Assessment of intracranial collaterals on CT angiography in anterior circulation acute ischemic stroke

BACKGROUND AND PURPOSE

Intracranial collaterals influence the prognosis of patients treated with intravenous tissue plasminogen activator in acute anterior circulation ischemic stroke. We compared the methods of scoring collaterals on pre-tPA brain CT angiography for predicting functional outcomes in acute anterior circulation ischemic stroke.

MATERIALS AND METHODS

Two hundred consecutive patients with acute anterior circulation ischemic stroke treated with IV-tPA during 2010-2012 were included. Two independent neuroradiologists evaluated intracranial collaterals by using the Miteff system, Maas system, the modified Tan scale, and the Alberta Stroke Program Early CT Score 20-point methodology. Good and extremely poor outcomes at 3 months were defined by modified Rankin Scale scores of 0-1 and 5-6 points, respectively.

RESULTS

Factors associated with good outcome on univariable analysis were younger age, female sex, hypertension, diabetes mellitus, atrial fibrillation, small infarct core (ASPECTS ≥8), vessel recanalization, lower pre-tPA NIHSS scores, and good collaterals according to Tan methodology, ASPECTS methodology, and Miteff methodology. On multivariable logistic regression, only lower NIHSS scores (OR, 1.186 per point; 95% CI, 1.079-1.302; P = .001), recanalization (OR, 5.599; 95% CI, 1.560-20.010; P = .008), and good collaterals by the Miteff method (OR, 3.341; 95% CI, 1.203-5.099; P = .014) were independent predictors of good outcome. Poor collaterals by the Miteff system (OR, 2.592; 95% CI, 1.113-6.038; P = .027), Maas system (OR, 2.580; 95% CI, 1.075-6.187; P = .034), and ASPECTS method ≤5 points (OR, 2.685; 95% CI, 1.156-6.237; P = .022) were independent predictors of extremely poor outcomes.

CONCLUSIONS

Only the Miteff scoring system for intracranial collaterals is reliable for predicting favorable outcome in thrombolyzed acute anterior circulation ischemic stroke. However, poor outcomes can be predicted by most of the existing methods of scoring intracranial collaterals.

Separation of finite electron temperature effect on plasma polarimetry

This study demonstrates the separation of the finite electron temperature on the plasma polarimetry in the magnetic confined fusion plasma for the first time. Approximate solutions of the transformed Stokes equation, including the relativistic effect, suggest that the orientation angle, θ, and ellipticity angle, ε, of polarization state have different dependency on the electron density, n(e), and the electron temperature, T(e), and that the separation of n(e) and T(e) from θ and ε is possible in principle. We carry out the equilibrium and kinetic reconstruction of tokamak plasma when the central electron density was 10(20) m(-3), and the central electron temperatures were 5, 10, 20, and 30 keV. For both cases when a total plasma current, I(p), is known and when I(p) is unknown, the profiles of plasma current density, j(φ), n(e), and T(e) are successfully reconstructed. The reconstruction of j(φ) without the information of I(p) indicates the new method of I(p) measurement applicable to steady state operation of tokamak.

Development of a YAG laser system for the edge Thomson scattering system in ITER

A prototype YAG laser system for the edge Thomson scattering system in ITER has been newly developed. Performance of the laser amplifier was improved by using flow tubes made of samarium-doped glass; the small signal gain reached 20 at its maximum. As a result, an output energy of 7.66 J at 100 Hz was successfully achieved, and the performance exceeded the target performance (5 J, 100 Hz).

Polychromator for the edge Thomson scattering system in ITER

A new type polychromator has been designed for the edge Thomson scattering system in ITER. Signal light is parallelly dispersed into two parts at the first interference filter. Spectral transmissivities for some spectral channels may enhance better than the conventional type polychromator. In the new type polychromator, the misalignment due to the machine accuracy is expected to be within the margin of APD area. In order to calibrate the spectral transmissivity using the dual-laser injection method during the plasma discharge, it is preferred that the spectral channels are separated at the geometric mean of the injected two wavelengths.

In situ spectral calibration method for the impurity influx monitor (divertor) for ITER using angled physical contact fibers

The in situ calibration method for the impurity influx monitor (divertor) is experimentally examined. The total reflectance of the optical path from the focal point of the Cassegrain telescope to the first mirror is derived using a micro retroreflector array. An optical fiber with angled physical contact (APC) connectors reduces the return edge reflection. APC fibers and a multimode coupler increase the signal-to-noise ratio by about one order compared to that of triple-branched fibers and enable measurement of the wavelength dependence of the total reflectance of the optical system even after potential deterioration of mirror surfaces reduces reflectance.

