Physical activity among other health-related behaviors in treatment of alcoholism.

AIM: Objective of the paper was to verify an association between the locus of control (LOC) and the level of physical activity (PA) in the group of alcohol addicts. METHODS: The study included 136 individuals (Females=53; Males=83; mean age 39.02±9.01 years) with established alcohol dependence, and an age- and education-matched control group (N.=289; Females=170; Females=119). Both groups were examined using Health Behavior Inventory by Juczynski, Rotter's Internal-External Locus of Control Scale, and an inventory of physical activity objectives (IPAO) by Lipowski and Zaleski. RESULTS: The alcoholics and the controls were characterized by similar average number of hours spent weekly for PA, but the former group declared slightly higher variability in its forms. Compared to males, female alcoholics spent significantly more time exercising. The alcoholics with various educational levels differed in terms of the PA form number: better educated males preferred greater variability in this matter (F=4.70; P=0.011). An opposite phenomenon was documented in the case of the locus of control (LOC): the level of LOC turned out to be lower among worse educated men (F=4.70; P=0.011). In contrast, female alcoholics with various educational levels did not differ significantly in terms of PA, health-seeking behavior, or LOC levels. Analysis of the control group revealed that educational level exerted significant effect on the number of hours spent on PA; the latter parameter was the highest among better educated respondents (F=6.50; P=0.002). CONCLUSION: Increased level of internal control can regulate health-related behaviors of alcoholics. The association between LOC and the role of PA is modulated by such sociodemographic factors as the level of education and gender.

Involvement of the different extracts from roots of Salvia miltiorrhiza Bunge on acute hypobaric hypoxia-induced cardiovascular effects in rats--preliminary report.

The present study was carried out to investigate the protective effects of roots of Salvia miltiorrhiza Bunge on hypobaric hypoxia. Two extracts of S. miltiorrhiza (extract 1: ethanol : water - 50 : 50; extract 2: 96% ethanol) were used. The experiments were performed after 7 consecutive days of administration of the extracts (200 mg/kg b.w., intragastrically) to male Wistar rats. Next, after placing animals for 60 min in the controlled acute hypobaric hypoxia (500 mm Hg) the systolic arterial blood pressure (SAP) in conscious rats, bioelectric heart activity in unconscious rats and analysis of oxidative stress parameters in the blood of rats: malonyldialdehyde (MDA) and lipid peroxidase (LPO) concentration, activity of superoxide dismutase (SOD) or glutathione peroxidase (GPX) were assayed. It was found out that the extract 1 augmented the lowering of SAP shown in hypoxia affected control rats. On the contrary the extract 2 reversed SAP to values obtained in control animals. Moreover, both extracts led to the normalization of hypoxia-induced tachycardia and levels of MDA, LPO and SOD. It seems that the above-mentioned effects are coupled with different active compounds content in the extracts, however more studies are needed to confirm this hypothesis.

Abdominal aortic Doppler waveform in patients with aorto-iliac disease.

OBJECTIVES: The mid-systolic deceleration (notch) in the proximal descending aortic Doppler waveform was reported to be common in patients with aorto-iliac disease. However, evaluation of the descending aorta is limited to echocardiography and may be technically difficult. Therefore, we decided to check whether similar Doppler flow disturbance can be found in abdominal aorta, which is easily evaluated in wider range of patients undergoing general abdominal and vascular ultrasound, as well as echocardiography. METHODS: We evaluated 115 consecutive symptomatic patients with severe peripheral artery disease admitted for vascular surgery, and 60 controls. The presence or absence of the mid-systolic deceleration in the Doppler waveform was evaluated retrospectively, by the single echocardiographer blinded to the localisation of the arterial occlusion or stenosis. RESULTS: The mid-systolic notch in the proximal abdominal aorta was present in 58 of 71 patients (82%) with significant aorto-iliac disease, seven of 44 (16%) patients with occlusion or significant stenosis distally to the external iliac artery (P < 0.001) and in none of the patients from the control group. Sensitivity, specificity and positive predictive value of the mid-systolic notch in the abdominal aortic Doppler waveform in the detection of aorto-iliac disease in patients with peripheral artery disease were 82%, 84% and 89%, respectively. CONCLUSION: The mid-systolic deceleration (notch) in the proximal abdominal Doppler waveform is a simple ultrasonographic marker of significant aorto-iliac disease.

