Myocardial infarction: thrombotic or metabolic?
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Biomedical subjects
Publications and source records attributed to C Smith.
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A number of sheep of the Orkney breed died of suspected copper poisoning while at pasture under circumstances which left sheep of other breeds apparently unaffected. Fresh seaweed offered to sheep with symptoms of copper toxicity appeared to be therapeutic and to lead to a reduction in plasma Cu level.
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Analysis of plasma lipids of 30- and 185-day-old BIO 82.62 myopathic hamsters and age-matched normal controls revealed a decrease in only the concentration of cholesteryl esters of 185-day-old diseased animals. Measurement of lipoprotein lipase (LPL) activity in heart, muscle, and adipose tissue showed no difference between the activity of the enzyme in the heart and muscle of the cardiomyopathic hamsters and that of the age-matched controls. In adipose tissue, however, LPL activity was depressed in the diseased animals in both age groups. No difference was found in the activity of hormone sensitive lipase. Incorporation of sn[U-14C] glycerol-3-phosphate into total lipids was found to be depressed in homogenates of heart, muscle, and adipose tissue but unchanged in liver homogenates of diseased animals. It was concluded that the decrease in the capacity to synthesize glycerides, rather than limiting substrate concentrations, could be the cause of the decrease in the lipid content in some tissues of the cardiomyopathic hamster.
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A child aged 3 1/2 died from a cardiac condition after many and prolonged antibiotic courses: bilateral glue ear had been treated for the previous 18 months. Histopathology showed cholesterol granulomata in the mastoid air cells, with evidence of old hemorrhage, and of former inflammation of bone. The exudate was histiocytic with some giant cells. An 'orange spot' on the tympanic membrane was hyperaemic middle-ear mucosa, heavily infiltrated by plasma cells, lymphocytes and histiocytes. There was no evidence of hypersecretion. Some of the most abnormal areas were around the stapedial niche and the round window.
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The echocardiographic abnormalities of tricuspid valve motion in 2 patients with left ventricular to right atrial shunts are described. In both patients the abnormal anatomy was defined at surgery, in one patient the shunt being above the tricuspid valve leaflets (supravalvar) and in the other patient through the septal leaflet (intravalvar). Different patterns of tricuspid valve systolic fluttering were seen in these two cases and the possible reasons for this are discussed. After surgical closure of the defects the systolic fluttering of the tricuspid valve was no longer observed. Echocardiography appears to be useful in detecting the presence of left ventricular to right atrial shunts which otherwise may be difficult to diagnose.
In view of the rarity of recurrent sterile meningitis in systemic lupus erythematosis a case of this syndrome in a 54-year-old man is reported. This association should be considered in patients with a meninigitic picture in whom pathogenic organisms are not identified, especially if the meningitis is recurrent.
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Views of family physicians, in training and in practice, were obtained on problem patients. Both groups identified problem patients by the presence of vague complaints of a functional nature and the presence of psychiatric symptoms. Views of problem patients did not change with age of physician or length of time since training. Neither group identified problem patients by the type of physician-patient relationship, a finding that probably contributes to increased difficulties with this group of patients.
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Isolation studies for bacterial and parasitic agents were carried out on stool specimens from Vietnamese infants at the time of their mass airlift to the United States. One or more bacterial pathogens were found in 49% of the 367 stool specimens cultured. The isolates included enteropathogenic Escherichia coli (161), Shigella (16), Salmonella (15), but no Salmonella typhi or Vibrio cholerae. Parasites identified in 88 stool specimens included Giardia lamblia (10), Ascaris lumbricoides (7), and Entamoeba histolytica (1). Transmission of agents to volunteers probably occurred, because 48% of 272 adults questioned had diarrhea shortly after caring for the children, and stool cultures from these adults resulted in the isolation of E coli (105), Salmonella (1), and Shigella (3).
Microscopic and analytical studies of the lipids in the heart and muscle of the BIO 82.62 myopathic hamsters and age-matched normal animals at the average ages of 33, 67, and 108 days were performed. Microscopic examinations did not show increased lipid depositions in the hearts of the diseased animals as was found in the BIO 14.6 strain. No consistent differences in the lipid content of the cardiomyopathic hamsters (BIO 82.62) and age-matched controls were observed in the three age groups except in the cholesterol content of muscle. Cholesterol increased significantly (P less than 0.01) in the 67 and 108 day old animals. This increase elevated the cholesterol/phospholipid ratio. Analysis of the fatty acid composition of triglycerides showed that the cardiomyopathic hamsters store more saturated fatty acids in both heart and muscle than do their normal counterparts. The abundance of more saturated fatty acids may imply that either the desaturation mechanism is altered in the diseased animals or that unsaturated fatty acids are preferentially utilized in other processes.