Terrace retro-reflector array for poloidal polarimeter on ITER

A new concept of a terrace retro-reflector array (TERRA) as part of the poloidal polarimeter for ITER is proposed in this paper. TERRA reflects a laser light even from a high incident angle in the direction of the incident-light path, while a conventional retro-reflector array cannot. Besides, TERRA can be installed in a smaller space than a corner-cube retro-reflector. In an optical sense, TERRA is equivalent to a Littrow grating, the blaze angle of which varies, depending on the incident angle. The reflected light generates a bright and dark fringe, and the bright fringe is required to travel along the incident-light path to achieve the objects of laser-aided diagnostics. In order to investigate the propagation properties of laser light reflected by TERRA, we have developed a new diffraction formula. Conditions for the propagation of the bright fringe in the direction of the incident light have been obtained using the Littrow grating model and have been confirmed in a simulation applying the new diffraction formula. Finally, we have designed laser transmission optics using TERRA for the ITER poloidal polarimeter and have calculated the light propagation of the system. The optical design obtains a high transmission efficiency, with 88.6% of the incident power returned. These results demonstrate the feasibility of applying TERRA to the ITER poloidal polarimeter.

Defining the infrared systems for ITER

The International Thermonuclear Experimental Reactor will have wide angle viewing systems and a divertor thermography diagnostic, which shall provide infrared coverage of the divertor and large parts of the first wall surfaces with spatial and temporal resolution adequate for operational purposes and higher resolved details of the divertor and other areas for physics investigations. We propose specifications for each system such that they jointly respond to the requirements. Risk analysis driven priorities for future work concern mirror degradation, interfaces with other diagnostics, radiation damage to refractive optics, reflections, and the development of calibration and measurement methods for varying optical and thermal target properties.

Development of in-vessel components of the microfission chamber for ITER

Microfission chambers (MFCs) will measure the total neutron source strength in ITER. The MFCs will be installed behind blanket modules in the vacuum vessel (VV). Triaxial mineral insulated (MI) cables will carry signals from the MFCs. The joint connecting triaxial MI cables in the VV must be considered because the MFCs and the MI cables will be installed separately at different times. Vacuum tight triaxial connector of the MI cable has been designed and a prototype has been constructed. Performance tests indicate that the connector can be applied to the ITER environment. A small bending-radius test of the MI cable indicates no observed damage at a curvature radius of 100 mm.

Conceptual design of the collection optics for the edge Thomson scattering system in ITER

Neutron and gamma-ray irradiation complicates the design of the edge Thomson scattering (TS) system in ITER. The TS light is relayed through the relaying optics with labyrinth and fiber coupling optics. Electron density of 2×10(19) m(-3) is sufficient to measure T(e) and n(e) within a 10% and 5% margin of error, respectively, with a spatial resolution of 5 mm. This system can cover from 0.85 to 1 of the normalized minor radius. The time resolution is 10 ms, which is determined by the repetition rate of the laser device. A super-Gaussian is the ideal laser profile for the laser injection optics to avoid a breakdown of the filling gas used in density calibration through Raman scattering.

Design of microfission chamber for ITER operations

Microfission chambers (MFCs) are one of the most important diagnostics for measuring neutron source strength in ITER. Using MFCs for high-power operations (fusion power of 100 kW-1 GW) and for low-power operations (<100 kW) in combination is one way to fulfill the target measurement requirements of ITER. The MFCs for high-power operations will be installed behind blanket modules in both the upper and lower outboard regions of the vacuum vessel so as to be insensitive to changes in the position of the plasma. For low-power operations, one possible location of MFCs is inside the equatorial (EQ) port. The effect of streaming neutrons and of changes in the position of the plasma on the responses of MFCs is estimated based on a neutron Monte Carlo calculation using the MCNP Version 5 code. Results suggest that the effect of streaming neutrons should be taken into account if the MFCs for high-power operations are installed closer than 20 cm to the gap between blanket modules. It has also been found for MFCs of low-power operations that the averaged output of the MFCs installed at the top and bottom of the EQ port is sensitive to horizontal plasma shifts but not to vertical shifts. This finding suggests that corrections based on the position of the plasma center will be needed for the absolute measurement of neutron source strength.

