LONG-TERM TREATMENT WITH A NEW NON-ERGOT LONG-ACTING DOPAMINE AGONIST, CV 205-502, IN WOMEN WITH HYPERPROLACTINAEMIA

Twenty-four hyperprolactinaemic women were treated for 6 months with the new, non-ergot, long-acting dopamine agonist, CV 205-502. The treatment resulted in normalization of PRL secretion in 17 of the 24 women at once-daily doses of 0.05 to 0.15 mg of the drug. Sixteen of these women as well as 4 of those who remained hyperprolactinaemic had regular menstrual bleeding. Five of the patients had previously discontinued bromocriptine therapy because of adverse effects but had no problems tolerating CV 205-502. Of three bromocriptine-resistant women, two responded partially while one also remained unresponsive to CV 205-502 treatment. Mild to moderate galactorrhoea was recorded at baseline in 19 of the 24 women. After 6 months' treatment mild galactorrhoea was still present in six patients, four of whom had attained normal PRL levels. Side-effects were mild and transient. CV 205-502 seems to be a valuable compound in the management of patients with hyperprolactinaemia.     

Reduction of Blood Pressure by Treatment with Alphacalcidol

ABSTRACT Disturbances of calcium or vitamin D metabolism have been suggested to be of pathogenetic importance both for hypertension and impaired glucose tolerance, two disorders that are commonly associated. In the present study 65 men, aged 61–65 years, with impaired glucose tolerance were enrolled in a prospective, double-blind, placebo-controlled study over 12 weeks evaluating the effects of 0.75 μg alphacalcidol, a synthetic analog to the active metabolite of vitamin D. In the 26 patients with blood pressure ≥ 150/90 mmHg before treatment a significant reduction (p < 0.01) of both the systolic (SBP) and diastolic (DBP) blood pressure was found after therapy (from 171/95 to 150/88 mmHg). The effect was additive to concomitant antihypertensive treatment and was correlated (p = 0.03) to a reduction of serum levels of parathyroid hormone. Also in the whole group of patients given alphacalcidol blood pressure was moderately lowered from a mean of 152/87 ± 22/10 (SD) to 143/84 ± 17/8 mmHg. There were no relationships between the changes in body weight, blood glucose or insulin parameters and the changes in blood pressure during the trial. The findings are compatible with the concept that calcium metabolism influences blood pressure regulation and suggest that supplementation with a physiologic dose of active vitamin D could be beneficial for patients with high blood pressure.     

Effect of delayed calcium hydroxide treatment on periodontal healing in contaminated replanted teeth

Abstract – The effect of delayed intracanal calcium hydroxide treatment on experimentally induced extensive inflammatory root resorption in monkeys was studied. A significant shift from inflammatory resorption to ankylosis was noted following calcium hydroxide treatment. Furthermore, calcium hydroxide treatment appeared to change the pattern of ankylosis over time, although the total ankylotic area remained the same. Ankylosis preceded by root resorption (replacement resorption) increased, while ankylosis not associated with root resorption decreased. It was concluded that intracanal calcium hydroxide treatment of teeth with compromised PDM may cause unnecessary replacement resorption if left in the root canal for a long time or changed repeatedly.     

Potent Antiarrhythmic Effects of Chronic Amiodarone in Canine Pulmonary Vein Sleeve Preparations

Objectives: To examine the effects of chronic amiodarone on the electrophysiology of canine pulmonary vein (PV) sleeve preparations and left ventricular wedge preparation.
Background: Amiodarone is commonly used for the treatment of ventricular and supraventricular arrhythmias. Ectopic activity arising from the PV plays a prominent role in the development of atrial fibrillation (AF).
Methods: Standard microelectrode techniques were used to evaluate the electrophysiological characteristics of superfused PV sleeve (left superior or inferior) and arterially perfused left ventricular (LV) wedge preparations isolated from untreated and chronic amiodarone-treated dogs (amiodarone, 40 mg/kg daily for 6 weeks).
Results: In PV sleeves, chronic amiodarone (n = 6) induced a significant increase in action potential duration at 90% repolarization (APD₉₀) and a significant use-dependent reduction in V_max leading to 1:1 activation failure at long cycle lengths (basic cycle length of 124 ± 15 ms in control vs 420 ± 320 ms after chronic amiodarone [P < 0.01]). Diastolic threshold of excitation increased from 0.3 ± 0.2 to 1.8 ± 0.7 mA (P < 0.01). Delayed and late phase 3 early afterdepolarizations and triggered activity could be induced in PV sleeve preparations using acetylcholine (ACh, 1 μM), high calcium ([Ca²⁺]_o= 5.4 mM), isoproterenol (Iso, 1 μM), or their combination in 6 of 6 untreated PV sleeves, but in only 1 of 5 chronic amiodarone-treated PV sleeve preparations. V_max, conduction velocity, and 1:1 activation failure were much more affected in PV sleeves versus LV wedge preparations isolated from amiodarone-treated animals.
Conclusions: The results point to potent effects of chronic amiodarone to preferentially suppress arrhythmogenic substrates and triggers arising from the PV sleeves of the dog.     

Coronary Thrombolysis

Myocardial infarction (MI) size is the major determinant of the function of the left ventricle and thus of the prognosis of the patient. Attempts to limit infarct size therefore constitute an important goal in modern coronary care. There is evidence that intravenous thrombolytic therapy can lyse coronary artery thrombi, restore antegrade coronary blood flow, preserve myocardial viability and function and improve survival. The time interval from onset of infarction, the extent of remaining ischemic myocardium and the rate at which myocardial necrosis is progressing are factors influencing the extent of myocardial salvage in reperfusion.     

