Echocardiographic detection of right-sided cardiac thrombi in pulmonary embolism.

Echocardiography has proved useful in detecting right-sided heart thrombi in cases of pulmonary embolization. We found echocardiographic evidence of right-sided cardiac thrombi in six of seven patients affected by pulmonary embolism referred to our hospital within the past five months. In one patient with clinical evidence of pulmonary and paradoxic embolization, echocardiography revealed, besides thrombi within the inferior cava and right atrium, a transient, wide, systolic movement of the valvula foraminis ovalis toward the left atrium, suggesting an interatrial communication that was confirmed by contrast echocardiography. Five patients had a good outcome, with disappearance of the thrombi following IV heparin therapy, and one patient died.

Echocardiographic recognition of mediastinal masses.

The aim of our study was to assess the ability of echocardiography to recognize mediastinal masses. We studied 50 patients: 25 with acute lymphoblastic leukemia, nine with lymphomas, four with pleural effusion and previously known neoplastic diseases, ten with nonlymphomatous mediastinal masses, and two with compression of the superior vena cava. In 33 of 50 patients, computed tomography (CT) showed mediastinal masses, and in one, an aneurysm of the thoracic descending aorta. All patients had previously had chest x-ray and two-dimensional echocardiographic (2-DE) examinations in order to recognize the presence of masses. Two-DE was found to have similar specificity (94.1 percent) but higher sensitivity (90.9 percent vs 60.6 percent) if related to radiographic examination. The positive predictive value was 96.7 vs 95.2 percent and the negative predictive value was 84.2 percent vs 55.1 percent. In particular, 2-DE was more useful than chest x-ray examination when a concomitant pleural or pericardial effusion was present. Moreover, abnormalities of cardiac function due to compression or infiltration and the follow-up of patients were better evaluated.

Cardiac toxicity of 5-fluorouracil. Report of a case of spontaneous angina.

We report a case of a patient with colon carcinoma and liver metastasis who presented chest pain after 5-fluorouracil (5-FU) administration. Clinical electrocardiographic evolution was similar to that observed in Prinzmetal's angina, and chest pain promptly resolved with nifedipine. These data suggest that coronary spasm may be the cause of cardiotoxicity due to 5-FU, and that calcium antagonists may probably be used in the prevention or treatment of 5-FU cardiotoxicity.

Polymorphism in fowl serum albumin. VI. Changes in in vitro protein synthesizing activity in developing embryonic fowl liver.

Cell-free protein synthesizing systems were prepared from the livers of chick embryos at selected ages and the characteristics of individual fractions were compared. While polysomes showed decreasing size with older embryos, isolated polysomes did not differ significantly in amino acid incorporating activity when assayed with standard cell sap. When assayed with standard polysomes, cell sap activity decreased with increasing developmental age whether incorporation was measured using (3H)lysine, (3H)leucine, or [3H]aminoacyl-tRNA. Free amino acid concentrations in the cell sap showed reproducidble independent variation during development which was taken into consideration in calculating net amino acid incorporation. A larger increase in ribonuclease activity was observed during development; however, nuclease inhibitor activity was absent before day 15 but increased thereafter. Aminoacyl-tRNA sythetase activity did not vary significantly. It is proposed that the observed changes in the rate of cell-free protein synthesis result not only from increasing ribonuclease activity with increasing developmental age but also from changes in the activity of other soluble factors.

[Severe cardiomyopathy in a woman with intermediate beta-thalassemia. Regression of cardiac failure with desferrioxamine]. / Severa cardiomiopatia in donna con beta-talassemia intermedia. Regressione dello scompenso cardiaco con desferrioxamina.

We describe a patient affected by intermedia beta-thalassemia who presented a severe heart failure when she was 27 years old. The heart failure and radiologic, electrocardiographic and echocardiographic manifestations of cardiomyopathy disappeared with desferrioxamine therapy.

[Echocardiography in primary hypothyroidism. Study of 25 patients]. / Aspetti ecocardiografici nell'ipotiroidismo primario. Studio di 25 pazienti.

25 patients affected by Primary Hypothyroidism and a control group of 25 subjects were studied with M-mode and Two-dimensional echocardiography. In hypothyroid patients mean left ventricular and aortic root dimensions were normal compared to control subjects. Pericardial effusion was found in 22 out of 25 patients (88%). Septal hypertrophy was found in 12 hypothyroid patients (48%), only in 3 out of these 12 patients left ventricular posterior wall hypertrophy was found. A moderate left atrial enlargement was found in 7 out of 25 hypothyroid patients. Two-dimensional echocardiography revealed an uniform degree of parietal hypertrophy from the basal segments to the cardiac apex. Therefore the main echocardiographic findings in hypothyroidism are: presence of pericardial effusion and asymmetrical septal hypertrophy. No correlations between these echocardiographic findings and age of patients, severity of "biochemical" alterations and duration of the thyroid disease was observed.