Human chorionic gonadotropin and alpha chain of glycoprotein hormones in patients with inflammatory bowel disease

In twenty patients with Crohn's disease and ten patients with ulcerative colitis serum levels of human chorionic gonadotropin and the common alpha-subunit of glycoprotein hormones were determined by radioimmunoassay. In contrast to published data, all serum samples except one revealed levels within the normal range of 148 controls (human chorionic gonadotropin levels up to 3.9 IU/l, alpha-subunit up to 3.8 micrograms/l). Neither the serum levels of human chorionic gonadotropin nor of the alpha-subunit differed significantly between patients with Crohn's disease (median/maximum: 0.9/4.4 IU/l; 0.7/3.6 micrograms/l) and ulcerative colitis (1.0/3.4 IU/l; 0.8/2.2 micrograms/l). Furthermore, the serum levels studied in patients with active (0.9/3.0 IU/l; 0.7/3.5 micrograms/l) and inactive (0.9/4.4 IU/l; 0.8/3.6 micrograms/l) Crohn's disease and in patients with active (1.1/3.4 IU/l; 0.9/2.2 micrograms/l) and inactive (0.9/2.9 IU/l; 0.8/1.3 micrograms/l) ulcerative colitis were not significantly different. There was no relationship of the duration of the disease or a bowel resection to the serum levels of human chorionic gonadotropin or the alpha-subunit. It is concluded that both parameters are not useful as markers in patients with Crohn's disease or ulcerative colitis. The normal serum levels found in patients with inflammatory bowel diseases indicate human chorionic gonadotropin as a highly specific marker for malignant diseases.     

Generalized Hailey-Hailey disease

A woman of 60 developed a generalized erythroderma. The case history revealed classical symptoms of Hailey-Hailey disease for 17 years. Light- and electron microscopic investigations confirmed the diagnosis of generalized Hailey-Hailey disease—an extremely rare condition. Two additional cases with widespread clinical manifestations are presented. These observations underline the fact that the whole epidermis is genetically disturbed and may react to various insults with suprabasal acantholysis.     

Erfahrungen mit dem CACH-Medium zum Nachweis von Trichomonaden und Hefepilzen bei Frauen mit Scheidenentzündungen

Das 1960 von W. A. MÜLLER entwickelte CACH-Medium hat sich gut für den kulturellen Nachweis von Trichomonaden und Hefepilzen in Vaginal- und Urethrasekret von Frauen mit Scheidenentzündungen, die die Ambulanz der Frauenklinik aufsuchten, bewährt. Die Zubereitung des Anreicherungsmediums und die Untersuchungstechnik zur Ermittlung dieser Mikroben werden beschrieben. Die mitgeteilten Erfahrungen stützen sich auf die Ergebnisse, die bei der mykologischen und parasitologischen Untersuchung von 1526 Vaginal- bzw. Urethraabstrichen von 639 Frauen mit Scheidenentzündungen erzielt werden konnten.     

KININS AND CARDIOPROTECTION

During the past decade it was recognised that kinins are potent endogenous vasoactive peptides with important cardioprotective actions which are of therapeutic relevance in the acute and chronic beneficial effects of ACE inhibitors. The effect of kinins is mediated through the release of autocoids from the endothelium, particularly nitric oxide (NO). In this review article the cardioprotective effects of kinins and their importance for the therapeutic effects of ACE inhibitors are highlighted.     

Ventricular Arrhythmias in Dilated Cardiomyopathy

Although prognosis of dilated cardiomyopathy (DCM) has improved due to advances in diagnosis and therapy, still too many sudden cardiac deaths occur in DCM. Spontaneous ventricular ectopy is a very common finding in patients with DCM, but the prognostic significance of Holter monitoring remains controversial. Other noninvasive methods, e.g., late potentials and QT dispersion, have not yet contributed to the evaluation of prognosis for arrhythmogenic events in DCM. Programmed ventricular stimulation has been repeatedly used to stratify long-term prognosis, yet satisfactory data are still missing as many deaths occur in patients without inducible arrhythmias. Several prognostic studies are still in progess, and preliminary data for the use of ICDs already appear to be promising. In patients with poor left ventricular function and ICDs in situ, prognosis is determined by progression of heart failure. Heart transplantation may be the ultimate therapeutic instrument for end-stage heart failure patients. For patients with advanced DCM and increased risk for malignant arrhythmias who are unsuitable for orthotopic heart transplantation, the combined therapy with an ICD and dynamic cardiomyoplasty may be an alternative treatment.     

