Changes in calcium dynamics following the reversal of the sodium-calcium exchanger have a key role in AMPA receptor-mediated neurodegeneration via calpain activation in hippocampal neurons

Proteolytic cleavage of the Na(+)/Ca(2+) exchanger (NCX) by calpains impairs calcium homeostasis, leading to a delayed calcium overload and excitotoxic cell death. However, it is not known whether reversal of the exchanger contributes to activate calpains and trigger neuronal death. We investigated the role of the reversal of the NCX in Ca(2+) dynamics, calpain activation and cell viability, in alpha-amino-3-hydroxy-5-methylisoxazole-4-propionate (AMPA) receptor-stimulated hippocampal neurons. Selective overactivation of AMPA receptors caused the reversal of the NCX, which accounted for approximately 30% of the rise in intracellular free calcium concentration ([Ca(2+)](i)). The NCX reverse-mode inhibitor, 2-[2-[4-(4-nitrobenzyloxy)phenyl]ethyl]isothiourea (KB-R7943), partially inhibited the initial increase in [Ca(2+)](i), and prevented a delayed increase in [Ca(2+)](i). In parallel, overactivation of AMPA receptors strongly activated calpains and led to the proteolysis of NCX3. KB-R7943 prevented calpain activation, cleavage of NCX3 and was neuroprotective. Silencing of NCX3 reduced Ca(2+) uptake, calpain activation and was neuroprotective. Our data show for the first time that NCX reversal is an early event following AMPA receptor stimulation and is linked to the activation of calpains. Since calpain activation subsequently inactivates NCX, causing a secondary Ca(2+) entry, NCX may be viewed as a new suicide substrate operating in a Ca(2+)-dependent loop that triggers cell death and as a target for neuroprotection.

General framework for phase synchronization through localized sets

We present an approach which enables one to identify phase synchronization in coupled chaotic oscillators without having to explicitly measure the phase. We show that if one defines a typical event in one oscillator and then observes another one whenever this event occurs, these observations give rise to a localized set. Our result provides a general and easy way to identify PS, which can also be used to oscillators that possess multiple time scales. We illustrate our approach in networks of chemically coupled neurons. We show that clusters of phase synchronous neurons may emerge before the onset of phase synchronization in the whole network, producing a suitable environment for information exchanging. Furthermore, we show the relation between the localized sets and the amount of information that coupled chaotic oscillator can exchange.

A twenty-year survey of dermatophytoses in Braga, Portugal

BACKGROUND

Modifications in social habits together with the increase of emigration have contributed not only to increased dermatophytoses but also to an altered etiology. During the last few years, Braga has suffered a radical change from a rural to a cosmopolitan life-style.

METHODS

A statistical study of dermatophytoses and the etiology of their causative agents was performed by a retrospective survey carried out among patients of Hospital de São Marcos, Braga, Portugal, from 1983-2002. In this study, a total of 10,003 patients were analyzed.

RESULTS

Over this period the frequency of dermatophytoses, as defined by the recovery of a dermatophyte in culture, was found to be 23.6%, whereas nondermatophytic infections accounted for 7.0%. Analysis of the clinical forms and the isolated fungi supports that the dermatophyte species have a predilection for certain body areas (P <or= 0.01). Age is a very important factor regarding the occurrence of dermatophytoses (P <or= 0.0001), with a correlation between increasing age and infection, positive for Trichophyton rubrum and negative for Microsporum canis. Overall the gender of the patients is not an association factor for the development of dermatophytoses; however, significant differences were detected in the distribution of some etiologic agents (P <or= 0.05).

CONCLUSIONS

The results showed the main etiologic agent of dermatophytoses to be Trichophyton rubrum (37.4%). Moreover, dermatophytoses are both decreasing and showing a new profile in Braga, and a pronounced decrease of Trichophyton megninii was observed throughout the study.