Angiogenesis gene therapy: phase I assessment of direct intramyocardial administration of an adenovirus vector expressing VEGF121 cDNA to individuals with clinically significant severe coronary artery disease.

BACKGROUND: Therapeutic angiogenesis, a new experimental strategy for the treatment of vascular insufficiency, uses the administration of mediators known to induce vascular development in embryogenesis to induce neovascularization of ischemic adult tissues. This report summarizes a phase I clinical experience with a gene-therapy strategy that used an E1(-)E3(-) adenovirus (Ad) gene-transfer vector expressing human vascular endothelial growth factor (VEGF) 121 cDNA (Ad(GV)VEGF121.10) to induce therapeutic angiogenesis in the myocardium of individuals with clinically significant coronary artery disease. METHODS AND RESULTS: Ad(GV)VEGF121.10 was administered to 21 individuals by direct myocardial injection into an area of reversible ischemia either as an adjunct to conventional coronary artery bypass grafting (group A, n=15) or as sole therapy via a minithoracotomy (group B, n=6). There was no evidence of systemic or cardiac-related adverse events related to vector administration. In both groups, coronary angiography and stress sestamibi scan assessment of wall motion 30 days after therapy suggested improvement in the area of vector administration. All patients reported improvement in angina class after therapy. In group B, in which gene transfer was the only therapy, treadmill exercise assessment suggested improvement in most individuals. CONCLUSIONS: The data are consistent with the concept that direct myocardial administration of Ad(GV)VEGF121.10 to individuals with clinically significant coronary artery disease appears to be well tolerated, and initiation of phase II evaluation of this therapy is warranted.

Echocardiographic assessment of left ventricular morphology and function in patients with Emery-Dreifuss muscular dystrophy.

BACKGROUND: Emery-Dreifuss muscular dystrophy (EDMD) characterized by musculoskeletal abnormalities is often associated with atrioventricular conduction disturbances. Although some EDMD patients were reported to develop dilated cardiomyopathy, there are limited data on their left ventricular (LV) performance. METHODS: Therefore, we echocardiographically assessed 27 men (23 cases aged 26.4+/-6.8 years with X-linked, and four cases aged 22.2+/-8.6 years with autosomal dominant (AD)) EDMD. Control group included 16 male healthy controls aged 24.8+/-6.0 (18-37) years. RESULTS: Although LV end diastolic dimension was similar in EDMD and controls (4.9+/-0.6 and 4.99+/-1.1 cm, ns), dilated left ventricle was found in three X-linked EDMD subjects. LV ejection fraction was significantly reduced in EDMD (62.3+/-1% vs. 71.2+/-2%, p=0.01) and was below 50% in six (22.2%) X-linked EDMD patients. Doppler analysis disclosed prolonged isovolumetric relaxation time of the left ventricle in the studied group. This finding may indicate impaired LV relaxation. CONCLUSION: A significant subgroup of X-linked EDMD patients shows pronounced abnormalities of left ventricular function. This warrants cardiologic follow up of EDMD patients.

Relation of obesity, high sodium intake, and eccentric left ventricular hypertrophy to left ventricular exercise dysfunction in essential hypertension.

PURPOSE: To elucidate determinants of abnormal left ventricular functional responses to exercise in hypertensive patients. PATIENTS AND METHODS: One hundred twenty-seven patients with uncomplicated essential hypertension were studied by rest and exercise radionuclide angiography and by echocardiography at rest. RESULTS: The 24 patients with subnormal left ventricular ejection fraction at peak exercise (less than 54%) were similar in age and rest and exercise blood pressures to the 103 with normal exercise ejection fraction, but were more obese (p less than 0.005) and had greater left ventricular mass (p less than 0.03) and internal dimensions (p less than 0.001). The parallel increase in left ventricular chamber size and mass (eccentric hypertrophy) in the group of patients with exercise dysfunction was associated with higher resting end-systolic wall stress (p less than 0.001) and abnormal increases of end-systolic left ventricular volume from rest to peak exercise (p less than 0.001). Multivariate analysis revealed that exercise left ventricular dysfunction was independently associated with higher left ventricular mass (p less than 0.0005), end-systolic wall stress (p less than 0.001), dietary sodium intake (p less than 0.01), and body mass index (p less than 0.03). CONCLUSION: Among patients with uncomplicated essential hypertension, abnormal functional responses to exercise are strongly associated with eccentric ventricular hypertrophy, obesity, and high sodium intake.

