We injected acetylcholine (ACh), the neurotransmitter of the parasympathetic nervous system, into the coronary arteries of 28 patients with variant angina. Injection of 10 to 80 gg ACh into the coronary artery responsible for the attack induced spasm together with chest pain and ST segment elevation or depression on the electrocardiogram in 30 of the 32 arteries of 25 of the 27 patients. The injection of 20 to 100 gg ACh into the coronary artery not responsible for the attack in 18 patients resulted in various degrees of constriction in most of them, but no spasm in any of them. After intravenous injection of 1.0 to 1.5 mg atropine sulfate, the injection of ACh into the coronary artery responsible for the attack did not induce spasm or attack in any of the nine coronary arteries injected in eight patients. We conclude that the intracoronary injection of ACh induces coronary spasm and attack in patients with variant angina and that the activity of the parasympathetic nervous system may play a role in the pathogenesis of coronary spasm. We also conclude that the intracoronary injection of ACh is a useful test for provocation of coronary spasm. Circulation 74, No. 5, 955-963, 1986. IT IS NOW widely accepted that spasm of an epicardial coronary artery (coronary spasm) plays an important role in the pathogenesis, not only of variant angina, but also of other forms of resting angina, some types of exertional angina, and types of acute myocardial infarction. quently Endo et al.'0 confirmed our results. On the basis of this fact and the fact that the activity of the parasympathetic nervous system is enhanced at rest and is suppressed by physical activity," we postulated that the activity of parasympathetic nervous system might be related to the pathogenesis of variant angina or coronary spasm.7 It has been shown that stimulation of the parasympathetic (vagus) nerve or intracoronary injection of ACh causes coronary vasodilatation, as demonstrated by an increase in coronary blood flow in dogs,'2-'5 and that ACh dilates isolated epicardial coronary arteries in dogs'6 and monkeys. 17 In humans subcutaneous injection of methacholine causes profound dilatation of systemic vasculature, resulting in a transient fall in blood pressure and compensatory tachycardia due to reflex sympathetic discharge.7 We therefore speculated that coronary spasm might be induced by sympathetic discharge by way of a-adrenergic stimulation.7 Recently, however, reports have appeared that show that ACh contracts strips of human coronary arteries obtained from hearts of transplant recipients'8 or cadav-955

The results of this study suggest that loading of the foot causes significant 3-D displacement not only at the TMT joint but also at the other joints of the first ray. There is increased mobility in the first ray in patients who have hallux valgus.

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Articles you may be interested inComparative electron temperature measurements of Thomson scattering and electron cyclotron emission diagnostics in TCABR plasmasa) Rev. Sci. Instrum. 81, 10D529 (2010); 10.1063/1.3494379 Measurement of electron temperature and density in an argon microdischarge by laser Thomson scattering Appl.A comparison of spectroscopic and Thomson scattering measurements of electron densities and temperatures in a transient expanding plasma flow Electron temperature T, and density n, in the source region of an electron cyclotron resonance discharge have been measured by incoherent Thomson scattering of the beam from a 0.5 J yttrium aluminum garnet laser. This is the first experiment in which this technique, routinely used on fusion plasmas, has been applied to a processing plasma. Measurements were made in an argon discharge at pressures from 0.3 to 2 mTorr and microwave powers from 250 to 1000 W. Velocity distributions were measured both parallel and perpendicular to the magnetic field and a slight anisotropy of electron temperature was observed for low-pressure discharges. Temperatures in the range of l-5 eV and densities in the range of 2-10x 10" rnd3 were measured. T, and n, were found to strongly depend on pressure but only weakly on the input power and discharge magnetic field. No deviations from a Maxwellian velocity distribution were observed.