Histories of recurrent infections were obtained from 955 adults with past or present atopic dermatitis (AD) and from 199 controls. Patients who had previously been hospitalized in childhood because of severe AD had a significantly higher incidence of recurrent (greater than 5 episodes per year) cold sores and upper respiratory tract infections as well as a higher incidence of herpes zoster, than non-atopic controls. Patients with milder AD in childhood (never hospitalized) had lower incidence of these diseases, but as regards cold sores, the frequency of recurrent infections was still significantly higher than that of the controls. AD patients with past or present respiratory allergy had a slight but not statistically significant increased incidence of recurrent infections, as compared to AD patients without concomitant respiratory allergy. The factors predisposing to frequent infections appeared to be those related to severity of the atopic condition, i.e. ongoing AD, need for hospitalization in childhood and extent of dermatitis. The increased susceptibility to recurrent viral infections in AD patients is most probably related to dysfunctioning cell-mediated immunity.

Recurrent viral infections in patients with past or present atopic dermatitis

PURPOSE: To validate coronary sinus flow measurements for quantification of global left ventricular (LV) perfusion by means of velocity-encoded cine (VEC) magnetic resonance (MR) imaging and flow probes. MATERIALS AND METHODS: Measurements of coronary sinus flow were performed in seven dogs by using VEC MR imaging at baseline, single coronary arterial stenosis, dipyridamole stress, and reactive hyperemia. These measurements were compared with flow probe measurements of coronary blood flow (CBF) in the left anterior descending coronary (LAD) and circumflex (CFX) arteries (CBFLAD+CFX) and coronary sinus. LV blood perfusion was calculated in milliliters per minute per gram from coronary sinus flow, and LV mass was obtained by using VEC and cine MR imaging. LV mass was validated at autopsy. RESULTS: CBFLAD+CFX and coronary sinus flow at VEC MR imaging showed close correlation (r = 0.98, P < .001). The difference between CBFLAD+CFX and MR coronary sinus flow was 3.1 mL/min ± 8.5 (SD). LV mass at cine MR imagin...

Coronary sinus flow measurement by means of velocity-encoded cine MR imaging: validation by using flow probes in dogs.

SUMMARY
The prevalence of cutaneous fungal infection was studied in 72 patients who had undergone renal transplantation and compared with a group of age and sex matched controls. Samples were obtained from toe nails, toe webs, and the upper back; clinically suspicious lesions from other areas were also examined. A total of 576 sites were sampled (288 in each group). Pathogenic fungi were identified from 44 sites (15%) in the renal transplant (RT) group compared with 26 sites (9%) in the control group, (P < 0.05). However, site-specific differences were less marked; no difference was found between the RT group and controls when the results from the toe nails and toe webs were analysed separately. Trichophyton mentagrophytes was the most common species isolated from both groups.

Colonization of the back with Pityrosporum yeasts was significantly more common in the RT group, but few patients in either group had tinea versicolor.‘Mixed infections, with more than one species of fungus isolated in an individual, were only found in the RT group.

We also examined the relationship between the presence of fungal infection and the presence or absence of cutaneous malignancy in the renal transplant group. No increase in the prevalence of fungal colonization was found in those patients who had developed cutaneous malignancy compared with those who had not.

Cutaneous fungal infection following renal transplantation: a case control study.

OBJECTIVE--To describe unusual venous communications from the right to the left atrium resulting in cyanosis after the modified Fontan procedure, and their management with transcatheter occlusion. METHODS--Between September 1992 and November 1994, eight patients were assessed for persistent cyanosis after a modified Fontan procedure. Desaturation was found to be caused by unusual venous shunts originating at atrial level, and transcatheter occlusion with either a double umbrella or coil was attempted. RESULTS--Three types of venous channels were identified. The first type of communication consisted of thin long tortuous channels originating from the right atrial wall, and draining into the left atrium through a capillary network. The second type of communication was in the superior anterior portion of the atrial baffle, incorporating the pectinate muscles of the right atrium, draining into the neoleft atrium. These channels were shorter and often fanned out into small vessels toward the right atrial appendage. In each instance, the shunts were in the superior suture line of a lateral tunnel modification of the Fontan procedure. The third type of communication originated from the inferior vena cava, connecting inferior phrenic veins to pericardial veins and subsequently to the left atrium, at or close to the ostium of the left pulmonary veins. Before device occlusion, the room air aortic oxygen saturation was 88(SD 4)% (range 84% to 94%), and increased to 95(3)% (range 91% to 100%) following occlusion (PL << 0.001). The mean right atrial pressure was 14(4)mm Hg and remained unchanged after occlusion. In six patients there was complete shunt obliteration, while in two both occluded with umbrella devices, a small residual leak persisted. No complication occurred during or immediately after catheterisation. CONCLUSIONS--Unusual venous communications can evolve after the Fontan procedure, resulting in the development or persistence of cyanosis. Some of these communications may be present preoperatively as normal veins draining into the right atrium, enlarging with the increased atrial pressure after surgery. These observations affect long term function after the Fontan procedure. Transcatheter occlusion of these communications is technically feasible and effective, although recurrence may occur.

https://heart.bmj.com/content/heartjnl/74/5/548.full.pdf

Right to left interatrial communications after the modified Fontan procedure: identification and management with transcatheter occlusion.

Hemodynamic significance of the coronary vein valves.

The morphology of the superficial cardiac veins draining the coronary sinus was investigated in 47 normal adult dogs, using the injection-corrosion-fluorescence technique. The veins pertaining to the left coronary territory all drain directly to the coronary sinus and include the following vessels: the great coronary vein and its tributaries, the left posterior atrial and ventricular veins. The veins pertaining to the right coronary territory include the posterior interventricular vein and the small cardiac vein. A comparison with the human pattern was made, particularly regarding the number of interventricular septal branches and it was suggested that such a reduction in number in the dog could be due to a take-over from the Thebesian veins in the venous drainage of the interventricular septum.

Morphology of the veins draining the coronary sinus of the dog.

Several types of vascular anastomoses were found in the normal human heart which mainly represent the increase in calibre of pre-existing channels in response to certain stimuli such as total or partial occlusion of the coronary arteries, generalized hypoxia, anaemia, bodily exercise, drugs, etc.. The heart circulation though looking rather simple with several types of vessels with different going in and out orifices, is in fact, extremely complex. We could show with this new technique different kind of anastomoses in normal hearts, between the same type of vessels, between vessels and heart chambers and between different types of vessels.

J. A. Esperanca Pina

Papers

Morphology of the veins draining the coronary sinus of the dog.

The vascular anastomoses of the human heart.

Microangiographic aspects of the thebesian veins.

Contents, Vol. 90, 1974

Microvascularisation de l'ovaire et de la trompe uterine chez la femme