Left ventricular outflow tract obstruction following an uncomplicated primary percutaneous coronary intervention: a recognized but rare cause of cardiogenic shock

Dynamic left ventricular outflow tract obstruction is a rare but important complication of myocardial infarction. It occurs acutely and may mimic the presentation of papillary muscle rupture or acquired ventricular septal defect. Unlike these mechanical complications, it does not require circulatory support or cardiac surgical intervention. Recognition is critical because it typically responds to volume loading and beta blockade. We report a case who displayed many classical features of this condition.

Generation of coherent 19- and 38-nm radiation at a free-electron laser directly seeded at 38 nm

Initiating the gain process in a free-electron laser (FEL) from an external highly coherent source of radiation is a promising way to improve the pulse properties such as temporal coherence and synchronization performance in time-resolved pump-probe experiments at FEL facilities, but this so-called "seeding" suffers from the lack of adequate sources at short wavelengths. We report on the first successful seeding at a wavelength as short as 38.2 nm, resulting in GW-level, coherent FEL radiation pulses at this wavelength as well as significant second harmonic emission at 19.1 nm. The external seed pulses are about 1 order of magnitude shorter compared to previous experiments allowing an ultimate time resolution for the investigation of dynamic processes enabling breakthroughs in ultrafast science with FELs. The seeding pulse is the 21st harmonic of an 800-nm, 15-fs (rms) laser pulse generated in an argon medium. Methods for finding the overlap of seed pulses with electron bunches in spatial, longitudinal, and spectral dimensions are discussed and results are presented. The experiment was conducted at FLASH, the FEL user facility at DESY in Hamburg, Germany.

Antibacterial activity of leaf extract of Breonadia salicina (Rubiaceae), an endangered medicinal plant of Saudi Arabia

Wild plants can contain bioactive compounds with potential activity against disease-causing microorganisms. In the Kingdom of Saudi Arabia, there are many plant species that may have antibacterial, antifungal, or antiviral activities, among other properties. We extracted bioactive compounds with methanol as well as with water from leaves of Breonadia salicina, which is an endangered plant found in the wild in Saudi Arabia. These extracts were tested against the bacteria Bacillus subtilis, Pseudomonas aeruginosa, Shigella sonnei, Escherichia coli, and Staphylococcus aureus. Both extracts showed antibacterial activity against all of the microorganisms, and thus, B. salicina leaf extract has potential as an antimicrobial agent for the preservation of foods, instead of synthetic chemical compounds. We found that the methanolic leaf extract was more effective than the aqueous crude extract against B. subtilis, P. aeruginosa, and S. aureus.

An in vitro study of alginate oligomer therapies on oral biofilms

OBJECTIVES

The in vitro effect of a novel, oligosaccharide nanomedicine OligoG against oral pathogen-related biofilms, both alone and in the presence of the conventional anti-bacterial agent triclosan, was evaluated.

METHODS

The effect of OligoG±triclosan was assessed against established Streptococcus mutans and Porphyromonas gingivalis biofilms by bacterial counts and image analysis using LIVE/DEAD(®) staining and atomic force microscopy (AFM). The effect of triclosan and OligoG surface pre-treatments on bacterial attachment to titanium and polymethylmethacrylate was also studied.

RESULTS

OligoG potentiated the antimicrobial effect of triclosan, particularly when used in combination at 0.3% against S. mutans grown in artificial saliva. OligoG was less effective against established P. gingivalis biofilms. However, attachment of P. gingivalis, to titanium in particular, was significantly reduced after surface pre-treatment with OligoG and triclosan at 0.01% when compared to controls. Light microscopy and AFM showed that OligoG was biocidal to P. gingivalis, but not S. mutans.

