Reproducible method for assessing the effects of blue light using in vitro human skin tissues

INTRODUCTION

High-intensity visible light (HEV), also referred to as blue light, has a wavelength of 400-500 nm and accounts for approximately one-third of the visible light. Blue light is also emitted from electronic devices and artificial indoor lighting. Studies have shown that exposure of human skin cells to light emitted from electronic devices, even as short as 1 h, can cause an increase in reactive oxygen species (ROS), apoptosis and necrosis. Despite comprising a significant portion of the light spectrum, the effects of HEV light have not been studied as extensively. This is in part due to a lack of suitable in vitro testing methods. This work was conducted in order to develop a reproducible testing method for assessing the effects of blue light on the skin.

METHODS

Testing was performed using a full thickness, 3D in vitro skin tissue model. Different exposure protocols were tested to (1) determine the biological effects of blue light on the skin and (2) to identify an appropriate exposure for routine testing of cosmetic materials that may protect the skin from blue light damage. Gene expression and protein biomarkers were measured using qPCR, ELISA and immunohistochemical (IHC) methods.

RESULTS

Our work demonstrates that daily exposure to blue light produced dose-and-time-dependent changes in biomarkers associated with skin damage. Exposure to blue light for 6 h for 5 consecutive days (total intensity of 30 J/cm² ) increased the expression of genes that regulate inflammation and oxidative stress pathways and decreased the expression of genes that maintain skin barrier and tissue integrity. Exposure to blue light significantly increased protein biomarkers associated with ageing, inflammation and tissue damage. IHC staining confirmed changes in collagen, filaggrin and NQO1 protein expression. Treatment with ascorbic acid inhibited the effects of blue light, demonstrating a role in protection from blue light.

CONCLUSION

Our results showed that consistent blue light exposure produced skin damage via alterations in biological pathways that are associated with skin ageing. This work provides a new, reproducible in vitro testing method for assessing the effects of blue light on human skin using gene expression, protein ELISA and IHC staining.

Cap-independent mRNA translation is upregulated in long-lived endocrine mutant mice

It has been hypothesized that transcriptional changes associated with lower mTORC1 activity in mice with reduced levels of growth hormone and insulin-like growth factor 1 are responsible for the longer healthy lifespan of these mutant mice. Cell lines and tissues from these mice show alterations in the levels of many proteins that cannot be explained by corresponding changes in mRNAs. Such post-transcriptional modulation may be the result of preferential mRNA translation by the cap-independent translation of mRNA bearing the N6-methyl-adenosine (m6A) modification. The long-lived endocrine mutants - Snell dwarf, growth hormone receptor deletion and pregnancy-associated plasma protein-A knockout - all show increases in the N6-adenosine-methyltransferases (METTL3/14) that catalyze 6-methylation of adenosine (m6A) in the 5' UTR region of select mRNAs. In addition, these mice have elevated levels of YTH domain-containing protein 1 (YTHDF1), which recognizes m6A and promotes translation by a cap-independent mechanism. Consistently, multiple proteins that can be translated by the cap-independent mechanism are found to increase in these mice, including DNA repair and mitochondrial stress response proteins, without changes in corresponding mRNA levels. Lastly, a drug that augments cap-independent translation by inhibition of cap-dependent pathways (4EGI-1) was found to elevate levels of the same set of proteins and able to render cells resistant to several forms of in vitro stress. Augmented translation by cap-independent pathways facilitated by m6A modifications may contribute to the stress resistance and increased healthy longevity of mice with diminished GH and IGF-1 signals.

Pilot Randomized Controlled Trial of a Home Vegetable Gardening Intervention among Older Cancer Survivors Shows Feasibility, Satisfaction, and Promise in Improving Vegetable and Fruit Consumption, Reassurance of Worth, and the Trajectory of Central Adiposity

BACKGROUND

Holistic approaches are sought to improve lifestyle behaviors and health of cancer survivors long term.

OBJECTIVE

Our aim was to explore whether a home-based vegetable gardening intervention is feasible and whether it improves diet and other health-related outcomes among older cancer survivors.

