Vascular dysfunction measured by fingertip thermal monitoring is associated with the extent of myocardial perfusion defect

Background  Previous studies have shown that vascular dysfunction measured by digital thermal monitoring (DTM) during an arm-cuff reactive hyperemia procedure correlates with the severity of coronary artery disease measured by coronary artery calcium in asymptomatic patients. Current study investigates the correlation between DTM and abnormal myocardial perfusion imaging (MPI). Methods  About 116 consecutive patients with chest discomfort, age 57 ± 10 years, underwent MPI, DTM and Framingham Risk Score (FRS) assessment. Fingertip temperature rebound (TR), DTM index of vascular reactivity, was assessed after a 2-minute arm-cuff reactive hyperemia test. The extent of myocardial perfusion defect was measured by summed stress score (SSS). Results  TR decreased from SSS < 4 (1.61 ± 0.15) to 4 ≤ SSS ≤ 8 (0.5 ± 0.22) to 9 ≤ SSS ≤ 13 (0.26 ± 0.15) to SSS > 13 (−0.37 ± 0.19) (P = .0001). After adjusting for cardiac risk factors, the odds ratio of the lowest versus two upper tertiles of TR was 3.93 for SSS ≥ 4 and 9.65 for SSS ≥ 8 compared to SSS < 4. TR correlated well with SSS (r = −0.88, P = .0001). Addition of TR to FRS increased the area under the ROC curve to predict abnormal MPI, SSS ≥ 4, from 0.65 to 0.84 (P < .05). Conclusion  Vascular dysfunction measured by DTM is associated with the extent of myocardial perfusion defect independent of age, gender, and cardiac risk factors. Electronic supplementary material  The online version of this article (doi:) contains supplementary material, which is available to authorized users.     

Idiopathic infantile arterial calcification: clinical presentation, therapy and long-term follow-up

Idiopathic infantile arterial calcification (IIAC) is a rare disease characterised by extensive depositions of hydroxyapatite in the internal elastic lamina of medium-sized and large arteries, frequently accompanied by periarticular calcifications. We report on three patients with various presenting signs and symptoms. Diagnostic imaging techniques and therapy with bisphosphonates will be discussed. For the first time long-term follow-up of up to 25 years will be reported.     

Cytokine Gene Polymorphisms in Iranian Patients with Beta-Thalassemia Major

Background: β-thalassemia as a hereditary disease is defined as defective synthesis of   β-globin chains, resulting in erythropoiesis abnormalities and severe anemia. Different studies have shown that cytokines and cytokine gene polymorphisms play a major role in the pathogenesis of   β-thalassemia. Single nucleotide polymorphisms (SNPs) within the promoter region or other regulatory sequences of cytokine genes lead to overall production of cytokines.   Objective: To analyze the genetic profile of Th1 and Th2 cytokines in Iranian patients with   β-thalassemia major. Methods: Allelic and genotype frequencies of cytokine genes were determined in 30 thalassemia patients and 40 healthy subjects using PCR-SSP assay. Allele and genotype frequencies were calculated and compared with those of normal controls.   Results: The results of our study show a significant decrease in A allele at position UTR 5644 IFN-   γ, G alleles at position -238 TNF-   α and 166 IL-2, and C allele at position -590 IL-4. TGF- β   haplotype TG/TG increased whereas TGF-β haplotype CG/CG and IL-10 haplotype GCC/ACC decreased significantly in all patients.   Conclusion: Data of this investigation suggest that variations among cytokine gene polymorphisms may contribute to the disease susceptibility. A finding which needs to be fairly clarified in other ethnic groups.     

Effect of memantine on plasma concentrations of carbamazepine and phenytoin in rats: A controlled experimental study

