Identification and quantification of ventricular dysfunction by echocardiography.
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Biomedical subjects
Publications and source records attributed to S Rasmussen.
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26 patients with moderate hypertension and no signs of heart failure were treated with metoprolol, labetalol or prazosin. Systolic time intervals (STI) were measured before and after several months of treatment. During treatment with metoprolol, a decrease in the preejection period index (PEPI), and preejection period/left ventricular ejection time ratio (PEP/LVET), was found. During treatment with labetalol or prazosin, a minor decrease in PEPI was observed, so that a significant decrease in PEP/LVET was not obtained. A decrease in PEPI and PEP/LVET may be due to improved cardiac performance, but in the given type of patients it is more dependent on the reduction in afterload. The STI measurement is less sensitive in discerning different mechanisms involved in lowering the blood pressure and cannot therefore be used for selecting the optimal antihypertensive drug.
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The Southwest Oncology Group in a prospective randomized study compared one year of adjuvant combination chemotherapy with continuous CMFVP to two years of intermittent L-PAM in women with operable breast cancer with histologically positive axillary lymph nodes. In fully evaluable patients with a 42-month median and 30-month minimum follow-up, treatment failures have occurred in 26% of 145 receiving CMFVP and 47% of 167 women given L-PAM (P = 0.002). Disease-free survival times were significantly longer with CMFVP than with L-PAM in the following subgroups: premenopausal women (P = 0.002), postmenopausal women (P = 0.002), women with 1-3 involved axillary nodes (P = 0.003), and women with four or more involved axillary nodes (P = 0.002). CMFVP was effective in pre- and postmenopausal women. There is a significant difference in survival in favor of CMFVP compared to L-PAM (P = 0.005). The life table estimates of survival at 42 months are 86% for women on the CMFVP treatment arm and 73% for women on the L-PAM treatment arm. There was no correlation between the interval from mastectomy to onset of chemotherapy (between one and six weeks) and recurrence rates. Acute toxicity with both treatment arms was moderate and reversible. These results show that continuous CMFVP is superior to intermittent L-PAM in decreasing recurrences and increasing survival in both pre- and postmenopausal women with operable breast cancer with histologically involved axillary nodes.
Forty breast cancer patients with meningeal carcinomatosis were treated with a combined program of whole brain irradiation therapy with intrathecal and intraventricular methotrexate and citrovorum factor rescue. Responses were seen in 26 patients (65%); 13 patients (35%) failed to respond. The median survival time for the responding patients was six months, and for the nonresponders, one month. Factors affecting response and survival included pretreatment spinal fluid glucose, protein, and duration of CNS-related symptomatology prior to onset of therapy. In contrast, pretreatment CSF tumor cell count, CEA and initial CNS functional status did not appear to have prognostic significance. The authors conclude that following intensive therapy there can be much improvement in the quality of life and disease-free survival in breast cancer patients with meningeal carcinomatosis.
Glomerular filtration rate (GFR; 51Cr-EDTA clearance), serum creatinine concentration and urinary excretion of prostaglandins were measured in 8 patients with systemic lupus erythematosus (SLE) before and after 2 weeks of treatment with acetylsalicylic acid (ASA). ASA 65 mg/kg or up to 4 g/daily was given as a sustained release preparation. The serum salicylate concentration ranged from 0.3 to 1.6 mmol/l. Serum creatinine after 1 and 2 weeks and GFR after 2 weeks of ASA treatment showed no significant changes. There was a clearcut decrease in urinary excretion of prostaglandins PGE2 and PGF2 alpha, by 44% and 50%, respectively. It is concluded that therapeutic doses of ASA do not cause deterioration of GFR in patients with SLE and normal or moderately reduced renal function.
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D2 is a nervous-specific membrane protein enriched in fractions of synaptosomal membranes from rat brain. Recently, an immunochemical relationship between D2 and the chick cell adhesion molecule (CAM) has been demonstrated. There is reason to believe that D2 is involved in adhesion phenomena between neurites. The purpose of the present study was to purify and further characterize the D2 protein from rat brain. In the developed purification procedure synaptosomal membranes from rat brains were prepared and solubilized by means of non-ionic detergent. The subsequent purification steps were hydroxylapatite chromatography, wheat germ lectin affinity chromatography, gel filtration, and lysine affinity chromatography. The purified D2 was found to be enriched 240 times compared with the starting brain homogenate and 120 times compared with the synaptosomal membrane fraction. The recovery of D2 was 26% when the amount of D2 in the synaptosomal membrane fraction was set to 100%. The purified D2 antigen was used for production of monospecific rabbit antisera, and it was found to be composed of two polypeptides of apparent molecular weights 130,000 and 150,000, respectively.
