Noninvasive Assessment by Doppler and M-Mode Echocardiography of Hemodynamic Responses to Temporary Pacing and to Ventriculoatrial Conduction

A new, dual-chamber temporary pacing lead was introduced via the subclavian vein in 20 patients who needed a temporary pacemaker. Stroke volume (SV) was measured continuously by combining M-mode and noninvasive Doppier echocardiography during spontaneous rhythm (SR), AV sequential pacing at a positive AV interval (DP), ventricular pacing (VP) and AV sequential pacing at a negative AV interval (VA pacing). The valvular functions were determined by Doppler echocardiography. Left ventricular dimensions and function, and left atrial size were measured by M-mode echocardiography. In the nine patients with no valvular heart disease and with no ventriculoatrial (VA) conduction (group I) the CO increased 83 ±11% during DP and 42 ± 9% during VP as compared to during SR when the heart rate (HE) was increased from 34 ± 3 to 72 ± 1 beats/min. The CO was 29 ± 3% higher during DP than that during VP. In the seven patients with valvulox heart disease and with no VA conduction (group II), the increment in CO compared to that during Sfi was SZ ± 12% during DP and 31 ±17% during VP: the CO was 17 ± 4% higher during DP than that during VP. In the four patients with spontaneous VA conduction (group III), the CO during DP was 35 ± 10% greater than that during VP, which did not result in an increase in the CO compared to that during SR in spile of an increase in HR from 52 ± 8 to 74 ± 2 beats/min. The study demonstrated that DP is the preferred temporary pacing mode and also that VA conduction during VP resulted in a mean decrease of 20% in CO compared to that during VP without VA conduction. The hemodynamic benefit from DP compared to SR seems to decrease when the left ventricular end-diastolic dimension increases. Furthermore, patients with large left ventricular end-systolic dimensions seem to have a lower increase in stroke index during DP as compared to that during VP than patients with smaller end-systolic dimensions.     

伤速康巴布膏对兔膝骨性关节炎模型关节液中SOD、NO水平变化影响的实验研究

目的：本实验选用伤速康巴布膏作为干预因素,观察在兔膝骨性关节炎模型用药后关节液中NO和SOD含量变化,从而探讨伤速康巴布膏治疗膝骨性关节炎疗效及其作用机理。方法：日本大耳白兔30只,雌雄不限,体重（1.85±0.15）kg,随机分为A组（模型对照组）、B组（伤速康巴布膏组）、C组（骨痛贴组）,每组10只。A、B、C 3组在＂Hulth造模法＂的基础上制作膝骨性关节炎模型。A组只以胶布固定,B组伤速康敷贴,C组骨痛贴敷贴胶布固定。于第2、4周,各组随机空气栓塞处死5只兔子,处死后用注射器抽取1mL生理盐水注入关节腔进行冲洗,4000r/min,取上清液,按试剂盒方法,检测关节液中超氧化物歧化酶（SOD）、一氧化氮（NO）的含量。结果：模型组关节液NO含量显著高于伤速康巴布膏组及骨痛贴组（P〈0.05）,伤速康巴布膏及骨痛贴可降低关节液NO水平,伤速康巴布膏组与骨痛贴组比较差异无统计学意义（P〉0.05）。模型组关节液SOD含量显著低于伤速康巴布膏组与骨痛贴组（P〈0.05）,伤速康巴布膏组与骨痛贴组比较差异无统计学意义（P〉0.05）。结论：伤速康巴布膏敷贴可对骨关节炎软骨退变起明显缓解作用;能显著降低兔关节液中N0含量以及升高关节液中SOD含量,并激发OA早期的关节软骨细胞增殖而治疗骨关节病,改善关节功能。     

HIV/AIDS related mortality among adult medical patients in a tertiary health institution in South–South,Nigeria

