Echocardiographic Aspects of Restrictive Cardiomyopathy

Background and Methods: We studied 17 patients with restrictive cardiomyopathy; eight had biventricular restriction (type A), four had left ventricular restriction (type B), and five had only right ventricular restriction (type C). Results: Type A disease was characterized by pulmonary and systemic venous congestion. The restrictive pattern was found in the inlet of both ventricles. Both atria were enormous, with small or normal-size ventricles. Differential diagnosis included constrictive pericarditis and systolic pump dysfunction. Type B restriction disease was characterized by venous pulmonary congestion, pulmonary hypertension, and important dilatation of the left atrium and right cavities with a small or normal-size left ventricle; the restrictive pattern was found only in the affected left ventricle. Conclusions: The clinical picture resembles that of rheumatic mitral valve disease with right ventricular failure. Type C disease had restriction only in the inlet of right ventricle, with giant right atrium, systemic venous hypertension with low flow, and normal pressure of pulmonary artery and left heart. Differential diagnosis included Ebstein's anomaly of tricuspid valve. The etiology of type A disease was amyloid, endomyocardial fibrosis of ventricles and idiopathic interstitial fibrosis. Asymmetric types were always caused by Davies' disease.     

Subchronic Intravenous Toxicity of the Antineoplastic Drug, Amsacrine, in Male Wistar Rats

Amsacrine, a DNA intercalator and topoisomerase II inhibitor,is efficacious as an antileukemogenic agent. This study wasconducted to assess the subchronic toxicity of amsacrine inrats following a cyclic clinical dosing regimen and as a range–findingexperiment for a subsequent carcinogenicity bioassay. Groupsof 30 male Wistar rats were administered drug intravenouslyat doses of 0, 0.25, 1.0, and 3.0 mg/kg daily for 5 days followedby 23 days without treatment. This cycle of dosing and recoverywas repeated six times to simulate human clinical usage of thedrug. Assessments of hematology, clinical chemistry, and grossand microscopic pathology were conducted 3 and 21 days followingcompletion of dosing in the first, third, and sixth cycles.There were no deaths during the study. Hair loss, diarrhea,tail injuries, chromodacryorrhea, and rhinorrhea were observedprimarily in animals administered 3 mg/kg. Hair loss and diarrheaoccurred during periods of dosing and generally resolved duringthe recovery phase of each cycle. Both of these signs becameprogressively more severe during the latter half of the study.Body weight loss and reduced food consumption also occurredin the 3 mg/kg group during each week of dosing. At study termination,mean body weight and food consumption of the 3 mg/kg group weresignificantly less than those of controls by approximately 20and 50%, respectively. Marked, reversible leukopenia associatedwith reductions in both neutrophil and lymphocyte counts occurredin cycles one and three in animals administered 1 and 3 mg/kg,respectively. Reversible neutropenia was also observed in the3 mg/kg group in cycle 6. Similar effects on platelet countswere seen in the 3 mg/kg group in all three cycles analyzed.Absolute and relative testes weights of the 3 mg/kg group weresignificantly less than the vehicle controls at all time pointsin the third and sixth cycles. Relative testes weights werealso decreased in the 1 mg/kg group in cycle 6.     

Performance of a New Cardiac Cryoablation System in the Treatment of Cavotricuspid Valve Isthmus-Dependent Atrial Flutter

We sought to evaluate prospectively the safety and efficacy of cryothermal energy to ablate typical atrial flutter (AFL). Ablation of cardiac tissue using cryothermal energy has recently been developed as an alternative to radiofrequency energy, which may offer certain advantages in the treatment of AFL. This prospective, multicenter nonrandomized study of a new catheter-based system for the treatment of cavotricuspid isthmus (CTI)-dependent AFL enrolled patients between 18 and 75 years of age. The CTI dependence of AFL was confirmed at electrophysiologic study with activation mapping and/or entrainment. Patients with atrial septal defect, recent myocardial infarction, left ventricular ejection fraction <0.30, or prior AFL ablation were excluded. Cryoablation of AFL was performed in 48 patients from 11 centers. The procedure was immediately successful in 45 patients (94%), and effective in 30 of 40 patients with complete data available at 6 months. Cryoablation is a promising new treatment of CTI-dependent AFL refractory to medical therapy. Further improvements in catheter design and intravascular sheaths will be tested in a larger multicenter trial.     

Recognition and utilisation of dansyl-dipeptides in manual dansyl-Edman sequencing

The chromatographic behaviour of the dansyl-dipeptides likely to be encountered in manual dansyl-Edman sequencing is presented. The dansyl dipeptides were either encountered in experimental sequencing or chemically synthesised and in some cases both. The advantages of using short hydrolysis times and deliberately generating these dipeptides are discussed.     

Evidence of Increased Gc: Actin Complexes in Pregnant Serum: A Possible Result of Trophoblast Embolism

ABSTRACT: The molecular configuration of group-specific component Gc protein in sera from pregnant and nonpregnant individuals was compared by analytical isoelectric focusing and by print immunofixation in conjunction with known standards of Gc:actin and Gc:vitamin D₃ complexes. These studies revealed that while complexes of Gc with actin and with vitamin D were detectable in small amounts in nonpregnant sera, much larger quantities of both types of complexes were consistently visualized in pregnancy. In addition, when actin was added to pregnant sera containing Gc:vitamin D₃ complexes, a third anodal complex was revealed which presented the molecular configuration of actin: Gc: vitamin D₃. These results demonstrate that Gc:actin complexes may be present under physiological circumstances in the circulation. Since large amounts of trophoblast enter the maternal circulation during both normal and abnormal human pregnancy, experiments were undertaken that showed that actin was released from isolated trophoblast membranes and also upon lysis of other viable cells under physiological conditions similar to those obtained in serum, and such actin complexed rapidly with Gc. Although the effects of this phenomenon upon the immunobiology of pregnancy are unknown, these findings are consistent with the concept that Gc protein may exert a “scavenger” function in mopping up actin released from damaged cells.     

Towards a new methodology for making sense of case material: an illustrative case involving attempted multiple murder

Functional analysis provides a method of understanding behaviour in terms of its consequences for the individual concerned. The suggestion is made here that the application of this method to past behaviour will be useful to both practitioners and researchers. It offers benefits in terms of organising case material, understanding the aetiology of the behaviour, planning interventions and predicting dangerousness. It should be noted, however, that this is not an exercise in developing causal models of specific offences. In this paper multiple sequential functional analysis methodology is described and the problems of applying it retrospectively to criminal behaviours discussed. The methodology is illustrated with the case of a man who formulated a plan to kill 20 people and was convicted of two counts of attempted murder.