Based on this experience, the MGuard stent implantation in STEMI patients is safe and highly effective. A larger randomised trial is warranted to confirm the clinical endpoints.

No abstract

Early rapid platelet inhibition with abciximab before primary percutaneous coronary intervention (PPCI) for ST-segment elevation myocardial infarction (STEMI) is suggested as beneficial. In previous studies on early abciximab administration clopidogrel was administered in cathlab in low loading dose. We investigated the role of early abciximab administration on top of early clopidogrel 600 mg loading dose in patients with STEMI treated with PPCI. A total of 73 non-shock STEMI < 6 h patients admitted to remote hospitals with anticipated delay to PPCI < 90 min were randomly assigned to three study groups--24 pts received abciximab before transfer to cathlab (early = group EA), 27 in cathlab during PPCI (late = group LA) and in 22 abciximab administration was left to operator's discretion during PPCI (selective = SA; given in 22.7% of patients). All patients received clopidogrel (600 mg), aspirin and heparin (70 U/kg) before transfer to cathlab. Angiography revealed more frequent infarct-related artery patency (TIMI 2 + 3: EA vs LA vs SA: 45.8 vs 18.5 vs 13.6%, P = 0.024), better myocardial tissue perfusion (MBG 2 + 3: EA vs LA vs SA: 45.8 vs 14.8 vs 13.6%, P = 0.02) in EA group in baseline angiography. There was no difference in these angiographic parameters and ECG ST-segment resolution after PPCI. In multivariate analysis early abciximab administration was an independent predictor of infarct-related artery patency in baseline angiography (OR 6.5; 95% CI 1.83-23.1; P = 0.004). Early abciximab administration before transfer for PPCI in patients with STEMI pretreated with 600 mg of clopidogrel results in more frequent infarct-related artery patency and better myocardial tissue perfusion before PPCI.

The effect of gonadotrophins on the secretion rate of gonadal hormones in sheep was investigated by perfusing the ovary in situ with luteinizing hormone (lh), luteotrophic hormone (lth) and follicle stimulating hormone (fsh). The gonadotrophins were infused through the side branch of the ovarian artery and the effluent blood was collected from the utero-ovarian vein. Perfusion of the ovary on the 8th day of the oestrous cycle with lh or lth resulted in the increase of the secretion rate of progesterone within 20 to 30 min after the beginning of the perfusion; when the perfusion of the ovary was terminated the rate of progesterone secretion reverted to the original level within 20 to 30 min. Unlike lh and lth, fsh infused on the 8th day of the oestrous cycle decreased the output of progesterone. On the 15th day of oestrous cycle progesterone could not be detected in the effluent blood from the ovarian vein. At that time, perfusion of the ovaries with gonadotrophic hormones produced no effect on the secretion rate of progesterone. Substances giving positive reaction with Barton's reagent and showing chromatographic characteristics of oestrone and oestradiol were detected in the ovarian venous blood in few animals only, and in very low concentrations. No relation was observed between the presence of these substances in the ovarian venous blood and either the phase of oestrous cycle or the type of gonadotrophin infused. Furthermore, perfusion of the ovary with fsh or lh resulted in the appearance in the ovarian venous blood of an unknown oestrogen-like substance of higher polarity than that of oestrone but lower than that of oestradiol.

Progesterone levels were determined in ovarian venous blood of nine cows with regular oestrous cycles and in three cows with prolonged maintenance of the corpus luteum. The ovarian venous blood was collected by chronic cannulation of the ovarian vein, through the anterior uterine vein. The progesterone level increased from 5\m=.\6 \g=m\g/100 ml plasma on the 1st day of the oestrous cycle to about 125 \g=m\g/100 ml on the 8th day and to about 180 \g=m\g/100 ml on Days 14 and 15 of the cycle. Thereafter, the level rapidly decreased to 10 to 20 \g=m\g/100 ml on the day of ovulation. In cows with prolonged maintenance of the corpus luteum when ovulation did not occur, the progesterone levels did not decrease and were as high as the highest luteal phase levels in cows with regular cycles. According to the data obtained, progesterone levels in ovarian blood of non-pregnant cows seem to reflect the luteal function of the ovary during the oestrous cycle.