ObjectiveTo determine the causes of death among human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients as a step to planning strategies to improve mortality from this condition.MethodsThis study retrospectively analyzed the mortality pattern of adult HIV/AIDS patients in the University of Calabar Teaching Hospital from January 2005 to December 2007. The data were obtained from sexually transmitted infection/acquired immunodeficiency syndrome (STI/AIDS) clinic register, admissions and discharge/death registers as well as the patients' case records and the hospitals monthly mortality reviews. Information obtained included age, sex, diagnosis and cause(s) of death. The causes of death considered were the direct causes of death, since the originating antecedent cause of death is the same in all the patients, in this case, HIV/AIDS. Data was analysed using Epi Info 2002.ResultsThe total number of mortalities during the study period was 350,100 were HIV positive representing 28.6% of all deaths. While advanced HIV/AIDS disease was the leading cause of death in our study representing 27.0%, tuberculosis was the single leading cause of deaths in HIV/AIDS patients constituting about 24.0% of deaths. This was followed by sepsis and septicaemia (13.0%), meningitis and encephalitis, and anaemia accounting for 11.0%, while respiratory diseases constituted 5.0% of the mortality burden. The highest number of deaths occurred in those aged between 21–50 years (82.0%).ConclusionsThe study has shown that HIV/AIDS is a major cause of morbidity and mortality in our hospital. The causes of death reflect the varied spectrum of infection and other forms of organ involvement that affect HIV/AIDS patients. The present dismal situation of adult patients living with HIV/AIDS calls for enhanced strategies to decrease the mortality trend observed in Nigeria and sub-Saharan Africa.     

Analysis of Gleason grade and scores in 90 Nigerian Africans with prostate cancer during the period 1994 to 2004

Objectives

To determine the relative frequency of prostate cancer among surgical specimens, and among prostate specimens received at the pathology department ,University Hospital Calabar.

Methods

Histology records were reviewed for the following: total number of histology specimens received; total number of prostate specimens; total number of prostate cancer; and the total number of cancers in males during the study period. Histology sections 4–5microns thick were cut from paraffin blocks and stained by Haematoxylin and Eosin (H&E). Histopathologic specimens were classified using the grading system of tumour differentiation described by Gleason and associates.

Results

One hundred and twenty three cancers of the prostate were received, constituting 2% of the total surgical specimens and 31% of prostate specimens. Thirty three cases (27%) could not be analyzed; therefore the study is based on 90 prostate cancer specimens. Eighty nine (99%) cases were epithelial tumours (adenocarcinoma.) There was a single mesenchymal tumour (rhabdomyosarcoma) (1%). The commonest grade in this study was the high grade (Gleason grade IV).

Conclusions

We observed that prostate cancer is a common among males (all sites) diagnosed at the University Hospital Calabar, with a peak incidence between the ages of 61 – 70 years (seventh decade).     

Effects of IL-13 on murine listeriosis

Acquired resistance against Listeria monocytogenes is a typical T helper (Th) 1 dominated immune response, whereas Th2 cytokines are thought to worsen listeriosis. We investigated effects of recombinant IL-13 (rIL-13) on the host response to L. monocytogenes in mice. Although IL-13 has been described as a Th2 cytokine with deactivating anti-inflammatory activities, it was found to enhance antilisterial resistance. In vitro, rIL-13 increased IL-12 p40 and p70 production by bone marrow macrophages infected with L. monocytogenes. In vivo, numbers of viable bacteria in spleens and livers were decreased after treatment of mice with rIL-13. In addition, granuloma formation was impaired and NK cell activity of spleen cells was enhanced. At the onset of infection, frequencies of IL-12-producing cells were increased and numbers of IL-4- and IFN-gamma-secreting cells were diminished in rIL-13-treated mice as compared to controls. In contrast, on day 6 after infection, IL-12, IL-4 and IFN-gamma levels in rIL-13-treated animals were equal to or even higher than those in controls. Although direct activation of host macrophages by IL-13 is possible, we consider it more likely that IL-13 acted indirectly through stimulation of IL-12 production and inhibition of IL-4 release early after infection. In contrast, our data argue against an apparent role of IFN-gamma in IL-13- induced antilisterial resistance.