REVERSIBLE HEART BLOCK IN LYME DISEASE

SUMMARY A case is described of a young man who was referred to a cardiology department with heart block which was found to be due to Lyme disease.     

A STUDY OF ANGIOTENSIN II RECEPTORS AFTER CHRONIC INHIBITION OF NITRIC OXIDE SYNTHASE IN THE SPONTANEOUSLY HYPERTENSIVE RAT

1. Nitric oxide (NO) synthase inhibition, induces a sustained increase in blood pressure and amplifies the pressor response to infused angiotensin II (AngII). This study was designed to investigate the contribution of AngII receptors to the elevated blood pressure and enhanced pressor response to AngII in the spontaneously hypertensive rat (SHR) chronically treated with N^G-nitro-l -arginine-methyl ester (l -NAME). 2. Two groups of 13 week old female SHR were housed four to a box. Group I rats received l -NAME for 7 days (2.5 mg/kg per day) in their drinking water. Group II rats received water only. Blood pressure was monitored daily by tail-cuff plethysmography. Plasma AngII was measured by radioimmunoassay. Aortic and uterine receptor binding was determined by saturation analysis using [¹²⁵I]-Sar⁸, Ile¹)AngII. Data was analysed using the computer program ligand. 3. Mean systolic blood pressure was significantly elevated in rats treated with l -NAME compared with the control group. Plasma AngII concentration was slightly decreased in rats treated with l -NAME compared with control. Densities of both aortic and uterine AngII receptors increased significantly following NO synthase inhibition. Receptor affinity in the aorta decreased in the l -NAME group compared with control. However, uterine AngII receptor affinity was unchanged. 4. We conclude that the increased blood pressure and enhanced pressor responsiveness that occurs with chronic inhibition of NO synthesis may result partly from increased vascular AngII receptor expression.     

Segmental coronary artery disease: detection by rotating slant-hole collimator tomography and planar thallium 201 myocardial scintigraphy

Normal quantitative circumferential profile limits were established for a 30 degrees bilateral rotating slant-hole (RSH) collimator tomographic system. This system's value in detecting segmental coronary artery disease was assessed in a study evaluating 196 patients by thallium 201 myocardial scintigraphy and coronary arteriography. Profile curves were calculated from images of 20 healthy patients and used to identify significant coronary artery disease (greater than or equal to 70% diameter narrowing) in the left anterior descending (LAD), the right, and the left circumflex (LCx) coronary arteries. In a group of 86 patients, an abnormality on the apical or middle plane optimally identified segmental coronary artery disease. When such abnormalities were prospectively evaluated in a test group of 110 patients, the sensitivity and specificity were 79% and 93% for LAD, 90% and 90% for right, and 83% and 83% for LCx coronary artery disease. Compared with qualitative interpretation of the planar and tomographic images, quantitative tomography significantly improved the sensitivity of T1-201 imaging in detecting LAD, right, and LCx coronary artery disease (P less than .001) in patients with or without previous myocardial infarction.     

Extracorporeal shock wave lithotripsy: impact on the radiology department of a stone treatment center

Extracorporeal shock wave lithotripsy (ESWL) was performed on 925 patients (1,222 treatments) for 446 calyceal, 345 pelvic, 172 ureteral, and 108 staghorn calculi. ESWL necessitated 6.3 KUB and 1.2 renal ultrasound studies per treatment session. Intravenous urography was required in 6% of patients after ESWL. Percutaneous nephrostomy tube placement was performed by the radiologists in 10% of patients. Procedures related to nephrostomy tube placement included percutaneous nephrolithotripsy, tube changes, nephrostography, and stone fragment irrigations and retrievals. Staghorn calculi treatment with ESWL required the most procedures by radiologists (34% for partial staghorn and 56% for complete staghorn) compared with 3%, 8%, and 11% for calyceal, pelvic, and ureteral stones, respectively. In all, 8,478 radiologic examinations and procedures were performed pertaining to ESWL. This is approximately 35 studies per day. While this number may be high because it represents the early experience of the authors with ESWL, the impact on the radiology department can be substantial.     