Design study of polychromators for ITER edge Thomson scattering diagnostics

In this study, we investigate designs for polychromators of the ITER edge Thomson scattering system by means of numerical calculations. For this purpose, we discuss the optimum transmission wavelength ranges of the optical filters and the optimum number of filters. Five different filter arrangements, including those with an optical notch filter to eliminate D(alpha) emission, are compared with each other. The measurement accuracy when using a polychromator is evaluated for midplane port configuration. It is found that the optimum filter number keeping in mind the cost performance cost is 5 or 6. Moreover, the use of an optical notch filter increases the measurement accuracy by approximately 5%.

Observation of nonlinear coupling between small-poloidal wave-number potential fluctuations and turbulent potential fluctuations in Ohmically heated plasmas in the JFT-2M tokamak

Two types of electrostatic modes with small-poloidal wave numbers (approximately 1 and 10-15 kHz) are observed in the edge region of Ohmically heated plasmas in the JFT-2M tokamak. The envelope of the higher frequency coherent mode is modulated at the frequency of the lower frequency mode. A bispectral analysis revealed that a significant nonlinear coupling among the two types of fluctuations and the broadband background turbulent potential fluctuations occurs inside the last closed magnetic flux surface, suggesting that a nonlinear process such as the parametric-modulational instability is involved.

Role of bremsstrahlung radiation in limiting the energy of runaway electrons in tokamaks

Bremsstrahlung radiation of runaway electrons is found to be an energy limit for runaway electrons in tokamaks. The minimum and maximum energy of runaway electron beams is shown to be limited by collisions and bremsstrahlung radiation, respectively. It is also found that a massive injection of a high-Z gas such as xenon can terminate a disruption-generated runaway current before the runaway electrons hit the walls.

Resting Ultrasonic Tissue Characterization and Dobutamine Stress Echocardiography for Prediction of Functional Recovery in Chronic Left Ventricular Ischemic Dysfunction

This study was designed to assess the diagnostic accuracy of the percentage of resting systolic wall thickening (WT), dobutamine stress echocardiography (DSE), resting cyclic variation of integrated backscatter (IBS-CV), and low-dose dobutamine stress IBS-CV (DSE-IB) for the prediction of regional function recovery (RFR) in patients with chronic left ventricular (LV) ischemic dysfunction. The study also evaluated whether or not global LV function affected the diagnostic accuracy. All studies were conducted before percutaneous transluminal coronary angioplasty (PTCA) and RFR was assessed after PTCA (mean interval, 10 months) in 30 patients with chronic LV ischemic dysfunction. Patients were divided into 2 groups according to the LV ejection fraction (LVEF): group A, LVEF<40%, n=14; group B, LVEF> or =40%, n=16. Of a total of 480 segments, 37 initially demonstrating akinetic wall motion before PTCA were analyzed. The wall motion of 24 of the 37 segments improved on visual analysis after PTCA. In the prediction of RFR, resting WT, DSE, resting IBS-CV and DSE-IB had sensitivities of 79%, 79%, 92% and 62%, and specificities of 54%, 84%, 83% and 69%, respectively. In particular, the resting IBS-CV in group A, as well as DSE, was an excellent predictor of RFR (sensitivity, 100%; specificity, 86%; vs sensitivity, 82%; specificity, 78%; respectively). Therefore, both resting IBS-CV and DSE are useful predictors for RFR in patients with chronic LV ischemic dysfunction.

A role of angiotensin-converting enzyme gene polymorphism in left ventricular remodeling after myocardial infarction

BACKGROUND

Left ventricular remodeling (LVR) process is one of the important secondary sequele after acute myocardial infarction (AMI). However, little is known about the relationship between LVR and angiotensin converting enzyme (ACE) gene polymorphism as well as endothelial nitric oxide synthase (ecNOS) gene polymorphism.

METHODS

Coronary angiography and left ventriculography were performed within 24 hours and 30+/-7 days after AMI onset. All consecutive 24 patients (57+/-6 years) had acute anterior MI with one vessel disease of left anterior descending artery and successful revascularization therapy during acute phase. Patients were divided into three groups according to the change of end-diastolic volume index (EDVI)(Delta EDVI = EDVI 1 month-EDVI within 24 hrs); LVR(+) (Delta EDVI>7.0 ml/m(2), n = 5), LVR (-)(Delta EDVI<-7.0 ml/m(2), n = 13), and LVR (+/-)(-7.0<Delta EDVI<7.0 ml/m(2), n = 6) groups. The polymorphisms of ACE and ecNOS gene were determined with PCR method after an extraction of genomic DNA from peripheral leukocytes.

