Electromiography (EMG) plays a key role in the evaluation of patients with neuromuscular diseases. It can be considered an extension of the neurological examination. So it must be individualized and ...based on differential diagnosis. We have analized data about EMG performed in a period of four months in the Unit of Neurophysiopatology of University of Bari and Foggia. Data collected show that in this period we have received 807 EMG bookings: we have performed 604 exams (75%) of whom 405 exams had pertinence with differential diagnosis (50%), 199 (25%) had no pertinence; 203 patients (25%) did not turn up for the exam. At Neurophysiopathology of Foggia we have received 540 EMG booking: we have performed 504 neurophysiological studies. In the total amount of EMG performed 326 had pertinence (60%), 178 had no pertinence (33%) and 36 patients did not turn up for the exam (7%). Data collected show that physicians, medical practictioners, neurologists and other specialists share similar difficulties to make a correct differential diagnosis in the field of neuromuscular diseases and that EMG can be the most useful test in clarifying the diagnosis only after a correct clinical examination.
Correspondence to Dr Dominika M Zoltowska, dominika.zoltowska@med.wmich.edu Description A 48-year-old woman, with medical history of bipolar disorder and no previous cardiovascular disease, presented ...to the emergency department with acute onset of typical angina. The diagnosis was made based on the characteristic findings on left ventriculogram, after exclusion of ischaemic heart disease.1 The incidence of TCM is highest in postmenopausal women, which grossly corresponds to our case. Both hyperthyroidism and hypothyroidism are known to cause cardiomyopathy and were previously reported as potential risk factors for TCM.2 Bipolar disorder comprises an interesting point of our patient’s medical history.
The opsoclonus–myoclonus syndrome is a pathological condition characterized mainly by involuntary myoclonic movements involving ocular, trunk and limb muscles associated with ataxia and other ...neurological signs.
We describe the case of a 30-year-old woman who developed this syndrome 15
days after anti-Rubella vaccination. This case suggests a possible autoimmune post-vaccinic etiopathogenesis of opsoclonus–myoclonus syndrome, rarely described in the literature.
The most studied mechanism of malignant transformation has been cell proliferation. The relationship between programmed cell death (apoptosis), cell proliferation, and apoptosis regulatory genes (p53 ...and bcl-2), was studied in normal colonic epithelium, 26 sporadic adenomas both early and late, 25 FAP adenomas, and 34 carcinomas. We showed a decrease in programmed cell death and an increase in cell proliferation during the transition from adenoma to carcinoma. The increase of expression of p53 from early (10%) to late adenomas (87%) contrasted with the decrease of bcl-2 staining. Sixty-two per cent and 23% of carcinomas were reactive for p53 and bcl-2 respectively. Abnormal early activation of the bcl-2 gene, rather than late p53 gene mutation appears to be responsible for inhibition of apoptosis in colorectal carcinogenesis. bcl-2 was higher in FAP adenomas than in sporadic cases, and in carcinomas favouring the accumulation of long-living cells, which are more subject to mutation and thus cancerization.
Hyaluronidase has been reported to be beneficial in reducing injury to the ischemic myocardium in several experimental studies. This effect may involve an enhancement in either the cardiac blood ...supply or lymphatic flow or a combination there of. In this experiment, a baboon open chest model of myocardial ischemia and reperfusion was used to determine if treatment with hyaluronidase would result in a reduction in infarct size. Baboons underwent occlusion of the left anterior descending coronary artery for 2 hr. Fifteen minutes after occlusion, a treated group (n = 6) received bovine testicular hyaluronidase (500 national formulary units/kg) iv over a 10-min period. The ischemic period was followed by 22 hr of reperfusion. A control group (n = 8) underwent the same protocol minus the hyaluronidase infusion. At the end of the reperfusion period, the hearts were excised and the perfusion bed at risk for infarction was determined by the infusion of a microvascular dye. The hearts were then sectioned and stained for the histological determination of infarct size. The volume of the perfusion bed infarcted was 66 ± 7% in the control group compared with 42 ± 10% in the treated group (P > 0.05). In this study using a primate model that has a minimal collateral blood supply, hyaluronidase did not significantly reduce the ultimate infarct size.
This study was performed in attempt to draw a correlation between the percentage of myocardial infarction across the left ventricular wall and changes in the QRS complex in the epicardial ECG in a ...primate model of ischemia-reperfusion injury.
Myocardial infarction was induced in six baboons by ligating the left anterior descending coronary artery for 2h. Using ECG leads, the presence of Q and R waves was recorded along with their associated left ventricular wall thickness.
The results indicate that Q-wave development and R-wave loss can be correlated with depth of infarct.
PDF
