Use of translesional coronary flow velocity for interventional decisions in a patient with multiple intermediately severe coronary stenoses

Translesional pressure gradients are currently not performed routinely for most angioplasty procedures because of the technical limitations. With the use of an 0.18 inch Doppler flow velocity guidewire, coronary flow velocity, both proximal and distal to a lesion, can be easily assessed. In branching arteries, significant lesions are characterized by a ratio of proximal to distal flow velocity of > 1.7, loss of the normal phasic diastolic predominant flow velocity pattern, and/or loss of distal hyperemia. We describe the use of coronary flow velocity in assisting important decision making in a young patient with a recent myocardial infarction and multiple coronary lesions. The decision for angioplasty of the hemodynamically significant stenosis was confirmed by translesional flow velocity measurements. A rational approach to coronary intervention in patients with multiple stenoses of intermediate severity appears to be facilitated by direct measurement of translesional flow dynamics. © 1993 Wiley-Liss, Inc.     

Carcinoma of the vulva. Report of a case originating from Bartholin's gland

A case of vulvar carcinoma arising from Bartholin's gland is described. At admission the patient showed a large suppurated swelling of the left labium maior. The neoformation reached the groin of the same side. Malignant cells were detected in biopsy specimens of both the vulvar swelling and the lymphonodes. The histological test showed a vulvar carcinoma arising from Bartholin's gland. The vulvar swelling and the ulcerated lesion were removed and the patient was treated with radiotherapy, chemotherapy (bleomicina) and immunomodulant therapy (Timostimoline). Pulmonary methastases were detected eighteen months after the operation and the patient died two years later.     

Osteoporosis in patients affected with thalassemia. Our experience.

The authors examine 72 patients affected with homozygous B-thalassemia; The study was conducted by clinical-hematological and radiologic examination. The Singh method is used to compare clinical data with the degree of osteoporosis. The results indicate that there is a high frequency of osteoporotic abnormalities in thalassemia. The authors postulate that osteoporotic lesions are principally caused by hyperplasia of the marrow, the overactive bone marrow widening the medullary space and the increased intramedullary pressure causing osteoporosis.     

Type A personality and risk of post-infarction coronary events

The purpose of this study was to verify the prevalence of Coronary-prone Behaviour Pattern in a group of eighty-eight patients recovering from their first episode of myocardial infarction. These patients were followed for a period of 4 years to verify the eventual appearance of coronary events, after their first myocardial infarction, with high Coronary-prone Behaviour Pattern levels. The results showed that the number of subjects who died from recurrent myocardial infarction was nearly twice as high in type B, non coronary-prone subjects, as in type A subjects. The Authors hypothesize that specific ways of coping with stressful events adopted by type A subjects may constitute a protection factor as regards the risk of death from recurrent myocardial infarction.     

Low-dose ARA-C and 1(OH) D3 administration in acute non lymphoid leukemia: pilot study.

BACKGROUND AND METHODS. Vitamin D3 metabolites have been shown to be able to induce monocytic differentiation both in vitro and in vivo. In this paper we report the preliminary results of an uncontrolled clinical trial where low doses of ARA-C and 1(OH)D3 were administered to patients affected by acute non lymphoid leukemia. The achievement of complete or partial remission was recorded. Morphological and cytochemical studies were performed in order to control the blastic populations under therapy. Immunocytochemical studies were also performed in some patients in order to detect the presence of 1,25(OH)2D3 receptors in the blast population. Seventeen percent reached complete remission and 45% reached only a partial remission. RESULTS AND CONCLUSIONS. The results are in line with those showing that low doses of ARA-C are an effective treatment in this type of leukemia. In some cases (7/11), a monocytic/monoblastic shift was detected. The demonstration of 1,25(OH)2D3 receptors in some blasts is also reported. Thus it is possible to suggest that the vitamin D metabolite displays "in vivo" the differentiating activity already shown "in vitro".