[Clinical nutrition knowledge in health care members of University Hospitals of Paraguay]

BACKGROUND

Adequate clinical nutrition care is an integral part of the complete treatment of hospitalised patients, requiring specific knowledge from the health care team. The aim of this study is to assess, in Paraguay, the health care team ability in clinical care nutrition.

MATERIALS AND METHODS

A survey was made including 174 people of Paraguay university hospitals (29% physicians, 29% medicine graduating students, 11% pharmaceutics, 24% nurses, 7% dieticians), by answering voluntarily a multiple choice questionnaire of 20 items.

RESULTS

The median score of the 20 questions was 6 (0-15). Physicians obtained a median of 6 (2-15), graduating students 7 (2-14), pharmaceutics 7 (0-15), nurses 3 (0-11), and dieticians 9 (4-13). The dieticians obtained a significantly higher score than the other groups (p < 0.005).

CONCLUSIONS

The knowledge about clinical nutrition in the health care members from university hospitals is not adequate. The level of education in clinical nutrition is better in the dietician.

Viability analysis of alginate encapsulated micro-organisms using fluorescent stains

The encapsulation of micro-organisms such as bacteria and fungi in biopolymers is currently being evaluated as delivery systems in many fields. Information about the viability and morphology of the organisms in the microparticle is often required to ascertain the longevity of the systems. A rapid method using fluorescent stains for microbial viability has been validated for organisms within alginate microparticles. Usually viability is assessed by dissolving the microparticles and cell culturing. This new method is advantageous for slow growing or filamentous organisms because these are not quickly or accurately enumerated by plate counts. In addition, the technique also allows the morphology of the organism to be monitored over time.

Global bifurcation destroying the experimental torus T2

We show experimentally the scenario of a two-frequency torus T2 breakdown, in which a global bifurcation occurs due to the collision of a torus with an unstable periodic orbit, creating a heteroclinic saddle connection, followed by an intermittent behavior.

Adenocarcinomas of the nasal cavity and paranasal sinuses: a clinicopathological and immunohistochemical study of 14 cases

AIMS

To evaluate the clinicopathological profile of 14 cases of nasal and paranasal sinusal adenocarcinoma, and to assess the usefulness of immunohistochemistry in the differential diagnosis of primary and metastatic intestinal-type adenocarcinoma.

METHODS AND RESULTS

Fourteen cases of nasal and paranasal adenocarcinoma, treated at IPOFG, Lisbon, between 1976 and 2002, were studied. Clinical records were reviewed and expression of cytokeratin (CK)7 and CK20 and of neuroendocrine markers was evaluated. The male : female ratio was 3 : 1, and the mean age of the patients was 65.3 years. Ten cases occurred in the paranasal sinuses. There was a history of professional exposure to dust in three patients. Twelve cases were high-grade intestinal type adenocarcinomas (ITAC) and two were low-grade. CK7 was present in 2/9 ITAC cases and CK20 in 8/9 ITAC and in cases of mixed and mucinous histology. All high-grade cases showed neuroendocrine differentiation. Seven of the 12 patients with high-grade adenocarcinoma died of the disease, with a mean follow-up of 47.4 months.

CONCLUSIONS

Nasal and paranasal adenocarcinoma mostly occurs in men in the 7th decade. ITAC is the most frequent histological type. The pattern of CK7/CK20 was not useful in the distinction between primary and metastatic intestinal adenocarcinoma. However, in the former, neuroendocrine differentiation proved to be a valuable tool in that distinction.

