Evaluation of coronary arterial disease by oral dipyridamole stress testing using 12-lead electrocardiography.

We studied the values of oral dipyridamole needed to detect coronary arterial disease using 12-lead electrocardiography. The relationship between dipyridamole-induced ST segment depression and coronary arterial lesions, coronary collaterals and myocardial infarction was investigated. 375 mg oral dipyridamole was given to 31 patients (22 with coronary arterial disease, 9 controls). 12-lead electrocardiogram was recorded before and 45 minutes after the test. The control group and the patients, who had no ST segment depression after dipyridamole, performed isometric contraction (handgrip) for 5 minutes and then the 12-lead electrocardiogram was recorded. All patients had coronary angiography. We also performed treadmill stress testing in 28 patients. Dipyridamole testing was positive (greater than or equal to 1 mm ST depression on electrocardiogram) in 7 of 22 patients with coronary arterial disease, of whom 6 had positive treadmill stress testing. Only 2 patients had previous myocardial infarction in the group with positive dipyridamole tests. Of the 15 in whom dipyridamole testing was negative, 5 had positive treadmill stress testing, while 13 of them had had previous myocardial infarction. All patients in the control group had negative dipyridamole stress testing and normal coronary angiograms. No additional ST segment changes were observed in the group who had performed isometric contraction test (both dipyridamole test negative and control groups). Sensitivity and specificity of the test were 32 and 100%, respectively. Comparison of collateral vessels between the groups positive and negative for dipyridamole revealed no difference. But the number of patients with old myocardial infarction was higher in those testing negative than in those who proved positive.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute myocardial infarction and normal coronary arteries in a pregnant woman.

As it is a rare case, we report a 37-year-old woman who had transmural myocardial infarction in her last trimester. Coronary arteriography done 15 days after her normal delivery showed normal coronary arteries and left ventriculography showed an apical aneurysm. The proposed cause appears to be coronary spasm.

The addictive potential of cannabis.

The author reviews the literature on the dependence potential of cannabis. Case studies and experiments of tolerance to cannabis as well as psychological and physical dependence on cannabis are presented in man and in laboratory animals. Some effects common to both species are also recorded. Although the addictive potential of cannabis is often compared with the addictive potential of alcohol and tobacco, the author concludes that the characteristics of cannabis tolerance are similar to those of opiate dependence.

Effect of delta 9-tetrahydrocannabinol on the morphine-induced hyperactivity of mice.

The effect of delta 9-tetrahydrocannabinol (THC) on the locomotor activity-stimulating action of morphine has been investigated in mice. THC (10 mg/kg) has been found to potentiate morphine-induced hyperactivity. On the other hand, the stimulating action of morphine on motor activity strongly diminished in mice rendered tolerant by the implantation of a morphine pellet. The pretreatment of morphine-tolerant mice with the same dose of THC did not change the effect of morphine on the motor activity. These results suggest that tolerance also developed to the potentiating action of THC on morphine-induced hyperactivity during the development of tolerance to this action of morphine.

Correlation between the dose and development of acute tolerance to the hypothermic effect of THC.

The administration of 0.3-40 mg/kg delta 9-tetrahydrocannabinol (THC) produced a dose-dependent hypothermia in rats. The maximal hypothermic effect was obtained with the dose of 2.5 mg/kg of THC. When the same doses of THC were repeated on days 2 and 3, tolerance to the hypothermic effect of THC was apparent. Doses of THC higher than 2.5 mg/kg induced a significant and dose-dependent tolerance after the first administration whereas with the lower doses, tolerance was only apparent after the second injection. The possible mechanism of these effects of THC is discussed.

[A case of subacute endocarditis caused by C. endocarditis (author's transl)]. / Corynebacterium endocarditis'e bagli bir subakut endokarditis olgusu.

Corynebacterium endocarditis isolated from the blood culture obtained in fever period of a patient who had endocarditis and hospitalized in cardiology department of Ankara University Medical School. Good result is obtained by penicillin therapy. Other cases in literature are discussed.

Interaction between delta 9-tetrahydrocannabinol and morphine on the motor activity of mice.

The present experiments dealt the effects of delta 9-tetrahydrocannabinol (THC) on the locomotor activity stimulating action of morphine in mice. In the first series of experiments, the pretreatments of mice by THC in doses up to 20 mg/kg have been found to potentiate the morphine-induced hyperactivity in dose-dependent manner, but higher doses of THC did not produce such an action. In the second series of experiments the dose-response curve of morphine for the motor activity has been found to shift to the left by the pretreatment of mice with 10 mg/kg of THC. These results show a synergism between morphine and THC and suggest that both drugs may share some common site of action.

The evidence of the release of prostaglandin-like material from rabbit kidney and guinea-pig lung by (minus)-trans-delta9-tetrahydrocannabinol.

Injection of (minus)-trans-delta9-tetrahydrocannabinol (THC) through the renal artery caused a decrease in perfusion pressure and an increase in urine produced by the isolated perfused rabbit kidney. Both effects of THC are inhibited by the prior addition of aspirin to the perfusion medium. THC also induced a dose-dependent increase in perfusion pressure on the isolated perfused lung of guinea-pig and the effluent from the lung produced a contraction on the isolated continuously superfused rat stomach fundus strip. These effects are prevented by the pretreatment of the lung with aspirin which inhibits the production of prostaglandins (PG) and SC 19220 which inhibits the pharmacological effects of PG.

Antihistaminic action of (--)-trans-delta 9-tetrahydrocannabinol.

THC has an antagonistic effect against histamine on the isolated perfused guinea-pig lung and rabbit kidney. This antagonism seems to be a competitive one at the concentrations used and interacts with histamine at H1-receptors. THC also antagonizes the effect of acetylcholine, PGE2, angiotensis II and histamine in the isolated continuously superfused guinea-pig ileum by a non-competitive manner. The antagonism between THC and histamine on the isolated superfused rabbit aortic strips was found to be highly specific, since 100% relaxation was obtained when the muscle contracted by histamine but not by the equipotent doses of angiotensin II and noradrenaline. THC also causes a significant increase in survival time of guinea-pigs when the animals were exposed to histamine aerosol. These results indicate a specific antagonism of THC against histamine in the preparations used in this investigation.

Potential dangers of cannabis.

Cannabis is not a harmless drug. The potential dangers of cannabis are briefly reviewed in this report. The above-mentioned observations on cannabis users should be kept in mind and carefully examined by all physicians. One could expect that as more potent cannabis preparations become available, some of the toxic manifestations which now seem rare might become more frequent. Some of the remarks about the dangers of cannabis may not be proved in future studies, and they may represent only our anxiety. However, prior to the elimination of these fears, no steps should be taken toward the legalizing of marijuana. At present there is no scientific evidence that cannabis is less harmful than either tobacco or alcohol. The opposite may be true. The analogy can be drawn between opium and cannabis. The permissive attitude toward the use of opium can easily lead to the use of morphine and other opiates. If we legalize the use of marijuana, we cannot prevent the use of more dangerous derivatives of cannabis; namely, hashish, cannabis oil and THC, itself. In my opinion, in the light of our present knowledge, legalizing of marijuana could be hazardous both for the individual and for society.