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1.
Mar Pollut Bull ; 58(11): 1599-604, 2009 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-19828157

RESUMO

Radar is becoming an important tool used to gather data on bird and bat activity at proposed and existing land-based wind energy sites. Radar will likely play an even more important role at the increasing development of wind energy offshore, given both the lack of knowledge about bird and bat activity offshore and the increased difficulty in obtaining offshore information. Most radar studies to date have used off-the-shelf or modified marine radars. However, there are several issues that continue to hinder the potential usefulness of radar at wind energy sites, with offshore sites providing a particular suite of challenges. We identify these challenges along with current or developing solutions.


Assuntos
Aves , Monitoramento Ambiental/métodos , Geografia , Centrais Elétricas , Radar , Animais , Biodiversidade , Monitoramento Ambiental/instrumentação , Oceanos e Mares , Vento
2.
Osteoarthritis Cartilage ; 17(1): 73-82, 2009 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-18805027

RESUMO

OBJECTIVE: To examine the radial variations in engineered cartilage that may result due to radial fluid flow during dynamic compressive loading. This was done by evaluating the annuli and the central cores of the constructs separately. METHOD: Chondrocyte-seeded agarose hydrogels were grown in free-swelling and dynamic, unconfined loading cultures for 42 days. After mechanical testing, constructs were allowed to recover for 1-2h, the central 3mm cores removed, and the cores and annuli were retested separately. Histological and/or biochemical analyses for DNA, glycosaminoglycan (GAG), collagen, type I collagen, type II collagen, and elastin were performed. Multiple regression analysis was used to determine the correlation between the biochemical and material properties of the constructs. RESULTS: The cores and annuli of chondrocyte-seeded constructs did not exhibit significant differences in material properties and GAG content. Annuli possessed greater DNA and collagen content over time in culture than cores. Dynamic loading enhanced the material properties and GAG content of cores, annuli, and whole constructs relative to free-swelling controls, but it did not alter the radial variations compared to free-swelling culture. CONCLUSION: Surprisingly, the benefits of dynamic loading on tissue properties extended through the entire construct and did not result in radial variations as measured via the coring technique in this study. Nutrient transport limitations and the formation of a fibrous capsule on the periphery may explain the differences in DNA and collagen between cores and annuli. No differences in GAG distribution may be due to sufficient chemical signals and building blocks for GAG synthesis throughout the constructs.


Assuntos
Cartilagem Articular/citologia , Condrócitos/fisiologia , Engenharia Tecidual/métodos , Animais , Cartilagem Articular/metabolismo , Cartilagem Articular/fisiologia , Bovinos , Condrócitos/metabolismo , Colágeno/metabolismo , DNA/metabolismo , Imunofluorescência/métodos , Glicosaminoglicanos/metabolismo , Hidrogel de Polietilenoglicol-Dimetacrilato/química , Teste de Materiais/métodos , Mecanotransdução Celular/fisiologia , Sefarose/química , Estresse Mecânico
3.
Amino Acids ; 35(2): 433-8, 2008 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-17713744

RESUMO

Increased amino acid supplementation (0.5 x, 1.0 x, and 5.0 x recommended concentrations or additional proline) was hypothesized to increase the collagen content in engineered cartilage. No significant differences were found between groups in matrix content or dynamic modulus. Control constructs possessed the highest compressive Young's modulus on day 42. On day 42, compared to controls, decreased type II collagen was found with 0.5 x, 1.0 x, and 5.0 x supplementation and significantly increased DNA content found in 1.0 x and 5.0 x. No effects were observed on these measures with added proline. These results lead us to reject our hypothesis and indicate that the low collagen synthesis in engineered cartilage is not due to a limited supply of amino acids in media but may require a further stimulatory signal. The results of this study also highlight the impact that culture environment can play on the development of engineered cartilage.


