The authors studied the modification of systolic time intervals (STI), pre-ejection period (PEP) and left ventricular ejection time (LVETc), before and after isometric exercise, in 294 diabetic patients without clinical evidence of cardiomyopathy and in good metabolic control compared to 132 normal subjects. The study was aimed at detecting preclinical alterations of left ventricular function. Diabetic patients considered together did not show any difference in STI in basal conditions or after isometric exercise compared to normal subjects. When diabetic patients were divided into sub-groups according to their treatment, the insulin-treated diabetics showed modification of STI after isometric exercise, which indicated an alteration of left ventricular function. Also subjects treated with oral hypoglycemic agents showed similar but less evident changes. In diabetic patients on diet only and in those with duration of diabetes of 6 months or less, STI was identical to that of normal subjects. These data do not explain the pathogenesis of myocardial involvement, although they are in accordance with studies which have laid emphasis on the alteration of compliance of the diabetic heart.

Adult↗

PubMedDate not supplied

Measuring parkinsonian symptoms with a tracking device.

After a brief discussion of the existing methods of measuring various motor and other neurological functions as well as methods of inferring the parkinsonian symptoms therefrom, a simple computer based device and a method making use of pursuit tracking to assess different motor and neurologic characteristics are proposed. Computational methods of extracting attributes from the tracking data like the reaction time, the movement time and the error area between the reference signal and the tracking response are discussed. Measurements with a control population of healthy subjects are synopsized. Measurements with parkinsonian patients presenting tremor or bradykinesia as major symptoms are described. Finally, both results are compared.

Adult↗

PubMedDate not supplied

Ultrasound biomicroscopy of the iris-claw phakic intraocular lens for high myopia.

PURPOSE: To study the in situ relative intraocular position of the Ophtec Artisan iris-claw phakic intraocular lens (PIOL) for high myopia using ultrasound biomicroscopy. METHODS: Three PIOLs (13.00, 17.00 and 18.00 D lens powers) were implanted in phakic myopic eyes. Using ultrasound biomicroscopy, echograms were taken in the anterior chamber to measure the preoperative anterior chamber depth, postoperative distance between the PIOL and the corneal endothelium (endothelial-optic distance), and the postoperative distance between the PIOL and the crystalline lens. RESULTS: Preoperative anterior chamber depth ranged from 3.10 to 3.40 mm and the postoperative endothelial-optic distance measured 2.11 to 2.44 mm. The distance between the crystalline lens and the posterior surface of the IOL ranged from 0.78 to 0.93 mm. Several echograms revealed the position of the PIOL on the iris. The pigment layer of the iris did not seem to be disturbed by the presence of the PIOL. CONCLUSION: The original anterior chamber depths were reduced by 28% to 34% after implantation. The PIOL-crystalline lens distance ranged from 0.78 to 0.93 mm. This study of 3 eyes revealed that echograms taken by ultrasound biomicroscopy are useful in verifying the intraocular position of the PIOL within the anterior chamber.

Anterior Chamber↗

PubMedDate not supplied

TNF-alpha and homocysteine levels in type 1 diabetes mellitus.

The role of homocysteine as an independent risk factor for vascular endothelial damage, and the possible link between homocysteine and tumour necrosis factor-alpha (TNF-alpha) as two synergistic risk factors for beta-cell apoptosis in type 1 diabetes mellitus was studied. Plasma homocysteine levels were significantly elevated in all diabetic patients compared with controls and diabetic patients with vascular complications showed higher elevations. Furthermore, homocysteine levels showed significant positive correlation with the degree of microalbuminuria. TNF-alpha levels were elevated in all diabetic patients compared with controls. These results may have therapeutic implications.

Adolescent↗

PubMedDate not supplied

The role of ultrasound biomicroscopy in predicting the result of temporal artery biopsy in temporal arteritis patients: a preliminary study.

PURPOSE: Temporal artery biopsy is considered the gold standard for the diagnosis of temporal arteritis (TA). However, complications following this procedure may occur. The goal of this study is to evaluate if ultrasound biomicroscope (UBM) findings are useful in predicting the result (positive or negative) of temporal artery biopsy in patients with TA. METHODS: Twenty-six consecutive patients with clinical diagnosis of TA seen at the Department of Ophthalmology, Royal Victoria Hospital, Montreal, Canada, were involved in this study. All patients were submitted to UBM before temporal artery biopsy. Eight patients presented histopathologic findings consistent with the diagnosis of TA. Thus, UBM findings of these patients were compared with those from 18 patients with negative biopsy. On UBM we searched for the presence of a hypoechoic effect surrounding the walls of the temporal arteries, the so-called halo sign, as well as an intra-arterial middle reflexive filling, the so-called intra-arterial filling. RESULTS: The halo sign and/or the intra-arterial filling were found in 8 (100%) of 8 patients with biopsy-proven TA. However, 10 (55.5%) of 18 patients with a negative biopsy presented one or both of these two UBM findings. On the other hand, the absence of these two parameters on the UBM of a patient with TA strongly suggests that the temporal artery biopsy will be negative (negative predictive value=100%). CONCLUSIONS: This preliminary work suggests that UBM may play a role in predicting a negative result of the temporal artery biopsy in patients with TA. In the present series approximately 30% of the patients could be spared this surgical procedure and its possible complications.

