Value of determining serum enzyme activity during the exercise test in evaluating the functional condition of patients with ischemic heart disease and concomitant diabetes mellitus

Exercise-induced changes in the activity of serum lactate dehydrogenase (LDG) and its isoenzymes, CK, aspartate and alanine aminotransferase, were examined in postmyocardial-infarction coronary patients with second-type diabetes mellitus and 18 chronic coronary patients with second-type diabetes mellitus. Patients from both groups showed increased total LDG and LDG-5 activity at rest and reduced total LDG, LDG-1, LDG-2 and LDG-3 activity in response to exercise, which may be an evidence of prevailing anaerobic glycolysis as a manifestation of tissue hypoxia. Rationed bicycle ergometric exercise produces no rise in blood CK, aspartate and alanine aminotransferase activities in coronary patients with second-type diabetes mellitus, suggesting that exercise of this kind has no damaging effect on myocardial and skeletal-muscle myocytes.     

Protein-loading test, urinary albumin excretion and renal morphology in diagnosis of subclinical diabetic nephropathy.

The acute effects of protein loading (1.5 g kg-1) on glomerular filtration rate (GFR) and urinary albumin excretion (UAE) were investigated in 23 type-I diabetic patients with no clinical nephropathy, and in 7 healthy subjects (controls). The results were compared with renal morphology data. In controls and in 14 diabetic patients (group 1) GFR increased by 27 and 37%, respectively, corresponding to normal renal reserve, but in 9 patients (group 2) GFR decreased by 20%, indicating the absence of a renal reserve. Microalbuminuria was found in none of the patients in group 1 and in 50% of patients in group 2. Two hours after the load UAE increased in all groups, but the increase was most marked in group 2, despite the fall in GFR. The two groups of patients did not differ with regard to the duration and control of diabetes, but differed markedly in terms of baseline GFR (131 vs. 195 ml min-1, P less than 0.01, in groups 1 and 2, respectively). Renal morphology showed minimal non-specific glomerular injury in group 1, and signs of glomerulosclerosis in group 2. We conclude that the impaired renal response to protein load precedes other subclinical manifestations of diabetic renal injury, and may be useful in the diagnosis of latent diabetic nephropathy.     

Mathematical model of the biomechanics of respiration during artificial ventilation

Conclusions The mathematical model of the biomechanics of respiration during AV presented makes it possible to solve particular problems of determining the parameters of the optimal regime of artificial ventilation for each particular patient (direct problem); to solve the problem of identification — to determine the characteristics of the human respiratory system (inverse problem); to expand the MIDIS to an adaptive system, where by adaptation is meant the solution of the inverse problem (identification of the model) and by control is meant the solution of the direct problem (determination of an equivalent AV regime).It is especially necessary to note that the use of the mathematical model of the biomechanics of respiration makes it possible to solve the problem of optimizing the AV process completely only in combination with other parts of the general mathematical model describing gas exchange, geodynamics, and other necessary subsystems.All-Union Scientific Surgical Center, Academy of Medical Sciences, Moscow. Translated from Meditsinskaya Tekhnika, No. 1, pp. 11–13, January–February, 1990.     

Effect of hydra peptide morphogen on cyclic nucleotide levels in injured tissues

Novokuznetsk Branch, Central Research Institute of Prosthetics. Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 108, No. 10, pp. 486–487, October, 1989.     

Acute coronary syndromes

The first 150 words of the full text of this article appear below. Key points Coronary artery disease accounts for >30% ofdeaths in Western society. The diagnosis of myocardial infarctionshould be qualified by size, causation and time from occurrence. Mortalityis reduced by immediate or ‘primary’ percutaneouscoronary intervention or thrombolysis within the first 24 hof onset of ST-segment elevation myocardial infarction. Strategiesto reduce platelet activation (glycoprotein IIb/IIIa receptorantagonists, or clopidogrel) are now recommended in the treatmentof high-risk non-ST-segment myocardial infarction/unstable angina. Elevatedserum troponins may be the result of non-ischaemic myocardialdamage, especially in critical illness.