Transmural high energy phosphate distribution and response to alterations in workload in the normal canine myocardium as studied with spatially localized 31P NMR spectroscopy

Spatially localized phosphorus-31 nuclear magnetic resonance (31P NMR) spectroscopy has been applied to the study of the normal canine myocardium to measure the relative content of high energy phosphates across the left ventricular wall. Transmural NMR data were acquired in five voxels spanning the wall of the left ventricle using the FLAX-ISIS technique. The validity of the FLAX-ISIS approach in acquiring localized spectra for transmural studies and in providing quantitative information from the localized spectra was examined rigorously by studies involving phantoms, intact rats, and the canine myocardium in vivo. The results indicated that (1) this technique yields spatially resolved spectra with partial overlap between adjacent voxels and virtually no overlap between every other voxel; (2) in the canine heart, signals from subepicardium, midwall, and subendocardium can be detected separately without cross contamination; and (3) relative metabolite contents within a voxel and among voxels can be quantitated. Transmural 31P NMR spectra were acquired with cardiac gating on 29 separate animals either at early systole or late diastole, and at three different workloads with the heart rate peak systolic pressure product (RPP) increasing from 6000 mmHg/min to 35,000 mmHg/min. The data revealed that in the normal canine myocardium, the creatine phosphate (CP) content and the CP/ATP ratio was significantly lower in the subendocardium than in the subepicardium. ATP levels were transmurally constant. Both the CP content and the CP/ATP ratio measured for each voxel remained unaltered in relation to either the phase of the cardiac cycle or approximately fourfold increase in workload. Free ADP levels calculated for each voxel showed that ADP was relatively higher in the subendocardium than the subepicardium, and in all transmural layers was higher than its apparent Km for oxidative phosphorylation. In this domain changes in ADP content with workload and MVO2 are not expected and were not observed.

Spectroscopic imaging and spatial localization using adiabatic pulses and applications to detect transmural metabolite distribution in the canine heart

Adiabatic pulses have been employed in spectroscopic imaging and relaxation rate measurements at 4.7 T to demonstrate the feasibility of obtaining spectroscopic data from the complete sensitive volume of a surface coil using the surface coil as a transmitter and receiver. With conventional B1 sensitive pulses, spectroscopic localization or imaging techniques, such as chemical-shift imaging, yield resonance intensities that are distorted severely as a function of space, and maximal signal is detected from a small region within the complete sensitive volume of the coil. With adiabatic pulses, however, this problem is eliminated completely. In addition, a new method of spatial localization is introduced. This method, referred to as FLAX-ISIS, is a derivative of longitudinally modulated Fourier series window and ISIS approaches and utilizes adiabatic inversion and excitation pulses. The method allows construction of localized spectra for multiple regions along the surface coil axis by postacquisition data manipulation of a single set of free induction decays. These techniques were applied to the study of the myocardium using an implanted surface coil in an instrumented closed-chest canine model and in an open-chest preparation. The results demonstrate that one-dimensional techniques are adequate for transmural detection of metabolites provided signal origin is restricted to a column perpendicular to the left ventricle wall.

Transmural metabolite distribution in regional myocardial ischemia as studied with 31P NMR

Phosphorus-31 nuclear magnetic resonance (31P NMR) has been applied to study the canine heart prior to and during regional myocardial ischemia induced by partial flow reduction in the left anterior descending coronary artery (LAD). NMR data were acquired in a transmural fashion by restricting the signal to a column perpendicular to the heart wall using B0 gradients and obtaining spectroscopic spatial resolution along the third dimension using the B1 gradient and adiabatic excitation. With this approach, transmural spectra were accumulated in five separate voxels spanning the wall of the left ventricle from the epicardium to the endocardium. In the normal canine myocardium the levels of high-energy phosphates CP and ATP were relatively constant throughout the left ventricular wall, with only minor evidence of free inorganic phosphate in any of the transmural voxels. However, during sustained partial occlusion of the LAD, significant regional differences between the epi- and the endocardium were noted. The data demonstrate the importance of studying cardiac bioenergetics with transmural differentiation.