Acute myocardial infarction following recovery from a normal treadmill exercise test.

Cardiologists today rely on stress testing to provide valuable diagnostic information about their patients. How and why can it cross the line to become a trigger for acute coronary events? Is patient selection important to avoid complications? Follow this patient through his stress test.

Transmyocardial laser revascularization dose response: enhanced perfusion in a porcine ischemia model as a function of channel density.

BACKGROUND: Transmyocardial laser revascularization (TMR) appears to provide symptomatic relief to patients with ischemic heart disease, but evidence that TMR enhances perfusion to ischemic myocardium remains limited. Furthermore, it is uncertain whether there exists a TMR dose-response relationship that is a function of channel number. We therefore compared restoration of blood flow as analyzed by rest and stress 99mTc-sestamibi scans and histologic grading of neovascularization after 50-channel, 25-channel, or 10-channel TMR using the excimer laser in an established model of porcine myocardial ischemia. METHODS: Yorkshire swine underwent a thoracotomy and placement of an ameroid constrictor around the proximal circumflex coronary artery. Three weeks later, the animals underwent resting and adenosine stress 99mTc-sestamibi scans for evaluation of ischemia immediately before repeat thoracotomy and TMR with either 50 channels (n = 4), 25 channels (n = 4), or 10 channels (n = 4) in the circumflex territory. The animals underwent repeat perfusion analyses 4 weeks later, after which the animals were sacrificed and the hearts were perfusion fixed for histologic evaluation of neovascularization. RESULTS: All animals survived to sacrifice. Semiquantitative analyses of the sestamibi perfusion scans 4 weeks after lasing demonstrated significant improvement (p < 0.04) in stress-induced ischemia in the 50-channel TMR animals, but not in the 25- or 10-channel TMR groups, as compared with scans obtained immediately before lasing. A computerized image analysis of perfusion scans similarly demonstrated an improvement in the area of ischemia of 42% +/- 22% in the scans obtained 4 weeks after lasing compared with scans obtained immediately before lasing in the 50-channel group (p < 0.004), but only a 12% +/- 9% improvement in the 25-channel group and an 8% +/- 4% improvement in the 10-channel group (p > 0.05). Histologic assessment of neovascularization demonstrated significantly greater number of microvessels per low-power field in the 50- versus the 25- and 10-channel groups (p < 0.001). CONCLUSIONS: In an animal model of myocardial ischemia, TMR appears to enhance myocardial perfusion. A dose-response relationship related to channel number may be of significance when evaluating the efficacy of various treatment strategies.

Transmyocardial laser revascularization with excimer laser: clinical results at 1 year.

BACKGROUND: Transmyocardial laser revascularization, a new strategy for the treatment of diffuse ischemic heart disease, uses laser technology for the theoretical purpose of forming transmyocardial channels in the heart to increase perfusion to ischemic zones. This report summarizes our initial clinical experience with the procedure. METHODS: Excimer transmyocardial laser revascularization was performed in a reversibly ischemic region of the heart in 15 patients. Ischemia and myocardial viability were evaluated by assessment of symptoms and of results of radionuclide single photon emission computed tomography imaging, exercise tolerance testing, and 24-hour Holter monitoring. RESULTS: No adverse events occurred as a result of the laser revascularization, although 1 patient with preoperative ventricular arrhythmias died 48 hours postoperatively as a result of refractory ventricular tachycardia. Angina class decreased significantly from base line values in patients who had undergone the procedure (mean Canadian Cardiovascular Association angina class, 3.5+/-0.5 at base line, 1.6+/-0.6 at 1 month, 1.5+/-0.8 at 3 months, 1.9+/-0.9 at 6 months, 1.8+/-0.8 at 12 months; p<0.002), and nitroglycerin requirements were similarly decreased in patients who had undergone laser revascularization (mean g/wk of sublingual nitroglycerin, 19+/-4 at baseline, 5+/-3 at 1 month, 4+/-2 at 3 months, 4+/-2 at 6 months, 2+/-1 at 12 months; p<0.02). Exercise tolerance testing demonstrated increase in exercise duration compared with base line values (mean minutes, 7.4+/-3.1 at base line, 8.0+/-3.9 at 1 month, 8.5+/-4.4 at 3 months, and 9.0+/-3.9 at 12 months; p>0.05); those increases were not large enough to be statistically significant, however. CONCLUSIONS: Our data are consistent with the concept that excimer transmyocardial laser revascularization in individuals with significant ischemic heart disease appears to be well tolerated, can be performed safely, and may lead to a reduction in ischemic symptomatology.

