Double-blind, placebo-controlled study to evaluate the effect of organic nitrates in patients with chronic heart failure treated with angiotensin-converting enzyme inhibition.

Background: Organic nitrates are widely used in the treatment of chronic heart failure (CHF). No information, however, is available regarding their effect in patients already treated with ACE inhibitors.

Methods And Results: In a randomized, double-blind, crossover design, we studied the effects of high-dose (50 to 100 mg) transdermal nitroglycerin (NTG) and placebo given daily for 12 hours in 29 patients with CHF (NYHA functional classes II to III).

Frostbite: epidemiology at high altitude in the Karakoram mountains.

During a 10-year period (December 1984 to December 1994), 1500 cases of frostbite were treated at a tertiary care medical facility. They were all males with their ages ranging from 17 to 43 years. All the patients sustained the frostbite injury in the northeastern part of Pakistan known as the Karakoram range of mountains.

Long QTc and torsades de pointes in human immunodeficiency virus disease.

Three patients with human immunodeficiency virus (HIV) infection presented with QT, prolongation (> 440 ms) and torsades de pointes. We sought to evaluate the etiology of the long QT syndrome in these patients without previously identified causes for QT, prolongation, and determine the prevalence among patients with HIV infection. The three index patients underwent: (1) left stellate ganglion block; (2) beta-blocker challenge; and (3) electrocardiographic stress testing.

Clinical features of infantile diarrhea associated with single or multiple enteric pathogens.

Clinical features of infantile diarrhea were studied among 603 infants from birth to 12 months of age to determine the predominant clinical feature(s) seen in infantile diarrhea associated with a specific enteric pathogen. Among the major clinical features, fever was most often seen in diarrhea due to Yersinia spp. (61.

Cell-cycle characteristics - alterable determinants of remission duration in a study of 179 standard risk newly diagnosed patients with acute myeloid-leukemia.

Prognostic factors were related to remission duration among 179 standard risk newly diagnosed acute myeloid leukemia (AML) patients who received identical induction and consolidation therapies. Following a bromodeoxyuridine infusion, labeling indices of bone marrow aspirate/biopsy, durations of S-phase and cell cycle (Tc) were determined. Patients with slowly cycling myeloblasts had longer remissions (Log rank p=0.

A novel triple label method validates the double label technique of defining cell cycle kinetics in HL-60 cells.

HL-60 cells were sequentially labeled with the thymidine analogues iododeoxyuridine (IUdR) and bromodeoxyuridine (BrdU). The labeling index (LI), the duration of S-phase (Ts) and the total cell cycle time (Tc) were measured immediately. It was therefore possible to predict the next time when the single versus double labeled cells would re-enter the S-phase.

Contribution of in vivo proliferation/differentiation studies toward the development of a combined functional and morphologic system of classification of neoplastic diseases.

Proliferation kinetics of both leukemia and a variety of solid tumors have been assessed after in vivo infusions of the thymidine analogues, iododeoxyuridine (IUdR) and bromodeoxyuridine (BrdU). In acute myeloid leukemia (AML), these data indicate that the pretherapy cell cycle time (Tc) of myeloblasts is a prognostic indicator for remission duration since patients with slowly cycling myeloblasts had more durable remissions. The presence of in vivo differentiation detected from the day 7 biopsy after chemotherapy was also of favorable prognosis as these individuals had statistically significant improvement in their remission duration.

In situ localization of transforming growth factor beta and S-phase cells in patients with acute myeloid leukemia and myelodysplastic syndrome.

In situ localization of transforming growth factor beta (TGF-B) was accomplished in 16 acute myeloid leukemia (AML) and 11 myelodysplastic syndrome (MDS) cases. A modified and greatly shortened procedure for immunohistochemical localization of TGF-B using a monoclonal antibody was undertaken in plastic embedded bone marrow biopsy sections that demonstrated excellent preservation of morphologic detail. In addition, a double-label procedure was developed for the simultaneous detection of TGF-B and cells actively engaged in DNA-synthesis which were labeled in vivo by infusing thymidine analogues.

Simultaneous assessment of TGFB and cell cycle kinetics using IUdR/BrdU infusions in human neoplasms from plastic-embedded tissue.

We describe an immunohistochemical technique that makes use of two monoclonal antibodies (MAb), one to detect the transforming growth factor B (TGFB) and another that reacts with iodo- and bromodeoxyuridine. The purpose of this technique is to determine the relationship between TGFB expression and the S-phase cells in human tumors. Since both can be distinctly identified in situ from tissue embedded in plastic, in assessment of the geographic orientation of S-phase cells in relation to such factors as TGFB, contiguity to blood vessels, nerve fibers, and macrophages can also be achieved.

High expression of transforming growth factor-beta long cell cycle times and a unique clustering of S-phase cells in patients with acute promyelocytic leukemia.

Expression of transforming growth factor-beta (TGF-beta), which inhibits the proliferation of hematopoietic progenitors, was investigated simultaneously with cell cycle characteristics in 63 bone marrow biopsies from 23 cases with acute promyelocytic leukemia (APL). Bromodeoxyuridine (BrdU) was administered to every patient (17 newly diagnosed) for determination of the labeling index (LI) and the durations of S-phase (Ts) and the cell cycle (Tc) of leukemic promyelocytes. APL cases had lower LI both in the bone marrow aspirate (6.

Novel derivation of total cell cycle time in malignant cells using two DNA-specific labels.

Cell cycle kinetic analysis in vitro has conventionally been accomplished by labeling S-phase cells using two DNA specific labels given sequentially and separated from each other by a certain time interval. By counting the cells labeled by both versus those labeled by either one of the two labels, and using the formulas described by Wimber and Quastler, approximate values for durations of S-phase (Ts) and the total cell cycle (Tc) can be determined. More recently, instead of radio-isotope labeled thymidine, two thymidine analogues have been used to label S-phase cells in vivo in a variety of human tumors based on the same principles.

Diverticulitis of the terminal ileum: report of a case and review of the literature.

In the past two decades, several reports have documented inflammatory changes in acquired diverticula of the terminal ileum and their associated complications, namely, perforation, intestinal obstruction, gastrointestinal hemorrhage, and fistulization. A comprehensive review revealed 28 cases of diverticulitis of the terminal ileum documented in the world medical literature. Only one case of internal fistula (ileovesical) has been reported previously.

All in the family: matrimonial mitral valve clicks.

Mitral valve clicks with or without late systolic murmurs were detected in genetically unrelated marital partners of 5 families. The first family represented 2 successive nonconsanguineous marital unions with 3 generations of mitral valve clicks. The second family included 1 natural and 2 adopted children with clinical and echographic evidence of mitral valve prolapse.

Maternal meconium granulomatous peritonitis.

A 32-year-old woman underwent cesarean section because of fetal distress. Meconium spilled into the incision during delivery. The patient subsequently had a fever, right-sided pleuritic chest pain, a right lower lobe infiltrate, and a pleural effusion.