Visceral Leishmaniasis Complicating Polycythemia Vera

Abstract. A case of visceral leishmaniasis is presented, where a pre-existing polycythemia vera obscured signs of the infection. Visceral leishmaniasis is a life-threatening but curable protozoan infection of the reticuloendothelial system. We wish to report a case where symptoms and signs were obscured by a preexisting hematologic disease, polycythemia vera.     

Modulation of Healthy Pig Coronary Arteries by Self-Expanding Stents

Objectives: To evaluate the expansion ratio of a self-expanding stem over time, and the chronic effect of stent pressure on the vessel wall . Methods: Self-expanding stents, developed by Medtronic Inc. (Minneapolis, MN, USA) and the Rouen group (Letac, Cribier, France), were implanted in 21 normal pig coronary arteries. Animals were sacrificed after recatheterization at 1 day (group I, n = 4), I week (group 2, n = 3), 3 weeks (group 3, n = 5), or 8 weeks (group 4, n = 4). Histological morphometry of the vessel medial and neointimal layers was performed. Changes were related to the, stent diameter and. its force on the vessel wall . Results: The stent expansion ratio gradually increased from 73% to 93% after 8 weeks, which implicates that radial force decreased concomitantly from 0.10 N to 0.03 N. Media compression under the rods ranged from 4l%-66% immediately after stent implantation. The mean compression was unrelated to stent expansion and remained nearly the same (40%-50%) during follow-up. Individual media rod compression ranged from 5%-95%. The neointimal layer on top of the rods increased until the third week after stent implant (neointimal thickness 211 ± 108 μm). The layer significantly decreased at 8 weeks (neointimal thickness 65 ± 9 μm). The cross-sectional neointimal area increased gradually only at the end of the stent during the 8-week follow-up . Conclusions: The self-expanding stent implanted in normal pig coronary arteries reached a gradual relaxation state 8 weeks after implantation due to the persistent radial force. This radial force induces medial wall compression, which was only positively related to the thickness of the neointimal layer at 3 weeks after implant . (J Interven Cardiol 1996;9:45–52)     

Controlled Clinical Trial of Treatment with Cimetidine for Non-ulcer Dyspepsia

ABSTRACT The effect of cimetidine (1 g daily) and placebo was studied in a controlled clinical trial comprising 50 patients with non-ulcer dyspepsia in whom an organic abnormality responsible for the dyspeptic symptoms was not disclosed by a standardized and extensive examination programme. Reduction of symptoms occurred in 13 (54%) out of 24 patients treated with cimetidine and in 16 (62%) out of 26 treated with placebo. The difference was insignificant, as were the alterations in the individual dyspeptic symptoms between the groups. Only 6 patients (25%) on cimetidine and 8 (31%) on placebo treatment had a total relief of symptoms. Of these, all cimetidine-treated patients remained free from symptoms during the successive 3-month observation period, while the dyspeptic symptoms relapsed in 3 (38%) placebo-treated patients. Subsequent resumption of placebo treatment reduced the symptoms in all 3 patients, but only one became free from symptoms. Cimetidine does not seem to be superior to placebo in the treatment of non-ulcer dyspepsia in patients without any previous history of ulcer or without any sign on endoscopy of an active or previous ulcer disease.     

Staging of Idiopathic Myelofibrosis: Significance of Haemoglobin Value and Reticulocyte Count

ABSTRACT. A retrospective analysis of 18 patients with idiopathic myelofibrosis (IMF) suggested that IMF is adequately staged by combining haemoglobin value and reticulocyte count. Four stages were recognized. All deaths occurred in late stage. The stages appeared to reflect a sequential course of the disease. The present staging system adequately identified patients at high risk. However, the rate of disease progress varied greatly. It is therefore suggested that the rate of disease progress should also be considered when an individual patient is evaluated.     

Enhanced emigration of crevicular leukocytes mediated by factors in human dental plaque

abstract – The present investigation was performed to study whether a filtrate from human dental plaque when applied topically to the gingival margin enhances gingivitis. Four-day-old plaque was sampled from 20 dental students. The plaque samples were pooled, suspended in NaCl, homogenized, centrifuged and filtered. The capacity of the plaque filtrate to attract neutrophil leukocytes was determined by measuring the number of leukocytes (a) which migrated into wound chambers containing the filtrate and (b) which could be sampled from the gingival crevices of dogs and monkeys after repeated topical application of the filtrate to the gingival margin. Gingivitis was assessed by gingival exudate measurements. The results showed that substances present in human dental plaque are highly chemotactic for neutrophil leukocytes. The filtrate stimulated enhanced emigration of leukocytes into the gingival crevices and enhanced gingival exudation. The observations indicate that a plaque filtrate may enhance vascular and cellular changes similar to those seen in incipient gingivitis.     

A PATIENT WITH HEREDITARY GALACTOKINASE DEFICIENCY

A case of hereditary galactokinase deficiency is reported, occurring in a newborn boy and detected through routine screening of newborns for increased blood concentration of galactose. Symptoms were equivocal and consisted only of mild feeding difficulties and a slightly insufficient weight gain. The only abnormality found on clinical examination was lens opacities which were obvious when the boy was 5 weeks old. The biochemical abnormalities found were: excretion of large amounts of galactose and ga-lactitol in the urine, galactosemia, and essentially no galactokinase activity in the red blood cells. On a galactose-free diet, introduced when the boy was 3½ weeks old, he grew and developed normally, his cataracts had improved considerably after 4 months. The boy's both parents, one brother and possibly one sister were considered carriers of the autosomal recessive gene, as the enzyme activity found in their red blood cells was roughly half of the normal value. The clinical findings in patients with the various enzyme defects leading to galactosemia are described and related to the biochemical abnormalities caused by the defects. Possible screening methods are discussed.