Echocardiographic wall motion abnormalities and the signal averaged electrocardiogram in the acute phase of a first myocardial infarction

We studied the relationship between wall motion abnormalitiesdetermined by echocardiography and the signal-averaged electrocardiogramin 82 consecutive patients during the acute phase of a firstmyocardial infarction. An abnormal signal-averaged electrocardiogramwas defined as the presence of two of the following criteria:a QRS duration 114 ms, a root mean square voltage (RMS) ofthe last 40 ms 25 µV and an amplitude signal lower than40µV lasting 39 ms. The left ventricle was divided into13 segments and the contraction pattern divided into akinesiaalone (including dyskinesia) (group A), hypokinesia alone (groupB) and both hypokinesia and akinesia (group C). An abnormal signal-averaged electrocardiogram was found in 14/82patients (17%) and was correlated with the persistence of occlusionof the infarct-related vessel (32% vs 9%. P < 0.02). In patientswith a patent vessel, the incidence of an abnormal signal-averagedelectrocardiogram was 14% in group A, 9% in group B and 0% ingroup C (NS). In patients with an occluded vessel an abnormalsignal-averaged electrocardiogram was found in 10% of groupA patients, in 36% in group B patients and in 75% of group Cpatients (P = 0.05). Our study suggests that the presence of hypokinetic areas duringthe acute phase of a first myocardial infarction and an abnormalsignal-averaged electrocardiogram indicate an occluded infarct-relatedvessel.     

Studies on Agranulocytosis. II. The Effect of Chlorpromazine upon the Influx of S35 L-Cystine and L-Methionine into Human Leukocytes

1. When whole blood was incubated in vitro with S-35 L-cystine and L-methionine, the blood cells became radioactive.

2. Preincubation of whole blood from normals and from patients susceptibleto agranulocytosis with chlorpromazine showed no effect upon uptake of S-35L-cystine and L-methionine by leukocytes.

3. The in vivo administration of S-35 L-cystine was followed by the appearance of radioactive leukocytes. Peak radioactivity occurred in leukocytes in 5to 12 days.

4. Pretreatment of test subjects with large doses of chlorpromazine did notblock the uptake of S-35 L-cystine by leukocytes in vivo. Leukocytes of womenshowed an increase in the incorporation of S-35 L-cystine, in vivo. Studiesperformed in vivo on two persons during recovery from agranulocytosisshowed enhanced uptake of L-cystine in one and a normal uptake in the other.

Submitted on March 24, 1960 Accepted on July 13, 1960     

Follow-up of Gambian children recruited to a pilot safety and immunogenicity study of the malaria vaccine SPf66

A pilot safety and immunogenicity trial of the malaria vaccine SPf66 was undertaken in The Gambia in 1993. One hundred and fifty infants aged 6–11 months were immunized with either 0.5 mg or 1.0 mg of SPf66 produced either in Colombia or in the USA or with a control vaccine. Children who received SPf66 experienced more clinical attacks of malaria than did children in the control group during the first period of surveillance and the difference in incidence between children who had received high dose Colombian vaccine and the control children was statistically significant at the 5% level. During the 1995 malaria transmission season, 127 children from the original cohort of 150 were observed. During 18 weeks of intensive surveillance, the incidence of clinical malaria was again higher among children who had received SPf66 than among children who had received inactivated polio vaccine (6.23 vs 4.89 clinical attacks per 1000 days at risk), the effect being most marked among children who were in the high dose groups, but differences between groups were now no longer statistically significant .     

Sulfonation of arginine residues as side reaction in Fmoc-peptide synthesis

Several arginine-rich peptides containing the C-terminus of neuropeptide Y (NPY) were prepared by solid phase peptide synthesis using Fmoc chemistry and cleaved from the resin with trifluoroacetic acid (TFA). The products were characterized by fast atom bombardment-MS, LC-thermospray-MS, ion spray-MS/MS, and Edman degradation. The side products could be identified as peptides with sulfonated arginine residues resulting from an unexpected cleavage of Mtr or Pmc protecting groups. The degree of sulfonation depended on the choice and composition of the cleavage solution. Several scavenger mixtures were used and a mixture of thioanisole/thiocresol was found to be the most efficient for suppressing sulfonation. Furthermore treatment with the enzyme arylsulfate-sulfohydrolase desulfonated the peptides yielding the correct sequence.