Analysis of intracardiac electrograms showing monomorphic ventricular tachycardia in patients with implantable cardioverter-defibrillators

Ventricular tachycardia (VT) initiation and its relation to various clinical factors was studied by reviewing intracardiac electrograms from patients with implantable cardioverter-defibrillators. Events were divided into (1) sudden onset without preceding ventricular premature complexes (VPCs), (2) extrasystolic onset with VPCs, or (3) paced, depending on the type and morphology of the last 5 beats before initiation of VT. Prematurity index, sinus rate, cycle length, and presence of short-long-short sequence for each episode was noted. A total of 268 episodes of VT among 52 patients were analyzed. Extrasystolic initiation was the most frequent pattern (177; 66%) followed by sudden onset (75; 28%) and paced (16; 6%). Among extrasystolic onset, 99 episodes (56%) were due to multiple VPCs and 149 episodes (84%) had different VPC morphology than the subsequent VT. Among pacing-induced VT, 13 of 16 episodes were due to inappropriate pacing due to undersensing of prior R waves. Sudden-onset episodes were slower (mean cycle length 383+/-97 ms) than extrasystolic (mean cycle length 336+/-88 ms, p = 0.002) and paced (mean cycle length 313+/-85 ms, p = 0.01) onset. Patients in the sudden-onset group had better left ventricular ejection fraction (33+/-15%) than the extrasystolic (29+/-11%, p<0.001) and paced (28+/-14%, p<0.01) groups. Extrasystolic onset with multiple, late coupled VPCs was the most common pattern of VT initiation and was associated with lower ejection fraction. Sudden-onset initiation was more common with better preserved systolic function.

The D arm of tRNATyr is necessary and sufficient for import into Leishmania mitochondria in vitro

Transfer RNAs are selectively imported from the cytoplasm into mitochondria of kinetoplastid protozoa such as Leishmania . The specific structural features of tRNA which determine selectivity are largely unknown. Using an in organello system from Leishmania , the import signals on tRNATyrand on a synthetic transcript which binds to the same receptor, were studied by deletion and reconstruction analyses. In both cases, short oligoribonucleotides (minihelices) containing the sequence UGGYAGAG were imported with high efficiency in the presence of ATP. This motif is present in the D arm of tRNATyr, as well as in the majority of imported Leishmania tRNAs. Deletion of the D arm, or a point mutation in the conserved motif, reduces importability. The import signal coincides with the binding site for the mitochondrial receptor TAB. tRNAGln, which is not imported, forms non-productive, TAB-independent complexes with the mitochondrial surface. However, the observation that the imported:bound ratio of the D arm minihelix is higher than that of the entire molecule suggests that the post-binding translocation step is constrained in terms of size or structural flexibility. Kinetic studies of minihelix import indicate stepwise insertion of the molecule into import channels.

Study on body mass index, lipid profile and lipid peroxidation status in coronary artery disease

Among the many known risk factors of coronary artery disease (CAD) obesity and hypercholesterolaemia are important ones. Whatever may be the risk factor, the basic pathology of CAD is deposition of altered lipids on the endothelium. One of such altered lipid is oxidatively modified low density lipoprotein (LDL). Lipid peroxidation has been assessed by several methods. Quantitation of malondialdehyde (MDA) by thiobarbituric acid (TBA) method is one of the commonly utilised method in several laboratories. In this study 40 cases of CAD were selected for evaluation. The body mass index (BMI), lipid profile and the level of lipid peroxidation (MDA) were measured. Seventeen cases (42.5%) had normal BMI (20-25), 20 cases (50%) were in the overweight range of BMI (26-30) and only 3 cases (7.5%) were in the obese group with a BMI more than 30. BMI correlated better with the level of total cholesterol (Tc), low density lipoprotein cholesterol (HDLc) and MDA. BMI did not show any correlation with triglyceride (Tg) or high density lipoprotein cholesterol (HDLc). MDA level correlated better with Tc, Tg levels and BMI, poorly correlated with LDLc and in inverse relationship was observed with HDLc.

The protective effect of red palm oil in comparison with massive vitamin A dose in combating vitamin A deficiency in Orissa, India

Vitamin A deficiency has long been a serious hazard to the world community, especially to children. The main reason for a higher incidence among children is lack of vitamin A in the diet. Carotene rich supplements with sources like Red Palm oil (RPO) could be used as a measure to combat vitamin A deficiency. This study evaluates the protective effect of RPO in comparison with massive vitamin A dose to combat vitamin A deficiency. The study was carried out for a period of three months in 36 school children. Twelve children received a massive dose (50,000 IU) of vitamin A, another twelve children received 4g of RPO containing B-carotene equivalent to 25,000 IU of vitamin A in "Besan laddu" and the remaining twelve received 8g of RPO containing B-carotene equivalent to 50,000 IU of vitamin A in "Besan laddu". Serum vitamin A levels were estimated initially, after 15 days of supplementation and 3 months after termination of supplementation. The levels were maximum 15 days after the supplementation and, though it fell by the end of 3 months, yet it was significantly higher than that of the initial levels in all the three groups. Among both the levels of RPO supplement, 8g RPO was as efficient as was a massive vitamin A dose in providing protection for three months, after cessation of supplementation.