Assuntos
Aminoácidos/administração & dosagem , Cartilagem/metabolismo , Meios de Cultura/química , Suplementos Nutricionais , Engenharia Tecidual , Animais , Cartilagem/citologia , Bovinos , Células Cultivadas , Colágeno Tipo II/biossíntese , DNA/análise
4.
J Leukoc Biol ; 70(2): 329-34, 2001 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-11493627

RESUMO

Lymphocyte function-associated antigen (LFA)-1/intercellular adhesion molecule (ICAM)-1 interactions mediate several important steps in the evolution of an immune response. LFA-1 is normally expressed in a quiescent state on the surface of leukocytes and interacts weakly with its ligands ICAM-1, -2, and -3. LFA-1 activity may be regulated by receptor clustering and by increasing the affinity of LFA-1 for its ligands. Affinity modulation of LFA-1 has been shown to occur via a conformational change in the LFA-1 heterodimer that can be detected by using monoclonal antibody 24 (mAb24). We have recently described a small-molecule antagonist of LFA-1, BIRT 377, that demonstrates selective in vitro and in vivo inhibition of LFA-1/ICAM-1-mediated binding events. We now demonstrate that BIRT 377 blocks the induction of the mAb24 reporter epitope on LFA-1 on the surface of SKW-3 cells treated with various agonists known to induce high-affinity LFA-1. These data imply that BIRT 377 exerts its inhibitory effects by preventing up-regulation of LFA-1 to its high-affinity conformation.


Assuntos
Imidazóis/farmacologia , Imidazolidinas , Antígeno-1 Associado à Função Linfocitária/efeitos dos fármacos , Regulação Alostérica , Adesão Celular , Relação Dose-Resposta a Droga , Epitopos/efeitos dos fármacos , Humanos , Imunossupressores/farmacologia , Molécula 1 de Adesão Intercelular/metabolismo , Antígeno-1 Associado à Função Linfocitária/química , Antígeno-1 Associado à Função Linfocitária/imunologia , Glicoproteínas de Membrana/química , Glicoproteínas de Membrana/efeitos dos fármacos , Glicoproteínas de Membrana/imunologia , Conformação Proteica/efeitos dos fármacos , Células Tumorais Cultivadas , Regulação para Cima/efeitos dos fármacos
5.
J Am Chem Soc ; 123(24): 5643-50, 2001 Jun 20.
Artigo em Inglês | MEDLINE | ID: mdl-11403595

RESUMO

The binding site on the lymphocyte function-associated antigen-1 (LFA-1) of a class of hydantoin-based antagonists of leukocyte cell adhesion has been identified. This site resides in the inserted-domain (I-domain) of the CD11a chain at a location that is distal to residues known to be required for interactions with the intercellular adhesion molecules. This finding supports the hypothesis that the molecules are antagonizing cell adhesion via an allosteric modification of LFA-1. The binding site was identified using an integrated immunochemical, chemical, and molecular modeling approach. Antibodies that map to epitopes on the I-domain were blocked from binding to the purified protein by the hydantoins, indicating that the hydantoin-binding site resides on the I-domain. Photoaffinity labeling of the I-domain followed by LC/MS and LC/MS/MS analysis of the enzymatic digest identified proline 281 as the primary amino acid residue covalently attached to the photoprobe. Distance constraints derived from this study coupled with known SAR considerations allowed for the construction of a molecular model of the I-domain/inhibitor complex. The atomic details of the protein/antagonist interaction were accurately predicted by this model, as subsequently confirmed by the X-ray crystal structure of the complex.


Assuntos
Hidantoínas/farmacologia , Antígeno-1 Associado à Função Linfocitária/efeitos dos fármacos , Sítio Alostérico , Anticorpos Monoclonais , Ligação Competitiva , Técnicas de Química Combinatória , Mapeamento de Epitopos , Humanos , Hidantoínas/síntese química , Hidantoínas/metabolismo , Molécula 1 de Adesão Intercelular/química , Molécula 1 de Adesão Intercelular/metabolismo , Antígeno-1 Associado à Função Linfocitária/imunologia , Antígeno-1 Associado à Função Linfocitária/metabolismo , Espectrometria de Massas , Modelos Moleculares , Marcadores de Fotoafinidade , Ligação Proteica , Estereoisomerismo , Relação Estrutura-Atividade
6.
Neuropsychobiology ; 42(4): 163-8, 2000.
Artigo em Inglês | MEDLINE | ID: mdl-11096329

