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Objectives: This study was designed to test the hypothesis that monitoring the ST segment on a single electrocardiographic (ECG) lead reflecting activity in the infarct zone provides sensitive and specific recognition of reperfusion within 60 min of initiation of therapy in acute myocardial infarction., Background: Infarct-related arteries that fail to recanalize early may benefit from immediate rescue angioplasty. Hence, detection of reperfusion has important practical clinical implications., Methods: Of 41 patients with acute myocardial infarction who had ambulatory ECG (Holter) monitors placed, 38 had adequate ST segment monitoring for 3 h; 35 of the 38 were treated with thrombolytic agents and 3 with primary angioplasty. All patients underwent early coronary angiography and were classified into two groups: Group P (22 patients) had angiographic patency (Thrombolysis in Myocardial Infarction [TIMI] grade 2 or 3 flow), the Group O (16 patients) had persistent occlusion (TIMI grade 0 or 1 flow) of the infarct-related vessel at 60 min from initiation of therapy. The initial ST segment level was defined as the first ST segment level recorded; the peak ST segment level was defined as the highest ST segment level measured during the 1st 60 min. To assess the optimal ST segment recovery criteria for reperfusion, the presence or absence of a > or = 75%, > or = 50% and > or = 25% decrement from initial and peak ST segment levels, sampled and analyzed at 2.5-, 5-, 10-, 15-and 20-min intervals, was correlated with patency of the infarct-related artery at 60 min., Results: ST segment recovery of > or = 50% reduction from peak ST segment levels with sampling rates at < or = 10-min intervals provided the optimal criterion for recognizing coronary artery patency at 60 min (sensitivity 96%, 95% confidence interval [CI] 77% to 99%; specificity 94%, 95% CI 69% to 99%, p < 0.0001). The subgroup of 13 patients in Group P with TIMI grade 3 reperfusion flow all met this criterion (sensitivity 100%, 95% CI 75% to 100%). The use of the initial ST segment level as the baseline for determining the presence of a > or = 50% reduction in ST segment levels within 60 min was less sensitive. Prediction of coronary reperfusion within 60 min of therapy on the basis of a > or = 75% decrement from peak ST segment levels was less sensitive, and the use of a > or = 25% decrement was less specific., Conclusions: ST segment monitoring of a single lead reflecting the infarct zone provides a reliable method for assessing reperfusion within 60 min of acute myocardial infarction. Optimal criteria for ECG reperfusion include a > or = 50% decrease from peak ST segment levels, with ST segment measurements recorded continuously or at least every 10 min.

Luminol-amplified CL of whole blood phagocytes was studied in rats given 3 consecutive doses of 0.1 mg L-triiodothyronine T3/kg or in hyperthyroid patients, after stimulation by zymosan. In both cases, CL was significantly increased, an effect which was produced independently of the opsonization of the zymosan particles and markedly inhibited by azide. The in vitro addition of T3 or L-thyroxine (T4) to whole blood phagocytes from normal rats did not modify the opsonized zymosan-dependent CL, when assayed at the concentrations found in euthyroid subjects or in hyperthyroid patients. Administration of propylthiouracil (400 mg/day for 2-3 months) to hyperthyroid patients reduced the CL response observed prior to treatment, to values comparable to those found in the euthyroid group. These data indicate that hyperthyroidism elicits an enhanced respiratory burst activity of whole blood phagocytes, probably related to adaptive changes induced by thyroid hormone on the mieloperoxidase-H2O2 system, rather than to direct actions of the hormone molecule or changes in the opsonic capacity of plasma.

