Effects of cigarette smoking and propranolol in survivors of acute myocardial infarction

The effect of propranolol on mortality and reinfarction after acute myocardial infarction (AMI) in cigarette smokers and nonsmokers was studied in the Beta Blocker Heart Attack Trial. Cigarette smokers (n = 2,332) were 5 years younger than nonsmokers and had a lower incidence of diabetes mellitus, systemic hypertension, previous AMI and cardiomegaly. Among cigarette smokers, the placebo group had a higher total mortality rate than the propranolol group (11.0 vs 7.4%, p less than 0.0008) and more sudden cardiac deaths (7.1 vs 4.6%, p less than 0.009). In nonsmokers the placebo group had a mortality (7.9 vs 7.1%, p greater than 0.64) similar to the propranolol group. After baseline adjustment, cigarette smokers were estimated to have 1.6 times the risk of dying as compared to nonsmokers (p less than 0.0007). Adjusting for baseline differences, both treatment with propranolol and nonsmoking were predictors of survival. No detectable nonsmoking/propranolol interaction could be identified. In survivors of AMI a beneficial effect of propranolol is observed for cigarette smokers. Nevertheless, cigarette smoking continues to be a risk factor for mortality after AMI even for those receiving propranolol.

Absence of reverse transcriptase activity in human diploid fibroblasts

The reverse flow of genetic information from RNA transcripts to DNA has been postulated to be the mechanism for the generation of pseudogenes, dispersed repetitious DNA families, and small extrachromosomal circular DNAs in eukaryotic cells. We were unable to detect reverse transcriptase-like activity in several strains of cultured human cells, with or without induction by a variety of chemical and physical agents known to induce latent retroviruses.

Nutrition and somatomedin. XXI. Insulin-like growth factor-I and somatomedin inhibitor in streptozotocin-diabetic rats: relation to ketogenesis and gluconeogenesis

Diabetes is associated with a fall in serum insulin-like growth factor-I (IGF-1) and a rise in somatomedin inhibitor, a circulating factor(s) of approximately 30,000 MW that is released by the liver and can antagonize both somatomedin and insulin action. Levels of inhibitor correlate with levels of glucose, beta-hydroxybutyrate, and weight loss. To study pathways that could underlie the fall in IGF-1 and rise in inhibitor, the effects of metabolic inhibitors on circulating metabolic fuels, serum IGF-1, and serum somatomedin inhibitor activity were studied. Rats given streptozotocin exhibited weight loss of 14% +/- 0.1%, glucose 457 +/- 26 mg/dL, and beta-hydroxybutyrate (BOHB) 6.3 +/- 0.5 mmol/L. Somatomedin inhibitor was separated from IGF-1 by size exclusion HPLC at pH 3; IGF-1 was measured by RIA, and somatomedin inhibitor by cartilage bioassay. Diabetic animals exhibited a fall in IGF-1 to 76% of normal (P less than .02) and a rise in inhibitor to 270% of normal (P less than .01). 3-Mercaptopicolinic (3-MPA) acid, an inhibitor of gluconeogenesis, lowered glucose to 68 +/- 2 mg/dL and BOHB to 0.96 +/- 0.09 mmol/L (both P less than .01 v diabetic), but levels of inhibitor did not fall. Nicotinic acid, an inhibitor of lipolysis, did not affect glucose but reduced BOHB to 0.42 +/- 0.02 mmol/L; somatomedin inhibitor fell 19% below diabetic levels (NS) but remained above normal (P less than .01). In contrast, inhibition of fatty acid oxidation with methyl-2-tetradecylglycidate reduced glucose to 191 +/- 18 mg/dL but lowered BOHB to normal, 0.16 +/- 0.02 mmol/L, accompanied by normalization of somatomedin inhibitor levels (152% +/- 33% of normal, NS). Below 1.0 mmol/L BOHB, somatomedin inhibitor and BOHB were strongly correlated (r = .67, P less than .001); no comparable relation was found with glucose.(ABSTRACT TRUNCATED AT 250 WORDS)

Werner syndrome: a molecular genetic hypothesis

On the basis of clinical and experimental observations, we postulate that the primary genetic abnormality in Werner syndrome (WS) is mutation in a gene encoding a trans-acting factor that normally represses a second genetic locus or its product, an inhibitor of DNA synthesis elaborated when cells reach the end of their replicative life span. The result is early derepression of this second locus, leading to reduced initiation of DNA synthesis and premature replicative senescence. This hypothesis and its corollaries provide a heuristic model for decisive experiments.

