The influence of age, gender and ABO blood group on soluble adhesion molecules and markers of endothelial function were tested by measurement of levels of von Willebrand factor, intercellular adhesion molecule-1, vascular cell adhesion molecule-1 (VCAM-1), P-selectin, E-selectin and thrombomodulin in venous blood from healthy subjects. Only VCAM-1 showed a significant multivariate correlation with age (r = 0.1, P = 0.019), and thrombomodulin (P = 0.0001) and E-selectin (P = 0.026) were lower in the women. Significant differences between ABO blood groups were found for von Willebrand factor (P = 0.024), E-selectin (P < 0.001) and thrombomodulin (P < 0.001). As these three are all specific endothelial products, our findings may have implications for vascular biology.

Patients were eligible if they presented within 24 hours of suspected acute myocardial infarction with no clear indications for, or contraindications to, the study treatments (although planned use of a few days of intravenous or oral nitrates was permitted). About 40% were within 6 hours of pain onset. 75% had ST elevation, 25% were aged 70% 15% had heart failure, and 2% had systolic blood pressure < 100 ramHgPatients were randomly allocated in a 2 x 2 x 2 factorial design between one month of oral captopril (6.25 mg initial dose, 12.5 rag 2 hours later, 25 mg 10-12 hours later and then 50 mg twice daily) versus placebo, one month of oral controlled-release isosorbide mouonitrate (lmdur: 30 mg initial dose, 30 mg 10-12 hours later and then 60 nag each morning) versus placebo, and 24 hours of intravenous magnesium sulphate (8 raraol initial bolus over 15 minutes followed by 72 mmcl)'versus open control. About 75% received fibrinolytic and almost all antiplatelet therapy.The main comparisons are to be of 5-week and longer-term mortality amongst all those allocated each active therapy versus all those allocated the corresponding control. Principal subsidiary comparisons involve subdivisun by planned nitrate at entry and by the other randomly allocated treatments. Mode of death and major morbidity results will also be considered. The decisions by a single cardiologist as to which of 308 consecutive patients to refer for angiography after treadmill testing were compared with their life expectancy gains from bypass surgery predicted by decision analysis. Neither patient age nor gender influenced the decision to perform angiography. The 94 patients sent for angiograms exercised for a significantly shorter time (p < 0.001 ), had more ST deviation (p < 0.001 ), more angina (p < 0.002) and were more likely to have had a prior myocardial infarction (p < 0.001) than the 214 patients not referred. The mean life expectancy gain predicted from bypass surgery was also greater (p < 0.001) in those referred (2.9 + 1.7 QALYs) than in those not referred for angiography (I.0 + 1,7 QALYs). However, 1~.3 patients not referred were predicted to gain up to 5.7 QALYs from bypass surgery. Consequently the overall predicted life expectancy gain from the cardiologist's 388 intuitive decisions was only 0. I + 2.5 QALYs per patient. Had the referral decision been solely directed by decision analysis the overall gain per patient would have been 1.9 4-1.6 QALYs, and 135 extra patients (229 in total) would have been sent for angiography. Use of decision analysis, therefore might help make referral for angiography more efficient and consistent. Persistent chest pain with normal cardiac investigations is not uncommon following treatment of coronary artery disease. Oesophageal problems are often suspected but to date evaluation has proved difficult. Eight patients who had previously undergone successful coronary artery bypass grafting or coronary angioplasty underwent 24hr ambulatory manoraetry, pH and ECG monitoring. Symptoms were correlated with ...

The most recent and exciting scientific information is often presented at conferences long before it makes its way through the peer review process into print. As a compromise between timeliness and thorough review, we once again print the abstracts of scientific papers presented at the annual conference of the International Society for Neuronal Regulation, ISNR.In full form these papers were presented in twenty-, forty-, and sixty-minute time slots, and contained much more detail than their abstracts would indicate. Although the abstracts presented in this issue of the Journal of Neurotherapy have not undergone the rigorous peer review process the Journal routinely applies to scientific papers, nevertheless they are reviewed carefully.The papers presented at the ISNR conference are first reviewed by the conference committee headed by Roger deBeus and including Joe Please note that this electronic prepublication galley may contain typographical errors and may be missing artwork, such as charts, photographs, etc. Pagination in this version will differ from the published version.

No abstract