Dissection of the atrial septum following mitral valve surgery.

Interlayer dissection of the atrial septum resulting in the formation of a cavity developed after an attempted repair of a mitral paraprosthetic leak. Subsequent rupture of the cavity into both atria resulted in a small left-to-right shunt and significant left ventriculoatrial regurgitation. Misplaced stitches, aimed at obliterating the paraprosthetic leak, were the cause of the dissection. This case illustrates a previously unreported complication of mitral valve surgery and stresses the importance of proper exposure and handling of the mitral annulus.

Recovery of biocatalysis products from reversed micellar reaction media: a preliminary evaluation of membrane extractors.

It has been demonstrated that ultrafiltration membranes of sufficiently low molecular weight cutoff can be used to retain reversed micelles and their hosted enzymes, while permitting the recovery of lipophilic products of enzymatically-catalysed, synthesis reactions in a stripping solution on the other side of the membrane. Calculations indicate that hollow fibre membranes having the same rejection characteristics and solvent resistance as the flat sheet membranes, will provide an attractive and efficient means for the recovery of these biosynthesis products; currently, such membrane modules are not available commercially.

The role of the renin-angiotensin system in normotensive and hypertensive rats with varying renin status.

We have investigated the relationship between the acute blood pressure lowering effect of captopril and renin status. Differences in renin status were induced by unilateral artery clipping combined with unilateral or bilateral nephrectomy in rats. The blood pressure lowering effect of captopril correlated very closely with plasma or aortic renin across a very wide range of renin levels.

Effect of acute administration of prazosin on blood pressure, heart rate and plasma renin level in the conscious normotensive rat.

This study investigated whether the specific alpha-antagonist, prazosin, stimulated basal plasma renin levels and heart rate. Furthermore the beta-adrenergic nervous system was also investigated to ascertain whether it was involved in this effect. Prazosin (0.1 or 1 mg/kg) was injected subcutaneously (s.c.) to conscious normotensive rats, either alone or in combination with the beta-adrenoceptor antagonist, DL-propranolol (1 or 3 mg/kg). Rats bore chronically implanted dorsal aorta cannula for measurement of blood pressure and heart rate and blood sampling for renin determinations. Acute administration of prazosin (1 mg/kg, s.c.) produced a fall in mean arterial pressure accompanied by renin release and tachycardia. A tenfold lower dose of prazosin did not alter blood pressure or heart rate but did stimulate renin release. Acute administration of DL-propranolol, (1 or 3 mg/kg, s.c.) produced falls in blood pressure and heart rate but did not affect plasma renin level. Combinations of prazosin with propranolol gave falls in blood pressure similar to those predicted on the basis of a simple addition of the effects of the two drugs given separately. Prazosin-induced tachycardia and renin release were attenuated by propranolol. It appears that prazosin produces renin release and tachycardia via stimulation of the beta-adrenergic adrenoceptor.

Chronic clonidine treatment and its withdrawal: effects on blood pressure and catecholamine synthesizing enzymes in brain-stem nuclei.

We have studied the effects of withdrawal from chronic clonidine treatment in the adult male spontaneously hypertensive rat (SHR). SHR received clonidine, 0.1 mg X kg-1 X day-1 i.v. for 10 days. Clonidine was delivered via osmotic minipumps. After 7 days of treatment there was a 16.5 +/- 2.5 mm Hg fall in mean arterial pressure. This was accompanied by a decrease in the dopamine-beta-hydroxylase and phenylethanolamine-N-methyl transferase activities of the A1/C1 region. Withdrawal from clonidine was characterized by tachycardia and an increase in mean arterial pressure and heart rate lability. Phenylethanolamine-N-methyl transferase of the the dopamine-beta-hydroxylase activity remained diminished. The dopamine-beta-hydroxylase activity of the A2/C2 region was also diminished during withdrawal. We suggest that the blood pressure lowering effect of clonidine is accompanied by a decreased capacity to synthesize adrenaline in the A1/C1 region where adrenaline could mediate a pressor effect. Increased blood pressure lability during withdrawal is accompanied by a restoration of synthesis of adrenaline in the A1/C1 region. There is also a decrease in the capacity of synthesis of noradrenaline in the A2/C2 region where adrenaline may mediate a vasodepressor effect.

Cyclohexamide and renin release following renal artery constriction.

