A description is given of a disease of infants occurring in Lhasa, Tibet at an altitude of 3600 m. Typically if affects infants who have been born at low altitude and subsequently brought to residue in Lhasa, and it is usually fatal within a few weeks or months. There is extreme medial hypertrophy of muscular pulmonary arteries and muscularization of pulmonary arterioles, together with dilatation of the pulmonary trunk and massive hypertrophy and dilatation of the right ventricle. The disease is distinct from acute or chronic mountain sickness and appears to be the human counterpart of 'brisket disease' in cattle.
With 4 plates in the text)Studies are presented on the pulmonary circulation of three Himalayan marmots (Marmota himuluyanu (Hodgson)) captured in the mountains north of Lhasa, Tibet. The pulmonary arterial pressure and resistance were low, the right ventricle was not hypertrophied and the arterioles and terminal portions of the muscular pulmonary arteries had thin walls. The observations suggest that this species has adapted through natural selection to high altitude by losing the capacity for hypoxic pulmonary vasoconstriction.
This case report is to demonstrate that a female patient had suddenly become unconscious 14 hours after percutaneous vertebroplasty. Bedside echocardiogram showed that the patient had a strong echo in the right heart with a small amount of pericardial effusion. CT showed high density in the distal branches of both pulmonary arteries and a high density in the right heart. With the help of that, the doctor made the diagnosis of intracardiac cement embolism in a very short time. The bone cement in the heart was removed under emergency cardiopulmonary bypass, then the patient was discharged smoothly.
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