Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Electrocardiograms of 90 patients with arteriographically documented acute submassive or massive pulmonary embolism and no associated cardiac or pulmonary disease were studied. Patients were derived from the Urokinase-Pulmonary Embolism Trial National Cooperative Study. In massive embolism, the electrocardiogram was normal in 6 per cent (3 of 50) of patients. With submassive embolism, 23 per cent of patients (9 of 40) had a normal electrocardiogram. Since one or more of the traditional manifestations of acute cor pulmonale (S1Q3T3, right bundle branch block, P pulmonale, or right axis deviation) occurred in only 26 per cent of patients, one could not rely exclusively upon these electrocardiographic abnormalities for the diagnosis of pulmonary embolism. The most common electrocardiographic abnormalities were nonspecific T wave changes which occurred in 42 per cent of patients and nonspecific abnormalities (elevation or depression) of the RST segment which occurred in 41 per cent of patients. Left axis deviation occurring in 7 per cent of the patients was as frequent as right axis deviation. Low voltage QRS complexes, previously undescribed in pulmonary embolism, occurred in 6 per cent of patients. None of the patients had atrial flutter or atrial fibrillation, which appears to occur more typically in patients with pulmonary embolism who have preexistent cardiac disease. All of the varieties of electrocardiographic abnormalities disappeared in some of the patients by 2 wk. Inversion of the T wave was the most persistent abnormality. Larger defects on the lung scan or pulmonary arteriogram occurred in patients with various abnormalities on the electrocardiogram than in patients with normal electrocardiograms. The pulmonary arterial mean pressure and/or right ventricular end-diastolic pressure was significantly higher in patients with several varieties of abnormal electrocardiograms, although the partial pressure of oxygen in arterial blood, in general, did not differ from that in patients with normal electrocardiograms. These hemodynamic correlations, made for the first time in patients, suggest that acute ventricular dilatation, possibly in combination with hypoxemia, is a causative factor of the electrocardiographic changes in acute massive or submassive pulmonary embolism.
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PMID:The electrocardiogram in acute pulmonary embolism. 12 74

The expression of certain proteolytic enzymes involved in cell migration (collagenase, urokinase) can be enhanced by the disruption of cellular cytoskeletal organization, suggesting an association between cell shape and gene expression. We have examined the effect of cytoskeleton-disrupting agents on the production and secretion of another proteolytic enzyme, tissue plasminogen activator (tPA), and its inhibitor, plasminogen activator inhibitor-1 (PAI-1), in human endothelial cells. Addition of 1 x 10(-6) M colchicine, 5 x 10(-6) M cytochalasin B, 10(-6) M nocodazole, or 10(-6) M tubulazole had no effect on the constitutive rate of release of tPA. However, the three microtubule-disrupting agents--colchicine, nocodazole, and tubulazole--depressed the stimulation of tPA secretion by phorbol myristate acetate (PMA) by 50- to 65%. Disruption of microfilament structure by cytochalasin B had no effect. In contrast, microtubule disruption in the absence or presence of PMA stimulated PAI-1 secretion by 2.5 and 2 times, respectively. The depression of tPA secretion was not due to inhibition of the secretory function since tPA did not accumulate intracellularly during colchicine treatment. Nor did colchicine affect the PMA activation of protein kinase C-alpha, upon which stimulation of tPA is dependent; neither translocation of the kinase nor phosphorylation of the protein kinase C substrate protein, P80, was inhibited. Measurement of tPA mRNA levels demonstrated that the increase which precedes PMA-enhanced tPA secretion was also inhibited by colchicine by 50%. However, tPA gene transcriptional activity was only reduced 13%, suggesting that a post-transcriptional event was affected by microtubule disruption. PAI-1 mRNA levels and transcription rates were elevated 3.5 times. This study suggests that the changes that occur in endothelial cells during PMA-induced signal transmission leading to enhanced tPA mRNA levels and tPA antigen production can be partly blocked by agents that disrupt microtubule organization.
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PMID:Disruption of microtubules inhibits the stimulation of tissue plasminogen activator expression and promotes plasminogen activator inhibitor type 1 expression in human endothelial cells. 163 33

