Simultaneous saccharification and fermentation of solid household waste following mild pretreatment using a mix of hydrolytic enzymes in combination with Saccharomyces cerevisiae.

Ethanol production from low severity pretreated (85 °C, 1 h) solid household waste was studied using simultaneous saccharification and fermentation (SSF). The aim of the study was to examine typical composition of the organic fraction of municipal solid waste (OFMSW) and to develop a simple method for simultaneous liquefaction and biofuels production. A model waste was prepared based on the composition of the organic waste in Masdar City. Chemical analysis of the OFMSW showed that it contained 37 % total solids with up to 57 g glucan/100 g total solid (TS). Hydrolysis of the wet OFMSW was carried out using a mix of hydrolytic enzymes: amylase, cellulase, protease, lipase, hemicellulase, and pectate lyase. The enzymatic hydrolysis using this enzyme mix was studied using different dilutions of the OFMSW at different enzyme loadings. This study has demonstrated that SSF of low severity pretreated OFMSW can be carried out using Saccharomyces cerevisiae without dilution (addition of water), and liquefaction of the undiluted OFMSW can be achieved in less than 24 h of hydrolysis. Also, SSF of the pretreated waste can be carried out with very low enzyme loading (10 % of the company recommended dosage)-0.1 % cellulase, 0.1 % amylase, 0.02 % protease, 0.02 % hemicellulase, 0.02 % lipase, and 0.02 % pectate lyase (w/w per TS) following mild heat pretreatment conditions of 85 °C for 1 h.

Moderate exercise training reduces arterial chemoreceptor reflex drive in mild hypertension.

The aim of our study was to check the responsiveness the chemoreceptor reflex in 28 young mildly hypertensive men (HTS), aged 18-32 years and 25 normotensive male subjects (NTS) aged 19-32 years, before and after 3-months dynamic exercise training. We tested the hypothesis that dynamic training reduces arterial chemoreceptor drive in mild hypertension. Circulatory response to 3-min hyperoxic inactivation of arterial chemoreceptors induced by 70% oxygen breathing was measured before and after training. Arterial blood pressure (BP) was recorded continuously by Finapres method, stroke volume and arm blood flow were registered by impedance reography, heart rate by ECG. Both groups were submitted to moderate 3-months dynamic exercise training. Before training the hyperoxic breathing caused in HTS a significant decrease in systolic BP by 6+/-1 mmHg p<0.01, in diastolic BP by 2+/-0.6 mmHg p<0.01, and in total peripheral vascular resistance (TPR) by 0.24+/-0.04 TPRU (p<0.01). After training hyperoxia augmented systolic BP by 2.64+/-1.9 mmHg (NS), diastolic BP by 2+/-1 mmHg p<0.05, and TPR by 0.043+/-0.05 TPRU (ANOVA). In NTS before training brief hyperoxia produced insignificant change in BP and TPR. In NTS after training hyperoxia increased systolic BP by 4.2 mm Hg+/-1.23 p<0.01 and diastolic BP by 3.1+/-0.6 mmHg p<0.01 respectively and TPR by 0.053+/-0.02 TPRU. Our results confirm earlier finding on the enhanced arterial chemoreceptor reflex drive in mild human hypertension. We conclude that normalizing arterial blood pressure in subjects with mild hypertension which occurred after 3-months dynamical exercise training is due to attenuation of the sympathoexcitatory chemoreceptor reflex drive by exercise training. The mechanism of this effect requires further study.

Effects of moderate physical training on blood pressure variability and hemodynamic pattern in mildly hypertensive subjects.