CONCLUSIONS

OligoG and triclosan when used in combination produced an enhanced antimicrobial effect against two important oral pathogens and reduced bacterial attachment to dental materials such as titanium, even at reduced triclosan concentrations. Whilst the use of triclosan against oral bacteria has been widely documented, its synergistic use with OligoG described here, has not previously been reported. The use of lower concentrations of triclosan, if used in combination therapy with OligoG, could have environmental benefits.

CLINICAL IMPORTANCE

The potentiation of antimicrobial agents by naturally occurring oligomers such as OligoG may represent a novel, safe adjunct to conventional oral hygiene and periodontal therapy. The ability of OligoG to inhibit the growth and impair bacterial adherence highlights its potential in the management of peri-implantitis.

Effect of sodium valproate on the toxicity of cyclophosphamide in the testes of mice: influence of pre- and post-treatment schedule

Recently, sodium valproate (VPA) has been proven as histone deacetylase (HDAC) inhibitor and potentiates the cytotoxicity of anticancer drugs, and also exhibit promising anti-cancer activity. Present study aimed to investigate the influence of pre- and post-treatment of VPA on cyclophosphamide (CP) induced genotoxicity and germ cell toxicity in mice. All the animals were treated with VPA at the dose of 500 mg/kg/day on alternate day thrice/week for a period of two weeks, CP at the dose of 200 mg/kg on 7^th and 15^th day and sacrificed 24 h after administration (i.p.) of the last dose. End point of evaluation includes sperm count, sperm head morphology, sperm comet assay and histology. VPA treatment significantly decreases CP induced sperm count, testes and epididymis weight; increased sperm head abnormality and sperm DNA damage. Both VPA pre- and post-treatment augmented CP induced DNA damage and the germ cell toxicity; however, pre-treatment induced more cytotoxicity and genotoxicity as compared to post-treatment.

In situ Gel of Metoprolol Tartrate: Physicochemical Characterization, In vitro Diffusion and Histological Studies

The purpose of the present investigation was to prepare an intranasal in situ gel with increased nasal residence time in order to improve bioavailability of metoprolol tartrate. The in situ gel systems containing carbopol, hydroxypropyl methylcellulose K4M and K15M in different concentrations were prepared. The samples were characterized for viscosity, rheological behavior, gelation behavior, gel strength, and mucoadhesion. The formulations F10 (0.4% w/v carbopol, 1% w/v hydroxylpropyl methylcellulose K15M) and F13 (0.3% w/v carbopol, 1% w/v hydroxypropyl methylcellulose K15M) showed gel strength of 40.33±0.47 and 43.00±1.41, respectively, and mucoadhesion strength 31.48±0.14×10³ and 32.12±0.05×10³ dyne/cm², respectively. In vitro release profiles showed initial burst followed by slow release. F10 and F13 released 88.08±0.98 and 91.18±1.09% drug in 8 h. R² value for F10 (0.9953) and F13 (0.9942) was maximum for Higuchi, showing mixed order kinetics while n value obtained on treatment with Korsemayer Pappas equation were near to 0.5, suggesting release by fickian diffusion mechanism. The nasal permeability of formulations F10 and F13 were found to be 0.057 and 0.063 cm/s, respectively. Histopathological examination revealed slight degeneration of nasal epithelium with increased vascularity by F10 but no inflammation by formulation F13. Thus, a pH triggered in situ gel system containing low concentration (0.3% w/v) of carbopol demonstrated sustained release of metoprolol tartrate without any destructive effect on the mucosa.

Telomeres and atherosclerosis

Abstract

In humans and other multicellular organisms that have an extended lifespan, the leading causes of death are atherosclerotic cardiovascular disease and cancer. Experimental and clinical evidence indicates that these age-related disorders are linked through dysregulation of telomere homeostasis. Telomeres are DNA protein structures located at the terminal end of chromosomes and shorten with each cycle of cell replication, thereby reflecting the biological age of an organism. Critically shortened telomeres provoke cellular senescence and apoptosis, impairing the function and viability of a cell. The endothelial cells within atherosclerotic plaques have been shown to display features of cellular senescence. Studies have consistently demonstrated an association between shortened telomere length and coronary artery disease (CAD).