RESUMO

The spontaneously hypertensive rat (SHR) has been used as an animal model of attention-deficit hyperactivity disorder (ADHD). This disorder, which is most prevalent in males during childhood, persists in adulthood more frequently in females. Since other work has shown that neonatal testosterone levels may be a contributing factor in the expression of ADHD-like behavior, the present study was designed to determine whether androgen levels also altered the neurobiology of adult SHRs compared to Wistar (WKY) controls. Males castrated on postnatal day 45 were implanted with testosterone, and the density of tyrosine-hydroxylase-immunoreactive (TH-ir) fibers (an indicator of catecholamine innervation) in the frontal cortex was compared between animals. The data show that testosterone-treated SHRs were associated with higher levels of TH immunoreactivity in the frontal cortex and hippocampus than WKY rats. These results may explain why high circulating levels of testosterone during adulthood do not support an increase in ADHD-like behavior in both the animal model and human males.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/metabolismo , Catecolaminas/fisiologia , Testosterona/fisiologia , Animais , Colesterol/sangue , Modelos Animais de Doenças , Imuno-Histoquímica , Masculino , Orquiectomia , Ratos , Ratos Endogâmicos SHR , Ratos Endogâmicos WKY , Testosterona/sangue , Tirosina 3-Mono-Oxigenase/metabolismo
7.
Behav Med ; 26(2): 67-73, 2000.
Artigo em Inglês | MEDLINE | ID: mdl-11147291

RESUMO

Assessments of cortisol levels in saliva have been widely used by both researchers and clinicians as an index of adrenal functioning. Quarterly measurements of morning and evening cortisol levels were determined in a longitudinal study of 147 participants (72 women and 75 men) followed for 1 year each. The analysis of salivary cortisol revealed no significant gender or age differences in the sample. There was a sequence effect in quarterly cortisol values with a progressive decrease in serial measurements, especially notable in the morning values; as well as a seasonal variation in cortisol levels with significantly higher levels found in winter and fall, compared with spring and summer. The findings in this study suggest that repeated saliva sampling and seasonal variation in cortisol levels may independently affect adrenal response and, therefore, need to be accounted for in longitudinal studies.


Assuntos
Hidrocortisona/metabolismo , Saliva/metabolismo , Estações do Ano , Adulto , Idoso , Nível de Alerta/fisiologia , Colesterol/sangue , Ritmo Circadiano/fisiologia , Feminino , Humanos , Sistema Hipotálamo-Hipofisário/fisiologia , Masculino , Pessoa de Meia-Idade , Sistema Hipófise-Suprarrenal/fisiologia , Valores de Referência
8.
J Immunol ; 163(10): 5173-7, 1999 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-10553036

RESUMO

LFA-1 (CD18,CD11a) is a cell-adhesion molecule that mediates critical immunological processes. In this paper we report the discovery and characterization of (R)-5-(4-bromobenzyl)-3-(3, 5-dichlorophenyl)-1,5-dimethylimidazolidine-2,4-dione (BIRT 377), an orally bioavailable small molecule that interacts specifically with LFA-1 via noncovalent binding to the CD11a chain and prevents LFA-1 from binding to its ligand, ICAM-1. BIRT 377 inhibits lymphocyte activity both in vitro and in vivo, in functional assays that require LFA-1-mediated cell adhesion. These results demonstrate that LFA-1-mediated leukocyte adhesion can be antagonized with noncharged, low m.w. molecules and suggest that the potential therapeutic value of adhesion inhibitors can be attained with a small, orally bioavailable compound.


Assuntos
Imidazóis/química , Imidazóis/farmacologia , Imidazolidinas , Imunossupressores/química , Imunossupressores/farmacologia , Antígeno-1 Associado à Função Linfocitária/fisiologia , Animais , Sítios de Ligação/efeitos dos fármacos , Sítios de Ligação/imunologia , Adesão Celular/efeitos dos fármacos , Adesão Celular/imunologia , Agregação Celular/efeitos dos fármacos , Agregação Celular/imunologia , Feminino , Humanos , Imidazóis/isolamento & purificação , Imidazóis/metabolismo , Imunossupressores/isolamento & purificação , Imunossupressores/metabolismo , Interleucina-2/antagonistas & inibidores , Interleucina-2/biossíntese , Teste de Inibição de Aderência Leucocítica , Antígeno-1 Associado à Função Linfocitária/metabolismo , Camundongos , Camundongos Endogâmicos BALB C , Peso Molecular , Ligação Proteica/efeitos dos fármacos , Ligação Proteica/imunologia , Relação Estrutura-Atividade , Células Tumorais Cultivadas
10.
Circulation ; 99(15): 1951-8, 1999 Apr 20.
Artigo em Inglês | MEDLINE | ID: mdl-10208997

