The therapeutic prospects of ischemic cardiopathy

Having thoroughly reviewed the risk factors and pathophysiologic features of ischemic heart disease, the authors describe therapeutic protocols at present in use and take stock of the perspectives opened by new drugs with different kinetic and dynamic and more advanced properties compared to those at present in use.     

Clinico-instrumental and pathologicoanatomic comparisons in diabetic cardiopathy and ischemic heart disease in diabetics

46 patients with diabetes mellitus (DM) of both sexes under 40 years of age in the state of compensation were found to have significantly greater figures (1, 3) for the parameter characterizing the subendocardial bloodflow, obtained by calculating technique, versus 33 DM patients beyond 40 in the state of compensation, which fact suggests the presence of diabetes macroangiopathies (IAD) in the latter. In 6 patients the diagnosis of IHD has been verified postmortem.     

Prostaglandins and the initiation of labor

A total of 96, dated pregnant, New Zealand white rabbits were studied. In 58 animals the intrauterine pressure (IUP) of the unstimulated and PGF2alpha-stimulated myometrium was recorded, by the extraovular microballoon technique, before, during and after parturition. In the remaining 38 the concentrations of PGE and PGF and progesterone (P) were measured by radioimmunoassays (RIA). The samples were collected individually or sequentially during the perinatal period from uterine tissue and uterine or peripheral vein blood. At the critical time, at around parturition, when the myometrium is converted from a suppressed and refractory muscle into a spontaneously active and reactive organ (quantitated by recording the IUP), the uterine PGE and PGF levels decreased rather than increased (quantitated by RIA). Thus, this critical regulatory and functional change of the myometrium cannot be accounted for by an increase in the intrinsic uterine stimulant: PG, but only by a decrease in the suppressor: P. These findings, 46 years after the discovery of P, demand the further exploration of Corner's legacy.     

Validation of a personality questionnaire designed for defining sub-groups at risk for ischemic cardiopathy or cancer in the Gazel cohort

Within the context of a prospective survey project among 20,000 volunteers working for "Electricité de France--Gaz de France" Company (GAZEL cohort), we performed a feasibility study using four self-assessment questionnaires: the Jenkins Activity Survey (measuring type A behaviour pattern), the Buss and Durkee Hostility Inventory, the Center for Epidemiologic Studies--Depression Scale and a personality questionnaire developed by Grossarth-Maticek and Eysenck (GME). Questionnaires were sent twice by mail, at an interval of three months, to a random sample of 408 males: 71% returned the filled forms the first time, 66% the second time, and 80% at least once. The test-retest correlation coefficients ranged from 0.62 to 0.87. The validity of the six personality type scores, calculated from GME, was tested by correlations with the scores of the three other instruments. These correlations appeared consistent with the proposed typology, especially for the "Healthy" type, the "Cancer prone" type and the "Coronary Heart Disease prone" type. The labelling of these types was justified by their association with different disease events, suggested from previous studies.     

Prostaglandins and renin release in vitro

The present studies were undertaken to explore further the role of prostaglandins in the release of renin from the renal cortex. To provide the best assessment of renin release, renin was determined by a radioimmunoassay for the direct measurement of renin. Slices of mouse renal cortex were incubated at 37 degrees C with arachidonic acid (AA), 5,8,11,14-eicosatetraenoic acid (ETA), indomethacin, prostaglandins, and synthetic prostaglandin endoperoxide analogue (EPA). Our results showed that AA at 1.5 X 10(-8) M significantly increased renin release at 10 and 30 min of incubation. This renin increase ws abolished by either ETA or indomethacin. Prostaglandin F2 alpha (PGF2 alpha) also significantly stimulated renin release at 10 and 60 min. PGE2 and 16,16-dimethyl PGE2 (DMPGE2) showed much less renin release-stimulating activity. EPA and PGI2 on the other hand very strongly stimulated renin release. However, at higher concentrations the stimulating effect of PGI2 and EPA disappeared and even became inhibitory in the case of EPA. Other prostaglandins were found to have no effect on renin release. The results suggest that the prostaglandin system directly affects renin release from the juxtaglomerular cells independent of systemic neurogenic and hemodynamic influences.     

