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Steblovnik K, Cercek M, Sustersic M, Terseglav S, Bunc M. Intravascular lithotripsy to facilitate transfemoral TAVI: a single-center experience. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Transfemoral is considered the approach of choice for transcatheter aortic valve implantation (TAVI) and improves clinical outcomes such as death or stroke compared to transaortic or transapical access. Intravascular lithotripsy (IVL) has enabled modification of calcified intimal and medial lesions to increase vascular wall compliance which might facilitate the transfemoral TAVI approach.
Purpose
To present a single-center experience with intravascular lithotripsy facilitating transfemoral TAVI approach.
Methods
A peripheral IVL catheter was used to perform lithotripsy of calcified iliofemoral stenosis. A 0.014" guidewire was used to guide the lithotripsy catheter with a balloon diameter of 5.0 or 6.0 mm. Inflating the balloon with 4–6 atm of pressure enabled apposition with the arterial wall and several cycles of 30 pulses have been performed at various locations of the iliofemoral arteries. IVL was planned in advance as primary strategy in case of ring or as baillout strategy in case of ring or excentric calcified periferial artery stenosis, respectively. The IVL was immediately followed by transfemoral TAVI. Retrograde data were collected for the purpose of this abstract.
Results
From December 2019 to December 2021 433 TAVI procedures were performed in the University Medical Centre Ljubljana. In 13 of the procedures (3%) IVL was used to facilitate the transfemoral approach. The mean minimal diameter of iliofemoral arteries was 5,2 mm with calcifications affecting at least three-quarters of arterial circumference in 92% and circular calcifications in 62% of cases. In all cases, IVL was performed in a common iliac artery or aortic bifurcation, while external iliac (15%) or femoral (8%) arteries were treated less often. A 5 mm IVL balloon was used in 2 (15%), and a 6 mm balloon in 9 (69%) cases, while a combination of 5 and 6 mm balloons was used in 2 (15%) cases. IVL and subsequent TAVI were successful in all the cases. No hospital mortality or major bleeding was observed. One patient needed one unit of blood transfusion due to loss during planned surgical preparation and closure of the puncture site. The puncture site was closed using a 2 Proglide technique and no conversion from percutaneous to surgical puncture site closure was needed. A self-expanding aortic prosthesis (Evolut R, Medtronic) was used in 11 (85%) and a balloon-expandable (Sapien 3, Edwards Lifesciences) in 2 (15%) cases.
Conclusion
In our experience IVL of iliofemoral arteries is a safe and effective method to facilitate transfemoral approach in TAVI, especially in cases of circular calcifications affecting the majority of arterial wall circumference.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- K Steblovnik
- University Medical Centre Ljubljana , Ljubljana , Slovenia
| | - M Cercek
- University Medical Centre Ljubljana , Ljubljana , Slovenia
| | - M Sustersic
- University Medical Centre Ljubljana , Ljubljana , Slovenia
| | - S Terseglav
- University Medical Centre Ljubljana , Ljubljana , Slovenia
| | - M Bunc
- University Medical Centre Ljubljana , Ljubljana , Slovenia
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Vitez L, Krajacic B, Starc V, Bunc M. P318Positive left ventricular remodeling after TAVI assessed by high resolution electrocardiography. Europace 2020. [DOI: 10.1093/europace/euaa162.201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Transcatheter aortic valve replacement (TAVI) is a novel treatment method for sever aortic stenosis that has a positive impact on reverse left ventricular (LV) remodeling. The morphology and function of the LV can be assessed by transthoracic echocardiography (TTE) and high resolution electrocardiography (HR-ECG).
Purpose
The purpose of our study was to investigate whether morphological and functional myocardial changes after TAVI seen on TTE can be tracked by advanced ECG parameters using HR-ECG.
Methods
Consecutive TAVI patients with transfemoral approach were included in this pilot prospective study. A 5 minute HR-ECG and TTE were performed before and one year after TAVI. Spatial QRS vector amplitude (3D_QRSm), total 12-lead QRS amplitude (12leadV), spatial QRS-T angle (QRST_aM) and spatial ventricular gradient (SVG) were measured using HR-ECG and interventricular septum diastolic diameter (IVSd), left posterior wall diameter (LVPWd), left ventricular ejection fraction (LVEF) and tissue Doppler peak septal systolic velocity (Sm) were obtained by TTE. Student"s test was used for pairs to analyze the differences in sets of variables before and after TAVI and Pearson correlation coefficient to analyze the relationship between TTE and HR-ECG parameters.
