Isolated placental vessel response to vascular endothelial growth factor and placenta growth factor in normal and growth-restricted pregnancy

Vascular endothelial growth factor (VEGF) and placenta growth factor (PlGF) cause vasodilation. We examined the vasomotor response of isolated placental vessels to VEGF and PlGF in normal (group I) and intrauterine growth retardation (IUGR)-complicated pregnancy (group II). Rings of vessels were prepared in vitro and mounted on the vessel myograph plunged in tissue bath. The magnitude of dilation to increased doses of VEGF and PlGF has been studied. VEGF is a more potent vasodilator than PlGF. Both, VEGF- and PlGF-induced vasorelaxation was diminished in the IUGR (group II) nearly by half, compared to control (group I). Relative placental nitric oxide deficiency, or decreased sensitivity to VEGF and PlGF may contribute to the development of high impedance fetoplacental circulation.     

Effect of long-term therapy with oral Beraprost on survival of patients with arterial and inoperable thromboembolic pulmonary hypertension

Beraprost sodium (BPS)--an orally active prostacyclin analogue--improves haemodynamic parameters and quality of life in group of patients with pulmonary arterial hypertension. Effect of long-term therapy with BPS is not well defined. This study assesses influence of long-term therapy with BPS on the survival of patients with precapillary pulmonary hypertension. Studied group consisted of 25 patients with precapillary PH (18 F, 7M, aged 34 +/- 13,9 years). Sixteen patients were diagnosed with primary PH, 3 pts had PH associated with connective tissue disease, 5 pts developed PH in course of congenital systemic to pulmonary shunt, and 1 patient suffered from inoperable chronic thromboembolic PH. At time of diagnosis 15 pts presented exercise impairment of WHO class II and 10 pts were in functional class III. All studied subjects had complete hemodynamic assessment of right heart and obtained values were used for estimation of hypothetic survival using prognostic equation proposed by D'Alonzo et al. On follow-up period patients received BPS in the highest tolerated dose (80-480 mg daily). During a follow-up period (mean: 22 months) 7 patients died. Cumulative survival rate BPS group was significantly higher in BPS group comparing to hypothetical survival at 6 months (96% (95% CI: 88-104%) vs 73% (95% CI: 67-78%), p = 0.02) and 12 months (94% (95% CI: 84-104%) vs 65% (58-71%), p = 0.01), respectively. At 18 and 24 months differences between BPS virtual and hypothetical survival were not statistically significant. There was no correlation between survival and maximal achieved dose of BPS. These results suggest, that BPS improves prognosis of patients with precapillary PH during 12 months after initiation of therapy. Later effect of BPS seems to decrease, requiring changing or intensification of therapy.     

Multiple MPEP administrations evoke anxiolytic- and antidepressant-like effects in rats

Several lines of evidence suggest a crucial involvement of glutamate in the mechanism of action of anxiolytic and antidepressant drugs. The involvement of group I mGlu receptors in anxiety and depression has also been proposed. In view of the recent discovery of anxiolytic- or antidepressant-like effects of acute injections of 2-methyl-6-(phenylethynyl)-pyridine (MPEP), a selective and brain penetrable mGlu5 receptor antagonist, we designed the present study to examine anxiolytic- and/or antidepressant-like effects of multiple administrations of this drug. The anxiolytic-like effects of MPEP were evaluated in rats using the conflict drinking test. The antidepressant-like effect was estimated using the rat olfactory bulbectomy model of depression. Seven subsequent injections of MPEP (1 mg/kg) significantly (by 320%) increased the number of shocks accepted during the experimental session in the Vogel test. MPEP given once daily at a dose of 10 mg/kg, restored the learning deficit of bulbectomized rats after 14 days of treatment, remaining without any effect in the sham-operated animals. N-methyl-D-aspartic acid (NMDA)-induced convulsions in mice were not affected by a single injection of MPEP (30 mg/kg) indicating that at this dose MPEP did not block NMDA receptors. The results indicate that the prolonged blockade of mGlu5 receptors exerts anxiolytic- and antidepressant-like effects in rats. No tolerance to anxiolytic-like action occurs. The previously mentioned results further indicate that antagonists of group I mGlu receptors may play a role in the therapy of both anxiety and depression.     

