Hypertrophic Cardiomyopathy: valuation and Treatment of Patients at High Risk for Sudden Death

Hypertrophic cardiomyopathy (HCM) is a heritable disease characterized by LV hypertrophy with markedly variable clinical, morphological, and genetic manifestations. It is the most common cause of sudden death in otherwise healthy young individuals. HCM patients often have disabling symptoms and are prone to arrhythmias. Frequently, there is associated LV systolic and diastolic dysfunction, LV outflow obstruction, and myocardial ischemia. Over the past decade, progress has been made in identifying patients who are at high risk for sudden death, in elucidating potential mechanisms of sudden death, and in defining therapeutic algorithms that may improve prognosis. It has also been possible to determine the genetic defect in some of the patients and to correlate clinical findings with the molecular defects. An exciting development has been the use of the dual chamber pacemaker as an alternative to cardiac surgery to improve symptoms and relieve LV outflow obstruction.     

Ringworm in a Child Due to Microsporum Distortum

The isolation of M. distortum from a child with ringworm of the scalp is reported. The geographical distribution, source of infection and the parasitic status of this dermatophyte are discussed.     

Virus-like Particles in the Lymphocytes of a Patient with Chronic Lymphocytic Leukemia

Lymphocytes from the peripheral blood of a patient with chronic lymphocytic leukemia were isolated and subjected to electron microscopy. Aggregatesof virus-like particles measuring 80 to 120 Å in diameter were observed asorganized structures in the cytoplasm of the cells. The true nature of theparticles remains to be established.

Submitted on July 27, 1962     

A NEW RATING SCALE FOR THE ASSESSMENT OF THE ALCOHOL-WITHDRAWAL SYNDROME (AWS SCALE)

A new rating scale for the quantitative assessment of the alcohol-withdrawalsyndrome (AWS) was developed from the CIWA-A scale by item analysisbased on the data from 132 alcoholic patients. The clinicalevaluation of this AWS scale in a second sample of 256 alcoholicpatients showed that it adequately assessed the course and severityof the AWS. The AWS scale provides data for a rational strategyof therapy for the AWS by rating mental and somatic symptomson different scales. In particular, the mental subscale allowsprediction of a complicated AWS. Subjects with an AWS score     

COMPARISON OF CAGE AND MAST WITH THE ALCOHOL MARKERS CDT, {gamma}-GT, ALAT, ASAT AND MCV

Many alcoholics deny abuse. To screen greater samples for alcoholdependence, short questionnaires, e.g. the CAGE or MAST areoften applied. Frequently laboratory parameters [i.e. ‘alcoholmarkers’, such as carbohydrate-deficient transfemn (CDT),     

Electron Microscopic Study of Human Basophils

Electron microscope studies were carried out on human basophils obtainedfrom peripheral blood and thoracic duct lymph. Delineation of the cells inthick sections was facilitated by staining with Toluidine Blue, which impartedthe characteristic purple-red color to the granules. The cytoplasm containsmany of the organelles seen in other cells, including a small Golgi apparatus,centrioles, mitochondria, fibrils and microtubules. Ribosomes and rough ERare rarely encountered. Basophil granules are surrounded by a unit membraneand contain particles which are uniform in size within the same granule butwhich vary in size in different granules within the same cell. Some granulesreveal a homogeneous texture and/or "myelin" figures. The appearance of mostbasophil granules differs from the ultrastructure of human mast cell granulesreported to date. It is suggested that the difference in fine structure may reflect a difference in the chemical constituents of the granules.

Submitted on September 20, 1966 Accepted on January 9, 1967     

Brief Report: Studies on Subcellular Platelet Particles

The phospholipids of subcellular platelet particles are very similar to thoseof the intact platelet. However, they contain a higher proportion of long-chain,highly unsaturated fatty acids, which confers upon them physical characteristics suggesting a dynamic biological system.

Submitted on August 29, 1963 Accepted on September 25, 1963     

Suppression of Incessant Ventricular Tachycardia in Hypertrophic Cardiomyopathy Associated with Improvement of Severe Left Ventricular Dysfunction

A 32-year-old black man presented with a history of palpitations since childhood and two syncopal episodes. He was found to have incessant ventricular tachycardia, impaired left ventricular contraction (ejection fraction 9%), and nonobstructive hypertrophic cardiomyopathy. Procainamide abolished the arrhythmia and the ejection fraction rose to 22% in sinus rhythm. Later treatment was switched to amiodarone, which suppressed the ventricular tachycardia but necessitated pacemaker implantation. He has remained well during the subsequent 2 years. Left ventricular ejection fraction has increased to 47% measured in paced rhythm. The improvement in left ventricular function has been attributed to suppression of the incessant ventricular tachycardia.     

Fungus Infections of the Skin in Australia

A series of 755 dermatophtes isolated at the Institute of Medical Research, Royal North Shore Hospital, from June 1, 1919, to September 13,1966, is reported and some of the relecant literature is discussed. Camlida infections during the same period are also recorded.