RESULTS

There were no significant difference among three groups as to baseline characteristics, including coronary risk factors, medications, serum CPKmax and patency of infarct-related artery. The incidence of DD genotype of ACE gene is significantly higher in LVR (+) than in the other two groups (0.60; 0; 0, respectively, chi(2) = 13.150, p<0.01). The incidence of D allele of ACE gene is also significantly higher in LVR (+) than in the other two groups (0.70; 0.17; 0.19, respectively, chi(2) = 10.221, p<0.01). Delta EDVI of DD genotype was significantly greater than in the other two groups (DD genotype = 30.1+/-18.1; ID genotype = -13.0+/-27.4; II genotype = -8.2+/-11.5 ml/m(2), respectively, p<0.05). There was no significant difference in ecNOS gene polymorphism among three groups. By stepwise regression analysis, the significant independent predictors of Delta EDVI were EDVI within 24 hrs and DD genotype (F = 16.88 and 8.641, respectively, p = 0.0024).

CONCLUSION

These results showed that left ventricular dilatation is related to DD genotype of ACE gene after successful reperfusion therapy of anterior AMI. Thus, renin-angiotensin system may play an important role in left ventricular remodeling after AMI.

Clinical significance of increased plasma concentration of macrophage colony-stimulating factor in patients with angina pectoris

OBJECTIVES

To determine the effect of macrophage colony-stimulating factor (MCSF) on atherogenesis in patients with coronary artery disease (CAD), we assessed the relation between the plasma concentration of MCSF and the incidence of acute coronary events in patients with CAD.

BACKGROUND

Cytokines such as MCSF play a central role in inflammatory and proliferative responses in patients with acute coronary syndromes. However, the effect of MCSF on the clinical course in patients with CAD is still not known.

METHODS

We measured the plasma MCSF concentration in 142 patients with documented CAD (62 +/- 9 years) and followed up for a mean period of 14 +/- 6 months. The study included 97 patients with stable angina (SA), 45 patients with unstable angina (UA) and 22 age-matched control subjects. The predictors of coronary events were analyzed by using a Cox proportional hazards model.

RESULTS

The mean plasma MCSF concentration in patients with UA was significantly higher than that in patients with SA and in control subjects (981 +/- 277 vs. 693 +/- 223 vs. 680 +/- 158 pg/ml, p < 0.001). The mean plasma MCSF concentration in the 20 patients with coronary events was significantly higher than that in patients without coronary events (1,192 +/- 232 vs. 690 +/- 213 pg/ml, p < 0.001). The predictors of unfavorable outcome were an increased MCSF concentration, the presence of CAD and a low ejection fraction.

CONCLUSIONS

These findings suggest that an increased circulating MCSF concentration reflects atherosclerotic progression in patients with CAD and predicts future cardiac events.

Transient left ventricular aneurysm and hypertrophy accompanied by polymorphic ventricular tachycardia in a patient suspected of acute myocarditis

A 75-year-old woman presented with recurrent ventricular tachycardia (VT) compatible with torsades de pointes (TdP) based on sinus bradycardia and QT prolongation. Previously she had received pirmenol, at a serum concentration within therapeutic range, for her paroxysmal atrial fibrillation. Emergent cardiac catheterization identified a ventricular aneurysm of the anteroapical and inferior wall along with angiographically normal coronary arteries. A right ventricular endomyocardial biopsy revealed postmyocarditic change. The left ventricular contraction improved after 5 weeks of conservative treatment. A follow-up echocardiogram revealed transient thickening of partial left ventricular wall consistent with the segment of the aneurysm. Several months later, almost all abnormal findings had improved except for sustained deep negative T waves in precordial leads. Acute myocarditis was primarily suspected as the cause of her clinical presentation.

[Assessment of left ventricular contraction abnormalities with myocardial infarction using gated technetium-99m sestamibi SPECT: comparison of wall thickening and regional ejection fraction analysis for the detection of coronary artery stenosis]