Results
15 patients (5 male; 33.3%) were included in the study. At one year follow-up we found statistically significant reduction in LV wall thickness and increase in LVEF (61.6 ± 6.50 % vs. 66.9 ± 7.84 %, p = 0.043). In the subgroup with narrow QRS (8 patients), we found a statistically significant correlation between change of left posterior wall thickness (deltaLVPW) and spatial QRS vector amplitude (delta3D_QRSm) (r = 0.795; p = 0.018), and between change of left ventricular ejection fraction (deltaLVEF) and spatial QRS-T angle (deltaQRST_aM) (r = 0.604; p = 0.038). No significant correlations were found in the subgroup of patients with wide QRS complex.
Conclusions
Our pilot study showed that morphological and functional myocardial changes after TAVI in patients with narrow QRS complex can be followed with advanced ECG parameters using HR-ECG. HR-ECG could prove to be a simple and inexpensive method of follow-up after TAVI in patients with narrow QRS. To ascertain the usefulness and reliability of HR-ECG, a study on a larger number of patients would be required.
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Affiliation(s)
- L Vitez
- University Medical Centre of Ljubljana, Ljubljana, Slovenia
| | - B Krajacic
- University of Ljubljana, Medical faculty, Ljubljana, Slovenia
| | - V Starc
- University of Ljubljana, Medical faculty, Ljubljana, Slovenia
| | - M Bunc
- University Medical Centre of Ljubljana, Ljubljana, Slovenia
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Abstract
1–Butanol is a colourless organic solvent with a rancid sweet odour. 1–Butanol ingestion may result in vomiting, abdominal pain, headache, drowsiness and unconsciousness. We present a 47–year–old male with no previous medical history, who was found comatose and soiled after having vomited while unconscious. On arrival, he had a Glasgow coma scale of 3, tachycardia, hypotension, shallow tachypnoic breathing, hypotonic muscles, absent myotatic reflexes and aromatic odour. The patient was intubated and treated with oxygen, dopamine and volume replacement therapy. Gastric lavage was performed and activated charcoal was given. His initial laboratory test revealed hypokaliemia, renal failure, acidosis with elevated lactate and hypercapnic respiratory insufficiency. Twelve hours after admission, the patient started to respond to a painful stimulus and 4 h later he was conscious. He was extubated 23 h after admission. All pathological laboratory results gradually returned within normal limits. The subsequent toxicological examination of gastric content and urine sample by gas chromatography revealed 1–butanol. On awakening, he confirmed ingestion of a solvent stored in an airport hangar. In conclusion, we describe a patient who ingested an unknown dose of 1–butanol. Symptoms were headache, vomiting, abdominal pain, coma, muscular hypotonus, hypotension, respiratory insufficiency and mixed acidosis. The patient totally recovered after supportive therapy over 30 h. In future cases, intravenous administration of ethanol or even hemodialysis can be considered analogous to the treatment of methanol and ethylene glycol poisoning.
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Affiliation(s)
- M Bunc
- Medical Faculty, Institute for Pathophysiology, Zaloska, Ljubljana, Slovenia
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Martins Fernandes S, Badano L, Garcia Campos A, Erdei T, Mehdipoor G, Hanboly N, Michalski BW, Vriz O, Mo VY, Le TT, Ribeiro JM, Ternacle J, Yurdakul SELEN, Shetye A, Stoebe S, Lisowska A, Chinali M, Orabona M, Contaldi C, De La Chica JA, Codolosa JN, Trzcinski P, Prado Diaz S, Morales Portano JD, Ha SJ, Valente F, Joseph G, Valente F, Scali MC, Cordeiro F, Duchateau N, Fabris E, Costantino MF, Cho IJ, Goublaire C, Lam W, Galli E, Kim KH, Mariani M, Malev E, Zuercher F, Tang Z, Cimino S, Mahia P, De La Chica JA, Petrovic J, Ciobotaru V, Remsey- Semmelweiss E, Kogoj P, Guerreiro S, Saxena A, Mozenska O, Pontone G, Macaya Ten F, Caballero L, Avegliano G, Halmai L, Reis L, Trifunovic D, Gospodinova M, Makavos G, D'ascenzi F, Dantas Tavares De Melo M, Bonapace S, Kulkarni A, Cameli M, Ingvarsson A, Driessen MMP, Tufekcioglu O, Radulescu D, Barac A, Cioffi G, Almeida Morais L, Ledakowicz-Polak A, Portugal