The value of the QRS scoring system in assessing regional and global left ventricular ejection fraction early after myocardial infarction

In 71 patients with a myocardial infarction (MI) (anterior in27, inferior in 44 patients) global (GEF) and regional (REF)left ventricular ejection fractions were determined by radionuclideventriculography and estimated from a 12 lead electrocardiogram(ECG), using Selvester's QRS score, during the early phase ofa MI (15 to 21 days following MI). Global ejection fractionsdetermined by radionuclide ventriculography and from ECG usingPalmeri's method were: for all M140.8 ± 12.6% vs 39.6± 11.4%; in the group of anterior M132.0 ± 10.0%vs 30.0 ± 9.7% and in the group of inferior MI 48.9±12.0%vs 45.1 ± 8.2%. A good correlation was found betweenglobal ejection fractions determined by radionuclide ventriculographyand ECG, as well as between radionuclide GEF and ECG score.A weaker correlation was found between radionuclide GEF andenzymes among all MIs and in the group of anterior MI, whilein the group of inferior MI this correlation was insignificant.The analysis of REF determined by radionuclide ventriculographyand ECG showed the greatest abnormalities in the infarct region,but in the group of anterior MI, dysfunction was present inthe whole left ventricle. The comparison of infarct-relatedREF derived from radionuclide ventriculography, with the QRSscore showed a significantly higher correlation than the comparisonwith enzymes. ECG estimation of REF from a modified Palmeri'sequation showed a better correlation with radionuclide REF thandid GEF derived from the standard Palmeri's equation: anteriorMI; r = 0.90 vs r = 0.82, inferior MI; r = 0.84 vs r = 0.69,respectively. Our results underline the value of relativelysimple ECG methods for the assessment of left ventricular globalfunction, and new possibilities for the estimation of regionalfunction in patients with myocardial infarction.     

Enhanced oxidative stress and increased mitochondrial mass during Efavirenz-induced apoptosis in human hepatic cells

BACKGROUND AND PURPOSE

Efavirenz (EFV) is widely used in the treatment of HIV-1 infection. Though highly efficient, there is growing concern about EFV-related side effects, the molecular basis of which remains elusive.

EXPERIMENTAL APPROACH

In vitro studies were performed to address the effect of clinically relevant concentrations of EFV (10, 25 and 50 µM) on human hepatic cells.

KEY RESULTS

Cellular proliferation and viability were reduced in a concentration-dependent manner. Analyses of the cell cycle and several cell death parameters (chromatin condensation, phosphatidylserine exteriorization, mitochondrial proapoptotic protein translocation and caspase activation) revealed that EFV triggered apoptosis via the intrinsic pathway. In addition, EFV directly affected mitochondrial function in a reversible manner, inducing a decrease in mitochondrial membrane potential and an increase in mitochondrial superoxide production, followed by a reduction in cellular glutathione content. The rapidity of these actions rules out any involvement of mitochondrial DNA replication, which, until now, was thought to be the main mechanism of mitochondrial toxicity of antiretroviral drugs. Importantly, we also observed an increase in mitochondrial mass, manifested as an elevated cardiolipin content and enhanced expression of mitochondrial proteins, which was not paralleled by an increase in the mtDNA/nuclear DNA copy number ratio. The toxic effect of EFV was partially reversed by antioxidant pretreatment, which suggests ROS generation is involved in this effect.

CONCLUSION AND IMPLICATIONS

Clinically relevant concentrations of EFV were shown to be mitotoxic in human hepatic cells in vitro, which may be pertinent to the understanding of the hepatotoxicity associated with this drug.     

Generation of a panel of antibodies against proteins encoded on human chromosome 21

Background  

Down syndrome (DS) is caused by trisomy of all or part of chromosome 21. To further understanding of DS we are working with a mouse model, the Tc1 mouse, which carries most of human chromosome 21 in addition to the normal mouse chromosome complement. This mouse is a model for human DS and recapitulates many of the features of the human syndrome such as specific heart defects, and cerebellar neuronal loss. The Tc1 mouse is mosaic for the human chromosome such that not all cells in the model carry it. Thus to help our investigations we aimed to develop a method to identify cells that carry human chromosome 21 in the Tc1 mouse. To this end, we have generated a panel of antibodies raised against proteins encoded by genes on human chromosome 21 that are known to be expressed in the adult brain of Tc1 mice     

生物全息论应用于创伤性骨折患者术后的舒适护理

舒适护理是指通过对护理活动的舒适干预，使人在心理、生理、社会交往等方面达到愉快的状态或降低不愉快的程度。骨科患者术后普遍存在疼痛、焦虑等身体、心理不适，会直接影响患者的术后康复。为减轻患者焦虑、控制术后疼痛，减少镇痛药的使用，增加患者术后舒适感，降低手术后并发症，促进康复，我科于2008年6至12月对65例住院的手术患者，     

Pain, quality of life, and coping in sickle cell disease

This study examined the frequency and severity of sickle related pain, its impact on quality of life, and methods of coping for 25 children with sickle cell disease, aged 6-16 years. Subjects were matched with non-affected peers and asked to complete the Central Middlesex Hospital Children's Health Diary for four weeks. Results indicated that sickle pain occurred on average one in 14 days, and total summary pain scores indicated significantly greater pain than for controls. Children with sickle cell disease could discriminate sickle pain and did not adopt sick role responses to ordinary childhood ailments. Nearly all sickle pain was dealt with at home. Sickle pain resulted in over seven times increased risk of not attending school and was highly disruptive of social and recreational activities. Careful assessment of sickle pain in the home environment is an essential part of a community focused pain management service, which effectively supports children's resilience and improves their quality of life.     

Ten years after acquiring an HIV-1 infection: a study in a cohort of eleven neonates infected by aliquots from a single plasma donation

We present data from a 10-year follow-up study of 11 children who had been infected in the neonatal period by small aliquots of plasma from a single donation. Three of the children died within the first 2.5 years of life, 5 other children died between 6.2 and 11 years after infection and 3 are alive at present. The latter children are classified as P1B (asymptomatic), P2A (non-specific findings) and P2B (neurological changes). All infected children showed progressive decline of cellular immunity. Immunoglobulin levels in serum were increased in the majority of children for prolonged periods and homogeneous immunoglobulin components were present. The severity of the disease was related neither to the clinical condition of the infants in the neonatal period nor to the volume of transfused plasma, the interval between freezing and thawing of the plasma, gestational age at birth and age at transfusion. Coinciding infections with other viruses had no impact on disease progression during the follow-up period of 10 years.     

Alpha thalassaemia mental retardation (ATR-X): an atypical family

A novel form of severe, X linked mental retardation associated with alpha thalassaemia (ATR-X syndrome) has recently been described. Two affected cousins are described, one of whom has an unusually mild haematological phenotype. HbH inclusions, which are the hallmark of this disease, were only detected in the peripheral red blood cells after repeated observations.