Identification of common cricket (Acheta domesticus) proteins, extracted by acid and alkaline methods

Edible insects currently represent an interesting alternative protein source to the animal ones. The objective of the present wok is to characterize proteins isolated from common cricket (Acheta domesticus). Powder samples of this insect-based flour were obtained using two extraction methods, i.e. acid and alkaline. Subsequently, the proteins isolated have been characterized. The fractionation of proteins in the flour of Acheta domesticus by acid or alkaline-based methods, gave rise to isolates with up to 71.6% in protein content. Extraction in an alkaline medium of insoluble proteins (pellet) resulted in the best performance on protein recovery. These isolates present a wide variety of peptides and proteins, having identified the following ones in the pellet fraction obtained with the acid method: myosin heavy-chain isoforms C, E and Miosin heavy chain (Mhc); tropomyosin; troponin; α and β actin, and some enzymes such as the β subunit ATP synthetase. The characterization results provide information which will enable us to predict the possible physicochemical (gel formation, solubility, water retention capacity, etc.) changes that could take place in the cricket protein during processing in the food and feed industry.

Novel complex-valued deep learning applied to automatic classification of heart sounds

Introduction

Cardiovascular disease (CVD) is a problem facing governments around the world. Early detection saves the healthcare system thousands of dollars by allowing prevention and avoiding costly treatments when the disease has progressed to advanced stages. According to the World Health Organization (WHO), cardiovascular diseases represent the leading cause of mortality worldwide (WHO, 2019). That is why, we have decided to develop novel artificial intelligence models for the detection of heart disease, with accuracies that allow us to put the obtained algorithms into production. The revolution of artificial intelligence allows the application Deep Learning techniques of two-dimensional images in the domain of both real numbers and complex value numbers, as classifiers of heart sounds, for the detection of normality or abnormality in the functioning of the heart.

Purpose

In the present work, we propose the comparison of a novel 2D convolutional neural network (CNN) algorithm in the domain of complex value numbers with its counterpart in the domain of real numbers for the automatic classification of heart sounds into normal or abnormal.

Material

The database we decided to use for our research is Pascal, which has audio files of cardiac activity, distributed in 351 normal sounds and 129 pathological sounds.

Methods

The following steps were applied to get the objectives of our work: 1) automatic segmentation of a single heartbeat, 2) conversion of the segmented sound into its associated image scalogram using the Hilbert transform, 3) classification of the sounds into normal and abnormal using the proposed algorithms, and 4) measurement and comparison of the results obtained by performing a two-tailed t-student hypothesis test and cross-validation.

Results

We present a comparative table between the two proposed models, finding that Accuracy, F1 Score, Precision and Recall metrics obtained using complex-valued convolution networks present significant improvements compared with the real valued one. The following table show us the obtained numbers.

For all cases, the t-student test shows us p-values less than 0.05%, giving statistical evidence that the means are significantly different between the two proposed models. Besides, in all cases, the performance of the Complex-valued model is better compared with the Real-valued one.

Conclusion

Complex-valued neural networks propose a significant advance around Deep learning, since they present a better performance than the traditional counterparts based on real numbers. This proposes an experimental basis for the construction of a new Deep learning paradigm, where information in another numerical domain, is better exploited with the help of mathematical transforms. The latter is a significant advance in health sciences, where the demand is higher, in terms of performance of the proposed models.

Funding Acknowledgement

Type of funding sources: Other. Main funding source(s): eVIDA research Group

P837 Isolated cleft posterior mitral valve leaflet

A 78-year-old man with a history of hypertension and diabetes mellitus was referred to the ER of our hospital due to an episode of shortness of breath of new onset, associated with dizziness and central thoracic pain of 5 minutes duration. Significant physical examination findings included a V/VI holosystolic murmur at fourth intercostal space with radiation to the axilla. ECG showed no significant abnormalities and cardiac enzymes were within normal ranges The TTE and 3D TOE showed dilated left atrial with normal ventricular size and function with an isolated cleft posterior mitral valve leaflet that bisected into two separate leaflets of identical morphology. Concomitant posterolateral leaflet prolapse was also present with two eccentric, posteriorly, and interatrial septum directed regurgitant jets visualized with colour flow Doppler.