G, Naksuk N, Parato VM, Kovalova S, Cherubini A, Corrado G, Malev E, 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Goncalves L, Wan FW, Sawaki DS, Dubois-Rande JLDR, Adnot SA, Czibik GC, Derumeaux GD, Ercan G, Tekkesin ILKER, Sahin ST, Cengiz B, Celik G, Demircan S, Aytekin SAIDE, Razvi NA, Nazir SA, Price N, Khan JN, Kanagala P, Singh A, Squire I, Mccann GP, Langel M, Pfeiffer D, Hagendorff A, Ptaszynska-Kopczynska K, Marcinkiewicz-Siemion M, Knapp M, Witkowski M, Musial WJ, Kaminski K, Natali B, D' Anna C, Leonardi B, Secinaro A, Pongiglione G, Rinelli G, Renard S, Michel N, Mancini J, Haentjens J, Sitbon O, Habib G, Imbriaco M, Alcidi G, Santoro C, Buonauro A, Lo Iudice F, Lembo M, Cuocolo A, Trimarco B, Galderisi M, Mora Robles J, Roldan Jimenez MA, Mancisidor MA, De Mora MA, Alnabelsi T, Goykhman I, Koshkelashvili N, Romero-Corral A, Pressman GS, Michalski BW, Kupczynska K, Miskowiec D, Lipiec P, Kasprzak JD, Montoro Lopez N, Refoyo Salicio E, Valbuena Lopez SC, Gonzalez O, Alvarez C, Moreno Yanguela M, Bartha Rasero JL, De La Calle M, Guzman Martinez G, Suarez-Cuenca JA, Merino JA, Gomez 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Donal E, Lim DS, Bianchi G, Rossi F, Gianetti J, Marchi F, Cerone E, Nardelli A, Terrazzi M, Solinas M, Maffei S, Pshepiy A, Vasina L, Timofeev E, Reeva S, Zemtsovsky E, Brugger N, Jahren S, De Marchi SF, Seiler C, Jin CN, Tang H, Fan K, Kam K, Yan BP, Yu CM, Lee PW, Reali M, Silvetti E, Salatino T, Mancone M, Pennacchi M, Giordano A, Sardella G, Agati L, Tirado G, Nogales-Romo MT, Marcos-Alberca P, De Agustin A, Almeria C, Rodrigo JL, Garcia Fernandez MA, Macaya C, Perez De Isla L, Mancisidor M, Lara Garcia C, Vivancos R, De Mora M, Petrovic M, Vujisic-Tesic B, Trifunovic D, Boricic-Kostic M, Petrovic I, Draganic G, Petrovic O, Tomic-Dragovic M, Furlan T, Ambrozic J, Mohorko Pleskovic PN, Bunc M, Ribeiras R, Abecasis J, Andrade MJ, Mendes M, Ramakrishnan S, Gupta SK, Juneja R, Kothari SS, Zaleska M, Segiet A, Chwesiuk S, Kroc A, Kosior DA, Andreini D, Solbiati A, Guglielmo M, Mushtaq S, Baggiano A, Beltrama V, Rota C, Guaricci AI, Pepi M, Pons Llinares J, Asmarats Serra L, Pericas 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Poster session 2THE IMAGING EXAMINATIONP536Appropriate use criteria of transthoracic echocardiography and its clinical impact: a continuous challengeP537Implementation of proprietary plug-ins in the DICOM-based computerized echo reporting system fuels the use of 3D echo and deformation imaging in the clinical routine of a multivendor laboratoryP538Exercise stress echocardiography appropriate use criteria: real-life cases classification ease and agreement among cardiologistsANATOMY AND PHYSIOLOGY OF THE HEART AND GREAT VESSELSP539Functional capacity in older people with normal ejection fraction correlates with left ventricular functional reserve and carotid-femoral pulse wave velocity but not with E/e and augmentation indexP540Survey of competency of practitioners for diagnosis of acute cardiopulmonary diseases manifest on chest x-rayASSESSMENT OF DIAMETERS, VOLUMES AND MASSP541Left atrium remodeling in dialysis patients with normal ejection fractionP542The prediction of postinfarction left ventricular remodeling and the role of of leptin and MCP-1 in regard to the presence of metabolic syndromeP543Ascending aorta and common carotid artery: diameters and stiffness in a group of 584 healthy subjectsAssessments of haemodynamicsP544Alternate echo parameters in patients without estimable RVSPAssessment of systolic functionP545Reduced contractile performance in heart failure with preserved ejection fraction: determination using novel preload-adjusted maximal left ventricular ejection forceP546Left ventricular dimensions and prognosis in acute coronary syndromesP547Time course of myocardial alterations in a murine model of high fat diet: A strain rate imaging studyP548Subclinical left ventricular systolic dysfunction in patients with premature ventricular contractionsP549Global myocardial strain by CMR-based feature tracking (FT) and tagging to predict development of severe left ventricular systolic dysfunction after acute st-elevation myocardial infarctionP550Echocardiographic analysis of left and right ventricular function in patients after mitral