Significance of systolic anterior motion of the mitral valve during dobutamine stress echocardiography.

Left ventricular outflow tract obstruction related to systolic anterior motion of the mitral valve (SAM) induced during dobutamine stress echocardiography (DSE) is not unusual but its significance is not established. A total of 100 consecutive patients (mean age 62 +/- 12 years; 67% male) without previous transmural myocardial infarction, valvular disease, or hypertrophic cardiomyopathy, undergoing DSE to assess the presence of myocardial ischemia, were prospectively evaluated. A SAM with DSE was searched and correlated with clinical and baseline echocardiographic findings. Patients who demonstrated SAM with DSE were selected for exercise echocardiographic Doppler study with bicycle, within 6 months of the DSE. The development of an intraventricular gradient with DSE or exercise was defined as a new gradient of > or =36 mm Hg. In all, 23 patients developed SAM during DSE with a mean gradient of 79 +/- 33 mm Hg (range: 39-144 mm Hg) and mitral regurgitation related to SAM. Compared with patients without SAM, patients who developed SAM with DSE were characterized at rest by a smaller mitroaortic angle and septoaortic angle, a higher posterior mitral leaflet length, and a smaller left ventricular cavity. Neither ischemic nor hypotensive response during DSE were correlated to SAM. In the group of patients with SAM, of the 9 patients who were referred for unexplained chest pain or dyspnea, 5 reproduced symptoms with DSE, compared with 2 of 17 patients in the group without SAM (P = .005). Despite these findings, only 3 of the 16 patients who underwent exercise echocardiography Doppler study developed SAM (two with symptoms), with a wide range of achieved heart rate, compared with DSE. Although patients with SAM with DSE exhibit predisposing echocardiographic findings, the clinical impact of this phenomenon is real in only a minority of patients, particularly those who experienced unexplained dyspnea or chest pain.     

Prognostic value of transthoracic coronary flow reserve in medically treated patients with proximal left anterior descending artery stenosis of intermediate severity

Aims: Prognostic value of transthoracic coronary flow reserve (T-CFR)is not established in patients with left anterior descendingartery (LAD) stenosis of intermediate severity. Objective isto determine the prognosis value of T-CFR > 2 in medicallytreated patients with angiographically intermediate [50–70%QCA (quantitative coronary angiography)] proximal LAD stenosis. Methods and results: Among 110 consecutive patients with intermediate LAD stenosiswho underwent prospectively T-CFR in the distal part of theLAD after intravenous administration of adenosine to assessthe functional significance of the stenosis, 80 patients hadT-CFR > 2 and were treated medically without revascularization(Group 1). Among the 30 patients who had T-CFR < 2, an additionaldobutamine stress echocardiography (DSE) was performed: 15 hada negative DSE; were treated medically and served as a comparativegroup (Group 2), and 15 had a positive DSE; underwent LAD revascularization,and were excluded from further analysis. All patients completedfollow-up (16 ± 10 months). During the follow-up period(range 6–45 months), 76 patients (95%) remained free ofdeath or LAD-related event in Group 1, vs. 12 patients (80%)in Group 2. By Kaplan–Meier method, at 30 months the percent estimated survival free from death or target vessel-relatedevents was 92 ± 4% in Group 1 and 44 ± 22% inGroup 2 (P < 0.01). By multivariate analysis, T-CFR remainedthe only independent predictor of death or LAD-related events. Conclusion: In patients with proximal LAD stenosis of intermediate severityand T-CFR > 2, deferral of revascularization is associatedwith low event rate.     

Toxicity and removal of heavy metals (cadmium, copper, and zinc) by Lemna gibba

Effects of cadmium, copper, and zinc on the aquatic plant Lemna gibba were determined under controlled conditions; in parallel their removal from the growth medium was followed. The results showed that the three heavy metals affected growth, a physiological stress index defined as the ratio of Chlorophyll to phaeophytin (D665/D665a), and the contents of proline. After 4 days, 10⁻³–10⁻¹ mg/L Cd inhibited growth by 25–100%, reduced D665/D665a by 35–89%, and increased proline content by 44–567%. Under the same conditions, 10⁻⁴–10⁻¹ μg/L Cu inhibited growth by 36–75%, reduced D665/D665a by 19–81%, and increased proline content by 67–288%. Comparable concentrations of Zn had little effect. However, higher concentrations (4, 30, and 50 mg/L) inhibited growth by 50–79%. Also, 0.1 and 30 mg/L induced a small reduction of D665/D665a (−3.8% and −22%) and an increase in proline contents (+144% and +177%). When it was observed, proline accumulation was always transient and the maximum was reached after 4 days. Monitoring metal concentration in the medium showed that L. gibba was able to remove metals from the medium. Zn and Cu removal was biphasic, it was rapid during the first 2 days (> 60% reduction) and slow (10–20%) during the following 8 days. For Cd, removal was linear and depended on the initial concentration. It reached approximately 90% after 6 or 8 days for initial concentrations of 10⁻¹ and 10⁻³ mg/L, respectively.     