ECG-gated myocardial Technetium-99m sestamibi SPECT is a useful technique to measure myocardial perfusion and function simultaneously. In this study, wall thickening (WT) and regional ejection fraction (rEF) using ECG-gated SPECT have been studied to determine which parameter would be more sensitive to detect coronary artery stenosis in patients with acute myocardial infarction (AMI). Forty-five patients (36 men, 9 women, mean age 63 +/- 9 years old) with AMI were examined. CAG was performed for all patients. ECG-gated SPECT was performed 60 min after the intravenous injection of 555 MBq 99mTc-sestamibi at rest. Commercially available software (QGS) was used to produce WT and rEF polar maps from acquired SPECT data. The WT and rEF polar maps were evaluated visually and quantitatively. WT indicated higher sensitivity (80.3% vs. 59.1%, p < 0.05) and accuracy (86.7% vs. 74.8%, p < 0.05) than rEF for detecting overall coronary artery stenosis on visual interpretation. On quantitative analysis, WT had higher specificity (91.3% vs. 75.4%, p < 0.05) and accuracy (85.9% vs. 72.6%, p < 0.05) than rEF for detecting overall coronary artery stenosis, and showed a higher specificity (93.8% vs. 59.4%, p < 0.01) and accuracy (88.9% vs. 62.2%, p < 0.01) for detecting LCX stenosis. Moreover, sensitivity of WT for detecting coronary artery stenosis without infarction was higher than that of rEF significantly in quantitative analysis (75.0% vs. 31.3%, p < 0.05). These results suggested that WT was superior to rEF for detecting the coronary artery stenosis in patients with and without myocardial infarction. We concluded that WT is more sensitive indicator to determine localization of regional left ventricular dysfunction in AMI than rEF.

Novel cyclopropapyrroloindole derivative (AT-3510) bearing methoxycarbonyl and trifluoromethyl groups

The seco-Cl 3-methoxycarbonyl-2-trifluoromethylcyclopropapyrroloindole (MCTFCPI) derivatives dl- and/or (S)-10 carrying various acyl moieties at the N6-position were synthesized along with their prodrugs (S)-12, and their antitumor activity was evaluated. Among these derivatives, AT-3510 [(S)-12m], the novel prodrug MCTFCPI derivative carrying a 5-(7-methoxybenzofuran-2-ylcarbonyl)aminoindole-2-carb onyl group at the N6-position, was found to exhibit more excellent antitumor activity against human tumor xenografts than the clinical trial candidates carzelesin (6) and KW-2189 (7) and cisplatin.

[Myocardial distribution of iodine-123-iodophenyl-9-methyl-pentadecanoic acid (9MPA) in patients with acute myocardial infarction: comparison with regional wall motion obtained from technetium-99m-sestamibi gated SPECT]

123I-iodophenyl-9-methyl-pentadecanoic acid (9MPA) is a modified long-chain (15 carbons) fatty acid with a methyl branch on its 9 carbon location. Myocardial SPECT images (two sets, 10 min each) were obtained starting 10 min (early phase) and 50 min (delay phase) after the injection of 160 MBq 123I-9MPA at rest in 10 patients with acute myocardial infarction. The segmental myocardial uptake (% uptake) and clearance (% washout) from early to delay image were calculated by the SPECT data. ECG-gated myocardial SPECT with 99mTc-sestamibi was also performed and segmental left ventricular (LV) wall motion was evaluated using QGS (quantitative gated SPECT) program. The % uptake of LV segments with hypokinetic or akinetic wall motion were significantly lower than those with normokinesis (p < 0.01) for both early and delay phases. The % washout of hypokinetic segments were significantly lower than those of normokinetic regions (p < 0.01), while the % washout of akinetic segments were significantly higher than those of severely hypokinetic segments (p < 0.05). Thus, 123I-9MPA myocardial distribution and clearance thought to be associated with left ventricular regional wall motion.

Negative U-wave as a predictor of antihypertensive treatment effect on regression of echocardiographic hypertrophy in hypertensive patients

To clarify the mechanism and the predictors of the reduction in left ventricular mass (LVM) induced by antihypertensive drugs, forty hypertensive patients were classified according to the presence of left ventricular hypertrophy (LVH) as a defined by echocardiographic LVM findings (LVH group: 27 patients, non-LVH group: 13 patients) and according to the presence of negative U-waves (NU) (NU group: 10 patients, non-NU group: 30 patients). Negative U-waves appeared in the LVH group only (10 of 27 patients). The hemodynamic determinants were investigated as a mechanism of LVM reduction in 38 of these patients who were treated for 2 years with antihypertensive drugs. In the LVH group, thickness of interventricular septum (IVST), posterior wall thickness (PWT) and LVM increased significantly compared to the non-LVH group. In the NU group, the left ventricular end-diastolic dimension (LVDD) was significantly larger and the relative wall thickness was significantly smaller compared to the non-NU group in the LVH group, with no difference in LVM between the two groups. Negative U-waves disappeared in all cases after treatment. Significant decreases in LVDD and LV wall thickness were observed in the NU group and significant decrease in LV wall thickness in the non-NU group. LVM index was reduced by 24.0% in the NU group and 9.5% in the non-NU group. The disappearance of negative U-waves was an independent predictor of the reduction of LVH.