The clinical features of acute non-Q wave myocardial infarction (NQMI) with R wave regression and no ST segment depression are distinct from those of acute Q wave myocardial infarction (QMI). NQMI patients showed ST segment elevation at admission, and significantly earlier regression of the ST segment elevation and appearance of coronary T waves were observed compared to QMI patients. In addition to the significantly lower level of mean peak serum creatine kinase activity and the significantly lower incidence of pump failure during the acute phase, the incidences of in-hospital mortality and multivessel disease were significantly lower in the NQMI patients. With respect to acute-phase coronary angiographic features within 48 h after the onset, the rate of spontaneous opening of infarct-related vessels was significantly higher in the NQMI patients. Thirteen of the 19 NQMI patients responded to urokinase infusion. These facts suggest that transient, intermittent or incomplete obstruction may favor this type of NQMI over QMI, and that thrombus might be an important factor in the pathogenesis of this type of NQMI.
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PMID:Coronary angiographic features within 48 hours from onset of non-Q wave myocardial infarction with R wave regression and no ST segment depression. 211 28

To evaluate the effects of neutrophil depletion on reperfusion arrhythmias using a leukocyte removal filter (LRF), the authors examined several cardiovascular variables in three patients with myocardial infarction who underwent successful thrombolytic therapy with LRF compared with control patients without LRF. Coronary angiography performed within 4 hr of onset revealed total occlusion in the proximal segment of the left anterior descending (LAD) coronary artery, without collaterals, in all patients. Thrombolysis was performed by intracoronary administration of urokinase (10,000 IU/ml, 1,000,000 IU total) mixed with filtered autologous blood. LRF was composed of a nonwoven polyester fabric (1.8 microns, 4.6 g). Removal rates of leukocytes and platelets by LRF were 98-100% and 98%, respectively. Average duration of the ischemic episodes, maximum ST segment elevation, and integral of T segment depression did not differ in the two groups. However, the frequency of ventricular premature beats (VPB) during the first 30 min after reperfusion were significantly lower in the LRF treatment group (3.8%) compared with the control group (10.7%). Segmental shortening, measured by echocardiography one hour after recanalization, exhibited higher values in the LRF treated patients than control patients, without significant difference. Data suggested that LRF is effective in reducing reperfusion arrhythmias during intracoronary thrombolysis and activated neutrophils may play an important role in stunned myocardium.
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PMID:The effect of neutrophil depletion on reperfusion arrhythmias during intracoronary thrombolysis using the leukocyte removal filter. 259 62

Clinical course of the disease and the formation of the necrotic focus (as evidenced by precordial mapping from 35 ECG leads) were assessed in 88 patients with acute myocardial infarction, treated with 1,000,000 IU urokinase, in comparison to 41 untreated control patients. Thrombolytic therapy, started within the first 6 hours of myocardial infarction, was associated with a better clinical course of the disease. Urokinase administration after 6 hours from the onset of the symptoms produced no clinical improvement, did not limit the necrotic focus and failed to reduce mortality, as compared to the controls. The assessment of the efficiency of thrombolytic treatment demonstrated an at least 30% increment of venous flow in 45% of patients. Intravenous urokinase administration was accompanied by an activation of blood fibrinolytic system, and there was a tendency to fibrinolysis depression on the day following the administration.
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PMID:[Use of urokinase in acute myocardial infarction]. 306 99