Several of the CAD risk factors and particularly type 2 diabetes are linked to telomere shortening and cellular senescence. Our interest in telomere biology was prompted by the high incidence of premature CAD and diabetes in a subset of our population, and the hypothesis that these conditions are premature-ageing syndromes. The assessment of telomere length may serve as a better predictor of cardiovascular risk and mortality than currently available risk markers, and anti-senescence therapy targeting the telomere complex is emerging as a new strategy in the treatment of atherosclerosis. We review the evidence linking telomere biology to atherosclerosis and discuss methods to preserve telomere length.

FPGA Based High Speed Data Acquisition System for Electrical Impedance Tomography

Electrical Impedance Tomography (EIT) systems are used to image tissue bio-impedance. EIT provides a number of features making it attractive for use as a medical imaging device including the ability to image fast physiological processes (>60 Hz), to meet a range of clinical imaging needs through varying electrode geometries and configurations, to impart only non-ionizing radiation to a patient, and to map the significant electrical property contrasts present between numerous benign and pathological tissues. To leverage these potential advantages for medical imaging, we developed a modular 32 channel data acquisition (DAQ) system using National Instruments' PXI chassis, along with FPGA, ADC, Signal Generator and Timing and Synchronization modules. To achieve high frame rates, signal demodulation and spectral characteristics of higher order harmonics were computed using dedicated FFT-hardware built into the FPGA module. By offloading the computing onto FPGA, we were able to achieve a reduction in throughput required between the FPGA and PC by a factor of 32:1. A custom designed analog front end (AFE) was used to interface electrodes with our system. Our system is wideband, and capable of acquiring data for input signal frequencies ranging from 100 Hz to 12 MHz. The modular design of both the hardware and software will allow this system to be flexibly configured for the particular clinical application.

An information systems model of the determinants of electronic health record use

OBJECTIVES

The prominence given to universal implementation of electronic health record (EHR) systems in U.S. health care reform, underscores the importance of devising reliable measures of factors that predict medical care providers' use of EHRs. This paper presents an easily administered provider survey instrument that includes measures corresponding to core dimensions of DeLone and McClean's (D & M) model of information system success.

METHODS

Study data came from self-administered surveys completed by 460 primary care providers, who had recently begun using an EHR.

RESULTS

Based upon assessment of psychometric properties of survey items, a revised D&M causal model was formulated that included four measures of the determinants of EHR use (system quality, IT support, ease of use, user satisfaction) and five indicators of provider beliefs about the impact on an individual's clinical practice. A structural equation model was estimated that demonstrated a high level of inter-correlation between the four scales measuring determinants of EHR use. All four variables had positive association with each of the five individual impact measures. Consistent with our revised D&M model, the association of system quality and IT support with the individual impact measures was entirely mediated by ease of use and user satisfaction.

CONCLUSIONS

Survey research provides important insights into provider experiences with EHR. Additional studies are in progress to investigate how the variables constructed for this study are related to direct measures of EHR use.

Micellar Behaviour of Copper Surfactants Derived from Fresh (Untreated) Sesame Oil and Used (Treated at High Temperature) Sesame Oil

Copper soaps have been prepared from fresh and used sesame oils. The formation of copper soaps has been confirmed by spectral technique. Micellar characterization of copper soaps has been studied by density, viscosity and ultrasonic measurements. The apparent molar volume and apparent molar compressibility have been enumerated at constant temperature using these data. The results were used to determine the critical micelle concentration (CMC), soap-solvent interaction. The results of apparent molar volume were discussed in terms of Masson's equation and the results of viscosity data have been discussed in terms of Jones-Dole equation. The CMC values are found to increase with decrease in average molecular weight of the soap. It has been observed that there is a decrease in soap-solvent interaction with the decrease in average molecular weight of copper soap.

