Effect of coronary artery bypass graft in patients with unstable angina on left ventricular remodelling in medium-term follow-up

INTRODUCTION: Left ventricular remodelling is a process of change in size, shape, wall thickness and heart function, initiated by a noxious stimulus such as ischaemia. Methods of pharmacological and surgical inhibition or reversal of remodelling are being sought. AIM: To assess the influence of coronary artery bypass grafting on echocardiographic measures of left ventricular size and shape in medium-term follow-up. METHODS: In a group of 30 patients three echocardiographic examinations were performed: before CABG operation, 3 months after and 20 months after the operation. Left ventricular area and volumes as well as indices of sphericity, thinning and expansion were calculated. RESULTS: After the operation, left ventricular areas measured in short axis and in apical four-chamber view increased among patients with a history of myocardial infarction. Improvement in the sphericity index occurred after the operation in patients with a history of myocardial infarction in whom the ejection fraction before the operation was less than 50%. CONCLUSIONS: The left ventricular remodelling process progresses after coronary artery bypass grafting in patients with a history of myocardial infarction. Inhibition of remodelling may be expected in patients without myocardial infarction, with preserved left ventricular systolic function.     

Thromboembolic and haemorrhagic complications in patients treated with anticoagulants after artificial heart valve replacement. Risk factors dependent on quality of anticoagulant treatment

Thromboembolic (TE) and hemorrhagic (H) complications are the most significant causes of morbidity and mortality in patients treated with oral anticoagulants (OA) after implantation of artificial valvular prostheses. The risk of complications is dependent on recommended target INR ranges and quality of anticoagulation treatment. We studied 358 patients with a mean age 56.9 +/- 10.3 (who underwent 144 mitral, 172 aortic, 42 both artificial heart valve replacement). The follow up was averaged 36.7 +/- 12.1 month. Linearized incidents of TE events was 2.7%/pty, H events--4.15%/pty. The quality of anticoagulant treatment based on following parameters: averaged INR +/- SD, percentage measurements of INR within the target range 2.5-3.5, within the broad range 2-4 and under 2 and over 5. Average frequency of tests, SD/averaged INR X 100%--was similar in patients with TE and H complications and event free patients. Significant differences were found when a shorter period of time-3 months preceding the TE or H incident was analized compared with the average results of measurements of event free patients. The patients with TE and H complications have statistically significant higher fluctuation ratio than event free patients (respectively: 1.09 -/+ 0.71 and 1.71 -/+ 1.06 vs 0.5 -/+ 0.32, p = 0.04 and 0.02 ) CONCLUSIONS: 1. The risk of TE and H complications was dependent on high fluctuation of INR values in the period of 3 months before the event. 2. The worse control of measurements of INR in the period of 3 months before the event in comparison with yearly values within the recommended target ranges show, that TE and H complications are directly dependent on period of poor INR control.     

The DNA ploidy and proliferative activity of transplantable melanoma cells in regard to their secretory function

The study concerns DNA ploidy and proliferative activity of the cells of two hamster transplantable melanoma lines - differing in many biological features - in the light of possible changes in their secretory activity. DNA ploidy was determined from the index of propidium iodide (PI) stained DNA content (DI), while the proliferative activity was defined as the percentage of cells in S and G2/M cell cycle phases. The secretory activity was described by determining total protein, interleukin 6 (IL-6), tumor necrosis factor alpha (TNF-alpha), oncostatin M (OSM), interleukin 10 (IL-10) and nitric oxide (NO) content in the supernatants after 1, 6, 24 and 48 hours in cell culture. Our results indicate that melanotic melanoma cells (Ma) have a near-tetraploid DNAcontent and about 18% of proliferating cells, while amelanotic melanoma cells (Ab) - have a near-triploid DNA content and almost twice as many proliferating cells. The Ab cells, in comparison with Ma cells, secreted in vitro less total protein and most of the cytokines examined except OSM, but a spontaneous alteration of transplantable melanoma was accompanied by an increase of the quantity and dynamics of NO secretion. So, the cells of two melanoma lines have their own characteristic pattern of secretory function. But, the aneuploidy which accompanied the changes in cell differentiation of the studied melanoma lines, although seemed to reflect their changes in the proliferative activity, nevertheless did not reflect, in a direct way, differences in the secretion of the substances studied.     

