Echocardiography-guided ethanol septal reduction for hypertrophic obstructive cardiomyopathy

BACKGROUND: Left ventricular outflow tract (LVOT) obstruction is frequently responsible for symptoms in hypertrophic obstructive cardiomyopathy (HOCM). Medical therapy is often not sufficient to control these symptoms, and surgical myotomy-myomectomy is required. METHODS AND RESULTS: We enrolled 33 symptomatic patients with HOCM and obstruction (>/=40 mm Hg gradient at rest or >/=60 mm Hg dobutamine-provoked). By contrast echocardiography, the bulging septum was localized and infarcted by injection of 2 to 5 mL of absolute ethanol into the septal artery(ies) supplying the hypertrophied area. Baseline echocardiograms with Doppler, myocardial perfusion tomograms, and treadmill exercise or pharmacological testing were compared with those at 6 weeks and 6 months. The mean rise in creatine kinase was 1964+/-796 U. All patients experienced symptomatic relief; NYHA class decreased from 3. 0+/-0.5 to 0.9+/-0.6 (P<0.001). Exercise time increased from 286+/-193 to 421+/-181 seconds (P=0.03). The resting and dobutamine-provoked gradient decreased from 49+/-33 and 96+/-34 mm Hg to 9+/-19 (P<0.001) and 24+/-31 mm Hg (P<0.001), respectively. Echocardiograms repeated at 6 weeks after the procedure showed a 28% reduction in septal thickness and 17% reduction in left ventricular mass. Myocardial perfusion imaging showed a "septal amputation pattern," with scarring in the upper and middle septal areas. Complete heart block developed in 11 patients, who then required permanent pacemaker implantation. CONCLUSIONS: Echocardiography-guided ethanol septal reduction in patients with HOCM is a safe, minimally invasive procedure that provides symptomatic relief with improved hemodynamic and left ventricular parameters.     

Depolarization shifts the voltage dependence of cardiac sodium channel and calcium channel gating charge movements

In cardiac ventricular myocytes, membrane depolarization leads to the inactivation of the Na channel and Ca channel ionic currents. The inactivation of the ionic currents has been associated with a reduction of the gating charge movement ("immobilization") which governs the activation of Na channels and Ca channels. The nature of the apparent "immobilization" of the charge movement following depolarization was explored in embryonic chick ventricular myocytes using voltage protocols applied from depolarized holding potentials. It was found that although all of the charge was mobile following inactivation, the voltage dependence of its movement was shifted to more negative potentials. In addition, the shift in the distribution of the Na channel charge could be differentiated from that of the Ca channel charge on the basis of kinetic as well as steady-state criteria. These results suggest that the voltage-dependent activation of Na channel and Ca channel charge movements leads to conformational changes and charge rearrangements that differentially bias the movements of these voltage sensors, and concomitantly produce channel inactivation.     

Discrimination between NL1- and NL2-mediated nuclear localization of the glucocorticoid receptor

Glucocorticoid receptor (GR) cycles between a free liganded form that is localized to the nucleus and a heat shock protein (hsp)-immunophilin-complexed, unliganded form that is usually localized to the cytoplasm but that can also be nuclear. In addition, rapid nucleocytoplasmic exchange or shuttling of the receptor underlies its localization. Nuclear import of liganded GR is mediated through a well-characterized sequence, NL1, adjacent to the receptor DNA binding domain and a second, uncharacterized motif, NL2, that overlaps with the ligand binding domain. In this study we report that rapid nuclear import (half-life [t1/2] of 4 to 6 min) of agonist- and antagonist-treated GR and the localization of unliganded, hsp-associated GRs to the nucleus in G0 are mediated through NL1 and correlate with the binding of GR to pendulin/importin alpha. By contrast, NL2-mediated nuclear transfer of GR occurred more slowly (t1/2 = 45 min to 1 h), was agonist specific, and appeared to be independent of binding to importin alpha. Together, these results suggest that NL2 mediates the nuclear import of GR through an alternative nuclear import pathway. Nuclear export of GR was inhibited by leptomycin B, suggesting that the transfer of GR to the cytoplasm is mediated through the CRM1-dependent pathway. Inhibition of GR nuclear export by leptomycin B enhanced the nuclear localization of both unliganded, wild-type GR and hormone-treated NL1(-) GR. These results highlight that the subcellular localization of both liganded and unliganded GRs is determined, at least in part, by a flexible equilibrium between the rates of nuclear import and export.     