Patent ductus arteriosus in an infant with atrioventricular septal defect and pulmonary hypertension: diagnosis by transesophageal color flow echocardiography.

An infant with complete atrioventricular septal defect (atrioventricular canal) was examined by standard transthoracic two-dimensional pulsed Doppler and color Doppler echocardiography. No evidence of ductus arteriosus was present. Preoperative transesophageal echocardiography identified a patent ductus: the left-to-right shunt seen by color Doppler echocardiography was enhanced by pharmacologic maneuvers aimed at decreasing pulmonary vascular resistance and increasing systemic vascular resistance. Transesophageal echocardiography was found to be more sensitive than transthoracic echocardiography even in a small infant.

Effect of x-ray filtration on dose and image performance of CT scanners.

X-ray source filtration as a means to reduce patient dose while maintaining image quality was investigated for CT scanners. The CT values, their variances for various materials, and the surface dose to a cylindrical phantom were calculated for different filter thicknesses and composition as well as for different tube potentials. Thermoluminescent dosimetry indicated that the maximum dose could be predicted by calculation with an accuracy of 10% (+/- 2 s.d.). The product of the variance of the CT values times surface dose was used to establish the appropriate thickness and composition of the filter, a figure of merit that was independent of dose and noise when the sole source of noise was Poisson statistics. This analysis indicated that source filter materials with an atomic number from 29 to 40 are optimum, and if aluminum is used, the minimum thickness, at 120 kVp, should be 4 mm.

Lesion detection and signal-to-noise ratio in CT images.

This study measured observers' ability to detect and locate focal lesions on simulated CT images. The difficulty of the detection task was manipulated by changing the difference in attenuation between the lesion and its background (contrast), the random variation in the CT values (noise) or the lesion's size. The human observers' performance was compared to that of matched filter detector, modified to include the effects introduced by the display window and the uncertainty about the lesion's location on the image. Changes in lesion contrast, lesion size and noise produced large variations in both the lesion signal-to-noise ratio (a measure of the matched filter detector's performance) and estimated measures of the observer's detection and localization ability. Changes in observers' performance were closely related to changes in lesion signal-to-noise ratio. Generally, changes in lesion contrast, lesion size or noise that produced similar values of lesion signal-to-noise ratios had equivalent effects upon the observers' performance.

Improved detection and derivatization in capillary electrophoresis.

Capillary electrophoresis is well known for its low mass detectabilities, but suffers from poor concentration detection limits. This review will discuss improvements in concentration detectability with an emphasis on derivatization methods. Sample concentration techniques and improved detector designs will also be discussed. Pre- and post-capillary derivatization methods for biofluid analytes such as amino acids, peptides, proteins, oligonucleotides, and oligosaccharides will be examined in detail.

Purification and some properties of hemagglutinin from Beauveria bassiana.

A novel hemagglutinin produced by insect pathogen Beauveria bassiana was isolated from mycelium of the stationary growing microorganism and purified by adsorption on carboxymethyl cellulose followed by separation on Spherogel TSK--phenyl 5 PW column using high performance liquid chromatography. The purified hemagglutinin was homogeneous in polyacrylamide gel electrophoresis and isoelectric focusing. Its molecular weight was estimated to be around 25,000, isoelectric point was found at pH 8.6 +/- 0.2. Amino acid composition of purified B. bassiana hemagglutinin was determined by HPLC fluorometric analysis of o-phthaldialdehyde derivatives of protein hydrolysate. Purified hemagglutinin agglutinated some animal and all human erythrocytes independently of blood group ABO phenotype. The observed hemagglutination is not inhibited by glucose/mannose, N-acetylglucosamine, N-acetyl galactosamine, galactose, L-fucose and sialic acid.

Reduction of pantethine in rabbit ocular lens homogenate.