RESUMO

BACKGROUND: Blockade of the platelet glycoprotein IIb/IIIa receptor with the monoclonal antibody fragment abciximab was shown in a placebo-controlled randomized trial to reduce the incidence of acute ischemic complications within 30 days among a broad spectrum of patients undergoing percutaneous coronary revascularization. The durability of clinical benefit in this setting has not been established. METHODS AND RESULTS: A total of 2792 patients enrolled in the Evaluation in PTCA to Improve Long-term Outcome with abciximab GP IIb/IIIa blockade (EPILOG) trial were followed with maintenance of double-blinding for 1 year. Patients had been assigned at the time of their index coronary interventional procedure to receive placebo with standard-dose, weight-adjusted heparin (100 U/kg initial bolus), abciximab with standard-dose, weight-adjusted heparin, or abciximab with low-dose, weight-adjusted heparin (70 U/kg initial bolus). The primary outcome was the composite of death, myocardial infarction, or urgent repeat revascularization by 30 days; this composite end point and its individual components were also assessed at 6 months and 1 year. Rates of any repeat revascularization (urgent or elective), target vessel revascularization, and a composite of death, myocardial infarction, or any repeat revascularization were also reported. Follow-up at 1 year was 99% complete for survival status and 97% complete for other end points. By 1 year, the incidence of the primary composite end point was 16.1% in the placebo group, 9.6% in the abciximab with low-dose heparin group (P<0.001), and 9.5% in the abciximab with standard-dose heparin group (P<0.001). Each of the components of this composite end point was reduced to a similar extent. Nonurgent or target vessel repeat revascularization rates were not significantly decreased by abciximab therapy. Mortality rates over 1 year increased with increasing levels of periprocedural creatine kinase MB fraction elevation. CONCLUSIONS: Acute reductions in ischemic events after percutaneous coronary intervention by abciximab are sustained over follow-up to at least 1 year. Early periprocedural myocardial infarctions suppressed by this therapy are associated with long-term mortality rates.


Assuntos
Angioplastia Coronária com Balão , Anticorpos Monoclonais/uso terapêutico , Doença das Coronárias/terapia , Fragmentos Fab das Imunoglobulinas/uso terapêutico , Isquemia Miocárdica/prevenção & controle , Inibidores da Agregação Plaquetária/uso terapêutico , Complexo Glicoproteico GPIIb-IIIa de Plaquetas/antagonistas & inibidores , Abciximab , Idoso , Angioplastia Coronária com Balão/estatística & dados numéricos , Biomarcadores , Causas de Morte , Terapia Combinada , Ponte de Artéria Coronária/estatística & dados numéricos , Doença das Coronárias/complicações , Doença das Coronárias/enzimologia , Creatina Quinase/sangue , Método Duplo-Cego , Quimioterapia Combinada , Emergências , Feminino , Seguimentos , Heparina/administração & dosagem , Heparina/uso terapêutico , Humanos , Incidência , Isoenzimas , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/mortalidade , Infarto do Miocárdio/prevenção & controle , Isquemia Miocárdica/mortalidade , Estudos Prospectivos , Recidiva , Análise de Sobrevida , Resultado do Tratamento
11.
J Am Coll Cardiol ; 32(5): 1312-9, 1998 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-9809941

