Implications of ST changes in reperfusion management of acute inferior myocardial infarction

ST elevation is the basis of management decisions in acute myocardialinfarction and may provide a quick means of stratifying patients.This is particularly relevant with inferior infarction becauseof the generally smaller benefit-to-risk ratio of reperfusiontherapy. We studied the relationship between ST changes and the perfusionterritory of the infarct-related artery in 95 patients: 77 withproximal right coronary related infarction (perfusion territoryquantitated by an angiographic score, maximum possible value=1.0)and 18 with circumflex related infarction (divided angiographicallyinto proximal and distal arterial occlusions). For right coronaryrelated infarction, the angiographic score ranged widely from0.25 to 0.82 (mean 0.53, standard deviation 0.13). Parametersthat correlated with the angiographic score on univariate analysiswere precordial ST depression (r= 0.59), inferior ST elevation(r=0.51), and number of leads with ST change (r=0.56). On multivariateanalysis, only precordial ST depression and the number of leadswith ST elevation were independent predictors of the angiographicscore (r=0.64), with precordial ST depression predicting themajor portion of its variability. For circumflex related infarction,precordial ST depression was the only predictor of a proximalocclusion. Summed precordial ST depression 0.3 mV, as comparedto less or no ST depression, predicted a larger territory ofthe infarct-related artery (either a right coronary angiographicscore >0.5 or a proximal left circumflex lesion, kappa=0.51,P<0.001). In acute inferior infarction, deep precordial ST depressionreflects large jeopardized territory, a subgroup that may benefitmore from aggressive reperfusion.     

Colovenous Fistula Complicating Diverticulitis

Colonic diverticulitis is frequently complicated by bowel obstruction, abscess, perforation and fistula formation. We report a unique case of colonic diverticulitis complicated by colovenous fistulization with Gastrografin^® enema examination demonstrating thrombus in the inferior mesenteric vein.     

CYP2C19 genotype and the PPIs – focus on rabeprazole

Abstract:   Amongst all the proton pump inhibitors (PPI), the hepatic metabolism of rabeprazole is least dependent on the CYP4502C19 system. Rabeprazole is therefore the PPI least affected by CYP4502C19 genetic polymorphism. This unique feature of rabeprazole complements rabeprazole's fast onset of action, and may lead to profound and consistent inhibition of gastric acid secretion in the treatment of acid-related disorders.     

中文大学生版Buss-Perry攻击性量表的修订与信效度分析

目的:引进Buss-Perry攻击性量表(BPAQ),并在大学生群体中进行修订,用来测量我国大学生的攻击性水平.方法:在不同行政区域的9所综合型大学抽取1722名在校大学生.对样本编号后,奇数组(n =864)被用于探索性因素分析以确认因子结构;偶数组(n=858)被用于对所得维度进行验证性因素分析.用大学生社会技能量表(ChUSSI)和羞涩量表(RCBS)为效标.抽取其中一所大学的165名学生于初评后2周进行重测.结果:通过探索性因素分析,得到由敌意、身体攻击、冲动、易怒性4个分量表(共22个项目)构成的中文大学生版Buss-Perry攻击性量表(CC-BPAQ);验证性因素分析显示数据拟合良好(GFI=0.917,AGFI=0.896,CFI=0.899,RMSEA=0.059);CC-BPAQ的敌意、身体攻击和易怒性分量表得分与ChUSSI得分呈负相关(r=-0.23、-0.19、-0.20,均P＜0.01),CC-BPAQ的4个分量表得分均与RCBS得分呈正相关(r=0.45、0.21、0.11、0.32,均P＜0.01).总量表的内部一致性Cronbach α系数为0.89,4个分量表的α系数为0.73 ～0.85;总量表的重测信度为0.91,4个分量表的重测信度为0.75 ～0.80.结论:修订后的中文大学生版Buss-Perry攻击性量表具有良好的信度和效度,可以用于大学生的攻击性测量.     

Inhibition of the Local Inflammatory Response in Man by Antimetabolites

The effects of chemotherapy on the local inflammatory response in man werestudied in 33 patients.

