ABSTRACT
Medical records and follow-up data were reviewed in 297 genetically proven myotonic dystrophy type 2 (DM2) patients. Patients were selected by the criteria of cardiac sudden death before age 45. Sudden death occurred in four patients, three of whom were cardiological asymptomatic, and one with a history of heart failure. Cardiac histopathology showed dilated cardiomyopathy in all, and conduction system fibrosis in two patients. Pathogenetic CCUG ribonuclear inclusions were demonstrable in cardiomyocytes.
Subject(s)
Cardiomyopathy, Dilated/etiology , Chromosomes, Human, Pair 3/genetics , Death, Sudden, Cardiac/epidemiology , Heart Failure/etiology , Microsatellite Repeats , Myocardium/pathology , Myotonic Dystrophy/complications , RNA/analysis , Adult , Bundle-Branch Block/etiology , Bundle-Branch Block/pathology , Cardiomyopathy, Dilated/pathology , Female , Fibrosis , Follow-Up Studies , Genetic Predisposition to Disease , Heart Conduction System/pathology , Heart Failure/pathology , Humans , In Situ Hybridization, Fluorescence , Intracranial Embolism/etiology , Intracranial Embolism/pathology , Male , Myocardium/chemistry , Myotonic Dystrophy/classification , Myotonic Dystrophy/genetics , RiskABSTRACT
This report describes two cases of isolated abdominal actinomycosis. a) A 52-year-old man developed a peripancreatic abscess in the course of two years after laparoscopic cholecystectomy and repeated laparotomy because of postoperative peritonitis. b) A 19-year-old man, who had a perityphlitic abscess following appendectomy performed because of appendicitis. The definitive diagnosis of abdominal actinomycosis was confirmed by percutaneous ultrasound-guided fine-needle aspiration: In both cases culture of the aspirated material yielded Actinomyces (A.) israelii. As concomitant microflora we found Klebsiella and Actinobacter species in the first case and Haemophilus (Actinobacillus) actinomycetem comitans in the other case. "Sulfur granules" obtained from the pus showed histological aggregates of Actinomyces in both cases. After surgical treatment and antibiotic therapy, both patients recovered completely.
Subject(s)
Abdominal Abscess/diagnostic imaging , Actinomycosis/diagnostic imaging , Suction/instrumentation , Abdominal Abscess/therapy , Actinomycosis/therapy , Adult , Appendectomy , Cholecystectomy, Laparoscopic , Humans , Male , Middle Aged , Postoperative Complications/diagnostic imaging , Postoperative Complications/therapy , UltrasonographyABSTRACT
The effect of morphine (0.1 mg/kg) on insulin secretion stimulated by oral, intraduodenal, or intravenous administration of glucose was studied in seven healthy volunteers. When glucose was given intravenously, morphine had no effect on plasma glucose, insulin, glucose-dependent insulinotropic polypeptide (GIP), or pancreatic glucagon. Following oral glucose, morphine slowed gastric emptying and reduced plasma concentrations of glucose, insulin, and GIP. During intraduodenal infusion of glucose, insulin concentrations of plasma were also decreased by morphine, an effect best explained by decreased small intestinal transit with delayed absorption of glucose and delayed release of GIP. We conclude that clinically relevant doses of morphine have no direct effect on insulin secretion and that the changes observed were secondary to slowed gastric emptying and small intestinal transit (AU)