The objective of our study was to compare the cardiovascular effects of moderate exercise training in healthy young (NTS, n=18, 22.9+/-0.44 years) and in hypertensive human subjects (HTS, n=30, 23+/-1.1). The VO(2max) did not significantly differ between groups. HTS of systolic blood pressure (SBP) 148+/-3.6 mmHg and diastolic blood pressure(DBP) 88+/-2.2 mmHg, and NTS of SBP: 128.8 +/- 4 mmHg and DBP: 72 +/- 2.9 mmHg were submitted to moderate dynamic exercise training, at about 50% VO(2max) 3 times per week for one hour, over 3 months. VO(2max) was measured by Astrand's test. Arterial blood pressure was measured with Finapres technique, the stroke volume, cardiac output and arm blood flow were assessed by impedance reography. Variability of SBP and pulse interval values (PI) were estimated by computing the variance and power spectra according to FFT algorithm. After training period significant improvements in VO(2max) were observed in NTS- by 1.92 +/-0.76 and in HTS by 3+/-0.68 ml/kg/min). In HTS significantly decreased: SBP by 19 +/-2.9 mmHg, in DBP by 10.7+/-2 mmHg total peripheral resistance (TPR) by 0.28 +/-0.05 TPR units. The pretraining value of low frequency component power spectra SBP (LF(SPB)) was significantly greater in HTS, compared to NTS. PI variance was lower in HTS, compared to NTS. After physical training, in HTS PI variance increased suggesting a decrease in frequency modulated sympathetic activity and increase in vagal modulation of heart rate in mild hypertension. A major finding of the study is the significant decrease of resting low frequency component SBP power spectrum after training in HTS. The value of LF(SPB) in trained hypertensive subjects normalized to the resting level of LF(SPB) in NTS. Our findings suggest that antihypertensive hemodynamic effects of moderate dynamic physical training are associated with readjustment of the autonomic cardiovascular control system.

Arteriovenous fistula of the kidney: a case report of 47-year-old female patient treated by embolisation.

Arteriovenous fistulas of the kidney are rare. They may be acquired, idiopathic or arise in congenital arteriovenous malformations. There are only few reports in the current literature describing the successful embolisation of idiopathic arteriovenous fistulas. We report a 47-year-old hypertensive female patient with a successfully embolised arteriovenous fistula. Diagnosis was made on the basis of colour duplex Doppler examination and this method enabled further successful embolisation of the fistula.

[Takayasu's arteritis: underestimated cause of hypertension]. / Choroba takayasu--niedoceniana przyczyna nadcisnienia tetniczego.

UNLABELLED: Takaysu's arteritis (TA) is regarded to be a frequent cause of hypertension in Asian population. However some reports have recently informed about increasing frequency of its also in non Asian people. The aim of this study was to evaluated own experiences on diagnosis and treatment of TA as well as prevalence of TA in hypertensive patients in Caucasian population. MATERIALS AND METHODS: During last 15 years we examined 4190 hypertensive patients hospitalized in our department. Renovascular hypertension was recognized in 139 cases. The diagnosis of TA was based on angiographically proven vascular changes and its inflammatory phase on estimation increased (> 40 mm/h) sedimentation rate and immunoglobulins above normal level. The patients with acute phase of TA initially received typical immunosuppressive therapy (prednisone in monotherapy or combined with azatioprine or cyclophosphamide), followed by chronic administration of prednisone. In every case, if it was possible, we proposed angio-corrective procedure. All patients have received hypotensive and antiplatelet therapy. RESULTS: TA was recognized in 15 patients--4 men and 11 women, average age 36.3 +/- 9.8 y. The patients with TA represented 0.37% hypertensive and 10.9% cases of renovascular hypertension. Significant stenosis of renal artery and various degree of lesions in aorta and some arteries was discovered in all persons. In the observed group hypertension was effectively controlled with 2-3 hypotensive drugs, including ACE inhibitors, diuretics and Ca antagonists. The acute phase of TA was diagnosed in 11 patients and it was treated successfully (except one case) with immunosuppressive therapy. After discontinuation of the treatment (4 patients) progression of the disease was observed. In 6 patients, characterised by clinical and biochemical remission of acute phase percutaneous angioplasty renal artery was performed. A good result in long-term follow-up period was observed in 4 cases (in 2 after repeated procedure). Surgical procedure was performed in 4 cases--in 2 on carotid and in 1 on renal and the next one on coronary artery. In first 3 cases the procedures were unsuccessful (reocclusion ?). CONCLUSIONS: Our observation suggested that 1. The incidence of TA in hypertensive (especially renovascular hypertension) population is more frequent than expected. 2. Acute phase of the disease is indication to long-term the immunosuppressive therapy. 3. Angiocorrective procedure is necessary reflected in every case in period of remission of acute phase.

Postexercise decrease in arterial blood pressure, total peripheral resistance and in circulatory responses to brief hyperoxia in subjects with mild essential hypertension.

