Hoveyda-Grubbs catalyst analogues bearing the derivatives of N-phenylpyrrol in the carbene ligand - structure, stability, activity and unique ruthenium-phenyl interactions.

We have synthesized a series of N-phenylpyrrole and N-phenylindole carbenes and used them as ruthenium-ligating moieties in the synthesis of Hoveyda-Grubbs catalyst derivatives. We show that most of these complexes are difficult to synthesize and unstable apart from the N-phenylpyrrole-2,6-diisopropylphenyl ruthenium complex and its perbrominated derivative. These two systems are almost completely inactive in ring-closing metathesis at room temperature and become active only at 80 °C. DFT, SAPT0 and DLPNO-CCSD(T) calculations suggest that the rarely occurring phenyl-ruthenium interactions are responsible for the very slow initiation of these precatalysts at low temperatures.

The influence of CYP2D6 polymorphism on the antiarrhythmic efficacy of propafenone in patients with paroxysmal atrial fibrillation during 3 months propafenone prophylactic treatment.

OBJECTIVE: Propafenone (PPF) is an antiarrhythmic, Class Ic agent. Its metabolism is genetically controlled by a cytochrome P450 isoenzyme named CYP2D6, which shows polymorphism in human population. The aim of this paper was to determine the correlation between the antiarrhythmic efficacy of PPF and the oxidation phenotype. SUBJECTS AND MATERIAL: The study group consisted of 42 patients, aged 36 to 75 years, suffering from paroxysmal atrial fibrillation (AF). The oxidation phenotype was described by the metabolic ratio (MR) of sparteine. The MR value separated the group of poor metabolizers (MR > 20) from the group of extensive metabolizers (MR < 20) with the subgroup of very extensive metabolizers (MR < 1). METHOD: The study was conducted during a 3-month PPF therapy for the prophylaxis of paroxysmal atrial fibrillation. PPF was given orally, 300-450 mg/day. The oxidation phenotype was checked prior to the administration of PPF. Serum concentration of PPF at 7, 11 days and the end of PPF therapy were determined. Statistical analysis of data was performed with the chi2 test and the Pearson's correlation methods. RESULTS: In the group of 42 patients, PPF therapy was 100% effective in poor metabolizers (PM). In extensive metabolizers (EM), 61% efficacy was observed with efficacy 0% in very extensive metabolizers (VEM). The correlation between oxidation phenotype and the ability to maintain sinus rhythm (SR) was statistically significant (r = 0.414, p < 0.05). CONCLUSIONS: The antiarrhythmic efficacy of propafenone depends on the oxidation phenotype; 100% efficacy occurred in the group of poor metabolizers whereas PPF, at the dose tested, was ineffective in very extensive metabolizers.

[Mitral valve prolapse--diagnostic and therapeutic implications]. / Wypadanie platka zastawki mitralnej--implikacje diagnostyczne i terapeutyczne.

In the most patients the mitral valve prolapse (MVP) syndrome has a good prognosis. The gradual progression of MR may cause the progressive LV dysfunction and development of heart failure. Long-term prognostic studies showed, that complications like endocarditis, cerebrovascular accidents occur frequently in pts. with mitral systolic murmur, thickened mitral valve leaflets and presence of MR. The diagnosis of MVP is made by cardiac auscultation and confirmed by echocardiography. The procedures usefulness in sudden death stratification are discussed. The management of the symptomatic patients, particularly the indication for prophylaxis of endocarditis and cerebrovascular accidents has been demonstrated. The indications for cardiac catheterisation and surgical treatment are presented.

[Quality of life two years after myocardial infarction. 1. Examination questionnaires]. / Jakosc zycia chorych w dwa lata po zawale miesnia serca. 1. Kwestionariusz do badan.

The purpose of the present study was to assess the quality of life (QOL) and factors influencing QOL in patients 2 years after myocardial infarction (MI). The study was performed in 100 pts (mean age 45.5) mean 2 years after MI. 50 pts of studied group (mean age 42.5) were resuscitated from ventricular fibrillation (VF) complicating acute phase of MI. The control group consisted of 100 healthy subjects persons (mean age 53.5). The QOL index was assessed with the use of 2 types questionnaires: "Quality of Well-Being Scale" (QWB) and questionnaires of QOL including 26 factors in terms of: pain, dyspnoea, anxiety, depression, energy, sleep, emotions, mobility, social isolation, sexual activity, hobby, subjective emotional, distress, functional and social state and return to work. The QOL index was assessed using mathematical Krefft method. The average value of QOL index in patients 2 years following MI was significantly lower when compared with control group. The mathematical method of Krefft showed, that out of 26 features the most important diagnostic power factor for the QOL index were: self estimation of physical performance, return to work, the lifestyle and presence of stenocardial pain and dyspnoea. The pts resuscitated from VF revealed the higher level of anxiety.

[Quality of life two years after myocardial infarction. 2. Examination of affecting factors]. / Jakosc zycia chorych w dwa lata po zawale miesnia serca. 2. Ocena wplywu czynników.