Quantitative assessment of mRNA TGF-beta1 in liver tissue in connection with serum mean daily level of TGF-1 in chronic hepatitis B patient

Monitoring of fibrosis process with the use of histopathologic studies on liver's bioptates is limited, so it is attempted to find reliable, obtained with less invasive methods, sensitive and reflecting fibrosis dynamics markers of this process. The aim of the study was simultaneously to assess liver's expression as well as circadian and mean daily TGF-betal concentration in serum of patients with chronic hepatitis type B in comparison to control group. Studies were performed on 50 patients (9 women, 41 men) aged 45.9 +/- 2.3 years with chronic hepatitis type B. Control group consisted of 20 patients (mean age 38.6 +/- 3.7 years), in which so called minimal changes without fibrosis were observed in histophatologic bioptate of liver. Blood for studies was collected every 4 houres during the day. Serum concentration of TGF-betal was assessed with the use of ELISA method, and expression of mRNA TGF-betal in liver with QRT-PCR method. No significant difference between circadian as well as mean daily serum TGF-betal concentration beetwen control group and the group with chronic hepatitis type B was shown. Increased expression of mRNA, TGF-betal in bioptate of liver of patients with chronic hepatitis type B in comparison to control group was noted. In "minimal changes" control group presence of significant positive correlation between expression of mRNA TGF-beta1 in liver and concentration of this cytokine in serum was shown, in the group of patients with chronic hepatitis B this connection was not noted.     

Relationship between class I and II HLA antigens in schizophrenia and eye movement disturbances: a preliminary study

The region coding human leukocyte antigen (HLA) on chromosome 6q21 was shown to be associated with both the vulnerability to schizophrenia and presence of eye movement disturbances (EMD). The aim of this preliminary study was to investigate how individual class I and II HLA antigens in schizophrenic patients may be related to schizophrenia and to the intensity of two kinds of EMD: fixation and smooth pursuit. The incidence of HLA antigens was compared between 40 schizophrenic patients (17 male, 23 female) and 198 healthy control subjects (112 male, 86 female). In schizophrenic patients, the intensity of EMD assessed by infrared reflectometry and quantified on a scale from 0 to 3 was correlated with the incidence of HLA antigens. A number of differences regarding HLA antigens were found between schizophrenic patients and healthy subjects. Significant correlation was also obtained between some EMD and a number of HLA antigens. Antigens A24 and A28 were found to occur in different frequencies in schizophrenic patients and healthy control subjects. They also correlated with EMD on the fixation and smooth pursuit tests. The results obtained show an association between HLA antigens and EMD as an endophenotypic marker of schizophrenia, and may add to other findings on susceptibility loci for schizophrenia on chromosome 6p21. A limitation of this study is a small number of investigated patients with schizophrenia.     

Transient forebrain ischemia effects interaction of Src, FAK, and PYK2 with the NR2B subunit of N-methyl-D-aspartate receptor in gerbil hippocampus

Two different models of brain ischemia were used to examine the evoked changes in the tyrosine phosphorylation of NMDA receptor subunits 2A and 2B (NR2A and NR2B), as well as their interactions with non-receptor tyrosine kinases (NRTKs: FAK, PYK2 Src), and PSD-95 protein. Only short-term 5 min ischemia followed by 3 h reperfusion resulted in the elevated tyrosine phosphorylation of both investigated NMDA receptor subunits, but in contrast to previously published data, more pronounced in the case of NR2B. Concomitantly, an increased association of NR2B with FAK, PYK2, Src and PSD-95 has been observed. This sharp early reaction to brief ischemia was markedly attenuated during prolonged recovery (72 h) with almost complete return to control values. The initial recruitment of tyrosine kinases to NMDA receptor during the first 3 h of reperfusion is generally consistent with an active postischemic remodeling of PSD and may participate in the induction of the postischemic signal transduction pathway in gerbil hippocampus. In contrast, ischemia of longer duration (up to 30 min) caused an immediate decrease in the protein levels as well as tyrosine phosphorylation of both NR2A and NR2B subunits which was accompanied by the marked attenuation of the association with their investigated molecular partners--PSD-95 and NRTKs. This effect may be mimicked in vitro by Ca2+-dependent activation of endogenous calpains in purified PSD preparation suggesting irreversible deterioration of the synaptic signaling machinery during irreversible long-term ischemia.     

Post-stroke dementia is associated with alpha(1)-antichymotrypsin polymorphism

BACKGROUND AND PURPOSE: Alpha-1-antichymotrypsin (ACT) is an acute phase protein involved in inflammatory reaction, promoting the assembly of beta amyloid protein into filaments and contributing to its resistance to proteolytic digestion. The aim of our study was to determine ACT signal peptide polymorphism (A/T) as a possible risk factor for post-stroke dementia (PSD). METHODS: 142 consecutive ischemic stroke patients and 188 controls were included in this study. Pre-stroke dementia (PRESD) was evaluated using the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE). The diagnosis of the post-stroke dementia (PSD) was established according to DSM-IV criteria. The ACT gene (A/T) polymorphism was determined by PCR-RFLR. RESULTS: Both ACT-TT genotype and T-allele were significantly more prevalent in patients with PSD than in non-demented stroke patients, controls or patients with PRESD. After adjustment for age, gender, and vascular risk factors, both the ACT-TT genotype and T-allele remained independently associated with PSD. CONCLUSION: Our findings suggest that ACT polymorphism (A/T) is a risk factor for PSD.