Patterns of creatine kinase release during acute myocardial infarction after nonsurgical reperfusion: comparison with conventional treatment and correlation with infarct size.

Coronary arteriography and biplane ventriculography were performed in 51 patients during the acute (mean of 6.6 hours after onset of symptoms) and chronic (1 to 3 months after admission) phase of myocardial infarction. Twenty-four patients were treated in a conventional manner. In 27 patients, reperfusion was achieved with intracoronary streptokinase after 24 +/- 20 minutes of infusion. Peak creatine kinase and cumulative creatine kinase release were derived from serial creatine kinase measurements. Ejection fraction and the length of the akinetic or dyskinetic segments were calculated in the chronic phase. The time interval between onset of symptoms and peak creatine kinase was significantly shorter for the streptokinase-treated patients as compared with the conventionally treated patients (13.5 +/- 5.3 versus 22.9 +/- 7.4 hours, p = 0.0001). Significant linear correlations were obtained for both streptokinase-treated and control patients, relating: 1) peak creatine kinase value to both length of the noncontracting segment and ejection fraction in the chronic phase, and 2) cumulative creatine kinase release to both length of the noncontracting segment and ejection fraction in the chronic phase. Patients treated with streptokinase experienced a relatively greater release of enzyme for a given infarct size as compared with those treated in a conventional manner. The difference in enzyme release between the two groups increased as infarct size increased. These observations may be explained by enhanced washout of enzyme from the infarct zone, secondary to reperfusion after intracoronary streptokinase therapy.(ABSTRACT TRUNCATED AT 250 WORDS)

Therapeutic in vivo and in vitro effects of argon dye laser and hematoporphyrin derivative in lung cancer.

In clinical and experimental study the therapeutic efficacy of argon dye laser irradiation with hematoporphyrin derivative (HpD) was evaluated in lung cancer. A total of 14 lung cancer cases including 12 squamous cell, 1 adeno- and 1 small cell carcinomas were irradiated superficially 48 hours or more after i.v. injection of 3 mg/kg of HpD (100-300 mW, 20-30 min.). Human adenocarcinoma cells implanted subcutaneously into nude mice were photoirradiated (200 mW, 20 min.) 48 h after i.p. injection of HpD. The in vitro effect of phototherapy was studied in the same cell line after incubation in medium containing HpD compared to untreated, only irradiated or only in HpD incubated cells. Among 3 early stage squamous cell carcinoma cases 2 complete and 1 partial remissions were obtained. Among 11 cases including 10 with advanced and 1 with recurrent disease 7 demonstrated partial remission. In vivo, two of 9 mice had a complete tumor remission. In the in vitro study, tumor cells incubated in 30 micrograms HpD/ml showed severe cytotoxic effects resulting in cell death 12 hours after photo irradiation, whereas cells incubated in 30 micrograms HpD/ml only regenerated after initial cytotoxic reaction. Laser irradiation only had no effects. HpD phototherapy demonstrated a considerable antitumor efficacy and must be considered as one of the promising endoscopic treatments in cases with early stage primary lung cancer.