Kearns-Sayre syndrome: complete auriculoventricular block, torsade de pointes and ventricular fibrillation

The authors present the case of a new case of Kearns-Sayre syndrome, with early manifestations (7 months) and dramatic cardiac course. They document the ultimate and often fatal stage of the cardiac disorders of this syndrome, which was usually related to an asystole due to a total atrio-ventricular block and represented in this case by a ventricular hyperexcitability (ventricular tachycardia--"torsade de pointes"--ventricular fibrillation) occurring on an atrio-ventricular block; only one previous, undocumented case was found in the literature. The literature is reviewed in order to analyze the nature and chronology of the heart disorders in the course of the disease, and stress the screening modalities and therapeutic indications (continuous heart stimulation).     

Cyclotron production of carrier-free 66Ga as a positron emitting label of albumin colloids for clinical use

A method for producing carrier free ⁶⁶Ga (T_1/2:9.4h; ⁺) by ⁴He bombardment of natural copper targets is presented. ⁶⁶Ga is formed by means of the ⁶³Cu (⁴He, n) ⁶⁶Ga reaction. Production yields are given in the 17.5 to 8 MeV ⁴He energy range. Chemical purification of ⁶⁶Ga from the copper target is described. The only radionuclidic impurity found in the final product was ⁶⁷Ga. Albumin colloids from commercially available kits designed for use with ^99mTc could easily be labeled with ⁶⁶Ga and employed for studies of the lymphatic system by positron emission tomography.     

Concept and technic of malleable subperiosteal onlay. Toward a new dimension in facial rejuvenation surgery

We believe that rejuvenation of the shapes and volumes of the face is just as important as "tightening of the skin and muscles". In this way a more complete rejuvenation effect is obtained which is better perceived by others. The SMO technique provides a solution by the use of malleable coral microgranules, which may constitute the first biomaterial of a new generation of plastic and malleable onlays. In this context, a more general volumetric concept of ageing is developed, leading to a modification in our consultation and our treatment. Most importantly, this approach opens a whole new field, that of preventative treatment of facial ageing, which will no doubt be multidisciplinary.     

Role of angiotensin in the salt-hypertension of rats

Summary Hypertension was induced in uninephrectomized rats by NaCl 0.9% drinking and deoxycorticosterone acetate (DOCA) administration for 6 weeks. Plasma renin activity was markedly reduced but not suppressed. Renal renin concentration and total renal renin content were moderately reduced. Intravenous injection of 0.2 ml of antiangiotensin plasma resulted in transitory hypotension both in salt and DOCA-treated rats, and in normotensive control rats. It is concluded that angiotensin participates in the maintenance of blood pressure in salthypertensive rats as well as in normal animals.This work was supported by grant 67-00-517 from D.G.R.S.T. (Délégation Générale à la Recherche Scientifique et Technique). The authors wish to thank Miss colette Innocenzi and Miss Sonia Culot for technical assistance.     

Association between hormonal changes at menopause and the risk of a coronary event: a longitudinal study

OBJECTIVE: To investigate the association of hormone levels at menopause, lifestyle variables, and body composition with the predicted 10-year risk of a coronary event, calculated using the PROCAM scoring system, in a population-based sample of Australian-born, middle-aged women. DESIGN: A 9-year prospective study of 438 Australian-born women, who at baseline were aged 45 to 55 years and had menstruated in the prior 3 months. Interviews, fasting blood, and physical measurements were taken annually. The risk of an acute coronary event was calculated using the PROCAM scoring system (includes: age, low-density lipoprotein cholesterol, smoking, high-density lipoprotein cholesterol, systolic blood pressure, family history of premature myocardial infarction, diabetes mellitus, and triglycerides). RESULTS: Retention rate after 8 years of follow-up was 88% (n = 387). In women not using hormone therapy (HT): higher than average body mass index (BMI) (P < 0.001), BMI that increased (P < 0.005), lower than average estradiol levels (P < 0.005), estradiol levels that decreased (P < 0.001), and high free testosterone levels (P < 0.05) were associated with increased risk of a coronary event. There was a trend for high exercise frequency to be associated with a decreased risk (P < 0.07). After BMI and lifestyle variables were taken into account, use of HT did not have a significant effect on risk of a coronary event. CONCLUSION: In this longitudinal observational study of middle-aged Australian-born women, high BMI, an increase in BMI, high free testosterone, low estradiol, and a decrease in estradiol levels were the main determinants of increased risk of an acute coronary event, based on the PROCAM scoring system calculation. More frequent exercise tended to lower the risk.     

Absence of Correlation Between Delayed-Type Hypersensitivity and Protection in Experimental Systemic Candidiasis in Immunized Mice

We found that in mice which had been immunized intraperitoneally with 2 × 10⁸ heat-killed Candida albicans cells there was a striking temporal relationship between resistance to systemic challenge with 10⁶ living C. albicans cells and a number of measurable cellular parameters of the host response. These included the emergence of delayed-type hypersensitivity and the development of granulocytosis. Since it had been shown in previous work that granulocytosis was associated with an increase in resistance when nonspecific immunostimulation was used, we performed experiments to induce delayed-type hypersensitivity without any measurable modification of the granulocyte population. Adoptive transfer of delayed-type hypersensitivity with spleen cells from immune and resistant donor mice did not produce any increase in resistance in normal recipients. When separate groups of mice were immunized intraperitoneally or subcutaneously with varying doses of heat-killed C. albicans, we found that doses of less than 10⁸ cells did induce significant delayed-type hypersensitivity without any increase in granulocytosis. In such mice, as well as in animals pretreated with immunomodulators before immunization with heat-killed C. albicans, the presence of cell-mediated immunity, as measured by the delayed-type hypersensitivity test, was not associated with an increase in resistance against systemic candidiasis. On the contrary, the results suggested that cell-mediated immunity was associated with an increase in the susceptibility of these mice. The same effect on candidiasis susceptibility was observed when animals were immunized with heat-killed filamentous C. albicans.     

Pathology of inverted Takotsubo cardiomyopathy

Myocardial dysfunction without coronary involvement may occur in acute cerebral diseases. The inverted Takotsubo pattern has been recently recognized as a novel heart neurologic stress-related syndrome. We report on the case of a 40-year-old woman presenting with massive subarachnoid hemorrhage and brain death. Echocardiography revealed an extensive left ventricular circumferential akinesis except at the apex. Histologic analysis of the heart confirmed the absence of myocardial infarction and revealed only sparse foci of myocyte necrosis with contraction bands in the akinetic areas.