（Sb2O3）1—x（Sb2S3）x系新型氧硫混合红外玻璃的研究

首次制备了一类新型的（Ｓｂ２Ｏ３）１－ｘ（Ｓｂ２Ｓ３）ｘ的氧硫混合体系玻璃,测定了玻璃的组成,形成区域,并用ＤＴＡ,ＩＲ,ＵＶ光谱对其性能进行了研究,同时与Ｓｂ２Ｏ３单组份玻璃,Ｓｂ２Ｏ３－ＲＸ２（Ｒ＝二价金属离子）系玻璃进行了比较,该玻璃易于制备,化学稳定性好,透光区０．７～７．０μｍ,Ｔｃ－Ｔｇ〉９０℃,通过远红外光谱的分析,对玻璃的结构进行了初步研究。     

采用低损耗IGBT为次级2.5kW逆变器应用提升开关性能

传统的lGBT(绝缘栅极型功率管)通常应用在要求高电压和高电流等级,以及相对缓慢的开关频率的场合.当开关频率低时,IGBT固有的低传导损耗源自IGBT中少数载流子工作产生的低VCE(on)(集电极-发射极饱和电压),其在价值上已经超过了它贫乏的开关性能,使获得高的整体操作效率成为可能.     

Complete eradication of Aspergillus fumigatus from the lung in an immunocompromised patient by oral itraconazole

Fifty-three deaf subjects with a history of prelingual profound bilateral sensorineural hearing loss, similar language habilitation with hearing aids, and normal velopharyngeal structures underwent a study protocol including speech evaluation, behavioral pure-tone audiometry, videonasopharyngoscopy, multiview videofluoroscopy, and electromyography of the velopharyngeal muscles. Subjects were divided into two groups: the first group included 13 subjects with normal nasal resonance or mild hypernasality (four normals and nine with mild hypernasality); the second group had subjects with severe hypernasality and severe articulation deficits. Pure-tone thresholds, velopharyngeal closure patterns, and electromyographic activity of velopharyngeal muscles were similar for both groups of subjects. However, in subjects with severe hypernasality, despite normal muscle activity as observed by electromyography, velopharyngeal valving activity lacked rhythm and strength during speech. It is concluded that deaf subjects may present a functional disorder of the velopharyngeal sphincter related to absence of auditory regulation during phonation. Visual biofeedback using videonasopharyngoscopy may be useful for treating this disorder.     

Peroxidation of LDL from combined-hyperlipidemic male smokers supplied with omega-3 fatty acids and antioxidants

The effects of marine omega-3 polyunsaturated fatty acids (FAs) and antioxidants on the oxidative modification of LDL were studied in a randomized, double-blind, placebo-controlled trial. Male smokers (n = 41) with combined hyperlipidemia were allocated to one of four groups receiving supplementation with omega-3 FAs (5 g eicosapentaenoic acid and docosahexaenoic acid per day), antioxidants (75 mg vitamin E, 150 mg vitamin C, 15 mg beta-carotene, and 30 mg coenzyme Q10 per day), both omega-3 FAs and antioxidants, or control oils. LDL and human mononuclear cells were isolated from the patients at baseline and after 6 weeks of supplementation. LDL was subjected to cell-mediated oxidation by the patients' own mononuclear cells, as well as to Cu(2+)-catalyzed and 2,2'-azobis-(2-amidinopropane hydrochloride) (AAPH)-initiated oxidation. Extent of LDL modification was measured as lag time, the formation rate of conjugated dienes (CDs), the maximum amount of CDs formed, formation of lipid peroxides, and the relative electrophoretic mobility of LDL on agarose gels. Dietary supplementation with omega-3 FAs increased the concentration of total omega-3 FAs in LDL and reduced the concentration of vitamin E in serum. The omega-3 FA-enriched LDL particles were not more susceptible to Cu(2+)-catalyzed, AAPH-initiated, or autologous cell-mediated oxidation than control LDL. In fact, enrichment with omega-3 FAs significantly reduced the formation rate of CDs when LDL was subjected to AAPH-induced oxidation. Supplementation with moderate amounts of antioxidants significantly increased the concentration of vitamin E in serum and increased the resistance of LDL to undergo Cu(2+)-catalyzed oxidation, measured as increased lag time, reduced formation of lipid peroxides, and reduced relative electrophoretic mobility compared with control LDL. Supplementation with omega-3 FAs/antioxidants showed oxidizability of LDL similar to that of control LDL and omega-3 FA-enriched LDL. In conclusion, omega-3 FAs neither rendered the LDL particles more susceptible to undergo in vitro oxidation nor influenced mononuclear cells' ability to oxidize autologous LDL, whereas moderate amounts of antioxidants protected LDL against oxidative modification.     

