Association of stromal-derived factor-1 alpha and endogenous sex hormones in men aged over 50 years with stable coronary artery disease.

PURPOSE: Many studies indicate an inverse relationship between stromal-derived factor-1 alpha (SDF-1 alpha), a chemokine, and coronary risk factors. Moreover, SDF-1 alpha is crucial in neoangiogenesis and in the mobilization and homing of endothelial progenitor cells to the ischemic coronary vessels. Numerous studies indicate that circulating sex hormones are associated with atherogenesis during male aging. The aim of this study was therefore to determine whether there exists a relationship between SDF-1 alpha and endogenous sex hormones in aging men with stable coronary artery disease (CAD). MATERIAL AND METHODS: Plasma concentrations of SDF-1 alpha, testosterone (T), estradiol (E2), and sex hormone binding globulin (SHBG) were measured and the E2/T ratio was calculated in a cross-sectional study of 82 men over 50 years of age with stable CAD. RESULTS: SDF-1 alpha was positively and significantly correlated with T (r = 0.233; p = 0.036) and with SHBG (r = 0.312; p = 0.004). There was a significant inverse correlation between SDF-1 alpha and the E2/T ratio (r = -0.463; p < 0.001). After adjustment for age, body mass index and smoking status, SHBG and E2/T ratio were the only factors associated with SDF-1 alpha. CONCLUSIONS: T and SHBG (directly) and the E2/T ratio (inversely) may be involved in the etiopathogenesis of CAD through their relationships to SDF-1 alpha.

[Let's calmly discuss death]. / Porozmawiajmy spokojnie o smierci.

Death is the only immovable issue in human's life and therefore it should be understood as human situation not as a tragedy. It is inseparable from life after all, and according to some theories it determines the essence of life, and partly it makes life possible. Moreover, it creates the feeling of responsibility for one's own existence. Most philosophers, except for the materialists, are in favour of the existence of the spiritual immortality. And consequently they reject the fear of the physical death, which relieves the sufferings, restores the calmness we were in before the nativity, and more importantly it secures equality as well as a fair treatment. Despite the existence of many philosophical concepts, death is and was an unknown matter. At present more than half the people die in hospital. The process of dying lasts much longer than before because of many medical and tending possibilities of maintaining life. The boundary between life and death became blurred. Furthermore, in many instances it is not life that is lengthened but dying. People are not accustomed to death and are afraid of it. The fear concerns not only the very moment of life end, but also many matters connected with death as well as with the passing person. Life lasting forever would be deprived of any meaning. One should consciously accept their own lot as well as the passing and they should be able to approve the inevitability of death.

[Psychologic problems in patients with diabetes mellitus and myocardial infarction]. / Psychologiczne problemy u chorych z cukrzyca i zawalem serca.

A group was studied of 20 patients with diabetes mellitus treated in the Department of Cardiology for acute myocardial infarction. The duration of diabetes mellitus in these patients was from 5 months to 6 years, and in all patients this was the first myocardial infarction. For the study of personal features of the patients with diabetes mellitus and myocardial infarction R.B. Cattell's Self-Perception Sheet, H. Gough's ACL Adjective Test, and Multi-symptomatic Diagnostic Scale MMPI-WISKAD were used. The studied showed that the group of patients with diabetes mellitus and myocardial infarction was characterized by greater intensity of depression symptoms, excessive interest in own organism and its fitness with significant manifestation of hypochondriac-hysterical features and high level of restlessness and anxiety. The results of our study revealed many common features (great similarity) in the personality of patients with diabetes mellitus and myocardial infarction and patients with only diabetes but less common features with non-diabetic patients with myocardial infarction.

[Overt and latent restlessness and the awareness of the meaning of life in patients with valvular heart disease]. / Niepokój jawnny i ukryty a poczucie sensu zycia u chorych z wadami serca.

By means of R. B. Cattell Self-Knowledge Sheet and Crumbough and Miholick Scale of the Awareness of the Meaning of Life, 25 patients were examined, prepared for surgical correction of valvular heart disease. By means of R.B. Cattell Self-Knowledge Sheet a group was isolated of patients showing high overt restlessness (OR) and high latent restlessness (LR). It was shown that the personalities of these two groups of patients demonstrated numerous common features, but very significant differences also existed. The patients with high latent restlessness (LR) demonstrated strong emotional tension caused by frustration, feeling of inferiority with low self-estimation, as well as many conflicts at super ego level, but they had strong defensive mechanisms of own personality. The patients with high overt restlessness (OR) revealed high degree of intensification of the feeling of isolation, loneliness, and existential emptiness resulting from the lost feeling of the meaning of further existence with the progress of disease. The results of our studies are guidelines for the choice of psychotherapeutic management of patients qualified for operation of valvular heart disease.

The personality and psychosomatic syndrome in patients with acquired valvular heart diseases.

Fifty patients (36 women and 14 men) aged 16-51 with valvular heart diseases qualified from surgical treatment were studied. For determination of personality traits the Self Knowledge Card by R. B. Cattell, The Minnesota Multiphasic Personality Inventory MMPI-WISKAD by Hathaway and McKinley and The Adjectives Test ACL by Gough and Heilbrun. Using these methods it was shown that patients with acquired valvular heart diseases had a much lower tolerance threshold for frustration and stressful situations and had a tendency for autoaggressive behaviour. Somatic symptoms in these patients cause a constant feeling of danger and anxiety and difficulties in adaptation to everyday life conditions with a tendency for self-effacement. Predominating needs were demonstrated in three sets: a) defense attitudes and strong self-control, b) needs connected with goal achievement and strivings, c) needs connected with normal relations with other people. A statistical comparison of the results obtained in patients with valvular heart diseases and in healthy controls showed very significant differences between them.