Role of an RNA-binding protein in import of tRNA into Leishmania mitochondria

Nuclear-encoded cytoplasmic tRNAs are imported into the mitochondria of kinetoplastid protozoa by an unknown mechanism. In a Leishmania in organello system, ATP-dependent import of a cloned, unspliced tRNATyr(GUA) transcript was demonstrated by protection from ribonuclease, whereas import of a tRNAGln(CUG) transcript was much less efficient. Specific binding of tRNATyr to two mitochondrial surface proteins of 15 and 22 kilodaltons was observed. Tubulin antisense-binding protein (TAB), the 15-kilodaton species, was purified to apparent homogeneity by RNA affinity chromatography. TAB forms stable complexes with the D stem-loop region of tRNATyr. Immunocytochemical and cell fractionation experiments, combined with limited proteolysis, suggested the association of TAB with the outer mitochondrial membrane. Importantly, anti-TAB antibody specifically inhibited binding as well as import of tRNATyr and of a synthetic structural homolog. These results support the role of TAB as a membrane-bound receptor or carrier for RNA import into Leishmania mitochondria.

Dual multimodular class A penicillin-binding proteins in Mycobacterium leprae

The ponA gene of cosmid L222 of the Mycobacterium leprae genome library encodes a multimodular class A penicillin-binding protein (PBP), PBP1. The PBP, labelled with a polyhistidine sequence, has been produced in Escherichia coli, extracted from the membranes with 3-[(3-cholamidopropyl)-dimethylammonio]-1-propane-sulfonate (CHAPS) and purified by Ni2(+)-nitrilotriacetic acid-agarose chromatography. In contrast to the pon1-encoded class A PBP1, PBP1 undergoes denaturation at temperatures higher than 25 degrees C, it catalyzes acyl transfer reactions on properly structured thiolesters, and it binds penicillin with high affinity.

Biochemical characterization of the 49 kDa penicillin-binding protein of Mycobacterium smegmatis

The 49 kDa penicillin-binding protein (PBP) of Mycobacterium smegmatis catalyses the hydrolysis of the peptide or S-ester bond of carbonyl donors R1-CONH-CHR2-COX-CHR2-COO- (where X is NH or S). In the presence of a suitable amino acceptor, the reaction partitions between the transpeptidation and hydrolysis pathways, with the amino acceptor, behaving as a simple alternative nucleophile at the level of the acyl-enzyme. By virtue of its N-terminal sequence similarity, the 49 kDa PBP represents one of the class of monofunctional low-molecular-mass PBPs. An immunologically related protein of M(r) 52,000 is present in M. tuberculosis. The 49 kDa PBP is sensitive towards amoxycillin, imipenem, flomoxef and cefoxitin.

Import of RNA into Leishmania mitochondria occurs through direct interaction with membrane-bound receptors

Cytoplasmic tRNAs are imported into the kinetoplast mitochondrion of Leishmania, but the mechanism of import is unknown, particularly whether RNA is transferred as a ribonucleoprotein complex through the protein import pathway or by a distinct receptor-mediated mechanism. Using isolated mitochondria, it was shown that a small, importable RNA, which is structurally homologous to tRNA, binds rapidly, specifically, and with high affinity to the mitochondrial surface in the absence of soluble protein factors to form an import intermediate. Two classes of binding site of apparent Kd 0.3 and 10 n, respectively, were distinguished. tRNA from Leishmania, but not yeast, competitively inhibited the binding. Northwestern blot analysis revealed the presence of a 15-kDa RNA binding protein on the mitochondrial surface. Whereas receptor binding was resistant to heparin and KCl, internalization was sensitive to both reagents. These results are consistent with the presence of a direct mechanism of receptor-mediated RNA import on Leishmania mitochondria.

Reversible cleavage and formation of the dioxygen O-O bond within a dicopper complex

A key step in dioxygen evolution during photosynthesis is the oxidative generation of the O-O bond from water by a manganese cluster consisting of M2(mu-O)2 units (where M is manganese). The reverse reaction, reductive cleavage of the dioxygen O-O bond, is performed at a variety of dicopper and di-iron active sites in enzymes that catalyze important organic oxidations. Both processes can be envisioned to involve the interconversion of dimetal-dioxygen adducts, M2(O2), and isomers having M2(mu-O)2 cores. The viability of this notion has been demonstrated by the identification of an equilibrium between synthetic complexes having [Cu2(mu-eta2:eta2-O2)]2+ and [Cu2(mu-O)2]2+ cores through kinetic, spectroscopic, and crystallographic studies.