Use of coronary arteriography in the preoperative management of patients undergoing urgent repair of the thoracic aorta

Noninvasive innovations have advanced the timing and precision of diagnosis of acute dissection or enlarging aortic aneurysm. However, the need to perform coronary arteriography prior to surgical repair in these patients remains a question for many clinicians. This retrospective 10-year (1978 to 1988) review examined data of 54 patients undergoing urgent surgical repair of thoracic aortic tear, aneurysm, or dissection in our institution. Results of coronary arteriography and clinical variables (history of coronary artery disease, electrocardiographic abnormalities, surgical procedures, and in-hospital mortality) were tabulated. Twenty-seven patients had type A aortic dissection and 27 patients had type B. Twenty-four patients had aortic dissection or tear (type A or B) due to motor vehicle trauma. In patients with type A, a history and/or electrocardiogram suggestive of coronary artery disease was present in 16, in whom cardiac catheterization was performed in five. None required coronary bypass surgery or died. In the 11 patients with no clinical history of coronary artery disease or electrocardiographic abnormalities, six had cardiac catheterization, none had coronary artery disease, two had coronary reimplantation, and six died. Only 1 of the 27 patients with type A dissection had a perioperative myocardial infarction (a patient with a clinical history of coronary artery disease who did not undergo cardiac catheterization). In patients undergoing type B aortic repair, 10 had a clinical history or electrocardiogram consistent with coronary artery disease but only one underwent cardiac catheterization and subsequent coronary artery bypass graft surgery for coronary artery disease.(ABSTRACT TRUNCATED AT 250 WORDS)

The impact of an integrated safer use space and safer supply program on non-fatal overdose among emergency shelter residents during a COVID-19 outbreak: a case study

Background

Opioid-related harms, including fatal and non-fatal overdoses, rose dramatically during the COVID-19 pandemic and presented unique challenges during outbreaks in congregate settings such as shelters. People who are deprived of permanent housing have a high prevalence of substance use and substance use disorders, and need nimble, rapid, and portable harm reduction interventions to address the harms of criminalized substance use in an evidence-based manner.

Case study

In February 2021, a COVID-19 outbreak was declared at an emergency men’s shelter in Hamilton, Ontario, Canada. Building on pre-existing relationships, community and hospital-based addictions medicine providers and a local harm reduction group collaborated to establish a shelter-based opioid agonist treatment and safer supply program, and a volunteer run safer drug use space that also distributed harm reduction supplies. In the 4 weeks preceding the program, the rate of non-fatal overdoses was 0.93 per 100 nights of shelter bed occupancy. During the 26 days of program operation, there were no overdoses in the safer use space and the rate of non-fatal overdoses in the shelter was 0.17 per 100 nights of shelter bed occupancy. The odds ratio of non-fatal overdose pre-intervention to during intervention was 5.5 (95% CI 1.63–18.55, p = 0.0059). We were not able to evaluate the impact of providing harm reduction supplies and did not evaluate the impact of the program on facilitating adherence to public health isolation and quarantine orders. The program ended as the outbreak waned, as per the direction from the shelter operator.

Conclusions

There was a significant reduction in the non-fatal overdose rate after the safer drug use and safer supply harm reduction program was introduced. Pre-existing relationships between shelter providers, harm reduction groups, and healthcare providers were critical to implementing the program. This is a promising approach to reducing harms from the criminalization of substance use in congregate settings, particularly in populations with a higher prevalence of substance use and substance use disorders.

Improved method for transcatheter retrieval of intracoronary detached angioplasty guidewire segments

A transcatheter technique using a probing catheter and 0.014 wire to form a loop snare was used percutaneously to safely retrieve segments of retained guidewire fragments in mid- and distal coronary arteries in three patients.

Enzymatic methyl esterification of Escherichia coli ribosomal proteins

Enzymatic methyl ester formation in Escherichia coli ribosomal proteins was observed. Alkali lability of the methylated proteins and derivatization of the methyl groups as methyl esters of 3,5-dinitrobenzoate indicate the presence of protein methyl esters. The esterification reaction occurs predominantly on the 30S ribosomal subunit, with protein S3 as the major esterified protein. When the purified 30S subunit was used as the methyl acceptor, protein S9 was also found to be esterified. The enzyme responsible for the esterification of free carboxyl groups in proteins, protein methylase II (S-adenosyl-L-methionine:protein carboxyl methyltransferase, EC 2.1.1.24), was identified in E. coli Q13. This enzyme is extremely unstable when compared with that from mammalian origin. By molecular sieve chromatography, E. coli protein methylase II showed multiple peaks, with a major broad peak around 120,000 daltons and several minor peaks in the lower-molecular-weight region. Rechromatography of the major enzyme peak showed activities in several fractions that are much lower in molecular weight. The substrate specificity of the E. coli enzyme is similar to that of the mammalian enzyme. The Km value for S-adenosyl-L-methionine is 1.96 X 10(-6) M, and S-adenosyl-L-homocysteine was found to be a competitive inhibitor, with a Ki value of 1.75 X 10(-6) M.