RESUMO

OBJECTIVES: The purpose of this study was to evaluate the importance of time to reperfusion for outcomes after primary angioplasty for acute myocardial infarction. BACKGROUND: Survival benefit of thrombolytic therapy for acute myocardial infarction is strongly dependent on time to treatment. Recent observations suggest that time to treatment may be less important for survival with primary angioplasty. METHODS: Consecutive patients (n=1,352) with acute myocardial infarction treated with primary angioplasty were followed for up to 13 years. Paired acute and follow-up ejection fraction data were obtained at cardiac catheterization in 606 patients. RESULTS: Reperfusion was achieved within 2 h in 164 patients (12%). Thirty-day mortality was lowest with early reperfusion (4.3% at <2 h vs. 9.2% at > or = 2 h, p=0.04) and was relatively independent of time to reperfusion after 2 h (9.0% at 2 to 4 h, 9.3% at 4 to 6 h, 9.5% at >6 h). Thirty-day-plus late cardiac mortality was also lowest with early reperfusion (9.1% at <2 h vs. 16.3% at > or = 2 h, p=0.02) and relatively independent at time to reperfusion after 2 h (16.4% at 2 to 4 h, 16.9% at 4 to 6 h, 15.6% at >6 h). Improvement in left ventricular ejection fraction was greatest in the early reperfusion group and relatively modest after 2 h (6.9% at <2 h vs. 3.1% at > or =2 h, p=0.007). CONCLUSIONS: Time to reperfusion, up to 2 h, is important for survival and recovery of left ventricular function. After 2 h, recovery of left ventricular function is modest and survival is relatively independent of time to reperfusion. These data suggest that factors other than myocardial salvage may be responsible for survival benefit in patients treated with primary angioplasty after 2 h.


Assuntos
Angioplastia Coronária com Balão , Infarto do Miocárdio/mortalidade , Infarto do Miocárdio/terapia , Reperfusão Miocárdica/métodos , Função Ventricular Esquerda/fisiologia , Idoso , Aspirina/uso terapêutico , Cateterismo Cardíaco , Causas de Morte , Angiografia Coronária , Quimioterapia Combinada , Eletrocardiografia , Feminino , Fibrinolíticos/uso terapêutico , Seguimentos , Heparina/uso terapêutico , Humanos , Masculino , Infarto do Miocárdio/fisiopatologia , Estudos Retrospectivos , Volume Sistólico , Taxa de Sobrevida , Terapia Trombolítica , Fatores de Tempo
12.
Am J Cardiol ; 82(1): 7-12, 1998 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-9671000

RESUMO

We determined the efficacy of abciximab, a platelet glycoprotein IIb/IIIa receptor antagonist, combined with low-dose weight-adjusted heparin in reducing ischemic complications in patients undergoing directional coronary atherectomy (DCA). The Evaluation of IIb/IIIa platelet receptor antagonist 7E3 in Preventing Ischemic Complications (EPIC) trial demonstrated a reduction in the incidence of non-Q-wave myocardial infarction in DCA patients who were treated with abciximab bolus and infusion plus heparin. This benefit, however, was associated with increased bleeding complications. Of the 2,792 patients who had coronary intervention in the Evaluation of PTCA to Improve Long-term Outcome by c7E3 GP IIb/IIIa receptor blockade (EPILOG) trial, 144 (5%) underwent DCA. Patients were randomly assigned to 3 treatment groups: placebo with standard-dose, weight-adjusted heparin; abciximab with low-dose weight-adjusted heparin; or abciximab with standard-dose weight-adjusted heparin. Study end points included 30-day and 6-month composite incidence of death, myocardial infarction, or revascularization. Compared with those undergoing percutaneous transluminal coronary angioplasty (PTCA), DCA patients had a higher rate of myocardial infarction (11.1 % vs 4.9%, p = 0.001) and predominantly non-Q-wave myocardial infarction (9.7% vs 4.4%, p = 0.004). Abciximab was associated with a 57% lower combined rate of death, myocardial infarction, or urgent revascularization within 30 days following DCA (20% placebo vs 8.7% abciximab with low-dose heparin) without excess risk of bleeding complications. A combined analysis of data from the EPIC and EPILOG trials demonstrates a reduction in the rate of death or myocardial infarction (19.9% vs 8.4%, p = 0.008) at 30 days that was sustained for up to 6 months in the abciximab-treated patients. These findings support the premise that non-Q-wave myocardial infarction in DCA patients are platelet mediated.


