Microencapsulation of Juniper and Black Pepper Essential Oil Using the Coacervation Method and Its Properties after Freeze-Drying

Essential oils are mixtures of chemical compounds that are very susceptible to the effects of the external environment. Hence, more attention has been drawn to their preservation methods. The aim of the study was to test the possibility of using the classical model of complex coacervation for the microencapsulation of essential oils. Black pepper (Piper nigrum) and juniper (Juniperus communis) essential oils were dissolved in grape seed (GSO) and soybean (SBO) oil to minimize their loss during the process, and formed the core material. Various mixing ratios of polymers (gelatin (G), gum Arabic (GA)) were tested: 1:1; 1:2, and 2:1. The oil content was 10%, and the essential oil content was 1%. The prepared coacervates were lyophilized and then screened to obtain a powder. The following analyses were determined: encapsulation efficiency (EE), Carr index (CI), Hausner ratio (HR), solubility, hygroscopicity, moisture content, and particle size. The highest encapsulation efficiency achieved was within the range of 64.09-59.89%. The mixing ratio G/GA = 2:1 allowed us to obtain powders that were characterized by the lowest solubility (6.55-11.20%). The smallest particle sizes, which did not exceed 6 μm, characterized the powders obtained by mixing G/GA = 1:1. All powder samples were characterized by high cohesiveness and thus poor or very poor flow (CI = 30.58-50.27, HR = 1.45-2.01).

Surgical treatment of liver metastases from colorectal carcinoma in elderly patients. When is it worthwhile?

BACKGROUND

The elderly are under-represented in series of patients operated on for colorectal liver metastases (LM).

OBJECTIVE

To analyse the influence of age on surgery of colorectal LM, and the identification of factors that could be used as exclusion criteria.

PATIENTS AND METHODS

Six hundred and forty-eight patients underwent liver resection between 1990 and 2006. Demographic data, primary tumour related variables, stage of the disease, morbidity, mortality, survival and recurrence were prospectively recorded.

RESULTS

One hundred and sixty of 648 patients (25%) were 70 years old or older. Postoperative mortality was significantly higher in elderly patients (8% vs. 3%, p=0.008). Morbidity was also higher (41% vs. 34%, p=0.008). Survival rate at 1, 3 and 5 years was 88%, 62% and 45% respectively in patients younger than 70 years, and 82%, 48% and 36% in the elderly (p=0.007). Excluding the postoperative mortality, the figures were 90%, 64% and 46%. 90%, 53% and 38% (p=0.061). Disease-free survival rates at 1, 3 and 5 years excluding postoperative mortality were 68%, 32% and 25% in younger patients, compared to 68%, 34% and 30% (p=0.71) in the elderly. Major liver resections increased mortality in the elderly. In the multivariate analyses only a tumour size equal to or more than 10 cm significantly increased the postoperative mortality risk in elderly patients.

CONCLUSIONS

The elderly have a higher mortality. In recent years that difference has been markedly reduced. Excluding the postoperative mortality, the overall survival and disease-free survival are similar between both groups. The criteria to indicate surgery must be the same in both groups.

Mechanisms of induction of typical and reversed atrial flutter

INTRODUCTION

Typical flutter is due to reentry around caval veins and terminal crest. In patients with typical flutter, reversed (clockwise) reentry can be induced. We studied mechanisms of typical and reversed flutter induction.

METHODS AND RESULTS

Thirteen patients (11 men) underwent 16 radiofrequency (RF) ablation procedures for typical (12) or reversed flutter (1). High right atrium (RA) stimulation included 1 to 3 extrastimuli over cycle lengths 600 to 250 msec, and burst. We recorded simultaneously from three levels of septal and anterior RA. RF was delivered to the inferior vena cava-tricuspid isthmus (CTI). Of 25 inductions, 4 were a result of single, 9 double, and 11 triple extrastimuli, and 1 burst. Clinical basal flutter was induced (7 typical, 1 reversed). After RF, typical flutter was reinduced in 9 cases and reversed flutter in 7, with only typical flutter seen clinically. All flutters were interrupted by ablation or catheter pressure on the CTI. Typical flutter began by low RA septal activation block, preceded by repetitive responses in 12 instances, atypical flutter in 1, and directly from stimuli in 4. Reversed flutter started in 8 instances by low RA block of a stimulated front descending the anterior wall and in 1 by repetitive responses.

CONCLUSION

Septal activation block was the usual mechanism of typical flutter induction by RA extrastimuli. Facilitation of reversed flutter after RF application is probably due to a new area of block in the CTI. Flutter induction without intermediate rhythms confirms the presence of block at the terminal crest at baseline.

Atrial flutter mapping and ablation II. Radiofrequency ablation of atrial flutter circuits

The definition of the anatomical substrate of reentry in atrial flutter has allowed the recognition of narrow, critical areas of the circuit, where radiofrequency ablation can interrupt reentry. In common flutter the isthmus between the inferior vena cava and the tricuspid valve appears the best target, but ablation between the coronary sinus and tricuspid valve can also be effective in some cases. In atypical flutter using the same circuit as common flutter in a "clockwise" direction, ablation of the same isthmus is effective. Flutter interruption is the main objective, but it does not mean complete isthmus ablation. If flutter remains inducible, new applications are delivered in the isthmus, until it is made noninducible. Complications are rare. Despite attaining noninducibility, flutter may recur, and new procedures may be needed to prevent recurrence. Atrial fibrillation can occur in up to 30% of the cases during follow-up, but it is generally well controlled with antiarrhythmic drugs, that were ineffective to treat flutter before ablation. In reentry circuits based on surgical atrial scars, ablation of an isthmus between the scar and the inferior vena cava can also be effective. Left atrial circuits are not known well enough to guide successful ablation.