Effect of developmental stage on arginase and urea production in the liver of rat

Arginase activity in the liver, brain, and testis of rats was examined during the different phases of life span. When expressed as specific activity (micromoles of L-arginine hydrolyzed per minute per gram of whole homogenate protein), the enzyme activity in the brain and testis decreased markedly during the early stage of life and stayed low during the remainder of the life span. On the other hand, the arginase in the liver showed a great dependency on the developmental phase of the animal, showing two distinct peaks: one during the early phase (20 days after birth) and the other at a later time (3 months of age). This pattern of change in the hepatic arginase activity closely coincided with the pattern of the rate of urea synthesis determined with liver slices and expressed in terms of micromoles of urea formed per hour per gram of tissue slice. In contrast to the above observations, however, curves obtained by plotting the total liver arginase or urea synthetic activity vs the developmental stage of rats showed no measurable discontinuity. Further studies revealed that the observed pattern of specific activity of hepatic arginase was, in part, due to the change in the relative concentration of arginase protein in the liver.

UASB reactor for domestic wastewater treatment at low temperatures: a comparison between a classical UASB and hybrid UASB-filter reactor

The performance of an upflow anaerobic sludge blanket (UASB) reactor and a hybrid UASB-filter reactor was investigated and compared for the treatment of domestic wastewater at different operational temperatures (28, 20, 14 and 10 degrees C) and loading rates. For each temperature studied a constant CODt removal was observed as long as the upflow velocity was lower than 0.35 m/h. At these upflow velocities similar removals were observed for both reactor types at 28 and 20 degrees C, 82 and 72% respectively. However, at 14 and 10 degrees C the UASB reactor showed a better COD removal (70% and 48%, respectively) than the hybrid reactor (60% and 38%). COD removal resulted from biological degradation and solids accumulation in the reactors. At 28 degrees C, a constant 200 g sludge mass was observed in both reactors and COD removal was attributed to biological degradation only. At lower temperatures, solids accumulation was observed in addition to biological degradation with an increase in reactor sludge as the temperature decreased. The decrease in biological degradation at lower temperatures was offset by solids accumulation and explains the similar overall COD removal efficiency observed at 28 degrees C, 20 degrees C and 14 degrees C. The decrease in temperature was also followed by an increase in the effluent TSS concentration in both reactors. At 14 and 10 degrees C a lower effluent TSS concentration and better performance was observed in the UASB reactor.

Temperature effect on UASB reactor operation for domestic wastewater treatment in temperate climate regions

The performance of an upflow anaerobic sludge blanket (UASB) reactor was investigated for the treatment of domestic wastewater at different operational temperatures (28, 20, 14 and 10 degrees C) and loading rates. For each temperature studied a constant COD(t) removal was observed as long as the upflow velocity was lower than 0.35 m/h: 82% at 28 degrees C, 68% at 14 degrees C and 44% at 10 degrees C. At 20 degrees C the COD removal increased with the HRT, reaching similar values as at 28 degrees C for long HRT. At upflow velocities higher than 0.35 m/h, a reduction in total COD removal was observed due to washout of influent TSS. At 28 degrees C, a constant 200 g sludge mass was observed and COD removal was attributed to biological degradation only. At lower temperatures, COD removal resulted from degradation and solids accumulation in the reactor. The increase in reactor sludge was greater as the temperature decreased and explains the similar overall COD removal efficiency at 28 degrees C, 20 degrees C and 14 degrees C. During the transition from winter to summer conditions (10 degrees C to 28 degrees C), methane production initially increased due to the degradation of accumulated solids. Afterwards, methane production gradually declined and an increase in COD removal was observed, indicating that the TSS accumulated during the winter was exhausted and influent degradation remained.

Ammonia gas treatment in low cost biological reactor

Ammonia gas contributes to a number of environmental and human health concerns. The use of chalk, a cheap alkalinity source may reduce costs for biological systems. This research studies a closed liquid flow reactor to treat ammonia gas using chalk as biomass media and alkalinity source with high value calcium nitrate fertilizer production. The proposed reactor showed complete ammonia gas removal at high rate (500 mg N/L/day) and with low cost; where chalk dissolution and ammonia gas absorption contributed to alkalinity in the water for nitrification. High calcium ion concentration (up to 10,000 mg Ca2+ as CaCO3/L) showed only minor effects on ammonia absorption and nitrification rate.