The authors hypothesized that patients with anxious or hostile depression may have a greater risk of mortality from coronary artery disease (CAD) than other depressed patients and therefore proceeded to assess the possible relationship between CAD risk factors and anger and anxiety in a sample of 138 depressed outpatients. The authors observed that increased anxiety scores were associated with higher cholesterol levels and with prolonged QTc intervals. Similarly, the patients with anger attacks tended to have higher cholesterol levels compared with the patients without these attacks. The study's findings partially support the authors' hypothesis that hostile or anxious depressed patients are at greater risk for CAD than other depressed patients.

Adolescent↗

PubMedDate not supplied

False inferior pseudoaneurysm: two-dimensional and Doppler echocardiographic findings.

The noninvasive differentiation of true aneurysm from pseudoaneurysm is sensitively and specifically accomplished with two-dimensional echocardiography. Recent reports suggest that Doppler flow patterns may further enhance the specificity of the diagnosis of pseudoaneurysm. We present a patient with ventriculographic and two-dimensional echocardiographic features of an inferior pseudoaneurysm. Doppler examination, however, failed to show phasic flow characteristic of a small communicating orifice between two larger chambers. At surgery, a large posterolateral true aneurysm was found. Thus the addition of Doppler flow patterns to imaging information may help to distinguish pseudoaneurysms from true aneurysms.

Cardiac Catheterization↗

PubMedDate not supplied

Echocardiographic diagnosis of pneumopericardium and hydropneumopericardium.

Pneumopericardium and hydropneumopericardium are rare conditions in which hemodynamic compromise is common. Loss of the M-mode and two-dimensional image coincident with the systolic phase of each cardiac cycle and swirling echogenic bubbles within the pericardial space produce a distinctive M-mode and two-dimensional echocardiographic appearance. This provides an additional method for prompt diagnosis.

Adult↗

PubMedDate not supplied

Ultrastructure of testicular cells in rats treated with dibromochloropropane (DBCP).

Three days after a single injection of rats with dibromochloropropane (DBCP) the testicular seminiferous tubules displayed focal damage, which became more pronounced six days after the treatment. Severely damaged tubules exhibited an almost complete exfoliation of the germ cells, while the Sertoli cells' lining remained mostly intact. The most affected germ cells were the spermatids. The mitochondrial sheath of the midpiece was often incomplete, vacuolated and/or broken into several pieces. In many cases the mitochondrial sheath protruded towards the interior, thus partially separating dense fibers 1, 2 and 9 from 3 to 8. In addition, cross sections revealed several midpieces of different flagellae surrounded by a single plasmalemma. In young spermatids, an atypical acrosome formation was noted concomitantly with a progressive emptying of the central nuclear region. This resulted in nuclei with electron lucent center surrounded by a chromatin belt. Sertoli cells displayed intense phagocytotic activity, their cytoplasm containing increased numbers of lysosomes, cellular debris and axonemal fragments.

Administration, Cutaneous↗

PubMedDate not supplied

Henoch-Schönlein's purpura in adults versus children/adolescents: A comparative study.

OBJECTIVE: To assess the possible differences in etiological and clinical factors between children/adolescents (< or = 20 years) and adults (> 20 years) with Henoch-Schonlein purpura (HSP). METHODS: A retrospective-cum-prospective study of consecutive patients with HSP who presented to our teaching hospital over 5 years. Patients were classified as having HSP according to the criteria proposed by Michel et al and the ACR criteria. RESULTS: 102 patients (43 of all patients being male and 59 female) were classified as having HSP; 20 of the patients were adults (mean age 32.1 +/- 11.7 years) and 82 were children/adolescents (mean age 6.2 +/- 2.6 years). We were unable to identify any precipitating event in 40% of the adults and 37% of the children/adolescents. The frequency of previous drug treatment and of previous upper respiratory tract infection was similar in both groups. At symptom onset, palpable purpura was the chief clinical manifestation in both groups. However, renal involvement, in all its aspects, was more frequent and severe in adults. Adults also had a higher frequency of diarrhoea (with or without occult blood) and leucocytosis, but a lower frequency of thrombocytosis. The frequency of joint manifestations, nausea, vomiting, malena/hematochezia and intussuseption was equal in both groups. Adults required more aggressive therapy, and had a longer hospital stay (10.2 vs. 4.3 days). The outcome was relatively worse in adults, with complete recovery in 18 adults (90%) compared to 81 children/adolescents (98.8%) after a mean +/- SD follow up of 2.8 +/- 1.7 and 2.4 +/- 1.3 years, respectively. CONCLUSION: In adulthood, HSP is a more severe clinical syndrome, with a higher frequency of diarrhoea and renal involvement. Adults also require aggressive treatment more frequently and have a longer hospital stay.

Adult↗