Correlates of Tc-99m tetrofosmin pulmonary uptake in patients with coronary artery disease and subjected to high dose dipyridamole stress

The stress-lung-to-heart ratio [LHR] of uptake of the tracers during myocardial perfusion imaging [MPI] has been shown to have diagnostic significance for the severity of the disease and left ventricular [LV] dysfunction in patients with coronary artery disease [CAD]. On the other hand, high-dose dipyridamole [HDD] stress myocardial single photon emission computed tomography [SPECT] has greater accuracy for determination of CAD severity than standard dose dipyridamole [SDD] or exercise stress [EST]. To test whether the stress LHR of Tc-99m tetrofosmin [Tc-99m TF] uptake is a determinant of the severity of CAD and left ventricular dysfunction in patients with CAD and subjected to high-dose dipyridamole [HDD] stress. This retrospective study comprised 39 patients with angiographically-proved CAD [group I] and 8 subjects [group II] with negative MPI [gated rest and stress; one-day protocol] and normal coronaries that have been subjected to MPI using Tc-99m TF under HDD [0.84mg/kg over 4 min.]. The LHR of Tc-99m TF uptake was calculated by area of interest [AOI] analysis for the normalized myocardial and right lung counts from the immediate post-stress anterior chest view. The LV transient ischemic dilation [LVTID] was visually-interpreted; while the summed stress score [SSS] and rest LV function parameters were calculated. Further grouping of all subjects into 0-2 vessels CAD [group A] and main stem/3 vessel CAD [group B] was performed. The mean LHRs were 0.48 +/- 0.09 SD and 0.39 +/- 0.07 SD in groups I and II respectively [P>0.05]. The LHR of all subjects showed significant positive correlations with the SSS mid LV volumes and significant inverse correlation with LVEF [P<0.001 each] with no significant correlation with LVTID [P>0.05]. The LHRs were 0.44 +/- 0.08 SD and 0.57 +/- 0.08 SD in groups A and B respectively [P<0.001]. High dose dipyridamole [HDD] is a safe mode of stress to evaluate patients with CAD who are unable to exercise. The lung-to-heart ratio of Tc-99m tetrofosmin [immediately post HDD stress] seems to be a diagnostic marker to elicit the severity of CAD as well as the systolic and diastolic LV dysfunction in such patients

Inhibition of gentamicin-induced nephrotoxicity by ascorbic acid and pyridoxal hydrochloride

This study was undertaken to compare the capability of blockade of gentamicin nephrotoxicity by either ascorbic acid [vitamin C] or pyridoxal hydrochloride [vitamin B6] and to evaluate whether their combination has a better protective effect than either alone, as manifested by changes in the serum urea and creatinine levels as well as the histological renal changes. For this purpose, 70 male Wister albino rats were equally divided into 7 groups. A negative control group receiving distilled water, a positive control group receiving vitamin C alone, a positive control group receiving vitamin B6, rats receiving gentamicin alone, rats receiving gentalicin as well as vitamin C, rats receiving gentamicin in addition to vitamin B6, and finally rats receiving gentamicin, vitamin C and vitamin B6. Our results showed that, vitamin B6 plays a better role in the protection against gentamicin nephrotoxicity than vitamin C, moreover, the combination of these two vitamins produced a better protection than either vitamin alone. Strict adherence to the prescribed dose of the aminoglycoside preparations especially gentamicin is required. In addition, a combination of vitamin C and vitamin B6 could provide adequate protection against gentamicin-induced nephrotoxitiy

Histochemical demonstration of certain enzymes in renal lithiasis

The present study was carried upon 25 patients, 20 of them had renal calculi and the other 5 non-calcular with ureteropelvic obstruction. Frozen sections and histochemical staining for alkaline, acid phosphatase and adenosine triphosphatase were done. The results showed marked reaction of the first two enzymes in calcular cases more than non calcular ones. However adenosine triphosphatase showed the reverse reaction

Immunohistochemical identification of prostatic acid phosphatase, correlation of normal, hyperplastic and neoplastic prostate

Immunohistochemical demonstration of prostatic acid phosphatase in normal, hyperplastic and neoplastic human prostates were studied by immunocytochemical methods. In normal or hyperplastic prostates, the localization of prostatic specific acid phosphatase was uniformly observed at the apical portion of the glandular epithelium of apical cells under light microscopy. Light microscopic examination of neoplastic prostates revealed a more intense and uniform staining of tumour cells of glandular epithelium of well differentiated adeno-carcinoma, whereas less intense and more variable staining was seen in neoplastic cells of moderately and poorly differentiated adenocarcinoma. Among neoplastic cells, positive granules with less intensity were found between collagen fibres as well as the endothelium of the stromal capillaries in anaplastic tissue

pattern of bilharzial infection with hepatitis B virus associated with delta agent

Delta hepatitis is a relatively common in Egypt especially in patients with chronic liver disease. Delta virus infection is associated with a high frequency of hepatic decompensation and it seems to impose additional burden on liver function. It does not seem to be more prevalent in particular type of cirrhosis, but the CAH pathology was found to be mostly associated with virus infection. HBV replication seems to be inhibited by the presence of delta virus as evidenced by the low frequency of HBeAg in serum and HBsAg in liver among patients with HDV infection

Hazards of ventilation during early separation from total cardiopulmonary bypass

The effect of pulmonary ventilation upon systemic arterial blood gases during cardiopulmonary bypass in presence of left ventricular ejection was evaluated in 20 adult male patients undergoing aortic vlave replacement. Following rewarming, establishment of a sinus rhythm, and production of pulse pressure of at least 20 mm Hg on the artirial pressure trace caused by left ventricular ejection, arterial blood gases were obtained from artirial and venous extracorporeal circuit and radial arterial cannula. Patients were divided into a non ventilated [n=10] or a ventilated [n=10] group. The ventilated group was given 10 breaths/min. with 100 oxygen at a tidal volume of 10 ml/kg. After 5 minutes the arterial blood gas data were again obtained. significant findings [p<0.05] include decrease in systemic carbon dioxide tension and increase in systemic pH in the ventilated group and decrease in systemic oxygen tension in the non-ventilated group. Although the changes in the arterial blood gases were significant. These changes occurred well within the limit of clinical acceptability. It is concluded that left ventricular ejection for short periods during full cardiopulmonary bypass does not necessitate pulmonary ventilation

Immunological reaction to bilharzial carcinoma of urinary bladder

Operative specimens taken from the urinary bladder of 50 patients formed the material of the present work. Immunohistochemical study of paraffin sections stained for subpopulations of lymphocytes using monoclonal antibodies and the immunoperoxidase procedure. Lymphocytic infiltration was seen in all studied cases of bilharzial carcinoma of the bladder.In transitional cell variety more than other cell types and in squamous Cell variety more than adenocarcinoma and undifferentiated carcinoma. In most cases lymphocytic infiltration was heavier in well differentiated tumour than in poorly differentiated and undifferentiated tumours. This study suggests that the natural host defence mediated through lymphocytes play a crucial role in determining the outcome of bilharzial carcinoma of the urinary bladder