Cleft mitral valve leaflet (CMVL) is an uncommon congenital cause of mitral regurgitation. Clefts are slit-like holes or defects hypothesized to be a result of incomplete expression of an endocardial cushion defect and most commonly involve the anterior mitral valve leaflet with a paediatric incidence of 1:1340. Clefts affecting only the posterior mitral valve leaflet are extremely rare . Important co-existing anomalies with either posterior and/or anterior CMVL include counterclockwise rotation of the papillary muscles, the presence of an accessory papillary muscle or mitral valve leaflet, atrial septal defects, and mitral valve prolapse. Acquired causes of clefts include infective endocarditis or trauma from surgical exploration.

Regurgitation in CMVL results from blood flow directly through the cleft itself or from malcoaptation from accessory chordae with or without papillary muscle distortion. Early detection through 3D TEE echocardiography can provide accurate anatomical images of the mitral valve structure and identify associated congenital anomalies.

Conclusion

Posterior CMVL is an extremely rare cause of mitral insufficiency. 3D TEE early recognition of this rare clinical entity and co-existent anomalies can identify afflicted patients who can be closely monitored for the progression of symptoms as well as ventricular dysfunction. 3D TEE permits a personalized medicine tailoring the medical treatment to the individual characteristics of each patient.

Abstract P837 Figure. Isolated cleft posterior mitral valve

Antimicrobial potential of macro and microalgae against pathogenic and spoilage microorganisms in food

Algae are a valuable and never-failing source of bioactive compounds. The increasing efforts to use ingredients that are as natural as possible in the formulation of innovative products has given rise to the introduction of macro and microalgae in food industry. To date, scarce information has been published about algae ingredients as antimicrobials in food. The antimicrobial potential of algae is highly dependent on: (i) type, brown algae being the most effective against foodborne bacteria; (ii) the solvent used in the extraction of bioactive compounds, ethanolic and methanolic extracts being highly effective against Gram-positive and Gram-negative bacteria; and (iii) the concentration of the extract. The present paper reviews the main antimicrobial potential of algal species and their bioactive compounds in reference and real food matrices. The validation of the algae antimicrobial potential in real food matrices is still a research niche, being meat and bakery products the most studied substrates.

Review: Application of Pulsed Electric Fields in Egg and Egg Derivatives

This work overviews works published on the application of pulsed electric fields (PEF) in egg and egg derivatives, grouped by subject, and arranged chronologically in terms of the factor studied (microorganisms, quality aspects, shelf life and structural changes in gel formation properties). The inactivation of microorganisms by PEF in egg is very considerable, 3.5 decimal reductions in egg white were achieved by PEF in Salmonella enteritidis, 5.5 log reductions of Listeria innocua by means of a synergistic effect of PEF and nisin in liquid whole egg, and 5.6 log reductions of Escherichia coli in beaten fresh liquid egg by PEF treatment applied continuously or discontinuously in five steps. The shelf life of PEF-treated fresh liquid egg was extended to 4 weeks in refrigeration, and quality (colour, viscosity and sensory attributes) was not affected by PEF treatment. PEF treatment did not cause notable changes in proteins in a solution of ovalbumin and dialysed fresh egg white. However, some structural changes and functional modifications were observed in fresh egg white as a result of PEF treatment. The texture and microstructure of gels were affected by the application of PEF, and therefore PEF treatment conditions in egg white must be optimised to minimise possible modifications.

Effects of high hydrostatic pressure and temperature increase on Escherichia coli spp. and pectin methyl esterase inactivation in orange juice

The aim of this study was to evaluate the effect of high hydrostatic pressure treatment combined with moderate processing temperatures (25 ℃-50 ℃) on the inactivation of Escherichia coli O157: H7 (ATCC 700728), E. coli K12 (ATCC 23716), and pectin methyl esterase in orange juice, using pressures of 250 to 500 MPa with times ranging between 1 and 30 min. Loss of viability of E. coli O157:H7 increased significantly as pressure and treatment time increased, achieving a 6.5 log cycle reduction at 400 MPa for 3 min at 25 ℃ of treatment. With regard to the inactivation of pectin methyl esterase, the greatest reduction obtained was 90.05 ± 0.01% at 50 ℃ and 500 MPa of pressure for 15 min; therefore, the pectin methyl esterase enzyme was highly resistant to the treatments by high hydrostatic pressure. The results obtained in this study showed a synergistic effect between the high pressure and moderate temperatures in inactivating E. coli cells.