A reinvestigation of the reaction of desferrioxamine with superoxide radicals. A pulse radiolysis study

The reaction of desferrioxamine with superoxide has been studied using the pulse radiolysis technique. The decay of O2- was not accelerated in the presence of up to 4 x 10(-4) M desferrioxamine at physiological pH. The rate constant was found to be lower than 2 x 10(4) M-1s-1. In acid solutions the rate constant of the reaction between desferrioxamine and HO'2 was found to be lower than 10(5) M-1s-1. The reaction was not studied in alkaline solutions due to the high absorbance of desferrioxamine in the U.V. region. The pK of desferrioxamine was determined to be 9.2 +/- 0.05.

Population movement in Zhejiang province, China: the impact of government policies

"China's urbanization policies include strict control of permanent migration to large cities, but encourage the growth of small cities and towns. Concurrently, temporary migration is widely permitted as a way to stimulate commerce. Data for Zhejiang province indicate that permanent mobility is largely directed toward urban places, that towns gain more than cities and that rural areas experience migration losses. Permanent migrants to urban places are selective of the better educated. Temporary migration is also urban directed but greater in volume than permanent migration, and places considerable strain on urban infrastructure. Government policies are a key to understanding the migration streams and migrant characteristics. The considerable net movement into cities suggests that strict control of city growth is more difficult to achieve than envisaged by policymakers." This is a revised version of a paper originally presented at the 1989 Annual Meeting of the Population Association of America (see Population Index, Vol. 55, No. 3, Fall 1989, p. 386).

Enhancement of the rate of the beta-elimination of phosphate from radicals derived from glycerol-2-phosphate by Cu(I)-phenanthroline. A pulse radiolysis study

Hydroxyl radicals abstract hydrogen atoms from glycerol-2-phosphate with a specific rate constant of (7.0 +/- 1.5) x 10(8) M-1s-1 forming the beta-phospho radical as the major product. At physiological pH this radical undergoes a beta-phosphate elimination with a rate constant less than or equal to 1 x 10(3) s-1. The beta-phospho radical reacts with Cu(I)-phenanthroline to produce an unstable transient with a metal-carbon sigma-bond which has an absorbance similar to that of the cuprous phenanthroline complex in the visible region. This intermediate decomposes via a beta-elimination of phosphate with a rate constant of (1.0 +/- 1.5) x 10(4) s-1, which was independent of the acidity in the pH range 4-9.

Clonal variation in gene methylation: c-H-ras and alpha-hCG regions vary independently in human fibroblast lineages

The stability of DNA methylation has been followed in clonal lineages of human diploid fibroblasts, for the gene regions encoding the c-H-ras proto-oncogene and the alpha subunit of human chorionic gonadotropin (alpha-hCG). Although methylation losses predominated, both de novo gains and losses of cytosine methylation were observed in subclones and sub-subclones, at frequencies which differed between individual clonal lineages, and between the 2 gene regions compared. Methylation of these loci varied independently among clones; e.g., a lineage which showed frequent methylation loss in the c-H-ras gene region remained highly methylated for alpha-hCG, and vice versa. Thus, the fidelity with which DNA methylation is inherited in specific endogenous gene regions must be governed by a clone-specific property affecting local chromatin structure, but apparently not by gene expression per se. Late in the replicative life-span of diploid fibroblasts, as cell replication slowed, restriction patterns for methylation-sensitive enzymes became simpler and more discrete, while those for other enzymes did not change. This is interpreted as a consequence of 'clonal succession', in which the fastest-replicating or longest-lived clones/subclones eventually predominate in a cell population; it could also reflect a decreased rate or a non-random selection of methylation changes in late-passage cells.

Aerobics enhances cardiovascular fitness and agility in preschoolers

Investigated effects of aerobic exercise on a sample of 24 preschoolers. Thirty minutes of aerobic exercises were provided daily for a period of 8 weeks for a group of 12 children while the remaining 12 children engaged in freeplay on the school playground. The children were given pretests and posttests on the following measures: a submaximal exercise test on a pediatric bicycle (baseline and three workloads), an agility test, a health knowledge test, a self-esteem scale, and an observational measure of their gross-motor activity. Despite comparability on pretests, significant group X repeated measures effects suggested that the aerobic exercise group showed decreases in heart rate at all three workloads as well as increases in agility and self-esteem following the exercise program. These findings suggest that cardiovascular fitness, agility, and self-esteem can be facilitated in preschoolers by an aerobic exercise program.