valve reconstructionP551The role of regional longitudinal strain assessment in predicting response to cardiac resynchronization therapy in patients with left ventricular systolic dysfunction and left bundle branch blockP552Speckle tracking automatic border detection improves echocardiographic evaluation of right ventricular systolic function in repaired tetralogy of fallot patients: comparison with MRI findingsP553Echocardiography: a reproducible and relevant tool in pah? intermediate results of the multicentric efort echogardiographic substudy (evaluation of prognostic factors and therapeutic targets in pah)Assessment of diastolic functionP554Relationship between left ventricular filling pressures and myocardial fibrosis in patients with uncomplicated arterial hypertensionP555Cardiac rehabilitation improves echocardiographic parameters of diastolic function in patients with ischemic heart diseaseP556Diastolic parameters in the calcified mitral annulusP557Biomarkers and echocardiography - combined weapon to diagnose and prognose heart failure with and without preserved ejection fractionP558Diastolic function changes of the maternal heart in twin and singleton pregnancyIschemic heart diseaseP559Syntax score as predictor for the correlation between epicardial adipose tissue and the severity of coronary lesions in patients with significant coronary diseaseP560Impact of strain analysis in ergonovine stress echocardiography for diagnosis vasospastic anginaP561Cardiac magnetic resonance tissue tracking: a novel method to predict infarct transmurality in acute myocardial infarctionP562Infarct size is correlated to global longitudinal strain but not left ventricular ejection fraction in the early stage of acute myocardial infarctionP563Magnetic resonance myocardial deformation assessment with tissue tracking and risk stratification in acute myocardial infarction patientsP564Increase in regional end-diastolic wall thickness by transthoracic echocardiography as a biomarker of successful reperfusion in anterior ST elevation acute myocardial infarctionP565Mitral regurgitation is associated with worse long-term prognosis in ST-segment elevation myocardial infarction treated with primary percutaneous coronary interventionP566Statistical significance of 3D motion and deformation indexes for the analysis of LAD infarctionHeart valve DiseasesP567Paradoxical low gradient aortic stenosis: echocardiographic progression from moderate to severe diseaseP568The beneficial effects of TAVI in mitral insufficiencyP569Impact of thoracic aortic calcification on the left ventricular hypertrophy and its regression after aortic valve replacement in patients with severe aortic stenosisP570Additional value of exercise-stress echocardiography in asymptomatic patients with aortic valve stenosisP571Valvulo-arterial impedance in severe aortic stenosis: a dual imaging modalities studyP572Left ventricular mechanics: novel tools to evaluate left ventricular performance in patients with aortic stenosisP573Comparison of long-term outcome after percutaneous mitral valvuloplasty versus mitral valve replacement in moderate to severe mitral stenosis with left ventricular dysfunctionP574Incidence of de novo left ventricular dysfunction in patient treated with aortic valve replacement for severe aortic regurgitationP575Transforming growth factor-beta dependant progression of the mitral valve prolapseP576Quantification of mitral regurgitation with multiple jets: in vitro validation of three-dimensional PISA techniqueP577Impaired pre-systolic contraction and saddle-shape deepening of mitral annulus contributes to atrial functional regurgitation: a three-dimensional echocardiographic studyP578Incidence and determinants of left ventricular (lv) reverse remodeling after MitraClip implantation in patients with moderate-to severe or severe mitral regurgitation and reduced lv ejection fractionP579Severe functional tricuspid regurgitation in rheumatic heart valve disease. New insights from 3D transthoracic echocardiographyP58015 years of evolution of the etiologic profile for prosthetic heart valve replacement through an echocardiography laboratoryP581The role of echocardiography in the differential diagnosis of prolonged fever of unknown originP582Predictive value for