DESIGN

We conducted a feasibility trial in which cancer survivors were randomized to receive a year-long gardening intervention immediately or to a wait-list control arm. Home visits at baseline and 1 year assessed physical performance, anthropometric indices, behavioral and psychosocial outcomes, and biomarkers.

PARTICIPANTS/SETTING

Participants included 46 older (aged 60+ years) survivors of locoregionally staged cancers across Alabama from 2014 to 2016. Forty-two completed 1-year follow-up.

INTERVENTION

Cooperative extension master gardeners delivered guidance to establish three seasonal vegetable gardens at survivors' homes. Plants, seeds, and gardening supplies were provided.

OUTCOMES

Primary outcomes were feasibility targets of 80% accrual and retention, and an absence of serious adverse events; other outcomes were secondary and explored potential benefits.

STATISTICAL ANALYSES

Baseline to follow-up changes were assessed within and between arms using paired t, McNemar's, and χ² tests.

RESULTS

This trial proved to be safe and demonstrated 91.3% retention; 70% of intervention participants rated their experience as "excellent," and 85% would "do it again." Data suggest significantly increased reassurance of worth (+0.49 vs -0.45) and attenuated increases in waist circumference (+2.30 cm vs +7.96 cm) in the gardening vs control arms (P=0.02). Vegetable and fruit consumption increased by approximately 1 serving/day within the gardening arm from baseline to follow-up (mean [standard error]=1.34 [1.2] to 2.25 [1.9] servings/day; P=0.02)] compared to controls (1.22 [1.1] to 1.12 [0.7]; P=0.77; between-arm P=0.06).

CONCLUSIONS

The home vegetable gardening intervention among older cancer survivors was feasible and suggested improvements in vegetable and fruit consumption and reassurance of worth; data also suggest attenuated increases in waist circumference. Continued study of vegetable gardening interventions is warranted to improve health, health behaviors, and well-being of older cancer survivors.

Mechanisms for the Inhibition of Colon Cancer Cells by Sulforaphane through Epigenetic Modulation of MicroRNA-21 and Human Telomerase Reverse Transcriptase (hTERT) Down-regulation

BACKGROUND

Epigenetic modulations such as histone modifications are becoming increasingly valued for their ability to modify genes without altering the DNA sequence. Many bioactive compounds have been shown to alter genetic and epigenetic profiles in various cancers. Sulforaphane (SFN), an isothiocyanate found in cruciferous vegetables such as kale, cabbage and broccoli sprouts, is one of the most potent histone deacetylase inhibitors (HDACis) to date. Recently, it has been identified that HDACis may play a vital role in regulating microRNAs (miRs) and human telomerase reverse transcriptase (hTERT).

OBJECTIVE

The aim of our study was to identify if aberrant HDAC, hTERT and miR levels could be regulated through novel dietary-based approaches in colorectal cancer (CRC) cells.

METHODS

We evaluated the in vitro epigenetic effects of SFN on CRC cells by MTT assay, cellular density assay, real-time reverse transcriptase-polymerase chain reaction (RT-PCR), cell cycle analysis, western-blot assay, HDAC activity assay and teloTAGGG telomerase PCR Elisa assay.

RESULTS

We demonstrated the inhibitory effects of physiologically relevant concentrations of SFN in both HCT116 and RKO CRC cells, and showed for the first time that SFN treatment decreased cell density, significantly inhibited cell viability and induced apoptosis in CRC cells. We also found that practical doses of SFN significantly down-regulated oncogenic miR-21, HDAC and hTERT mRNA, protein and enzymatic levels in CRC cells.

CONCLUSION

Our studies suggest that the regulation of HDAC, hTERT and miR-21 is a promising approach for delaying and/or preventing CRC and may be accomplished via the consumption of SFN in cruciferous vegetables.