Identification and overexpression in Escherichia coli of a Mycobacterium leprae gene, pon1, encoding a high-molecular-mass class A penicillin-binding protein, PBP1

Cosmid B577, a member of the collection of ordered clones corresponding to the genome of Mycobacterium leprae, contains a gene, provisionally called pon1, that encodes an 821-amino-acid-residue high-molecular-mass class A penicillin-binding protein, provisionally called PBP1. With similar amino acid sequences and modular designs, M. leprae PBP1 is related to Escherichia coli PBP1a and PBP1b, bienzymatic proteins with transglycosylase and transpeptidase activities. When produced in E. coli, His tag-labelled derivatives of M. leprae PBP1 adopt the correct membrane topology, with the bulk of the polypeptide chain on the surface of the plasma membrane. They defy attempts at solubilization with all the detergents tested except cetyltrimethylammonium bromide. The solubilized PBP1 derivatives can be purified by affinity chromatography on Ni2+-nitrilotriacetic acid agarose. They have low affinities for the usual penicillins and cephalosporins.

Subclinical status epilepticus following ECT

Subclinical status epilepticus is a rare complication of electroconvulsive therapy (ECT). We describe the case of a 70-year-old man with psychotic depression who developed prolonged subclinical status epilepticus following an initial ECT treatment; he subsequently received a course of ECT without complications. It is important to consider status epilepticus in the differential diagnosis of patients who do not regain consciousness following ECT, even in the absence of overt motor seizure activity. The development of this complication does not preclude the future use of ECT; in fact, ECT has been repeated successfully in individuals who developed this complication, including this case. Identification of potential risk factors, appropriate preventive measures, and early intervention are important in the management of this complication. The literature is reviewed and appropriate preventive and treatment measures are discussed.

STUDY OF SERUM AND BILE FROM PATIENTS OF CHOLELITHIASIS IN NORTH-EASTERN INDIA

Biochemical analysis of serum and bile from patients with cholelithiasis hailing form north-eastern India was done to provide pointers for lithogenicity. In comparison to controls, patients with cholelithiasis showed significant increase in serum phospholipid levels and lecithin cholesterol acyl transferase activity was significantly decreased. Enzymes like gamma glutamyl transferase, aspartate aminotransferase, alanine aminotransferase and alkaline phosphatase showed a small though significant increase as compared to controls, suggesting evidence of subclinical hepatic dysfunction and probable evidence of relative bile stasis. Levels of cholesterol, lecithin and lecithin cholesterol acyl transferase activity were seen to be increased in gall bladder bile as compared to hepatic duct bile.

Characterization of a 38 kDa penicillin-binding protein and its possible involvement in maintaining stationary-phase cells of Shigella dysenteriae

This paper reports the first attempt to characterize the penicillin-binding proteins (PBPs) of Shigella dysenteriae, an important human pathogen. The PBP pattern of the membranes of S. dysenteriae closely resembles that of Escherichia coli membranes. A 38 kDa PBP which is an important target for the penem SCH34343, the cephamycin cefoxitin and the oxacephem moxalactam, has been purified. This PBP is immunologically related to a PBP of similar molecular mass in E. coli and is present at high levels in stationary-phase cells of S. dysenteriae.

Import of small RNAs into Leishmania mitochondria in vitro

Using an in vitro ribonuclease protection assay, it was shown that synthetic antisense transcripts from the 5'-upstream region of the beta-tubulin gene are efficiently imported into isolated Leishmania mitochondria. Import occurred after a lag of about 30 min at 25 degrees C and was dependent on ATP. Preincubation experiments suggested that import consists of a slow interaction of mitochondria with RNA, followed by rapid ATP-dependent uptake. Import was saturable with antisense RNA at about 1 nM concentration, and sequence-specific, as shown by lack of import of other labelled transcripts. Deletion analysis demonstrated a correlation between efficiency of import and the number of oligopurine motifs on the antisense RNA. Several small ribosomal RNAs (srRNAs) and Leishmania tRNA competed with antisense RNA for import. Incubation of mitochondria with srRNAs and tRNA in the presence of radiolabelled UTP resulted in the ribonuclease-resistant labelling of these RNAs by the mitochondrial terminal uridylyl transferase. Extracts of isolated mitochondria contain a factor binding to antisense RNA, as shown by gel retardation assay. These observations indicate the presence of a receptor-mediated import pathway for srRNAs and tRNA in Leishmania mitochondria.