Inhibition of the mononuclear cell phase of the response at 4, 8 and 24hours was noted. The median on-therapy values at these hours were 0, 8.5and 23 per cent compared to control values of 4, 24.5 and 86 per cent, respectively.

The 24-hour values for the individual types of therapy were 13.5 per centfor intensive combination therapy with 4 antitumor agents, 21 per cent for6-mercaptopurine given i.v. daily for 5 days, 2 per cent for methotrexate giveni.v. daily for 5 days, 37 per cent for intermittent methotrexate and 56 percent for other therapy. Recovery was substantial within 5 days of the end oftherapy.

The inhibition was not correlated with alterations in the levels of circulatinggranulocytes or lymphocytes, nor with the numbers of granulocytes enteringthe inflammatory site.

Complicating infections were noted in eight patients, seven of whom werein the most strongly inhibited group. Observations of the response in ten untreated patients with acute leukemia showed both impaired granulocyte andmononuclear phases of the response.

Submitted on March 15, 1965 Accepted on May 18, 1965     

Inhibitory effects of aspirin and indometacin on the growth of Helicobacter pylori in vitro

OBJECTIVE: The interactions between non‐steroidal anti‐inflammatory drugs and Helicobacter pylori have not been sufficiently documented to date. The aim of this study was to investigate the possible effects of aspirin and indometacin on the growth of H. pylori and to determine the effects of aspirin on the susceptibility of H. pylori to some antimicrobials. METHODS: Kinetic studies were performed by inoculating strains of H. pylori in brucella broth with different concentrations of aspirin and indometacin. Growth of bacteria in the broth was assessed spectrophotometrically and by viable colony counts after incubation for 24 and 48 h. Bacterial morphology was determined by Gram stain under light microscopy. The minimal inhibitory concentration (MIC) of aspirin and indometacin was determined by the standard agar dilution method. The MIC of amoxicillin, clarithromycin and metronidazole was measured in the presence and absence of aspirin by the E‐test method. RESULTS: Kinetic studies revealed that aspirin and indometacin inhibited the growth of H. pylori in a dose‐dependent manner. The bactericidal activity of these agents was expressed by cell lysis. Aspirin at 400 µg/mL produced an almost 2‐log decrease in the number of CFU/mL at 48 h. Similar inhibitory effects were obtained when 100 µg/mL indometacin was tested. The MIC at which 90% of H. pylori was inhibited was 512 µg/mL and 128 µg/mL for aspirin and indometacin, respectively. Increased susceptibility of H. pylori to amoxicillin, clarithromycin and metro­nidazole was found in the presence of aspirin. CONCLUSIONS: Aspirin and indometacin could significantly inhibit the growth of H. pylori when incubated in brucella broth in vitro. A subinhibitory concentration of aspirin enhanced the susceptibility of H. pylori to some antimicrobial agents.     

The relationship between the diameter of chemically-functionalized multi-walled carbon nanotubes and their organ biodistribution profiles in vivo

Carbon nanotubes (CNTs) exhibit unique properties which have led to their applications in the biomedical field as novel delivery systems for diagnosis and therapy purposes. We have previously reported that the degree of functionalization of CNTs is a key factor determining their biological behaviour. The present study broadens the spectrum by investigating the impact of the diameter of CNTs using two series of multi-walled CNTs (MWNTs) with distinct differences in their diameters. Both MWNTs were doubly functionalized by 1,3-dipolar cycloaddition and amidation reactions, allowing the appended functional groups to be further conjugated with radionuclide chelating moieties and antibodies or antibody fragments. All constructs possessed comparable degree of functionalization and were characterized by thermogravimetric analysis, transmission electron microscopy, gel electrophoresis and surface plasmon resonance. The MWNT conjugates were radio-labelled with indium-111, which thereby enabled in vivo single photon emission computed tomography/computed tomography (SPECT/CT) imaging and organ biodistribution study using γ-scintigraphy. The narrow MWNTs (average diameter: 9.2 nm) demonstrated enhanced tissue affinity including non-reticular endothelial tissues compared to the wider MWNTs (average diameter: 39.5 nm). The results indicate that the higher aspect ratio of narrow MWNTs may be beneficial for their future biological applications due to higher tissue accumulation.