Sublethal injury and virulence changes in Listeria monocytogenes and Listeria innocua treated with antimicrobials carvacrol and citral

The aim of this study was to evaluate the effect of two antimicrobial substances, carvacrol and citral, on Listeria monocytogenes and Listeria innocua cells, as well as possible virulence changes in injured cells, using Caenorhabditis elegans as a model test. The results indicated that the percentage of sublethal damage was higher in L. monocytogenes than in L. innocua. The results of the study carried out by using C. elegans indicated that C. elegans fed in a lawn of L. monocytogenes previously treated with carvacrol showed a loss in life span (p ≤ 0.05) as compared with L. monocytogenes treated with citral, Escherichia coli OP50 as a negative control, and treated and untreated L. innocua. Egg laying was also affected: worms fed in a lawn of treated and untreated L. monocytogenes laid fewer eggs than those fed in a lawn of treated and untreated L. innocua or fed with OP50 as a negative control. Worms fed in a lawn of treated and untreated L. innocua also laid fewer eggs than those fed with OP50 as a negative control. A phenotype named bag of worms and an undescribed new one, "vulva inflammation", were also observed.

Effect of citral and carvacrol on the susceptibility of Listeria monocytogenes and Listeria innocua to antibiotics

The aim of this study was to evaluate the antibiotic susceptibility of Listeria innocua (L. innocua) and Listeria monocytogenes (L. monocytogenes) cells in the presence of citral and carvacrol at sublethal concentrations in an agar medium. The presence of terpenes in the L. monocytogenes and L. innocua culture medium provided a reduction in the minimal inhibitory concentration (MIC) of all the antibiotics tested. These effects were dependent on the concentration of terpenes present in the culture medium. The combination of citral and carvacrol potentiated antibiotic activity by reducing the MIC values of bacitracin and colistin from 32.0 and 128.0 μg ml⁻¹ to 1.0 and 2.0 μg ml⁻¹, respectively. Thus, both Listeria species became more susceptible to these drugs. In this way, the colistin and bacitracin resistance of L. monocytogenes and L. innocua was reversed in the presence of terpenes. Results obtained in this study show that the phytochemicals citral and carvacrol potentiate antibiotic activity, reducing the MIC values of cultured L. monocytogenes and L. innocua.

SIGNIFICANCE AND IMPACT OF THE STUDY

Phytochemicals citral and carvacrol potentiate antibiotic activity of erythromycin, bacitracin and colistin by reducing the MIC values of cultured Listeria monocytogenes and Listeria innocua. This effect in reducing the MIC values of the antibiotics tested in both micro-organisms was increased when natural antimicrobials were combined. This finding indicated that the combination among terpenes and antibiotic may contribute in reducing the required dosage of antibiotics due to the possible effect of terpenes on permeation barrier of the micro-organism cell membrane.

Changes of colour and carotenoids contents during high intensity pulsed electric field treatment in orange juices

Liquid chromatography (LC) was the method chosen to evaluate the effects of high intensity pulsed electric fields (HIPEF), with different electric field intensities (25, 30, 35 and 40 kV/cm) and different treatment times (30-340 micros), on orange juice cis/trans carotenoid contents. In parallel, a conventional heat treatment (90 degrees C, 20 s) was applied to the orange juice in order to compare the effect on the carotenoid contents. HIPEF processing of orange juice is an alternative to the thermal treatment of pasteurization, provided that it is kept refrigerated, because, when the most extreme conditions of this kind of treatment are applied, the decrease in the concentration of carotenoids with vitamin A activity is very small, and also most of the carotenoids identified have a slightly increased concentration after application of the most intense treatments, although always less than in untreated fresh juice. In any case, pasteurization treatment causes a greater decrease in the concentration of most of the carotenoids identified and the carotenoids with vitamin A activity. The total carotenoid concentration decreased by 12.6% in pasteurized orange juice with respect to untreated fresh orange juice, as opposed to decreases of 9.6%, 6.3% or 7.8% when fields of 25, 30 or 40 kV/cm were applied. Orange juice treated with HIPEF shows a greater tendency towards the colour yellow and a lesser tendency towards red with respect to untreated orange juice, while the luminance of the juice remains practically invariable. This tendency is less than in pasteurized orange juice.

