[Activation and inhibition of adrenergic effects on the coronary vessels of patients with different forms of angina pectoris].

Experimental data in animals indicate that coronary vasoconstriction occurs following blockade of the beta-adrenergic receptors or alpha-receptors activation. The vasomotor effects of these maneuvers in man are unclear. Therefore we investigated whether and to which extent alpha-stimulation (cold pressor test: CPT) and beta-blockade (propranolol) cause coronary vasoconstriction; whether this effect involves the resistance arterioles as well as the large epicardial branches, and, within these, whether the normal and stenotic tracts are involved.

[Comparison of the coronary vasomotor response to nifedipine in syndrome X and in Prinzmetal's angina].

In this study we tested whether Ca++ has a similar part in the coronary vasomotion of patients with syndrome X (n = 29) and patients with Prinzmetal angina pectoris (n = 12). Through quantitative angiography we evaluated the influence of nifedipine (10 mg sl) on the lumen diameter of proximal, mid and distal thirds of normal epicardial branches. The main differences in the coronary vasomotor reaction were: uniform vasodilatation in Prinzmetal angina and a variable response in syndrome X; greater increase in the coronary lumen in patients in the former as compared to those in the latter group who showed vasodilatation.

Comparison of coronary vasomotor responses to nifedipine in syndrome X and in Prinzmetal's angina pectoris.

To test whether calcium channel blockade plays a similar role in the coronary vasomotion of patients with syndrome X (n = 29) and patients with Prinzmetal's angina pectoris (n = 12), quantitative angiography was used to evaluate the effect of nifedipine (10 mg, sublingually) on the lumen diameter of proximal, mid and distal thirds of normal epicardial branches. The main differences in the coronary vasomotor reaction were uniform vasodilatation in Prinzmetal's angina and a variable response to syndrome X, and a greater increase in the coronary lumen in patients with Prinzmetal's angina as compared with those with syndrome X who showed vasodilatation. The variable response in syndrome X was not related to changes in diastolic pressure and cardiac output.

Elicitation of myocardial ischemia by nifedipine in a case of coronary artery fistula.

A 63-year-old woman had chest pain that worsened when nifedipine was given. She was found to have a right coronary-to-thorax angioma/fistula. Acute nifedipine administration elicited precordial symptoms, associated with ischemic changes in the inferior ECG leads and an obvious vasodilatation of the fistulous tract, suggesting that a nifedipine-induced "steal" phenomenon might be responsible for the paradoxic clinical response.

Different vasomotor action of nifedipine on dynamic coronary obstructions and therapeutic response in effort and prinzmetal angina.

Variations induced by nifedipine (10 mg sublingually) in the residual lumen diameter of significant (greater than 50%) coronary lesions were assessed angiographically in 58 patients with effort angina (group 1) and in 19 patients with Prinzmetal angina (group 2). A relationship was sought between these acute variations of the stenotic lumen and the clinical response to treatment with the same drug (20 mg four times daily). Treatment efficacy was evaluated with exercise testing in group 1 and Holter monitoring in group 2.

Different coronary vasomotor effects of nifedipine and therapeutic correlates in angina with spontaneous and effort components versus Prinzmetal angina.

Flow impedance, probably of vasomotor origin, superimposed on severe coronary stenosis has been considered a trigger for the spontaneous component of angina occurring both on effort and at rest. To investigate more thoroughly this pathophysiologic aspect we evaluated (by means of quantitative coronary angiography) the acute vasomotor reaction to nifedipine (10 mg sublingually) of significant (greater than 50%) stenotic lesions in 22 patients with double-component angina. We also correlated this reaction with the clinical response (daily number of ischemic episodes evaluated by means of 48-hour Holter ambulatory monitoring) to treatment with nifedipine (20 mg four times a day); calcium channel blockade, in fact, is considered a specific remedy in cases of altered coronary vasomotility.

