Interleukin-6 in experimental endometriosis

OBJECTIVE

To measure the concentration of interleukin-6 (IL-6) in peripheral serum and conditioned media (CM) of macrophages collected from the peritoneal cavity in rats before and after surgically inducing endometriosis.

DESIGN

Adult female rats (n = 50) underwent autotransplantation of adipose tissue or uterine squares. Peritoneal cavity macrophages were collected at the initial laparotomy. Rats were killed 4 or 8 weeks later, and peripheral serum and peritoneal cavity macrophages were collected. Macrophages were cultured for 48 hours, and the IL-6 concentrations in CM and serum were measured using the B9 hybridoma cell line bioassay.

RESULTS

Serum IL-6 levels were significantly increased at 4 weeks but not at 8 weeks in rats receiving endometrial implants. Interleukin-6 production by macrophages from rats with endometrial implants at 4 or 8 weeks was not significantly different from baseline or from rats receiving adipose tissue implants.

CONCLUSION

The increased serum IL-6 levels at 4 but not 8 weeks after surgical induction of endometriosis suggest that IL-6 may be involved in the initial development of endometriosis in this experimental model.

Echocardiographic diagnosis of quadricuspid aortic valve

Isolated quadricuspid aortic valve is a rare congenital anomaly. We present a case diagnosed on cross-sectional echocardiography. To the best of our knowledge, this is the first case report on echocardiographically diagnosed quadricuspid aortic valve in Singapore.

A review of patients with a 'normal' coronary angiogram over a 3-year period

Over a period of 36 months, we detected 54 patients with normal coronary arteries or non-critical coronary artery stenosis within our study series of coronary angiography. We studied these patients to determine their clinical, electrocardiographic, stress testing and angiocardiographic characteristics. We detected among them a preponderance of female sex and a higher incidence of ethnic Indians. The majority of the patients studied had one or more coronary risk factors. 52% had a normal resting ECG. In those with a positive stress test and reports available for review, there is a near equal distribution of horizontal and J-type ST depression. Those patients with a positive treadmill tend to have a higher left ventricular end diastolic pressure (LVEDP) at cardiac catheterization. We also noted in this group of patients a higher proportion with a small distal left anterior descending artery. These patients also tend to have higher LVEDP even in the presence of normal left ventriculogram. Our current series suggests the possibility of raised left ventricular end-diastolic pressure and the presence of a "small distal left anterior descending artery" syndrome in association with patients with a 'false positive' treadmill test.

Spontaneous coronary artery dissection in a young man with anterior myocardial infarction

A case of spontaneous coronary artery dissection in a young male with subsequent myocardial infarction is reported. In addition, distal vessel occlusion is noted, presumably from embolization of thrombotic material originating from the site of dissection. Postulated mechanisms of this uncommon cause of myocardial infarction and subsequent therapeutic options are reviewed.

Comparison of three benzodiazepines for oral premedication in minor gynaecological surgery

Diazepam 10 and 20 mg, lorazepam 2.5 and 5.0 mg, flunitrazepam 1 and 2 mg, and a placebo, were compared in a randomized double-blind controlled trial as oral premedication for 210 patients undergoing minor gynaecological surgery. Flunitrazepam 1 mg and lorazepam 2.5 mg were superior to placebo (P less than 0.001 and P less than 0.05 respectively) in relieving patient anxiety when assessed by a trained observer 60 min after premedication. Flunitrazepam 1 mg also produced more drowsiness (P less than 0.01) than the placebo. Comparisons of other low-dose benzodiazepine groups with the placebo, and of the large dose with the small dose of each drug revealed no significant changes in anxiolysis or drowsiness. Dizziness and prolonged drowsiness were not apparent with low-dose flunitrazepam. The data suggests that flunitrazepam 1 mg offers advantages over placebo, diazepam 10 mg and lorazepam 2.5 mg for routine oral premedication in minor gynaecological surgery.