Pulsed electric fields versus thermal treatment: equivalent processes to obtain equally acceptable citrus juices

Pulsed electric field treatment has been claimed to produce more acceptable chilled citrus juices than those obtained by conventional thermal treatment. The pectin methylesterase activity and the acceptability of nine juices obtained from Clementine mandarins, Valencia oranges, and Ortanique fruits (hybrid of mandarin and orange), untreated, pasteurized (85 degrees C for 10 s), and treated by pulsed electric fields (25 kV/cm for 330 micros), were evaluated. The treatments, selected to reach a similar level of pectin methylesterase inactivation, produced juices that did not differ in acceptability from each other for the three varieties and in all cases were less acceptable than the untreated juice.

Effect of storage period under variable conditions on the chemical and physical composition and colour of Spanish refrigerated orange juices

The effects of the physicochemical and quality characteristics of various minimally pasteurized refrigerated orange Spanish juices and their changes with storage time and temperature were investigated. Essential oils, acidity, conductivity, diacetyl index, hydroxymethylfurfural, formol index, viscosity and ascorbic acid varied with storage time more significantly at 10 degrees C than at 4 degrees C. Density, colour and pectinmethylesterase did not vary at 4 degrees C. Some of the parameters could be used as indicators of quality loss or spoilage of the juices. The degradation kinetics of the concentration of remaining ascorbic acid against time follows a straight line whose slope indicates the degradation rate. A period of at least 42 days at 4 degrees C and 35 days at 10 degrees C was established as the shelf life of the juices.

Quality and Safety Aspects of PEF Application in Milk and Milk Products

The articles published to date on the possibilities of applying the new PEF technology to milk and milk products are summarized in a review that presents them in chronological order and grouped on the basis of the factor studied (microorganism, enzyme, quality parameter, or shelf-life). An accompanying table shows details of the equipment and process corresponding to each article in chronological order.

Pectin methyl esterase and natural microflora of fresh mixed orange and carrot juice treated with pulsed electric fields

The effects of pulsed electric fields (PEFs) on pectin methyl esterase (PME), molds and yeast, and total flora in fresh (nonpasteurized) mixed orange and carrot juice were studied. The PEF effect was more extensive when juices with high levels of initial PME activity were subjected to treatment and when PEF treatment (at 25 kV/cm for 340 micros) was combined with a moderate temperature (63 degrees C), with the maximum level of PME inactivation being 81.4%. These conditions produced 3.7 decimal reductions in molds and yeast and 2.4 decimal reductions in total flora. Experimental inactivation data for PME, molds and yeast, and total flora were fitted to Bigelow, Hülsheger, and Weibull inactivation models by nonlinear regression. The best fit (lowest mean square error) was obtained with the Weibull model.

Weibull distribution function based on an empirical mathematical model for inactivation of Escherichia coli by pulsed electric fields

The pulsed electric field inactivation kinetics of Escherichia coli suspended in orange juices with three different concentrations of carrot juice (0, 20, and 60%) was studied. Electric field strengths ranged from 25 to 40 kV/cm, and treatment times ranged from 40 to 340 micros. Experimental data were fitted to Bigelow, Hülsheger, and Weibull distribution functions, and the Weibull function provided the best fit (with the lowest mean square error). The dependency of each model's kinetic constant on electric field strength and carrot juice concentration was studied. A secondary model was developed to describe the relationship of Weibull parameters a and n to electric field strength and carrot juice concentration. An empirical mathematical model based on the Weibull distribution function, relating the natural logarithm of the survival fraction to treatment time, electric field strength, and carrot juice concentration, was developed. Parameters were estimated by a nonlinear regression. The results of this study indicate that the error rate for the model's predictions was 6.5% and that the model was suitable for describing E. coli inactivation.

