Lowering of blood pressure and coronary blood flow in isolated systolic hypertension.

BACKGROUND: In essential hypertension, the lower limit of autoregulation of coronary flow shifts to higher perfusion and the hypertensive ventricle is at a higher than normal risk of ischemia, and less able to tolerate acute reduction of coronary perfusion pressure. Little is known about pattern of coronary flow in isolated systolic hypertension, a pathologic condition in which the elevated systolic blood pressure is associated with a lower than normal vascular compliance and normal or slightly greater than normal mean arterial pressure and vascular resistance. OBJECTIVE: To evaluate the effects of rapid normalization of blood pressure on coronary blood flow in isolated systolic hypertension. METHODS: We subjected 20 patients with isolated systolic hypertension to intraoperative hemodynamic and transesophageal echocardiographic monitoring during peripheral vascular surgery. Coronary flow velocity integrals and diameters in the left anterior descending coronary artery were evaluated under baseline conditions and after normalization of blood pressure, which occurred spontaneously during anesthesia (10 cases; group 1A) or was induced by infusion of nitrate (10 cases, group 1B). RESULTS: After normalization of systolic blood pressure integrals decreased significantly only for patients in group 1A; percentage changes of diameter were significantly greater for patients in group 1B. Therefore, coronary blood flow after normalization of systolic blood pressure increased for patients in group 1B (by 28+/-25%) and decreased for patients in group 1A (by 30+/-21%). Changes in integrals were inversely related to those in diameter (r= -0.72, P < 0.001); for patients in group 1A changes in coronary perfusion pressure and diameter were related to those of integrals (r= 0.94; P < 0.0005). CONCLUSIONS: In isolated systolic hypertension, despite there being similar changes of the systolic blood pressure, administration of nitrates caused a marked increase of coronary flow through direct effects on coronary circulation, whereas spontaneous normotension was associated with a significant reduction of coronary flow.     

CSF levels of diazepam-binding inhibitor correlate with REM latency in schizophrenia,a pilot study

CSF diazepam-binding inhibitor-like immuno-reactivity (DBI-LI) and polysomnography were studied in 28 drug-free male schizophrenic (DSM-III-R) patients. They underwent a three-night polysomnography evaluation and a lumbar puncture. CSF DBI-LI correlated positively with REM latency, the REM latency/2^d nonREM period ratio and stage-4% sleep, and negatively with stage-1% sleep. CSF DBI-LI did not correlate significantly with duration of sleep or sleep latency. CSF DBI-LI during haloperidol treatment did not correlate significantly with sleep EEG measures. The results of this first study of the relationship between endogenous DBI and sleep in humans suggest that physiological effects of DBI other than interactions with the BZD/GABA_A receptor complex may explain its positive effects on sleep. However, the absence of similar sleep data in normal subjects precludes us from establishing a specific relationship between DBI and sleep in schizophrenia.     

Tissue distribution and retention of74As-dimethylarsinic acid in mice and rats

The metabolism of dimethylarsinic acid (DMA), a common pesticide and the primary metabolite of inorganic arsenic in mammals, has been studied in mice and rats. About 80% of an oral dose (0.4 mg As/kg body weight) was absorbed from the gastrointestinal tract. In the mice, more than 99% of the dose was eliminated within 3 days, as compared to about 50% in the rats, mainly due to accumulation in the blood. The tissue distribution in the mice was characterized by highest initial (0.5–6 hr) concentrations in kidneys, lungs, intestinal mucosa, stomach, and testes. Tissues with longest retention time were lungs, thyroid, intestinal walls and lens. No demethylation of the⁷⁴As-DMA to inorganic arsenic was observed, but some of the⁷⁴As-DMA in the tissues was apparently in a complexed form.This work was performed within the framework of the contract of collaboration No. 1644-81-10 TS ISP S between the Commission of the European Communities and the National Institute of Environmental Medicine, Stockholm     

Effects of 2,3,7,8-tetrachlorodibenzo-p-dioxin administered to pregnant rats during the preimplantation period

2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD) was given by gavage to pregnant rats on the 1st–3rd days of gestation in dosages of 0 (control), 0.125, 0.5, and 2 μg/kg/day. The treatment did not increase pre- and postimplantation losses. Mean fetal weight was reduced at the 0.5 and 2 μg/kg dose levels.     

Sex Differences in Recovery from Aphasia

The influence of sex on recovery from aphasia was investigated for oral expression and auditory verbal comprehension separately in 264 males and 121 females subdivided according to presence/absence of rehabilitation. The conclusions were that females recover significantly better than males in oral expression, but not in auditory verbal comprehension.These results are discussed with regard to the possible existence of a different cerebral organization in males and females.     

GM1 ganglioside therapy in acute ischemic stroke. Italian Acute Stroke Study--Hemodilution + Drug

Eleven of 31 clinical centers participating in the Italian Acute Stroke Study--Hemodilution carried out a preliminary study on the effectiveness of ganglioside GM1 in acute stroke; 502 patients were randomized to GM1 (GM1, n = 121), GM1 plus hemodilution (GM1 + H, n = 128), placebo (P, n = 130), or placebo plus hemodilution (P + H, n = 123) groups less than or equal to 12 hours after onset of a hemispheric cerebral infarct. The patients were treated for 15 days and were evaluated on Days 21 and 120 after the onset of stroke. Intention-to-treat analysis failed to show any differences in neurologic deficit, mortality, or neurologic disability among the groups. Efficacy analysis showed a significantly higher degree of neurologic improvement in GM1 group patients compared with patients in the P group during the first 15 days. GM1-treated patients (GM1 and GM1 + H groups) showed a significantly higher degree of neurologic improvement during the first 10 days compared with the placebo-treated patients (P and P + H groups). These differences were no longer statistically significant at Day 120. Our results provide a rationale for the planning of a larger, multicenter trial of GM1 ganglioside in acute stroke.