SUMMARY Percutaneous transluminal coronary angioplasty (PTCA) was performed in 21 patients with acute myocardial infarction (AMI) treated by intracoronary infusion of streptokinase within 8 hours after the onset of symptoms. Streptolysis therapy began a mean of 3.6 1.2 hours (±+ SD) after the onset of symptoms. The vessel was occluded in 14 patients and highly stenosed in seven. After the infusion of 67,300 + 63,200 IU of streptokinase over 26.1 21.5 minutes, patency of the occluded vessels was reached.PTCA as performed 20-60 minutes after the end of streptokinase treatment in 19 patients and 24 and 31 hours after treatment in two patients. The dilation was successful in 17 patients (81%). The degree of vessel obstruction was reduced from 90.2 + 7.3% to 58.6 19.5% (area method) and from 71.4 + 12.4% to 39.2 + 19.7% (diameter method). The improvement was 31.5 18.4% and 32.2 ± 19.3%, respectively. No reocclusion was induced by PTCA. Twenty patients were discharged. One died during hospitalization; at autopsy, the treated vessel was still patent. During the follow-up period, two reinfarctions and one asymptomatic reocclusion occurred.The clinical findings during the hospital course and the follow-up period were compared with those of a control group of 18 patients with AMI and comparable coronary stenoses who were treated only with streptokinase infusion. Four of these patients had a reinfarction during the hospital course, and three died during the follow-up period.PTCA can be performed safely and successfully immediately after intracoronary infusion of streptokinase in patients with AMI. By reducing the subtotal stenosis, this treatment contributes to the reperfusion of the ischemic myocardium, diminishes the risk of a reocclusion and seems to improve the prognosis.
Experiments were performed on three groups of rats. The first group consisted of sodium loaded (SL) rats (high sodium diet, 10 meq Na/day, the second group consisted of sodium restricted (SR) rats (low sodium diet, 0.7 meq Na/day) and the third group consisted of hemorrhagic rats (HR), which were bled with 1-1,5% of the body weight. Blood pressure, glomerular filtration rate (GFR) and sodium excretion were measured. In some animals renal blood flow (RBF) was recorded with an electromagnetic flow meter. Adenosine was injected or infused into the thoracic aorta. Bolus injection of 10 nmoles adenosine resulted in a rapid and marked decrease of RBF (40%) in SR rats whereas in SL rats only a very small decrease of RBF (2%) was observed. Continuous infusion of adenosine (10(-7) moles/min) decreased GFR by 54% in SR rats and by 33% in HR rats, whereas GFR in SL rats did not change significantly. 5'-AMP decreased GFR in SR rats by 18% and in HR rats by 32%. Adenosine and 5'-AMP caused a slight fall in the systemic blood pressure, but this decrease could not account for the decrease of GFR. The sensitivity of kidney vasculature to adenosine parallelled high plasma renin activity (162 ng ang/ml-h in SR and 76 ng ang/ml-h in HR), elevated renal vascular resistance and low GFR. Simultaneous infusion of angiotensin (Hypertensin), 250 ng/min, in SL rats resulted in an increase of sensivity to adenosine infusion: GFR decreased by 21%. Our experiments demonstrated that a marked renal vasoconstriction caused by adenosine only occurs in rats in which renin-angiotensin system was stimulated.
Radiation conditions are introduced as an exact method to truncate numerical solutions of the timedependent Schrödinger-equation at the boundaries of the numerical grid. A rigorous derivation of radiation conditions is given by the Green-function method for one-and three-dimensional regions. An accurate finitedifference representation is obtained for a one-dimensional region. The method is applied to calculations of strong-field photoionization. The calculation of ionization probabilities and energy spectra by the truncated solution is illustrated. ͓S1050-2947͑97͒06107-6͔PACS number͑s͒: 32.80.Rm, 31.15.Ϫp
A relativistic treatment of strong-field photoionization based on the phase-space-averaging method is presented. A procedure is described for preparing a relativistic microcanonical ensemble of the atomic ground state and for calculating the final compensated energies for relativistic electrons. The method is applied to over-the-barrier ionization of hydrogen with ultrashort laser pulses. Ionization probabilities and electron energy spectra have been obtained for laser pulse amplitudes near and well above the atomic unit. The results are in excellent agreement with previous experiments under similar conditions. In sufficiently strong fields, saturation of ionization is shown to limit the attainable electron energies.
In this study, the effects of a six week treatment with the calcium channel blocking agent nitrendipine were assessed in 20 hypertensive type I diabetic patients who received a single oral dose of 20 mg daily. Plasma concentrations of atrial natriuretic peptide (ANP), plasma renin activity (PRA) and active renin, aldosterone, glycosylated hemoglobin (HbA1) and fructosamines were determined at the beginning and the end of the study. Interactions of these endocrine parameters with blood pressure behaviour were analyzed by a correlation matrix. In response to the drug treatment, the blood pressure was significantly lowered from 158.0/97.2 to 145.7/88.2 mmHg. The plasma concentrations of ANP were also significantly reduced from 106.8 to 89.7 pg/ml. There were no changes in serum aldosterone, while PRA and active renin exhibited a significant increase following the six week treatment. HbA1 and fructosamines remained unaltered. There were no significant correlations for ANP and blood pressure values, as well as for ANP and PRA or aldosterone. We did find, however, a significant correlation of the ANP values with the difference of the systolic blood pressure levels pre- and post-treatment. These data fully confirm the blood pressure lowering properties of this calcium channel blocker and its possible interference with steroidogenesis, since the effects of increased PRA on aldosterone secretion were clearly blunted. The lowering of plasma ANP levels may represent a decreased ANP secretion due to calcium channel blockade or might also be due to the natriuretic effects of nitrendipine, thus allowing ANP levels to decline as a function of lessened sodium retention.(ABSTRACT TRUNCATED AT 250 WORDS)
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