Kinetic model for the inactivation of Lactobacillus plantarum by pulsed electric fields

The kinetics of Lactobacillus plantarum inactivation by pulsed electric fields (PEF) was studied in two different growth stages (exponential and stationary), but in the same reference medium (0.6% peptone water). Electric field intensity and treatment time varied from 20 to 28 kV/cm and 30 to 240 micros, respectively. The experimental data showed that cells in the exponential growth stage were more sensitive to PEF treatment than those in the stationary stage. The inactivation data were adjusted to the Bigelow and Hülsheger models and the Weibull frequency distribution function, and constants were calculated for both growth stages in each model. The models were tested and their accuracy was assessed by using the Accuracy Factor. According to this parameter, the Weibull frequency distribution function gave better fittings for the inactivation by PEF than Bigelow or Hülsheger models. On the other hand, the Bigelow model gave a good accuracy factor and is simpler.

Study of inactivation of Lactobacillus plantarum in orange-carrot juice by means of pulsed electric fields: comparison of inactivation kinetics models

The inactivation kinetics of Lactobacillus plantarum was studied in orange-carrot juice using high intensity pulsed electric fields. The results indicated that under the treatment conditions applied, 28.6, 32.0, and 35.8 kV/cm and treatment times ranging from 10.2 to 46.3 micros, the inactivation of L. plantarum obtained was up to 2.5 decimal reductions. Experimental and literature data were fitted to Bigelow, Hülsheger et al. and Peleg models and to Weibull frequency distribution function. Weibull was the one that best interpreted the data with accuracy factor values closer to 1.

[A 49 year old patient with single left ventricular morphology who underwent surgical repair and good outcome ]

We report a 51-year-old patient, diagnosed with single left ventricle and anterior rudimentary chamber which was corrected by a Fontan procedure in 1997. The echocardiogram, Holter and pulmonary perfusion scintigraphy, isotopic ventriculography, magnetic resonance and blood tests performed during follow-up showed an uncomplicated postoperative course. The patient remains asymptomatic. We believe that this is the oldest case suffering from this anomaly who underwent surgical repair.

[An anomalous origin of the left coronary artery in the right pulmonary artery with interventricular communication]

A six-month-old female baby with a left coronary artery of anomalous origin in the right pulmonary artery, associated with a interventricular septal defect and a slight mitral pathology, was operated on direct implantation of the left coronary artery with a small segment of the pulmonary artery in the posterior wall of the ascending aorta and closure of the perimembranous defect was performed. The patient has been asymptomatic for one year since surgery.

Prognosis of patients with a first episode of sustained monomorphic ventricular tachycardia

AIMS

To evaluate the cardiac mortality in patients suffering from a first episode of sustained monomorphic ventricular tachycardia (SMVT).

METHODS

100 patients less than 75 years old were evaluated during a 50-month follow-up period. Patients were classified into four groups: myocardial infarction, dilated cardiomyopathy, normal heart and miscellany. Seventeen patients underwent a cardioverter-defibrillator implantation, two heart transplant, three aneurysmectomy and 10 other types of cardiac surgical proceedings.

RESULTS

Patients with a left ventricle ejection fraction (EF)> or =50% presented a cardiac mortality of 5% compared with 38% of those with EF<50%. Etiology of underlying cardiomyopathy with an EF> or =50% was associated with a cardiac mortality of 5% (normal heart), 5% (myocardial infarction) and 9% (miscellany) compared to those with EF<50%: 33% (dilated cardiomyopathy) and 40% (myocardial infarction). Patients who experienced syncope during the first episode of SMVT showed a cardiac mortality of 31% compared to those 14% (P < 0.05) who did not experience. Patients with syncope, myocardial infarction and EF<50% showed a cardiac mortality of 68%.

CONCLUSION

The present study shows that survival after the first episode of SMVT is closely related to EF and the existence of syncope. Patients with myocardial infarction and EF<50% had a worse prognosis when the site was the inferior wall.

[Late reopening of patent ductus arteriosus after complete closure with the Rashkind prosthesis. Possible traumatic origin]

We report the case of a symptomatic adult with an occluded persistent duct with a transcatheter proceeding using a Rashkind prosthesis. After a month of follow up the color-coded Doppler-flow echocardiogram did not show residual shunt, posteriorly the patient's symptoms disappeared and the left ventricular dimensions were reduced. At the thirteen month of follow-up, the patient had an accident while working, falling down from a scaffold. Afterwards, a ductal jet was observed in the echocardiogram with an increased size of the left ventricle, symptoms also appeared. A cardiac catheterism was then performed showing a pulmonary/systemic flow rate of 2 and a 3 mm flow jet at the superior border of the prosthesis. A second prosthesis was implanted with no residual shunts.

