Entrainment of Ventricular Tachycardia by Sinus Rhythm

Entrainment of ventricular tachycardia (VT) may be manifest as fixed and progressive QRS fusion with ventricular and, rarely, atrial pacing. Only a single example of spontaneous VT entrainment by another rhythm, rapid atrioventricular nodal tachycardia, has been reported. This article describes an example of fixed and progressive QRS fusion between conducted sinus rhythm and VT consistent with entrainment. In contrast to entrainment with pacing, entrainment of VT by sinus rhythm occurred with drug-mediated arrhythmia slowing and demonstrated progressive QRS fusion at a constant cycle length. However, it did not demonstrate unfused but entrained QRS complexes. The resulting short PR interval and wide QRS mimicked a preexcited rhythm.     

Therapy burden, drug resistance, and optimal treatment regimen for cancer chemotherapy

Email: boldrini{at}ime.unicamp.brAuthor to whom correspondence should be addressed. Email: michel{at}Incc.br Three nonlinear models of tumour cell growth under continuousdelivery of cycle nonspecific anticancer agents are studied.A dynamical optimization problem with the objective of minimizingthe final level of tumour cells is posed for these mathematicalsetups. The simplest setup does not possess toxicity constraints,whereas the other setups contain a dynamical equation describingthe therapy burden as a toxicity criterion. In addition, thethird setting contains the dynamics of drug resistant cells.A discussion conceming the optimal strategies of the respectivemodels is performed.     

Cryoglobulins III: FURTHER STUDIES ON THE NATURE, INCIDENCE, CLINICAL, DIAGNOSTIC, PROGNOSTIC, AND IMMUNOPATHOLOGIC SIGNIFICANCE OF CRYOPROTEINS IN RENAL DISEASE

Serial serum samples from a large number of patients with immunologicrenal disease, normal healthy controls, acute infections aswell as non-immunological renal disease were studied for thepresence, nature and properties of cryoproteins, and these correlatedwith serial renal functional, morphologic, immunohistologicand clinical findings as well as serologic observations. A highincidence of cryoproteins were found in renal disease thoughtto be mediated by immune complexes. Cryoprecipitates were notdetected in the other patients. The presence of fibrinogen ina serum cryoprecipitate was always associated with rapidly progressivedisease and poor prognosis. An association between the detectionof cryoproteins and the clinical and morphological activityof disease was observed. Persistence of cryoproteinemia wasassociated with progression and apparent disappearance withresolution or progression to end stage renal disease. In patientswith hematuria or proteinuria of questionable significance cryoproteindetection was always associated with immune complex nephritis.Renal transplantation in the presence of cryoproteinemia wasassociated with recurrent nephritis in the graft. Cryoproteins were found to have biologic properties attributableto antigen—antibody complexes, to contain immune complexesof antigen and antibody and to have serologic factors concentrated.The detection of serum cryoglobulins was found to be a betterindex of clinical and morphologic activity of immune complexrenal disease than was serum complement. As in our previousstudies, these proteins appear to be of diagnostic and prognosticvalue in renal disease and provide a method of antigen identificationin these disorders.     

Anomalous Panleukocytic Granulation

Anomalous panleukocytic granulation is described in the peripheral blood,bone marrow and spleen of a 3 year old girl. Myeloid leukocytes showedgiant peroxidase and Sudan Black B-positive granules. Lymphocyte corpuscles were positive in the periodic acid-Schiff test. Deviations in thestructure and segmentation of the neutrophil nuclei were observed. Increaseof gamma globulins and decrease of lipoproteins were found in the bloodserum.

Hepatosplenomegaly, psychomotor underdevelopment, respiratory tract infections, roentgenologic changes of bones, lungs and heart were also found.The parents were first cousins, and anomalous corpuscles were seen in thefather’s lymphocytes.

At necropsy diffuse or focal infiltration of the organs by lymphoid, plasmaand reticular cells suggested a systemic condition.

Submitted on July 26, 1958 Accepted on April 11, 1959     

Colonoscopic Polypectomy

A total of 87 polyps were treated during 62 colonoscopic examinations on 60 patients; 69 polyps were resected and 18 were fulgurated with the hot-biopsy forceps. Fifteen patients were under 13 years old, and the average age was 38 years. Twelve patients had more than one polyp. There were no complications and the method could be carried out in all patients, whenever it was indicated. Sixteen polyps were hamartomas, 13 shistosomatic, six hyperplastic, two lymphoid and 36 adenomas. Among these adenomas, six showed evidence of foci carcinoma, one in situ and five, invasive. Surgical resection was indicated in only one patient with sessile polyp with invasive focus of carcinoma. No metastasis was detected whatsoever.