Coronary hyperreactivity to adrenergic stimulation and increased nocturnal vagal tone trigger coronary vasospasm

The relationship between autonomic nervous system activity (ANA) and coronary vasoreactivity during transient myocardial ischemia was determined in patients with vasospastic angina (VA). ANA was measured by power spectral analysis of heart rate variability and humoral factors following intravenous infusion of insulin in 24 patients with VA and 6 control patients. Nine (38%) of the VA patients had significant ST segment depression (STD), and 4 of these patients had symptomatic STD. The frequency of anginal episodes in the 9 patients with VA and STD was significantly greater than that in the 15 VA patients without STD (3.4 +/- 3.1 vs 0.5 +/- 0.8 episodes/week, p < 0.05). The increase in the LF/HF ratio 30 min after insulin injection in patients with STD was significantly greater than that in patients without STD (34 +/- 31% vs 4 +/- 34%, p < 0.05). All of the patients with VA and STD had significant coronary vasospasm in response to the infusion of < or = 20 micrograms of acetylcholine, higher levels of nocturnal parasympathetic activity, and greater norepinephrine production in response to insulin stimulation than the VA patients without STD. These findings suggest that increased vagal tone and hyperreactivity to adrenergic stimulation may trigger vasospasm in patients with VA.

[Effect of phenylephrine, endothelin and angiotensin II on reperfusion arrhythmias. A role for Na+/H+ exchanger activation via protein kinase C]

Stimulation of receptors for alpha 1-adrenergic agonist, endothelin (ET) and angiotensin II (AT) activates the cardiac sarcolemmal Na+/H+ exchanger (NHE), perhaps via protein kinase C(PKC)-mediated pathway(s). We tested for the ability of these extracellular stimuli to exacerbate reperfusion arrhythmias and for the possible role of NHE activation and PKC in such phenomena. Isolated rat hearts (n = 12/group) were subjected to dual coronary perfusion. After 15 min of aerobic perfusion, flow to the left coronary bed was reduced to 5% of basal values for 12 min, and the same bed was then reperfused for 5 min. An alpha 1-adrenergic agonist phenylephrine (PE) at 1 or 10 mumol/L, ET at 0.5 or 5nmol/L or AT at 1 or 10mumol/L was infused selectively into the left coronary bed during 12 min of regional low flow ischemia. The incidence of reperfusion-induced ventricular fibrillation (VF) was increased from 17% in control to 33% and 75%* with 1 and 10 mumol/L PE(*p < 0.05 vs control) from 8% in control to 8% and 12% with 0.5 and 5 nmol/L of ET. However, AT had no effect. The selective NHE inhibitor NOE642 at 1 mumol/L, infused concomitantly with 10 mumol/L PE, reversed the proarrhythmic effects of PE; VF incidence was reduced from 67% to 8%*. However, glibenclamide (a blocker for the ATP-sensitive K+ channel) at 1 mumol/L did not affect the proarrhythmic effects of PE. Infusion of a specific PKC inhibitor GF109203X(GF) at 30 or 300 nmol/L, starting from 5 min before ischemia and maintained throughout ischemia concomitantly with 10 mumol/L of PE, was partially effective in reducing VF incidence; which reduced from 75% in control to 42% with 300 nmol/L of GF. These results suggest that, in rat hearts subjected to regional low-flow ischemia and reperfusion, stimulation of alpha 1-adrenergic receptor can exacerbate reperfusion-induced VF, whose mechanism(s) may involve NHE activation. Moreover, PKC activation does not appear to be the sole signaling mechanism for this phenomenon.

The novel cyclopropapyrroloindole(CPI) bisalkylators bearing methoxycarbonyl and trifluoromethyl groups

The novel 3-methoxycarbonyl-2-trifluoromethylcyclopropapyrroloindole (MCTFCPI) bisalkylators were synthesized and their antitumor activity was evaluated. Among these derivatives, 7f in which two MCTFCPI moieties are connected with a 5,5'-bis(2-carbonyl-1H-indole) group, was found to exhibit more prominent cytotoxicity and antitumor activity than U-77,779 (bizelesin) (2).