[Evaluation of pulmonary arteries using nuclear magnetic resonance in patients with pulmonary atresia]

OBJECTIVES

Patients with pulmonary atresia and a ventricular septal defect have one outlet vessel; the aorta. The pulmonary arteries may be present or absent, and there is a collateral shunt. Magnetic resonance imaging is used to study this.

MATERIAL AND METHODS

We evaluated 10 patients with pulmonary atresia with ventricular septal defect. Five were males and the others were females, ages ranged between 1 day and 25 years, three patients were newborns. We used common planes, but mainly: axial-transverse and coronal, normal and right or left oblique projections.

RESULTS

The size of the ventricular septal defect was 1.75 +/- 0.67 cm (0.5-3.2). The pulmonary trunk was absent in 7 patients, it was atretic in 2 and it was present in one. Confluent pulmonary branches were seen in 6 patients (right 0.58 +/- 0.12, left 0.53 +/- 0.19), not confluent in 2 (with only one branch in each case) and absent in the other two. There was collateral shunt flowing from the descending aorta in 7 patients, from the ascending aorta in two and from the aortic in the final case. The ascending aorta was dilated in all cases (diameter 3.04 +/- 1.39), afterwards the relation between the ascending aorta and the descending aorta was 1.87 +/- 0.25. The aortic arch was right sided in 5 patients.

CONCLUSIONS

Magnetic resonance imaging is an alternative diagnostic method to angiocardiography. It gives complete information about the size, the position and the connection of the pulmonary arteries. It is also useful to evaluate the aortopulmonary to bronchial shunt.

[Univentricular heart with left morphology with permeable atrio-ventricular valves. Study of the bulbo-ventricular foramen with color echo-Doppler. Importance for the surgical repair]

INTRODUCTION AND OBJECTIVES

Bidimensional and color-coded Doppler echocardiography were used to study 19 patients with univentricular heart, permeable atrioventricular valves, muscular bulbo-ventricular foramen and an anterior rudimentary chamber. We evaluated the influence of the foramen upon the size of the great vessels, and in consequence the most appropriated surgical techniques.

MATERIAL AND METHODS

The foramen was measured in two projections at the end of the systolic period, and its area was calculated, according to the body surface, with the formula S = pi (D1/2 x D2/2). Indexes lower than 2 cm2/m2 were considered as restrictive. We studied 19 patients that presented a mean age of 11 +/- 12 years (range 1 day-39 years). The patients were classified in two groups. Group A: patients who had transposition of the great vessels (13 cases). Group B: patients who had normal connection of the great vessels (6 cases). Each group was classified in two subgroups: subgroup 1, patients who presented a restrictive foramen, and subgroup 2, patients who presented a normal foramen. In this study, we evaluated the associated cardiac anomalies.

RESULTS

Group A. Thirteen cases. The index value for the whole group was 2.47 +/- 1.18 cm2/m2. The first subgroup included 6 cases with a restrictive foramen, 2 patients presented pathology of the arch. Four patients had a pressure gradient between the ventricle and the rudimentary chamber beyond 20 mmHg. The index of this subgroup was 1.68 +/- 0.39 cm2/m2, the median was 1.7. Seven cases, with a normal foramen, were included in the second subgroup, six of them had pulmonary valve stenosis, and the other one had undergone a pulmonary artery bandage 2 months before. Only one patient had a gradient pressure at the foramen beyond 20 mmHg. The index for this second subgroup was 3.34 +/- 0.83 cm2/m2.

GROUP B

Six patients with normal connection of the great vessels were included. The index was 1.56 +/- 1.17 cm2/m2. The first subgroup included 3 cases with a restrictive foramen. The index was 0.72 +/- 0.29 cm2/m2 (range 0.41-1) and the median was 0.75. Pressure gradient between the ventricle and the rudimentary chamber was greater than 20 mmHg. Three patients with a normal foramen were in the second subgroup and here, the index was under normal limits 2.4 +/- 0.52 cm2/m2 (range 2.1-3), the median was 2.1. One patient underwent a pulmonary artery bandage two months before.