Mass transfer and structure of asbestos and non-asbestos diaphragms for chlorine and caustic production

Models and equations describing aspects of diaphragm performance are discussed in view of recent experiences with non-asbestos diaphragms. Excellent control of wettability and, therefore, of the amount of gases inside the diaphragm, together with chemical resistance to the environment during electrolysis, was found to be an essential prerequisite to performances of non-asbestos diaphragms that are comparable to those of asbestos diaphragms. Equations, derived and supported by experimental evidence from previous work, are shown to describe and predict hydrodynamic permeability and ohmic voltage drop of diaphragms, even in cases where the amount of gases inside the diaphragm slowly increases during electrolysis. Current efficiency is observed to be only dependent to a slight extent on the effective electrolyte void fraction inside the diaphragm. Major effects that determine current efficiency at 2 kA m^–2 and 120 gl^–1 caustic are shown to be diaphragm thickness, pore diameter distribution and the number of interconnections between pores inside the diaphragm. A discussion on design of the structure of non-asbestos diaphragms is presented.Nomenclature B permeability coefficient (m²) - c _i,x concentration of ionic species i at position x (mol m^–3) - c _k concentration of hydroxyl ions in catholyte (mol m^–3) - CE current efficiency - d thickness of diaphragm (m) - thickness of layer (m) - D _i ionic diffusion coefficient of species i (m²s^–1) - D _e dispersion coefficient (m²s^–1) - electrolyte void fraction - E potential inside diaphragm (V) - F Faraday constant, 96487 (C mol^–1 of electrons) - F _j,i flux of ionic species i in the stagnant electrolyte inside small pores of layer j - H hydrostatic head (N m^–2) - i flux of current =j/F (mol m^–2s^–1) - j current density (A m^–2) - k _i,l constant representing diffusion in diaphragm (m²s^–1) - k ₂ constant representing migration in diaphragm (m^–1) - v _p hydraulic pore radius according to [15] (m) - N number of layers - N _j,i flux of ionic species i in layer j (mol m^–2s^–1) - P hydrodynamic permeability (m³ N^–1s^–1) - R gas constant, 8.3143 (J mol^–1 K^–1) - density of liquid (kg m^–3) - R ₀ electric resistivity of electrolyte (ohm m) - R _d electric resistivity of porous structure filled with electrolyte (ohm m) - R _m resistance of the diaphragm (ohm m²) - R _a resistance of anolyte layer (ohm m²) - R _e resistance of electrodes (ohm m²) - s specific surface of porous structure (m^–1) - s ₀ standard specific surface of solids in porous structure (m^–1) - tortuosity defined according toR _d/R ₀=/ - T absolute temperature (K) - u superficial liquid velocity (m s^–1) - U cell voltage (V) - dynamic viscosity (N s m^–2) - v kinematic viscosity (m²s^–1) - x diaphragm dimensional coordinate (m) - y radial coordinate inside pores (m) Paper presented at the meeting on Materials Problems and Material Sciences in Electrochemical Engineering Practice organised by the Working Party on Electrochemical Engineering of the European Federation of Chemical Engineers held at Maastricht, The Netherlands, September 17th and 18th 1987.