Pesticides in Portuguese surface and ground waters

Pesticides used in Portuguese agricultural areas have been found in surface and ground waters. In the surface water collected in three river basins from 1983 to 1999, insecticides and herbicides were detected from the monitored pesticides, particularly atrazine, chlorfenvinphos (Z+E), alpha- and beta-endosulfan, lindane, molinate and simazine, reaching the maximum values, respectively, of 0.63, 31.6, 0.18 microg/L (alpha-endosulfan), 0.18 microg/L (beta-endosulfan), 0.24, 48 and 0.3 microg/L. In the ground water collected from the wells of seven agricultural areas from 1991 to 1998, several monitored herbicides were detected: alachlor, atrazine, metolachlor, metribuzine and simazine, reaching the maximum concentration values of 13, 30, 56, 1.4 and 0.4 microg/L, respectively. The herbicides more frequently detected were atrazine (64%), simazine (45%) and alachlor (25%). Other than these, the monitored pesticides can be present in Portuguese surface and ground waters. Therefore, to improve the analytical conditions, the use of multiresidue methods and automated techniques are desirable in future work.

Male breast cancer--a reappraisal of clinical and biologic indicators of prognosis

Between 1970 and 1998, 90 cases of male breast cancer with available pathological material were retrieved. The disease often presented in aged patients (median--66 years) and as advanced stage (stage III/IV-51%). Excluding stage IV disease, the neoplasia were predominantly ductal invasive carcinomas. NOS (not otherwise specified) (92%), grade 1 and grade 2 (94%), positive for estrogen and progesterone receptors (72% and 74%), negative for androgen receptors (100%), p53 negative (95%), c-erbB-2 negative (88%) and DNA aneuploid (73%). Assessment of disease outcome is determined by stage at time of diagnosis, and axillary lymph node status was the only parameter found to have a statistically significant correlation with either disease-free interval or overall survival (p < 0.001) by multivariate analysis. Clinically useful information on the probability of relapse can be added by determining c-erbB-2 (p = 0.02) and progesterone receptors (p = 0.04) in stage III and tumor ploidy (p = 0.04) in pN1 subgroups of patients.

Prognostic comparative study of S-phase fraction and Ki-67 index in breast carcinoma

AIMS

To investigate the prognostic value of recently proposed flow cytometric S-phase fraction (SPF) variables (average SPF and SPF tertiles) compared with conventional SPF, and to compare the one with the best predictive value with the immunohistochemical Ki-67 index in breast carcinoma.

METHODS

A short term follow up study (median, 39.6 months) of a large series of patients (n = 306) was conducted. DNA ploidy was analysed on fresh/frozen tumour samples by flow cytometry, and the SPF was calculated from the DNA histogram using an algorithm. The Ki-67 index was assessed on paraffin wax embedded material by immunohistochemistry (cut off point, 10%). The two methods were compared by means of kappa statistics, and the prognostic significance of both in relation to disease free survival (DFS) and overall survival (OS) was determined.

RESULTS

SPF and Ki-67 analysis was performed on 234 (76.5%) and 295 (96.4%) tumours, respectively. The two assessments were simultaneously available in 230 cases. All SPF variables analysed in the whole series significantly correlated with disease evolution, with the conventional median SPF (cut off point, 6.1%) showing the highest predictive value in relation to both DFS (p = 0.0001) and OS (p = 0.0003). SPF tertiles and median SPF evaluated according to DNA ploidy status had no prognostic significance. The Ki-67 index showed a trend in relation to DFS (p = 0.086) that did not reach significance, and no correlation with OS was found (p = 0.264). The comparative analysis of SPF and Ki-67 revealed some agreement between the two methods (agreement, 69.13%; kappa statistic, 0.3844; p < 0.001), especially in the subgroup of diploid tumours.

CONCLUSIONS

Flow cytometric SPF is a better prognosticator than the Ki-67 index, but only SPF variables applied in the whole series show potential clinical usefulness.

C-erbB-2 oncoprotein overexpression identifies a subgroup of estrogen receptor positive (ER+) breast cancer patients with poor prognosis

PURPOSE

To investigate the predictive value of c-erbB-2 oncoprotein expression as compared with established histopathological and cytometric indicators of disease evolution in breast carcinoma.

PATIENTS AND METHODS

A short-term retrospective study was conducted on a series of 306 breast cancer patients. Classic prognostic factors included tumour size, nodal involvement, histological grading, and hormone receptor status. Flow cytometric DNA ploidy and S-phase fraction (SPF) were also assessed. A Cox proportional hazards regression model was used for multivariate statistical analysis.

