Our data show that the addition of limited exercise to dipyridamole results in benefits during Tc-99m sestamibi imaging, increasing heart-to-liver activity ratio, preventing vasodilator-induced hypotension, and improving ECG sensitivity for the detection of ischemia. Furthermore, this protocol also provides an estimation of the patient's physical capacity and could be used as an alternative for patients undergoing dipyridamole infusion who are not completely unable to exercise.

Fatal vaccine-induced canine distemper virus inifection in black-tooted ferrets. Jourtnal of the Attmericanii 5 eterinary Medical Associationi 169, 961-964 FELSENSTEIN, J. (1989) Phylip 3.2 Manual. Berkeley, University of Californlia FORSYTH, M. A. & BARRETT, T. (1995) Evaluation of polymerase chaini reaction for the detection of rinderpest and peste des petits ruminants viruses for

Evaluation of contractile reserve by means of LDD gated SPECT with Tl-201 is safely feasible early after AMI, with incremental value over perfusion assessment alone for myocardial viability detection.

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SHORT COMMUNICATIONS which encode chlamydial heat shock protein 60 (cHSP60) and omp2 protein, respectively. The PCR assays were performed by the method described by Fukushi and Hirai (1994) for groEL and as described by Hartley and others (2001) for omp2. The PCR products were of approximately 1300 bp and 600 bp, as expected. The amplicons were purified and sequenced (GenBank accession numbers AY184288 and AY184289). Comparison by CLUSTAL W of the omp2 sequence of the FEIS-M isolate with that of the FP strain (accession number AF367407) in the GenBank database showed 99-8 per cent similarity. The AluI restriction pattern of the ompA gene of the FEIS-M isolate was found to be identical to that obtained previously from DNA extracted from conjunctival swabs of 12 cats in the same cattery and from 18 cats in two other catteries in Bologna (Di Francesco and others 2003). The nucleotide and predicted amino acid sequences of groEL and omp2 genes of the FEIS-M isolate were also identical to the same regions amplified and sequenced from these conjunctival swabs (GenBank accession numbers AF448139 and AF484215). These results suggest the presence in the area surveyed of only one strain of Cfelis showing a high degree of genomic similarity with other feline chlamydial strains isolated in other countries. In view of the limited geographical area surveyed so far, further investigations of Cfelis isolates from other areas of Italy are necessary to confirm the strain homogeneity.

We report a rare case of anomalous origin of the left coronary artery from the pulmonary trunk in a 45-year-old woman. The approach and technique used for selective catheterization of an anomalous left coronary artery arising from the pulmonary trunk are described. Six years after diagnosis, echocardiography showed left ventricular disfunction, and surgical treatment was indicated again. The origin of the left coronary artery from the pulmonary trunk was closed, and the postoperative period was uneventful, with recovery of left ventricular function and disappearance of ischemic features on stress myocardial perfusion imaging with 99m Tc-sestamibi, performed 4 weeks after surgery

A 50-year old male individual with refractory heart failure secondary to dilated cardiomyopathy due to Chagas' disease was referred to our Institute that is authorized by the Brazilian Health Ministry to employ stem cell therapy for dilated cardiomyopathy, Chagas' disease and acute myocardial infarction.The myocardial perfusion study with 99 mTc SESTAMIBI showed large areas with low uptake in the anterior, apical and septal walls of the left ventricle (Fig. 1). Cardiac catheterization revealed severe left ventricular dysfunction (ejection fraction = 15.3%) and normal coronary arteries. Despite the optimization of medication, the clinical response remained poor. The patient was informed about the potential risks and benefits of the treatment with stem cell transplantation and signed the Term of Authorized Consent.After the approval of the Research Ethics Committee, the patient underwent stem cell transplantation.The patient received epidural anesthesia, and bone marrow cells were obtained by means of punctures in the iliac crest. Twenty milliliters of suspension of mononuclear cells were obtained employing the technique described in the literature 1 . Three milliliters of the suspension were labeled with 99mTc HMPAO. The mononuclear cell suspension was slowly injected (1 ml/minute) into the coronary arteries. Fifty per cent of the suspension was injected into the anterior descending artery, 25% into the left circumflex artery and 25% into the right coronary artery. The 99 mTc HMPAO-labeled cells were injected only into the anterior descending artery. New scintigraphic studies were performed 2 hours and 6 hours after the procedure, respectively. DiscussionIn patients for whom stem cell transplantation is indicated for the treatment of end stage dilated cardiomyopathy, if the coronary arteries are normal, the selective infusion of the mononuclear cell suspension into the anterior descending artery, the left circumflex artery and the right coronary artery will be our preferred technique. The infusion of the suspension is always made in the distal end of the proximal third of coronary arteries, after proof of absence of retrograde flow is obtained by making a previous injection of contrast medium through the infusion catheter.There were doubts, however, whether the cells were retained by the cardiac muscle. This is the reason why the infusion of 99 mTc HMPAO-labeled mononuclear cells was performed using the intracoronary technique previously described.Myocardial perfusion studies were repeated to analyze the same axes, 2 and 6 hours, respectively, after the transplantation of labeled mononuclear cells through the intracoronary route and revealed their uptake and retention in areas that had not uptaken SESTAMIBI before (Fig. 1). The whole-body scintigraphic image showed that the remaining Key wordsStem cell transplantation; Chagas' cardiomyopathy; Chagas' disease.Stem cell transplantation is a new therapy applied to produce cardiac regeneration through differentiation or increase of heart myocytes or neovascular proli...

WEIGAND, P. (2001) Relatediness of Streptococcuis smiis isolates of various serotypes and cliniical backgrounds as evaluated by macrorestriction analysis and expression of potenitial virulence traits. Joturnal ofClinical Microbiology 39, 445-453 ARENDS, J. P. & ZANEN, H. C. (1988) Meningitis caused by Streptococclus sulis in humans. Reviews of Inifectious Diseases 10, 131-137