Clinical data of 29 patients with uterine malformation treated at the Fertility Unit, Service and Department of Obstetrics and Gynecology, Dr. G. Grant B. Clinical Hospital, Concepción Chile from January 1978 to May 1990 are presented. Uterine septa (19 cases, 65.5%) were the most common uterine malformation found. Less frequent were: uterus bicornuous 7 cases (24.1%) and uterus didelphis 3 cases (10.4%). The high frequency (92.8%) of pregnancy wastage is detached. Surgical treatment was practiced in 24 patients. Thirteen Tompkins and 5 Jones techniques were performed in 18 uterine septa. Five Strassman techniques and one extirpation of a rudimentary not communicated horn were practised in the 6 cases with uterus bicornuous. In patients with adequate follow-up, the overall term birth rate after metroplasty is 84.6% compared with only 2.4% before surgical treatment. This study concludes that in despite of the lack of hysteroscopy as a new method of uterine septa treatment our patient's infertility was benefited with surgical treatment of uterine anomalies.

Antigenic differences were demonstrated between the primary murine fibrosarcoma and its metastases. Immunization with irradiated primary tumor cells (TC) protected C57B1/6J mice against subsequent challenge with those cells, but not against challenge with cells from pulmonary metastases (PMC). Mice immunized with irradiated PMC were protected from challenge with those cells, but not against challenge with TC. Mice with fibrosarcomas produced by the injection of 5 X 10(3) cells from the primary tumor were treated by resection of the tumor-bearing limb (Amp), Amp plus cyclophosphamide (Amp + Cy), Amp plus primary TC (Amp + TC), Amp plus primary TC and from its metastatic variant (Amp + TC + PMC), and with combinations of the last two groups with Cy. Although Amp + Cy improved survival, no animal lived 100 days and metastases increased as compared to controls. Immunotherapy significantly improved survival and decreased pulmonary metastases. Antigen combinations from primary and metastatic tumors resulted in significantly better survival than did a single preparation only from TC. Chemotherapy did not enhance the results obtained with immunotherapy and surgery. Immunity conferred in long-term survivors was permanent.

Monoclonal antibodies selective for rat brain choline acetyltransferase (acetyl-CoA: choline O-acetyltransferase, EC 2.3.1.6) were prepared by standard techniques. Five cell lines were isolated from spleen cell-SP/2 hybrids by repetitive cloning with a screening method that used the intrinsic activity of the enzyme. All cell lines secrete immunoglobulin of mouse subclass IgGl, and none inhibit the enzyme activity directly. The size of antibody-enzyme immune complexes formed with different pairs of the monoclonal antibodies was determined by gel filtration with HPLC. By comparing the elution position of choline acetyl-transferase activity after incubation with paired monoclonal antibodies, the spatial relationship of antibody binding domains relative to each other can be defined and classified as independent, mutually exclusive, or overlapping. Immune complexes in excess of Mr 600,000 were formed by some pairs of antibodies with the antigen, indicating independent binding domains on the enzyme. In one case, the paired antibodies formed an immune complex of only Mr 300,000, indicating that they bound in a mutually exclusive fashion. In most cases, pairs of antibodies reacted with the enzyme to give simultaneously both higher and lower Mr immune complexes. We conclude that all five antibodies bind to a relatively localized region of the enzyme surface. Antibodies were screened for usefulness as immunohistochemical markers of choline acetyltransferase-containing neurons by using the indirect immunoperoxidase method. One antibody intensely stains cell bodies of motor neurons and processes in a selective manner in the rat spinal cord and brain stem by using aldehyde-fixed tissue; the remaining antibodies do not react with fixed tissue.

The sperm of the blood fluke Schistosoma mansoni consist of a bulbous head 8 by 2 mum, with a rounded anterior tip and tapering posterior region, followed by a relatively short flagellum ca. 20 mum long. Electron microscopic observations revealed that these sperm are devoid of an acrosome, while a few undifferentiated mitochondria accumulate at the anterior part of the head. The nucleus appears dense, except for some electron-lucent patches. The flagellum starts at the basal body, posterior and slightly lateral to the nucleus, and the axial complex is of the 9 + 0 type. A layer of microtubules runs longitudinally, just beneath the plasmalemma, from the anterior part of the head to the initial part of the flagellum, where they overlap with the axial complex. It is suggested that this relatively rudimentary type of the S. mansoni sperm is probably related to the low activity required for fertilization.