Changes in AV Node Conduction Curves Following Slow Pathway Modification

GELLER, J.C., et al. : Changes in AV Node Conduction Curves Following Slow Pathway Modification. Dual AV node physiology often persists after successful slow pathway (SP) ablation, and the mechanism of tachycardia elimination is unresolved. Therefore, AV node conduction curves were analyzed following successful ablation (  4 ± 1  energy applications) in 85 consecutive patients (58 women, age  50 ± 2  years) with typical AVNRT. Twenty-seven patients (32%) had complete elimination (group 1) whereas 58 (68%) patients had persistence (group 2) of dual AV node physiology. A significant increase in the AV node Wenckebach cycle length (WB-CL) was observed in both groups (  310 ± 9 to 351 ± 15 ms  in group 1, and  325 ± 8 to 369 ± 9 ms  in group  2, P < 0.05  ). A decrease in the fast pathway (FP) ERP (  339 ± 15 to 279 ± 12 ms  ) and an increase in the maximum FP AH interval (  141 ± 5 to 171 ± 7  ) were observed only in group 1 (P < 0.05). In group 2, no change in the SP ERP (  267 ± 7 to 280 ± 10 ms  ) was observed, and the change in the maximum SP-AH following ablation showed a significant inverse relation to the maximum SP-AH at baseline in group 2. In conclusion, (1) an increase in the WB-CL is observed independent of the persistence or elimination of dual physiology after successful ablation; (2) when dual physiology is eliminated, significant changes in the FP ERP and the maximum FP-AH occur; (3) when dual physiology persists, FP physiology and the SP ERP remain unchanged, and a significant inverse relation between the change in the maximum SP-AH following ablation and the maximum baseline SP-AH is observed.     

Simplification of local therapy of psoriasis with 8-methoxypsoralen

Local 8-methoxypsoralen black-light treatment was carried out on sixty-two patients. For the first time, oil was employed as a preparation base in order to increase the transparency and so the effectiveness of irradiation. Also the need for a descaling pretreatment was avoided. In investigations still being carried out, 27.5% patients showed very good improvement, 48-4% good and 24-2% unsatisfactory results of treatment. In many cases, less than fifteen irradiation sessions were necessary for clinical healing. However, to obtain a uniform pigmentation, additional irradiation proved necessary.     

Cardiac Output Versus Pacing Rate at Rest and with Exercise in Dogs with AV Block

To achieve maximum benefit from exercise (rate)-responsive pacing in subjects with sinus node dysfunction and AV block, it is necessary to determine the pacing rate (HR) which produces maximum cardiac output (CO) under specified exercise conditions. However, the CO-HR relationship for exercise has not been systematically investigated. To permit determination of the optimum HR, CO was measured at rest and with exercise for different pacing rates. Seven dogs with complete AV block and permanently implanted ventricular pacemakers were exercised on a treadmill for 5 min at each of four pacing rates (55, 76, 101, 116/min) and at two constant exercise levels (225 and 560 kg.m/min). CO was determined by impedance cardiography during the resting state preceding exercise and during a brief period (10-20 s) immediately after exercise, and was expressed as a percent of the CO determined at rest with HR = 55/min. A three-phase pattern of CO versus HR appears to exist for exercise as for rest. For exercise, starting from a low HR, CO increases markedly; a "plateau" is reached during which moderate increase in CO is achieved by increasing HR. At very rapid pacing rates, CO may actually decrease with further increase in HR. The results of this study suggest that a subject-specific optimum HR exists for each constant exercise level. Moreover, the methodology employed in the study is applicable to the identification of optimum HR for any exercise (rate)-responsive pacemaker.