ABSTRACT
UNLABELLED: Nitric oxide (NO) reduces platelet aggregation in vitro. However, repeated measurements of platelet aggregation in infants and small children are impossible due to the large blood samples required. Instead, the expression of different platelet receptors mediating platelet adhesion (CD 36 and CD 42b), activation (CD 42b and CD 61) and aggregation (CD 41a) was measured repeatedly by flow cytometry. First, the expression of platelet receptors was quantified in platelet suspensions of 20 healthy volunteers after incubation with different concentrations of NO (0, 25, 100 and 640 ppm) and compared to changes in platelet aggregation and intrathrombocytic cGMP levels. It was then studied in 21 infants and children before, during and up to 3 days after cardiopulmonary bypass surgery. Seven of these patients required NO inhalation postoperatively. The in vitro experiments showed a reduced expression of the CD 41a, CD 42b and CD 61 receptors with increasing doses of NO, predominantly affecting the CD 41a receptor (-11% at 100 ppm and -20% at 640 ppm). This significant effect is in keeping with the observed NO-induced inhibition of platelet aggregation (-44% at 100 ppm) and the rise in platelet cGMP levels (+69% at 100 ppm). In patients without inhaled NO, the expression of CD 41a was slightly attenuated during cardiopulmonary bypass surgery (-15%) but increased significantly afterwards (2 h: +31%, 1st day: +129%, 2nd day: +120%, 3rd day: +111%). Comparable results were obtained regarding the other adhesion molecules CD 36, CD 42b and CD 61. In patients with inhaled NO the same pattern was observed and analysis of variance did not reveal any significant difference between both groups of patients. CONCLUSIONS: NO (> or = 100 ppm) decreases the expression of different platelet adhesion molecules and platelet aggregation, presumably via an increase in intracellular cGMP. However, due to the low dose range used in the clinical setting (1-40 ppm) this is clinically not relevant. Immediately after cardiopulmonary bypass surgery the expression of these adhesion molecules is reduced, but recovers on the 1st postoperative day.
Subject(s)
Blood Platelets/drug effects , Cardiopulmonary Bypass , Heart Defects, Congenital/blood , Heart Defects, Congenital/therapy , Nitric Oxide/administration & dosage , Platelet Aggregation/drug effects , Administration, Inhalation , Analysis of Variance , Antigens, CD/drug effects , Child, Preschool , Dose-Response Relationship, Drug , Female , Flow Cytometry , Guanosine Monophosphate/analysis , Hemodynamics/drug effects , Hemodynamics/physiology , Humans , In Vitro Techniques , Infant , Male , Platelet Adhesiveness/drug effects , Platelet Aggregation Inhibitors/administration & dosage , Platelet CountABSTRACT
In 200 patients with upper abdominal complaints biopsy material was taken by fiberoptic endoscopy for histologic evaluation. Histology was normal in both the gastric fractions from fundus and antrum and from the duodenal mucosa in 53 cases. 36 Patients showed the histologic picture of duodenitis with leucocytic infiltrates of the villous stroma in the vicinity of erosions or ulcerations. In 28 cases duodenitis was found without such mucosal lesions, accompanying coexistent gastritis. This is, however, not a constant finding in patients with gastritis of either histologic type in either gastric region: 82 cases from all age groups had gastritis without accompanying duodenitis. In contrast to a good deal of the literature reports about duodenitis being a disease entity, we could not find but one case of isolated duodenitis without gastritis and/or duodenal mucosal lesions. Furthermore, there is no specific clinical symptomatology.
Subject(s)
Duodenal Diseases/pathology , Duodenal Diseases/complications , Duodenal Diseases/diagnosis , Enteritis/complications , Enteritis/diagnosis , Enteritis/pathology , Gastritis/complications , Gastritis/diagnosis , Gastritis/pathology , HumansABSTRACT
In an open controlled multicenter study the effectiveness of various dose levels of (+)-Cyanidanol-3 (Catergen) in patients suffering from chronic liver disease and treated over a period of 6 months is assessed. Subjective symptoms as fatigue, nausea, loss of appetite, vomiting and pruritus are positively influenced at all dose levels. A statistically significant fall of the transaminases SGOT, SGPT and gamma--GT however occurs only at a dosage of 6 tablets per day (3000 mg per day) of (+)-Cyanidanol-3, which cannot be demonstrated at a dose level of 3 X 1 tablet per day. Between the dosage of 2 X 3 or 3 X 2 tablets per day is no significant difference. Side effects due to therapy could not be observed.