Uncoupling between beta-adrenoceptors and adenylate cyclase in dog ischemic myocardium

Summary We evaluated the effects of ischemic injury on the myocardial adenylate cyclase system, 5 h after ligation of the left anterior descending coronary in 5 anesthetized dogs. Crude cardiac membrane preparations were isolated from control and ischemic areas of ventricular myocardium and tested for: 1. L-(¹²⁵I)iodocyanopindolol binding, in the absence and presence of ±-isoprenaline and GTP, and 2. adenylate cyclase activity. The density of beta-adrenoceptors increased by 35% in membranes from ischemic areas while the proportion of receptors in a high affinity state for ±-isoprenaline decreased from 43% to 20%. Adenylate cyclase activities in the basal state and under stimulation with NaF, forskolin, Gpp(NH)p, ±-isoprenaline and VIP were all markedly and similarly reduced, being only about 30% of comparable activities in membranes from control areas. The ±-isoprenaline subsensitivity of cardiac adenylate cyclase can, thus, be attributed to a defective enzymatic system and not to a reduction in the number of beta-adrenoceptors implying that the internal components of the system were more sensitive to acute ischemia than the outward oriented hormone receptors. It is tempting to ascribe this uncoupling to a functional depletion in the guanine nucleotide-binding regulatory protein Ns that might reflect a loss of high energy phosphate stores including GTP.Abbreviations CYP cyanopindolol - Gpp(NH)p 5-guanyl imidodiphosphate - VIP vasoactive intestinal peptide - Ns guanine nucleotide-binding regulatory protein     

A critical approach to gamma variate fit of radionuclide-angiography pulmonary histograms

Radionuclide-angiography (RNA_ left-to-right intracardiac-shunt quantification algorithms, based on the part-by-part fit technique and the use of a so-called gamma variate model function (GVF), were tested via simulation analysis using data obtained from normal subjects. A good bolus of radioindicator was obtained by administering it directly into the vena subclavia. Normal subjects were defined as those having pulmonary histograms (PH) with no visible distortion caused by a shunt. Pure, non-superimposed data on the downslope of the PH curves, which are lost in presence of a shunt, proved to be appropriate reference values for testing the accuracy of results of standard shunt quantification algorithms. A generalized four-parameter GVF was introduced in order to extend the flexibility of the model function. The use of the three-parametric GVF to reconstruct the downslope of the PH curve out of the upslope data proved to be inadequate. This reveals an evident source of error in algorithms that calculate the shunt contribution by fitting GVF parameters to so-called difference-curve data. It is concluded that the inherent restricted statistical weight of RNA data prevents accurate results being obtained from standard RNA-shunt-assessment algorithms.     

Model identification and estimation of organ-function parameters using radioactive tracers and the impulse-response function

Examination of the input-output events in functioning organs by the use of the impulse-response function (IRF) for a radioactive tracer is gaining more and more ground in nuclear medicine. This study summarizes the development of deconvolution analysis, laying special stress on the model-free approach. System linearity and time invariance are discussed, and means of eliminating noise in IRFs originating from the input and organ-time-activity curves are outlined. Typical IRFs are illustrated by flow diagrams, time-domain curves, and their representation by Laplace transforms. The cases of nondiffusible and diffusible tracers as well as parenchymally extracted and transported substances are discussed. Methods for the derivation of models and for the calculation of physiologically important parameters from theIRFs are suggested.At present, a guest scientist at the Institute for Medicine, Nuclear Research Center Jülich, Jülich, Federal Republic of Germany     

“Pulmonary tongue” a right ventricle phase abnormality in muga studies in patients with pulmonary hypertention

Pulmonary hypertension (PH) produces strain followed by hypertrophy and later dilatation of the right ventricle (RV) and pulmonary artery. The signs and symptoms are nonspecific. There is a need for a noninvasive sensitive way to diagnose PH. The purpose of this study is to evaluate phase abnormalities in radionuclide MUGA studies of patients with referred diagnosis of PH. In a retrospective analysis of 44 patients who had a radionuclide multigated study (MUGA) and contrast ventriculography (CV), 19 had high mean pulmonary pressure (over 20 mmHg) and a high pulmonary vascular resistance index (over 2.0). In 15 patients, a delayed phase segment in the RV corresponding to the pulmonary infundibulum and pulmonary conus was noted The Pulmonary Tongue sign (PT), 12 had PH (True positive) and 3 did not (false positive) on CV. No PT was seen in the remaining 29 patients, only 7 of them had PH (False negative). The sensitivity, specificity and accuracy of the PT sign in detecting PH was 80%, 72% and 77% respectively. The number of patients was too small to calculate the correlation of the grade of PT with the severity of PH. We conclude that The Pulmonary Tongue sign on a MUGA study is clinically useful in detecting PH.This project is supported by research project MLNO13 and funded by research Council, Kuwait University     

Monitoring effects of α-human atrial natriuretic polypeptide (α-hANP) on left ventricular function in patients with essential hypertension with a cardiac probe