RESULTS

c-erbB-2 overexpression was present in 43 out of 295 (14.6%) tumours, and showed a statistically significant correlation with high histological grade, DNA aneuploidy, high SPF and lack of estrogen receptors (ER). Univariate analysis revealed its association with worse disease-free survival (DFS) and overall survival (OS). The combined evaluation of c-erbB-2 with ploidy and SPF defines a variable (P + S + c) that showed a significant correlation with disease outcome. By multivariate analysis, only nodal status (P < 0.001) and P + S + c subgrouping (group 2: P = 0.002; group 3: P = 0.001) in relation to DFS, and nodal status (P = 0.001) and DNA ploidy (P = 0.006) in relation to OS, retained independent prognostic significance. Subset analyses showed that cytometric parameters, P + S + c subgrouping and hormone receptors were significantly correlated with disease outcome in node-positive patients, whereas in node-negative subgroup no prognostic indicators were found. c-erbB-2 overexpression exhibited a trend in node-positive breast cancer (DFS: P = 0.068; OS: P = 0.086), and significant correlation with poor clinical evolution in ER positive patients (DFS: P = 0.015; OS: P = 0.004), mostly receiving tamoxifen.

CONCLUSIONS

c-erbB-2 is an independent prognostic indicator of DFS when evaluated in conjunction with ploidy and SPE. It also seems to predict response to tamoxifen therapy, by identifying a subgroup of ER positive (ER+) breast cancer patients with poor prognosis.

Expression of CD44 isoforms in squamous cell carcinoma of the border of the tongue: A correlation with histological grade, pattern of stromal invasion, and cell differentiation

BACKGROUND AND OBJECTIVES

Oral squamous cell carcinoma is a frequent disease with reserved prognosis, where the routinely evaluated morphological features lack a major correlation with prognosis. In order to assess the potential value of the immunoexpression of CD44 isoforms v3, v4-5, and v6, we studied it in a series of 56 consecutive cases of squamous cell carcinomas of the border of the tongue.

METHODS

All the histological (World Health Organization grade, Bryne score, degree of keratinization, and pattern of stromal invasion) and immunohistochemistry (using monoclonal antibodies to CD44v) results were exclusively assessed at the deep invasion front of the neoplasms. Downregulation of CD44v was defined by focal or irregular staining of < 10% of the cells at the deep invasive front.

RESULTS

There was downregulation of CD44v3 in 37.5% of the cases, CD44v4-5 in 67.9%, and CD44v6 in 33.9%, occurring mostly in cases with low Bryne scores and graded as well-differentiated according to the WHO classification. Downregulation of CD44v was found to correlate with cell differentiation, tumor grade, and the pattern of neoplastic invasion.

CONCLUSIONS

Our findings in the present series point to the consideration that CD44v pattern and intensity of immunoexpression in the deep invasive front of squamous cell carcinoma of the tongue are mostly related to tumor grade, the features of stromal invasion, and to the presence of cervical lymph node metastases.

Mechanism of regulation of the hypoxia-inducible factor-1 alpha by the von Hippel-Lindau tumor suppressor protein

In normoxic cells the hypoxia-inducible factor-1 alpha (HIF-1 alpha) is rapidly degraded by the ubiquitin-proteasome pathway, and activation of HIF-1 alpha to a functional form requires protein stabilization. Here we show that the product of the von Hippel-Lindau (VHL) tumor suppressor gene mediated ubiquitylation and proteasomal degradation of HIF-1 alpha under normoxic conditions via interaction with the core of the oxygen-dependent degradation domain of HIF-1 alpha. The region of VHL mediating interaction with HIF-1 alpha overlapped with a putative macromolecular binding site observed within the crystal structure of VHL. This motif of VHL also represents a mutational hotspot in tumors, and one of these mutations impaired interaction with HIF-1 alpha and subsequent degradation. Interestingly, the VHL binding site within HIF-1 alpha overlapped with one of the minimal transactivation domains. Protection of HIF-1 alpha against degradation by VHL was a multistep mechanism, including hypoxia-induced nuclear translocation of HIF-1 alpha and an intranuclear hypoxia-dependent signal. VHL was not released from HIF-1 alpha during this process. Finally, stabilization of HIF-1 alpha protein levels per se did not totally bypass the need of the hypoxic signal for generating the transactivation response.

