Accumulation of calpain and caspase-3 proteolytic fragments of brain-derived alphaII-spectrin in cerebral spinal fluid after middle cerebral artery occlusion in rats.

Preclinical studies have identified numerous neuroprotective drugs that attenuate brain damage and improve functional outcome after cerebral ischemia. Despite this success in animal models, neuroprotective therapies in the clinical setting have been unsuccessful. Identification of biochemical markers common to preclinical and clinical cerebral ischemia will provide a more sensitive and objective measure of injury severity and outcome to facilitate clinical management and treatment. However, there are currently no effective biomarkers available for assessment of stroke. Nonerythroid alphaII-spectrin is a cytoskeletal protein that is cleaved by calpain and caspase-3 proteases to signature alphaII-spectrin breakdown products (alphaII-SBDPs) after cerebral ischemia in rodents. This investigation examined accumulation of calpain- and caspase-3-cleaved alphaII-SBDPs in cerebrospinal fluid (CSF) of rodents subjected to 2 hours of transient focal cerebral ischemia produced by middle cerebral artery occlusion (MCAO) followed by reperfusion. After MCAO injury, full-length alphaII-spectrin protein was decreased in brain tissue and increased in CSF from 24 to 72 hours after injury. Whereas alphaII-SBDPs were undetectable in sham-injured control animals, calpain but not caspase-3 specific alphaII-SBDPs were significantly increased in CSF after injury. However, caspase-3 alphaII-SBDPS were observed in CSF of some injured animals. These results indicate that alphaII-SBDPs detected in CSF after injury, particularly those mediated by calpain, may be useful diagnostic indicators of cerebral infarction that can provide important information about specific neurochemical events that have occurred in the brain after acute stroke.     

Focal atrial tachycardia from the ostium of the coronary sinus: electrocardiographic and electrophysiological characterization and radiofrequency ablation

OBJECTIVES: The goal of this study was to characterize the electrocardiographic and electrophysiologic features and frequency of focal atrial tachycardia (AT) originating from the coronary sinus ostium (CS). BACKGROUND: The ostium of the coronary sinus has been described as a site of origin of AT, but detailed characterization of these tachycardias is limited. METHODS: Thirteen patients (6.7%) of 193 undergoing radiofrequency ablation (RFA) for focal AT are reported. Endocardial activation maps (EAM) were recorded from catheters at the CS (10 pole), crista terminalis (20 pole), and His positions. The P waves were classified negative, positive, isoelectric, or biphasic. RESULTS: The mean age was 41 +/- 6 years, seven female patients, with symptoms for 8 +/- 3 years. Tachycardia was induced by programmed extra-stimuli in eight patients, was spontaneous in three patients, and in response to isoproterenol in two patients. These foci had a characteristic P-wave morphology. At the CS ostium, the P-wave was deeply negative in all inferior leads, negative or isoelectric becoming positive in lead V(1), then progressively negative across the precordium. Lead aVL was positive in all patients. Earliest EAM activity occurred at the proximal CS at 20 +/- 3 ms ahead of P-wave. Mean activation time at the successful RFA site = -36 +/- 8 ms; RFA was acutely successful in 11 of 13 patients. Long-term success was achieved in 11 of 11 over a median follow-up of 25 +/- 4 months. CONCLUSIONS: The CS ostium is an uncommon site of origin for focal AT (6.7%). It can be suspected as a potential anatomic site of AT origin from the characteristic P-wave and activation timing. Long-term success was achieved with focal ablation in the majority of patients.     

Pulmonary vein paced activation sequence mapping: comparison with activation sequences during onset of focal atrial fibrillation

INTRODUCTION: Atrial fibrillation (AF) may originate from a single focus, with the vast majority observed within the pulmonary veins. To facilitate mapping, we hypothesized that there would be a characteristic right atrial endocardial activation sequence pattern associated with pacing and spontaneous focal activity from each of the four pulmonary veins. METHODS AND RESULTS: In 10 patients with focal AF, a standardized set of catheters was positioned in the right atrium. These included a 20-pole catheter along the crista terminalis, a decapolar catheter in the coronary sinus (CS), and a His-bundle electrode. Pacing (700 and 300 msec) was performed with a mapping catheter from each of the four pulmonary veins. Activation sequence maps were created by measurement of activation times to each of the recording bipoles with the proximal CS bipole as the arbitrary reference point. Similar maps were constructed for the activation sequence of the pulmonary vein ectopic that initiated AF. There was a characteristic right atrial activation map created by pacing each pulmonary vein that corresponded closely with the map from the same pulmonary vein during initiation of focal AF. The pulmonary vein of origin could be distinguished on the basis of this characteristic pattern and some stereotypic observations. CS activation occurred proximal to distal for right pulmonary veins and distal to proximal for left pulmonary veins. Significant differences in activation timing between the CS and crista terminalis differentiated upper from lower pulmonary veins. CONCLUSION: There is a characteristic right atrial activation map for activity arising from each of the four pulmonary veins that corresponded closely with the map from the same pulmonary vein during initiation of focal AF. These findings may facilitate mapping and ablation of focal AF.     