Assuntos
Anticorpos Monoclonais/uso terapêutico , Aterectomia Coronária/efeitos adversos , Fragmentos Fab das Imunoglobulinas/uso terapêutico , Isquemia Miocárdica/tratamento farmacológico , Inibidores da Agregação Plaquetária/uso terapêutico , Abciximab , Idoso , Anticoagulantes/uso terapêutico , Método Duplo-Cego , Quimioterapia Combinada , Feminino , Heparina/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Isquemia Miocárdica/etiologia , Complexo Glicoproteico GPIIb-IIIa de Plaquetas/metabolismo , Fatores de Tempo , Resultado do Tratamento
14.
Am J Cardiol ; 79(12): 1586-91, 1997 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-9202345

RESUMO

We reviewed the timing and mechanism of death in 1,184 consecutive patients with acute myocardial infarction (AMI) treated with primary angioplasty from 1984 to 1995. Of 98 deaths, 48 (49%) occurred early on day 0 or 1. The mechanisms of death were pump failure in 60 patients (61%), reinfarction in 7 patients (7.1%), left ventricular rupture in 5 patients (5.1%), arrhythmia in 3 patients (3.1%), other cardiac causes in 5 patients (5.1%), stroke in 6 patients (6.1%), anoxic encephalopathy in 7 patients (7.1%), and procedure-related deaths in 5 patients (5.1%). The strongest predictors of mortality were cardiogenic shock and unsuccessful reperfusion. Our data indicate that mortality after primary angioplasty, like thrombolytic therapy, is highest in the early hours and is usually due to pump failure. In contrast to thrombolytic therapy, the incidence of death from myocardial rupture and bleeding complications is low. Future treatment strategies will need to focus on the large number of patients with early death due to pump failure, especially patients with cardiogenic shock.


Assuntos
Angioplastia Coronária com Balão , Infarto do Miocárdio/mortalidade , Infarto do Miocárdio/terapia , Idoso , Constrição Patológica , Feminino , Mortalidade Hospitalar , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/patologia , Análise de Sobrevida , Fatores de Tempo
15.
J Med Chem ; 40(6): 980-9, 1997 Mar 14.
Artigo em Inglês | MEDLINE | ID: mdl-9083488

RESUMO

Meloxicam (5), an NSAID in the enol-carboxamide class, was developed on the basis of its antiinflammatory activity and relative safety in animal models. In subsequent screening in microsomal assays using human COX-1 and COX-2, we discovered that it possessed a selectivity profile for COX-2 superior to piroxicam and other marketed NSAIDs. We therefore embarked on a study of enol-carboxamide type compounds to determine if COX-2 selectivity and potency could be dramatically improved by structural modification. Substitution at the 6- and 7-positions of the 4-oxo-1,2-benzothiazine-3-carboxamide, alteration of the N-methyl substituent, and amide modification were all examined. In addition we explored several related systems including the isomeric 3-oxo-1,2-benzothiazine-4-carboxamides, thienothiazines, indolothizines, benzothienothiazines, naphthothiazines, and 1,3- and 1,4-dioxoisoquinolines. While a few examples were found with greater potency in the COX-2 assay, no compound tested had a better COX-2/COX-1 selectivity profile than that of 5.


Assuntos
Anti-Inflamatórios não Esteroides/química , Anti-Inflamatórios não Esteroides/farmacologia , Inibidores de Ciclo-Oxigenase/química , Inibidores de Ciclo-Oxigenase/farmacologia , Isoenzimas/metabolismo , Prostaglandina-Endoperóxido Sintases/metabolismo , Tiazinas/farmacologia , Tiazóis/farmacologia , Ciclo-Oxigenase 1 , Ciclo-Oxigenase 2 , Inibidores de Ciclo-Oxigenase 2 , Inibidores de Ciclo-Oxigenase/síntese química , Humanos , Espectroscopia de Ressonância Magnética , Meloxicam , Proteínas de Membrana , Estrutura Molecular , Proteínas Recombinantes/metabolismo , Relação Estrutura-Atividade , Especificidade por Substrato , Tiazinas/química , Tiazóis/síntese química , Tiazóis/química
16.
J Am Coll Cardiol ; 28(2): 319-25, 1996 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-8800104

