Severe course of neuromyelitis optica in a female patient with chronic C hepatitis

Neuromyelitis optica (NMO) is a rare, disabling, recurring inflammatory demyelinating disease affecting the spinal cord and optic nerves with predominance in women.We present the case of a female patient with chronic C hepatitis, who, despite treatment, developed severe symptoms of NMO during pregnancy and postpartum.     

Cardiovascular status after postural change in compensated cirrhosis: an argument for vasodilatory concept

Abstract: It seems that hypervolemia and vasodilatation coincide in compensated cirrhosis, but neither rank nor importance of these factors has been fully clarified in adaptive response to postural change. We studied, with gated equilibrium radionuclide angiography and thoracic electrical bioimpedance the hemodynamic status of 19 patients with compensated cirrhosis and 18 healthy subjects in upright and supine positions. In the upright position, the cirrhotic patients were hypotensive and had decreased peripheral vascular resistance despite increased cardiac output. The transition to the supine position was accompanied by a significant fall in the heart rate and an increase in the stroke volume in both controls (92±22 to 63±10 beats/min, and 38±9 to 62±19 ml/m², respectively) and cirrhotic patients (101±20 to 79±13 beats/min, and 44±15 to 63±19 ml/m², respectively). Besides, the diastolic arterial pressure fell in controls from 89±9 mmHg to 81 ± 11 mmHg; p <0.01, while it remained unchanged in cirrhotic patients (77±17 vs 82±13 mmHg). In the supine position, the cirrhotic patients presented tachycardia and left ventricular hyperkinesy (increased velocity of left ventricular filling and emptying). In conclusion, these results show that in compensated cirrhosis the decreased arterial tone and peripheral blood pooling are important factors of adaptive hemodynamic reaction to postural change.     

Synthesis,spectroscopic characterization,and anticancer activity of new 10-substituted 1,6-diazaphenothiazines

New phenothiazine derivatives as 10-substituted dipyridothiazines of the 1,6-diazaphenothiazine structure were obtained in the cyclization reaction of 3-amino-3′-nitro-2,2′-dipyridinyl sulfide and 3,3′-dinitro-2,2′-dipyridinyl disulfide, and in the reaction of 2-chloro-3-ntropyridine with sodium 3-amino-2-pyridinethiolate followed by various alkylation and arylation reactions. The reaction of the thiazine ring formation ran via the Smiles rearrangement of the S-N type. As the alkylation reactions could proceed at the thiazine, azine or both nitrogen atoms, the product structure elucidation was based on the 2D NMR (Rotating-frame Overhauser Effect Spectroscopy, Correlated Spectroscopy, Heteronuclear Single Quantum Coherence, and Heteronuclear Multiple Bond Correlation) spectra of the N-methylated product. Some 10-substituted 1,6-diazaphenothizines (5, 10, 12, 13) were at least anticancer active against melanoma C-32 and breast cancer MCF-7 cell lines as a reference drug – cisplatin. The monoazaphenothiazine drug, prothipendyl, turned out to be less active than least 6 derivatives of the 1,6-diazaphenothiazine structure.     

Serum Hepatocyte Growth Factor Concentration in Obese Women Decreases after Vertical Banded Gastroplasty

