Sympathetic reinnervation after heart transplantation, assessed by iodine-123 metaiodobenzylguanidine imaging, and heart rate variability.

OBJECTIVE: Complete allograft denervation occurs during heart transplantation. Partial ventricular sympathetic reinnervation may develop one year or later after transplantation and can be measured with iodine-123-meta-iodobenziylguanidine (MIBG) uptake. Aim of this study was to assess sinus node sympathetic reinnervation measured with heart rate variability and ventricular sympathetic reinnervation evaluated with MIBG. METHODS: Twelve patients and 14 healthy controls were included. In patients, MIBG scintigraphy with early and late imaging was performed. Heart to mediastinum ratio (HMR) was calculated and patients were divided in groups with (HMR>1.3) and without left ventricular reinnervation (HMR<1.3). Bipolar ECG with high sampling rate and resolution was recorded over 8.5 min in supine position and in upright position after 10 min interval. R-R intervals in time domain and heart rate variability in frequency domain through spectral power analysis of R-R intervals were analysed to evaluate sinus node reinnervation. Spectral power in low frequency range (0.04-0.15 Hz) above 4.5 ms(2) was considered as sinus node sympathetic reinnervation. RESULTS: Six (50%) patients had evidence of left ventricular sympathetic reinnervation on scintigraphy. Sinus node sympathetic reinnervation based on heart rate variability was detected in 6 (50%) patients in supine, and in 4 (33%) patients in upright body position. Four patients groups were discerned: (1) with ventricular and sinus node sympathetic reinnervation, (2) with sinus node sympathetic reinnervation, (3) with ventricular sympathetic reinnervation and (4) without atrial or ventricular sympathetic reinnervation. Ventricular reinnervation process was time dependent and sinus node reinnervation was not. CONCLUSIONS: Simultaneous ventricular sympathetic reinnervation assessed by MIBG and sinus node sympathetic reinnervation assessed by heart rate variability in supine as in upright position were detected only in two patients (17%). The results of our study show that eventual sinus node sympathetic reinnervation and left ventricular sympathetic reinnervation do not occur simultaneously.     

Unterschiede in der Widerstandskraft der weiblichen und männlichen Keimdrüse

Ohne ZusammenfassungMit 15 Textabbildungen.Das Bedürfnis nach Stützung schwächerer Gedanken durch stärkere wird auchKausalitäts bedürfnis genannt und ist die Haupttriebfeder aller naturwissenschaftlichenErklärungen. Ernst Mach.Nach einem auf der 89. Versammlung deutscher Naturforscher und Ärzte in Düsseldorf im September 1926 gehaltenen Vortrage. Vgl. auch Fortschritte d. naturwissenschaftl. Forschung, herausgeg. vonE. Abderhalden, Bd. XII, H. 4.     

Statistics of oncourologic diseases in Russia in 1996

The trends in male urinary and genital cancer morbidity and mortality are specified. Statistics on separate malignant urological diseases are provided. In 1996 the number of patients with cancer of male urinary and sex organs reached 31.700. A growth in morbidity was due rather to a higher risk to develop the disease than because of changes in the population age. Urological cancer reduces mean life span of Russian population by 2 months, and the patients' life terminates 10-19 years earlier. Financial losses due to deaths of urological cancer stand as high as 197 million roubles as estimated in 1990 prices.