Lege Artis Medicinae

[A newly discovered vasoconstrictor peptide: endothelin]

SÜTŐ Tamás1, DEVECSERI Zsuzsanna1, ROSIVALL László1

MARCH 31, 1992

Lege Artis Medicinae - 1992;2(03)

[The discovery of endothelium-derived relaxing (prostacyclin, EDRF) and contracting factors (EDCF) in the last decade opened up new vistas in investigating the regulation of the cardiovascular system. In this review, recent results of the research of a 21 amino acid residue EDCF, called Endothelin, including its discovery, isolation, biosynthesis, tissue specific expression, receptors and the characteristics of the Endothelin converting enzyme are summarized. Based on present knowledge of the wide variety of biological actions of Endothelins, we present their possible autocrine, paracrine and humoral actions, and their significance in the physiological regulation of the cardiovascular system as well as in pathological conditions. Despite the abundance of information however, the actual role of Endothelins in the short- and long-term modulation of the tissue function still remains to be determined.]

AFFILIATIONS

  1. Semmelweis Orvostudományi Egyetem Kórélettani Intézet, Budapest

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[Recently great interest has been concentrated on potassium channels inhibited by intracellular adenosine triphosphate (ATP-sensitive potassium channels), which connect the metabolic state of cells with their electrical activity. Channel closure initiates the secretion of insulin from pancreatic ß-cells; a number of hormones altering the level of blood-sugar act via these channels. The channels are present in neurones; they regulate both in the cell bodies and the nerve terminals (e. g. peripheral nerves) the excitability. The reby, in the central nervous system, they influence the neuronal activity both in the satiety center and some catecholaminergic brain nuclei. These channels mediate the effects of endogenous vasodilators in vascular smooth muscle. They have a pathophysiological role in protecting neurones and muscle cells from hypoxic damage. The ATP-sensitive potassium channels are targets of the sulphonylurea antidiabetic agents and of a new class of drugs, the potassium channel agonists. The latter compounds are investigated or used for the treatment of hypertension, angina pectoris, cardiac insufficiency, bronchial asthma, irritable bladder syndrome, chronic occlusive arterial disease and even in impotence. They are relatively well-tolerated drugs. Their adverse effects are related to their basic vasodilator profile and most commonly include headache, dizziness, palpitation or oedema. ]

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[The high incidence of intra-articular ligament injuries of the knee justifies a more frequent use of noninvasive diagnostic procedures such as the native CT scan. In positive cases, a correct preoperative diagnosis may be produced; a negative result is especially important, since diagnostic arthroscopy may be avoided. Due to the anatomic arrangement of the knee joint ligaments and theis density, which differentiates them from adjacent structures, an accurate, reliable, and reproducible image can be obtained with the native CT scan. With the high resolution charactaristic of the native CT scan, the ligaments of Humphry and Wrisberg can be visualized, and the two bundles of the anterior cruciate ligament can be distinguished from one another. Exact localization of intra-articular ligament rupture is essential in the planning of an optimal treatment schedule. According to the literature and the authors experience, the native CT scan is equivalent to the MRI as a diagnostic procedure in knee intra-articular ligament lesions. It has the advantage of being far less expensive and it is presently available in Hungary. ]

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