Objectives We sought to compare long-term outcomes after coronary bypass surgery with and without an internal thoracic artery graft. Methods We analyzed clinical outcomes over a median follow-up of ...6.7 years among 3,087 patients who received coronary bypass surgery as participants in one of 8 clinical trials comparing surgical intervention with angioplasty. We used 2 statistical methods (covariate adjustment and propensity score matching) to adjust for the nonrandomized selection of internal thoracic artery grafts. Results Internal thoracic artery grafting was associated with lower mortality, with hazard ratios of 0.77 (confidence interval, 0.62–0.97; P = .02) for covariate adjustment and 0.77 (confidence interval, 0.57–1.05; P = .10) for propensity score matching. The composite end point of death or myocardial infarction was reduced to a similar extent, with hazard ratios of 0.83 (confidence interval, 0.69–1.00; P = .05) for covariate adjustment to 0.78 (confidence interval, 0.61–1.00; P = .05) for propensity score matching. There was a trend toward less angina at 1 year, with odds ratios of 0.81 (confidence interval, 0.61–1.09; P = .16) in the covariate-adjusted model and 0.81 (confidence interval, 0.55–1.19; P = .28) in the propensity score–adjusted model. Conclusions Use of an internal thoracic artery graft during coronary bypass surgery seems to improve long-term clinical outcomes.
OBJECTIVEIschemic preconditioning is an increased tolerance to myocardial ischemia during the second of two consecutive exercise tests. ATP-sensitive K channel blockers, such as glinides and ...sulfonylurea drugs, can induce loss of ischemic preconditioning. This study aimed to investigate the effects of repaglinide, a hypoglycemic agent with an affinity for myocardial ATP-sensitive K channels, on the results of consecutive exercise tests in patients with diabetes and multivessel coronary artery disease.
METHODSForty-two patients with type 2 diabetes and chronic stable angina pectoris, and two-vessel or three-vessel disease participated in this study. The patients underwent two consecutive treadmill exercise tests (phase 1). On the day after these exercise tests, 2 mg of oral repaglinide was given to the patients. One week later, two exercise tests were repeated consecutively (phase 2).
RESULTSAll patients achieved 1.0-mm ST-segment depression during the four exercise tests (T1, T2, T3, and T4). In phase 2, seven patients improved in time to onset of 1.0-mm ST-segment depression. The worsening of the time to onset of 1.0-mm ST-segment depression in phase 2 demonstrated ischemic preconditioning block in 83.3% of patients (P=0.0001). Even the postexercise electrocardiographic parameters (ST-segment depression morphology and magnitude and arrhythmias) were significantly different between the groups with and without pharmacologic ischemic preconditioning block (P=0.031).
CONCLUSIONSRepaglinide, an oral hypoglycemic agent with ATP-sensitive K channel-blocker activity, eliminated the myocardial ischemic preconditioning in patients with coronary disease and diabetes.
Cells of the yeast Saccharomyces cerevisiae display a wide range of glucose-induced regulatory phenomena, including glucose-induced activation of the RAS-adenylate cyclase pathway and ...phosphatidylinositol turnover, rapid post-translational effects on the activity of different enzymes as well as long-term effects at the transcriptional level. A gene called GGS1 (for General Glucose Sensor) that is apparently required for the glucose-induced regulatory effects and several ggs1 alleles (fdp1, byp1 and cif1) has been cloned and characterized. A GGS1 homologue is present in Methanobacterium thermoautotrophicum. Yeast ggs1 mutants are unable to grow on glucose or related readily fermentable sugars, apparently owing to unrestricted influx of sugar into glycolysis, resulting in its rapid deregulation. Levels of intracellular free glucose and metabolites measured over a period of a few minutes after addition of glucose to cells of a ggs1 delta strain are consistent with our previous suggestion of a functional interaction between a sugar transporter, a sugar kinase and the GGS1 gene product. Such a glucose-sensing system might both restrict the influx of glucose and activate several signal transduction pathways, leading to the wide range of glucose-induced regulatory phenomena. Deregulation of these pathways in ggs1 mutants might explain phenotypic defects observed in the absence of glucose, e.g. the inability of ggs1 diploids to sporulate.