Single-dimension left ventricular echocardiographic measurements are currently being used in investigational studies as the basis for evaluating cardiac output parameters in normal subjects, even though validity of the method for normal subjects has not been established. We prospectively compared stroke volume derived from M mode left ventricular dimensions (LVID) to Fick stroke volume in 20 patients with no objective evidence of cardiac disease. Based on simultaneous studies, stroke volume by Fick ranged from 39 to 121 ml and cardiac output ranged from 3.9 to 10.4 L/min. Comparing the LVID cubed method with Fick, the correlation coefficient was r = .47 for stroke volume and r = .36 for cardiac output. LVID absolute error in cardiac output ranged -2.11 to +3.21 L/min. Use of other published formulas for calculating stroke volume from LVID did not improve accuracy. These data indicate that stroke volume and cardiac output cannot be accurately measured or reliably estimated from M mode left ventricular internal dimensions.
Intermediate filaments from rat astrocytes in culture were isolated by subcellular fractionation. The fractionation was monitored by electron microscopy and by quantitative immunoelectrophoresis using rabbit antibody directed against human glial fibrillary acidic protein (GFA). Morphologically intermediate filaments appeared helical with a mean diameter of 10 nm. Isolated filaments were disassembled at highly alkaline pH. After lowering of pH to slightly acidic values reassembled filaments, approximately 17 nm in diameter, were observed. As revealed by sodium dodecyl sulfate polyacrylamide gel electrophoresis the filament preparation was composed predominantly of a 51,000 molecular weight protein, corresponding to GFA. At high loads additional proteins of molecular weights 43,000 and 58,000 were detected. These latter proteins may represent residual actin and vimentin, respectively.
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A solid-phase radioimmunoassay was utilized to evaluate the antibody response of 21 acute myelogenous leukemia (AML) patients to active specific immunotherapy with either pooled allogeneic AML blast cells or leukemia-associated antigen (LAA), admixed with BCG cell-wall skeleton (CWS). Five of 13 patients treated with LAA had a significant antibody response to LAA after immunotherapy. Antibody response correlated with an increased remission duration (159+ vs. 75+ weeks) and an increased survival (164+ vs. 98+ weeks). Two of eight patients treated with cells responded to LAA, and three patients had initially high anti-LAA antibody levels. In the total study, eight of 11 patients surviving longer than 2 1/2 years and six of seven patients maintaining a complete remission longer than 2 years were antibody responders. Neither protocol induced significant antibody to a normal spleen extract, BCG-CWS, or a measles recall antigen. However, five of seven patients with initially high levels of antibody to BCG (following weekly BCG scarification) were long-term survivors. These data suggest that the humoral immune response to immunotherapeutic agents may be a useful parameter for monitoring immunotherapy of AML patients.
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1. We have measured plasma concentrations of renin, renin substrate and angiotensins I and II as well as plasma renin activity in nine patients with severe or malignant hypertension during treatment with captopril, hydrochlorothiazide and propranolol. 2. On captopril and hydrochlorothiazide the plasma concentrations of renin substrate and angiotensin II decreased markedly, while renin and angiotensin I levels were increased. 3. The changes in renin substrate concentration suggest a consumption of substrate induced by an increased renin release. Further, the positive feedback of angiotensin II on hepatic renin substrate synthesis may be inhibited. 4. The sequential changes in renin release during captopril treatment should be monitored by measuring plasma renin concentration since plasma renin activity measurements will be profoundly influenced by the marked changes in plasma renin substrate concentration.
1. Sixteen 44-year-old males with chronic high alcohol intake were investigated. Seventeen 44-year-old males with low alcohol intake from the same population served as controls. 2. Plasma noradrenaline concentrations did not differ significantly between individuals with high and low alcohol intake, neither at rest nor after acute stimulation induced by ambulation for 15 min. However, 63% (10 out of 16) of the individuals with high intake showed resting values within the upper quartile range for individuals with low intake. 3. Plasma renin concentration was twice as high (P less than 0.01) in the group with high alcohol intake as in the group with low intake. 4. Systolic as well as diastolic blood pressure was significantly higher (P less than 0.01) in the group with high intake compared with the group with low intake. 5. Sympathetic nerve activity, as defined from measurements of plasma noradrenaline concentration, is not uniformly increased in individuals with chronic high alcohol intake. The mechanism behind the increased plasma renin level as well as the possible role of the renin--angiotensin system in alcohol-induced hypertension remain unsettled.