[Dramatic symptoms of pheochromocytoma in old woman during antiarrhythmic therapy with sotalol: case report]. / Dramatyczne ujawnienie sie guza chromochlonnego u chorej w wieku podeszlym po zastosowaniu sotalolu--opis przypadku.

We present the case of 81-years old woman with diabetes mellitus and moderate hypertension who reported multiple syncope's. Cerebral and metabolic causes of syncope's were excluded and the patient was diagnosed to have sick sinus syndrome. After implantation of the cardiac pacemaker the treatment with sotalol was started. After introducing the antiarrhythmic drug the frequency of syncopes increased dramatically and blood pressure rose unusually (up to 250/140 mm Hg). Subsequently phaeochromocytoma was suspected. Laboratory data as well as computed tomography confirmed the diagnosis of left adrenal tumour. After successful surgery the blood pressure normalized and the patient recovered uneventfully. The reported cases describes the difficulties in diagnosing phaeochromocytoma in elderly people with multiple different accompanying diseases.

Do catecholamines influence the level of plasma leptin in patients with phaeochromocytoma?

The relationship between plasma leptin and catecholamine concentrations during chronic and acute catecholamine excess is studied. Patients with phaeochromocytoma, divided according to gender, were examined under basal conditions (n = 18) and at selected time-points during surgical removal of the tumour (n = 12). Appropriate controls were used (n = 23) for the basal study. Plasma leptin was determined by radioimmunoassay (RIA) and plasma noradrenaline (NA) and adrenaline (A) by high-performance liquid chromatography (HPLC). Statistical evaluation employed Student's t-test, Wicoxon test and Spearman's correlation coefficient. Gender-related differences in plasma leptin in normal subjects was confirmed, and these were maintained in the patients. Phaeochromocytoma patients had normal plasma leptin levels in the basal state and decreased levels following the massive catecholamine surge provoked by surgery. Plasma leptin concentration did not correlate with plasma NA or A in either group studied. In the patients with phaeochromocytoma, acute but not chronic catecholamine excess affected plasma leptin, suggesting a role for sympathetic activity in modulating leptin release.

Do catecholamines influence the level of plasma leptin in patients with phaeochromocytoma?

The relationship between plasma leptin and catecholamine concentrations during chronic and acute catecholamine excess is studied. Patients with phaeochromocytoma, divided according to gender, were examined under basal conditions (n=18) and at selected time-points during surgical removal of the tumour (n=12). Appropriate controls were used (n=23) for the basal study. Plasma leptin was determined by radioimmunoassay (RIA) and plasma noradrenaline (NA) and adrenaline (A) by highperformance liquid chromatography (HPLC). Statistical evaluation employed Student's t-test, Wicoxon test and Spearman's correlation coefficient. Gender-related differences in plasma leptin in normal subjects was confirmed, and these were maintained in the patients. Phaeochromocytoma patients had normal plasma leptin levels in the basal state and decreased levels following the massive catecholamine surge provoked by surgery. Plasma leptin concentration did not correlate with plasma NA or A in either group studied. In the patients with phaeochromocytoma, acute but not chronic catecholamine excess affected plasma leptin, suggesting a role for sympathetic activity in modulating leptin release.

Electron microscope investigation of the role of Chlamydia sp. in the process of rebuilding the arterial wall. Neoangiogenesis in atherosclerotic plaques in human cervical artery walls.

BACKGROUND: The inflammatory process has an essential impact on the development of atherosclerosis. Three mechanisms are mentioned: 1) possibility of direct development of Chlamydia infection in the vicinity of the blood vessel wall; 2) impact of persistent or recurrrent Chlamydia infection on the increased blood concentration of risk factors for atherosclerosis; 3) an autoimmunological reaction. MATERIAL/METHODS: Electron microscope examinations were performed on specimens from atherosclerotic lesions of the interior cervical arteries, collected from patients who had undergone endarterectomy. The material came from 8 patients (age from 58 to 72). The specimens were fixed for electron microscopy, and after dehydration were immersed in Spurr resin. Ultrathin slices were examined under a transmission electron microscope. RESULTS: In the successive tested layers nearest the lumen of the vessel we found erythrocytic elements, fibrin, and lipid membranes. In deeper layers there were lymphocytic cells, monocytes, and macrophages loaded with phagocyted lipid material. Under this layer we found in some specimens a coating which had undergone mineralization: calcium structures and cholesterol were overlaid on a proteoglycanate base. Smooth muscles cells had undergone the heaviest proliferation among the cells on artery wall. In the tested material we detected diversified morphological forms of Chlamydia sp. Particular attention should be drawn to the appearance of very young vessel forms, which suggests a process of angiogenesis in the atherosclerotic plaques. CONCLUSIONS: We found that one of the pathogens that may lead to atherosclerotic lesions is Chlamydia sp. The process of atherogenesis in cervical arteries is accompanied by angiogenetic processes.