Finger prosthesis with an alternative approach

This report describes the case of a 42 years old male patient whose one right hand finger was partially lost as a result of occupational trauma. A modified impression technique was used for impression making and wax pattern was fabricated using the normal hand of the same patient. A special type of wax was formulated to make a pattern which was easily molded and carved. Two indexed casts were used to determine the length of fingers. Intrinsic and extrinsic staining was also done to match the adjacent skin colour. A ring was used as a retentive method. The patient was highly appreciative of the social acceptance after he started wearing the finger prosthesis.     

The Role of Catchment Vegetation in Reducing Atmospheric Inputs of Pollutant Aerosols in Ganga River

The role of woody perennials in the Ganga river basin in modifying the run-off quality as influenced by atmospheric deposition of pollutant aerosols was investigated. The concentration of seven nutrients and eight metals were measured in atmospheric deposits as well as in run-off water under the influence of five woody perennials. Nutrient retention was recorded maximum for Bougainvillea spectabilis ranged from 4.30 % to 33.70 %. Metal retention was recorded highest for Ficus benghalensis ranged from 5.15 % to 36.98 %. Although some species showed nutrient enrichment, all the species considered in the study invariably contribute to reduce nutrients and metal concentration in run-off water. Reduction in run off was recorded maximum for B. spectabilis (nutrient 6.48 %–40.66 %; metal 7.86 %–22.85 %) and minimum for Ficus religiosa (nutrient 1.68 %–27.19 %; metal 6.55 %–31.55 %). The study forms the first report on the use of woody perennials in reducing input of atmospheric pollutants to Ganga river and has relevance in formulating strategies for river basin management.     

Dietary intake of pollutant aerosols via vegetables influenced by atmospheric deposition and wastewater irrigation

Pot culture experiments were conducted to study dietary intake of heavy metals via vegetables, spinach (Spinacia oleracea L.), radish (Raphanus sativus L.) and tomato (Lycopersicon esculentum Mill) grown under the influence of atmospheric deposition and wastewater irrigation. The results indicated substantial accumulation of heavy metals in vegetables, which contribute significantly to dietary intake of total heavy metals ranging from 1.34 to 110.40 μg g?1 through leaves (spinach), 1.04 to 105.86 μg g?1 through root (radish) and 0.608 to 82.19 μg g?1 through fruits (tomato). Concentration of Cd, Ni and Pb in vegetables exceeded the safe limits of Prevention of Food Adulteration Act 1954. Health risk index for Cd and Pb exceeded the safe limits set by the United States Environmental Protection Agency. The study indicated that the atmospheric depositions as well as wastewater irrigation have significantly elevated the levels of heavy metals in dietary vegetables presenting a significant threat for the health of users.     

Annual risk of tuberculosis infection in West Sumatra Province, Indonesia.

OBJECTIVE: To estimate the annual risk of tuberculosis infection (ARTI) among children attending elementary school Classes I-III in West Sumatra Province, Indonesia. METHODS: The survey was designed to estimate ARTI among children, irrespective of BCG scar status. Fieldwork was carried out in 72 schools selected by two-stage sampling. Children were administered 2 TU of purified protein derivative RT23 with Tween 80 intradermally on the mid-anterior aspect of the left forearm. The maximum transverse diameter of induration was measured at about 72 h. Analysis was carried out among 5653 satisfactorily test-read children aged 6-9 years. RESULTS: The estimation by mirror-image method among all children (without and with BCG scar) revealed an ARTI of between 1% and 1.3%. The estimated ARTIs among children without and with BCG scar varied between 0.8-1.3% and 0.9-1.4%, respectively, using the mirror-image method, anti-mode method and mixture model. CONCLUSION: Tuberculosis control efforts need to be intensified to reduce the risk of transmission of infection.