Two dimensional echocardiographic demonstration of an unusual complication of aortic infective endocarditis

The two dimensional echocardiographic findings of aortic root abscess have been described. The echocardiographic findings in a patient with aortic valve endocarditis complicated by abscess formation, tear in the intima of the ascending aorta, and rupture of abscess cavity into the right ventricle are reported.     

Sulfamic acid incorporated HKUST-1: a highly active catalyst and efficient adsorbent

Herein we introduce an effective approach for incorporating sulfamic acid (SA) into HKUST-1. The synthesized materials have been characterized using XRD, XPS, BET, FT-IR, SEM, EDX and TEM. The X-ray diffraction pattern of SA@HKUST-1 is analogous to that of parent HKUST-1 in line shape and d-spacing, proving that chemical modification could be obtained without damage to structural solidity. The XPS spectra confirmed successful sulfonation, due to the single S 2p peak being attributable to SO₃H groups at 168 eV. Catalytic efficiency was studied for 7-hydroxy-4-methyl coumarin and 3,4-dihydropyrimidinone synthesis and it was found to be highly dependent on the amount of SA loaded over HKUST-1. Moreover, the adsorptive removal activity of some common organic and inorganic pollutants from water has been studied. To fully understand the adsorption process, the effects of initial dye concentration, pH of solution, adsorbent dosage, contact time and temperature on the adsorption process were successfully studied. Under the optimum conditions 10 wt% SA@HKUST-1 was able to reach the maximum adsorption capacity for Pb²⁺ (298 mg g⁻¹) and Malachite green (290 mg g⁻¹). Hopefully, this will facilitate research on improving the prospective use of MOFs for future applications.

Herein we introduce an effective approach for incorporating sulfamic acid (SA) into HKUST-1.     

Results from a prospective, randomized, controlled study evaluating the acceptability and effects of routine pre-IVF counselling

BACKGROUND: The aim of this study was to evaluate a model of routine pre-IVF counselling focusing on the narrative capacities of couples. The acceptability of counselling, the effects on emotional factors and the participants' assessments were considered. METHODS: The study included 141 consecutive childless couples preparing for their first IVF. Randomization was carried out through sealed envelopes attributing participants to counselled and non-counselled groups and was accepted by 100 couples. Another 12 couples refused randomization because they wanted counselling and 29 because they did not. Questionnaires including the State-Trait Anxiety Inventory, the Beck Depression Inventory and assessments of help were mailed to couples before IVF and counselling, and after the IVF outcome. RESULTS: Counselling was accepted by 79% (112/141) of couples. There was no significant effect of counselling on anxiety and depression scores which were within normal ranges at both times. Counselling provided help for 86% (75/87) of initially non-demanding subjects and 96% (25/26) of those initially requesting a session. Help was noted in areas of psychological assistance, technical explanations and discussing relationships. CONCLUSIONS: This model of routine counselling centred on the narrative provides an acceptable form of psychological assistance for pre-IVF couples.     

Measurements of the gastric emptying rate by use of ultrasonography: studies in humans using bread with added sodium propionate

BACKGROUND: Foods with a low glycemic index are increasingly being acknowledged as beneficial for individuals with disorders related to the insulin resistance syndrome. The presence of certain salts of organic acids has been shown to lower the glycemic index of bread products and one of the suggested mechanisms is a lowered gastric emptying rate (GER). One obvious pitfall with many of the common techniques for GER measurement is that the food structure, and hence the gastric release of nutrients, may be affected by enclosure of the marker for gastric emptying, eg, paracetamol. Ultrasonography is a noninvasive method for which the above pitfall is to a large extent avoided. OBJECTIVE: The main objective was to evaluate the use of ultrasonography to determine whether the lowered glycemic and insulinemic responses to bread ingestion after the addition of sodium propionate are explained by a specific effect of propionate on the GER. DESIGN: The effect of sodium propionate in bread was evaluated in 9 healthy volunteers. Barley bread products, with or without added sodium propionate, were ingested as breakfast after an overnight fast. The GER was monitored for 2 h by ultrasonography; during this period, capillary blood was withdrawn repeatedly for measurement of blood glucose and insulin. RESULTS: The GER of the barley bread decreased markedly after the addition of sodium propionate and was accompanied by lowered glycemic and insulinemic responses. CONCLUSION: The lowered glycemic response to ingestion of bread with added sodium propionate appears to be related to a lowered GER.     