The objective of our study was: (1) to compare the influence of moderate exercise on circulatory after-response in mildly hypertensive (n = 8) and normotensive male subjects (n = 9); (2) to examine the circulatory response to 3-min hyperoxic inactivation of arterial chemoreceptors at rest and during postexercise period in both groups. Hypertensive men (HTS) with a systolic blood pressure (SBP) 148 +/- 5 mm Hg, diastolic blood pressure (DBP) 92.4 +/- 4 mm Hg; and normotensive men (NTS), with a SBP 126 +/- 3 mm Hg, DBP 75.6 +/- 1.3 mm Hg, were submitted to 20-min of moderate exercise on a cycloergometer (up to the level of 55% of each subject's resting heart rate reserve). Finger arterial BP was recorded continuously with Finapres, impedance reography was used for recording stroke volume, cardiac output and arm blood flow. In HTS a significant decrease in SBP by 14.5 +/- 3.4 mm Hg, DBP by 8.9 +/- 1.9 mm Hg, total peripheral resistance (TPR) by 0.45 +/- 0.05 TPR u. (33.7 +/- 2.7%), and in arm vascular resistance (AVR) by 11.0 +/- 2.7 PRU u. (35.6 +/- 7%), was observed over a 60-min postexercise period. NTS exhibited insignificant changes in SBP, DBP, AVR except a significant decrease in TPR limited only to 20-min postexercise period. Hyperoxia decreased SBP, DBP and TPR in HTS. This effect was significantly attenuated during the postexercise period. Long-lasting antihypertensive effect of a single dynamic exercise in HTS suggests that moderate exercise may be applied as an effective physiological procedure to reduce elevated arterial BP in mild hypertension. We suggest also that the attenuation of the sympathoexcitatory arterial chemoreceptor reflex may contribute to a postexercise decrease in arterial BP and in TPR in mildly hypertensive subjects.

[Plasma renin activity, aldosterone and adrenergic activity in patients with hypertension and in normotensives with a family history of hypertension]. / Aktywnosc reninowa osocza, aldosteron i aktywnosc adrenegiczna u pacjentów z nadcisnieniem tetniczym i zdrowych osób z obciazeniem genetycznym w tym kierunku.

UNLABELLED: The aim of the study was to analyse plasma renin activity (PRA), aldosterone (Ald) and catecholamines at rest, after psychological stress and physical exercise in patients with essential hypertension (EH) and normotensive persons with (FH +) and without (FH-) family history of hypertension. MATERIALS AND METHODS: 100 men, aged 18-35 years, were investigated: 36 in EH, 32 in FH + and 32 in FH- groups. PRA, Ald and plasma level of adrenaline (A), noradrenaline (NA) and dopamine (D) were estimated at rest, after 30' of stress (Kraepelins test) and at the end and 30, after submaximal ergometric exercise. RESULTS: The groups did not differ in respect to PRA and Ald in all periods of study as well as to A and NA at rest and during stress. A in EH and FH + as well as NA in FH + were significantly higher than FH- at the end and 30 after exercise. D in EH was higher (p < 0.05) than in both normotensive groups and at rest and stress than FH- during exercise and recovery. There were also some correlations between PRA, Ald and catecholamines. In FH + and FH- but not in EH group PRA and Ald positively correlated at rest (r = 0.588 and 0.612) and during stress (r = 0.626 and 0.477). On the contrary in EH as well as FH + groups PRA positively correlated with A (r = 0.385 and 0.368) and NA (r = 0.370 and 0.386) at rest. In addition PRA correlated positively with A during stress (r = 0.368) as well as with NA during recovery (r = 0.313) in FH + groups. Ald correlated with D positively in FH + (r + 0.380) and negatively (r = 0.304) in FH- at rest, whereas Ald was positively correlated with A in EH (r = 0.511) as well as in FH + (r = 0.354) during exercise. CONCLUSIONS: Hypertension and family history of it changes adrenergic reactivity and influences the relationship between plasma renin activity, aldosterone, and catecholamines.

[Takayasu's arteritis--course, diagnosis and long term results of treatment]. / Choroba Takayasu--przebieg, rozpoznawanie i odlegle wyniki leczenia.

