Transient cortical blindness, an uncommonly recognized complication of cerebral angiography, is an exceedingly rare event after cardiac catheterization and angiography. This report describes a sixty-two-year-old patient who had transient cortical blindness following bypass graft angiography. In this case, the authors showed that cortical blindness was associated with the breakage of the blood-brain barrier (BBB) and an increase in vascular permeability rather than with primary cerebral circulatory insufficiency. When the possibility exists that an excess volume of contrast medium may enter the cerebral circulation as in this case, that is, following a coronary artery bypass graft (CABG) using the internal mammary artery (IMA), precautionary measures may be necessary such as changing the type of contrast medium to be used or decreasing the volume injected. When cortical blindness occurs, it is a serious clinical problem whether transient or permanent. Therefore, the circumstances leading to this complication should be understood to determine suitable treatment and management.
A 59-year-old woman with nephrotic syndrome was diagnosed as having primary amyloidosis based on the detection of amyloid deposition (AL-protein) in the esophagus and kidneys. Bone marrow aspirate showed plasmocytic proliferation, leading to a diagnosis of multiple myeloma (IgG i,-type). In addition, a very rare translocation t(1; 20) (q21; qil) was seen by chromosomal analysis of both the bone marrow and peripheral blood, multiple myeloma ; amyloidosis ; chromosomal abnormality Then, an azoospermic man with t(1; 20)(q21 ; q13) was reported by Antonelli et al. in 1983. Madan andKleinhout (1987) subsequently showed that the women of a large family that suffered from first trimester abortions had t(1; 20)(p36 ; p11). Most recently, Weh et al. (1990) have reported two patients with multiple myeloma and t(1; 20)(q12.3 ; p13). We here report a woman with multiple myeloma, the nephrotic syndrome and systemic amyloidosis, who also had the chromosomal abnormalities t(1; 20) (q21; q11). CASE REPORTA 59-year-old house-wife was admitted for treatment of the nephrotic syndrome on 26 May, 1989. The hemogram was normal and the Westergren sedimentation rate was increased. Liver and kidney function was normal. Urinary protein excretion ranged between 10 and 15 g/day, with Bence-Jones protein being detected by immunoelectrophoresis. Her serum total protein level was low (4.9 g/100 ml), but there was an increase of y-globulin (16.9%). This M-protein was shown to be an IgG A-type paraprotein by immuno-electrophoresis. The serum IgG level was elevated (1,473 mg/100 ml), while both the IgA (47 mg/100 ml) and IgM (61 mg/100 ml) levels were low. Bone marrow aspiration microscopically showed the proliferation of plasmocytis (18.0%) with scattered plasmocytic packets, leading to a diagnosis of multiple myeloma. Needle biopsy of the kidney indicated amyloidosis ; with Congo Red staining AL-type amyloid deposition along the capillary walls thickened the basement membrane, resulting in the nephrotic syndrome. Chromosomal analysis by G-banding was performed after the culture of the bone marrow
Understanding the flow of groundwater is very important, not only for water management but also for the prevention and mitigation of natural disasters. The electrical resistivity method has been established as an effective groundwater exploration method in geological surveys. The purpose of this study is to develop an accurate investigation method for groundwater flow using soil impedance fluctuations. As a preliminary experiment, the apparent soil impedance was measured by applying a low-frequency current through a soil column with water flow inside. The apparent impedance showed fluctuations due to water flow at frequencies above 20 Hz, and the fluctuation range increased with the flow rate of water. It has been proposed that groundwater flow can be detected by measuring impedance fluctuations, and it is considered that this method can be applied to groundwater surveys and embankment and reservoir leak surveys.
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