Tissue Doppler imaging: clinical topics for the new millenium

INTRODUCTION

Tissue Doppler imaging is an echocardiographic technique that allows the selective visualization and quantification of myocardial signals. Its aim is to complement the conventional Doppler study, adding more and better information on specific topics of cardiovascular diseases. During the first seven years of the technique, much scientific work was produced and some clinical applications of the method have emerged.

CLINICAL APPLICATIONS

I--non ischemic heart disease: The technique has been widely used in diastology, in hypertrophic cardiomyopathy, in heart transplant patients and in arrhythmology. II--ischemic heart disease: The quantitative assessment of regional diastolic and systolic function makes the technique very promising during stress echocardiography and during percutaneous transluminal coronary angioplasty.

CONCLUSIONS

In 2000, tissue Doppler echocardiography is still a young, exciting and promising technique. Despite the fact that much has already been done, there is still a long way to go, implying a great amount of time and personal investment. How often do we feel that we are building a small part of the future?

Use of new microbiotests with Daphnia magna and Selenastrum capricornutum immobilized forms

A preliminary assessment of toxicity to aquatic life of water from rice fields treated with pesticides, and particularly with the herbicides molinate and quinclorac, was performed from June to August 1996 in a rice paddy area integrated in a Natural Reserve. New rapid-screening microbiotests with Daphnia magna and Selenastrum capricornutum were used. Water samples were collected from: a water source for irrigating the rice fields, two rice plots, a drainage channel and the river in which the water is discharged. The results showed that while the water for irrigation was not toxic to D. magna, the samples collected from the river were very toxic causing 100% immobility in D. magna and substantial inhibition of Selenastrum growth. This, however, is due to the brackish nature of the river water. Water collected in the drainage channel of the rice fields were also found to be quite toxic. A greater effect was detected in samples from the rice plot treated with molinate than from that treated with quinclorac, suggesting that molinate treatment was more toxic to both species. The results indicate that the rapidity, simplicity and relatively low cost of the new microbiotests make them very practical for initial acute toxicity screening and offer an alternative to provide evidence for changes needed in agriculture practices for a better protection of the aquatic environment.

[Aortic peri-valvular abscess, mycotic aneurysm of Valsalva sinus, and fistula to the right ventricle in a context of acute infectious endocarditis]

Infective endocarditis continues to attract the attention of many physicians. The authors present a case report of a 64 year old man with a history of infective endocarditis of a native aortic valve complicated by a perivalvular abscess, mycotic aneurysm of a sinus of valsalva and acquired aorta-right ventricular shunt.

Regional diastolic function in hypertrophic cardiomyopathy: a tissue Doppler echocardiographic study

BACKGROUND

Tissue Doppler echocardiography (TDE) is a recent ultrasonic technique. One of its potential clinical uses is the assessment of regional diastolic function.

OBJECTIVES

To compare left ventricular global diastolic function with interventricular septum regional diastolic function in patients with hypertrophic cardiomyopathy with different levels of global diastolic dysfunction.

METHODOLOGY

10 normal subjects (group 1), eight hypertrophic cardiomyopathy patients with abnormal relaxation (group 2) and 12 patients with hypertrophic cardiomyopathy with restrictive pattern (group 3) on the mitral inflow profile (pulsed wave Doppler) were studied. Each patient performed an M-mode color; TDE of the basal septum in the four chamber view. Velocities during the rapid filling phase (RF), and during atrial contraction (AC) were measured and RF/AC ratio calculated in each patient.