Synthesis, Characterization and Antifungal Activities of Copper(II) Soaps and their Complexes Derived from Azadirecta Indica (Neem) and Pongamia Pinnata (Karanj) Oil

Neem (Azadirecta indica) and Karanj (Pongamia pinnata) oils are ecofriendly, non-toxic, completely biodegradable with antiviral, antifungal, and antibacterial properties. The dark green colour Copper(II) soaps derived from Neem and Karanj oil, their greenish brown complexes with ligand 2-amino-6-methyl benzothiazole containing nitrogen and sulphur have been synthesized and characterized by elemental analysis. IR and NMR of complexes suggest that the complexation has taken place successfully. From the analytical data the stoichiometry of the complexes has been observed to be 1:1 (metal-ligand). Copper soaps and their complexes are good anti-fungal agents. The fungi toxicities of the oils, soaps and complexes of neem and karanj have been investigated. The results indicate that the strain of Candida species is susceptible towards complexes of benzothiazole.

Assessment of phylogenetic relationship of rare plant species collected from Saudi Arabia using internal transcribed spacer sequences of nuclear ribosomal DNA

The rare and endangered plants of any country are important genetic resources that often require urgent conservation measures. Assessment of phylogenetic relationships and evaluation of genetic diversity is very important prior to implementation of conservation strategies for saving rare and endangered plant species. We used internal transcribed spacer sequences of nuclear ribosomal DNA for the evaluation of sequence identity from the available taxa in the GenBank database by using the Basic Local Alignment Search Tool (BLAST). Two rare plant species viz, Heliotropium strigosum claded with H. pilosum (98% branch support) and Pancratium tortuosum claded with P. tenuifolium (61% branch support) clearly. However, some species, viz Scadoxus multiflorus, Commiphora myrrha and Senecio hadiensis showed close relationships with more than one species. We conclude that nuclear ribosomal internal transcribed spacer sequences are useful markers for phylogenetic study of these rare plant species in Saudi Arabia.

The incidence and magnitude of fibrinolytic activation in trauma patients

BACKGROUND

Trauma is a global disease, with over 2.5 million deaths annually from hemorrhage and coagulopathy. Overt hyperfibrinolysis is rare in trauma, and is associated with massive fatal injuries. Paradoxically, clinical trials suggest a much broader indication for antifibrinolytics.

OBJECTIVE

To determine the incidence and magnitude of fibrinolytic activation in trauma patients and its relationship to clot lysis as measured by thromboelastometry.

METHODS

A prospective cohort study of 303 consecutive trauma patients admitted between January 2007 and June 2009 was performed. Blood was drawn on arrival for thromboelastometry (TEM) and coagulation assays. Follow-up was until hospital discharge or death. TEM hyperfibrinolysis was defined as maximum clot lysis of > 15%. Fibrinolytic activation (FA) was determined according to plasmin-antiplasmin (PAP) complex and D-dimer levels. Data were collected on demographics, mechanism, severity of injury, and baseline vital signs. The primary outcome measure was 28-day mortality. The secondary outcome measures were 28-day ventilator-free days and 24-h transfusion requirement.

RESULTS

Only 5% of patients had severe fibrinolysis on TEM, but 57% of patients had evidence of 'moderate' fibrinolysis, with PAP complex levels elevated to over twice normal (> 1500 μg L(-1)) without lysis on TEM. TEM detected clot lysis only when PAP complex levels were increased to 30 times normal (P < 0.001) and antiplasmin levels were < 75% of normal. Patients with FA had increased 28-day mortality as compared with those with no FA (12% vs. 1%, P < 0.001), fewer ventilator-free days, and longer hospital stay.

CONCLUSIONS

FA occurs in the majority of trauma patients, and the magnitude of FA correlates with poor clinical outcome. This was not detected by conventional TEM, which is an insensitive measure of endogenous fibrinolytic activity.