OBJETIVO: Estudar o efeito da reperfusão precoce da artéria relacionada ao infarto sobre a dispersão do intervalo QT(deltaQT), e seu valor como marcador de reperfusão coronária e de arritmias ...ventriculares. MÉTODOS: Foram avaliados 106 pacientes com reperfusão (CR) e 48 pacientes sem reperfusão (SR) que receberam terapia trombolítica na fase aguda do infarto. Foram analisados os eletrocardiogramas realizados na admissão e no 4º dia de evolução. A deltaQT, definido como a diferença entre o maior e o menor intervalo QT, foram medidos no ECG de 12 derivações. RESULTADOS: Na evolução do grupo com reperfusão, houve redução significativa da deltaQT de 89,66±20,47ms para 70,95±21,65ms (p<0,001). Por outro lado, no grupo sem reperfusão, houve aumento significativo da deltaQT de 81,27±20,52ms para 91,85±24,66ms (p<0,001). Análise de regressão logística demonstrou que a magnitude de redução entre a deltaQT pré e pós-trombólise foi o fator independente que identificou mais efetivamente a reperfusão coronária (OR 1,045, p<0,0001; IC 95%). Não houve diferença significativa das medidas de dispersão quando comparados os pacientes que apresentaram arritmias ventriculares nas primeiras 48 h com aqueles sem arritmias. CONCLUSÃO: Esse estudo mostra que a deltaQT reduz significativamente em pacientes com infarto agudo do miocárdio submetidos à trombólise com sucesso, aumentando nos pacientes que evoluem com a artéria fechada. A redução deltaQT entre a situação pré e pós-trombólise foi fator preditor de reperfusão coronária nesses pacientes, não apresentando correlação com arritmias ventriculares.
OBJETIVO: Estudar o efeito da reperfusão precoce da artéria relacionada ao infarto sobre a dispersão do intervalo QT(deltaQT), e seu valor como marcador de reperfusão coronária e de arritmias ...ventriculares. MÉTODOS: Foram avaliados 106 pacientes com reperfusão (CR) e 48 pacientes sem reperfusão (SR) que receberam terapia trombolítica na fase aguda do infarto. Foram analisados os eletrocardiogramas realizados na admissão e no 4º dia de evolução. A deltaQT, definido como a diferença entre o maior e o menor intervalo QT, foram medidos no ECG de 12 derivações. RESULTADOS: Na evolução do grupo com reperfusão, houve redução significativa da deltaQT de 89,66±20,47ms para 70,95±21,65ms (p<0,001). Por outro lado, no grupo sem reperfusão, houve aumento significativo da deltaQT de 81,27±20,52ms para 91,85±24,66ms (p<0,001). Análise de regressão logística demonstrou que a magnitude de redução entre a deltaQT pré e pós-trombólise foi o fator independente que identificou mais efetivamente a reperfusão coronária (OR 1,045, p<0,0001; IC 95%). Não houve diferença significativa das medidas de dispersão quando comparados os pacientes que apresentaram arritmias ventriculares nas primeiras 48 h com aqueles sem arritmias. CONCLUSÃO: Esse estudo mostra que a deltaQT reduz significativamente em pacientes com infarto agudo do miocárdio submetidos à trombólise com sucesso, aumentando nos pacientes que evoluem com a artéria fechada. A redução deltaQT entre a situação pré e pós-trombólise foi fator preditor de reperfusão coronária nesses pacientes, não apresentando correlação com arritmias ventriculares.OBJECTIVE: To study the effect of early reperfusion of infarct-related artery on QT(deltaQT) dispersion interval, as well as how valuable it is as a marker for coronary reperfusion and ventricular arrhythmias. METHODS: One hundred and six patients with reperfusion (WR) and 48 without reperfusion (WtR) who have received thrombolytic therapy in the acute phase of infarction were studied. ECG carried out on admission as well as on day 4 of patient’s course were analyzed. deltaQT - defined as the difference between maximum and minimum QT interval - was measured by 12-lead ECG. RESULTS: The reperfusion group showed significant deltaQT reduction - from 89.66±20,47ms down to 70.95±21.65ms (p<0.001). On the other hand, the group without reperfusion showed deltaQT significant increase - from 81.27±20.52ms up to 91.85±24.66ms (p<0.001). Logistic regression analysis showed that reduction magnitude beween pre- and post-thrombolysis deltaQT was the independent factor to most effectively identify coronary reperfusion (OR 1.045, p<0.0001; CI 95%). No significant difference was found in dispersion measures when patients with ventricular arrhythmias were compared with those with no arryhthmias in the course of the first 48 hours. CONCLUSION: The study shows that deltaQT is significantly reduced in patients with acute myocardial infarction submitted to successful thrombolysis, and is increased in infarcted patients with closed artery. deltaQT reduction between the pre- and post-thrombolysis condition was a predictor for coronary reperfusion of those patients, and did not show correlation to ventricular arrhythmias.