Renal artery constriction in the uninephrectomized conscious rat produced "renin release": i.e. an increase in plasma renin level and a decrease in renal cortex renin level, and an increase in mean arterial pressure. A high dose (4 mg.kg-1) of the protein synthesis inhibitor, cyclohexamide, halved the rise in plasma renin level (with no change in renal cortex renin level and a fall in mean arterial pressure). We suggest that the increase in plasma renin level following renal artery constriction depends on (a) release from preformed renin stores and (b) de novo renin synthesis.

Interaction between the renin-angiotensin and beta adrenergic nervous systems in drinking and pressor responses after renal artery constriction.

Constriction of the remaining renal artery of a uninephrectomized rat produced an increase in plasma renin level, a decrease in renal cortex renin level, an increase in blood pressure and a drinking response. Simultaneous infusion with the angiotensin II antagonist, saralasin, potentiated the rise in plasma renin level and blocked the rise in blood pressure. Drinking was only partially attenuated. Pretreatment with l-propranolol had no effect on the changes in plasma or kidney renin levels, but the increase in blood pressure was potentiated and the drinking response was attenuated. It is concluded that the pressor and drinking responses to renal artery constriction are partially mediated by the beta adrenergic nervous system.

The role of plasma and renal renin in the rise in blood pressure following unilateral renal artery constriction.

Constriction of the artery to the remaining kidney of control rats uninephrectomized 24 h previously induced a sixfold rise in plasma renin level from 11 +/- 1 to 60 +/- 11 ng AI ml-1 h-1, a 43% decrease of renal cortical renin level, and a 21% rise of mean arterial pressure from 119 +/- 2 to 144 +/- 3 mm Hg. Constriction of the artery to a renin-depleted kidney (with a renin level which was 5% of normal) was not followed by any significant increase in plasma renin level or mean blood pressure. Renin-depleted kidneys were produced by removing the clipped kidney from two-kidney one-clip hypertensive rats, 24 h before the experiment. Such a maneuver induces renin depletion but does not completely normalize blood pressure. When a large dose of frusemide (50 mg/kg i.p.) was injected immediately following removal of the clipped kidney, mean arterial pressure (117 +/- 7 mm Hg) returned to control values 24 h later but again constriction of the remaining renal artery failed to induce a rise in plasma renin level or mean arterial pressure. By 7 days after removal of the clipped kidney, plasma renin level and mean arterial pressure were normal and clipping of the remaining kidney (in spite of the fact that kidney renin level was still low) now produced a wave of renin release and an increase in mean arterial pressure. These results suggest that the initial, rapid increase in mean arterial pressure following unilateral renal artery constriction is dependent on an increase in plasma renin level. Our results from animals with kidneys of varying renin levels suggest the existence of a cortical renin content of about 20% of normal below which the kidney is incapable of responding to renal artery constriction with significant renal release. Complete recovery of the renin (and blood pressure) response to clipping occurred when the renin content had reached about 75% of normal.

Influence of streptozotocin-induced diabetes on blood pressure and on renin formation and release.

I.v. injection of 40 mg/kg or 65 mg/kg streptozotocin reliably induced diabetes in female Sprague-Dawley rats, but failed to induced hypertension within the following 42 days. In most animals injected with the higher dose and in some animals injected with the lower dose the tail blood flow was permanently impaired so that no blood pressure signals could be obtained by tail plethysmography. This phenomenon occurred also when the drug was injected into the jugular vein and thus was not due to a local effect of streptozotocin. 15 days after 65 mg/kg streptozotocin, the mean arterial pressure of the rats was similar to that of controls, when measured inthe awake state (carotid cannula) or under ether anaesthesia. 42 days after streptozotocin, under pentobarbital anaesthesia, the blood pressure was again normal in the animals given 40 mg/kg of the drug and depressed in the animals given 65 mg/kg of the drug 42 days previously. The increase of blood pressure induced by 1 microgram/kg (-)-noradrenaline i.v. was similar in the latter group of animals and in controls. The renal cortical renin concentration was much lower than in controls 42 days after either dose of streptozotocin, while the plasma renin activity was normal (40 mg/kg) or increased 65 mg/kg). The low renal renin content may have been due to the diabetic state, rather than to the drug itself. Adrenal medullary dopamine-beta-hydroxylase activity was increased 42 days after the higher dose of streptozotocin.