Influence of local peripheral temporary ischaemia on biochemical and histological effects in small intestine and serum of rats following abdominal irradiation.

The local temporary ischaemia effect on radiation-induced lipid peroxidation, superoxide dismutase isoenzyme activities, and intestinal crypt number was estimated in male WAG-strain rats in vivo. The animals were irradiated in the abdomen area with doses of 2 Gy for ten consecutive days using a Philips 60Co source. The calculated dose rate was 0.595 Gy/min. Local temporary ischaemia was induced by clamping the tail base before each irradiation. The parameters evaluated were: TBA-RS level and enzymatic activities of CuZnSOD, MnSOD in serum and jejunum. The number of jejunum crypts was assigned as a histopathologic parameter. The results showed a clear protection by ischaemic preconditioning for crypt survival. The difference in the number of crypts in irradiated animals with and without local temporary ischaemia was statistically significant (Student's t-test P < 0.05). Also, significant enhancement of TBA-RS was observed in the serum of irradiated animals. Local temporary ischaemia application diminished the concentration of radiation- induced TBA-RS. The differences in the levels of TBA-RS in the serum were statistically significant (ANOVA P < 0.002). In contrast, there was no evident effect on the level of TBA-RS in tissue homogenates in any investigated groups. Some fluctuation of CuZnSOD isoenzyme activity in intestinal tissue was noted; however, the differences were not significant. Local temporary ischaemia had no influence on Mn- SOD activity in serum, and in both irradiated groups the behaviour of this isoenzyme was similar. Also, there were no differences in MnSOD activity measured in tissue homogenates. These findings support results of our previous in vivo studies, suggesting that local temporary ischaemia can prevent oxidative effects of fractionated radiotherapy.

Cardiac and regional haemodynamic effects of endothelin-1 in rats subjected to critical haemorrhagic hypotension.

In the present study, we examined cardiac and regional haemodynamic effects of endothelin-1 (ET-1), a potent vasoconstrictive factor, in a rat model of pressure-controlled irreversible haemorrhagic shock resulting in the death of all control animals within 30 min. Experiments were carried out in male ethylurethane-anaesthetised Wistar rats subjected to hypotension of 20-25 mmHg, which resulted in bradycardia, an extreme decrease in cardiac index (CI) and an increase in total peripheral resistance index (TPRI), with reductions in renal (RBF), hindquarters (HBF) and mesenteric blood flow (MBF). ET-1 (50, 200 pmol/kg) administered intravenously at 5 min of critical hypotension produced increases in mean arterial pressure (MAP) and heart rate (HR), which were significantly higher than those in normotensive animals, and a 100% survival at 2 h after treatment. The effects were accompanied by a rise in CI, a decrease in TPRI, with increases in RBF and HBF and persistently lowered MBF, and an increase in circulating blood volume 20 min after treatment. The cardiovascular effects of ET-1 were inhibited by the ETA receptor antagonist BQ-123 (1 mg/kg), while the ETB receptor antagonist BQ-788 (3 mg/kg) had no effect. In conclusion, ET-1 acting via ETA receptors produces reversal of haemorrhagic hypotension in rats due to the mobilisation of blood from venous reservoirs, with the improvements in cardiac function and the perfusion of peripheral tissues.

Inhibitory effect of local ischemic preconditioning on gamma ray-induced lipid peroxidation in rats: a preliminary study.

We examined the effect of local ischemic preconditioning on postradiation lipid peroxidation in the serum of total body irradiated rats. Markers of peroxidative damage provoked by radiation alone or radiation preceeded by ischemic preconditioning were thiobarbituric acid reactive substances, triglycerides and uric acid concentrations in serum. These data indicated that local ischemic preconditioning modifies the peroxidizing effects of radiation through inhibition of free radical-dependent lipid peroxidation. Other unrecognized mechanisms are probably also involved. Uric acid could act as an antioxidant against radiation alone and local preconditioned ischemia together with radiation.

[Statistical analysis of decision making in the treatment in two-vessel coronary artery disease]. / Statystyczna analiza wyboru sposobu leczenia w dwunaczyniowej chorobie wiencowej.