Delayed gastric emptying rate in Type 1 diabetics with cardiac autonomic neuropathy

Gastroparesis is a frequent complication of longstanding diabetes and has been attributed to vagal nerve dysfunction, occurring as part of a generalized autonomic neuropathy. We wanted to clarify the relationship between delayed gastric emptying (GE) and cardiac autonomic neuropathy (CAN) in type 1 diabetics. Using a standardized ultrasound technique, GE was studied in 20 type 1 diabetic patients with poor glycaemic control despite good compliance and 10 normal healthy volunteers (Group 1). Measurements of GE were done on condition that the fasting blood glucose was 3.5-9.0 mmol/l. Diabetic patients were classified into two groups according to the absence (Group 2) or presence (Group 3) of CAN, using the deep breathing test (E:I ratio) to evaluate parasympathetic vagal nerve function. Age-related reference values were used to evaluate the indices of CAN. The supine resting heart rate was also checked, and the patients were asked for symptoms of gastroparesis. The three groups were similar in terms of sex and smoking habits, and there was no significant difference regarding the age and body mass index (BMI). The mean duration of diabetes and the glycaemic control (HbA1c) was insignificant between patients in Groups 2 and 3. Diabetic patients in Group 3 showed lower gastric emptying rates (GER) than the healthy volunteers in Group 1 (median GER 16% vs. 63%, P<.01) and the patients in Group 2 (median GER 16% vs. 54%, P<.01). No significant difference in GER could be seen between patients in Group 2 and subjects in Group 1 (median GER 54% vs. 63%, P=.08). Assuming that GER<45% indicated a delayed GE, 8 of 10 patients in Group 3 had delayed GE compared to only 3 of 10 patients in Group 2. There were disagreements between symptoms of gastroparesis and delayed GE. We conclude that there is a significant lower GER in type 1 diabetic patients with CAN than in those without, unrelated to symptoms of gastroparesis.     

Detection of transketolase in bone marrow-derived insulin-producing cells: benfotiamine enhances insulin synthesis and glucose metabolism

Adult bone marrow (BM)-derived insulin-producing cells (IPCs) are capable of regulating blood glucose levels in chemically induced hyperglycemic mice. Using cell transplantation therapy, fully functional BM-derived IPCs help to mediate treatment of diabetes mellitus. Here, we demonstrate the detection of the pentose phosphate pathway enzyme, transketolase (TK), in BM-derived IPCs cultured under high-glucose conditions. Benfotiamine, a known activator of TK, was not shown to affect the proliferation of insulinoma cell line, INS-1; however, when INS-1 cells were cultured with oxythiamine, an inhibitor of TK, cell proliferation was suppressed. Treatment with benfotiamine activated glucose metabolism in INS-1 cells in high-glucose culture conditions, and appeared to maximize the BM-derived IPCs ability to synthesize insulin. Benfotiamine was not shown to induce the glucose receptor Glut-2, however it was shown to activate glucokinase, the enzyme responsible for conversion of glucose to glucose-6-phosphate. Furthermore, benfotiamine-treated groups showed upregulation of the downstream glycolytic enzyme, glyceraldehyde phosphate dehydrogenase (GAPDH). However, in cells where the pentose phosphate pathway was blocked by oxythiamine treatment, there was a clear downregulation of Glut-2, glucokinase, insulin, and GAPDH. When benfotiamine was used to treat mice transplanted with BM-derived IPCs transplanted, their glucose level was brought to a normal range. The glucose challenge of normal mice treated with benfotiamine lead to rapidly normalized blood glucose levels. These results indicate that benfotiamine activates glucose metabolism and insulin synthesis to prevent glucose toxicity caused by high concentrations of blood glucose in diabetes mellitus.