Changes in blood viscosity and plasma proteins in myocardial infarction.

A clinical study of some biological and biochemical factors was carried out on patients with acute myocardial infarction. It was shown that: (i) the plasma viscosity was highly correlated to the clinical evolution of myocardial infarction; (ii) the variations of plasma viscosity were related to changes in the connection of fibrinogen and globulin; (iii) the highest correlation was between the plasma viscosity and alpha2-globulin concentration. The monitoring of these may be useful in the clinical evaluation of myocardial infarction.     

Sequential combination chemotherapy for malignant germ cell tumors of the ovary

Fourteen patients with malignant ovarian germ cell tumors were treated postoperatively with a short-term, sequential regimen combining cisplatin, vincristine, methotrexate, bleomycin, dactinomycin, cyclophosphamide, etoposide, Adriamycin (Adria Laboratories, Columbus, OH), and vinblastine (POMB/ACE/PAV). Two patients had Stage I disease, Five had Stage II, five had Stage III, and two had Stage IV. The histologic diagnosis was immature teratoma in five cases (two cases were Grade 2 and three cases were Grade 3) endodermal sinus tumor in two cases, dysgerminoma in three cases, and mixed germ cell tumors in four cases. The chemotherapy regimen appeared to be highly effective against all histologic types, including advanced stages, with 12 of 14 (86%) overall sustained remissions. The median duration of treatment was 5 months. The toxicity of the regimen, which contained low total doses of cisplatin and bleomycin, was only moderate. After a median follow-up of 53+ months, 13 patients were alive without evidence of disease. The results and toxicity obtained were compared with those from other currently used regimens. Also, some comments on initial surgery and second-look surgery are given.     

Cardiovascular effects of cigarette smoking.

The risk of cardiovascular morbidity and mortality is greatly affected by cigarette smoking. In order to study the pressor response to smoking, 10 normotensive and 10 mild or moderate essential-hypertensive smokers (> 20 cigarettes daily) were compared with 2 comparable groups of non-smokers. All subjects were asked to smoke 4 cigarettes during 1 h; blood pressure (BP) and heart rate (HR) were monitored beat-to-beat by a non-invasive device (Finapres Ohmeda) during the smoking period and during the immediately preceding non-smoking hour. Furthermore, all subjects underwent 24-hour ambulatory BP monitoring. In all groups, each cigarette induced a similar and statistically significant increase from baseline for both BP and HR. The recovery from the marked rise in BP and HR was very slow so that in the smoking hours BP and HR were persistently higher than in non-smoking hours; there were no statistically significant differences between the four groups. During 24-hour ambulatory monitoring both normo- and hypertensive smokers showed higher BP values and higher BP variability in comparison with the respective non-smokers' group. In conclusion, smoking habits were associated with a persistent increase in BP in each group we studied, possibly contributing to a smoking-related cardiovascular risk.     

Ultrasound-guided puncture. A modern treatment of liver abscess

The treatment of liver abscesses has benefitted from progress in imaging, particularly ultrasonography which allows simple and reliable aspiration and drainage. A series of 32 cases is reported, consisting of 29 pyogenic abscesses and 3 amoebic abscesses. Eighty-one per cent of patients were cured by aspiration and/or drainage, while 19% of patients had to be operated. The mean hospital stay was 11 days. Failures of ultrasound-guided aspiration are essentially due to multifocal abscesses caused by multiple organisms.     

Ovarian heterotopic pregnancy after IVF and contralateral tubal ectopic pregnancy after GIFT.

One case of ovarian ectopic associated with twin intrauterine viable pregnancy after in vitro fertilization, and one case of contralateral tubal ectopic pregnancy after gamete intra fallopian transfer performed with normal fallopian tubes, are reported. The possible pathogenesis and the management are discussed. The risk of ectopic pregnancy after assisted conception can be present even when the fallopian tubes are apparently normal.