[Use of intravascular ultrasonography (IVUS) for diagnosis and treatment of coronary artery disease--case report]. / Zastosowanie ultrasonografii wewnatrznaczyniowej (IVUS) w diagnostyce i leczeniu choroby niedokrwiennej serca--opis przypadku.

One of the additional methods of coronary artery assessment is intravascular ultrasound (IVUS). Contrary to coronary angiography this relatively new technic provides new information including precise calculations of stenosis degree, morphology of atheromatous plaque and differentiation of its structure. Coronary angiography was performed in 54 years old male patient with unstable angina, revealing 99% stenosis in distal RCA. Discrepancy between clinical presentation and angiographic findings and exercise test resulted in performing IVUS of LAD. Angiographically clear LM and LAD were found to be narrowed 52% and 58% on IVUS. Subsequent CABG resulted in symptoms withdrawal and increase of physical tolerance. Exercise test after CABG did not reveal ischaemia in area of LCA at 10 METs. IVUS is found to be an important technic in assessment of silent or ambiguous lesions and in many cases allows to choose the optimal method of treatment of coronary artery disease.

[Angioplasty of several stenoses including the left main coronary artery in a patient with acute circulatory insufficiency after myocardial infarction]. / Angioplastyka kilku zwezen, w tym pnia lewej tetnicy wiencowej, u chorego z ostra niewydolnoscia krazenia po zawale serca.

A 74 year old man with diabetes and multivessel coronary heart disease involving also left main coronary artery is presented. The patient was admitted to the hospital because of acute myocardial infarction. PTCA of left main coronary artery and other four severe stenoses was attempted. The clinical status after procedure, short-term (after eight months) and long-term (after five years) was much improved.

[Invasive treatment of recent myocardial infarction. Evaluation of left ventricular function]. / Leczenie inwazyjne swiezego zawalu serca. Ocena funkcji lewej komory.

Hemodynamic parameters of left ventricular function were assessed in 179 patients with acute myocardial infarction, who were treated with intracoronary thrombolysis during first six hours after the onset of chest pain. Some of them were subjected to coronary angioplasty. Patency of the infarct related artery was controlled between the 2nd and 3rd week after acute myocardial infarction concomitant with evaluation of EF and LVEDP. Reperfusion of the infarct related artery was obtained in 121 patients (67.6%) and also significant increase of EF was observed in those patients. EF rose in patients with a patent coronary artery after 2-3 weeks (not significant) in contrast to patients with obstructed coronary artery in whom there was a fall in EF. The rise of EF was more pronounced in patients with reperfusion reached in 3 hours after the onset of infarct pain and without coronary angioplasty. It was shown that LVEDP is not usefull in estimation of left ventricular function.

Synthesis and pharmacological properties of a phthalide derivative containing methoxy groups.

4,6-Dimethoxy-5-hydroxyphthalide 2 was obtained on three routes: by selective demethylation of 4,5,6-trimethoxyphthalide and by the action of formaldehyde on either syringic acid or acetylsyringic acid. Pharmacological tests carried out on rats showed that the product significantly increased bile excretion, its activity being five times higher than those of dehydrocholic acid.