Tissue-type plasminogen activator after venous occlusion in pregnancy and puerperium.

Pregnancy is associated with depressed fibrinolysis as judged from the decreased fibrinolytic response to venous occlusion. In order to elucidate if this decreased response is due to an increase in plasminogen activator inhibitors 1 and 2 (PAI-1, PAI-2), and/or to decreased release of tissue-type plasminogen activator (t-PA) antigen during venous occlusion, 36 women (18 women with normal pregnancy and 18 with gestational hypertension without proteinuria) were followed during pregnancy and puerperium. In each women a 20 min venous occlusion was performed in the second and in the third trimester of pregnancy and 3 days after delivery.

Glucose-induced water movement from the intracellular to the extracellular space and its influence on calculations of glucose metabolism.

The osmotic effect of intravenous glucose was investigated in eight healthy volunteers. Increases in plasma glucose can induce water movement from the intracellular to the extracellular space. Serum choline esterase was used as an endogenous marker of serum dilution.

Fibrinolytic response to venous occlusion in healthy subjects: relationship to age, gender, body weight, blood lipids and insulin.

The physiological variability of fibrinolytic response to 20 min upper arm venous occlusion was studied in 191 healthy women and men, 19-80 years old. It was observed that fibrinolytic response measured by the absolute amount of t-PA antigen after venous occlusion increased with increasing age (from 10.7 at 19-30 years to 25.

Lysing patterns of retracted blood clots with diffusion or bulk flow transport of plasma with urokinase into clots--a magnetic resonance imaging study in vitro.

Fresh retracted clots are known to be poorly lysable by fibrinolytic agents. We have studied whether lysis of retracted clots could be enhanced by bulk transport in comparison to pure diffusion of plasma containing urokinase (400 IU/ml) into the clots. Cylindrical retracted blood clots were occlusively glued by a polyester into plastic tubes and put in contact with plasma through the clot bases.

New concept in activity-controlled pacemakers: clinical results with an accelerometer-based rate adaptive pacing system.

An accelerometer-based rate adaptive generator (EXCEL VR) has been introduced. A preclinical group of 22 subjects with strap-on devices was observed and reported. A clinical protocol including observation of rate adaptive response to typical daily activities and incremental exercise on a treadmill was administered in seven implanted patients.

Tissue plasminogen activator release in chronic venous hypertension due to heart failure.

In order to study the effects of chronic venous hypertension due to heart failure on blood fibrinolytic activity, tissue plasminogen activator (t-PA) antigen, plasminogen activator inhibitor 1 (PAI-1) antigen, t-PA activity and PAI activity were measured before and after venous occlusion of the arm for 20 min in 15 patients with right-sided heart failure, 15 patients with left-sided heart failure, and 30 control healthy subjects. Central venous pressure, measured by observing the jugular veins, was above 15 cm of the blood column in all patients with right-sided heart failure, and normal (below 8 cm) in all patients with left-sided heart failure and control subjects. There was no difference in the basal concentrations of t-PA (11.

Which anti-hypertensive to add to a beta-blocker: ACE inhibitor or diuretic?

Thirty-eight patients already treated with atenolol 50 mg once daily were randomly assigned to treatment with either hydrochlorothiazide (12.5-25 mg once daily) or lisinopril (10-20 mg once daily) for 8 weeks in a double-blind crossover study. Eight weeks' treatment with the combination of ACE inhibitor and beta-blocker or the diuretic and beta-blocker produced falls in blood pressure (lying: -8.

Magnetic resonance imaging of retracted and nonretracted blood clots during fibrinolysis in vitro.

Magnetic resonance imaging (MRI) of retracted blood clots embedded in nonretracted clots was used to follow their lysis with urokinase in a plasma milieu in vitro. The two types of clots that were imaged in the same plane differed in signal intensity on T2-weighted spin echo MR images throughout the 20-hour observation period. It was thus possible to delineate the contours of both clot types and measure their relative sizes by digital image processing.

Increased plasminogen activator inhibitor activity in survivors of myocardial infarction is associated with metabolic risk factors of atherosclerosis.

