[The comparison of hypotensive efficiency and tolerability of amlodipine and enalapril in patients with essential hypertension]. / Porównanie skutecznosci hipotensyjnej i tolerancji amlodypiny oraz enalaprylu u chorych z pierwotnym nadcisnieniem tetniczym.

In this multicentre, double-blind trial in 176 patients with mild or moderate essential hypertension were randomized to amlodipine or enalapril monotherapy after 2-week period of placebo. Doses of amlodipine (2.5-10 mg once daily) and enalapril (5-20 mg once daily) were titrated to achieve office blood pressure below 140/90 mm Hg during 8 weeks of therapy. Both drugs were similarly effective in lowering blood pressure and goal blood pressure was achieved in 72.4% patients treated with amlodipine and 67.4% with enalapril. Also, degree of reduction of blood pressure was similar in both groups. Compared to initial values: systolic/diastolic blood pressure decreased by 23.5/14.9 mm Hg in amlodipine group and 23.2/14.0 mm Hg in subjects receiving enalapril. However, adverse effects, especially dry cough were more frequent in enalapril-treated patients. Both amlodipine and enalapril provide significant blood pressure reduction in stage I-II hypertension. Tolerance of short-term therapy was good in both groups however number of adverse events was significantly lower in amlodipine-treated patients.

Dopamine and dopa urinary excretion in patients with pheochromocytoma--diagnostic implications.

Pheochromocytoma, a potentially life-threatening disease, is a rare cause of hypertension. Most pheochromocytomas secrete excessive amounts of noradrenaline and adrenaline. It has been suggested by some authors that high circulating levels of dopamine and the catecholamine precursor dihydroxyphenylalanine (dopa) are more often associated with malignant rather than benign pheochromocytomas. Therefore the aim of this study was to evaluate urinary excretion of dopamine and dopa in patients with pheochromocytoma and to determine their role as a potential marker for malignancy of the tumour. We retrospectively analysed 120 consecutive patients (mean age 41 +/- 12 years) with histopathologically confirmed pheochromocytomas. All subjects were divided as follows: group 1 included patients with both elevated and normal dopamine urinary excretion; group 2 was characterized by increased and normal dopa urinary excretion. Dopamine urinary excretion was increased in all patients with malignant pheochromocytoma, but higher levels were also observed in some patients with a benign tumour included in group 1. Urinary excretion of dopa was in the normal range in all subjects with malignant pheochromocytoma. The results indicate that in some pheochromocytoma patients excessive dopamine excretion may point to malignant tumour, but is not a discriminating marker for malignancy in the whole studied group.

[Evaluation of the usefulness for measuring catecholamines and their principle metabolites in the diagnosis of pheochromocytoma]. / Ocena przydatnosci oznaczania katecholamin i ich glównych metabolitów w diagnostyce guzów chromochlonnych.

Objective of the study was assessment of the usefulness of determination of noradrenaline (NA) and adrenaline (A) in urine and blood as well as the total methoxycatecholamines (MNA +MA), vanillylmandelic acid (VMA), DOPA and dopamine (DA) urinary excretion in diagnosis of pheochromocytoma. The experience based on 155 patients with pheochromocytoma (105F, 50M, age 18-82 yrs) diagnosed in the Department of Hypertension and Angiology Academy of Medicine in Warsaw will be discussed. In all patients excluding 2 cases pheochromocytoma has been proven histopathologically. The most considerable diagnostic usefulness of MNA + MA indication was proven. MNA + MA was increased in 96.6 patients. In 89.6% patients an increased excretion of NA and A or one of this catecholamines was demonstrated. An increased excretion of VMA was demonstrated in 75%. The excretion of DOPA and dopamine was tested in 120 cases. An increased excretion of DA was shown in 31% and DOPA in 16%.

Murine lymph nodes in response to the local administration of dextran sulphate.

In mice a single injection of 4 mg of Dextran sulphate within a few days produces an enlargement of area draining lymph nodes and activates basophils/mast cells. This activation is manifested by many-fold increase of mast cell number per lymph node, degranulation of mast cells and appearance of young, immature mast cells capable to synthetize new granules. In contrast to the lymph nodes, the Dextran-injected connective tissue mast cells remained unchanged. This suggest that Dextran sulphate directly activates lymph node mast cells, probably by activation of T-cell suppressor or macrophages.