paravalvular regurgitation of 3-dimensional anatomic aortic annulus shape assessed by multidetector computed tomography post-transcatheter aortic valve replacementP583The significance and advantages of echo and CT imaging & measurement at transcatherter aortic valve implantation through the left common carotid accessP584Comparison of the self-expandable Medtronic CoreValve versus the balloon-expandable Edwards SAPIEN bioprostheses in high-risk patients undergoing transfemoral aortic valve implantationP585The impact of transcatheter aortic valve implantation on mitral regurgitation severityP586Echocardiographic follow up of children with valvular lesions secondary to rheumatic heart disease: Data from a prospective registryP587Valvular heart disease and different circadian blood pressure profilesCardiomyopathiesP588Comparison of transthoracic echocardiography versus cardiac magnetic for implantable cardioverter defibrillator therapy in primary prevention strategy dilated cardiomyopathy patientsP589Incidence and prognostic significance of left ventricle reverse remodeling in a cohort of patients with idiopathic dilated cardiomyopathyP590Early evaluation of diastolic function in fabry diseaseP591Echocardiographic predictors of atrial fibrillation development in hypertrophic cardiomyopathyP592Altered Torsion mechanics in patients with hypertrophic cardiomyopathy: LVOT-obstruction is the topdog?P593Prevention of sudden cardiac death in hypertrophic cardiomyopathy: what has changed in the guidelines?P594Coronary microcirculatory function as determinator of longitudinal systolic left ventricular function in hypertrophic cardiomyopathyP595Detection of subclinical myocardial dysfunction by tissue Doppler ehocardiography in patients with muscular dystrophiesP596Speckle tracking myocardial deformation analysis and three dimensional echocardiography for early detection of chemotherapy induced cardiac dysfunction in bone marrow transplantation patientsP597Left ventricular non compaction or hypertrabeculation: distinguishing between physiology and pathology in top-level athletesP598Role of multi modality imaging in familiar screening of Danon diseaseP599Early impairment of global longitudinal left ventricular systolic function independently predicts incident atrial fibrillation in type 2 diabetes mellitusP600Fetal cardiovascular programming in maternal diabetes mellitus and obesity: insights from deformation imagingP601Longitudinal strain stress echo evaluation of aged marginal donor hearts: feasibility in the Adonhers project.P602Echocardiographic evaluation of left ventricular size and function following heart transplantation - Gender mattersSystemic diseases and other conditionsP603The impact of septal kinetics on adverse ventricular-ventricular interactions in pulmonary stenosis and pulmonary arterial hypertensionP604Improvement in right ventricular mechanics after inhalation of iloprost in pulmonary hypertensionP605Does the treatment of patients with metabolic syndrome correct the right ventricular diastolic dysfunction?P606Predictors of altered cardiac function in breast cancer survivors who were treated with anthracycline-based therapyP607Prevalence and factors related to left ventricular systolic dysfunction in asymptomatic patients with rheumatoid arthritis: a prospective tissue-doppler echocardiography studyP608Diastolic and systolic left ventricle dysfunction presenting different prognostic implications in cardiac amyloidosisP609Diagnostic accuracy of Bedside Lung Ultrasonography in Emergency (BLUE) protocol for the diagnosis of pulmonary embolismP610Right ventricular systolic dysfunction and its incidence in breast cancer patients submitted to anthracycline therapyP611Right ventricular dysfunction is an independent predictor of survival among cirrhotic patients undergoing liver transplantCongenital heart diseaseP612Hypoplasia or absence of posterior leaflet: a rare congenital anomaly of the mitral valveP613ECHO screening for Barlow disease in proband's relativesDiseases of the aortaP614Aortic size distribution and prognosis in an unselected population of patients referred for standard transthoracic echocardiographyP615Abdominal aorta aneurysm ultrasonographic screening in a large cohort of asympromatic volounteers