[Hyperhomocysteinemia and hypothyroidism]. / Hyperhomocysteinaemi og hypotyreose.

Moderate hyperhomocysteinaemia is associated with hypothyroidism. Increased levels of homocysteine might contribute to a greater cardiovascular risk. This paper reports a case of transient myxoedema, owing to postpartum thyroiditis. The fluctuation of P-homocysteine was inversely correlated to the free thyroxine index. We recommend TSH screening of patients with unexplained hyperhomocysteinaemia.

Myocardial perfusion scintigraphy as a screening method for significant coronary artery stenosis in cardiac transplant recipients.

BACKGROUND: Several studies have explored the feasibility of using myocardial perfusion imaging to detect allograft vasculopathy after heart transplantation. We undertook the present prospective consecutive study to comparatively evaluate the role of serial myocardial perfusion single-photon emission computed tomography (SPECT) scanning and coronary arteriography (CAG) in detecting coronary artery stenosis suitable for coronary angioplasty in heart transplant recipients. METHODS: Within a 2-week interval during a follow-up period of 5.6 (95% confidence limits 2.1 to 12) years, 255 serial CAGs and myocardial perfusion scintigraphies were performed in 67 patients. Arteriography and scintigraphy were performed once yearly after heart transplantation. We retrospectively analyzed the data. RESULTS: Myocardial scintigraphy showed pathologic reversible defects in 9 out of 67 patients. Four of these patients had significant (>50% and also >70%) focal segmental stenosis in the middle and proximal parts of the coronary arteries (Type A lesions), 1 had diffuse and circumferential narrowing in the distal parts (Type B lesions), whereas CAG showed no lesions in the remaining 4 patients. The patients with significant Type A lesions were revascularized with percutaneous coronary angioplasty. Coronary arteriography showed that 1 patient had extensive Type A and Type B lesions, whereas myocardial perfusion scans detected no. The predictive value of a negative (normal) SPECT was 98% (95% confidence limits 94% to 100%) for the detection of lesions suited for revascularization. CONCLUSIONS: Annual myocardial SPECT seems well suited to screen for significant coronary artery stenosis. A SPECT study without reversible defects virtually excludes lesions suitable for coronary artery revascularization.

The heart of the senior oarsman: an echocardiographic evaluation.

We evaluated left ventricular mass and function in 15 oarsmen aged 78 (65-82) yr (median and range) and in 15 sedentary males aged 72 (65-81) yr by 2-D and M-mode echocardiography and cycle ergometry. The weekly time spent exercising among the oarsmen was 6 (2-18) h and two of the oarsmen were former national and international champions. The two groups of subjects had similar weight, height, and resting blood pressure. The oarsmen reached a maximal work rate of 142 (117-174) vs 113 (75-150) W for the sedentary group (P < 0.01). The internal diameters of the left ventricle were not significantly different, but the septum and posterior wall thicknesses were larger in the oarsmen (11 (8-20) vs 9 (7-11) mm, and 9 (8-13) vs 8 (7-19) mm, respectively, P < 0.023). Thus, the left ventricular mass index of the oarsmen was 19% larger (127 (101-284) vs 103 (74-134) g.m-2, P < 0.01). Also, the systolic function appeared to be superior in the oarsmen as the fractional shortening was 0.45 (0.28-0.55) vs 0.36 (0.18-0.49) in the controls (P < 0.05). In conclusion, we found that long-term rowing in the senior oarsman is associated with enlarged myocardial wall thickness, a normal systolic function, and a high work capacity.

[Tobacco and leukocytosis]. / Tobak og leukocytose.

Six heavy smokers with leucocytosis are described. Except for leucocytosis, laboratory tests were normal. A strong tobacco-induced leucocyte response indicates an increased risk of developing arterial diseases and lung diseases.

[Tendency to edema as the initial symptom of hyperthyroidism]. / Odemtendens som debutsymptom ved hypertyreose.

Peripheral oedema which is not of cardiac origin may be an early clinical sign of hyperthyroidism. Measurement of the thyroid parameters is recommended in patients with sudden onset of oedema of the lower limbs and tachycardia without any immediate cause.

[Production of human antimurine antibody after in vivo use of radioisotope labelled murine antibodies]. / Produktion af humant antimurint antistof efter in vivo anvendelse af radioaktivt maerkede murine antistoffer.

In vivo employment of monoclonal antibodies of murine origin (MoAb) with the object of immunotherapy or immunoscintigraphy may result in formation of human antimouse antibodies (HAMA) in a number of the persons exposed. HAMA is of IgG and also IgM types. Allergic reactions may occur but only few are of serious nature (less than 0.3 per thousand). In cases where MoAb is administered on repeated occasions, HAMA forms complexes with the injected which results in resuced quality of immunescintigraphic examinations, increased clearance of MoAb and reduced effect of immunetherapy. "Sandwich" type of immune analyses on blood samples which contain HAMA must be planned so that HAMA interference is eliminated.