Epigenetic-based combinatorial resveratrol and pterostilbene alters DNA damage response by affecting SIRT1 and DNMT enzyme expression, including SIRT1-dependent γ-H2AX and telomerase regulation in triple-negative breast cancer

Background

Nutrition is believed to be a primary contributor in regulating gene expression by affecting epigenetic pathways such as DNA methylation and histone modification. Resveratrol and pterostilbene are phytoalexins produced by plants as part of their defense system. These two bioactive compounds when used alone have been shown to alter genetic and epigenetic profiles of tumor cells, but the concentrations employed in various studies often far exceed physiologically achievable doses. Triple-negative breast cancer (TNBC) is an often fatal condition that may be prevented or treated through novel dietary-based approaches.

Methods

HCC1806 and MDA-MB-157 breast cancer cells were used as TNBC cell lines in this study. MCF10A cells were used as control breast epithelial cells to determine the safety of this dietary regimen. CompuSyn software was used to determine the combination index (CI) for drug combinations.

Results

Combinatorial resveratrol and pterostilbene administered at close to physiologically relevant doses resulted in synergistic (CI <1) growth inhibition of TNBCs. SIRT1, a type III histone deacetylase (HDAC), was down-regulated in response to this combinatorial treatment. We further explored the effects of this novel combinatorial approach on DNA damage response by monitoring γ-H2AX and telomerase expression. With combination of these two compounds there was a significant decrease in these two proteins which might further resulted in significant growth inhibition, apoptosis and cell cycle arrest in HCC1806 and MDA-MB-157 breast cancer cells, while there was no significant effect on cellular viability, colony forming potential, morphology or apoptosis in control MCF10A breast epithelial cells. SIRT1 knockdown reproduced the effects of combinatorial resveratrol and pterostilbene-induced SIRT1 down-regulation through inhibition of both telomerase activity and γ-H2AX expression in HCC1806 breast cancer cells. As a part of the repair mechanisms and role of SIRT1 in recruiting DNMTs, the effects of this combination treatment was also explored on DNA methyltransferases (DNMTs) expression. Interestingly, the compounds resulted in a significant down-regulation of DNMT enzymes with no significant effects on DNMT enzyme expression in MCF10A control cells.

Conclusion

Collectively, these results provide new insights into the epigenetic mechanisms of a novel combinatorial nutrient control strategy that exhibits synergy and may contribute to future recalcitrant TNBC prevention and/or therapy.

Electronic supplementary material

The online version of this article (doi:10.1186/s12885-015-1693-z) contains supplementary material, which is available to authorized users.

Molecular mechanisms for inhibition of colon cancer cells by combined epigenetic-modulating epigallocatechin gallate and sodium butyrate

Bioactive compounds are considered safe and have been shown to alter genetic and epigenetic profiles of tumor cells. However, many of these changes have been reported at molecular concentrations higher than physiologically achievable levels. We investigated the role of the combinatorial effects of epigallocatechin gallate (EGCG), a predominant polyphenol in green tea, and sodium butyrate (NaB), a dietary microbial fermentation product of fiber, in the regulation of survivin, which is an overexpressed anti-apoptotic protein in colon cancer cells. For the first time, our study showed that the combination treatment induced apoptosis and cell cycle arrest in RKO, HCT-116 and HT-29 colorectal cancer cells. This was found to be regulated by the decrease in HDAC1, DNMT1, survivin and HDAC activity in all three cell lines. A G2/M arrest was observed for RKO and HCT-116 cells, and G1 arrest for HT-29 colorectal cancer cells for combinatorial treatment. Further experimentation of the molecular mechanisms in RKO colorectal cancer (CRC) cells revealed a p53-dependent induction of p21 and an increase in nuclear factor kappa B (NF-κB)-p65. An increase in double strand breaks as determined by gamma-H2A histone family member X (γ-H2AX) protein levels and induction of histone H3 hyperacetylation was also observed with the combination treatment. Further, we observed a decrease in global CpG methylation. Taken together, these findings suggest that at low and physiologically achievable concentrations, combinatorial EGCG and NaB are effective in promoting apoptosis, inducing cell cycle arrest and DNA-damage in CRC cells.