in an Italian urban settingP616Thoracic aortic aneurysm and left ventricular systolic functionStress echocardiographyP617Wall motion score index, systolic mitral annulus velocity and left ventricular mass predicted global longitudinal systolic strain in 238 patients examined by stress echocardiographyP618Prognostic parameters of exercise-induced severe mitral valve regurgitation and exercise-induced systolic pulmonary hypertensionP619Risk stratification after myocardial infarction: prognostic value of dobutamine stress echocardiographyP620relationship between LV and RV myocardial contractile reserve and metabolic parameters during incremental exercise and recovery in healthy children using 2-D strain analysisP621Increased peripheral extraction as a mechanism compensatory to reduced cardiac output in high risk heart failure patients with group 2 pulmonary hypertension and exercise oscillatory ventilationP622Can exercise induced changes in cardiac synchrony predict response to CRT?Transesophageal echocardiographyP623Fully-automated software for mitral valve assessment in chronic mitral regurgitation by three-dimensional transesophageal echocardiographyP624Real-time 3D transesophageal echocardiography provides more accurate orifice measurement in percutaneous transcatheter left atrial appendage closureP625Percutaneous closure of left atrial appendage: experience of 36 casesReal-time three-dimensional TEEP626Real-time three-dimensional transesophageal echocardiography during pulmonary vein cryoballoon ablation for atrial fibrilationP627Three dimensional ultrasound anatomy of intact mitral valve and in the case of type 2 disfunctionTissue Doppler and speckle trackingP629Left ventricle wall motion tracking from echocardiographic images by a non-rigid image registrationP630The first experience with the new prototype of a robotic system for remote echocardiographyP631Non-invasive PCWP influence on a loop diuretics regimen monitoring model in ADHF patients.P632Normal range of left ventricular strain, dimensions and ejection fraction using three-dimensional speckle-tracking echocardiography in neonatesP633Circumferential ascending aortic strain: new parameter in the assessment of arterial stiffness in systemic hypertensionP634Aortic vascular properties in pediatric osteogenesis imperfecta: a two-dimensional echocardiography derived aortic strain studyP635Assessment of cardiac functions in children with sickle cell anemia: doppler tissue imaging studyP636Assessment of left ventricular function in type 1 diabetes mellitus patients by two-dimensional speckle tracking echocardiography: relation to duration and control of diabetesP637A study of left ventricular torsion in l-loop ventricles using speckle-tracking echocardiographyP638Despite No-Reflow, global and regional longitudinal strains assessed by two-dimensional speckle tracking echocardiography are predictive indexes of left ventricular remodeling in patients with STEMIP639The function of reservoir of the left atrium in patients with medicaly treated arterial hypertensionP640The usefulness of speckle tracking analysis for predicting the recovery of regional systolic function after myocardial infarctionP641Two dimensional speckle tracking echocardiography in assessment of left ventricular systolic function in patients with rheumatic severe mitral regurgitation and normal ejection fractionP642The prediction of left-main and tripple vessel coronary artery disease by tissue doppler based longitudinal strain and strain rate imagingP643Role of speckle tracking in predicting arrhythmic risk and occurrence of appropriate implantable defibrillator Intervention in patients with ischemic and non-ischemic cardiomyopathyComputed Tomography & Nuclear CardiologyP644Cardiac adrenergic activity in patients with nonischemic dilated cardiomyopathy. Correlation with echocardiographyP645Different vascular territories and myocardial ischemia, there is a gradient of association? Eur Heart J Cardiovasc Imaging 2015. [DOI: 10.1093/ehjci/jev278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Korošec B, Sova M, Turk S, Kraševec N, Novak M, Lah L, Stojan J, Podobnik B, Berne S, Zupanec N, Bunc M, Gobec S, Komel R. Antifungal activity of cinnamic acid derivatives involves inhibition of benzoate 4-hydroxylase (CYP53). J Appl Microbiol 2014; 116:955-66. [PMID: 24314266 DOI: 10.1111/jam.12417] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2013] [Revised: 11/06/2013] [Accepted: 11/25/2013] [Indexed: 11/27/2022]