Echocardiographic and Electrocardiographic Predictors for Atrial Fibrillation Recurrence Following Cardioversion

Introduction: Identification of suitable candidates for cardioversion currently is not based on individual electrical and mechanical atrial remodeling. Therefore, this study analyzed the meaning of atrial fibrillatory rate obtained from the surface ECG (as a measure of electrical remodeling) and left atrial size (as measure of mechanical remodeling) for prediction of early atrial fibrillation (AF) recurrence following cardioversion.
Methods and Results: Forty-four consecutive patients (26 men and 18 women, mean age 62 ± 11 years, no antiarrhythmic medication at baseline) with persistent AF were studied. Fibrillatory rate was obtained from high-gain, high-resolution surface ECG using digital signal processing (filtering, QRST subtraction, Fourier analysis) before electrical cardioversion. Univariate and multivariate regression analysis revealed larger systolic left atrial area (Beta = 0.176, P = 0.031) obtained by precardioversion echocardiogram from the apical four-chamber view and higher atrial fibrillatory rate (Beta = 0.029, P = 0.021) to be independent predictors for AF recurrence (n = 13). Stratification based on the regression equation (electromechanical index [EMI]= 0.176 systolic left atrial area + 0.029 fibrillatory rate − 17.674) allowed identification of groups at low, intermediate, or high risk. No patient with an EMI < −1.85 had early AF recurrence, as opposed to 78% with an EMI > −0.25. Intermediate results (40% recurrence rate) were obtained when the calculated EMI ranged between −1.85 and −0.25 (P < 0.001).
Conclusion: Fibrillatory rate obtained from the surface ECG and systolic left atrial area obtained by echocardiography may predict early AF recurrence in patients with persistent AF. These parameters might be useful in identifying candidates with a high likelihood of remaining in sinus rhythm after cardioversion. (J Cardiovasc Electrophysiol, Vol. 14, pp. S162-S165, October 2003, Suppl.)     

Dose-dependent Subcutaneous Absorption of Porcine,Bovine and Human NPH Insulins

ABSTRACT The absorption of ¹²⁵I-labelled porcine, bovine and human neutral protamine Hagedorn (NPH) insulins was compared in 40 diabetic patients after subcutaneous injections in the thighs using doses of 6 and 24 IU (40 IU/ml). Furthermore, the absorption of porcine NPH insulin was compared with bovine NPH insulin and porcine lente type insulin in the same dose (6 IU). All these intermediately acting insulins showed similar absorption rates when administered in the same dose. However, an increase in the injected dose from 6 to 24 IU resulted in a decrease of approximately 30% in the absorption rate of all NPH insulins.     

INTRANASAL LHRH AGONIST TREATMENT FOR INHIBITION OF OVULATION IN WOMEN: CLINICAL ASPECTS

Daily intranasal administration of the potent stimulatory LHRH analogue D-Ser(TBU)⁶-EA¹⁰-LHRH was given to fifty healthy women for 3 months. Twenty-six women received 400 μg LHRH agonist/day and twenty-four women received 600 μg/day. Inhibition of ovulation occurred during 147 of the 150 treatment months. The three presumptively ovulatory cycles were probably the result of initial technical problems with the nasal spray. No pregnancies occurred. Reactivation of corpus luteum with slightly raised progesterone levels in serum at initiation of treatment was observed in six women. During 20 months of treatment the serum progesterone levels were slightly raised, indicating luteinization of follicles or defect luteal phases. Most of the women had menstrual-like bleeding during treatment. Seventeen volunteers had regular bleeding and twenty-three women had oligomenorrhoea. No dysfunctional uterine bleeding occurred, but three women reported spotting. The remaining ten women had amenorrhoea during treatment without any symptoms of oestrogen deficiency. After discontinuation of treatment the women regained ovulatory menstrual cycles after 31 days on average. The treatment was very well accepted by all the women.     

QUANTITATIVE DETERMINATION OF IMMUNOGLOBULINS, LYSOZYME, and CERTAIN ELECTROLYTES IN BREAST MILK DURING THE ENTIRE PERIOD OF LACTATION, DURING A 24-HOUR PERIOD, and IN MILK FROM THE INDIVIDUAL MAMMARY GLAND

ABSTRACT: Peitersen, B., Bohn, L., and Andersen, H. (The Children's Hospital, Fuglebakken and the Department of Clinical Chemistry, Bispebjerg Hospital, Copenhagen, Denmark). Quantitative determination of immunoglobulins, lysozyme, and certain electrolytes in breast milk during the entire period of lactation, for a 24-hour period, and in milk from the individual mammary gland. Acta Paediatr Scand, 64:709, 1975.–During a period commencing at birth and lasting for up to 27 months 193 milk samples have been collected from 29 mothers. The IgA globulin content was high immediately after birth, averaging 2.7 arb.U, decreasing to 0.3 arb.U within the first 2 to 3 weeks after birth, then remaining almost constant for the rest of the lactational period. In the case of IgG globulin, similar results were obtained, but the quantity was much smaller. IgM globulin was demonstrated in small quantities during the first 3 weeks of lactation. The lysozyme content varied considerably during the whole lactational period. Individual variations were found for all the immunoglobulins, while the concentration in the individual woman varied only slightly from day to day following in other respects the pattern described above. In 19 mothers IgA, IgG, IgM, lysozyme and electrolyte content were determined in serum and in milk from the right and the left breast on the same day. No difference in content was found between milk from the left and the right mammary gland. A positive correlation was found between the concentrations of IgA and sodium chloride in milk, between those of IgG in milk and serum, and between those of lysozyme in milk and serum. No variations were registered during the individual breast feeding, nor for the 24-hour period as a whole.