Effect of sodium fluoride on gastric emptying and intestinal transit in mice

Fluoride, a well-recognised harmful substance, is easily absorbed by the gastrointestinal mucosa. It is therefore conceivable that any alteration of the gastrointestinal motility can affect the rate of absorption of fluoride and leads to aggravation of its toxic effects. The effects of fluoride on gastric emptying and intestinal transit were studied in the mouse using a carboxymethyl cellulose (CMC) solution as a non-nutrient meal. The participation of the cholinergic and nitrergic systems in these effects was also evaluated. Oral gavage of 5 mM NaF had no significant effect on gastric emptying and intestinal transit of the CMC meal, whereas a decrease of gastric emptying (-33%, P<0.05) and an increase in intestinal transit (+20.7%, P<0.05) were observed with 20 mM NaF. Atropine injection induced a significant decrease of gastric emptying. Combined treatment of atropine with 20 mM NaF brought about a further, but not significant decrease in gastric emptying. N-G-nitro-L-arginine-methyl ester (L-NAME) treatment with or without oral administration of NaF decreased gastric emptying. Atropine treatment significantly depressed intestinal transit from 56.5% to 37.7% in the absence of NaF and from 70.1% to 42.8% in its presence. In contrast, L-NAME administration either alone or with fluoride increased intestinal transit (P<0.05). The present results suggest that fluoride alter gastrointestinal motility, an effect that may partly involve the cholinergic pathway.     

Argan oil improves surrogate markers of CVD in humans

Limited - though increasing - evidence suggests that argan oil might be endowed with potential healthful properties, mostly in the areas of CVD and prostate cancer. We sought to comprehensively determine the effects of argan oil supplementation on the plasma lipid profile and antioxidant status of a group of healthy Algerian subjects, compared with matched controls. A total of twenty healthy subjects consumed 15 g/d of argan oil - with toasted bread - for breakfast, during 4 weeks (intervention group), whereas twenty matched controls followed their habitual diet, but did not consume argan oil. The study lasted 30 d. At the end of the study, argan oil-supplemented subjects exhibited higher plasma vitamin E concentrations, lower total and LDL-cholesterol, lower TAG and improved plasma and cellular antioxidant profile, when compared with controls. In conclusion, we showed that Algerian argan oil is able to positively modulate some surrogate markers of CVD, through mechanisms which warrant further investigation.     

Gastroprotective effects of honey and glucose-fructose-sucrose-maltose mixture against ethanol-, indomethacin-, and acidified aspirin-induced lesions in the rat.

The gastric cytoprotective properties of natural honey (monofloral and polyfloral specimens) and of a glucose-fructose-sucrose-maltose mixture (GFSM) was evaluated in the rat using absolute ethanol, indomethacin and acidified acetylsalicylic acid (ASA-HCl) as necrotising agents. Prior gastric administration of honey (2.5 g/kg) to animals induced a net reduction of hemorrhagic lesions length of the mucosa. Protection of the stomach elicited by both types of honey and GFSM was almost total against ethanol-induced lesions. Similar results were also observed when using ASA-HCl except that the percent protection was 87%. The percent reduction of indomethacin-induced gastric lesions was variable according to the nature of the test solution: GFSM mixture (41.1%) < polyfloral honey (55.2%) < monofloral honey (64.0%). Perfusion of the stomach with isotonic honey resulted in (1) a 70% reduction of the area of the lesions caused by ethanol, (2) the failure to prevent the transmural potential difference fall induced by ethanol, (3) an increase of basal and histamine-stimulated acid secretion. These results suggest that sugar rich solutions (GFSM and honey) may prevent gastric damage by a mechanism involving the release of some protective agents.     

Simultaneous effects of two fungicides (copper and dimethomorph) on their phytoremediation using Lemna minor

Effects of two fungicides, copper and dimethomorph ((E,Z)4-[3-(4-chlorophenyl)-3-(3-4dimethoxyphenyl) acryloyl] morpholine) on Lemna minor growth and phytoremediation were evaluated. The toxicity of copper and dimethomorph alone and in combination, was assessed by growth inhibition of L. minor cultures after 96 and 168 h. Copper had a severe impact on growth (max. inhibition: 90 % at 1,000 μg L^?1) while dimethomorph (as pure ingredient or formulated as Forum) did not (inhibition <45 % at 1,000 μg L^?1) after 168 h of treatment. When both chemicals were combined, synergism was observed after 96 h of exposure to copper and Forum. However, this interaction was a simple additivity after 168 h. Additivity was also observed when the pure active ingredient (dimethomorph) replaced Forum in the mixture of copper and dimethomorph at 96 and 168 h. L. minor showed an excellent performance in removing copper from the medium since after 96 h, 36, 60, and 76 % removal were reached for 10, 20, and 30 μg L^?1 of Cu respectively. Copper accumulated in the plants. The removal of copper increased with Forum concentration. After 96 h copper (10 μg L^?1 initial concentration) elimination increased from 36.39 ± 5.86–60.70 ± 6.06 % when Forum concentration increased from 0 to 500 μg L^?1. Accumulation of copper in plants was also increased by Forum but not by the active ingredient alone. Depuration of Forum by L. minor varied between 10 and 40 % after 96 h and it was generally more efficient than that of the pure ingredient. This depuration decreased in the presence of copper possibly due to the metal toxicity.