Lege Artis Medicinae

[Predicting restenosis after coronary angioplasty by very early dobutamine stress test]

VÉRTES András1, KOLONICS István1, NAGY András1, HANKÓCZY Judit1, PALIK Imre1, KELTAI Mátyás1

JUNE 30, 1992

Lege Artis Medicinae - 1992;2(06)

[Increasing dose of intravenous dobutamine infusion and bicycle exercise test was used in patients with angina pectoris before and after successful coronary angioplasty to predict the development of restenosis. Ten patients were enrolled (mean age 55.9). Before PTCA, DST was positive in 9 of the 10 patients. This was similar during maximal bicycle exercise test. After successful PTCA, DST remained negative in one, became negative in four, and remained positive in five patients. The day after PTCA (and DST), repeated coronary arteriography did not disclose significant residual or restenosis in any case. In one patients with positive early DST, symptomatic restenosis developed three days later. Follow-up coronarography was performed 6 months later. There were two patients with significant restenosis and one patients with remote progression of CAD. All of them had demonstrated a positive early DST. There was no restenosis at 6 months in the group of patients with negative early DST. The authors concluded that DST is suitable for detecting myocardial ischemia in single vessel disease; DST is safe immediately after PTCA; the risk of the development of restenosis is low if DST is negative after PTCA, while a positive recoronarography and redilatation may be advised in the latter group of patients. ]


  1. Országos Kardiológiai Intézet



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[The process of inflammation can be classified as acute, subacute and chronic, as well as the special category of granulomatous inflammation. Classification of granulomatous inflammation based on morphologic criteria. These are epitheloid, histiocytic, foreign-body, necrobiotic and mixed inflammatory granuloma. The current knowledge suggests the following sequences for the mechanisms of granuloma formation in sarcoidosis (Fig 2): 1. T-cells are locally activated and proliferating 2. These activated T-cells release lymphokines that recruit and activate monocytes/macrophages 3. These activated monocytes/macrophages may differentiate into granuloma cells such as epithelioids cells and multinucleated giant cells and release pro-inflammatory profibrotic mediators that modulate the granulomatous and fibrotic process. It is hoped that further studies in sarcoidosis will help not only in clarifying the pathogenic mechanisms leading to granuloma formation, but also in eventually revealing the etiology of sarcoidosis. ]

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[Transvaginal ultrasound examination of embryo development in early pregnancy (sono-embryology) II. central nervous system]

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[In the second part of their paper, the authors look over the most important phases of the development of the central nervous system during the first trimester of pregnancy - especially considering the stages, which can be differentiated with a high resolution transvaginal transducer. The closed neural tube is developing at days 40 to 44 by the closure of the posterior neuropore, however at this time no brain structures can be detected by ultrasound. During the 7th week the three primary brain vesicles (prosencephalon, metencepha lon, myelencephalon) can be identified – a single ventricle can be seen by ultrasound. During the 8th week the secondary brain vesicles (telencephalon, diencephalon, mesencephalon, metencephalon, myelencephalon) can be separated. During the 9th week the lateral ventricles are filled out by the choroid plexus, which are retracted to the occipital horn by the 13th week. The appearance of the brain structures also takes place according to an accurate „calendar". The structures recognized by ultrasound can be compared to those of the central nervous system known from embryology. The problem of the primary prevention of the cerebrospinal malformations, which are among the most frequent congenital disorders, is not yet solved; therefore the early prenatal diagnosis of the structural anomalies has great importance. ]

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