Radionuclide and angiographic evidence of right coronary artery spasm

Summary  Coronary artery spasm as a cause of coronary insufficiency is often difficult to diagnose. Myocardial perfusion imaging provides important information on segmental ischemia and LV systolic function. Combined noninvasive myocardial imaging and coronary angiography can offer complementary information on functional and anatomic evaluation of myocardial perfusion and coronary circulation. We thank Daniel Harold, CNMT, for his assistance processing the SPECT images.     

Use of and verification with biological indicators in sterilizers belonging to dentistry surgeons from San Luis Potosi, Mexico]

OBJECTIVE: To assess the utilization of sterilizing equipment used by dentists, and verification of sterilization using biological indicators. MATERIAL AND METHODS: A cross-sectional study was conducted in 1999-2000, among 130 (65%) dentists having sterilizing equipment, at Facultad de Estomatología, Universidad Autónoma de San Luis Potosí and Colegio Dental Potosino. Biological indicators for sterilization containing Bacillus subtilis and Bacillus stearothermophilus were used. RESULTS: Thirty autoclaves and 100 dry-heat sterilizers were evaluated: 23 (17.7%) of them showed bacterial growth. Twenty-one (16.1%) dentists already were using biological indicators to verify their sterilizing equipment. Both sterilization methods were found to allow bacterial growth with similar frequencies (p = > 0.66). CONCLUSIONS: Few dentists verify the quality of sterilization process through biological indicators; bacterial growth and failure of sterilization were evidenced.     

Necrotizing lesions of soft tissues: A review

Necrotizing lesions of the soft tissues are grave entities not infrequently seen in daily surgical practice. They may occur with epidemic proportions after natural disasters, representing a serious challenge to the surgeon since they are characteristically associated with high mortality rates unless an early diagnosis is made and prompt aggressive surgical management is initiated. Necrotizing fasciitis is the currently accepted generic term to encompass into a single category the diverse syndromes of progressive gangrenous infections of the skin and subcutaneous tissues. Necrotizing fasciitis must be viewed as a clinical entity rather than a specific type of infection: it is a clinical infection most commonly caused by a mixed aerobic/anaerobic synergistic polymicrobial combination. Zygomycetes may appear as major causal organisms (mucormycosis) and they should be actively searched for. Initial diagnosis of necrotizing fasciitis is established through the characteristic physical signs, Gram stain, and, in some doubtful cases, through frozen-section tissue biopsy. Aggressive and urgent radical debridement is the key to survival, combined with widespectrum antibiotic therapy.

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Resumen Las lesiones necrotizantes de los tejidos blandos constituyen entidades clínicas graves que no son infrecuentes en la práctica diaria. Estas lesiones pueden presentarse en proporciones epidémicas con ocasión de desastres naturales, lo cual representa un desafío serio para el cirujano, puesto que en forma característica se asocian con altas tasas de mortalidad, a menos que se establezca un diagnóstico precoz y se inicie prontamente el tratamiento quirúrgico radical. El término fascitis necrotizante es aceptado en la actualidad para designar en forma genérica, pero cobijando en una sola categoria clínica, a los diversos síndromes de infección grangrenosa de la piel y de los tejidos subcutáneos. La fascitis necrotizante debe ser considerada como una entidad clínica más que una infección específica: se trata de una infección clínica generalmente causada por una combinación polimicrobiana sinergística aeróbica/ anaeróbica. Los zigomicetos pueden también aparecer como agentes causales principales (mucormicosis), por lo cual su presencia debe ser investigada en todo patiente que presente una fascitis necrotizante. El diagnóstico inicial de fascitis necrotizante puede ser establecido por los signos físicos característicos, el frotis con tinción de Gram y, en algunos casos dudosos, mediante biopsia por congelación. El tratamiento urgente y agresivo, consistente en desbridación quirúrgica radical, es la clave para la superviviencia, combinado con terapia antibiótica de amplio espectro.

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Résumé Les lésions nécrosantes des tissus mous sont graves et se recontrent assez souvent dans la chirurgie quotidienne. Elles peuvent se présenter dans des proportions épidémiques après des désastres naturels, posant un sérieux problème au chirurgien, car elles sont spécifiquement associées à un taux élevé de mortalité si l'on ne pose pas le diagnostic précoce et si l'on n'entreprend pas un traitement chirurgical immédiat et agressif. La cellulite nécrosante est le terme le plus souvent cité pour définir l'ensemble d'une catégorie unique les diverses infections gangréneuses progressives de la peau et des tissus souscutanés. La cellulite nécrosante doit être considérée comme une entité clinique plutôt que comme un type particulier d'infection: elle est le plus souvent due à une combinaison polymicrobienne mixte, synergique, aérobie/anaérobie. Les organismes les plus souvent en cause sont les zygomycètes (mucormycosis). On doit les rechercher avec acharnement. Le diagnostic de cellulite est établi grâce à des signes cliniques caractéristiques, à la coloration de Gram, et dans les cas douteux grâce à la biopsie extemporané. La mise à plat immédiate, agressive et radicale, associée à une antibiothérapie à large spectre, est la clé de la guérison.

     

Gastroesophageal infection caused by cytomegalovirus in immunodepressed patients. Presentation of 3 cases]

We report three cases of upper gastrointestinal infection by Cytomegalovirus in immunocompromised patients. Two patients suffered from AIDS and the other one had a recent heart transplantation and was on immunodepressant drugs for an episode of rejection. The stomach in two cases and the esophagus in the other were the affected organs. In all cases there were upper gastrointestinal symptoms and the diagnosis was established by biopsy of endoscopically suspicious lesions. Antiviral therapy was effective in all three cases. This diagnosis has to be considered whenever immunocompromised patients present with unusual clinical and endoscopic findings.     

Protection against selenite cataract in rat lens by drevogenin D, a triterpenoid aglycone from Dregea volubilis

Dregea volubilis is a woody climbing plant commonly found in the hotter parts of India. The leaves are edible and used as a green vegetable, while the plant extract has been used traditionally to treat several diseases including eye ailments. Drevogenin D is a triterpenoid aglycone that has been isolated, purified, and characterized as an active component from the leaves of D. volubilis. In this study, drevogenin D was evaluated for antioxidant and potential anticataractogenic activity in an in vitro model. 1,1-Diphenyl-2-picrylhydrazyl radical and superoxide radical scavenging activities of drevogenin D were studied and found to exhibit a 50% inhibitory concentration of 43 microg/mL and 200.6 microg/mL, respectively. Normal rat lenses cultured in 0.1 mM sodium selenite-supplemented medium were used as the experimental model for this study. Selenite-induced models are excellent mimics of oxidative stress induced cataract. Treatment with drevogenin D at a concentration of 50 microg/mL medium was found to reverse the level of activity of superoxide dismutase, catalase, glutathione peroxidase, and glutathione reductase, elevate the level of reduced glutathione and protein sulfhydryl, and lower the level of lipid peroxidation as indicated by the concentration of thiobarbituric acid-reacting substances. These results indicate good antioxidant activity and potential anticataractogenic activity for drevogenin D against selenite-induced cataractous changes, which have been reported for the first time.