RESUMO

OBJECTIVES: The purpose of this study was to evaluate the importance of late infarct-related artery patency for recovery of left ventricular function and late survival after primary angio-plasty for acute myocardial infarction. BACKGROUND: Infarct-related artery patency is thought to improve late survival by its effect on preservation of left ventricular function. Patency may also enhance late survival by preventing left ventricular dilation and reducing arrhythmias, independent of myocardial salvage. However, most studies have not shown patency to be an independent predictor of survival when late left ventricular function is taken into account. METHODS: We followed up 576 hospital survivors of acute myocardial infarction treated with primary angioplasty for 5.3 years. Ejection fraction and infarct-related artery patency were determined at follow-up catheterization at 6 months. Predictors of late cardiac survival were determined using Cox regression models. RESULTS: Patients with patent arteries had more improvement and a better late ejection fraction than patients with occluded arteries (56.3% vs. 47.9%, p = 0.001). In patients with acute ejection fraction < 45%, late survival was better in those with patent versus occluded arteries (89% vs. 44%, p = 0.003), but patency was not a significant predictor after improvement in ejection fraction was taken into account. In patients with a large anterior infarction, patency was a significant independent predictor of late survival. CONCLUSIONS: Infarct-related artery patency is important for recovery of left ventricular function, and in patients with acute ejection fraction < 45%, patency is important for late survival. Our data are consistent with the hypothesis that the survival benefit is due primarily to the effect of patency on recovery of left ventricular function. In patients with a large anterior infarction, patency appears to provide an additional late survival benefit independent of myocardial salvage. These observations support the need for additional clinical trials of late reperfusion in patients with a large anterior infarction.


Assuntos
Angioplastia Coronária com Balão , Vasos Coronários/fisiopatologia , Infarto do Miocárdio/mortalidade , Infarto do Miocárdio/terapia , Função Ventricular Esquerda/fisiologia , Cateterismo Cardíaco , Estudos de Casos e Controles , Angiografia Coronária , Eletrocardiografia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/fisiopatologia , Modelos de Riscos Proporcionais , Estudos Prospectivos , Análise de Sobrevida , Fatores de Tempo , Grau de Desobstrução Vascular/fisiologia
17.
J Med Chem ; 39(10): 2087-94, 1996 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-8642568

RESUMO

A series of prolineboronic acid (boroPro) containing dipeptides were synthesized and assayed for their ability to inhibit the serine protease dipeptidyl peptidase IV (DPPIV). Inhibitory activity, which requires the (R)-stereoisomer of boroPro in the P1 position, appears to tolerate a variety of L-amino acids in the P2 position. Substitution at the P2 position which is not tolerated include the D-amino acids, alpha,alpha-disubstituted amino acids, and glycine. Specificity against DPPII and proline specific endopeptidase is reported. A correlation between the ability to inhibit DPPIV in cell culture and in the human mixed lymphocyte reaction is demonstrated. A synthesis of prolineboronic acid is reported as well as conditions for generating the fully unprotected boronic acid dipeptides in either their cyclic or acyclic forms.


Assuntos
Ácidos Borônicos/química , Ácidos Borônicos/farmacologia , Dipeptidil Peptidases e Tripeptidil Peptidases/antagonistas & inibidores , Inibidores Enzimáticos/química , Inibidores Enzimáticos/farmacologia , Humanos , Teste de Cultura Mista de Linfócitos , Espectroscopia de Ressonância Magnética , Espectrometria de Massas , Estereoisomerismo , Relação Estrutura-Atividade
18.
J Med Chem ; 38(24): 4830-8, 1995 Nov 24.
Artigo em Inglês | MEDLINE | ID: mdl-7490732

RESUMO

The major cause of viral resistance to the potent human immunodeficiency virus type 1 reverse transcriptase (RT) inhibitor nevirapine is the mutation substituting cysteine for tyrosine-181 in RT (Y181C RT). An evaluation, against Y181C RT, of previously described analogs of nevirapine revealed that the 2-chlorodipyridodiazepinone 16 is an effective inhibitor of this mutant enzyme. The detailed examination of the structure-activity relationship of 2-substituted dipyridodiazepinones presented below shows that combined activity against the wild-type and Y181C enzymes is achieved with aryl substituents at the 2-position of the tricyclic ring system. In addition, the substitution pattern at C-4, N-5, and N-11 of the dipyridodiazepinone ring system optimum for inhibition of both wild-type and Y181C RT is no longer the 4-methyl-11-cyclopropyl substitution preferred against the wild-type enzyme but rather the 5-methyl-11-ethyl (or 11-cyclopropyl) pattern. The more potent 2-substituted dipyridodiazepinones were evaluated against mutant RT enzymes (L100I RT, K103N RT, P236L RT, and E138K RT) that confer resistance to other non-nucleoside RT inhibitors, and compounds 42, 62, and 67, with pyrrolyl, aminophenyl, and aminopyridyl substituents, respectively, at the 2-position, were found to be effective inhibitors of these mutant enzymes also.


