Heart size and function of soldiers, athletes, and sedentary men

This study compares the heart sizes and left ventricular masses of soldiers (n = 11) with age- and body size-matched groups of sedentary men (n = 10) and accomplished athletes (n = 11). Echocardiography revealed that active duty soldiers (A) who met minimal fitness standards and pentathletes (P) had greater average left ventricular (LV) end-diastolic volumes (A = 10%, NS; P = 28%, p less than 0.05), stroke volumes (A = 29%, NS; P = 44%, p less than 0.01), and LV masses (A = 22%, NS; P = 76%, p less than 0.01) than sedentary subjects. Athletes had an average LV wall thickness which was 23% (p less than 0.05) greater than that of soldiers and 32% (p less than 0.01) greater than that of sedentary men. The LV wall thickness to radius ratio (h/r) was similar between soldiers and sedentary men, but in athletes the h/r was greater (p less than 0.01) than in the less conditioned subjects. These data suggest that soldiers who meet minimal standards of fitness exhibit cardiac morphometric features consistent with endurance conditioning. However, the soldiers studied were significantly less (p less than 0.001) conditioned than the competitive athletes. These data suggest that improvements in aerobic and cardiac conditioning could be achieved through a greater emphasis on physical training.     

The endoscopic bronchial picture of patients with pulmonary tuberculosis of various age groups

Endoscopic pictures of the bronchi were studied in 509 new cases of pulmonary tuberculosis. Tuberculosis of the bronchi and its aftereffects such as cicatricial lesions were detected in 31.1 per cent of the children and adolescents, 7.9 per cent of the adults at the age of 18 to 29 years, 9.0 per cent of the adults at the age of 30 to 55 years and 14.7 per cent of the adults at the age of 56 to 75 years. Nonspecific endobronchitis was diagnosed in 27.9 per cent of the children and adolescents, 44.9 per cent of the adults at the age of 18 to 29 years, 46.3 per cent at the age of 30 to 55 years and 44.1 per cent at the age of 56 to 75 years. The incidence and nature of tuberculosis of the bronchi and nonspecific endobronchitis were not related to the patients' age.     

Leprosy and hepatitis B surface antigen

An ELISA technique has been developed to detect HBsAg in the sera of leprosy patients. Out of ninety-two serum samples taken from untreated leprosy patients, 10 samples were positive for HBsAg. The ELISA used in the present investigation is a low cost, reliable and sensitive marker of HBsAg. It is better than lesser sensitive (haemagglutination and counterimmunoelectrophoresis), costly and hazardous (radioimmunoassay) techniques and is therefore recommended for routine use.     

Mebendazole retention enema for severe Trichuris trichiura (whipworm) infection: a case report

The authors report a case of massive Trichuris trichiura infection, resulting in severe anaemia and congestive cardiac failure in a 9-year-old Iban boy, who was resistant to the usual oral anthelmintic treatment, but promptly responded to mebendazole retention enema. This patient also had an associated Entamoeba histolytica infection.     

Recovery of memory after severe closed head injury: dissociations in recovery of memory parameters and predictors of outcome

This study examined selective reminding and recognition memory performance of 21 severe closed-head injured patients tested within 6 months of regaining consciousness and then again after at least 1 year. Performances on selective reminding parameters were highly correlated and patients performed significantly worse at both testings than did hospitalized controls matched for age, education, and sex. Patients improved from testing 1 to testing 2 on only four of six memory variables. Average Impairment Rating at testing 1 was a marginally better predictor of memory performance at testing 2 than was length of coma. Results are discussed in terms of (a) utility of selective reminding parameters and predictors of outcome and (b) dissociations in recovery of memory parameters.     

Procalcitonin''s amino-terminal cleavage peptide is a bone-cell mitogen.

