The influence of the atrial natriuretic factor on venous tone in man

To assess the effect of the human atrial natriuretic factor (ANF) in vivo on human veins, a series of investigations was done on the dorsal hand vein of 11 healthy volunteers (ten men, one woman), aged from 25 to 49 years. In the case of intact veins the human ANF effect was evaluated by the "venoconstriction" test; on veins constricted by a reflex sympathetic discharge, the ANF effect was evaluated by the test of "venous reflexes", and on veins constricted with serotonin and angiotensin II by the "preconstriction" test. The results were expressed in venoconstrictive units (VCU). ANF was injected into the vein under study in increasing bolus doses (from 50 pg to 500 ng). The results indicate that this peptide did not affect either intact veins or these constricted by sympathetic discharge. On veins preconstricted with serotonin, ANF had a slight, statistically insignificant effect (848.57 +/- 378.67 VCU 30 sec before, compared to 670.00 +/- 460.25 VCU 30 sec after the injection of 50 pg; n = 7; p greater than 0.05), up to a maximal local dose of 500 ng. The same was true for the vein preconstricted with angiotensin II. It is concluded that the human atrial natriuretic factor has no significant influence on peripheral venous tone in man.     

Free wall rupture (FWR) in patients with acute ST-elevation myocardial infarction (STEMI) receiving fibrinolytic therapy (FT): a 7-year prospective study

Previous studies have shown a paradoxical increase in early mortality in older patients (>70 years) with acute STEMI treated with fibrinolytic therapy (FT), which has been attributed to the development of free wall rupture (FWR). Our aim was to assess occurrence of FWR in STEMI patients receiving FT. In this 7-year prospective study, data from 1701 consecutive patients were obtained. We analyzed predictors of the in-hospital mortality in patients > 70 years old. The independent contribution of several variables to overall mortality and FWR development was assessed using multiple logistic regression analyses. The mortality of entire cohort was 18% (306/1701). Diabetes mellitus, anterior infarction, smoking, female gender and hypercholesterolemia were independent predictors of in-hospital mortality. FT was given to 18% of all patients (304/1701) of which 13% died (39/304). FWR was 18.4-times more often in patients who received FT. Among patients younger than 70 years who received FT there was no FWR, while in patients ≥70 years of age FWR was found in almost half of the deceased (30/68; 44%). Application of FT in STEMI patients is not associated with higher mortality, but significantly increases number of FWR, especially in patients over 70 years of age.     

Enalapril versus captopril: a double-blind multicentre comparison in essential hypertension

A collective, multicentre (Ljubljana, Split, Zagreb) comparison of the antihypertensive effects between two angiotensin converting enzyme inhibitors (ACEI) captopril and enalapril was made in 69 hypertensives of both sexes, having a diastolic blood pressure (DBP), following two weeks on a placebo, of between 110 and 130 mm Hg (14.7 and 17.3 kPa). There were 35 patients on enalapril (20-40 mg), and 34 on captopril (50-100 mg). Both drugs under study decreased significantly the mean DBP already after the first week of ACEI treatment (p less than 0.001). By the end of the trial (9th week) captopril had decreased the DBP in the supine position from the initial 180.3 +/- 15.3/117.7 +/- 6.4 mm Hg to 151.6 +/- 11.1/96.8 +/- 7.2 mm Hg. Enalapril had lowered the DBP more efficiently: from 182.7 +/- 16.7/118.7 +/- 7.7 to 145.6 +/- 12.8/92.2 +/- 6.4 mm Hg (p less than 0.05). The average reduction in mean DBP was 16.9% on captopril, and 20.9% on enalapril. Low dose ACEI monotherapy (i.e. 50 mg and 20 mg) achieved DBP normalization in 11.8% on captopril and in 26.4% on enalapril (p less than 0.01). There were no significant heart rate changes. The laboratory results did not change appreciably and there were no relevant side-effects, although particular attention was paid to the expected adverse reactions, such as cough, ageusia or proteinuria. It is concluded that the ACEIs under study showed comparable effectiveness within the used dose range, enalapril being more potent, longer acting, and possibly safer.     

健康颈髓灌注CT测量:可行性和可重复性以及应用2种有效的商业软件包进行灌注评估的可互换性研究

本研究目的是检测颈髓灌注CT研究的可行性、可重复性和2种后处理方法所得数据的可互换性。40例颈部肿瘤病人行灌注CT检查,经2种软件包进行后处理(