Abstract
AIMS CYP53A15, from the sorghum pathogen Cochliobolus lunatus, is involved in detoxification of benzoate, a key intermediate in aromatic compound metabolism in fungi. Because this enzyme is unique to fungi, it is a promising drug target in fungal pathogens of other eukaryotes. METHODS AND RESULTS In our work, we showed high antifungal activity of seven cinnamic acid derivatives against C. lunatus and two other fungi, Aspergillus niger and Pleurotus ostreatus. To elucidate the mechanism of action of cinnamic acid derivatives with the most potent antifungal properties, we studied the interactions between these compounds and the active site of C. lunatus cytochrome P450, CYP53A15. CONCLUSION We demonstrated that cinnamic acid and at least four of the 42 tested derivatives inhibit CYP53A15 enzymatic activity. SIGNIFICANCE AND IMPACT OF THE STUDY By identifying selected derivatives of cinnamic acid as possible antifungal drugs, and CYP53 family enzymes as their targets, we revealed a potential inhibitor-target system for antifungal drug development.
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Affiliation(s)
- B Korošec
- National Institute of Chemistry, Ljubljana, Slovenia
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Gong L, Ye Z, Zeng Z, Xia M, Zhong Y, Yao Y, Lee E, Ionescu A, Dwivedi G, Mahadevan G, Jiminez D, Frenneaux M, Steeds R, Moore C, Samad Z, Jackson K, Castellucci J, Kisslo J, Von Ramm O, D'ascenzi F, Zaca' V, Cameli M, Lisi M, Natali B, Malandrino A, Mondillo S, Barbier P, Guerrini U, Franzosi M, Castiglioni L, Nobili E, Colazzo F, Li Causi T, Sironi L, Tremoli E, Clausen H, Macdonald S, Basaggianis C, Newton J, Cameli M, Lisi M, Bennati E, Reccia R, Malandrino A, Bigio E, Maccherini M, Chiavarelli M, Henein M, Mondillo S, Floria M, Jamart J, Arsenescu Georgescu C, Mantovani F, Barbieri A, Bursi F, Valenti C, Quaglia M, Modena M, Kutty S, Gribben P, Padiyath A, Polak A, Scott C, Waiss M, Danford D, Bech-Hanssen O, Selimovic N, Rundqvist B, Schmiedel L, Hohmann C, Katzke S, Haacke K, Rauwolf T, Strasser R, Tumasyan LR, Adamyan K, Kosmala W, Derzhko R, Przewlocka-Kosmala M, Mysiak A, Stachowska B, Jedrzejuk D, Bednarek-Tupikowska G, Chrzanowski L, Kasprzak J, Wojciechowska C, Wita K, Busz-Papiez B, Gasior Z, Mizia-Stec K, Kukulski T, Gosciniak P, Sinkiewicz W, Moelmen H, Stoylen A, Thorstensen A, Torp H, Dalen H, Groves A, Nicholson G, Lopez L, Goh CW, Ahn H, Byun Y, Kim J, Park J, Lee J, Park J, Kim B, Rhee K, Kim K, Park J, Yoon H, Hong Y, Park H, Kim J, Ahn Y, Jeong M, Cho J, Kang J, Grapsa J, Dawson D, Karfopoulos K, Jakaj G, Punjabi P, Nihoyannopoulos P, Ruisanchez Villar C, Lerena Saenz P, Gonzalez Vilchez F, Gonzalez Fernandez C, Zurbano Goni F, Cifrian Martinez J, Mons Lera R, Ruano Calvo J, Martin Duran R, Vazquez De Prada Tiffe J, Pietrzak R, Werner B, Voillot D, Huttin O, Zinzius P, Schwartz J, Sellal J, Lemoine S, Christophe C, Popovic B, Juilliere Y, Selton-Suty C, Ishii K, Furukawa A, Nagai T, Kataoka K, Seino Y, Shimada K, Yoshikawa J, Tekkesin A, Yildirimturk O, Tayyareci Y, Yurdakul S, Aytekin S, Jaroch J, Loboz-Grudzien K, Bociaga Z, Kowalska A, Kruszynska E, Wilczynska M, Dudek K, Kakihara R, Naruse C, Hironaka H, Tsuzuku T, Cucchini U, Muraru D, Badano L, Solda' E, Tuveri M, Al Nono O, Sarais C, Iliceto S, Santos L, Cortez-Dias N, Ribeiro S, Goncalves S, Jorge C, Carrilho-Ferreira P, Silva D, Silva-Marques J, Lopes M, Diogo A, Hristova K, Vassilev D, Pavlov P, Katova T, Simova I, Kostova V, Esposito R, Santoro A, Schiano Lomoriello V, Raia R, De Palma D, Dores E, De Simone G, Galderisi M, Zaborska B, Makowska E, Pilichowska E, Maciejewski P, Bednarz B, Wasek W, Stec S, Budaj A, Spinelli L, Morisco C, Assante Di Panzillo E, Crispo S, Di Marino S, Trimarco B, Santoro A, Schiano Lomoriello V, Esposito R, Farina F, Innelli P, Rapacciuolo A, Galderisi M, Polgar B, Banyai F, Rokusz L, Tomcsanyi I, Vaszily M, Nieszner E, Borsanyi T, Kerecsen G, Preda I, Kiss RG, Bull S, Suttie J, Augustine D, Francis J, Karamitsos T, Becher H, Prendergast B, Neubauer