Chicken's valve in a human heart

A 73-year-old woman was studied after admission for anteriorwall ST-segment elevation myocardial infarction. Transthoracicechocardiography (GE Vingmed, Vivid 7, Horten, Norway)     

Surgical management of tuberculous broncholithiasis with hemoptysis: experience with 5 operated cases.

INTRODUCTION: Broncholithiasis is often seen after chronic granulomatous diseases such as tuberculosis and hystoplasmosis and leads to a wide spectrum of signs and symptoms; including hemoptysis which often needs surgical management. The goal of this study is evaluation of surgery in patients with tuberculous broncholithiasis who present with hemoptysis. MATERIALS AND METHODS: In this study all patients with tuberculous broncholithiasis had been operated on between 1991 and 2005, followed up at least 6 months and at most 9 years, and studied relating to age, sex, clinical symptoms, diagnostic methods, type of surgical treatment, complications and mortality. RESULTS: Overall 5 patients have been studied (male:female=2:3, mean=31 years); 2 with severe and 3 mild to moderate and recurring hemoptysis, lesion at left in 80% and at right in 1, in 3 patients some degree of bronchiectasia was seen, in 4 the lesion was visible in bronchoscopy and endoscopic removal of the lesion failed in all. Three of patients underwent pulmonary resections and in 2 broncholithotomy has been done. In follow-up, patients treated with pulmonary resection have had no subsequent problems, but in patients treated with broncholithotomy due to occurring late bronchiectasia, re-operation and pulmonary resection was inavoidable. There was no mortality. CONCLUSION: Regarding the dangers of hemoptysis and excellent results of surgery and possible occurance of late bronchiectasia after broncholithotomy, the results of our study show that pulmonary resection distal to the lesion and as the retention of lung of parenchyma is preferable. Broncholithotomy should be done only in patients in whom pulmonary resection is not technically possible. Because of the very low occurance of this complication complete studies are needed.     

Commercial preparations of lipoteichoic acid contain endotoxin that contributes to activation of mouse macrophages in vitro

Lipoteichoic acids (LTA), cell wall components of gram-positive bacteria, have been reported to induce various inflammatory mediators and to play a key role in gram-positive-microbe-mediated septic shock. In a large number of these studies, investigators used commercially available LTA purified from a variety of gram-positive bacteria, including Staphylococcus aureus, Bacillus subtilis, and Streptococcus sanguis. We report here that, although these commercially available LTA could be readily shown to stimulate production of nitric oxide (NO) in RAW 264.7 mouse macrophages, the activity was dramatically inhibited by polymyxin B, a relatively specific inhibitor of endotoxin biological activity. One-step purification of the commercially available S. aureus LTA using hydrophobic interaction chromatography resulted in two well-separated peak fractions, one highly enriched for LTA and a second highly enriched for endotoxin. The LTA-enriched fractions did not induce production of NO in RAW 264.7 macrophages, although they caused a dose-dependent induction of NO in the presence of low concentrations of gamma interferon (IFN-gamma) (which by itself induced little NO), regardless of the presence of polymyxin B. In contrast, the endotoxin-enriched fractions by themselves inhibited in high levels of NO in RAW 264.7 macrophages but activity was almost completely inhibited in the presence of polymyxin B. Consistent with these findings, our data also indicate that commercial LTA preparations from S. aureus, B. subtilis, and S. sanguis were not able to induce NO from lipopolysaccharide-hyporesponsive C3H/HeJ mouse peritoneal macrophages, but in the presence of IFN-gamma, these LTA preparations were able to induce relatively high levels of NO from C3H/HeJ macrophages. These results indicate that commercially available LTA can contain contaminating and potentially significant levels of endotoxin that can be expected to contribute to the putative macrophage-stimulating effects of LTA as assessed by NO production. The fact that the purified LTA, by itself, was not able to induce significant levels of NO secretion in RAW 264.7 macrophages supports the conclusion that caution in attributing high-level biological activity to this microbial cell wall constituent should be exercised.     

Designing a high-performance smart drug delivery system for the synergetic co-absorption of DOX and EGCG on ZIF-8

Due to the extreme pore volume and valuable surface area, zeolitic imidazole frameworks (ZIFs) are promising vehicles that enhance the delivery of therapeutic agents to tissues. Furthermore, these nanoporous materials have high stability in the pH and temperature of the surrounding healthy cells (37 °C and pH = 7) and an exotic potential to deform in carcinogenic environment (T > 37 °C and pH ∼ 5.5), which make them perfect smart drug delivery vehicle candidates. In this work, a series of molecular dynamics (MD) and metadynamics simulations have been performed to gain molecular insight into the mechanisms involved in the process of co-loading of doxorubicin (DOX) and EpiGalloCatechin-3 Gallate (EGCG) on ZIF-8, which form a smart drug delivery system (SDDS). The obtained results revealed that DOX was adsorbed on the carrier mostly through electrostatic interactions (E_coul = ∼−1200 kJ mol⁻¹, E_tot = −1700 kJ mol⁻¹), and EGCG was stacked on ZIF-8 mainly via van der Waals interactions (E_L-J = ∼−600 kJ mol⁻¹, E_tot = ∼−1200 kJ mol⁻¹). It is worth mentioning that the drug–drug L-J interactions (E_L-J = ∼500 kJ mol⁻¹) were also important in the co-loading process. The insertion of DOX and EGCG as additive agents to the initial ZIF-8/EGCG and ZIF-8/DOX systems led to the enhancement of the drug–carrier pair interactions to about ∼−2300 kJ mol⁻¹ and ∼−2000 kJ mol⁻¹, respectively. This finding implied that the drug–drug interactions had a complementary role in the development of SDDS via ZIF-8. From the metadynamics simulation, it was found that the geometry of the drugs is a determining factor in an efficient co-loading SDDS.

