In many cases blunt chest trauma involves cardiac lesions, such as pericardial effusion, aneurysma dissecans, or valvular rupture. Early diagnosis with routine transthoracic and/or transesophageal echocardiography is essential to prevent a fatal outcome. In the case reported, a previously healthy 68-year-old woman fell 7 meters from the roof of a barn and sustained blunt injury to the chest as well as fractures of the face. Physical examination revealed a systolic murmur at the cardiac apex, and chest x-ray film showed a severe pulmonary edema. Transesophageal echocardiography demonstrated a ruptured anterolateral papillary muscle with fourth degree mitral insufficiency. An immediate mitral valve replacement was necessary.
A method of photometric measurement of ciliary beat frequency is described. Brush biopsies of human bronchial epithelium were obtained. Twenty healthy persons were investigated, sampling brush biopsies from trachea, main bronchus and segmental bronchus. Ciliary beat frequency was measured over a period of time at 37 degrees C as well as under increasing temperature from 20 degrees C to 40 degrees C. Mean ciliary beat frequency in the trachea is 12.5 Hz +/- 2.8 at 37 degrees C, slightly increasing ciliary beat frequency towards the periphery of the bronchial tree. Ciliary beat frequency found at 20 degrees C is almost exactly half the frequency found at 37 degrees C. When rising the temperature from 30 degrees C to 40 degrees C, ciliary beat frequency increases nearly in a linear line. A well reproducible method is used to measure ciliary beat frequency in vitro under different conditions.
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