To assess the relationship between the fibrinolytic system and coronary risk factors, several fibrinolytic parameters were measured in 72 male survivors of myocardial infarction and in 53 age-matched healthy controls. The coronary patients had significantly higher plasminogen activator inhibitor (PAI) activity than the control subjects, while t-PA antigen did not differ between the groups. After stratifying the coronary patients in 14 diabetic and 58 nondiabetic patients, the elevated PAI activity remained limited to the diabetic group.

Poor fibrinolytic response to venous occlusion by different criteria in patients with deep vein thrombosis.

Five criteria for poor response to a 20 min venous occlusion test were applied to 58 patients 3 months or more after acute deep vein thrombosis (DVT). The criteria were arbitrarily defined as the last 5 percentiles of response distributions in an age- and sex-matched healthy control group of 51 subjects. The criteria were: 1.

Influence of beta-adrenergic stimulation on the fast sodium current in the intact rat papillary muscle.

The loose-patch-clamp technique was used on intact cardiac papillary muscle of the rat to examine whether the fast sodium inward current (INa+) is influenced by the beta-adrenergic stimulant isoproterenol (ISO) or by 8-bromo-3',5'-cyclic adenosine monophosphate (8-Br-cAMP), respectively. The amplitude of INa+ evoked by test pulses of 5 ms to a transmembrane potential of 0 mV and its time to peak were analyzed. The availability of INa+ was tested with conditioning pulses of 2.

Prevalence of antiphospholipid antibodies in deep vein thrombosis and their relationship to blood coagulation and fibrinolysis.

Elevated levels of antiphospholipid antibodies are associated with an increased risk of thrombosis. To establish the prevalence of these antibodies in deep vein thrombosis (DVT), IgG and IgM antibodies to cardiolipin (aCL) and phosphatidylserine (aPS) were determined by enzyme-linked immunosorbent assay in 118 patients with DVT either during an acute episode (N = 53) or at least 2 months after acute DVT (N = 65). Most patients (76%) had proximal leg DVT and no one had evident autoimmune disorder.

Lack of beta 2-adrenoceptor induced long-acting effect on glucose tolerance in type 2 diabetic patients.

The long-acting effect of a 10-min pulse infusion of the beta 2-adrenergic agonist fenoterol on oral glucose tolerance tests in controls and in normotensive patients with type 2 diabetes mellitus on diet was compared. During an oral glucose load starting 2 h after fenoterol control persons showed hyperglycemia (area: 25,950 +/- 467 vs. 22,650 +/- 410, P less than 0.

Dependence of blood clot lysis on the mode of transport of urokinase into the clot--a magnetic resonance imaging study in vitro.

Magnetic resonance imaging was employed to study the dependence of clot lysing patterns on two different modes of transport of urokinase into whole blood clots. In one group of clots (nonperfused clots, n1 = 10), access of urokinase to the fibrin network was possible by diffusion only, whereas in the other group (perfused clots, n2 = 10) bulk flow of plasma containing urokinase was instituted through occlusive clots by a pressure difference of 3.7 kPa (37 cm H2O) across 3 cm long clots with a diameter of 4 mm.

Serum levels of interleukin-6 in multiple myeloma and other hematological disorders: correlation with disease activity and other prognostic parameters.

Interleukin-6 (IL-6) is a multifunctional cytokine involved in the regulation of the terminal differentiation pathway of B lymphocytes. Recent reports revealed its potential role in the in vitro and in vivo growth of human multiple myeloma cells. The mechanism, however, by which IL-6 triggers proliferation of malignant plasma cells remains controversial.

Symptoms, cardiovascular risk profile and spontaneous ECG in paced patients: a five-year follow-up study.

Unlabelled: Only few data are available about the course of symptoms, cardiac diseases, and spontaneous rhythm in pacemaker patients. Therefore, we followed the course of 308 paced patients (age 72 +/- 11 years) with a mean implantation time of 63 +/- 45 months.

Results: The symptom triad of syncope, dizziness, and dyspnea improved remarkably in 93% of patients.

The six-minute walk--an adequate exercise test for pacemaker patients?

