Risk factors of Egyptian male osteoporosis

Background: Osteoporosis (OP) is a growing health problem not only in women but also in men. Subjects and methods: This study was carried out on 100 healthy men, age range 30–65 years (mean ± SD, 44.65 ± 8.3). All were randomly recruited from Assiut city during the period January 2005 to January 2006. Complete clinical history included occupational history, smoking habit, physical activity and calcium intake. Complete clinical examination and anthropometric measurments were done. Laboratory investigations for serum calcium, phosphorus and osteocalcin were performed. Bone mineral density (BMD) was measured by calcaneal ultrasound. Results: Sixty‐three percent of participants had normal BMD, 37% had low BMD, (26% had quantitative bone ultrasound [QUS] T‐score –1 to –2.5 and 11% had QUS T‐score ≤ –2.5). Smoking and low physical activity were risk factors for low BMD. Significant positive correlations were found between BMD and body mass index, serum calcium, and osteocalcin and negative correlation with phosphorus. We concluded that low BMD occurs with high frequency in Egyptian men. Smoking, physical inactivity and low body index are significant risk factors. Low serum calcium, low serum osteocalcin and high serum phosphorus are biochemical risk factors of low BMD in males.     

Breast and axillary tissue MR imaging: correlation of signal intensities and relaxation times with pathologic findings

We tested a variety of inversion-recovery (IR) and spin-echo (SE) sequences by imaging the breast masses of 22 patients before surgery and 23 tissue specimens with magnetic resonance (MR) imaging at 0.6 T to determine the most effective pulse sequences to evaluate breast disease. An SE pulse sequence using a long repetition time (TR) of 1,600 msec and a long echo time (TE) of 90 msec was found to be the most sensitive in depicting carcinoma in the excised tissue specimens, with all of the carcinomas (n = 15) demonstrating irregular areas of higher signal intensity (SI) than that of the adjacent fat. However, only five of 11 breast carcinomas present in the preoperative patients produced a higher SI than that produced by fat on the same T2-weighted sequence. Five of the remaining six carcinomas in the preoperative patients appeared as localized distortions of fibroductular architecture on both T2-weighted SE and IR sequences. In axillary tissue specimens, both metastatic carcinoma and hyperplastic lymph nodes produced a high SI on T2-weighted SE sequences. However, metastatic carcinoma had a significantly longer T2 relaxation time than did hyperplastic lymph nodes.     

Precise intraoperative location of gastrointestinal bleeding with a hand-held counter. Work in progress

The nuclear medicine bleeding scan is frequently insufficient to locate sites of bleeding precisely, in spite of its great sensitivity. A small, hand-held Geiger-Müller counter, placed directly on exposed intestine in the operating room, enables precise location of the probable bleeding site. In three patients, the technique allowed a minimal amount of intestine to be resected, distinguished between large- and small-intestinal hemorrhage, and eliminated other foci as sites of bleeding.     

Changes in Morphology of the Paced QRS Complex Related to Pacemaker Output

The influence of pacemaker output on the morphology of the paced QRS complex was studied from standard lead electrocardiograms in 69 patients with bipolar pacemakers. In 40 of the 69 patients (58%), there was a significant (P less than 0.001) change in electrical axis, from -75 degrees at the low output setting (2.7 V, 0.15 msec) to -67 degrees at the high output setting (8.1 V, 2.29 msec). In 30 patients, these changes were also associated with changes in the QRS morphology and in the T-wave. This phenomenon may be explained by additional stimulation from the proximal electrode at high output, thus altering the pattern of depolarization.     

Upper Rate Pacing After Radiofrequency Catheter Ablation in a Minute Ventilation Rate Adaptive DDD Pacemaker

A 58-year-old man with an implanted minute ventilation rate adaptive DDD pacemaker underwent RF ablation of the AV junction because of symptomatic supraventricular tachyarrhythmias. Immediately after ablation, while the pacemaker was programmed in the DDDR mode, AV sequential pacing at upper rate was observed. After programming the pacing system to the DDD mode and repeated ablation, no abnormalities were observed. It was concluded that AV sequential upper rate pacing was caused by false interpretation of the RF current by the sensor measuring transthoracic impedance as an indicator for minute ventilation.     

Myopotential Interference Inducing Pacemaker Tachycardia in a DVI Programmed Pacemaker

A 67-year-old male, suffering from ventricular tachycardia unresponsive to drug therapy, received a universal AV sequential pacemaker (DDD,M). Tim pacemaker was programmed in the DVI mode, pacing role 100 bpm, AV interval 250 ms. After implantation, the patient experiences two episodes of tachycardia that proved to be pacemaker tachycardia with a rate of 150 bpm. The first period was self-terminating, and the second had to be stopped by reprogramming the pulse generator. Pacemaker tachycardia could easily be provoked by instructing the patient to contract the pectoral muscle adjacent to the pulse generator. To our knowledge, this is the first report to pacemaker tachycardia provoked by myopotentials in a pulse generator programmed in the DVI mode.