Cardiac event rate after non-Q-wave acute myocardial infarction and the significance of its anterior location

To correlate cardiac event rate with infarct location on the electrocardiogram in patients recovering from a non-Q-wave acute myocardial infarction (AMI), 135 consecutive patients with enzymatically proven non-Q-wave AMI were followed prospectively for a median of 9.9 months. Of these, 65 patients were classified as having had an anterior non-Q-wave AMI, defined as new ST- or T-wave changes, or both, in leads V1 through V4 (group 1). The remaining 70 patients were classified as having had inferior or lateral non-Q-wave AMI, or both, defined as ST- or T-wave changes in 2 consecutive leads (II, II aVF; II and aVL or V5 and V6) (group 2). At baseline group I was older and had a higher incidence of previous AMI than group 2. After adjusting for baseline variables, the patients in group I had a 29% reinfarction and 32% mortality rate, which was significantly higher (p less than 0.002 for both) when compared to group 2, which had a reinfarction and mortality rate of 8 and 9%, respectively. Patients with anterior non-Q-wave AMI are at very high risk for developing a major cardiac event very soon after the index AMI. This high risk is probably related to a larger area of residual ischemic but viable myocardium in the infarct-related artery when compared to inferolateral non-Q-wave AMI.

Relation between plasma norepinephrine and response to medical therapy in men with congestive heart failure secondary to coronary artery disease or idiopathic dilated cardiomyopathy

This study examines the relation between the change in clinical status and the change in plasma norepinephrine concentration in patients with congestive heart failure (CHF) receiving standard medical therapy. Hemodynamic measurements in 11 patients with CHF (ejection fraction 19 +/- 4%) were obtained before and immediately after the administration of digoxin and angiotensin-converting enzyme inhibitors. Patients were then followed for 1 year. Clinical status was determined using the Boston Clinical Heart Failure scoring system. Of the 11 patients, 6 demonstrated significant clinical improvement after therapy, based on the Boston score, over a 1-year period. Five patients did not respond to therapy: 4 died and the remaining patient had worsening CHF. There was no difference between responders and nonresponders in either baseline hemodynamics or acute response to the administration of digoxin and an angiotensin-converting enzyme inhibitor. In the patients who improved, plasma norepinephrine decreased from 706 +/- 235 to 545 +/- 223 pg/ml (p = 0.08) after 1 year of medical therapy. In patients whose CHF worsened or who died, plasma norepinephrine increased from 715 +/- 275 at baseline to 1,237 +/- 671 pg/ml at their last measurement (p = 0.06). Although at baseline the plasma norepinephrine levels were similar in both groups of patients, a significant difference between responders and nonresponders was observed at final follow-up (p less than 0.002). Change in plasma norepinephrine correlated with change in CHF score (r = 0.79, p less than 0.004). Thus, in patients with CHF, serial measurements of plasma norepinephrine correlate with changes in clinical status.

Biologic theories of aging

Many theories have been proposed to explain aging. Currently, the most important theories include genetic control, deterioration of the immune system, somatic mutation, accumulated damage by free radicals, cross-linkage of macromolecules, and metabolic causes. While no single theory accounts for all of the observations about aging, recent research suggests that the primary process is under genetic control, with contributions from environmental factors.

Predictors of total mortality and sudden death in mild to moderate heart failure. Captopril-Digoxin Study Group

The relation between baseline clinical variables and subsequent mortality was examined in 295 patients with mild to moderate heart failure who participated in a multicenter trial comparing the effect on treadmill exercise tolerance of captopril, digoxin and placebo given in addition to a diuretic drug. At baseline study, all patients had a left ventricular ejection fraction less than or equal to 40%; 81% were in New York Heart Association functional class II. The etiology of heart failure was ischemic in 62% and nonischemic in 38%. During an average follow-up period of 16 months, 47 patients (16%) died and 24 deaths were classified as sudden. By univariate analysis, left ventricular ejection fraction, ventricular premature beat frequency, couplet frequency, ventricular tachycardia frequency, functional class, treadmill exercise time and nonischemic heart disease were statistically associated with mortality. With multiple logistic regression analysis, left ventricular ejection fraction was identified as the variable most closely associated with total mortality (p = 0.006). Twenty-seven percent of patients with an ejection fraction less than or equal to 20% died compared with 7% with an ejection fraction greater than or equal to 30%. Ventricular tachycardia frequency on Holter monitoring was independently associated with both total mortality (p = 0.008) and sudden death (p = 0.003). Patients with a ventricular tachycardia frequency of greater than 0.088 events/h had a mortality rate of 34% compared with 12% in those without ventricular tachycardia. In the multivariate model, functional class (p = 0.02) and etiology of nonischemic heart disease (p = 0.04) remained as independent predictors of mortality, whereas treadmill exercise duration did not.(ABSTRACT TRUNCATED AT 250 WORDS)