RESULTS

While in normal subjects (group 1) the RF/AC ratio was always higher than 1, in patients with hypertrophic cardiomyopathy patients with different levels of global diastolic dysfunction (groups 2 and 3), the RF/AC ratio was always lower than 1 (velocities during atrial contraction always higher than during rapid filling), despite the level of global diastolic dysfunction.

CONCLUSIONS

A ratio between myocardial velocities during the rapid filling phase and during atrial contraction lower than one (RF/AC < 1) is a tissue Doppler echocardiography index of regional diastolic dysfunction, independently of the severity of global diastolic dysfunction.

[Heart disease induced by mediastinal radiotherapy in Hodgkin's disease: report of a clinical case]

As the number of adults surviving radiation therapy for Hodgkin's disease increases, the long-term clinical sequelae of such treatment is becoming increasingly more evident. Mediastinal radiation has been linked to acute and chronic pericarditis (with or without pleural effusion), coronary artery disease, myocardial fibrosis, valvular dysfunction and arrhythmias. The AA describe a case of a young patient with evidence of significant valvular disease following mediastinal irradiation, and review the radiation-induced cardiotoxicity, discussing aspects concerned with pathophysiology, diagnosis and therapy.

Genetic and cytological analyses of a partial-female-sterile mutant (PS-1) in soybean (Glycine max; Leguminosae)

Soybean partial-female-sterile mutant 1 (PS-1) was recovered from a gene-tagging study. The objectives were to study the inheritance, linkage, allelism, and certain aspects of the reproductive biology of the PS-1 mutant. For inheritance and linkage tests, PS-1 was crossed to flower color mutant Harosoy-w4 and to chlorophyll-deficient mutant CD-1, also recovered from the gene-tagging study. For allelism tests, reciprocal crosses were made with PS-1 and three other partial-sterile mutants (PS-2, PS-3, and PS-4) recovered from the same gene-tagging study. The PS-1 mutant is inherited in a 3:1 ratio and is a single recessive gene. Linkage results indicated that the gene for partial sterility in PS-1 is not linked either to the w4 locus or to the CD-1 locus. Allelism tests showed that the gene in PS-1 is nonallelic to the gene in PS-2, PS-3, and PS-4. Investigations of developing and mature pollen indicated no differences in morphology, stainability, or fluorescence between normal and partial-sterile genotypes. The PS-1 mutant is completely male fertile. Confocal scanning laser microscopy was used to determine that early embryo abortion in PS-1 is due indirectly to abnormal migration of the fused polar nucleus, which prevented it from being fertilized. Subsequent absence of endosperm development leads directly to abortion of the proembryo.

[Cardiac amyloidosis: review of the literature]

The authors review the clinical impact of cardiac amyloidosis and new aspects concerning the management of this disease in the literature. Cardiac amyloidosis accounts for 5-10% of non-coronary myocardial disorders. It is a distinct form of cardiomyopathy with a severe prognosis. The authors review the role of endomyocardial biopsy and the relative sensitivity of non-invasive diagnostic methods. Chemical and genetic typing of amyloid, which is of considerable clinical value, is also reviewed due to recent evidence of treatment for different types of systemic and cardiac amyloidosis, such as the most common hereditary form caused by transthyretin gene mutation.

Microtubule inhibitors: structure-activity analyses suggest rational models to identify potentially active compounds

Trifluralin, a dinitroaniline microtubule inhibitor currently in use as an herbicide, has been shown to inhibit the proliferation of Plasmodium falciparum, Trypanosoma brucei, and several species of Leishmania, in vitro. As a topical formulation, trifluralin is also effective in vivo (in BALB/c mice) against Leishmania major and Leishmania mexicana. Although trifluralin and other dinitroaniline herbicides show significant activity as antiparasitic compounds, disputed indications of potential carcinogenicity will probably limit advanced development of these substances. However, researchers have suggested that the activity of trifluralin is due to an impurity or contaminant, not to trifluralin itself. We have pursued this lead and identified the structure of the active impurity. This compound, chloralin, is 100 times more active than trifluralin. On the basis of its structure, we developed a rational structure-activity model for chloralin. Using this model, we have successfully predicted and tested active analogs in a Leishmania promastigote assay; thus, we have identified the putative mechanism of action of this class of drugs in Leishmania species. Potentially, this will allow the design of noncarcinogenic, active drugs.