MicroRNAs: an emerging science in cancer epigenetics

MicroRNAs (miRNAs) are remarkable molecules that appear to have a fundamental role in the biology of the cell. They constitute a class of non-protein encoding RNA molecules which have now emerged as key players in regulating the activity of mRNA. miRNAs are small RNAmolecules around 22 nucleotides in length, which affect the activity of specific mRNA, directly degrading it and/or preventing its translation into protein. The science of miRNAs holds them as candidate biomarkers for the early detection and management of cancer. There is also considerable excitement for the use of miRNAs as a novel class of therapeutic targets and as a new class of therapeutic agents for the treatment of cancers. From a clinical perspective, miRNAs can induce a number of effects and may have a diverse application in biomedical research. This review highlights the general mode of action of miRNAs, their biogenesis, the effect of diet on miRNA expression and the impact of miRNAs on cancer epigenetics and drug resistance in various cancers. Further we also provide emphasis on bioinformatics software which can be used to determine potential targets of miRNAs.

Nitroglycerin ointment effective for seven hours in severe angina pectoris

The efficacy and tolerability of nitroglycerin (NTG) ointment were studied in 80 male patients with severe angina pectoris. Two symptom-limited exercise tests were performed on successive days after application of an ointment containing 15 mg NTG or a placebo (P) ointment. The patients were assigned to 4 groups. The study was conducted in a double-blind, cross-over manner. The total amount of work performed was higher in all groups on NTG (46-70%) compared to P ointment. The difference was statistically significant (p less than 0.001) at all points of time from 0.5 to 7 hours. The ST segment depression in ECG at the end of the exercise test was slightly greater on P than on NTG, but the difference was statistically significant only in the 3-hour group (p less than 0.01). The frequencies of headache and dizziness were 35% and 16%, respectively, on NTG. Eight patients (10%) reported that headache was severe enough to prevent regular use of NTG ointment. NTG ointment is effective, has a long duration of action and is relatively well tolerated by patients with severe angina pectoris.

Ambulatory ECG recording in patients referred because of syncope or dizziness

Data are presented on patients referred for ambulatory ECG recording because of syncope or dizziness during a 2-year period. Of the 272 consecutive patients subjected to the recording, 107 (39.3%) had syncope or dizziness as the main indication for referral. Sixteen of these patients (14.9%) experienced the presenting symptom during the recording, and in 8 (50%) of these the simultaneous ECG finding was interpreted as causative. In patients who were symptom-free during the recording, sinus arrests exceeding 2.5 seconds seemed to be a valuable finding to support the cardiac aetiology of the syncopal symptoms, whereas the diagnostic value of second degree AV block with either Wenckebach or Mobitz II like patterns, as such, and of ventricular tachycardia remained mostly unsettled.

Ion imprinted polymer based sensor for monitoring toxic uranium in environmental samples

In view of the extreme toxicity of uranium and consequent stringent limits fixed by WHO and various national governments, it is essential to monitor the uranium content in the environment which is at ultratrace levels. Conventional ionophore based ion selective electrodes, barring a few, have limitations in terms of sensitivity and selectivity for the above mentioned purpose. We now propose an ion imprinted polymer (biomimetic) based potentiometric sensor by dispersing the uranyl ion imprinted polymer particles in 2-nitrophenyloctyl ether (plasticizer), which is embedded in polyvinyl chloride matrix. The sensor responds to uranyl ion over a wide concentration range of 2.0 x 10(-8) to 1.0 x 10(-2) M. The limit of detection was 2.0 x 10(-8) M. It showed a good selectivity for uranyl ion over alkali, alkaline earth, transition and heavy metal cations. The sensor is successfully tested for the monitoring of toxic uranium in tap and sea water samples.

Metal ion-imprinted polymers—Novel materials for selective recognition of inorganics

Ion-imprinted polymers (IIPs) are recently identified nano-porous polymeric materials which on leaching the imprint ion can rebind, sense or transport (when cast as membranes) selectively the target analyte in presence of closely related inorganic ions. The IIPs find interesting applications in solid phase extraction, sensors and membrane separations of inorganics. Unlike the molecularly imprinted polymers, the IIP field is in its infancy and has been briefly reviewed here along with some rough guidelines and concepts for further development of IIPs.