Proportions of H1 histone subspecies in human fibroblasts shift during density-dependent growth arrest independent of replicative senescence

H1 histone subspecies have been reported to vary during tissue differentiation, during aging of mammalian tissues, and as a function of DNA replicative activity. Since cultured human fibroblasts have a limited replicative life span which features arrest in the G1 phase of the cell cycle, we sought to distinguish whether any changes in the proportions of the principal H1 histone subspecies (H1A, H1B, and H1o) in late-passage fibroblasts were specific for senescent loss of replicative potential, or rather ensued as a result of prolonged inhibition of cell division. We observed an identical shift in the proportions of H1 histone subspecies during prolonged density-dependent inhibition of growth in both early-passage and late-passage cells. Since under these conditions there were no passage-specific changes, replicative senescence of human fibroblasts does not appear to involve a defect in the control of H1 histone proportions.

Nutrition and somatomedin: nutritionally regulated release of somatomedins and somatomedin inhibitors from perfused livers in rats

Circulating somatomedin activity reflects the presence of both somatomedins and somatomedin inhibitors, factors which antagonize the growth-promoting actions of somatomedins. Although both are regulated by nutrition, somatomedin inhibitors respond more rapidly than somatomedins to refeeding in fasted animals. To explore the role of the liver in such responses, release of somatomedin activity and somatomedin inhibitor activity was assessed during perfusion of livers from normal, fasted, and fasted-refed rats. Size-exclusion high-performance liquid chromatography (HPLC) revealed that liver perfusates contain both somatomedin and somatomedin inhibitor activity of apparent molecular weight (mol wt) comparable to that found in the circulation (approximately 7,000 and approximately 30,000, respectively), as well as activity of apparently higher wt. In subsequent studies, responses to nutrition were evaluated as fluctuations in bioactivity only of mol wt comparable to that found in the circulation. Release of both somatomedin and somatomedin inhibitor activity was progressive over at least two hours of recirculating perfusion. Perfusates of livers from normal fed rats had somatomedin activity (stimulation of cartilage SO4 uptake) 94 +/- 19% above buffer (P less than .01), which fell to undetectable levels after three days of fasting. With refeeding, perfusate somatomedin activity rose within three hours to approximately 25% of levels in fed rats, but did not become significant until after 12 hours (29 +/- 7%, P less than .02). Perfusates of livers of fed rats also contained somatomedin inhibitor activity (42 +/- 10% inhibition of cartilage stimulation by normal serum), which rose after three days of fasting to 114 +/- 22% (P less than .02).(ABSTRACT TRUNCATED AT 250 WORDS)

The normalcy of self-proclaimed "normal volunteers"

Volunteers who claimed they were "healthy and normal" and did not reveal any physical or mental abnormality or medication use during brief structured interviews underwent detailed structured interviews with the Schedule for Affective Disorders and Schizophrenia. Diagnoses were based on the Research Diagnostic Criteria (RDC), and family history was determined with the Family History RDC. Of the 121 volunteers, 16.5% met criteria for diagnoses of current mental disorders. Of the 104 without current DSM-III axis I diagnoses, 35.6% had past histories and 39.4% had family histories of mental illness. These results emphasize the need for thorough assessment of "normal volunteers."

Review of beta blocker myocardial infarction trials

This is a brief review of the current state of knowledge of beta adrenergic-blocking agents in the treatment of acute myocardial infarction. Their effects when administered in the acute phase of infarction, and in special subgroups of patients who have sustained an acute infarction, are discussed. Particular emphasis is directed to their effect on arrhythmias and in patients with left ventricular dysfunction. In addition, data are presented which suggest the advantage of permanent therapy of beta blockers in patients who have sustained a myocardial infarction and in whom the drug is tolerated.

