Possible implication of hippocampal cholinergic neurostimulating peptide (HCNP)-related components in Hirano body formation.

We have previously demonstrated that hippocampal cholinergic neurostimulating peptide (HCNP)-related components accumulate in almost all Hirano bodies in Sommer's sector of the hippocampus of elderly individuals, and that the number of HCNP-positive Hirano bodies is greater in patients with Alzheimer's disease. Although Hirano bodies occur preferentially in the neuronal processes of the stratum pyramidale of the hippocampus, they can be seen occasionally as small inclusions, intermingled with neurofibrillary tangles and in association with senile plaques. Here we show that the small inclusions are also recognized by an anti-HCNP antibody, and by using immunoelectron microscopy demonstrate that these HCNP-positive inclusions, intermingled with tau protein-positive neurofibrillary tangles and beta-amyloid-positive senile plaques are indeed Hirano bodies. These findings strongly suggest that HCNP-related components may be involved in Hirano body formation.

[Anterior ST-segment deviation during inferior myocardial infarction: arteriographic correlations during the acute phase].

Electrocardiographic changes in the anterior wall lead in inferior myocardial infarction were studied in coronary angiographic findings in the acute stage. The subjects were 40 patients with initial inferior myocardial infarction due to right coronary lesions. ST segments were elevated in 7 patients, remained unchanged in 11 and were depressed in 22. Two patients predominantly perfused in the left coronary artery showed ST elevation. All seven patients who showed elevation of the ST segments had occlusion of the ventricular branch proximal to right. However, another 15 (68%) of the patients with occlusion of the same lesion did not show elevation of any ST segment. There was no difference in left ventricular ejection fraction between the groups. The regional ejection fraction at the left ventricular inferior wall was significantly (p less than 0.01) higher in the ST elevated group than in the ST depressed group. Elevation of the ST segments in the anterior wall lead was observed only when the right ventricular free wall sustained injury, and no elevation of any ST segment was observed when the range of injury in the inferoposterior wall was wide, even in the presence of injury to the right ventricular free wall.

Identification and quantification of the left-to-right shunt in adults with atrial septal defect by two-dimensional negative contrast echocardiography.

Negative contrast echocardiograms of two-dimensional long axis view of the right ventricle and the atrium were compared with the results of cardiac catheterization and surgical findings in 33 adults with atrial septal defects. Contrast echocardiographic evidence of atrial communication was noted in 30 cases (91%), and, in 28 cases, the negative contrast during one cardiac cycle could be measured. This could be applied even in cases with a small left-to-right shunt or with Eisenmenger's syndrome. No obvious difference in the behavior of negative contrast was documented among the cases with distinct types of septal defects. The maximum negative contrast area and the duration of appearance in one cardiac cycle were related to the pulmonary-to-systemic flow ratio. However, a significant overlap and considerable effects of transducer angulation on measurements were documented. Thus, negative contrast echocardiography may be widely used for the noninvasive identification of a left-to-right shunt in atrial septal defects. However, the method is not appropriate for a precise quantification of three-dimensional shunt flow.

Postoperative thallium-201 myocardial images. Evidence of regression of right ventricular hypertrophy in man.

Thallium-201 myocardial scintigraphic studies were performed on 24 patients with chronic right ventricular overload before and after surgical correction of haemodynamic overload. The ages of the patients ranged from 20 to 65 years (mean 39 years) at operation. The degree of right ventricular visualisation remained essentially unchanged in an early postoperative study (four to 60 days), though a decrease in right ventricular cavity size was noted in patients with right ventricular volume overload. On later follow-up (18 to 36 months), thallium uptake in the right ventricle was definitely less than before operation in all 13 patients studied at this time. Because thallium-201 radioactivity reflects myocardial blood flow and mass, our study indicates that right ventricular hypertrophy is largely reversible. Thus, thallium-201 myocardial scintigraphy can be used to assess non-invasively regression of right ventricular hypertrophy in patients with right ventricular overload.