Adsorption free energy of a molecule depends on where and how the molecule meets ZIF-8 surface.     

Human Stimulus Factor Is a Promising Peptide for Delivery of Therapeutics

Fluticasone propionate uptake in the presence of a proprietary cell-penetrating peptide (human stimulus factor, [HSF]) based on the N-terminal domain of lactoferrin was studied, alone and in combination with salmeterol, using an air interface Calu-3 epithelial model. The HSF enhanced uptake and transport of fluticasone propionate across the epithelial barrier when alone and in presence of salmeterol. This was attributed to transcellular-mediated uptake. This HSF is a promising peptide for delivery of therapeutics where enhanced epithelial penetrating is required.     

Time-dependent changes in the plasma concentration of matrix metalloproteinase 9 after acute myocardial infarction

Matrix metalloproteinase (MMP)-2 and MMP-9 are believed to play a pathophysiologic role in acute myocardial infarction (MI). The time course of their plasma concentrations in correlation with the extent of myocardial damage is unclear. In a prospective study, 20 patients with proven acute MI underwent successful reperfusion within 6 h after the onset of symptoms. The patients were divided into two groups according to the size of their MI, i.e. large or moderate MI. Plasma concentrations of MMP-2, MMP-9 and tissue inhibitor of metalloproteinase (TIMP)-1 were determined on admission, and after 24 h, 48 h, 1 week, 4 weeks, 3 months and 6 months. MMP-2 levels remained unchanged over time in both groups. The plasma concentration of MMP-9 was elevated on admission in patients with large MI versus moderate MI (195 +/- 190 versus 78 +/- 63 ng/ml, p < 0.01) as determined by left ventriculography, and returned to baseline (18 +/- 16 ng/ml) by 1 week after MI. TIMP-1 levels rose slowly in patients with large MI and returned to baseline at 6 months. The ratio of MMP-9 to TIMP-1 was significantly increased on admission in both groups and returned to baseline at 48 h. These data suggest that MMP-9 might play a pathophysiologic role during the early phase of acute MI.     

A hybrid approach for quantification of aortic valve stenosis using cardiac magnetic resonance imaging and echocardiography.

BACKGROUND: Doppler-derived calculation of aortic valve area (AVA) using the continuity equation can be difficult at times, e.g. due to poor acoustic windows, heavy calcification of the aortic valve, or significant flow acceleration in the left ventricular outflow tract. The aim of this study was to compare AVA as assessed by means of transthoracic echocardiography (TTE) with a hybrid approach, where the Doppler-derived numerator in the continuity equation was replaced by cardiovascular magnetic resonance (CMR) determination of stroke volume. METHODS: Twenty consecutive patients admitted for evaluation of aortic stenosis underwent transthoracic echocardiography and CMR determination of stroke volume within a time period of 3 weeks. Additionally, continuous-wave Doppler spectra of the aortic valve were acquired immediately after the CMR examination. RESULTS: There was no statistically significant difference for mean AVA between the two methods (0.88 +/- 0.23 cm2 by the standard continuity equation versus 0.86 +/- 0.23 cm2 by the hybrid approach, p = 0.55; r = 0.73, p < 0.01). The mean difference was 0.02 cm2 and the limits of agreement were -0.32 to 0.36. Only 2 patients were classified differently by the two methods. Intraobserver and interobserver variability and reproducibility were superior for the hybrid approach. CONCLUSION: The hybrid method for determination of AVA is an excellent alternative to the standard approach by TTE.     

Validation of the peak to mean pressure decrease ratio as a new method of assessing aortic stenosis using the Gorlin formula and the cardiovascular magnetic resonance-based hybrid method

BACKGROUND: We sought to validate the recently introduced peak to mean pressure decrease ratio (PMPDR), using the Gorlin formula and a hybrid method which combines cardiovascular magnetic resonance (CMR)-derived stroke volume with transaortic Doppler measurements to calculate aortic valve area (AVA). METHODS: Data analysis in 32 patients with severe (AVA 相似文献   

Isolation of <Emphasis Type="Italic">Balamuthia mandrillaris</Emphasis> from urban dust,free of known infectious involvement

The free-living amoeba Balamuthia mandrillaris can cause fatal encephalitis in humans and other mammals. The organism is associated with soils, and soil exposure has been identified as a risk factor for this pathogen. However, B. mandrillaris has been isolated only once from soils believed to be the source of the infection in child from California, USA who died of Balamuthia amoebic encephalitis and once from another unrelated soil source. We report for a third time the isolation of B. mandrillaris from the environment and for the second time its isolation from a sample not known to be involved with pathogenicity. We have established the new clonal B. mandrillaris strain (ID-19) in axenic media. The identity of our isolate was originally by morphology using a light microscope and this has been confirmed by 16S rRNA gene PCR. The new strain ID-19 groups with others of the species. The fact that our isolate came from dust particles deposited on surfaces from the air in an urban environment may suggest that it is not just soil exposure that constitutes a risk factor for Balamuthia infection. This is the first report of this organism from Iran.