ECG Case of the Month: ECG in a 20-Year-Old Woman with Dyspnea. Sinus tachycardia (104 beats/minute), slight right axis deviation of the QRS (+92°), an R/S ratio greater than 1 in lead V1 with ST depression and T wave inversion in leads V1 - V4, and a prominent S wave in lead I, Q wave in lead III, and inverted T wave in lead III(S1 Q3 T3). These findings suggest right ventricular hypertrophy or strain and are consistent with pulmonary emboli.

A 20-year-old Hispanic woman presented to the emergency department complaining of six months of progressive dyspnea on exertion associated with intermittent palpitations. Her only past medical history was a stillbirth at 32 weeks gestation about two years ago. Her vital signs in the emergency department were a heart rate of 120 beats/minute, a blood pressure of 145/86 mmHg, and an arterial oxygen saturation of 98 percent with her breathing air.

ECG of the month. Cardiac failure and stroke in a 43-year-old woman. Coarse atrial fibrillation indicating left atrial enlargement and left ventricular hypertrophy with repolarization abnormality.

A 43-year-old woman with a long history of heavy cigarette smoking was in good health until she developed fatigue, dyspnea on exertion, and paroxysmal nocturnal dyspnea approximately three months before admission to our hospital. Four weeks before admission, she was admitted to another hospital for the sudden onset of a right hemiparesis. She was noted to be in atrial fibrillation, and cardiac catheterization and angiocardiography revealed triple-vessel coronary arterial disease and moderately severe mitral regurgitation.

A novel hemodynamic observation: worsening of tricuspid regurgitation with dobutamine infusion during a hemodynamic study.

Dobutamine has been shown to improve right ventricular contractility and cardiac output in right ventricular failure. However, the effect of dobutamine in the select group of patients with severe tricuspid regurgitation (TR) has not been described previously. We report the case of a patient with severe TR and right heart failure who developed ventricularization of right atrial pressure after dobutamine infusion.

Stable transgene expression in tumors and metastases after transduction with lentiviral vectors based on human immunodeficiency virus type 1.

The relatively low efficiency of target cell transduction and variations in the stability of transgene expression by retroviral vectors based on the Moloney murine leukemia virus (MoMLV) are major impediments to the use of such vectors in cancer gene therapy approaches. The present study was designed to investigate the stability and efficiency of transgene expression in human lung and breast cancer cell lines transduced with vectors based on human immunodeficiency virus type 1 (HIV-1) in vitro and in vivo in nude mouse models of metastasis. H460 lung carcinoma cells and MDA-MB-231 breast carcinoma cells were transduced with lentiviral vectors encoding enhanced green fluorescent protein (EGFP) and beta-galactosidase (beta-Gal), respectively.