Angiotensin II AT1 receptor antagonists inhibit platelet adhesion and aggregation by nitric oxide release

This study investigated the process of nitric oxide (NO) release from platelets after stimulation with different angiotensin II type 1 (AT1)-receptor antagonists and its effect on platelet adhesion and aggregation. Angiotensin II AT1-receptor antagonist-stimulated NO release in platelets was compared with that in human umbilical vein endothelial cells by using a highly sensitive porphyrinic microsensor. In vitro and ex vivo effects of angiotensin II AT1-receptor antagonists on platelet adhesion to collagen and thromboxane A2 analog U46619-induced aggregation were evaluated. Losartan, EXP3174, and valsartan alone caused NO release from platelets and endothelial cells in a dose-dependent manner in the range of 0.01 to 100 micro mol/L, which was attenuated by NO synthase inhibitor N(G)-nitro-L-arginine methyl ester. The angiotensin II AT1-receptor antagonists had more than 70% greater potency in NO release in platelets than in endothelial cells. The degree of inhibition of platelet adhesion (collagen-stimulated) and aggregation (U46619-stimulated) elicited by losartan, EXP3174, and valsartan, either in vitro or ex vivo, closely correlated with the NO levels produced by each of these drugs alone. The inhibiting effects of angiotensin II AT1-receptor antagonists on collagen-stimulated adhesion and U46619-stimulated aggregation of platelets were significantly reduced by pretreatment with N(G)-nitro-L-arginine methyl ester. Neither the AT2 receptor antagonist PD123319, the cyclooxygenase synthase inhibitor indomethacin, nor the selective thromboxane A2/prostaglandin H2 receptor antagonist SQ29,548 had any effect on angiotensin II AT1-receptor antagonist-stimulated NO release in platelets and endothelial cells. The presented studies clearly indicate a crucial role of NO in the arterial antithrombotic effects of angiotensin II AT1-receptor antagonists.     

RF ablation of longstanding persistent atrial fibrillation in patient with familial dilated cardiomyopathy

A vicious circle of interactions between dilated cardiomyopathy and longstanding persistent AF/AFL may cause symptoms of advanced congestive heart failure. In a 31-year-old patient with diagnosis of familial dilated cardiomyopathy and permanent AF lasting for five years, gradually decreased left ventricular ejection fraction (LVEF) and increased diameter of heart chambers - left ventricular diastolic dimension (LVdD) 7.7 cm, left atrium (LA) 5.4 cm, and LVEF 15% were noted. Pharmacological treatment was ineffective Successful RF ablation of AF/AFL substrate (CTI block, PVs isolation, CFAE ablation, roof and MIG line, CS applications) reversed symptoms of significant heart remodeling (LVdD 5.9 cm, LA 4.3 cm, LVEF 50%).     

Occurrence of Pneumocystis carinii DNA and anti-Pneumocystis antibodies in the sera of infants during a period of of physiologic decreased immune response

The polymerase chain reaction (PCR) and indirect immunofluorescent test (IF) were used for examination of serum samples obtained from infants with respiratory tract infections. Sixty (11.9%) out of the 503 examined infant samples were positive for anti-P. carinii IgM and 354 (70.4%) contained anti-Pneumocystis IgG. P. carinii DNA was found in 6 (6.7%) sera from 90 of infected infants. Five out these 6 samples were for anti-Pneumocystis antibodies positive; 4 contained both IgG and IgM classes and one had only IgG. The sixth sample had neither IgG nor IgM, despite of P. carinii DNA presence. The results of the studies indicated that for diagnosis Pneumocystis carinii pneumonia (PCP) in infants on serum specimens detection of antibodies by IF test is of greater value than Pneumocystis DNA amplification by PCR method.     