Background: Human obesity is associated with increased serum hepatocyte growth factor (HGF) concentration. This study examines whether reduced body fat mass after vertical banded gastroplasty (VBG) is associated with a decrease in serum HGF concentration. Methods: Serum HGF concentration and body weight, BMI, body fat mass, blood pressure, serum leptin, insulin, triacylglycerol, and cholesterol concentrations were studied in 10 obese women before and 1 year after VBG. 10 lean, healthy women were used as controls. Results: Obese women showed significantly higher serum HGF concentration than control (lean, healthy) subjects. The mean serum HGF concentration decreased significantly 1 year after VBG, but did not reach the value observed in lean women. After VBG, BMI, body fat mass and serum HGF had similar patterns of decrease. Moreover, serum HGF concentration was positively correlated with both BMI (r=0.6, P<0.01) and body fat mass (r=0.6, P<0.01). Before surgery in obese women, elevated blood pressure was observed, which decreased after VBG. Linear regression analysis between blood pressure and serum HGF concentration using all subjects, showed no correlation between either systolic blood pressure and serum HGF concentration (r=.15, P=NS) or between diastolic blood pressure and serum HGF concentration (r=0.1, P=NS). Insulin resistance index (HOMA score), serum leptin, insulin and triacylglycerol concentrations decreased 1 year after VBG. However, serum cholesterol concentration did not change significantly. Conclusions: These results indicate that VBG results in a reduction in circulating HGF concentration. The reduced body fat mass may contribute in part to the decrease of serum HGF concentration after VBG. Because elevated serum HGF concentration may contribute to the progression of atherosclerosis, the decrease in serum HGF concentration after VBG may be beneficial for obese subjects.     

Diagnosis by sheer coincidence

We present a case of a 69 year-old woman complaining of palpitations and worsening heart failure, after the 2nd cycle of fludarabine due to Hodgkin’s lymphoma. Echocardiography revealed abnormalities typical for corrected transposition of the great arteries (CTGA), which were confirmed in multislice computed tomography (MSCT), as well as subvalvular pulmonary stenosis. There is the case of one of the oldest patients with CTGA and subvalvular pulmonary stenosis. MSCT seems to be a useful and complementary method in diagnosis such diseases.     

Recent progress in biological activities of synthesized phenothiazines

This review summarizes recent medicinal chemistry investigations in vitro and in vivo in search for new phenothiazines of promising biological activities. New phenothiazine derivatives (over 50 main structures) contain dialkylaminoalkyl, cycloaminoalkyl and aminoalkyl substituents and their acyl and sulfonyl derivatives, and other substituents with varied the monocyclic (pyrazole, thiazole, oxadiazole, thiadiazole, tetrazole) and bicyclic (quinolizine, pyrazolopyrimidine, thiazolopyridine, azabicyclononane and spiro[chromanpyrimidine] heterocycles linked directly or via the alkyl chain with the thiazine nitrogen atom or with the benzene ring. The modifications of the tricyclic ring system with the bicyclic homoaromatic ring (naphthalene) and monocyclic and bicyclic azine rings (pyridine, pyrimidine, pyrazine and quinoline) led to compounds of significant biological activities. Recently obtained phenothiazines exhibit promising antibacterial, antifungal, anticancer, antiviral, anti-inflammatory, antimalarial, antifilarial, trypanocidal, anticonvulsant, analgesic, immunosuppressive and multidrug resistance reversal properties. These activities were the results of the actions of phenothiazines on biological systems via the interaction of the pharmacophoric substituent (in some cases of strict length), via the interaction of the multicyclic ring system (π-π interaction, intercalation in DNA) and via the lipophilic character allowing the penetration through the biological membranes. The activities were examined by using various biological systems such as cell lines, bacteria, viruses, parasites, laboratory mice, rats and rabbits, and monolayer and bilayer membranes. Some mechanisms of the actions are discussed. This review shows current tendency in the phenothiazine synthesis (without synthetic routes) and reveals the phenothiazine core to be very potent pharmacophoric moiety which can be a rich source of new compounds having desirable biological activities.     