CONCLUSIONS

Bulbo-ventricular foramen size/body surface index may exert an influence on the size of the vessel connected to the rudimentary chamber. The index vary in a negative way with the evolution time, or in those cases with transposition of the great vessels after a pulmonary artery bandage. Whenever the foramen is restrictive, the pulmonary artery or the aorta have a smaller diameter and the pressure gradient between the ventricle and the rudimentary chamber rises.

[The efficacy of verapamil in sustained monomorphic ventricular tachycardia]

We present a 36-year-old male without overt cardiac disease who suffered, since he was 15 years old, from sustained monomorphic ventricular tachycardia of left bundle branch block with a right axis, lasting for several hours; sometimes, syncope was a clinical form of manifestation. Electrophysiologic study, twenty-four hours Holter recording, cardiac catheterization and blood analysis were not useful in order to find its etiology. Efficacy of different drugs, like Mexiletil, Amiodarone, Atenolol and Verapamil (at a dose of 240 mg/day) were tested through multistaged graded-treadmill stress-testing using the Bruce protocol. Ventricular tachycardia was suppressed by administration of Lidocaine. Oral verapamil given at a dose of 360 mg/day prevented the induction of the arrhythmia, the efficacy was tested with maximal treadmill exercise and twenty-four hours Holter recording.

Asystole and bradycardia during maxillofacial surgery

A Chinese female undergoing maxillary osteotomy developed asystole when the maxillary tuberosity was cut. Surgery was stopped. After about 10 sec and before instituting cardiac massage, sinus rhythm and bradycardia ensued. Atropine was administered intravenously, resulting in an increase in heart rate. No further episodes of asystole or bradycardia were encountered.

Septal dissection in a ventricular septal rupture

Images

[The study of zinc in osteonecrosis]

Plasmatic, urinary and intra-erythrocytic zinc levels did not modify in patients with head of femur aseptic osteonecrosis (HFAO), except for those patients with raised alkaline phosphatase who showed a diminution in zinc plasmatic levels, being found a negative correlation between plasmatic zinc levels and a raise in serum alkaline phosphatase. A raise on the latter would mean a raise on the osteoblastic activity in a repair intent from the bone of the small trabecular fractures and/or of the necrotic zone which is produced in HFAO. These results show the relationship of zinc with the increase on bone metabolic activity in patients with HFAO, but the scarce previous references force to study them in depth.

[Zinc and osteoporosis]

The relevant role of zinc in osteoporosis, its correlation with nutrient intake and the modifications of its urinary and serum levels, have been demonstrated. In this paper, we have studied the plasmatic, urinary and intraerythrocitary levels of zinc in a group of patients with extended primary osteoporosis, most of them women with postmenopausic osteoporosis. No significant differences were observed in zinc levels between osteoporotic patients and controls. We think that certain aspects regarding the correlation between zinc and bone mineral content still have to be defined, as well as zinc intake and osteoporosis.

[Zinc in arthrosis and microcrystalline arthritis]

Plasma, urine, intra-erythrocytes and salivary zinc levels are not modified in Generalized Primary Arthrosis. In patients with microcrystalline arthritis (Gout and Joint Chondrocalcinosis), zinc levels do not vary in the absence of disease activity. In patients suffering gout with clinical activity, the lowest plasma zinc levels are observed. Zinc concentrations in patients presenting Chondrocalcinosis, since they belong to groups C and D ("pseudoarthrosis"), were not modified, similarly to the group of patients with arthrosis. The mechanisms of action of zinc in relation to the pathogenesis of the microcrystals induced inflammation are analyzed.

[Plasma and intraerythrocytic zinc in rheumatoid arthritis and ankylosing spondylitis]

The levels of plasmatic and intraerythrocyte zinc in our control group did not show differences in accordance with age or sex. Patients affected by rheumatoid arthritis showed a decrease of plasmatic levels of zinc and an increase of intraerythrocyte zinc level. The patients with ankylosing spondylitis did not show significant variations of zinc levels, even though the patient with increased SR after the first hour (25 mm) showed lower plasmatic zinc with statistical significance. Finally, patients with rheumatoid arthritis in treatment with NSAID, low dose of steroids, gold salts, D-penicilamin, did not show differences compared to the total group of patients with this disease.