In several animal models, preliminary studies have indicated that pantethine may inhibit cataract formation. Therefore, preclinical trials need to be conducted to study the pharmacology of pantethine in the ocular lens and to establish its efficacy. Since pantethine, which is a disulfide, can undergo a variety of chemical modifications such as reduction and formation of mixed disulfides, a detailed study was first conducted to determine the stability of pantethine in rabbit lens homogenate. A knowledge of the stability of pantethine in lens homogenate was necessary to establish if pantethine could be metabolized in the time it takes to harvest and homogenize a lens. The results of this study will be used to establish a protocol for harvesting and homogenizing lens samples. Pantethine (100 microM) is completely reduced to pantetheine in rabbit lens homogenate in about 16 min. About 1.5% of the pantethine added to lens homogenate forms a mixed disulfide with lens proteins, and the remainder is found in the supernatant. The supernatant pantethine concentration decreases exponentially as a function of time, and the terminal half-life for this process is 3.3 min. The free supernatant pantetheine concentration increases in pseudo first order manner as a function of time with a rate constant of 4.3 min. Pantethinase activity is not significant, because the free supernatant pantetheine concentration did not decrease. The exact mechanism of pantethine reduction in rabbit lens homogenate remains to be determined.

[Neurogenic pulmonary edema: case report and analysis of pathogenesis]. / Neurogenny obrzek pluc: opis przypadku i omówienie patogenezy.

We describe a young female with subarachnoid haemorrhage (SAH) who developed neurogenic pulmonary edema (NPE). The symptoms of NPE were associated with severe mitral regurgitation. Both NPE and mitral insufficiency were completely reversible. The pathogenesis of NPE and cardiac injury is discussed.

[Clinico-echoencephalographic-electroencephalographic-angiographic correlations in supratentorial glioma]. / Niektóre korelacje kliniczno-echoencefalograficzno-elektroencefalograficzno-angiograficzne w glejakach nadnamiotowych mózgu.

The paper contains conclusions from a comparative evaluation of neurological, echoencephalographic, electroencephalographic and angiographic investigations in supratentorial cerebral gliomas. The results of the analysis were based on 55 cases and were related to the whole material as well as to various localization groups. The usefulness of A echoencephalography is discussed from the standpoint of possibility of indicating the cerebral hemisphere involved by the tumour and in comparision with the results of other investigations.

[A case of meningitis and uveitis caused by Spirochetes of the genus Leptospira]. / Opis przypadku zapalenia opon mózgowo-rdzeniowych i naczyniówki w przebiegu zakazenia kretkiem z rodzaju leptospira.

A case of meningitis and uveitis caused by spirochetes of the genus leptospira is reported in 21 year old man.

[Trichinellosis focus resulting from consumption of wild boar meat]. / Ognisko wlosnicy spowodowane spozyciem miesa dzika.

The focus of trichinellosis was presented comprising 28 patients and resulting from consumption of the wild boar meat. Early confirmation of trichinellosis diagnosis in the first case (index case) and an accurate epidemiological analysis established that the patients became infected with Trichinella spiralis strain originating from natural environment. A severe clinical course was disclosed in the index case, moderate course of trichinellosis in 11 patients, a mild course in 15 cases and an abortive course in one patient. The most frequent trichinellosis symptoms included muscular pain (92.3% cases), fever above 38 degrees C (62.2% cases), conjunctivitis (53.3%), periorbital and facial oedema (42.9% cases); headaches and excessive sweating were less frequent (35.8%), while diarrhoea, hemorrhages to the fingernail beds and skin rush were noted in single cases only. No leukocytosis was detected in 15 patients (53.5%) and number of acidophilic granulocytes was normal in 8 patients (28.5%) including 5 patients with moderate course of the disease. Also, no full correlation was detected between severity of the clinical course and anti-Trichinella antibody titres. Increased activity of a muscular enzymes creatine kinase (CPK) could be detected in 27 patients and increased activity of lactic acid dehydrogenase (LDH) in 9 patients. The increase in muscle enzyme activity (CPK in particular) in some patients failed to correlate with the severity of the clinical course. In 10 patients parasitological and histological study of muscle tissue biopsies was performed to determine intensity of the invasion and the character of pathomorphological lesions.

[Differential diagnosis of angioimmunoblastic lymphadenopathy and AIDS-related complex. Case report]. / Róznicowanie limfadenopatii angioimmunoblastycznej z AIDS-related-complex--opis przypadku.

A case of angioimmunoblastic lymphadenopathy in a boy aged 19 years was observed, with long-standing fever, peripheral lymphadenopathy, considerable weight loss. In the differential diagnosis septicaemia was considered, including tuberculous septicaemia, collagen diseases, neoplasms and lymphoproliferative diseases. Attention is called to the similarity of this symptom complex to that observed in AIDS.