The effect of metals accumulated in reed (Phragmites australis) on the structure of periphyton

Studies on trace elements in reed stands and limiting effect of the reed substrate on the periphyton structure were performed in various aquatic ecosystems of Greece during the summer and autumn of 2006. The analysed factors were concentrations of chemical elements (cadmium, lead, zinc, chromium, nickel, copper, cobalt, iron, manganese, potassium, sodium, calcium, magnesium) in reed shoots as well as the density of zooperiphyton and phytoperiphyton taxa. The relationships between metal concentrations and periphyton structure were determined with the use of the multivariate methods Canonical Correspondence Analysis (CCA), Detrended Correspondence Analysis (DCA) and RDA (Redundancy Analysis). The results showed that bioaccumulation of lead and cadmium in the reed had the most negative influence on zooperiphyton species, while low concentrations of alkali metals favoured the occurrence of Cyclopoida, Cladocera (Chydorus sp.) and Oligochaeta (Neis sp.). A considerable resistance to toxic heavy metals characterised Cyanophyta representatives and, partly, colonial Bacillariophyta. High concentrations of alkali metals supported the presence of unicellular Bacillariophyta but diminished the densities of colonial Bacillariophyta and Chlorophyta of the genus Scenedesmus.     

Thin-layer chromatographic detection of new azaphenothiazines

Many new phenothiazines exhibit promising anticancer and antibacterial activities, reversal of multidrug resistance and potential treatment in Alzheimer's, Creutzfeldt-Jakob and AIDS diseases. Their synthesis may proceed through a stage of the Smiles rearrangement and may lead to different products: cyclic phenothiazines (rearranged or not), cyclic side-products of isosteric structures and non-cyclic products when the ring-closure processes did not occur. The TLC method was found suitable for detection of new modified phenothiazines (being tri-, tetra- and pentacyclic azaphenothiazines with hydrogen, alkyl, dialkylaminoalkyl, aryl and heteroaryl substituents at the thiazine nitrogen atom and in a few cases additional substituents in the benzene ring) during their synthesis. The natural fluorescence of phenothiazines and azaphenothiazines under irradiation of UV light of 365nm is very characteristic and becomes useful additional analytical information of these compounds. The spots of azaphenothiazines were also distinguished from the spots of substrates and side-products by giving color reactions with the visualizing reagents: sulfuric acid in ethanol, concentrated nitric acid and citric acid in acetic anhydride. The combination of the separation (the R(F) values) and the spot color detection (as the native fluorescence and the results of the usage of visualizing reagents) facilitated the identifications of new azaphenothiazines in the reaction mixtures containing also other compounds. This paper is the first attempt of the determination of new azaphenothiazines by TLC method preceding the identification by spectroscopic methods. It facilitates the separation of the proper fraction in column chromatography and preparative TLC.     

Correlation between electrical and mechanical properties of the left ventricle in patients with postinfarction ventricular tachycardia

BACKGROUND: Electroanatomical mapping allows differentiation between viable and scarred myocardium. Echocardiography is widely used to assess myocardial contractility. The relationship between electrophysiological and echocardiographic assessment of left ventricular function has not yet been well established. AIM: To correlate mechanical and electrical function of the left ventricle in patients with postinfarction ventricular tachycardia and to assess clinical, echocardiographic and angiographic parameters affecting regional electrical function. METHODS: In 32 patients (25 males, 64+/-9 years old) mean unipolar (UP) and bipolar (BP) voltages were obtained with electroanatomical mapping (CARTO system) for a 12-segment model and compared with segmental wall motion function scored as normal, hypokinetic and a- or dyskinetic. UP voltage in individual groups of segments was: 7.8+/-4.2 mV, 6.5+/-4.2 mV, 4.7+/-2.5 mV, p <0.01 and for BP voltage 2.1+/-1.5 mV, 1.9+/-1.9 mV, 1.1+/-1.0 mV, p < 0.01, respectively. Left ventricular ejection fraction < or =30%, end-diastolic diameter >56 mm, previous inferior or anterior myocardial infarction (MI), MI < or =5 years and open infarct-related artery were associated with lower voltage in normokinetic segments. CONCLUSIONS: Segments with advanced systolic dysfunction had significantly lower uni- and bipolar voltage than normo- and hypokinetic segments. However, preserved local electrical function could be found in a/dyskinetic regions. Left ventricular remodelling, time and location of MI and patency of infarct-related artery influenced voltage in normokinetic segments.