Solid phase extraction vis-à-vis coprecipitation preconcentration of cadmium and lead from soils onto 5,7-dibromoquinoline-8-ol embedded benzophenone and determination by FAAS

This article compares the solid phase extraction (SPE) and coprecipitative preconcentration of cadmium and lead from dilute aqueous solutions as a function of pH and weight of chelating agent. SPE enriches cadmium and lead over a wider pH range (6.0-8.0) and requires lower weight of DBQ chelate embedded benzophenone. Among the quinoline-8-ol and its dihaloderivatives, DBQ embedded benzophenone allows quantitative enrichment over a wide pH range (6.0-8.0) for both cadmium and lead unlike DCQ ( approximately 6.5 for Cd and 6.5-7.0 for Pb), DBQ was preferred. The calibration plots were rectilinear over the concentration range of 0.1-50 and 2.5-200mugl(-1) of cadmium and lead with detection limits of 0.1 and 2.0mugl(-1), respectively, which are 400 times lower than the direct FAAS method. The precision of the developed procedure is good as it provides relative standard deviation values of 2.20 and 2.45% during five replicate determinations of 2 and 25mugl(-1) of cadmium and lead, respectively. The accuracy of the developed procedure was tested by analyzing certified reference materials (CRM's) of soil and marine sediment samples supplied by IAEA, Italy and NRC, Canada, respectively. Furthermore, the developed procedure has been successfully used for the speciative determination of cadmium and lead in soil samples collected from the vicinity of industries in India.

Use of coronary angiography and revascularization procedures following acute myocardial infarction. A European perspective

AIMS

There is little evidence to inform routine practice in the use of coronary angiography and revascularization procedures after acute myocardial infarction. Large differences in the uptake of these procedures have been reported but representative data are scarce. Outcome studies have produced opposing conclusions concerning the impact of the high rate of these cardiac procedures.

METHODS AND RESULTS

A population-based patient sampling approach was utilized to identify routine practice in representative samples from 11 European countries. Data were collected retrospectively on treatment in the 6 months following acute myocardial infarction (n=2807). There was wide variation in utilization of coronary angiography and revascularization procedures. Even after restricting the analysis to patients <65 years (n=1262), there remained a 6 13 fold variation in the use of these procedures. A decreased likelihood of undergoing these procedures was associated with older age. In addition, there was an independent and negative association between female sex and utilization of coronary angiography and coronary artery bypass grafting (CABG).

CONCLUSION

The effect on patient outcome of the observed variation in use of these procedures is not known but has important cost and resource implications for the health services. Outcome research is needed to define patient selection criteria and to measure the cost-utility of different angiography and revascularization rates.

Beta-blockers and antithrombotic treatment for secondary prevention after acute myocardial infarction. Towards an understanding of factors influencing clinical practice. The European Secondary Prevention Study Group

AIMS

Long-term beta-blockade reduced mortality after acute myocardial infarction by about a quarter in a series of published trials. Representative data on beta-blocker use for secondary prevention are scanty but indicate wide variations. We have analysed European practice, and sources of variation, by regional sampling of acute myocardial infarction patients admitted to hospital in 11 countries during the period January 1993-June 1994.

METHODS AND RESULTS

Treatment data for 4035 representative patients were collected for the hospital phase and 6 months after discharge. A logistic regression model was developed to describe the predictors of beta-blocker use. In the 11 regional samples, 6-38% (20% overall) of patients had no recorded contraindications but were discharged without a beta-blocker. In the absence of perceived contraindications, there was a strong, independent negative association between age and odds of treatment (P < 0.001), and women were less likely to be treated than men (adjusted odds ratio 0.76, 95% CI 0.58-0.99). Discontinuation of beta-blocker treatment by 6 months was significantly less likely in regions where the proportion given such treatment at discharge was high. In contrast, use of antithrombotic agents in the samples was consistently high.

CONCLUSIONS

There is persisting low use of beta-blocker secondary prophylaxis, particularly in the elderly and in women, not attributable to perceived contraindications or intolerance. Considerable regional variations persist despite shared trials evidence. Discharge treatment strongly influences long-term medication.