In many pacemaker patients bicycle and treadmill ergometry are not practicable. As an alternative, we performed a 6-minute walk on a 20-m corridor in 97 pacemaker patients, who were asked to walk as far as possible determining their speed by themselves. Results were compared with those of bicycle ergometry in 42 of these patients and with treadmill exercise of a group of 92 other pacemaker patients.

Increase of tissue plasminogen activator in limbs during venous occlusion: a simple haemodynamic model.

Venous occlusion of a limb is an established procedure for increasing the venous plasma concentration of tissue plasminogen activator (t-PA). In this paper a simple haemodynamic model was developed to describe the venous plasma t-PA concentration as a function of haemodynamic parameters and the local release rate of t-PA during venous occlusion of the limb. The venous plasma pool of a limb was regarded as a single well-mixed compartment with a constant input rate of t-PA.

A new software for initiating and optimising insulin treatment of out-patients.

Two computer programs were developed, program I to optimise insulin treatment using six injections per day, and program II to convert these insulin profiles into less frequent injections of mixtures of regular and NPH insulin. The first software in an HP 41 CV pocket computer uses iterative adjustments during the day and on subsequent days to determine the optimal timing and dosage of insulin. Six self-monitored glucose values at 3 h intervals, insulin doses, and the effects of insulin on plasma glucose are memorised for calculations.

Stimulation of colony formation of various human carcinoma cell lines by rhGM-CSF and rhIL-3.

We studied the effects human recombinant granulocyte-macrophage colony-stimulating factor and human recombinant interleukin-3 on the colony formation of three human solid tumor cell lines. Using a modified double-layer soft agar clonogenic assay rhGM-CSF enhanced colony formation of all cell lines tested in a dose dependent manner (up to twofold for the breast cancer cell line BT-20, up to 163% of the control for the hypernephroma cell line C 94 and up to 147% for the non-small cell lung cancer cell line CCL 185 at a concentration of 100 ng/ml). RhIL-3 stimulated colony formation of the cell lines C 94 and BT-20, whereas on the cell line CCL 185 rhIL-3 had no effect even at the highest dose level tested (100 ng/ml).

Different tissue plasminogen activator release in the arm and leg during venous occlusion is equalized after DDAVP infusion.

The mechanism of tissue plasminogen activator (t-PA) release during arm and leg venous occlusions and DDAVP (1-desamino-8-D-arginine vasopressin) infusion was studied in 10 healthy males. The following determinations were carried out on venous blood: t-PA antigen (ELISA), t-PA activity, and t-PA inhibitor (PAI) activity (amidolytic assays). Before DDAVP, there was a 270% t-PA antigen increase in the arm at the end of occlusion as opposed to only a 40% increase in the leg.

Comparative analysis of the action of class I antiarrhythmic drugs (lidocaine, quinidine, and prajmaline) in rabbit atrial and ventricular myocardium.

Effects of three class I antiarrhythmic drugs (quinidine, lidocaine, and prajmaline) on transmembrane resting (RMP) and action potentials (AP) of isolated rabbit atrial and ventricular myocardium were studied at different stimulation rates. The frequency-dependent depression of the maximal upstroke velocity (Vmax) of the AP (sodium channel block) was analyzed according to the "guarded receptor" hypothesis. The resting block (Vmax depression after a resting period) induced by prajmaline (10(-6) M), quinidine (2.

Lethal myocarditis with atrioventricular block and ventricular tachycardia--a case report.

This case report details the acute clinical course and the follow-up of a 42-year-old woman with active recurring myocarditis, the main electrical features of which were atrioventricular block and ventricular tachycardia. It also focuses on immunohistological and serological parameters of autoreactivity that might explain the chronic clinical course over a period of 10 years.

Carotid arteries in central retinal vessel occlusion as assessed by Doppler ultrasound.

Doppler ultrasound was used to detect possible flow changes in the carotid arteries of patients with central retinal artery and vein occlusion. Twenty-three patients with central retinal artery occlusion (mean age 56, SD 11, years) were examined 4 to 48 months after the development of the occlusion and compared with age and sex matched control subjects with no history of any disease known to be associated with pathological changes in carotid vessels. Significant stenosis or occlusion of one or more carotid arteries was discovered in eight patients with retinal artery occlusion, while the ultrasonic findings were normal in all the controls (p less than 0.