The objective of this paper was to analyze the choice of treatment in two-vessel coronary artery disease and to evaluate the effectiveness of the chosen treatment. The data of sixty-five patients with two-vessel coronary artery disease was analyzed. Two-vessel coronary artery disease was recognized when critical stenoses were present in two arteries with a diameter no less than 2 mm across. Patients who had a CABG were excluded. Patients were divided into three groups according to their treatment: those treated with CABG (29 patients), those treated with coronary angioplasty (20 patients), and those treated conservatively (16 patients). The mean follow-up was 29.3 months (12-48 mo). There were two groups of data collected. The first group consisted of data which might have influenced the decision-making and state of the patients after they had been introduced to the selected treatment. The second group consisted of data necessary to evaluate the state of the patients during the follow-up period. The statistical analysis was divided into three stages. In the first stage, clinical data connected to the selected treatments was studied. In the second, the effects of the chosen treatment were examined. During the third stage of analysis, variables which influenced the effectiveness of the specific treatment were evaluated. Decision-making in patients with two-vessel coronary artery disease depended on the co-existence of hypertension, diabetes, lower-limb ischemia and earlier-performed coronary angioplasty. The only statistically important angiographic feature was the condition of the proximal LAD. Objective improvements in the states of patients (evaluated by exercise tests) were frequently connected to CABG treatment. Subjective improvements in the states of patients were more often connected to conservative treatment. Elevated cholesterol levels were connected to the progression of the disease both in those treated conservatively and interventionally.

[Use of radiotherapy in treatment of painful scapula-humeral periarthritis]. / Zastosowanie radioterapii w leczeniu zespolów bólowych barków.

In 10 cases of painful scapulo-humeral periarthritis radiotherapy was used. In all cases conventional anti-inflammatory treatment was unsuccessful or impossible to deliver. Patients were treated using gamma 60Co radiation and 6 Gy was delivered in 1 Gy fractions over 8 days. The average degree of pain relief and improvement of limb mobility was assessed after radiotherapy completion, 1 week, 7 weeks after treatment and at final-up. The degree of pain relief was respectively 27%, 72%, 85% and 93%. Significant improvement of limb mobility was noted in all cases. Obtained results allow to conclude that anti-inflammatory radiotherapy is an effective treatment of painful scapulo-humeral periarthritis.

Statistical dependence of clinical data on the chosen treatment of patients with a multivessel coronary artery disease.

BACKGROUND: In this study we tried to check which clinical data are connected with the choice of treatment in patients with a multivessel coronary artery disease. MATERIAL AND METHODS: The data of 137 patients with a multivessel coronary artery disease, were analysed retrospectively. The patients were divided into three groups: treated conservatively, CABG and PTCA. Multivessel coronary artery disease was recognised when there were atherosclerotic changes in more a 2 vessels with a not less a 2 mm in diameter. Patients with previous CABG or a left main coronary artery disease were excluded. The data were analysed by means of several methods, variance analysis, correlation analysis, discriminant functions, chi-square test and T-Student test. RESULTS: For treatment decision making in multivessel coronary artery disease of statistical significance were: the state of the left anterior descendent artery below the first diagonal branch, the state of the first diagonal branch and peripheral parts of the left anterior descendent artery and right coronary artery, the systolic function of the antero-lateral, apical and phrenic segments of the left ventricle, the global left ventricular ejection fraction in angiography and echocardiography, local systolic disturbances of the left ventricular observed in echocardiography, the coexistence of symptoms of heart failure as well as unstable angina. CONCLUSION: Treatment decision making will always depend not only on diagnostic procedures but also on all the clinical data about the patient and the experience of coworking cardiology and surgery centres.

[Results of promoting fibrinolytic therapy for myocardial infarction in the Katowice Province from 1996-1998]. / Wyniki akcji promujacej leczenie fibrynolityczne zawalu serca na terenie województwa katowickiego w latach 1996-1998.

The action promoting fibrinolytic treatment of myocardial infarction and questionnaire-based follow up of the results was carried out over a four million people area. 5262 questionnaires, in which physicians answered a number of questions, were received. The poll revealed that 79% of patients received fibrinolytic treatment. The authors estimate the overall percent of patients, treated in hospital wards, at about 27.7%. The mortality rate in the group of patients, who received streptokinase, was 8.61% and in the group of patients, who did not receive the treatment, was 16.28%. The signs of reperfusion were present in 60.38% of patients. The authors conclude that the increase in the number of patients administered fibrinolytic treatment should be aimed, and the results obtained in this group of patients come close to published data. Exercise tests are performed in too small number of myocardial infarction patients and only little proportion of them undergoes further coronary angiography.