Sleep and cardiac rhythm in healthy men

Cardiac rhythm during sleep was analysed in 168 healthy men aged 19 to 30 (mean 21.8) years using continuous nocturnal ECG recordings. Thirty five of the subjects were endurance athletes; 99 were recorded at home and 69 at a garrison during military service. The number of short term (less than one min) accelerations of heart rate of more than ten beats per minute ranged from 1.3 to 14.3 per hour; the number or accelerations (greater than one min) of more than 25 beats per minute typical of nocturnal restlessness ranged from zero to 6.1 per hour. The accelerations indicating nocturnal restlessness were more common during recordings done at the garrison than at home (2.2 per hour vs 1.3 per hour, P less than 0.01), whereas the short term accelerations were not (5.8 per hour vs 5.1 per hour, NS). Sinus pauses exceeding 2.00 sec occurred in 17 men (13 in athletes), occasional second degree atrioventricular block in 19 (eight in athletes) and ventricular premature beats in 37. Eighty-two per cent of sinus pauses, 83% of second degree atrioventricular blocks, and 81% of ventricular premature beats (when less than ten in the same subject) were associated with short term changes in heart rate. In conclusion, rapid changes in heart rate, presumably as a results of autonomic activation, are closely associated with most arrhythmias in healthy men during sleep, whereas changes in heart rate typical of nocturnal restlessness have little arrhythmogenic effect.

Adverse reactions to fluorescein angiography

Adverse reactions to ophthalmic patients during 9909 fluorescein angiographies during 9 years were registered. Nausea (4.6%) and vomiting (1.3%) were the most common untoward reactions. Allergic skin manifestations occurred in 48 patients, and 5 patients complained of shortness of breath. 56 patients (0.6%) felt dizzy during or immediately after the investigation. Nine patients complained of chest pain, three of whom developed myocardial infarction. Sixteen patients collapsed during the procedure. One healthy male, 42-year-old, collapsed after the injection of fluorescein during angiography, and electrocardiogram showed an asystole of 24 seconds. Otherwise, the electrocardiograms registered on 100 consecutive patients did not reveal any systematic changes in heart rate or rhythm during fluorescein angiography.

Parent-child agreement on child psychiatric symptoms assessed via structured interview

Correlations between scores derived from structured interviews with 299 disturbed children aged 6-18 and their parents indicated low-to-moderate levels of agreement regarding the presence and severity of child psychiatric symptoms. Agreement was higher on behavior and conduct problems than on anxiety, fears, obsessions-compulsions, psychotic symptoms and affective disturbances. Parents reported more child behavior and conduct problems than children, whereas children reported more affective and neurotic symptoms than parents. Parent-child agreement also increased sharply with age.

Influence of laryngoscope design on heart rate and rhythm changes during intubation

One hundred and twenty adult patients about to undergo surgery were premedicated with either meperidine or meperidine and atropine. After anaesthesia was induced with thiopentone and succinylcholine given, tracheal intubation was performed with the use of either a Magill or a Macintosh laryngoscope. There were no statistical differences in changes of heart rate and rhythm between the groups, as regards the type of premedication given or the design of laryngoscope used.

Effect of beta-blocking drugs on beta-cell function and insulin sensitivity in hypertensive non-diabetic patients