CT-guided laser therapy in resistant human tumors: phase I clinical trials

Photodynamic therapy was performed on ten tumors in patients who did not respond to initial therapy and for whom no additional conventional therapy was available. A sensitizing agent (hematoporphyrin derivative [HpD]) was injected directly into each tumor under computed tomographic (CT) guidance to deliver high concentrations to the tumor and to minimize systemic toxicity. Three to 6 days after the injection, a clear Teflon sheath catheter was placed into the tumor under CT guidance. The tumor was exposed to red light (630-nm wavelength) through laser fiberoptics inserted in the sheath. The initial investigation confirmed the technical feasibility of CT-guided photodynamic therapy by means of intratumoral HpD injections and laser exposure through fiberoptics inserted in sheath catheters. The toxicity from a single treatment was minor, and the tumor response was encouraging.     

Role of B7-1 in mediating an immune response to myeloid leukemia cells

A costimulatory signal from B7-1 (CD80) to its counter-receptor CD28 is required for T-cell activation. Many tumors, including most human leukemias, lack expression of B7-1, and this has been suggested to contribute to the failure of immune recognition of these diseases. A murine leukemia model system was developed to assess the potential role of B7-1 in the induction immunity to leukemia cells. The nonleukemic 32Dc13 myeloid cell line was transformed by transfection of the BCR/ABL gene, generating a subline (32Dp210/clone 26) that was leukemic and rapidly lethal to syngeneic, immunocompetent C3H/HeJ mice or T-cell- deficient nude mice. B7-1-modified leukemic cells remained lethal in nude mice, but caused only a transient, nonlethal leukemia in C3H/HeJ mice. After a single exposure to live, nonirradiated B7-1-modified leukemic cells, C3H/HeJ mice developed protective immunity against subsequent challenge with B7-1(-) leukemic cells. Further, hyperimmunization with B7-1(+) leukemic cells prolonged the survival of mice previously injected with a lethal number of B7-1(-) leukemic cells. These results indicate that myeloid leukemic cells may be attractive candidates for B7-1 gene transfer.     

Lupus anticoagulant in preeclampsia and non-proteinuria gestational hypertension in primiparous women

The purpose of this study was to determine the relationship between the lupus anticoagulant and the proteinuric and non-proteinuric Gestational Hypertension in primigravids without subjacent pathology. Sixty- five patients with a single gestation of twenty or more weeks long were studied. Thirty four patients (Group A) were pregnant women with a normal blood pressure. Hypertensive disease developed during pregnancy (according to Davey and MacGillivray, classification) affected 31 patients (Group B). A test to determine the presence of the lupus anticoagulant was performed on all of them, according to the method of the diluted Russel viper venom. None of the patients developed any other symptomatic subjacent pathology. Fifty-five percent of the Group B patients developed proteinuric gestational hypertension (preeclampsia) and forty-five percent of them non-proteinuric gestational hypertension. The test to determine the lupus anticoagulant was negative in all the patients from both groups. The results suggest that the presence of a lupus anticoagulant is unlikely in the proteinuric and non-proteinuric gestational hypertension in primigravidas without subjacent pathology, therefore it remains as a controversial study issue.     

石斛类叶鞘的显微鉴定研究

商品石斛的植物来源复杂,规格繁多,外形鉴定较困难。为了准确鉴定石斛的品种,对常作为药用的16种石斛属(Dendrobium Sw)植物的叶鞘进行了显微观察,发现其表皮细胞的形状,大小,所含草酸钙结晶的形状、大小、分布等种间区别较明显,可作为鉴别石斛种类的科学依据之一。本文对金钗石斛D.nobile Lindl。等16种石斛的叶鞘表面特征加以描述,并附主要特征图和检索表。