Neuroendocrine activation and markers of early reperfusion in the acute phase of myocardial infarction

Potentially harmful stimulation of the neuroendocrine axis occursin the early hours of myocardial infarction. It has been suggestedthat this acute neuroendocrine response might be attentuatedby early therapeutic reperfusion. To test this hypothesis wemeasured plasma concentrations of atrial natriuretic factor(ANF), renin, adrenaline (ADR) and noradrenaline (NADR) on admissionand at 1 h and 4 h in 32 patients undergoing streptokinase treatmentwithin 6 h of myocardial infarction. Fractional changes (FC)in hormone levels were calculated: e.g. ANFO-ANF4/ANFO. Resolutionof ST segment elevation at 4 h was the primary measure of reperfusion.Sixteen patients showed ST segment resolution. There was nodifference in hormone levels at baseline between reperfusedand non-reperfused patients. Fractional changes in ANF, reninand ADR were similar in both groups. NADR fell from admissionto 4 h in reperfused patients but rose in non-reperfused (FC0.28 vs –0.10; P=0.054). There was no difference in thechanges in pulse rate or blood pressure from admission to 4h between the two groups. Thus there is no evidence that earlyreperfusion acutely alters the release of ANF, renin or ADRto myocardial infarction. Although plasma NADR tended to fallacutely in reperfused patients this was not accompanied by othermarkers of sympathetic withdrawal.     

PREOPERATIVE CIMETIDINE DOES NOT PREVENT SUBCLINICAL HALOTHANE HEPATOTOXICITY IN MAN

To assess the influence of pretreatment with cimetidine on changesin hepatocellular integrity after halothane anaesthesia, 53patients were allocated randomly to receive either cimetidine1600 mg orally or placebo tablets before anaesthesia. Plasmaconcentrations of glutathione S-transferase (GST) were measuredas an index of hepatic damage. Data from 45 patients were availablefor analysis. Plasma GST concentration increased significantly3 h after induction of anaesthesia in both groups (P < 0.01,both groups) and at 6 h in the cimetidine groups (P < 0.05).Pretreatment with cimetidine did not influence the magnitudeof increase in GST concentration. There was no difference betweenthe groups in the frequency of abnormal GST concentrations atany time. Cimetidine does not appear to prevent release of GSTfrom the liver by halothane anaesthesia in man.     

Extracellular 5-hydroxytryptamine concentration in rat hypothalamus after administration of fluoxetine plus l-5-hydroxytryptophan

Abstract— Fluoxetine (10 mg kg^?1, i.p.) caused a three- to fourfold increase in extracellular 5-hydroxytryptamine (5-HT) concentration measured by microdialysis in hypothalamus of freely moving rats. The addition of l-5-hydroxytryptophan at 20 or 40 mg kg^?1, i.p. doses, magnified the increase in extracellular 5-HT to as much as 16 times basal levels, although these doses of l-5-hydroxytryptophan alone had only small effects on extracellular 5-HT. The increased formation of 5-HT following l-5-hydroxytryptophan administration appears to overcome homeostatic mechanisms that limit the increases in extracellular 5-HT caused by uptake inhibition.     

THE TREATMENT OF SKIN CARCINOMA WITH PODOPHYLLUM DERIVATIVES*

SUMMARY.— The local chemotherapy of cutaneous carcinoma with 5-fluorouracil, methotrexate and colcemide is reviewed. The use of podophyllin has been less reported and the results of the treatment of 68 cases are given here. These are compared with a similar use of podophyllotoxin. This has been followed by trials of Proresid, the ethyl hydrazide of podophyllic acid. The results are comparable with those obtained by other methods and warrant further investigation. Local irritant effects are minimal and the risk of systemic toxicity is remote. The possible advantages of this form of treatment are considered.     

The Diet of Steady Drinkers with Special Reference to Social Variables

The influence of a number of variables on the diets of 65 steady drinkers from alcohol rehabilitation units on Merseyside, United Kingdom was investigated. All drank principally beer or spirits. Social variables studied included age, sex, living alone or with others, employment status and socio-economic status. Alcohol-related variables included quantity consumed and preferred beverage. Dietary outcome was assessed in terms of the variety of foods and the number of meals eaten per week. Living alone proved by far the most important determinant of reduced diet. Spirit drinkers ate more meals than beer drinkers, but only if living with others. Increased alcohol consumption related modestly to fewer foods and meals being consumed. Drinkers living alone constitute a much larger proportion of those entering rehabilitation programmes in Queensland, Australia than in the United Kingdom. The present findings may help to explain the high incidence in Queensland of thiamin deficiency syndromes including the Wernicke-Korsakoff syndrome.