable. In contrast, in ventricular arrhythmias, the mechanisms are variable, the circuits are very difficult to identify and involve healthy and sick tissues. The therapeutic indication is very difficult and incorrect in many occasions. It is possible that, in the future, the study of hereditary arrhythmias could be the basis for a better understanding of these problems.

Arrhythmias, Cardiac↗
PubMed2001

[Plastic surgery on the lower eyelid destroyed by a bear's paw].

PURPOSE: We present a primary plastic surgery in a rare case of traumatic destruction of an inferior eyelid--it was torn by a bear paw. MATERIAL AND METHODS: A 64 years old bear-trainer with almost completely torn inferior eyelid was accepted in the clinic for treatment. The trauma was caused by a circus bear while he was taken out from the cage. During the examination we found the eyelid almost completely torn, extremely deformed, strained, smashed and hanging from the outer eyelid corner area. Under the operational microscope we performed primary plastic operation. RESULTS: The postoperative period was calm, a good adaptation of the wound surfaces, anatomic rehabilitation, fine cosmetic effect and eye ball preservation were reached. CONCLUSION: The presented case is interesting with the cause of the trauma. Despite the hard eye lid destruction the modern microsurgical techniques allowed us to attain good repositioning and good cosmetic effect. We provided defending holding of the eyeball and especially of the cornea and thus we saved them from serious complications.

Animals↗
PubMed2002

Gerrit Dou: 17th century Dutch artist portraying dentists at work.

The Dutch painter, Gerrit Dou (1613-1675), was, during his lifetime, a prestigious and highly paid artist. Critics and collectors of that era marveled at his extraordinary technical skill, his masterful illusionism and his keen portrayal of everyday life. He was the first artist to perfect the technique of "fine painting"--the production of small, detailed pictures wherein subjects are painted in a photographically realistic style. Because of his exceptional skill in this technique, the brushwork in his painting was almost invisible. Additionally, he masterfully used light and shade to achieve the effect of a third dimension. In many of his portraits, subjects stare ahead from inside a window (or niche), whose sill is overflowing with small, familiar objects. Dou's focus was on 17th century Holland and his work included: portraits, genre (scenes of everyday life) and religious themes. Between 1628 and 1675, he painted about three hundred pictures: six of these portrayed dentists at work. Most artists of those days depicted dentists as plying their trade in theatrical, circus-like environments, as in crowded county fairs. However, Dou's dentists interact with their patients in a realistic, professional manner. In this article, his most famous dental painting, "The Dentist," created in 1672, is analyzed in detail. Over the centuries, Dou's public recognition has faded into obscurity. However, his exceptional talents are currently being rediscovered.

Dentists↗
PubMed1992

[Current problems in the diagnosis and surgical treatment of rare developmental defects of the lungs].

The author analyzes questions of diagnosis and surgical treatment of 168 patients with rare malformations of the lungs which made up 5.6% of the general amount of patients with surgical nonspecific diseases of the lungs and 36.1% among all defects of development of the lungs. It was established that diagnostics of rare defects of development of the lungs might be of full value but when using a complex of roentgenological, bronchiological and functional methods of examination. Surgical treatment of rare defects of the lung development is indicated to 86.1% of the patients and must be performed till the progressing of secondary alterations, when disturbances of ventilation and oxygenation are observed, there is blood flow shunt disturbances of hemodynamics of the pulmonary circus of blood circulation.

Abnormalities, Multiple↗
PubMed1992

[Surgical anatomy of the middle meatus and ethmoid].

The evolution of rhino-sinusal endoscopy and the progress in endonasal surgery under endoscopic guidance, justifies a review of the ethmoid anatomy. A simple and logical scheme of the ethmoid bone is presented. The observer has to develop an "endoscopic eye" since the panoramic view offered by the optics modifies the image. Special attention is drawn upon the endoscopic anatomical fine points in the crucial area of the "bullar circus". These are necessary guides in surgical practice.

Endoscopy↗
PubMed1992

[A case of incessant junctional tachycardia in a female patient with aneurysm of the interauricular septum].

A permanent supraventricular tachycardia (SVT) was diagnosed in a 54-year-old hypertensive but cardiologically asymptomatic female patient, admitted to a surgery department for biliary lithiasis and hepatic echinococcosis. Heart rate was about 130 bpm and ECGs showed negative P waves in leads I, II, III, aVF, and precordial leads V2 to V6, being the RP' interval longer than P'R interval. Pharmacological intervention during Holter monitoring (20 hours) was instituted: following i.v. propranolol (4 mg), heart rate progressively decreased (to 112 bpm), mainly due to an increase in SVT RP' interval, and brief, spontaneous SVT interruptions occurred, preceded by P'R interval prolongation; SVT stopped after P' recording, and resumed after 2 sinus beats, (showing enlarged P waves and slightly prolonged PR interval), induced by cycle length shortening; later on, under i.v. amiodarone infusion (100 mg/hour) and coincident with the sleeping period, SVT cycle length progressively increased (to 600 msec), due to equivalent increases in P'R and R'P intervals. Two premature ventricular contractions (PVC) occurred during Holter monitoring at a coupling interval of 80-85% of SVT cycle length (480 msec): one PVC apparently originated in left ventricle lateral wall, captured the atria, which were activated 75 msec earlier than expected; the other PVC, apparently originated in left ventricle septoapical region, did not interfere with SVT cycle length. Before these data, a diagnosis of circus movement tachycardia, incorporating a concealed accessory pathway with slow retrograde conduction and ventricular insertion in the postoroseptal or left posterior paraseptal region, and showing minor impairment of antegrade AV nodal conduction, was made. Invasive electrophysiological study was then discarded. With combined oral antiarrhythmic therapy (amiodarone, 600 mg/d), plus propafenone, 450 mg/d), sinus rhythm was permanently restored, with evidence of intraatrial block, slightly prolonged PR interval and no preexcitation. Transesophageal echocardiography revealed a small atrial septal aneurysm associated with a small atrial septal defect; echocardiographic features were consistent with the hypothesis of incomplete regression of the atrial septal aneurysm after partial closure of the atrial septal defect. Abdominal surgery (cholecystectomy plus partial hepatic pericystectomy) was performed without any complications or SVT recurrences. During a 6-month follow-up period, maintaining amiodarone (200 mg/d) and propafenone (450 mg/d), the patient remained SVT-free, and Holter monitoring performed at 3 and 5 months showed permanent sinus rhythm and 1:1 AV conduction with slightly prolonged PR interval (less than 0.29 sec and shortening at faster heart rates). This case documents Holter monitoring capability for the evaluation of tachycardia mechanisms in patients with permanent SVT.

Amiodarone↗