Injections of corticosteroid cannot be recommended over polidocanol or autologous blood, because despite beneficial short-term effect there were inferior long-term effects. Whether polidocanol or autologous blood injections are effective is unknown, especially as their global effect profiles are not unlike previously reported for wait-and-see.
Letters tors are modified and regulated by cerebellar connections.12 In Wallenberg's syndrome, both 1800 visual inversions, and associated 90°inversions,1 and less dramatic defective perceptions of the vertical axes occur.' 13-15 A number of observations suggest that these two pathological processes may be nosologically distinct. One astute patient noted that, during a transient episode of visual inversion, his appendicular movements and general body habitus appeared normal, as if superimposed on an inverted landscape. This suggests a differential interface between the pathological substrate mediating complete visual inversion and neural mechanisms which govern the elaboration of egocentric, allocentric and extrapersonal space.
A 22-year-oldfemale with mirror image dextrocardia and rheumatic valvularmitral stenosis underwent closedmitral valvotomy using a Tubb 'sdilator with good results. Despite abnormalposition of situs, the surgical approach was simple through right anterolateral thoracotomy, and the operator's hands were mirror image to that of levocardia valvotoniy'in certain steps. Preoperative mitral valve area was 0.8 em2, and peak and .mean diastolic gradients were 21 and 15 mmHg respectively. Postoperatively, valve area improved to 2.16 em2, and peak and mean diastolic gradients were 8 and 3.1 rnmHg, respectively.(Asian Curdiovasc
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