Prostaglandins in liver disease and liver transplantation

This brief review summarizes the physiology and pharmacology of eicosanoids and describes how they have been tested for possible application in liver disease and transplantation. The objective is to trace the stepwise application from the laboratory to the bedside. Although many questions remain to be answered, the observations summarized in this article have opened up new and potentially rewarding prospects in application to liver disease.     

Reversible cardiopathy after accidental overdose of mitoxantrone

Corpora lutea from Sprague-Dawley rats that were orally administered 0.0 (control), 1.0, 10.0, and 100.0 mg/kg hexachlorobenzene (HCB) for 21 days were analyzed by electron microscopy. Granulosa lutein cells (GLC) from animals of the 10.0 mg group showed differences from the cells of animals that served as the controls. Golgi complexes and smooth endoplasmic reticulum appeared more conspicuous, possibly due to dilation resulting from hyperactivity. Free polysomes seemed more prominent in the cells of the 10.0 mg group. The GLC architecture from animals of the 1.0 and 100.0 mg groups was similar to that of the corresponding cells in the control group. Since smooth endoplasmic reticulum is involved in the synthesis of steroid hormones, and that free polysomes are engaged in synthesis of cytoplasmic proteins, it is suggested that HCB at a dose of 10.0 mg/kg given for 21 days may alter the synthetic activity of the GLC of the rat.     

High-fidelity spectrocardiography for the diagnosis of ischemic cardiopathy. The validation of a new method for analyzing the spectral components of the QRS complex

BACKGROUND: Analysis of high-frequency QRS complex envelope has been suggested as a method that could detect myocardial ischemia but the characteristics of the turbulence spectral from an spectral-temporal mapping into the QRS complex has not been studied yet. This is a prospective study of phase I for the validation of a new diagnostic test. AIMS: The aims for this study are: 1) To validate a new method for the detection of transient myocardial ischemia by both, high-frequency QRS and spectral turbulence analysis, which we have named "high-fidelity spectrocardiogram" (HFS). 2) To compare the sensitivity, specificity and accuracy of this HFS versus those obtained from nuclear medicine (NM-MIBI) and a conventional exercise ECG test, in a highly selected population. PATIENTS AND METHODS: Twenty-five patients (P) were studied: 10 P (Group B) with risk factors for coronary artery disease, without previous infarct, who had atypical precordial pain and a conventional ECG considered as "normal" by two cardiologists. The group A was formed by 15 P without risk factors or another kind of heart disease. All patients underwent a conventional surface ECG, which had to be normal in order to be considered for this study. Echocardiogram, exercise testing ECG and a NM-MIBI study were also normal. The HFS recording was taken before and after Dipyridamole testing, similar to the conventional method for the NM-MIBI (dipyridamole 0.25 mg/Kg/doses) studies. Our software for the analysis of QRS-frequencies was constructed from a language Turbo C++. The Fourier's transform allowed the construction of 3-dimensional graphics. After the determination of the best wide band for detecting changes in the frequency contained of QRS, the determination coefficients (r2) were obtained and compared before and after the challenge with dipyridamole. These changes were compared between groups (A vs B) later. RESULTS: The r2 changed more than 30% after dipyridamole in those patients in whom myocardial ischemia was demonstrated later by NM-MIBI. The sensitivity (85%) and specificity (90%) of HFS were similar to the nuclear medicine for identifying myocardial ischemia, but higher than a conventional exercise ECG testing (p.001). The main change in HFS was in the frequency-contained QRS in the 130-260 Hz band. The accuracy of our method was increased when an analysis of each orthogonal lead was made. There was a clear tendency of the group B to increase the QRS duration, while the contrary was found in group A, being the QRS the shorter (p.064). The chronological responses were different in those patients with ischemia. CONCLUSION: This study suggests that an episode of myocardial ischemia is able to change in a dramatic manner the frequency-contained within of the QRS complex, in spite of an unchanged ST segment in the conventional exercise ECG. We suggest that the HFS could be a good method for identifying myocardial ischemia. Its advantages could be important, particularly when the conventional exercise ECG is non informative.     

Prostaglandins: critical roles in pregnancy and colon cancer

Cyclooxygenase catalyses a key step in prostaglandin biosynthesis, and recent work suggests that one isoenzyme, COX-2, has important roles in early stages of pregnancy; it also appears to be involved in the somewhat analogous process of colon tumor formation and spread.