[Acute juvenile myocardial infarct. A clinical case and review of the literature]

Authors report one case of myocardial infarction in a young man 23 years old. Prevalence of acute myocardial infarction under the age of 35-40 years is not negligible. Pathogenic mechanisms, risk factors, clinical presentation, prognosis, and findings in selective coronary angiography are reviewed.

[Transesophageal echocardiography. Experience at the Pulido Valente Hospital (the first 50 cases)]

The use of echocardiography is increasingly important in the evaluation of cardiac patients.

METHODS

The results of the First fifty examinations of the Department of cardiology (Hospital de Pulido Valente). We evaluate the contribution of the T-E-E on the therapeutic decisions of these patients.

RESULTS

The clinical condition for which T-E-E were particularly appropriate were: embolism detection, evaluation of Mitral valvular regurgitation and prosthetic function, detection of vegetations in patients with suspicion of bacterial endocarditis, detection of intracardiac shunts. The examines were conclusive in 88% of the patients.

[Efficacy of the electrocardiographic diagnosis of left ventricular hypertrophy on the basis of gender]

STUDY OBJECTIVE

To determine the efficacy of electrocardiographic criteria of Left Ventricular Hypertrophy (RVL greater than 11 mm, SVE3 + RVL greater than 20 mm in females and greater than 28 mm in males, SV1 + RV6 or SV2 + RV5) in hypertensive patients according to sex.

DESIGN

Retrospective study. Gold standard M mode echocardiography.

SETTING

Pulido Valente Hospital Department of Cardiology (Lisbon).

PATIENTS

56 hypertensive patients (age 55.1 s.d. 11.6), 27 females and 29 males, with LVH by echocardiographic Left Ventricular Mass Index (LVMI) greater than 110 g/m2 in woman and greater than 134 g/m2 in men, respectively 10 and 19 patients. The LVMI was calculated by the formula of the American Society of Echocardiography modified by Devereux.

RESULTS

The LVMI was smaller in females than in males (P = 0.007). The Cornell Criteria had the greatest efficacy in woman and the Sokolow criteria satisfactory efficacy but in man. The electrocardiogram (1 of the 4 criteria positive) had low diagnostic efficacy in woman.

CONCLUSIONS

We concluded that echocardiogram is the best non-invasive diagnostic tool of Left Ventricular Hypertrophy in hypertensive females and is necessary to adjust and choose the electrocardiographic Left Ventricular Hypertrophy criteria according to sex.

[Electrocardiographic symptom-signal correspondence in Holter records]

STUDY OBJECTIVE

To determine the correspondence symptom-sign in 24-hours ambulatory electrocardiography records.

DESIGN

Retrospective study.

SETTING

Pulido Valente Hospital (Lisbon). Serviço de Cardiologia. Department of Ambulatory Electrocardiography.

PATIENTS

80 patients, who made 24-hours ambulatory electrocardiography and wrote correctly the diary. Two observators analysed the correspondence symptom-sign of 269 symptomatic moments, 10 minutes before and after the symptom by reviewing the compressed print.

RESULTS

We found correspondence symptom-sign in 50% of the symptomatic moments. The correspondence change with the symptom type (increased for palpitations and dyspnea), the presence of Cardiopathy (increased for chest pain and dyspnea in patients with cardiopathy) type of cardiopathy (increased in patients with Mitral Valve Prolapse and Valvular disease) and expression used by the patient.