Background: Elderly patients, especially those with Alzheimer's disease, may be prescribed memantine and an antiepileptic drug concurrently.Objective: The aim of this study was to compare the interaction of memantine with phenobarbital (an enzyme inducer) and chloramphenicol (an enzyme inhibitor) on plasma concentrations of carbamazepine (CBZ), CBZ-10,11-epoxide (CBZE), and phenytoin in an experimental model.Methods: Eight groups of rats (200-230 g) were treated for 14 days each. In groups 1 and 2, phenobarbital 50 mg/kg was administered daily as an enzyme inducer 60 minutes before CBZ 50 mg/kg or phenytoin 30 mg/kg administration, respectively. In groups 3 and 4, chloramphenicol 300 mg/kg was administered daily as an enzyme inhibitor 60 minutes before CBZ or phenytoin administration, respectively. In groups 5 and 6, memantine 20 mg/kg was administered daily 60 minutes before CBZ or phenytoin, respectively. In group 7, CBZ alone was administered daily; in group 8, phenytoin alone was administered daily. Two hours after the last intragastric gavage, animals were anesthetized with ether and 2 mL of blood was drawn from the heart into a syringe containing EDTA. A validated method developed in this study was used for simultaneous determination of CBZ, CBZE, and phenytoin concentrations in rat plasma.Results: The study comprised 8 groups of 9 male adult Wistar rats each. Compared with groups 7 and 8, concurrent use of CBZ or phenytoin with phenobarbital (groups 1 and 2) was associated with significantly lower mean (SEM) plasma concentrations of CBZ (3.45 [0.16] vs 2.20 [0.21] μg/mL; P < 0.001) and phenytoin (3.68 [0.09] vs 1.63 [0.15] μg/mL; P < 0.001) and a significantly higher plasma CBZE concentration (9.85 [0.29] vs 11.18 [0.29] μg/mL; P < 0.05). Concurrent use of CBZ or phenytoin with chloramphenicol (groups 3 and 4) was associated with significantly higher plasma concentrations of CBZ (4.81 [0.17] μg/mL; P < 0.001) and phenytoin (6.24 [0.22] μg/mL; P < 0.001) and a significantly lower plasma CBZE concentration (3.88 [0.25] μg/mL; P < 0.001). Concurrent use of CBZ or phenytoin with memantine (groups 5 and 6) was not associated with a significant change in the plasma concentration of CBZ, CBZE, or phenytoin.Conclusion: Memantine was not associated with a significant change in the plasma concentration of CBZ, CBZE, or phenytoin in this experimental model.     

Unusual acute formed gastric bezoars due to plaster ingestion successfully treated by gastric irrigation: report of two cases

Bezoars usually present as a mass in the stomach. One of the uncommon causes of bezoars is ingestion of plaster in a suicidal attempt. We present here two patients with acute formed gastric bezoars due to plaster ingestion. Their main complaints were abdominal pain, nausea, and vomiting. Clinical examination revealed a slightly distended abdomen and a palpable mass in the epigastric region. Plain abdominal radiograph showed plaster casts in the stomach. They were successfully treated by insertion of a nasogastric tube and gastric irrigation using saline solution over 24 h. Post-treatment abdominal X-ray showed dissolved plaster passing through the small intestines and the colon. The treatment course was uneventful, and finally patients were discharged with good condition and referred to a psychiatric clinic for treatment of underlying psychological disorder.     

Determination of morphine in the plasma of addicts in using Zeolite Y extraction following high-performance liquid chromatography

BACKGROUND: The measurement of morphine in biological samples has become a routine in many clinical and forensic toxicology laboratories. A high-performance liquid chromatography (HPLC) method was developed for the determination of morphine in plasma. METHODS: Samples were extracted using Zeolite Y column followed by reversed phase HPLC with fluorescence detection. This method was based on an ex-calibration procedure and was linear between 20 and 200 ng/ml of morphine. Blood from 10 male opiate addicts were obtained from Rosbeh Hospital. All of the male smoked opiate (heroin, opium) and cigarettes. RESULTS: The mean total level 5 h after the last abuse was 152.4 ng/ml and 37.6 ng/ml at 10-15 h. The method was reliable for morphine determination in blood even after 5 half-lives after the last abuse. CONCLUSIONS: This method is simple and rapid and may be useful for routine monitoring of plasma morphine concentration.     

Modern human sperm freezing: Effect on DNA,chromatin and acrosome integrity

Objective

Presence of vitrification method in sperm freezing and the introduction of solid surface vitrification beside rapid freezing in vapour, opens an easy and safe way to help infertility centres. While the effects of cryopreservation on motility, morphology and viability of sperm are documented, the question of the probable alteration of sperm DNA, chromatin and acrosome integrity after freezing and thawing procedures in different methods is still controversial.