Dynamic Coronary Thrombosis: A Possible Cause of Prinzmetal's Variant Angina

Two patients presented with features typical of Prinzmetal's variant angina: recurrent episodes of chest discomfort at rest associated with transient ST segment elevation. Episodes of recurrent ischemia persisted despite treatment with intravenous nitroglycerin. Coronary arteriography disclosed a high grade stenotic lesion and intracoronary thrombus in both patients. Coronary spasm was not demonstrated. These observations suggest that "dynamic thrombosis" may have a more important role than heretofore recognized in some patients with Prinzmetal's variant angina.     

SPINAL BRUCELLOSIS

The findings in 44 patients with back pain and brucellosis aredescribed. Radiological changes tended to occur in older patientswith a longer duration of disease. The younger patients moreoften experienced an acute arthritis with sacroiliitis resemblinga reactive disease. Bone scanning was more sensitive than radiographs,particularly in detecting acute sacroiliitis and hip involvement.The lumbar spine was the most frequently involved site althoughno part of the spine was spared. Extensive destruction of avertebral body with little involvement of the adjacent vertebrae,lower lumbar spondylolysis and spondylolisthesis, and discitiswith calcification were striking radiological findings hithertoundescribed in brucellosis. Computerized axial tomography (CAT)scanning revealed vertebral-arch destruction in three casesof spondylolisthesis. Circumferential sclerosis of the vertebralbodies was another CAT-scan finding. KEY WORDS: Brucella, Back pain, Sacroiliitis, Bone scan, Spine     

The effect of halothane on neonatal ciliary beat frequency

The effect of a commonly used anaesthetic agent, halothane, on neonatal cilial function was determined. A nasal cilial sample was taken from 13 healthy, term, newborn infants. For 1 h, half of each sample was exposed to halothane and half to air. Cilial function was assessed by measuring beat frequency with a modified light transmission method. Cilial beat frequency was significantly slower in the cilia exposed to halothane, 9(s.d. 2.5)Hz, than to air, 12.9(s.d. 1.5)Hz. Decreased mucociliary clearance following halothane anaesthesia is due, at least in part, to a directly depressant effect of halothane on ciliated cells.     

CHOLINORECEPTORS IN THE CORPUS CAVERNOSUM MUSCLE OF THE HUMAN PENIS

• 1 Acetylcholine produced contraction, relaxation or a biphasic effect on corpus cavernosum muscle strips of human penis. These effects were antagonized by atropine but were modified by hexamethonium or tetrodotoxin suggesting the presence of excitatory and inhibitory muscarinic receptors in the human penis.
• 2 Nicotine and DMPP also produced contraction or relaxation of the corpus cavernosum muscle strips. These effects were presumably indirect as they were abolished by hexamethonium and tetrodotoxin.
• 3 Contractions produced by nicotine or DMPP were abolished by atropine whereas the relaxations produced by these agents were only partially blocked by atropine. Hence, the receptors mediating these relaxations are unlikely to be entirely muscarinic.

     

Laparoscopic management of a transitional cell carcinoma arising in a right ectopic ureter

Ectopic ureter is a rare abnormality, so presenting a transitional cell carcinoma (TCC) arising from an ectopic ureter is extremely rare. We report here a case of a man with an invasive transitional cell carcinoma arising from a right ectopic ureter and managed by laparoscopy. To our knowledge, this is the fourth case described in the literature, and the second case of a TCC arising in a right ectopic ureter.     

Multifocal Malignant Hemangioendothelioma Presenting as Acute Hepatitis A Clinicopathologic Study

A patient with malignant hemangioendothelioma of the liver is described. The patient's clinical presentation and course were that of fulminant hepatic necrosis. Complications included upper gastrointestinal hemorrhage, hepatic encephalopathy, abnormal coagulation parameters and the hepatorenal syndrome. The duration of the illness from the onset of symptoms to its fatal outcome was five weeks.     

Enhanced Transmural Dispersion of Repolarization in Patients with J Wave Syndromes

J Wave Syndromes . Introduction: Recently, great attention has been paid to the risk stratification of asymptomatic patients with an electrocardiographic early repolarization (ER) pattern. We investigated several repolarization parameters including the Tpeak‐Tend interval and Tpeak‐Tend/QT ratio in healthy individuals and patients with J wave syndrome who were aborted from sudden cardiac death. Methods and Results: Ninety‐two subjects were enrolled: 12 patients with ventricular fibrillation associated with J waves, 40 healthy subjects with an uneventful ER pattern and 40 healthy control subjects (C) without any evident J waves. Using ambulatory electrocardiogram recordings, the average QT interval, corrected QT interval (QTc), Tpeak‐Tend (Tp‐e) interval, which is the interval from the peak to the end of the T wave, and Tp‐e/QT ratio were calculated. Using ANOVA and post hoc analysis, there was no significant difference in the average QT and QTc in all 3 groups (QT; 396 ± 27 vs 405 ± 27 vs 403 ± 27 m, QTc; 420 ± 26 vs 421 ± 21 vs 403 ± 19 milliseconds in the C, ER pattern and J groups, respectively). The Tp‐e interval and Tp‐e/QT ratio were significantly more increased in the J wave group than the ER Pattern group (Tp‐e: 86.7 ± 14 milliseconds vs 68 ± 13.2 milliseconds, P < 0.001, Tp‐e/QT; 0.209 ± 0.04 vs 0.171 ± 0.03, P < 0.001), but they did not significantly differ between the C and ER pattern groups (Tp‐e: 68.6 ± 7.5 vs 68 ± 13.2, P = 0.97, Tp‐e/QT 0.174 ± 0.02 vs 0.171 ± 0.03, P = 0.4). Conclusion: As novel markers of heterogeneity of ventricular repolarization, Tpeak‐Tend interval and Tp‐Te/QT ratio are significantly increased in patients with J wave syndromes compared to age and sex‐matched uneventful ER. (J Cardiovasc Electrophysiol, Vol. 23 pp. 1109‐1114, October 2012)