UNLABELLED: Nonspecific aortoarteritis (Takayasu's arteritis) is a systemic disease of unknown cause. No characteristic symptoms may delay diagnosis and treatment as well as deteriorate prognosis. The aim of the study was analysis of prevalence, course, diagnosis and treatment of Takayasu's arteritis. 10 patients (9 female, 1 male) with inflammatory phase of Takayasu's arteritis were seen at the Department of Hypertension of Institute of Cardiology between 1981 and 1992 (0.1% of all patients). The diagnosis was performed on the basis of typical arteriographic picture and laboratory investigations such as elevated of erythrocyte sedimentation rate and increase of immunoglobins, especially G fraction levels. Three patients were in poor general condition (fever, tachypnea, progressive weakness and severe arthralgia); in the remaining the symptoms were less severe, consisting mainly of weakness and arthralgia. All patients had multiple sites of arterial involvement (clinically and angiographically). Hypertension occurred in 9, aortic valve disease in 4, mitral valve disease in 2 and angina pectoris in 3 persons. All patients were treated with prednisone in initial dose of 1-1.5 mg/kg daily. After normalization of inflammatory indices (in average after 3 weeks therapy) this dose was gradually diminished to maintenance dose 5-15 mg daily. 4 patients were treated with prednisone in monotherapy, 6 received combined therapy--prednisone and cyclophosphamide or prednisone and azathioprine. Responses to immunosuppressive treatment were usually very good. In follow-up period (43.4 +/- 30.7 months) in 9 patients the regression of symptoms of inflammatory phase was observed (all patients were treated with maintenance dose of prednisone). Immunosuppressive therapy was ineffective in one woman, despite long term treatment with prednisone combined alternately with cyclophosphamide, azathioprine or methotrexate. She died of progressive heart and renal failure. CONCLUSIONS: 1. Takayasu's arteritis is serious systemic disease with considerable risk of death. 2. Early and proper management of Takayasu's arteritis can improve prognosis of this disease. 3. In every case with multiple sites of arterial involvement, especially with associated symptoms of unidentified inflammatory disease it is necessary to consider diagnosis of Takayasu's arteritis, which prevalence seems to be underestimated.

[Renovascular hypertension--clinical observations and long-term follow-up]. / Nadcisnienie naczyniowo-nerkowe--obserwacja kliniczna i odlegle wyniki leczenia.

Renovascular hypertension is one of the most common causes of secondary hypertension. Its early diagnosis is particularly important, firstly because it is one of the few potentially reversible causes of chronic renal failure. In many centers, including our own, renal angioplasty (PTA) or surgery is the treatment of choice for patients with renovascular hypertension. The aim of the study was the evaluation of the early and late results of PTA versus renovascular surgery. The diagnostic procedures and clinical course of renovascular hypertension were also analyzed. Among patients with renovascular hypertension treated in our Department during the 1981-1993 years, 89 patients (46 men, 43 women) were diagnosed and having renovascular hypertension (3% of all hypertensive patients). The average duration of hypertension in this group was 5 years. High incidence of accelerated hypertension (18%) and cardiovascular complications were observed: myocardial infarction in 20.2% of cases and stroke in 4.5%. The presence of renal failure was found in 22.5% of cases, hypokalemia in 11.2%, 38.3% of patients had changes in other arteries. Renal angioscintigraphy and captopril renal scintigraphy were performed in accordance with renal arteriography in 80% of patients. Arteriography showed unilateral renal artery stenosis in 78.7% of patients and bilateral - in 21.3%. The most common cause of renovascular hypertension in our material was atherosclerosis (65.2%). Fibromuscular dysplasia and Takayasu arteritis were diagnosed less frequently (25.8% and 9.0% respectively). Forty four patients were treated with PTA, 15 underwent surgical revascularization and 11 - unilateral nephrectomy. Early beneficial therapeutic effect (normalization or improvement of blood pressure control) was observed in 88.6% for PTA and 66.7% for surgery.(ABSTRACT TRUNCATED AT 250 WORDS)

[Doxazosin (alpha 1-adrenoreceptor antagonist) used in primary hypertension and it's beneficial effect on lipid metabolism]. / Doksazosyna (bloker alfa 1-receptorów) skuteczny lek w nadcisnieniu pierwotnym o korzystnym wplywie na gospodarke lipidowa.

The aim of the study was to investigate the effect of a new selective alpha 1-adrenoreceptor blocker doxazosin on blood pressure, serum lipids and lipoproteins in patients with essential hypertension. The study was done in 32 out-patients with mild-to-moderate hypertension (22 men and 10 women, mean age 45.6 +/- 10.1). After 2-week placebo period the patients were given doxazosin in increasing doses from 1 to 8 mg daily for 6 to 14 weeks (mean daily dose 2.24 +/- 1.6 mg). Twenty-nine patients completed the study. The active treatment caused highly significant drop in systolic and diastolic blood pressure both in supine and standing positions. No orthostatic hypertension was noted. There was also a statistically significant decrease in serum total cholesterol, VLDL-cholesterol, and triglyceride levels and increase in the positive prognostic lipid indicators. HDL3-cholesterol and apolipoprotein AI levels as well as HDL/total cholesterol ratio. Accordingly, the statistically significant decrease of the so called atherogenic index was noted. The drug was well tolerated and only one patient dropped from the study because of side effects. The authors conclude that doxazosin appears to be an effective and well tolerated antihypertensive drug with a favorable effect on lipid metabolism. It may be particularly useful in hypertensive patients with coexisting lipid abnormalities.