Assuntos
Piridinas/química , Inibidores da Transcriptase Reversa/química , Linhagem Celular , HIV-1 , Humanos , Estrutura Molecular , Nevirapina , Piridinas/farmacologia , Inibidores da Transcriptase Reversa/farmacologia , Relação Estrutura-Atividade
19.
J Med Chem ; 38(24): 4839-47, 1995 Nov 24.
Artigo em Inglês | MEDLINE | ID: mdl-7490733

RESUMO

Molecular modeling analysis of the recently published X-ray crystal structure of nevirapine bound to wild type human immunodeficiency virus type 1 reverse transcriptase (WT-RT) indicated the presence of a lipophilic cavity proximal to the 4-position of the inhibitor. A series of 4-substituted derivatives of nevirapine were thus synthesized to assess structure-activity relationships (SARs) and to see if increased binding to this region might translate into greater activity against mutant RTs. The results show that compounds with an appropriately spaced aryl ring appended to the 4-position of the dipyridodiazepinone ring system show good activity against WT-RT. Furthermore certain derivatives appear to inhibit the Y181C mutant RT. Attempts to combine these results with the recent discovery that 2-substituents enhance activity against the Y181C mutant led to a few compounds with moderate activity against both enzymes. The SAR of these two positions, however, could not be combined in a simple fashion.


Assuntos
Piridinas/química , Inibidores da Transcriptase Reversa/química , HIV-1 , Humanos , Modelos Moleculares , Conformação Molecular , Nevirapina , Piridinas/síntese química , Inibidores da Transcriptase Reversa/síntese química , Relação Estrutura-Atividade
20.
Am J Cardiol ; 74(6): 538-43, 1994 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-8074034

RESUMO

The benefit of thrombolytic therapy given late after the onset of acute myocardial infarction (AMI) has been controversial because of low reperfusion rates and limited myocardial salvage. Persistent chest pain has been used as a criteria for late intervention, but there is little documentation to validate this practice. Clinical outcomes and myocardial salvage were evaluated in 74 patients with AMI and persistent chest pain who underwent late reperfusion (> 6 hours) with direct coronary angioplasty, and these were compared with outcomes in 460 patients with early reperfusion (< or = 6 hours). Patients with late reperfusion had a high infarct artery patency rate (96%), a low hospital mortality rate (5.4%), and a low incidence of reinfarction (1.4%) and recurrent ischemia that were similar to patients with early reperfusion. Patients with late reperfusion had surprisingly good recovery of left ventricular function with improvement in ejection fraction from 50% to 60% at follow-up angiography. Patients with late reperfusion had a greater incidence of collateral flow (45% vs 22%, p < 0.001) and a lower value of peak creatine kinase (1,357 vs 2,057 U/liter, p < 0.001) than patients with early reperfusion. This study emphasizes the importance of persistent chest pain as a marker of continued myocardial viability in patients who present late after AMI. These data suggest that the probable mechanism of continued viability is preserved flow to the infarct zone. Patients with AMI and persistent chest pain may benefit from reperfusion therapy beyond 6 to 12 hours.


Assuntos
Angina Pectoris/terapia , Angioplastia Coronária com Balão , Infarto do Miocárdio/terapia , Idoso , Angina Pectoris/mortalidade , Angina Pectoris/fisiopatologia , Distribuição de Qui-Quadrado , Fatores de Confusão Epidemiológicos , Feminino , Mortalidade Hospitalar , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/mortalidade , Infarto do Miocárdio/fisiopatologia , Recidiva , Estudos Retrospectivos , Fatores de Tempo , Resultado do Tratamento , Grau de Desobstrução Vascular , Função Ventricular Esquerda
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