ALCOHOL DEHYDROGENASE FROM HUMAN STOMACH: VARIABILITY IN NORMAL MUCOSA AND EFFECT OF AGE, GENDER, ADH3 PHENOTYPE AND GASTRIC REGION

Alcohol dehydrogenase (ADH) has been analysed in 36 endoscopicbiopsies of normal gastric body and/or antrum mucosa, from 31individuals with an age between 17 and 79 years. Oesophageal,duodenal and oral mucosa specimens have been also examined.Stomach mucosa contains three isozyme types: the     

GENETIC POLYMORPHISM OF LIVER ALCOHOL DEHYDROGENASE IN SPANTSH SUBJECTS: SIGNIFICANCE OF ALCOHOL CONSUMPTION AND LIVER DISEASE

Class I alcohol dehydrogenase (ADH) phenotypes have been studiedby starch gel electrophoresis and activity analysis in livertissue obtained at necropsy from 61 non-alcoholic subjects withnormal liver (controls), and in biopsies from 60 chronic alcoholicswith liver disease and from 24 subjects with non-alcoholic liverdisease. Twenty-three per cent of controls exhibited the ADH₂^2–1phenotype, which represents the highest frequency for atypicalADH found in a Caucasian population. Both alcoholic and non-alcoholicpatients with liver disease showed a lower frequency of theatypical phenotype (6.6% and 8.8%, respectively). No differencesin the ADH₂ locus were detected among groups of patients withdifferent severity of alcoholic and non-alcoholic liver disease.Theallele frequencies of the ADH₃ locus for the controls (ADH₃¹= 0.63, ADH₃² = 0.37) are common to those of other Caucasianpopulations. Similar ADH₃ allele frequencies were observed inpatients with alcoholic and non-alcoholic liver disease. Discrepanciesbetween the various phenotyping and genotyping studies now knownfor several populations suggest that local differences may existin the distribution of the ADH polymorphism in even geographicallyclose regions, and that the effect of ADH polymorphism on vulnerabilitytowards alcohol may not be identical in different populations.     

Molecular detection of t(8;21)/AML1-ETO in AML M1/M2: correlation with cytogenetics,morphology and immunophenotype

The t(8;21) identifies a subgroup of acute myeloid leukaemia (AML) with a relatively good prognosis which may merit different treatment. It is associated predominantly, but not exclusively, with AML M2, and corresponds to rearrangements involving the AML1 and ETO genes. AML1-ETO positive, t(8;21) negative cases are well recognized but their incidence is unknown. In order to determine optimal prospective AML1-ETO RT-PCR screening strategies, we analysed 64 unselected AML M1 and M2 cases and correlated the results with other biological parameters. Molecular screening increased the overall detection rate from 8% to 14%. AML1-ETO was found in 3% (1/32) of AML M1 and 25% (8/32) of M2, including three patients without a classic t(8;21) but with chromosome 8 abnormalities. It was more common in younger patients. Correlation with morphology enabled development of a scoring system which detected all nine AML1-ETO-positive cases with a false positive rate of 7% (4/55). Although certain AML1-ETO-positive cases demonstrated characteristic immunological features (CD19 and CD34 expression, CD33 negativity), each of these markers was insufficiently specific to permit prediction in an individual case. We conclude that initial routine prospective molecular screening for AML1-ETO in all AMLs, combined with standardized morphological and immunological analysis, is desirable in order to produce improved prognostic stratification and to determine whether screening can ultimately be restricted to appropriate subgroups.     

Dual Chamber Pacing in Hypertrophic Obstructive Cardiomyopathy: Beneficial Effect of Atrioventricular Junction Ablation for Optimal Left Ventricular Capture and Filling

Clinical improvement with dual chamber pacing bas largely been reported in patients suffering from hypertrophic obstructive cardiomyopathy and mainly attributed to the reduction of the subaortic pressure gradient. To be effective, pacing must induce a permanent and complete capture of the LV. In two patients of our collective, symptoms (angina and dyspnea NYHA Class III and/or syncopes) persisted or relapsed despite pacing. This was related to the inability to obtain full LV capture due to a too-short native PR interval. RF ablation of the AV junction was therefore performed in botb patients, resulting in permanent AV block in one and prolonged PR interval up to 310 ms in the second. Pacing was thereafter associated with an immediate and significant clinical improvement related to permanent LV capture, whatever the patient's activity. After RF ablation, the AV delay was set up to induce the best LV filling, as assessed by Doppler analysis of mitral flow. Our observations suggest that RF ablation or modification of the AV junction can be a successful procedure in some patients with residual or recurrent symptoms, when the latter result from a loss of capture or from the inability to program an AV delay tbat does not compromise the active component to LV filling. Doppler echocardiography is a simple and effective mean to assess the hemodynamic effect of AV interval modulation in this setting.     

Washing Machine Associated 50 Hz Detected As Ventricular Fibrillation by An Implanted Cardioverter Defibrillator

SABATÉ, X., et al. : Washing Machine Associated 50 Hz Detected As Ventricular Fibrillation by An Implanted Cardioverter Defibrillator. This case report describes a patient with an automatic ICD who suffered a defibrillation shock without warning symptoms. An electrical interference can be observed in the stored EGM of the episode. The patient explained that the moment he felt the shock he was touching a washing machine. After correct grounding of this machine the patient did not suffer more inappropriate shocks.     

Survival after a first episode of spontaneous bacterial peritonitis. Prognosis of potential candidates for orthotopic liver transplantation

Abstract To determine the potential role of orthotopic liver transplantation (OLT) in cirrhotic patients surviving a first episode of spontaneous bacterial peritonitis (SBP), medical records of 79 patients presenting with a first episode of SBP were reviewed. Of these patients, 37 were selected as potential candidates for OLT using the following criteria: absence of hepatocellular carcinoma; no severe organ failure other than the liver; age ≤ 66 years; and survival after SBP > 60 days. Survival time was calculated from the day of SBP diagnosis. Prognostic value of clinical, biological and bacteriological data recorded at the time of SBP was determined using univariate and multivariate analysis (Cox's regression model).
Survival rate of the potential candidates for OLT at 3 months, 1 year and 2 years was 94, 46 and 30%, respectively. Serum creatinine value ( P = 0.001) and Pugh score ( P = 0.005) were independently correlated with death. The 1 year survival rate was 80% for the 11 patients with a Pugh score < 10, and 26% for the 26 patients with a Pugh score ≥ 10.
Our results suggest that after SBP, OLT should be considered in patients with severe liver disease. Survival of patients with a moderate liver disease (i.e. Pugh score < 10) might be relatively high.