Despite successful thrombolysis of occluded prosthetic grafts, rethrombosis remains a problem. We investigated the efficacy of aspirin in maintaining patency of polytetrafluoroethylene grafts (3 mm X 3.5 cm) in canine femoral arteries after thrombolytic therapy. After induction of thrombosis, either tissue-type plasminogen activator (t-PA) or urokinase (UK) was infused just proximal to the thrombus (4000 U/min) until complete thrombolysis was achieved. Five of the 10 UK-treated dogs and five of the 10 t-PA-treated dogs received aspirin immediately after recanalization, and aspirin was continued (325 mg/day) for 4 weeks or until occlusion occurred. A systemic aspirin effect was confirmed by marked depression of serum thromboxane B2 and absent platelet aggregation. Only two of the 10 grafts in the aspirin-free group remained patent for 4 weeks. The remaining eight grafts had all reoccluded by 2 weeks. None of the 10 grafts in the aspirin-treated group reoccluded during the 4 weeks. This significantly improved patency (p less than .001) in the aspirin-treated group was observed equally in grafts treated with t-PA or UK. Thus aspirin is a potent agent in preventing rethrombosis after thrombolytic recanalization of prosthetic grafts.
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PMID:Beneficial effect of aspirin in maintaining the patency of small-caliber prosthetic grafts after thrombolysis with urokinase or tissue-type plasminogen activator. 309 Dec 89

Intracoronary thrombus is regarded as a potentially important factor in the etiology of unstable angina, but the incidence of intracoronary thrombus in unstable angina has not been clearly defined. To determine the occurrence of intracoronary thrombus during ongoing angina pectoris, coronary angiography was performed during spontaneous ischemic attacks in 37 patients with prolonged rest angina. All patients exhibited significant (greater than 50%) stenoses of at least one major coronary artery. Of the 37 patients, 21 (57%) had intracoronary thrombus in major coronary arteries, whereas 14 (38%) had fixed narrowings without evidence of intracoronary thrombus and two exhibited coronary spasm. ST segment elevation was observed in 16 of 21 patients with thrombus and in all of the patients with coronary spasm, but all the patients with organic stable obstruction showed ST segment depression. Twenty of the 21 patients with thrombus improved after thrombolytic therapy with intracoronary injection of urokinase; obstructed arteries were reopened, or narrowings were attenuated, with relief of ischemic symptoms. In patients with fixed obstructions, the rate-pressure product during active symptoms was significantly higher than during an asymptomatic period, indicating that a transient increase in myocardial oxygen demand may contribute to the ischemic attack in these patients. A high incidence (71%) of recurrent symptoms was observed in patients with intracoronary thrombus even after successful thrombolysis, in contrast to a much lower incidence (36%) in those without intracoronary thrombus. Myocardial infarction within 4 weeks after catheterization was observed more frequently in patients with intracoronary thrombus (24%) than in those without thrombus (7%).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The role of intracoronary thrombus in unstable angina: angiographic assessment and thrombolytic therapy during ongoing anginal attacks. 334 83

A phase I study with continuous administration of epirubicin for 21 days using a venous access port and a portable pump was performed. The first dose step was 2 mg/m2/d for 21 days. Interval between courses was 3 weeks. Dose increment per step was 1 mg/m2/d. Twenty-two patients entered the study and received a total of 58 courses with a median of two (range, one to nine). Up to 5 mg/m2/d no toxicity (according to World Health Organization [WHO] criteria) occurred. At 6 mg/m2/d (six pts), one patient had leukopenia grade 3. Two others had some hair loss. At 7 mg/m2/d (four patients), all patients developed mucositis (two grade 3). Three patients had bone marrow depression (one grade 3 anemia, one grade 4 leukocytopenia), and one patient developed the hand-foot syndrome. No other toxicity occurred in the patients. One patient obtained a partial response (18 weeks), ten had stable disease (12 to 54 weeks), seven had progressive disease, and four were not evaluable for response. One patient developed cellulitis around the port, responding to antibiotic treatment; one patient developed a vena cava superior syndrome that resolved with urokinase and removal of the access port. No septicemia occurred. Pharmacokinetic studies were performed by high-performance liquid chromatography (HPLC) with fluorometric detection. Plasma steady state was reached after 57 hours. During steady state there was a linear relationship between epirubicin dose administered and epirubicin level in plasma (r = .58, P less than .05), whole blood (r = .75, P less than .005), and in leukocytes (r = .68, P less than .05). The area under the curve in leukocytes was higher with continuous infusion of 6 mg/m2 for 21 days compared with bolus injection of 80 mg/m2. This method of continuous infusion with epirubicin may be a way to increase intracellular drug-uptake as expressed by intracellular area under curve (AUC). We recommend 6 mg/m2/d for 3 weeks for evaluation of antitumor efficacy in phase II studies.
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PMID:A phase I and pharmacokinetic study with 21-day continuous infusion of epirubicin. 347 90