The effects of two beta-blocking drugs on endogenous insulin secretion and insulin sensitivity were investigated in a double-blind cross-over study in 13 hypertensive patients. The patients were randomly allocated to each of three 2-week treatment periods with propranolol 80 mg b.i.d., atenolol 50 mg b.i.d. and placebo b.i.d. Endogenous insulin secretion was assessed by measuring serum insulin and C-peptide before and 6 min after iv administration of glucagon; insulin sensitivity was determined by measuring insulin binding to erythrocytes, and as the glucose disappearance rate (KITT) after i.v. insulin. Fasting concentrations of serum free fatty acids (S-FFA) and plasma gastric inhibitory polypeptide (P-GIP) were also recorded during the three study periods. Both propranolol and atenolol reduced blood pressure, heart rate and S-FFA concentrations compared to placebo, and all patients showed measurable plasma concentrations of propranolol and atenolol. The results can be considered representative, therefore, of clinical beta-blockade. The two drugs did not significantly influence the fasting blood glucose level. There was an increase in fasting and glucagon-stimulated serum C-peptide concentration during propranolol therapy compared with placebo (p = 0.037 and p = 0.030, respectively), although this was not reflected by a significant change in serum insulin. Propranolol and atenolol did not significantly influence insulin binding to erythrocytes, but they clearly reduced the glucose disappearance rate KITT was compared to placebo (p = 0.0036 and p = 0.0003), respectively). The findings support the view that beta-blocking drugs can influence glucose metabolism by mechanisms other than inhibition of endogenous insulin secretion.

Ambulatory electrocardiographic findings in young athletes between 14 and 16 years of age

Ambulatory electrocardiographic recordings were obtained from 35 male athletes between 14 and 16 years old, and from 35 male non-athlete controls of the same ages, in order to determine the effects of regular physical training on cardiac electrical activity. In the young athletes, the heart rates were significantly (P less than 0.01) lower than in the nonathletes. Sinus intervals over 2.00 s were present in five athletes (14%) and one control (3%). First-degree atrioventricular block was detected in eight athletes (23%) and four controls (11%), and second-degree block was detected in seven athletes (20%) and one control (3%) (P less than 0.05). Ventricular premature beats were present in 60% of athletes and 57% of controls. The bradycardia in athletes did not predispose to ventricular ectopic activity, since heart rates at the times of occurrence of extrasystoles were higher in athletes than in controls. Even after two years of regular physical training there are significant differences in sinus nodal function and atrioventricular conduction as between young athletes and controls.

Ambulatory electrocardiographic recording in mild or moderate myotonic dystrophy and myotonia congenita (Thomsen's disease)

Ambulatory electrocardiographic recording (AER) was performed on 27 adult patients with mild or moderate myotonic dystrophy (MD) and in 12 adult patients with mild myotonia congenita (MC) to determine whether characteristic arrhythmias and conduction disturbances occur in the early stages of these myotonic disorders. In MD and MC, AER showed at least one finding regarded as normal in 93% and 0% of cases, respectively. The most common abnormalities in MD were first degree atrioventricular (A-V) block (in 70% of cases) and QTc greater than or equal to 0.46 s (in 33%). Abnormal sinus intervals and frequent second degree A-V block were rare, each occurring in 4% of patients. Ventricular tachycardia did not occur. It is concluded that signs of involvement of cardiac conductive tissue in the MD disease process are very common, even in the early stages. Delayed A-V conduction in the most common single finding. Sinus nodal dysfunction, severe disturbances in A-V conduction, and ventricular arrhythmias are not common in mild disease. Repeated AER is indicated, to evaluate whether conduction disturbances in MD are progressing.

Ambulatory electrocardiographic recording in endurance athletes

Data from ambulatory electrocardiographic recording in 35 highly trained endurance athletes and in 35 non-athletic controls of similar ages are given. The minimal, mean hourly, and maximal heart rates were significantly lower in the athletes. Thirteen athletes (37 . 1%) but only two controls (5 . 7%) had sinus pauses exceeding 2 . 0 seconds. First degree atrioventricular block was observed in 13 athletes (37 . 1%) and five controls (14 . 3%), second degree Wenckebach type block in eight athletes (22 . 9%) and two controls (5 . 7%), and second degree block with Mobitz II-like pattern in three athletes (8 . 6%) and no control. All athletes with Mobitz II-type pattern also had first degree and Wenckebach-type second degree atrioventricular block. The behavior of sinus rate on development of atrioventricular block varied, not only interindividually but also intraindividually, from absence of change to an increase or decrease in most subjects in both study groups. A decrease in sinus rate on appearance of atrioventricular block was found constantly in only two athletes and one control. Atrioventricular dissociation with junctional rhythm occurred in seven athletes (20%) and with ventricular rhythm in one athlete. Neither of these phenomena was seen in the group of controls. The athletes had slightly fewer ventricular extrasystoles than controls, and no athlete had ventricular tachycardia, whereas two controls had ventricular tachycardia.

