Zinc ions and alkaline PH alter the phosphorylated state of proteins 3 and 4.2 in human erythrocyte membranes

The phosphorylation patterns of isolated red blood cell (RBC) membranes labeled with [ γ-³²p]ATP are altered by Zn⁺⁺ ions. Zn⁺⁺ ions caused an increased phosphate incorporation into a 72 KDa protein and several proteins in the 40–60 KDa region and a decrease in the labeling of a 53 KDa protein. The 72 KDa and 53 KDa proteins have been identified as protein 4.2 and a protease-cleaved fragment of protein 3, respectively. Evidence suggests that the changes in phosphorylation pattern may be due to the stimulation of endogenous membrane alkaline phosphatase(s). Our results suggest that Zn⁺⁺, at physiological concentrations in the intact erythrocyte, could modulate the phosphorylation of selected proteins which may regulate their association in the cytoskeletal network.     

Oesophageal dissection after thrombolytic treatment for myocardial infarction.

A 62 year old woman admitted with a history suggesting acute myocardial infarction had thrombolytic treatment with anisoylated plasminogen-streptokinase activator complex, which resulted in submucosal haemorrhage in the oesophagus; this caused dissection of the wall of the oesophagus and complete dysphagia. The haematoma resolved spontaneously, leaving behind a diverticulum, with reduced peristalsis and delayed emptying but no obstruction.     

Focal lung uptake of Gallium-67 in patients with acquired immunodeficiency syndrome secondary to pneumocystis carinii pneumonia

It is generally accepted that the lung uptake of ⁶⁷Ga in patients with pneumocystis carinii pneumonia (PCP) is diffuse and bilateral. Three cases of focal lung uptake of ⁶⁷Ga in AIDS patients with PCP but without other opportunistic infection are described. While focal lung uptake is characteristic of opportunistic infections other than PCP, we wish to emphasize that focal uptake of gallium in the chest does not rule out PCP and may represent its earliest stage of presentation.     

Probe™, a balloon wire: Initial experience

Coronary angioplasty is unsuccessful in <3–5% of cases because the balloon catheter fails to follow a guidewire that has traversed a lesion. Between June 1986 and August 1987, 31 lesions were unable to be crossed with at least two standard angioplasty catheters. Finally, a 2.0-mm-diameter Hartzler LPS (ACS) was utilized and successfully crossed and dilated 16 out of 31 lesions (52%). In the remaining 15 lesions, the Probe^TM (USCI) 2.0 mm diameter × 1.5 cm long balloon wire was able to cross the lesions in 13 (82%) and successfully dilated 12. In one case, lesion rigidity prevented the balloon from expanding at 14 atm. A right coronary artery lesion was attempted in 11 cases, and a left anterior descending and circumflex artery lesion in two patients each. No complications were encountered. In seven out of 12 successful Probe^TM cases, a larger balloon catheter was used to further dilate the artery. This new balloon wire has increased our success rate in severe stenoses and in tortuous vessels with severe distal lesions, in which presently available angioplasty equipment has failed.     

The future of cardiovascular imaging and non-invasive diagnosis

Advances in medical imaging now make it possible to investigate any patient with cardiovascular disease using multiple methods which vary widely in their technical requirements, benefits, limitations and costs. The appropriate use of alternative tests requires their integration into joint clinical diagnostic services where experts in all methods collaborate. This statement summarises the principles that should guide developments in cardiovascular diagnostic services.This paper is published simultaneously in the European Heart Journal (2006;27:1750–1753) and in the European Journal of Echocardiography (2006;7:268–273).     

未破裂脑动脉瘤的治疗选择

未破裂脑动脉瘤的处理存在争议。由于其自然史尚未完全明确,因此最佳的治疗策略也不清楚。目前对未破裂脑动脉瘤处理的共识包括观察、显微手术夹闭和血管内治疗。用于随访已知未破裂脑动脉瘤的方法学也有争议,可能取决于经治医生的偏好。大多数动脉瘤由神经外科医师和介入神经放射科医师处理,但未破裂动脉瘤通常是由神经科医师在对患者进行其他神经系统疾病的筛查时首先发现的。因此,关于何时对患者进行筛查和如何对未破裂动脉瘤采取最佳处理的知识将对其日常医疗实践有直接的影响。未破裂动脉瘤经常导致包括缺血事件、癫和头痛在内的其他神经系统症状,这些症状可能促进更积极的干预治疗。由于缺乏设计完善真正基于人群的研究或随机试验,因此目前的最佳处理必须以现有文献和每例患者当时的具体情况为根据。