The parafollicular-cell (C-cell) hormone calcitonin (CT) can preserve or even augment skeletal mass by inhibiting osteoclast-mediated bone resorption. The possibility of an additional anabolic skeletal influence has also been raised: C cells might, via CT or other secretory products, affect osteoblast-mediated bone formation. The 57-residue amino-terminal procalcitonin cleavage peptide, N-proCT, has recently been identified in human and rat C cells, where it is made and secreted in equimolar amounts with CT. The coelaboration of N-proCT and CT and N-proCT's sequence conservation during evolution prompted us to investigate the potential skeletal bioactivity of N-proCT. We found that synthetic human N-proCT, at nanomolar concentrations, stimulated proliferation of normal and neoplastic human osteoblasts. At maximally effective doses, human N-proCT caused more than a 100% increase above the control rate of DNA synthesis, an effect comparable to the maximal growth effect of insulin, a potent mitogen for osteoblasts. Human N-proCT exerted a similar maximal mitogenic effect in chicken osteoblast cultures but at 1000-fold greater concentrations than in human bone-cell cultures. The bone-cell action of N-proCT was potentiated with insulin with a greater than 200% increase in DNA synthesis at high insulin concentrations. In sharp contrast to these findings for N-proCT, the other bioactive C-cell peptides, CT and somatostatin, showed no mitogenic effects in human or chicken osteoblast cultures. Our results indicate that the action of N-proCT on cultured bone cells is separate from and potentiated by insulin, a known growth factor. Unlike insulin and related growth factors such as insulin-like growth factor I, N-proCT is not mitogenic in skin fibroblast cultures. We propose that N-proCT is a C-cell hormone that promotes bone formation via stimulatory actions on osteoblasts and preosteoblasts.     

Electrocardiographic criteria of left ventricular hypertrophy in the presence of left bundle branch block

When left bundle branch block (LBBB) is present on the electrocardiogram, the diagnosis of left ventricular hypertrophy (LVH) may be difficult. The left ventricular mass in 70 patients with LBBB was estimated by echocardiography, and was compared to the QRS configuration on the electrocardiogram. We found that there was agreement between a monophasic R pattern in lead 1 or V6 (sensitivity 79.3%, 70.7%) and left ventricular hypertrophy. We suggest that a monophasic R pattern in L1 and V6 may provide a useful simple index of left ventricular hypertrophy in the presence of left bundle branch block.     

Preload-induced curvilinearity of left ventricular end-systolic pressure-volume relations. Effects on derived indexes in closed-chest dogs

End-systolic pressure-volume relations (ESPVRs) were analyzed in 10 closed-chest autonomically blocked dogs before and after volume loading that restored end-diastolic volume to its value measured in the control conscious state. Dogs had been previously instrumented with a left ventricular pressure micromanometer and ultrasonic crystals for measurements of major, anteroposterior, and septum-free wall diameters. Left ventricular volume was calculated with an ellipsoidal model in the left ventricular cavity. ESPVRs obtained during caval occlusion after volume loading were curvilinear as shown by the division of the relation into two parts. The initial part of the relation had a significantly smaller ESPVR slope (Ees, 12.0 +/- 1.8 mm Hg/ml) and ESPVR volume-axis intercept (Vd, - 3.5 +/- 0.8 ml) than the final part of the relation (19.5 +/- 3.1 mm Hg/ml and 0.0 +/- 0.6 ml, respectively, p less than 0.01). The end-diastolic volume-peak dP/dt relation showed a similar curvilinearity when end-diastolic volumes were larger than 1.5-1.7 times the minimal end-diastolic volume reached during caval occlusion. ESPVRs were not different during aortic constriction and caval occlusion when end-diastolic volume was small. In contrast, with large end-diastolic volumes, Ees and Vd were significantly smaller during caval occlusion than during aortic constriction. The final part of ESPVR (with small end-diastolic volume) had the same slope and intercept as that during aortic constriction. We conclude that preload produces a curvilinearity of ESPVR that significantly modifies derived indexes when the range of preload changes is large.