Chest pain and rate-dependent left bundle branch block in patients with normal coronary arteriograms

A triad of exertional chest discomfort, transient rate-dependent left bundle branch block (LBBB), and normal coronary arteries is presented in seven consecutive patients. Although the clinical symptoms resembled effort angina, qualities atypical of classic angina pectoris were commonly noted: 1) the onset was always abrupt; and 2) the pain was local, never radiating; 3) palpitation; and 4) "walk through" phenomenon were often present. The abrupt pain took place simultaneously with the appearance of LBBB induced by physical exercise in all seven patients. Atrial pacing or spontaneous resting heart rate changes produced similar sensations and LBBB in four of the five patients examined in this way. Similarly, in the same four patients kinetocardiographic recordings disclosed a sudden occurrence of paradoxic cardiac movement at the moment LBBB and chest pain appeared. The paradoxic systolic motion disappeared at reversion to normal conduction.

Atrioventricular block, including Mobitz type II-like pattern, during ambulatory ECG recording in young athletes aged 14 to 16 years

Twenty young male athletes, aged 14 to 16 years, and 20 nonathletic male controls of the same ages were studied with regard to atrioventricular block using ambulatory ECG recording. Among the athletic youngsters, the mean hourly heart rates were significantly (p less than 0.01) lower during most of the night hours and during school hours when activities in both groups were uniform. First degree block was found in the athletes in 3 cases, second degree Wenckebach-type block in 3 cases and second degree block with Mobitz type II-like pattern in 2 cases. Among the nonathletes, first degree block was found in one case and second degree Wenckebach-type block in another. The results indicate that after approximately 3 years of physical training, on average 5 times a week, various forms of atrioventricular block, apparently vagally mediated, are observable in young athletes more often than in nonathlete controls.

Antiarrhythmic significance of dosing intervals in beta receptor blocking therapy of hypertension with acebutolol

Six hypertensive patients with daily ventricular arrhythmias underwent a double-blind crossover study to examine whether a once daily regimen of beta receptor blockade was equipotent in antihypertensive and antiarrhythmic activity to a twice daily regimen. Acebutolol, a relatively cardioselective beta blocking compound with intrinsic sympathomimetic properties, was given in two regimens: 200 mg twice daily or 400 mg once daily. Ventricular ectopic beats were analyzed both during physical exercise and with multiple 24 hour ambulatory electrocardiographic (Holter) recordings. Serum concentrations of acebutolol and its acetyl metabolite were determined using high pressure liquid chromatography. The two regimens of acebutolol were equally potent in reducing the blood pressure and heart rate at rest and during physical exertion. The hourly heart rates during 24 hours were reduced to the same extent by both regimens. The single daily 400 mg dose did not significantly reduce the incidence of arrhythmias, whereas 200 mg twice daily evoked a significant reduction during 24 hours. Serum concentrations of acebutolol were twice as great with the twice daily regimen as with the single dose. Both treatments significantly shortened the Q-Tc interval. The data suggest that, despite apparent beta receptor blockade and good blood pressure control, beta blocking agents with a relatively short plasma half-life lose their antiarrhythmic potency when administered on a once daily basis. This property seems to be more related to the plasma concentration of the compound than to the degree of clinically assessed beta receptor blockade.

Psychotic jealously: a phenomenological study

Sociodemographic, clinical, marital and sexual characteristics of 50 consecutive patients having delusions of infidelity were studied. Females outnumbered males after excluding alcoholics. Most of the patients were older than 30 yrs. and the onset occured more than 20 yrs. after marriage in about half the patients. Male patients were more often eldest siblings as compared to females. About one third of the patients had a history of marital and sexual difficulties prior to onset. The "third person" involved in the delusion was often a family member, particularly in patients coming from joint families. Possible causes of tie-in between delusion of jealousy and social factors are discussed.