Vasospastic Angina with J‐Wave Pattern and Polymorphic Ventricular Tachycardia Effectively Treated with Quinidine

Background: Myocardial ischemia during coronary spasm may generate malignant ventricular arrhythmias. The J‐wave pattern was suggested to be a marker of a disorder associated with life‐threatening arrhythmias. Results: We report the case of a patient with vasospastic angina and J‐wave pattern in inferior and lateral leads associated with polymorphic ventricular tachycardia which was effectively treated only with quinidine—vasodilating drugs were not able to prevent the arrhythmia although they were effective in preventing ischemic events. Conclusion: The J‐wave pattern in inferolateral leads may be a sign of electrical vulnerability to lethal ventricular arrhythmia in patients suffering from vasospastic angina—quinidine can effectively prevent such arrhythmias in these patients.     

Polymorphism of the sulfonylurea receptor gene in type 2 diabetes mellitus

Sulfonylureas are used in treatment of diabetes. Resistance to these derivatives is a therapeutical problem. Sulfonylureas act through sulfonylurea receptor 1 (SUR1) in the beta cell. SUR1 also enhances a physiological secretion of insulin induced by an increase of glucose concentration. It may be expected that polymorphism of SUR1 gene can lead to beta cell dysfunction and resistance to sulfonylureas. The aim of this study was to examine the frequency of polymorphism in exon 22 of SUR1 gene and its correlation with type 2 diabetes mellitus and sulfonylurea treatment failure. The group consisted of 42 patients with type 2 diabetes. The controls were 46 persons with proper glucose tolerance. Polymorphism was found in 5 patients and in 1 control person. Neither statistically significant difference of polymorphism frequency nor correlation between polymorphism and sulfonylurea failure was found due to a low number of cases. Polymorphism of exon 22 of SUR1 gene appeared more frequent in diabetic than in non-diabetic subjects but this was statistically not significant.     

Critical review of the uroflowmetry

Uroflowmetry is the measurement of a urinary flow rate by using the flow meter. A urine flow rate is the volume of urine (millilitres) expelled from the bladder via the urethra per unit of time (second). It is expressed in ml/s.(1) Urine flow curve is the plot of velocity of the voided urine against time. The urine stream is affected by voiding pressure (detrusor power) and bladder outlet resistance. Therefore, uroflowmetry evaluates the interaction of the urinary bladder expelling strength and bladder outlet resistance. This is the initial, non-invasive urodynamic investigation for evaluation of patients with lower urinary tract symptoms (LUTS). Although, it is very simple and widely used urodynamic test, the results are nonspecific and required caution interpretations. In the next few pages we will review some aspects of this test, i.e. brief history, equipment, indications, procedure itself and interpretation of the results.     

Colorectal carcinoma in Poland in 1975 and 1995: not only more,but also different

BACKGROUND AND AIMS: We previously reported that the sole clinicopathological parameters of carcinomas diagnosed in a single institution in 1975 differed from those in patients diagnosed in 1995. The findings might be compatible with the loss of importance of the microsatellite instability of the carcinogenic pathway. MATERIALS AND METHODS: We examined the microsatellite status and selected immunomarkers (Ki-67, p53, BAX) in the archival material from 1975 (n=76) and 1995 (n=105). RESULTS AND CONCLUSION: The distribution of tumors showing no microsatellite instability, low microsatellite instability, and high microsatellite instability in the 2-yearly cohorts was similar (1975: 55.6%, 22.2%, 22.2%; 1995: 60.2%, 20.4%, 19.4%, respectively). The percentage of carcinomas showing microsatellite instability at the APC locus differed significantly (1975: 37.5%; 1995: 21.4%). The typical clinicopathological parameters of carcinomas exhibiting high microsatellite instability were largely shared by the carcinomas demonstrating instability at the APC locus. The carcinomas resected in 1995 more frequently demonstrated high expression of an antiapoptotic protein BAX and a different distribution of their Ki-67 proliferation fraction. The evolution of colorectal carcinoma in Poland also involves qualitative changes, including its genetic background.     

Multivariate analysis of risk factors for development of duodenal ulcer in Helicobacter pylori-infected patients

BACKGROUND: Although Helicobacter pylori is a significant etiologic factor of peptic ulcer disease, it remains unknown why ulcers develop only in the minority of infected individuals. AIM: The aim of this cross-sectional study was to evaluate the association between the presence of duodenal ulcer in H. pylori-infected patients and different risk factors. METHODS: A total of 122 H. pylori-infected patients were enrolled; 79 had duodenal ulcer and 43 gastritis. Univariate analysis was conducted using either Fisher's exact test or exact Cochrane-Armitage trend test. In multivariate analysis the logistic model was used. RESULTS: Univariate analysis indicated six factors (male sex, smoking, antral H. pylori density, CAGA presence in antrum, and VACA s1a presence in antrum and corpus). Four factors (sex, smoking-alcohol index, H. pylori density index, and CAGA index) were found to be significant in multivariate analysis. The best model predicting duodenal ulcer included male sex, smoking, presence of H. PYLORI on histopathology in antrum and CAGA presence in corpus. CONCLUSION: Although several risk factors were significantly associated with duodenal ulcer, we failed in the identification of either a single risk factor or a set of factors that can unequivocally differentiate patients with ulcer from those with gastritis.     

Homozygosity for human leucocyte antigen-C ligands of KIR2DL1 is associated with increased risk of relapse after human leucocyte antigen-C-matched unrelated donor haematopoietic stem cell transplantation

Human leucocyte antigen (HLA)-C molecules regulate the function of natural killer cells and may be subdivided into two groups, C(1) and C(2), based on their specificity for inhibitory killer immunoglobulin-like receptors. We analysed the impact of the HLA-C genotype on outcome of HLA-C-matched unrelated donor haematopoietic stem cell transplantation (URD-HSCT) recipients. HLA-C(2) homozygous patients (n = 18) had lower probability of overall survival (P = 0.01) and disease-free survival (P = 0.02), resulting from increased relapse rate (P = 0.02) when compared with both HLA-C(1) homozygous (n = 43) and HLA-C(1),C(2) heterozygous (n = 50) subgroups. Patients lacking HLA-C(1) should, therefore, be considered at increased risk of relapse following HLA-C-matched URD-HSCT.     

Type A aortic intramural haematoma--clinical course in two patients

Aortic intramural haematoma (AIH) is a variation of aortic dissection where blood collects within the aortic media without the presence of an intimal flap. The natural history of the disease has not yet been definitely established. Two cases of AIH type A are presented--an 81-year-old hypertensive male, and a 60-year-old male, both admitted to the hospital with sudden-onset severe chest pain. In both cases AIH type A was confirmed using computed tomography. One patient underwent successful conservative treatment, whereas another one had urgent surgery.