Coronary vasomotor and therapeutic influences of propranolol and nifedipine on the spontaneous component of mixed angina.

In 24 patients with spontaneous and effort-related angina (mixed angina), propranolol (80 mg q.i.d.

Nifedipine and angina pectoris. Short-term changes in quantitative coronary angiography with nifedipine and clinical response to treatment in effort-induced, mixed, and spontaneous angina pectoris.

Changes induced by nifedipine (10 mg sublingually) in the residual luminal diameter of significant (greater than 50 percent) coronary lesions were assessed angiographically in 69 patients with effort-induced angina (group 1), in 22 patients with mixed angina (group 2), and in 14 patients with Prinzmetal's angina (group 3). These changes were related to the clinical response to treatment with the same drug, as evaluated through diary records and Holter monitoring in the mixed (spontaneous component) and Prinzmetal forms and through exercise testing in effort-induced and mixed (effort-associated component) angina. In groups 1 and 2, segments of stenotic vessels showed either an increase or decrease or no change in diameter with the calcium antagonist; in group 3, the majority of the lesions had compliant portions which invariably responded with dilatation.

Coronary vasomotor and clinical effects of nifedipine in effort, mixed and Prinzmental angina.

Changes induced by nifedipine (10 mg s.l.) in the residual lumen diameter of significant (greater than 50%) coronary lesions were assessed angiographically in 69 patients with effort angina (Group 1), in 22 patients with mixed angina (Group 2), and in 14 patients with Prinzmental angina (Group 3).

Subaortic aneurysm of the left ventricle obstructing a coronary artery.

We report a subaortic aneurysm of the left ventricle causing compression of a coronary artery in a 52-year-old white man presenting with angina on effort. Endocarditis seemed to be implicated as the cause of this rare condition. To what extent coronary obstruction influenced the development of myocardial ischaemia was not defined since the patient also had aortic valvular disease.

Free CEA binding substance in cancer sera.

In the serum of some cancer bearing patients we found a substance that bind carcinoembryonic antigen (CEA) and that was detectable by rabbit anti-goat antiserum for a cross-reaction phenomenon. We called this substance "CEA Binding Substance" (CBS). CBS was present only in patients with CEA negative tests.

Two CEA cross-reacting antigens: differences in absorbing the same anti-CEA serum.

A factor that cross reacts with the carcinoembryonic antigen (CEA), which we call P factor, was isolated from normal human plasma. To demonstrate the difference between this P factor and the nonspecific cross-reacting antigen (NCA), the same anti-CEA serum was absorbed in an identical manner with both the antigens. Absorption was checked by immunohistochemistry by the beta-galactosidase procedure on sections of colonic adenocarcinoma and normal colonic mucosa.

Calcium channel blockade with nifedipine reduces the systemic and the pulmonary vascular reactivity to adrenergic activation in hypertension.

In hypertension the systemic and the pulmonary circulation show exaggerated vascular tone and responsiveness to adrenergic stimuli. In 22 hypertensive men we tested whether the regulation of the two vascular beds is improved by calcium entry blockade with nifedipine. Mental arithmetic raised epinephrine plasma concentration (by 80%), cardiac output (CO) and blood pressure in both circuits, and caused systemic vasodilatation and pulmonary vasoconstriction.

[Cardiac magnetic resonance with electronic axial angulation].

MR usually provides sections in three standard orthogonal plans (axial, sagittal, coronal). In the present research we have studied the possibilities and the benefit of the anatomical images performed along the main cardiac axis, using--beyond the cardiac gating--a particular software which allows to obtain layers with a double angulation, still keeping the patient supine. This provides a more detailed visualization of the cardiac architecture and a good evaluation of its functional conditions.

Anti-carcinoembryonic antigen sera acquiring higher tumor specificity by absorption with a plasma factor.