The locus of pain control in patients with lower limb ulcerations

Aims and objectives. (1) To analyse the distribution of pain control profiles of individuals suffering from the lower limb ulcerations. (2) To identify sociodemographic and clinical factors determine the locus of pain control in this group of patients. Background. The locus of pain control can play a critical role in determining the quality of life in patients with lower limb ulcerations, and identification of individuals with an unfavourable pain control profile would enable the opportunity of offering them dedicated psychological counselling. Design. Quantitative survey. Methods. This study included 298 patients with lower limb ulcerations resulting from chronic venous insufficiency (n = 101), lower limb atherosclerosis (n = 98), or having mixed arteriovenous aetiology (n = 99). The study included the completion of the Polish version of the Beliefs about Pain Control Questionnaire. Results. The most important role in the control of pain was assigned to the powerful others locus. This locus correlated directly with poorer educational level and higher professional activity. Additionally, the intensity of usual pain correlated inversely with the powerful others locus. Respondents’ age was the only sociodemographic variable decreasing the level of the internal locus. Moreover, the severity of usual and maximal pain and the area of ulceration correlated inversely with the internal locus of pain control. In contrast, the aetiology of lower limb ulceration did not affect significantly any of the dimensions of pain control. Conclusion. The control of pain in ulceration patients is mostly determined by the support of medical personnel, which generally should be considered a negative finding. Relevance to clinical practice. Determination of the locus of pain control should be included in the complex medical evaluation of individuals suffering from ulcerations.     

The influence of selected demographic factors and wound location on the concentration of vascular endothelial growth factor (VEGF‐A) in the wound healing process after neurosurgery: Brief report

The main aim of the work was to estimate the influence of selected demographic factors and wound location on the concentration of the vascular endothelial growth factor (VEGF‐A) in patients after neurosurgical operations. The study included 20 adult patients who received a surgical treatment because of degenerative spine changes. Measurements of the concentration of the VEGF‐A in the patients' blood serum were taken three times (the first time––before the operation; the second time––during the first 24 hours after surgery; and the third time––between the fifth and the seventh day after the operation). No statistically significant correlation between the concentration of VEGF‐A in the patients' blood serum before and after the operation was noted. A statistically significant correlation between the concentration of VEGF‐A in the individual measurements was found. It can be concluded that people with a higher concentration of VEGF‐A before surgery obtained a higher concentration of VEGF‐A in the measurements taken after the operation. There is a statistically significant link between the patient's age and the concentration of VEGF‐A during the immediate postoperative period (the older the patient, the higher the level of VEGF‐A is observed).     

Relationship between total prothrombin, native prothrombin and the International Normalized Ratio (INR).

Plasma levels of total prothrombin and fully-carboxylated (native) prothrombin were compared with results of prothrombin time (PT) assays for patients undergoing oral anticoagulant therapy. Mean concentrations of total and native prothrombin in non-anticoagulated patients were 119 +/- 13 micrograms/ml and 118 +/- 22 micrograms/ml, respectively. In anticoagulated patients, INR values ranged as high as 9, and levels of total prothrombin and native prothrombin decreased with increasing INR to minimum values of 40 micrograms/ml and 5 micrograms/ml, respectively. Des-carboxy-prothrombin increased with INR, to a maximum of 60 micrograms/ml. The strongest correlation was observed between native prothrombin and the reciprocal of the INR (1/INR) (r = 0.89, slope = 122 micrograms/ml, n = 200). These results indicated that native prothrombin varied over a wider range and was more closely related to INR values than either total or des-carboxy-prothrombin. Levels of native prothrombin were decreased 2-fold from normal levels at INR = 2, indicating that the native prothrombin antigen assay may be a sensitive method for monitoring low-dose oral anticoagulant therapy. The inverse relationship between concentration of native prothrombin and INR may help in identification of appropriate therapeutic ranges for oral anticoagulant therapy.