Aged↗

PubMedDate not supplied

[Clinical and epidemiological features of diabetic patients followed under non-specialized conditions].

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Diabetes Mellitus↗

PubMedDate not supplied

Formation and effects of leukotrienes and lipoxins in human bone marrow.

The present results demonstrate leukotriene and lipoxin synthesis in human bone marrow and link these findings to biological effects in the same tissue. However, the mechanisms behind the described effects on myeloid progenitor cell growth are presently unknown. It is conceivable that both leukotrienes and lipoxins may act through modulation of endogenous cytokine production. However, it should be noted, that these lipoxygenase products totally failed to induce colony growth in the absence of GM-CSF. Moreover, the role of lipoxins in the bone marrow needs to be further clarified, since LXA4 induced both synergistic (with GM-CSF) and antagonistic (with LTC4) effects on progenitor cell growth. A possible pathophysiological role for leukotrienes and lipoxins may be suggested in chronic myelogenous leukemia. Thus, the capacity of hematological cells from CML patients to synthesize LTC4 was significantly increased. In addition, we have recently reported that CML platelets possessed a markedly decreased ability to participate in transcellular synthesis of the potential inhibitors of myelopoiesis, LXA4 and 5(S),12(S)-diHETE (Stenke et al., 1991b). Moreover, the production of these compounds was totally abolished in platelets obtained from CML patients in blastic crisis. Further studies should aim at defining the mechanisms behind the regulatory actions of leukotrienes and lipoxins in normal and leukemic human myelopoiesis.

Bone Marrow↗

PubMedDate not supplied

Radiographic screening for tuberculosis in a large urban county jail.

OBJECTIVE: This study was designed to evaluate an innovative program of high speed radiographic screening for pulmonary tuberculosis (TB) at a large urban correctional institution, Cook County Jail in Chicago. METHODS: From March 1992 to February 1994, 126,608 inmates were screened on intake with a 100-mm mini-chest radiograph. RESULTS: Sixty-seven cases of active TB were identified by radiograph and 19 others from diagnostic work-up. The case finding rate for active disease with radiographic screening was approximately double the rate previously achieved with Mantoux skin testing. Mean time from jail entry to isolation was reduced from 17.6 days with Mantoux skin testing to 2.3 days with radiographic screening. CONCLUSIONS: In large jail facilities, high speed X-ray screening for TB can minimize disruption of the intake process and lead to dramatic improvements in the efficiency of medical follow-up and isolation.

Chicago↗

PubMedDate not supplied

Granulocyte-macrophage colony stimulating factor and interleukin-6 enhanced white blood cell synthesis of leukotrienes in chronic myelogenous leukemia.

The effect of Granulocyte-Macrophage, Colony Stimulating Factor (GM-CSF) and Interleukin-6 (IL-6) on leukotriene production by CML white blood cells induced by calcium ionophore (A23187) was investigated and the leukotrienes formed were identified and quantified using high performance liquid chromatography (HPLC). The in vivo levels of IL-6 and LTB4 were determined by enzyme immunoassay reagents, while GM-CSF was measured by enzyme amplified sensitivity immunoassay. Although GM-CSF or IL-6 alone did not stimulate the synthesis of 5-lipoxygenase product, preincubation of the white blood cells of CML with GM-CSF or IL-6 for 30 minutes at 37 degrees C enhanced the ionophore A23187 induced leukotrienes synthesis, thus the CML white blood cell suspension primed with GM-CSF or IL-6 produced 26.6 +/- 2.8 and 18.9 +/- 1.3 pmol LTC4/10(6) cells respectively, and 30.2 +/- 3.6 and 25.5 +/- 2.5 Pmol LTB4/10(6) cells. In contrast minute amount of leukotrienes were produced by the control cells. In vivo levels of GM-CSF, IL-6 and LTB4 were investigated in CML and normal healthy donors, elevated chemotactic B4 was found in plasma from CML (267 +/- 70.4) while the mean value in normal healthy donors was (127 +/- 13.6) pg/ml. The plasma level of GM-CSF was 32.4 +/- 15.7 pg/ml and 10.5 +/- 3.1 pg/ml respectively in CML and normal healthy donors, while the mean value of GM-CSF and IL-6 in normal healthy donors were 6.7 +/- 2.2 and 4.9 +/- 2.4 pg/ml respectively. No significant correlation was observed between the level of LTB4 and the level of GM-CSF or IL-6 in CML.

Calcimycin↗