[Individual reactions and psychophysiologic reactions in patients with mild primary hypertension]. / Reakcje osobowosci i psychofizjologiczne reakcje u chorych na lagodne nadcisnienie tetnicze pierwotne.

Fourteen male patients with mild hypertension, aged between 20 and 46 years (mean = 32.4 years) measured their arterial blood pressure thrice daily for 6 weeks. Prior to and after this period psychological tests were carried out, including Gough's ACL test and Spielberger's STAI questionnaire. All patients underwent also Kraeplin's test under stress conditions twice during the experiment. It was found that there is significant correlation of personality response syndromes such as: need for acceptance, inferiority complex, need for success, trust to themselves, anger and some values of blood pressure. So-called personality syndrome related to hypertension was established. Psychophysiological picture accompanying emotional stress was discussed and relationship between blood pressure values (prior to and after emotional stress) and personality syndromes were defined.

[Ambulatory 24-hour blood pressure monitoring in patients with resistant hypertension]. / Rejestracja 24-godzinna cisnienia tetniczego krwi u chorych z tzw. Opornym nadcisnieniem tetniczym.

The aim of the study was to assess the usefulness of 24-hour blood pressure (BP) and heart rate (HR) monitoring in patients with "resistant" hypertension. 30 patients (44.1 +/- 9.9 years) with diastolic BP 100 mm Hg or more in spite of treatment with three or more antihypertensive drugs were studied. Ambulatory recording of BP and HR was performed by means of Del Mar Avionics monitoring system 9000. Mean recording time was 21.5 hours and mean number of measurements during one recording--56.7. Mean ambulatory systolic and diastolic BP values were significantly lower than mean value of three casual measurements (146.0 +/- 24.6 vs 171.5 +/- 21.2 mm Hg for systolic and 97.2 +/- 11.3 vs 110.4 +/- 7.5 mm Hg for diastolic BP p less than 0.01) In 14 (46.6%) systolic BP and in 10 patients (33.3%) diastolic BP were normal. The patients with normal and abnormal ambulatory BP recordings did not differ in regard to age and mean clinic BP levels. However, patients with abnormal ambulatory BP recordings were more often overweight and showed a greater frequency of left ventricular hypertrophy and family history of hypertension and its complications. The results of the study show that ambulatory BP monitoring may be of value in assessing the response to antihypertensive treatment in patients with so called resistant hypertension as judged on the basis of clinic pressure.

[Twenty-four hour automatic recording of blood pressure and cardiac rhythm in patients with borderline hypertension]. / Calodobowa automatyczna rejestracja cisnienia tetniczego krwi i rytmu serca u chorych z granicznym nadcisnieniem tetniczym.

The aim of the study was to evaluate the usefulness of 24-hour automatic recording of blood pressure and cardiac rhythm in patients with borderline hypertension. The study was performed in 50 patients aged 38.8 +/- 13.1 using the Del Mar Avionics device. Mean time of recordings was 21.3 hours, and the mean number of blood pressure measurements per one patient was 52.4. Great fluctuations of systolic blood pressure (from 92.1 +/- 12.6 to 191 +/- 37.0 mm Hg) and diastolic one (from 57.3 +/- 11.4 to 118.9 +/- 13.8 mm Hg) were observed. Mean systolic blood pressure (125.6 +/- 10.6 mm Hg) was significantly lower than the mean value of last three ambulatory measurements (141.9 +/- 9.8; p less than 0.001). Also mean diastolic pressure was lower than that obtained in the out patient clinic (84.7 +/- 9.7 vs 91.9 +/- 3.2 mm Hg; p less than 0.001). Mean heart rate during the day was 86.2 +/- 10.7 and at night 69.7 +/- 10.5 beats per minute. Ventricular and/or supraventricular cardiac arrhythmias were observed in 14 (28%) of examined patients. Results of the study indicate, that 24-hour automatic blood pressure recording is the valuable method, affording possibilities for more precise estimation of blood pressure and its 24-hour fluctuations in patients with borderline hypertension.