The discrete scar in prominent ear correction: a digital 3-dimensional analysis to determine the ideal incision for otoplasty.

Introduction: Various postauricular incision sites can be used for prominent ear correction depending on technique and surgeon preference. No study has previously looked at the most aesthetic (least visible) location for the postauricular scar. We investigated the visibility of various scar locations on the posterior ear from a third person perspective through a "Visibility Arc"-a formal assessment of the range of degrees where a particular scar is visible.

Anistreplase in early acute myocardial infarction and the one-year follow-up.

Of consecutive patients seen with first myocardial infarction (88 of whom were treated out-of-hospital by mobile coronary care staff), 139 received 30 units of intravenous anistreplase at a mean of 101 minutes (range 35-180) from onset of symptoms. Thrombolysis in myocardial infarction patency grade 2 or 3 was found in 76/91 (83.5%) patients.

Ectopic right coronary artery to pulmonary artery fistula masquerading as patent arterial duct.

A patient is described in whom communication between an ectopic right coronary artery and the main pulmonary artery presented with clinical features of a patent arterial duct. Full clinical data documented by Doppler echocardiography, cardiac catheterisation and intra-operative findings are described.

Comparison of once and twice daily oral dosing schedules of bevantolol, a new beta-adrenoceptor antagonist with alpha-adrenoceptor partial antagonist activity in patients with angina of effort.

In a placebo controlled double-blind cross-over study following a dose titration phase, we compared the efficacy of benantolol, a new beta 1 adrenoceptor antagonist with alpha-adrenoceptor partial antagonist activity at 12 and 24 hours after dosing in patients with angina of effort. Twenty patients aged 43-65 years were studied. Each study phase lasted four weeks.

Surgical implications of anomalous aortic origin of the left coronary artery.

We report a patient with exertional chest pain and anomalous aortic origin of the left coronary artery from the right coronary sinus. This patient also had circumflex coronary and right coronary artery stenoses. Following coronary bypass grafting of the circumflex and right coronary arteries in this patient, angina persisted and there was abnormal septal perfusion shown on the exercise thallium imaging despite patent grafts.

Angiographic, electrocardiographic and surgical features of single coronary artery producing myocardial ischaemia.

A patient is described in whom an unstenosed single coronary artery was associated with angina and syncope. Full clinical documentation of the patient with ambulatory electrocardiography, angiography, surgical findings and stress testing before and after bypass grafting are described.

Accelerated atherosclerosis and myocardial infarction complicating anomalous origin of the right from the left coronary artery.

A patient is described in whom a previously unstenosed single coronary artery was complicated 12 months later by anterior myocardial infarction. Full clinical features documented by exercise thallium scintigraphy and coronary angiography before and after myocardial infarction are described.

Actuarial analysis of late results after closed mitral valvotomy.

The long-term results of closed mitral valvotomy performed between 1978 and 1985 in 198 patients with noncalcific mitral stenosis were analyzed. Follow-up data were available on 185 patients (93%); 1 patient died in the postoperative period, and 12 foreign patients were lost to follow-up. At the 4-year and 8-year intervals, 91% and 80% of patients, respectively, were event free (not in need of further operative procedures).

Thallium-201 myocardial imaging in patients with angina pectoris and anomalous aortic origin of the circumflex coronary artery.

Anomalous aortic origin of the circumflex coronary artery is the commonest coronary artery anomaly. In this study, the significance of anomalous aortic origin of the circumflex coronary artery was investigated in seven patients with exertional chest pain using exercise thallium scintigraphy. Five patients with circumflex coronary arterial disease served as controls.

The effects and dose-response relationship of xamoterol in patients with ischaemic heart disease.

1. In a double-blind placebo controlled four-way crossover study the effects and dose response relationships of xamoterol were studied in nine patients with angina and dyspnoea secondary to chronic left ventricular dysfunction. The duration of exercise on a treadmill and heart rate were measured at the end of each phase of the study at 2 h and 24 h after dosing.

Comparison of the performance of superflow (5F) and conventional 8F catheter for cardiac catheterization by the femoral route.

In order to determine whether the use of a smaller catheter would allow day-case cardiac catheterization by the femoral route, the performance of the Superflow (5F) and the 8F catheters was compared in 34 adults who underwent left ventriculography and coronary angiography. As shown by the significantly lower fluoroscopy time [2.8 +/- 1.

Cardiac lymphoma: an unusual case of myocardial perforation--clinical, echocardiographic, haemodynamic and pathological features.

A patient is described in whom lymphoma infiltrated the pericardium and myocardium resulting in right ventricular rupture. Pericardial blood and lymphoma deposit were demonstrated echocardiographically as echolucent and echodense areas respectively and confirmed at autopsy. The patient presented with the clinical and haemodynamic features of cardiac tamponade.

Clinical implication of inadvertent monitoring of pulmonary artery pressure via a "left atrial" catheter.

A patient is described in whom a left atrial catheter was inadvertently wedged in a pulmonary vein following mitral valve replacement. The pulmonary vein wedge pressure obtained approximated the pulmonary artery pressure and was suggestive of paraprosthetic mitral valve regurgitation.

Effect of percutaneous transluminal coronary angioplasty on arrhythmias complicating angina.

Four patients who had stenosis of a single major coronary artery which was treated by percutaneous transluminal coronary angioplasty are described. Three had exercise induced myocardial ischaemia complicated by ventricular tachycardia, fibrillation, and sinus bradycardia, respectively. Asystole developed in a fourth patient who had spontaneous chest pain.

Effect of xamoterol (ICI 118587), a new beta1 adrenoceptor partial agonist, on resting haemodynamic variables and exercise tolerance in patients with left ventricular dysfunction.

The effect of xamoterol, a beta1 adrenoceptor partial agonist, on resting haemodynamic measurements and exercise tolerance was studied in 10 patients with dyspnoea of effort. All patients had poor left ventricular function due to myocardial infarction with ejection fractions ranging from 15% to 35% (mean 28%). The cardiac index and stroke work index both rose significantly.

Comparison of vitreous carbon and elgiloy transvenous ventricular pacing leads.

In a randomized prospective study of 150 patients, we compared two porous-tipped, finned leads, one with a vitreous carbon tip (surface area = 12 mm2) and the other with an Elgiloy tip (surface area = 8 mm2). We assessed the acute and chronic stimulation thresholds and the ease of implantation of the two leads. The acute current thresholds for the vitreous carbon and Elgiloy-tipped leads were 1.

Effect of Corwin (ICI 118587) on resting and exercise heart rate and exercise tolerance in digitalised patients with chronic atrial fibrillation.

The effect of Corwin, a new oral beta, partial agonist, on the ventricular response to atrial fibrillation was studied in digitalised patients during 24 hour ambulatory electrocardiography and during exercise on a treadmill in a double blind placebo controlled crossover trial. Corwin reduced the maximum heart rate during exercise from 162(16) beats/min to 120(9) beats/min and reduced the peak heart rate during ambulatory electrocardiography from 113(11) to 90(6) beats/min consistent with a beta adrenoreceptor antagonist action at higher levels of sympathetic nervous system activity. Minimum heart rate during ambulatory electrocardiography was increased from 62(5) to 70(5) beats/min indicating that at lower levels of sympathetic activity the drug acts as a beta agonist.