Using colony formation technique and KK-47 cell line established from a human bladder transitional cell carcinoma, the effect of 6 anticancer drugs, thio-TEPA, Bleomycin, mitomycin C, carbazilquinone, Adriamycin and cis-Platinum, were compared. On the results of tests performed to establish the drug concentration required to achive a 50% inhibition of cell survival, carbazilquinone was chosen for the prevention of recurrences of bladder cancer. The two groups studied consisted of 56 patients (previously untreated groups) who were rendered free of tumours by surgical intervention and of 19 patients (thio-TEPA failures group) who had experienced a persistent recurrence of tumours after prophylactic thio-TEPA instillations and were presumed free of the recurrence of tumours after the next surgical intervention. The 2 groups were subjected to prophylactic combined intravesical instillation therapy with carbazilquinone and urokinase. In the previously untreated group, 6 of the 56 patients (10.7%) had a recurrence of tumours, and the recurrence rate after 21 months was 16.7%, using the actuarial method. In the thio-TEPA failures group, 12 of the 19 patients (63.2%) had a recurrence of tumours, a rate at 21 months of 76.1%. A considerable drop in the recurrence rate was obtained by the combined instillation therapy in the previously untreated group. The results in the thio-TEPA failures group suggested the presence of a cross-resistance between both alkylating agents, and of a persistent susceptibility to multifocal lesions. No bone marrow depression was observed but an episode of anaphylactic shock attributable to the use of carbazilquinone occurred in 1 out of a total 75 patients.
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PMID:Anticancer drug sensitivity in vitro in the bladder cancer cell line, KK-47 and prophylactic use of carbazilquinone and urokinase in bladder cancer. 702 55

The epithelial lining of the airways is subject to injury through several processes, including infections, bronchiolitis, and fume exposures. Because airway fibrin deposition influences the course of local injury, we examined how two inflammatory cytokines influenced fibrin formation and clearance in human tracheal epithelial cells (TEC). TEC were treated with transforming growth factor-beta (TGF-beta) and tumor necrosis factor-alpha (TNF-alpha). TNF-alpha increased release of tissue factor (TF)-related procoagulant activity that, through generation of factor Xa, promotes assembly of the prothrombinase complex at the cell surface. Fibrinolytic activity was plasminogen dependent and due to both urokinase (uPA) and tissue plasminogen activator (tPA). The cells expressed plasminogen activator inhibitor 1 (PAI-1), but relatively little PAI-2. Depression of fibrinolysis by TGF-beta correlated with increased PAI-1. Conversely, TNF-alpha increased plasminogen activator (PA) activity due to increased uPA. Fibrinolytic activity was inhibited by actinomycin D and cyclohexamide, but changes in mRNAs for uPA, tPA, PAI-1, and TF by either cytokine were not appreciable. PAI-2 mRNA was not found. The data indicate that TGF-beta decreases the fibrinolytic capacity of TEC, suggesting that this cytokine promotes fibrin retention. TNF-alpha increases expression of both procoagulant and fibrinolytic activities; this differential regulation could favor both pericellular fibrin formation and dissolution.
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PMID:Effects of TGF-beta and TNF-alpha on procoagulant and fibrinolytic pathways of human tracheal epithelial cells. 781 Jun 74


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