[Pathogenesis of myocardial ischemia and acute coronary syndromes]. / Patogenéza ischémie myokardu a akútnych koronárnych syndrómov.

Since the seventies, and in particular the eighties of this century, findings on pathogenetic mechanisms of ischaemic heart disease are expanding markedly and are becoming more accurate. This makes it possible to know and understand better factors which influence the genesis and development of myocardial ischaemia including the most serious clinical forms (unstable angina pectoris, acute myocardial infarction and sudden cardiac death). Diminution of the cardiac flow and/or increased oxygen demands of the heart muscle are not the only determinants of myocardial ischaemia which is influenced markedly also by neurohumoral, metabolic, prothrombotic (proaggregation and procoagulation) factors as well as antithrombotic and haemodynamic factors. Acute coronary syndromes have as a rule, in particular in patients with out severe atherosclerotic stenosis of the coronary arteries, a common pathophysiological mechanism of fissuration of the atherosclerotic plaque followed by different grades of dynamic coronary occlusion depending on vasoconstriction--spasm of the coronary arteries and thrombus formation. The coronary arteries, usually affected with atherosclerosis, may be due to the comprehensive action of various factors temporarily, intermittently or permanently occluded. In case of the development of acute coronary syndromes thrombosis plays a key role. Better knowledge of pathogenetic mechanism of IHD markedly changes views on treatment and management of patients with IHD in particular patients with acute coronary syndromes. The authors emphasize strategies focused (also preventively) on preventing progression of the disease with the aim to improve survival and the short-term and long-term prognosis.

[Pathogenesis and fundamentals of treatment in acute myocardial infarct]. / Patogenéza a zásady liecby akútneho infarktu myokardu v súcasnosti.

Recent findings which extend and render more accurate factors which influence the genesis and course of experimental and clinical acute myocardial infarction change in a significant way the treatment and management of patients with acute infarction. The authors discuss the basic factors and complex of interactions which play the most important part in the pathophysiology of acute infarction. They pay attention also to other factors which can influence in a significant way the course of acute infarction and the patient's prognosis (residual thrombosis, rethrombosis, extension, expansion of the infarction and remodelling of the left ventricle). In recent years it has become obvious that the most important determinants of the final extent of acute infarction is the duration and site of occlusion of the coronary artery, its recurrence and degree (magnitude), the condition of the collateral circulation and the consumption and requirements of the myocardium with respect to oxygen during the time of occlusion. The contemporary reperfusion-thrombotic era of treatment of acute myocardial infarction and management of the patient is based on logical multifactorial and to a certain extent preventive, active or aggressive approach and omission of all even potentially harmful approaches. All therapeutic operations (incl. invasive and radical ones) must be consistent with contemporary pathogenetic findings. They should be implemented before possible reinfarction, sudden cardiac death or treatment which has only little effect on heart failure which may be associated also with undesirable expansion of the infarction and remodelling of the left ventricle after acute myocardial infarction. Recent pathophysiological findings and the development of treatment of myocardial infarction are a challenge for cardiologists of the nineties to make use of these important findings in the treatment of patients with myocardial infarction and to ensure for them optimal treatment and management.

Increased radioresistance of offspring in rats after maternal stimulation with benzene blood cell extracts.

Benzene extracts from human blood cells were inoculated intraperitoneally into female rats on days 13, 17, and 21 of pregnancy. Their offspring at 13 to 15 weeks of ago were irradiated with gamma rays for 49 h, with a total dose of 15.6 Gy. The number of survivors 30 days after irradiation was significantly greater in offspring from mothers treated with extracts as compared with controls.

Complement consumption in fresh blood sera by double culture of Paramecium caudatum and Aerobacter cloacae compared with survival and stage of disease in some malignant tumors in man.

Using the complement consumption test by double culture of Paramecium caudatum and Aerobacter cloacae (DPA) as antigen we examined blood sera and compared survival rates and stage of disease in 124 patients with carcinoma of cervix uteri, corpus uteri, ovaries and breast. The evidence suggests that bacteria Aerobacter cloacae constitute the proper antigenically effective substances of DPA. The intensity of reaction and therapy the relative titres of antibodies detected by the test were expressed by the amount of complement consumed in the reaction and designated by the abbreviation "NMHD", i. e. number of minimum haemolytic doses of complement fixed by antigen in the reaction. Patients with NMHD above 8 (i. e. with an intensive reaction corresponding to a high level of antibodies) exhibited partly higher three-year survival rates -- starting from the time of diagnosis, partly more often the clinical stages of disease I or II as compared with patients with NMHD below 4. The best survival rates were found in patients with NMHD above 8 and clinical stage I or II. NMHD values in patients with the initial period of disease and in healthy women did not differ substantially.