Preexcitation in Hypertrophic Cardiomyopathy: A Case of a Fasciculoventricular Mahaim Fiber

STELLBRINK, C., et al .: Preexcitation in Hypertrophic Cardiomyopathy: A Case of a Fasciculoventricular Mahaim Fiber . A patient with hypertrophic cardiomyopathy (HCM) who presented with preexcitation pattern on the surface ECG suggestive of the Wolff-Parkinson-White (WPW) syndrome is described. Intracardiac electrophysiological study revealed a fixed anomalous QRS complex and a short fixed His-ventricular interval indicating a fasciculoventricular Mahaim fiber. As this specific form of accessory connection does not cause reentrant tachycardias, no treatment was required. It is important to distinguish this entity from atriofascicular or nodoventricular Mahaim fibers or the WPW syndrome in patients with HCM showing a preexcitation pattern in the surface ECG, as these may cause life-threatening arrhythmias in this patient population.     

Cyclosporine overcomes cold preservation/reperfusion injury of liver graft: Chemokine release and liver ultrastructure

There is a growing body of evidence that the cytokine, tumor necrosis factor-α (TNF-ga), plays an important role in the development of hepatic ischemia/reperfusion injury. We found that the immunosuppressants, cyclosporine-A (CsA), azathioprine, and FK506, have protective effects on such injury. The purpose of the present study was to elucidate mechanisms involved in these beneficial effects of the immunosuppressant, CsA, on liver injury following cold preservation and transplantation, with special reference to the suppression of TNF-α release. Rat livers were stored in Euro-Collins solution (EC) at 4°C for 6h and orthotopically transplanted. The animals allotted to two groups: group A (untreated controls) and group B (CsA pretreatment of recipients). CsA (10 mg/kg, p.o.) was given for 3 consecutive days preoperatively. CsA pretreatment of the recipients significantly improved the 2-week survival rate (0/6 for group A, 3/6 for group B;P<0.05) and this was associated with a significant decrease in serum TNF-α levels 2h posttransplantation (group A, 69.8±15.7 pg/ml; group B, 22.8±6.8; mean±SEM;n=12 each;P<0.05) and amelioration of sinusoidal endothelial injury, assessed by electron microscopy. Plasma endotoxin levels following reperfusion of the grafts were not altered by the CsA therapy. Morphologically, CsA pretreatment of the recipients did not alter activation of Kupffer cells. CsA pretreatment of the recipient aids in preventing cold preservation/reperfusion injury of the liver graft, possibly by modulating effects of TNF-α.     

Choreoathetosis related to lithium intoxication

A 76-year old woman was admitted because of severe gait ataxia and dysarthric speech that had worsened over the last 24 h. The patient was initially suspected of having repeated transitory ischemic attacks (TIAs) as her daughter reported a similar episode that had happened 3 weeks prior to admission. The onset of spontaneous twisting, choreoathetotic movements of both hands and arms and worsening of symptoms one hour after admission together with a history of lithium therapy lead to the correct diagnosis and appropriate treatment.     

小檗碱对大鼠再灌心律失常及钙调节的作用

小檗碱（Ｂｅｒ，１０ｍｇ·ｋｇ－１）使缺血／再灌后ＶＴ发生率明显降低，持续时间明显缩短，无１例发生ＶＦ及死亡，与对照组比较差异有显著性。离体实验表明：小檗碱（３０μｍｏｌ·Ｌ－１），能抑制高钙条件下Ｃａ２＋内流，而增加低钙条件下的Ｃａ２＋内流。结果表明：小檗碱具有预防再灌心律失常作用；不同Ｃａ２＋浓度能够影响心肌４５Ｃａ内流；小檗碱对心肌Ｃａ２＋内流有双向调节作用，尤其在高Ｃａ２＋条件下，降低４５Ｃａ内流可能是其抗心律失常作用机制之一。     

脑卒中患者下丘脑─垂体─肾上腺皮质轴功能改变及临床意义

观察了１７２例脑卒中患者血清促肾上腺皮质激素（ＡＣＴＨ）、皮质醇的变化，发现ＡＣＴＨ、皮质醇水平明显高于正常对照组，脑出血组高于脑梗塞组；病情轻重与ＡＣＴＨ、皮质醇的变化明显相关。治疗前后ＡＣＴＨ、皮质醇水平明显不同，治疗后明显降低（Ｐ＜０．０１）。说明治疗后可改善下丘脑－垂体－肾上腺皮质轴（Ｈ／Ｐ／Ａ）功能紊乱。     

病毒性心肌炎及扩张型心肌病患者心内膜心肌活检标本中免疫球蛋白的检测

对病理学确诊的25例病毒性心肌炎（VMC）和10例扩张型心肌病（DCM）患者心内膜心肌活检标本，运用ABC技术，进行了免疫球蛋白IgG、IgM、IgA和补体C3的检测。结果：20例VMC和9例DCM的标本中，发现了IgG和IgM的沉积，主要分布于心肌肌膜和毛细血管内皮，IgG的肌膜沉积与同步做的病理切片中观察到的心肌细胞坏死和炎性细胞浸润有病理形态学联系。两组患者中均未发现IgA和C3沉积。结果显示，IgG是参与VMC和DCM心肌损伤的主要免疫球蛋白，心肌病变与抗体诱导的免疫反应有关。     

大鼠局灶性脑缺血再灌注模型的建立及其组织形态改变

目的：建立大鼠脑缺血2h再灌注不同时程实验动物模型，探讨其病理形态学HE染色特点。方法：线栓法行大鼠大脑中动脉闭塞(MCAo)造成局灶性脑缺血2h再灌注模型，假手术组不插入线栓。HE染色观察病理组织形态学特点。结果：所有局灶性脑缺血再灌注模型在麻醉苏醒后均表现为局灶性神经功能缺陷。再灌注后3h，神经功能缺陷部分恢复。这些表现与临床局灶性脑缺血再灌注溶栓治疗的病人相似。HE染色可见胞浆均质红染、细胞核固缩以及细胞膜和细胞结构破坏的嗜伊红的死亡神经元。结论：Wistar大鼠局灶性脑缺血再灌注模型的神经功能缺损与人类缺血性脑血管病相近，是研究脑缺血再灌注损伤的病理形态学机制的良好模型。     

急性缺血性卒中抗凝治疗研究进展

急性缺血十牛卒中的抗凝治疗存在着很大的争议。本文综述了常用抗凝药物如肝素、低分子肝素的作川机制，并从循证医学角度对近年来发表的一些关于急性缺血性卒中抗凝治疗的大型临床试验进行了总结。     

多糖硫酸脂(PSS)治疗缺血性脑血管病临床观察和实验室研究

应用PSS治疗270例缺血性脑血管病并进行了临床、实验室以及动物试验的观察.总有效率为92.27%;显效率65.24%,与对照组相比较有显著性差异(P<0.005).实验室观察发现PSS有显著的抗凝血、降低血粘度,降低血脂及血管扩张作用.动物实验也说明了这一点.