The effects of -hANP on left ventricular function were studied with a cardiac probe in ten patients with essential hypertension. Our data showed that intravenous administration of -hANP significantly elevated left ventricular function. At 5 min, the elevation of EF, RCO, ER, RSV, PFR were 13.23% (P<0.02), 12.7 (P<0.02), 0.618 (P<0.02), 0.133 (P<0.05), 0.283 (P<0.01), respectively. At 10 min, the increase of EF, ER, were 11.07% (P<0.02) and 0.233 (P<0.01), respectively. Atriopeptin significantly reduced systolic and diastolic blood pressure from 2 min to 20 min (P<0.001–0.05).Supported by IAEA Grant No. 4062/RI/RB     

Microproteins in amniotic fluid as an index of changes in fetal renal function during development

Protein content and protein composition were studied in amniotic fluid obtained from 171 healthy pregnant women between the 16th and 38th week of gestation, using microgradient gel electrophoresis to separate proteins according to their molecular size into albumin (68 KD), proteins of low molecular weight (LMW proteins, <68 KD), and proteins of high molecular weight (HMW proteins, >68 KD). Additionally -1-microglobulin (-1-MG, 33 KD) and -2-microglobulin (-2-MG, 11,8 KD) were analysed as micromolecular marker proteins. Concentrations of LMW proteins were 0.15–0.22 g/l, of -1-MG 28.4–34.5 mg/l, and of -2-MG 7.2–11.6 mg/l during the second trimester of gestation, and thereafter decreased progressively to 0.03 g/l, 14.1 mg/l and 2.4 mg/l respectively near term. The same developmental trends were confirmed by calculating the protein/creatinine ratios in amniotic fluid. The concentrations of LMW proteins found in the first postnatal urine of 73 healthy infants born prematurely or at term were similar to those in amniotic fluid of corresponding fetal age. Concentrations of albumin and HMW proteins in postnatal urine were about 5% and 15% respectively when compared with amniotic fluid concentrations. No strong correlation existed between gestational age and either of the analysed proteins which would allow accurate assessment of fetal maturation by protein analysis in amniotic fluid. It is concluded that fetal urinary excretion is the major determinant of the microprotein content of amniotic fluid. Microproteins seem to reflect an increasing tubular reabsorption capacity, which accelerates rapidly after the second trimester of gestation.     

刍议祖国医学中时间与人体的关系——34年1054例住院心脏病患者死亡时间规律探讨

本文从中医“天人相参”的基本观点出发,根据祖国医学中大量关于时间与人体关系方面的资料记载,结合本院34年住院心脏病死亡病例,就其死亡时间与人体关系进行分析讨论,应证了时间节律不但存在,而且对疾病的发生发展及预防和治疗都有十分重要意义.     

丹参和黄芪治疗气虚血瘀型心力衰竭的作用

本文报道91例气虚血瘀型心力衰竭(心衰)病人选用丹参和黄芪治疗作用。16例作气囊漂浮导管监测,发现黄芪明显增加心排出量、每搏量及心脏指数,而丹参无此作用,提示黄芪有正性肌力作用;30例给黄芪加党参,治疗后心功能分级及某些异常的血液流变学指标均有改善;44例先丹参,继之丹参加黄芪,治疗后心功能分级有明显改善,且能改善异常的血液流变学指标,明显抑制血小板聚集功能。提示丹参具有活血化瘀改善血液流变学及抑制血小板的聚集性,黄芪有补气强心改善心功能的作用。     

输精管绝育者的精子免疫反应及其与冠心病的关系——707例精子循环抗体的测定

本文报告707例精子自身抗体的研究结果。其中健康男性输精管绝育者278例,未绝育者231例;男性冠心病人输精管绝育者87例,未绝育者111例。明胶凝集试验(GAT)、试管玻片凝集试验(TSAT)和精子制动试验(SIT)检测结果表明:精子抗体在手术后6月内就已产生,并持续20年以上。曾作输精管绝育术的健康男性和冠心病人二组比较,抗体的阳性率和滴度皆无差异显著性。没有证据表明输精管绝育术后的精子免疫反应会增加冠心病的发病率。     

Psychomotor impairment and anticonvulsant therapy in adult epileptic patients

Summary Using a battery of simple tests, psychomotor performance was assessed in 11 healthy subjects, 14 untreated epileptic patients and 66 epileptics on chronic anticonvulsant medication. Significant differences were found between controls and untreated patients for choice reaction time, card sorting and Simple Simon memory game. Treated patients performed less well than both untreated epileptics and controls in choice reaction time (p<0.05; p<0.001), card sorting (p<0.01; p<0.001), Simple Simon (p<0.05; p<0.001) and finger tapping (p<0.05; p<0.001). Patients with centrencephalic epilepsy were slower than those with discrete focal EEG abnormalities in reaction time and card sorting. Patients receiving treatment with carbamazepine, phenytoin or sodium valproate alone all performed similarly to each other and to those patients taking anticonvulsant polypharmacy. Monotherapy patients with potentially toxic plasma anticonvulsant concentrations did no worse than those within or below the therapeutic range. Both the disease and its treatment reduce psychomotor performance. All major anticonvulsants appear to cause a similar degree of impairment across a wide range of concentrations. The effect of chronic anticonvulsant medication on quality of life should not be neglected in the pursuit of perfect seizure control.