To study the effect of early reperfusion of infarct-related artery on QT(DeltaQT) dispersion interval, as well as how valuable it is as a marker for coronary reperfusion and ventricular arrhythmias.
...One hundred and six patients with reperfusion (WR) and 48 without reperfusion (WtR) who have received thrombolytic therapy in the acute phase of infarction were studied. ECG carried out on admission as well as on day 4 of patients course were analyzed. DeltaQT - defined as the difference between maximum and minimum QT interval - was measured by 12-lead ECG.
The reperfusion group showed significant DeltaQT reduction - from 89.66+/-20.47ms down to 70.95+/-21.65ms (p<0.001). On the other hand, the group without reperfusion showed DeltaQT significant increase - from 81.27+/-20.52ms up to 91.85+/-24.66ms (p<0.001). Logistic regression analysis showed that reduction magnitude between pre- and post-thrombolysis DeltaQT was the independent factor to most effectively identify coronary reperfusion (OR 1.045, p<0.0001; CI 95%). No significant difference was found in dispersion measures when patients with ventricular arrhythmias were compared with those with no arrhythmias in the course of the first 48 hours.
The study shows that DeltaQT is significantly reduced in patients with acute myocardial infarction submitted to successful thrombolysis, and is increased in infarcted patients with closed artery. DeltaQT reduction between the pre- and post-thrombolysis condition was a predictor for coronary reperfusion of those patients, and did not show correlation to ventricular arrhythmias.
As observações de diversos caracteres morfológicos em plantas de berinjela (Solatium melongena L.) provenientes de tratamentos com colquicina levaram à separação de razoável número de possíveis ...poliplóides. O número de cromossomos determinado em células-mães de pólen revelou a existência de plantas tetraplóides e plantas quiméricas, além das normais diplóides. Numa amostra representando os diferentes tratamentos, encontrou-se uma associação quase perfeita entre a natureza tetraplóide ou quimérica da planta e a irregularidade do tamanho do pólen; tal associação não foi encontrada quando se analisou a quantidade de pólen vazio. Os frutos tetraplóides obtidos produziram sementes maiores e em número bem menor que os diplóides de pesos equivalentes.
The observations on several morphological characteristics made on plants derived from treatments of seed with colchicine in the egg-plant (Solatium melongena L.) led to separation of a reasonable number of possible polyploids. Chromosome number determined in P.M.C. indicated the existence of tetraploid plants, chimeric plants at level 24-48 and at level 48-96 beside the diploid normal ones. In a certain number of plants representing the different treatments, it was found an almost perfect association between tetraploidy and chimeric condition of the plants at one side and irregular size of the pollen at the other side; such an association was not found when the amount of empty pollen was analysed. The tetraploid fruits produced low number of seeds which were not uniform in size but were larger and in general heavier than the diploid ones.
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