Parasite fauna of selected fish species of Lake Miedwie

A total of 136 fishes, representing 9 species (perch, Perca fluviatilis L.; pike, Esox lucius L.; European eel, Anguilla anguilla (L.); common bream, Abramis brama (L.); roach, Rutilus rutilus (L.); tench Tinca tinca (L.); European whitefish, Coregonus lavaretus (L.); vendace, Coregonus albula (L.); and zander, Sander lucioperca (L.)), from Lake Miedwie were studied within 1997-1999. The necropsies yielded 41 parasite species (taxa). The most diversified were parasite faunas of pike (19 parasite species) and perch (16 species). The parasites found represented 13 higher taxa: Monera, Fungi, Protista, Myxozoa, Monogenea, Cestoda, Digenea, Nematoda, Acanthocephala, Branchiura, Copepoda, Mollusca, and Acarina. The parasites affecting fishes of Lake Miedwie exhibited diversified host-specificity. The most fish species were infected by metacercariae of Diplostomum spp. (8 fish species) and Tylodelphys clavata (7). Three fish species harboured: Ichthyocotylurus platycephalus, Ergasilus sieboldi, and glochidia Unionidae gen. sp. while Dermocystidium sp., Trichodinella epizootica, Henneguya psorospermica, Triaenophorus nodulosus, Posthodiplostomum cuticula, and Camallanus lacustris parasitised two host species. The remaining parasites were found in single fish species.     

Comparison of defibrillation efficacy using implantable cardioverter-defibrillator with single- or dual-coil defibrillation leads and active can

INTRODUCTION: The reduction of defibrillation threshold (DFT) in patients treated with an implantable cardioverter-defibrillator increases patients' safety and prolongs ICD battery life. AIM: To evaluate the possibility of reducing the defibrillation threshold in ICDs with an active can and an additional atrial defibrillation coil instead of the typical intracardiac single-coil lead. METHOD: This study involved 138 patients (36 F and 102 M, mean age 54+/-15 years) including 62 subjects with dual-coil defibrillation lead (group A) and 76 ones with single-coil defibrillation lead (group B). No statistically significant differences with respect to age, left ventricular function, main disease or exacerbation of heart failure according to the NYHA functional class were observed between groups. The defibrillation threshold was measured using the DFT+ protocol. RESULTS: No significant differences between groups were identified with respect to pacing and sensing parameters. The comparison of DFT values between the two studied groups revealed significant improvement (by 14% mean) of defibrillation efficacy in group A. In group A, the mean DFT was 9.8+/-4.6 J (3-20 J) and mean defibrillation resistance - 45+/-7 W (32-73 W), whereas in group B: 11.45+/-5.25 J (3-28 J) and 72+/-12.8 W (38-106 W), respectively. In 93% of patients from group A, DFT was below 15 J, in comparison to 81% of patients from group B (p=0.046). The odds ratio of a higher defibrillation threshold (?15 J) in group A vs. group B was 0.3 (95% confidence interval: 0.09-0.98). The DFT reduction associated with modified ICD system use was independent of following clinical parameters: patient age, gender, main disease, end-diastolic left ventricular diameter, left ventricular ejection fraction, NYHA functional class and concomitant treatment with antiarrhythmic agents. CONCLUSIONS: Modification of the electric field during defibrillation, achieved with the use of active-can ICDs with dual-coil defibrillation leads, allows a reduction of DFT by 14%. At the same time, it reduces the risk of a higher (> or =15 J) DFT by three times compared to patients with a standard single-coil defibrillation lead.     

Clinical usefulness of implantable loop recorder in diagnosis of unexplained syncope--case report

Clinical usefulness of implantable loop recorder in diagnosis of unexplained syncope - case report. A case of a 67-year-old female with recurrent syncope is presented. In spite of extensive investigation, the cause of syncope remained unknown. The patient received insertable loop recorder (ILR). One month after implantation the patient suffered two syncopal episodes. ECG recorded by ILR showed asystolic pause of 8 seconds at the time of conversion of atrial fibrillation to sinus rhythm. This was the first ILR implantation in Poland which was covered by public health insurance and not by private funds.     

Congenital stridor

Fifty-two infants and children with stridor were examined. The median age was 5 months and the boy/girl ratio was 2:1. Fiberoptic bronchoscopy was performed when other diagnostic methods had failed to establish the origin of stridor. The most common cause of stridor was laryngornalacia, which was found in 34 children (65%). The most common form of laryngomalacia was due to large, floppy atytenoid cartilages; this was observed twice as often as other forms of laryngomalacia and boys suffered from this abnormality more than twice as often as girls. Children with laryngomalacia had significant weight (24%) and height (8%) deficits in comparison with the normal healthy population (P < 0.001). In all but four patients with laryngomalacia, blood gases were within normal limits. In 18 children (35%) stridor was not caused by laryngomalacia. This group showed significant etiologic heterogeneity. However, identification of the cause of stridor in these patients is important because specific treatment can be offered and prognosis depends on the type and cause of the anatomical and functional abnormality present. Pediatr Pulmonol. 1995; 20:220–224 . © 1995 Wiley-Liss, Inc.