A factor reacting with antisera against carcinoembryonic antigen (CEA) was isolated from healthy donors' plasma. Ten different antiCEA sera were absorbed with this plasma factor (P-factor): the antiCEA activity was mostly, or completely, removed in 8 sera. Only 2 of these absorbed sera (here defined as type A) still presented a high CEA binding activity by radioimmunoassay and, on tissue sections, selectively stained most of the colonic adenocarcinomas and areas of severe dysplasia in neoplastic adenomas.

Calcium-channel blockade with nifedipine and angiotensin converting-enzyme inhibition with captopril in the therapy of patients with severe primary hypertension.

Nifedipine (10 mg qid) and captopril (25 mg qid) were tested alone and in combination in 14 patients suffering from severe primary hypertension. Each study period was of 1 week's duration. Circulatory response was evaluated through hourly pressure and pulse rate readings.

Severe hypertension in childhood due to prolonged skin application of a mineralocorticoid ointment.

We report the case of a 9-year-old boy suffering from exzematous dermatitis who was treated for 6 years with a daily dose of 100 mg of a dermatological ointment containing 9 alpha-fluoroprednisolone-21-acetate. At examination the patient's blood pressure was persistently 230/160 mm Hg and was considered essential in origin after secondary forms of arterial hypertension had been excluded. Treatment with nifedipine and labetalol lowered the blood pressure to 150/100 mm Hg.

Treatment of hypertension with calcium antagonists. Review.

Calcium channel blockers have a selective action on the cardiovascular system. They reduce the energy requirement of the heart, reduce vascular smooth muscle tone, and increase systemic blood flow. Vasodilatation occurs in both the systemic and the pulmonary systems to an extent proportional to the baseline level of vascular resistance, and results in reduction of blood pressure when it is elevated.

Evidence of a shared mechanism of vasoconstriction in pulmonary and systemic circulation in hypertension: a possible role of intracellular calcium.

We investigated the hemodynamics of the greater and lesser circulation in 35 patients with primary hypertension, as well as the effects of calcium-channel blockade, to test whether a common factor may account for the excessive vascular resistance in the two circuits and whether intracellular calcium concentration ([Ca++]i) may be involved. We proved that (1) elevated pulmonary arteriolar resistance (PAR) is not related to pulmonary blood flow and volume, pleural pressure, arterial oxygen or carbon dioxide tension and pH, left ventricular filling pressure and function; (2) systemic vascular resistance (SVR) significantly correlates with PAR; (3) calcium-channel blockade with nifedipine reduces systemic and pulmonary arterial pressures toward normal and significantly lowers both SVR and PAR; (4) the percent decrease in vascular resistance after nifedipine is related to the baseline level of resistance in both the greater and the lesser circulations. Failure of the mechanisms currently indicated as responsible for pulmonary vasoconstriction to explain convincingly the increased PAR, the correlation between SVR and PAR, as well as the qualitatively similar response to calcium-channel blockade suggest that a common factor produces vasoconstriction in the two circuits.

Extraction and partial purification of a CEA-like BCA from a pool of pre-selected breast carcinomas.

By exploiting the cross-reaction among the antigens associated with a pool of breast carcinomas, preselected according to their antigenic content, a CEA-like BCA, with a specific activity of 1400 U/micrograms has been extracted, by means of 3M KCl, and partially purified by means of ConA Sepharose affinity chromatography and bioabsorption, employing, for the latter, a cross-reacting antiserum (anti CEA). The subsequent labelling, after Sephadex G-200 gel filtration, points out an immunological activity at the apex of the first peak versus anti CBC (or C.BCA) and anti CEA.

BCA (breast cancer antigens): different purification extraction methods.

Various types of extraction were tested to increase the immunological yield of BCA, a CEA-like primary breast cancer associated carcinoma antigen. To allow a comparison, the different extraction techniques were applied to only one breast tumour. The comparison of the various systems was based on two parameters: protein yield and immunological activity, assayed in a RIA 125I CEA-anti CEA system.