Nutritional and hormonal regulation of articular collagen production in diabetic animals

Although changes in collagen production probably play a major role in the connective tissue defects of diabetes, we do not know to what extent these changes are attributable to hormonal/metabolic versus nutritional alterations. To study collagen production as influenced separately by nutrition versus hormonal/metabolic factors, rats were given 50 mg/kg i.v. streptozocin (STZ) (mild weight-gaining diabetes) or 100 mg/kg STZ (severe weight-losing diabetes) and compared with nondiabetic food-restricted rats to match weight changes in diabetic animals. Articular cartilage was incubated with [3H]proline, and uptake of [3H]proline into both collagen and noncollagen proteins was determined with purified bacterial collagenase. Collagen decreased to 49% in mildly diabetic rats and 16% in severely diabetic rats, compared with control rats fed ad libitum and decreased to 85 and 73%, respectively, in food-restricted rats (both P less than .01 vs. diabetes). Diabetes induced a greater defect in collagen production than food restriction and a greater decrease in collagen than noncollagen protein production within each group, suggesting a specific effect on collagen. With comparable levels of metabolic severity (glucose, beta-hydroxybutyrate), diabetic animals that lost weight produced significantly less collagen than animals that gained weight, suggesting separate mechanisms. Quantitation of the impact of undernutrition on collagen production in diabetes demonstrated that approximately 31 to 32% of the defect was due to undernutrition, leaving approximately 68-69% of the defect due to the diabetic state.(ABSTRACT TRUNCATED AT 250 WORDS)

Glucocorticoid effects on IGF-1/somatomedin-C and somatomedin inhibitor in streptozotocin-diabetic rats

Diabetes is associated with a fall in serum levels of insulin-like growth factor-1/somatomedin-C (IGF-1/Sm-C) and a rise in somatomedin inhibitor, a factor which antagonizes somatomedin action. We attempted to determine if the presence of glucocorticoids was required for diabetes-related alterations in these circulating growth factors. Diabetes was induced with streptozotocin in intact or adrenalectomized rats. Adrenalectomized-nondiabetic and adrenalectomized-diabetic rats were given either no glucocorticoids or daily hydrocortisone acetate at 0.5 or 50 mg/kg body weight, and killed 48 hours after streptozotocin treatment. After serum fractionation via size exclusion high performance liquid chromatography (HPLC), IGF-1/Sm-C was determined by radioimmunoassay, and somatomedin inhibitor by bioassay according to the ability of serum fractions to blunt cartilage stimulation by normal serum. Intact-diabetic rats had 22% weight loss, glucose 427 mg/dL, and beta-hydroxybutyrate 7.2 mmol/L (all P less than .001 v control). Serum IGF-1/Sm-C levels in intact-diabetic rats were decreased 71%, while somatomedin inhibitor rose to 470% of the control values (both P less than .004). Adrenalectomized-diabetic rats displayed comparable hyperglycemia (greater than 400 mg/dL) and decline in IGF-1/SmC, with or without glucocorticoid replacement. However, adrenalectomized-diabetic rats had greatly reduced weight loss (10%), beta-hydroxybutyrate (1.5 mmol/L), and somatomedin inhibitor (59% of control), all P less than .01 v intact-diabetic. Hydrocortisone 0.5 mg/kg in these animals increased weight loss but had no significant effect on beta-hydroxybutyrate or somatomedin inhibitor levels.(ABSTRACT TRUNCATED AT 250 WORDS)

Enhanced transfection efficiency and improved cell survival after electroporation of G2/M-synchronized cells and treatment with sodium butyrate

To achieve high transfection efficiency in human fibroblasts with good preservation of proliferative capacity we developed an electroporation procedure that combines two distinct modalities: use of recipient cells synchronized in the late G2/mitotic phase of the cell cycle and treatment of cells post-electroporation with 5 mM butyrate. This combination enabled reduction of plasmid DNA concentration and electroporation voltage, both associated with cytotoxicity, while greatly enhancing transfection efficiencies. Although the method was primarily developed for transient expression it was also found to improve stable expression. This procedure should have wide applicability, particularly in studies seeking to identify DNA sequences that lead to inhibition of DNA synthesis and proliferation in human fibroblasts and other cells refractory to transfection.