This study aimed at determining these factors--ventricular fibrillation (VF) in acute phase of myocardial infarction MI), thrombolytic therapy, beta-blockers after MI, cardiac rehabilitation--affect quality of life (QOL) during the follow-up. The study involved 100 patients (mean age 45.5 years), on the average 2 years after MI, MI has complicated VF in 50 patients. Questionnaire of QOL after MI developed internally, taking into account 26 features (clinical, emotional and social status), and estimating anxiety level (STAI) were used. Computer medical diagnostics "SyntMED" (Krefft's method) was used. In both groups after MI (complicated and not complicated VF) beneficial effect of: thrombolytic treatments in acute phase MI (0.65 vs conventional 0.45, p > 0.05), use of beta-blockers after MI (0.56 vs 0.41 p < 0.05), and cardiac rehabilitation (0.64 vs 0.44 p < 0.05) on value QOL were noted. Patients after MI complicated VF had higher level of anxiety. Patients who returned to work had higher index QOL (0.62 vs 0.39). Ventricular fibrillation complicated the acute phase of MI had no significant effect on follow-up QL.

[Left ventricular diastolic function evaluated by Doppler echocardiography in coronary artery disease in relation to to systolic function]. / Czynnosc rozkurczowa lewej komory oceniana metoda echokardiografii dopplerowskiej w chorobie niedokrwiennej serca w zaleznosci od czynnosci skurczowej.

The aim of the study was to assess the relationship between left ventricular (LV) diastolic dysfunction measured by Doppler mitral flow indices (D.m.f.i.) and LV systolic performance in coronary artery disease (CAD). 107 pts with confirmed CAD without or after MI in I, II NYHA class was divided into 2 groups according to ejection fraction (EF) value = 55%. 13 D.m.f.i. regarding to the time, velocity, flow volume and derivates were calculated. In the patient with CAD with normal EF, the diastolic dysfunction was characterised by the impaired relaxation. There were prolonged isovolumic relaxation time IVRT and deceleration time of early filling flow DT, reduced early filling fraction EFF and increased the atrial filling fraction AFF, decreased E/A ratio and E/A-VTI. The regression analysis revealed the positive correlation between EF and DT r = 0.35 and inverse correlation between wall motion score index WMSI and DT r = DT r = -0.33. The stepwise regression analysis revealed that EF and WMSI are independent factors influencing on DT. Our results confirm that diastolic dysfunction precedes the systolic dysfunction in CAD. The correlation between D.m.f.i. and LV systolic function parameters were obtained. The results suggest that the LV systolic function should be take to account in the Doppler mitral flow analysis.

[Monitoring kidney function in patients with essential hypertension treated with enalapril]. / Monitorowanie czynnosci nerek u chorych na samoistne nadcisnienie tetnicze leczonych enalaprylem.

Hypertension may to be both, cause and the results of the renal dysfunction. The N-acetyl-glucosaminidase (NAG) is a lysosomal enzyme of renal proximal tubular cells. An elevation of the enzyme activity in urine was observed in kidney diseases and also in hypertension. The aim of our study was the evaluation of the influence of the 6-months-lasting enalapril therapy on function of renal tubules and glomeruli in patients with essential hypertension. This study included 30 patients with essential hypertension (I-II grade according to WHO criteria), divided into two groups according to the initial NAG activity in urine: I-with normal NAG activity, II-with elevated NAG activity. Enalapril administered in doses 2.5-10 mg per day. The urine NAG activity, the urine and serum creatinine concentrations, the urea serum concentration and the creatinine clearance were determined after 2, 4, 8 weeks, 3 and 6 months of enalapril therapy. Simultaneously, the blood pressure and the heart rate were measured and the resting ECG was registered. In the course of the 6-months enalapril therapy of hypertension, NAG activity in urine in the group II was declined to normal values, the creatinine concentration in the urine increased in groups I and II, and the blood pressure was significantly reduced. The results of our study imply that the monitoring of the NAG activity in urine during the enalapril therapy of hypertension, may to be a indicator of protective action of the drug on the kidney and its antihypertensive efficacy.

[A case of perforation of the pericardial sac by Seldinger's catheter guide]. / Przypadek przebicia do worka osierdziowego prowadnikiem cewnika Seldingera.

This is a case report of perforation by Seldinger's catheter leader into pericardial sack. The leader was inserted contrary-wise++ to the subclavian vein with the sharp end in front. The leader moved forward toward the venous system and perforated into the pericardial sack. The preceding steroid therapy which the patient had undergone due to asthmatic status resulted in mediastinitis after the primary surgery. Right technique of reoperation and intensive postoperative care led to patient recovery.

[Diagnosis of blood flow disorders in the common carotid arteries by the ultrasonic Doppler method]. / Rozpoznawanie zaburzen przeplywu krwi w tetnicach szyjnych wspólnych metoda ultradzwiekowa oparta na zjawisku Dopplera.

The aim of this work was evaluation of the usefulness of the Doppler ultrasound method for detection of blood flow disturbances in carotid arteries. The investigations were done in 110 patients with symptoms of cerebral circulatory disorders. In 45 patients carotid arteriography was done. In 30 cases arterial reconstructive operations were performed. The curves of blood flow velocity in the common carotid arteries were recorded with a UDP-10 ultrasound blood flow detector. The obtained curves were subjected to morphological analysis and the mean momentary velocity of the systolic and diastolic flow wave was calculated. In 80% of cases with impaired patency of the carotid arteries demonstrated by angiography abnormal curves of blood flow velocity in the common carotid arteries were obtained. The method of ultrasound recording of blood flow velocity is non-invasive and safe and it is very useful for establishing indications to angiography and for postoperative control.