[Use of fourier row as a method for analyzing the course of circadian heart rate in patients with left ventricular ejection fraction impairment]. / Zastosowanie szeregu Fouriera do analizy dobowego przebiegu akcji serca u pacjentów z uposledzeniem frakcji wyrzutowej lewej komory serca.

The circadian heart rate course was assessed in 3 groups of patients with left ventricular ejection fraction (LVEF) 10-15%, 20-25% and 30-35%. The study comprised 36 persons. In 9 patients heart failure was due to MI and in 17--to dilated cardiomyopathy. Those with atrial fibrillation, ventricular tachycardia, supraventricular tachycardia, diabetes, valvular heart diseases and with central system disorders were excluded from the study. Left ventricular ejection fraction was evaluated by echocardiography. Heart rate, calculated as a mean value every 5 minutes, was taken in patients during 24 hour recordings. For each patient separately, mean value of all measurement was calculated. Then a ratio of each actual value to the mean value was calculated. This ratio was defined as relative heart rate; [formula: see text] Circadian heart rate courses were approximated by Fourier row: [formula: see text]. The 24 harmonics were analyzed. Statistically significant differences in circadian courses were closed to amplitudes of 1st, 12th, 13th, 14th, 16th, 18th harmonics. Using test of variance homogeneity it has been demonstrated that variability of amplitudes of 12th and 17th harmonics as well as phase of 5th harmonic depend on left ventricular ejection fraction.

[Equivalent occlusion of the left main coronary artery--case report]. / Ekwiwalent niedroznosci pnia lewej tetnicy wiencowej--opis przypadków.

In the paper two cases are described of patients in whom during angiography coexistent occlusion of the left descending artery and left circumflex artery was found. ECG and echocardiography in both cases were not indicating such a high coronary vessel defect. In both patients angiography was performed leading in one case to development of shock with fatal outcome.

[Analysis of usefulness for quantitative methods determining segmental mobility in assessing contrast ventriculography of the left ventricle]. / Analiza przydatnosci ilosciowych metod wyznaczania ruchomosci odcinkowej dla oceny wentrykulogramów kontrastowych lewej komory.

The aim of this study was to compare two different quantitative methods used to determine left ventricular regional wall motions. Circumferential and radial methods were used to distinguish between normo- and hypokinesia of the 5 segments proposed by AHA for RAO position. One hundred ventriculograms were analyzed. Fifty cases with normal wall motion and ejection fraction greater than 55% were chosen as a base to enumerate normokinetic values of regional contractility. The other fifty cases represented hypokinesia of different segments. Respective values for the radial method were 61.42 vs 38.10 for antero-basal segment, 73.8 vs 58.5 for antero-lateral segment, 67.74 vs 42.5 for apical segment, 69.88 vs 47.70 for postero-lateral segment and 41.72 vs 33.4 for postero-lateral segment. The values obtained with the circumferential method were 12.27 vs 10.21, 20.06 vs 16.21, 22.19 vs 18.78, 17.08 vs 11.39 and 8.50 vs 8.15, respectively. These results suggest that the radical method allows to better differentiate between hypo- and normokinesia. Postero-basal segment proved to be most difficult to assess. Both methods fail to make a clear distinction in these cases.

[Level of copper in plasma and tissue of patients with esophageal and large bowel cancer]. / Poziom miedzi w osoczu i tkankach chorych z rakiem przelyku i rakiem jelita grubego.

Using the technique of atomic absorption spectrophotometry copper level was determined in cancerous tissues and in unchanged homologous tissues and in the plasma of 32 patients with digestive tract cancer (17 patients with squamous oesophageal cancer and 15 with large bowel adenocarcinoma). For examination the tissues were used, removed during operation. In the control group plasma copper concentration was determined. The purpose of the work was to establish whether the increased metabolism of cancerous tissue caused cumulation of copper in cancerous cells (as it was found in cases of many other microelements), and whether it caused a significant fluctuation of plasma copper level. It was found that in patients with large bowel cancer and oesophageal cancer the mean copper concentration in cancerous tissues was lower than that in unchanged homologous tissue. It was also found that the plasma copper level in patients with cancer was not differing from normal values.