S, Myerson S, Lodge F, Broyd C, Milton P, Mikhail G, Mayet J, Davies J, Francis D, Clavel MA, Ennezat PV, Marechaux S, Dumesnil J, Bellouin A, Bergeron S, Meimoun P, Le Tourneau T, Pasquet A, Pibarot P, Herrmann S, Stoerk S, Niemann M, Hu K, Voelker W, Ertl G, Weidemann F, Tayyareci Y, Yurdakul S, Yildirimturk O, Aytekin V, Aytekin S, Kogoj P, Ambrozic J, Bunc M, Di Salvo G, Rea A, Castaldi B, Gala S, D'aiello A, Mormile A, Pisacane F, Pacileo G, Russo M, Calabro R, Nguyen L, Ricksten SE, Jeppsson A, Schersten H, Bech-Hanssen O, Boerlage-Van Dijk K, Yong Z, Bouma B, Koch K, Vis M, Piek J, Baan J, Scandura S, Ussia G, Caggegi A, Cammalleri V, Sarkar K, Mangiafico S, Chiaranda' M, Imme' S, Pistritto A, Tamburino C, Ring L, Nair S, Wells F, Shapiro L, Rusk R, Rana B, Madrid Marcano G, Solis Martin J, Gonzalez Mansilla A, Bravo L, Menarguez Palanca C, Munoz P, Bouza E, Yotti R, Bermejo Thomas J, Fernandez Aviles F, Tamayo T, Denes M, Balint O, Csepregi A, Csillik A, Erdei T, Temesvari A, Fernandez-Pastor J, Linde-Estrella A, Cabrera-Bueno F, Pena-Hernandez J, Barrera-Cordero A, Alzueta-Rodriguez F, De Teresa-Galvan E, Merlo M, Pinamonti M, Finocchiaro G, Pyxaras S, Barbati G, Buiatti A, Dilenarda A, Sinagra G, Kuperstein R, Freimark D, Hirsch S, Feinberg M, Arad M, Mitroi C, Garcia Lunar I, Monivas Palomero V, Mingo Santos S, Beltran Correas P, Gonzalez Lopez E, Garcia Pavia P, Gonzalez Mirelis J, Cavero Gibanel M, Alonso Pulpon L, Finocchiaro G, Pinamonti B, Merlo M, Barbati G, Dilenarda A, Sinagra G, Zaidi A, Ghani S, Sheikh N, Gati S, Howes R, Sharma R, Sharma S, Calcagnino M, O'mahony C, Coats C, Cardona M, Garcia A, Murphy E, Lachmann R, Mehta A, Hughes D, Elliott P, Di Bella G, Madaffari A, Donato R, Mazzeo A, Casale M, Zito C, Vita G, Carerj S, Marek D, Indrakova J, Rusinakova Z, Skala T, Kocianova E, Taborsky M, Musca F, De Chiara B, Belli O, Cataldo S, Brunati C, Colussi G, Quattrocchi G, Santambrogio G, Spano F, Moreo A, Rustad L, Nytroen K, Gullestad L, Amundsen B, Aakhus S, Maroz-Vadalazhskaya N, Shumavetc V, Kurganovich S, Seljun Y, Ostrovskiy A, Ostrovskiy Y, Rustad L, Nytroen K, Segers P, Amundsen B, Aakhus S, Przewlocka-Kosmala M, Orda A, Karolko B, Mysiak A, Driessen MMP, Eising JB, Uiterwaal C, Van Der Ent CK, Meijboom FJ, Shang Q, Tam L, Sun J, Sanderson J, Zhang Q, Li E, Yu C, Arroyo Ucar E, De La Rosa Hernandez A, Hernandez Garcia C, Jorge Perez P, Lacalzada Almeida J, Jimenez Rivera J, Duque Garcia A, Barragan Acea A, Laynez Cerdena I, Kaldararova M, Simkova I, Pacak J, Tittel P, Masura J, Tadic M, Ivanovic B, Zlatanovic M, Damjanov N, Maggiolini S, Gentile G, Bozzano A, Suraci S, Meles E, Carbone C, Tempesta A, Malafronte C, Piatti L, Achilli F, Luijendijk P, Stevens A, De Bruin-Bon H, Vriend J, Van Den Brink R, Vliegen H, Mulder B, Bouma B, Chow V, Ng A, Chung T, Kritharides L, Iancu M, Serban M, Craciunescu I, Hodo A, Ghiorghiu I, Popescu B, Ginghina C, Styczynski G, Szmigielski CA, Kaczynska A, Leszczynski J, Rosinski G, Kuch-Wocial A, Slavich M, Ancona M, Fisicaro A, Oppizzi M, Marone E, Bertoglio L, Melissano G, Margonato A, Chiesa R, Agricola E, Zito C, Mohammed M, Cusma-Piccione M, Piluso S, Arcidiaco S, Nava R, Giuffre R, Ciraci L, Ferro M, Carerj S, Uusitalo V, Luotolahti M, Pietila M, Wendelin-Saarenhovi M, Hartiala J, Saraste M, Knuuti J, Saraste A, Kochanowski J, Scislo P, Piatkowski R, Grabowski M, Marchel M, Roik M, Kosior D, Opolski G, Bartko PE, Graf S, Khorsand A, Rosenhek R, Burwash I, Beanlands R, Clavel MA, Baumgartner H, Pibarot P, Mundigler G, Kudrnova S, Apor A, Huttl H, Kudrnova S, Apor A, Huttl H, Mori F, Santoro G, Oddo A, Rosso G, Meucci F, Pieri F, Squillantini G, Gensini G, Scislo P, Kochanowski J, Piatkowski R, Roik M, Postula M, Opolski G, Park DG, Hong JY, Kim SE, Lee JH, Han KR, Oh DJ, Muraru D, Dal Bianco L, Beraldo M, Solda' E, Cucchini U, Peluso D, Tuveri M, Al Mamary A, Badano L, Iliceto S, Aggeli C, Felekos I, Poulidakis E, Pietri P, Roussakis G, Siasos G, Stefanadis C, Furukawa A, Hoshiba H, Miyasaka C, Sato H, Nagai T, Yamanaka A, Kataoka K, Seino Y, Ishii K, Lilli A, Baratto M, Magnacca M, Comella A, Poddighe R, Talini E, Canale M, Chioccioli M, Del Meglio J, Casolo G, Kuznetsov VA, Melnikov NN, Krinochkin DV, Calin A, Enache R, Popescu B, Beladan C, Rosca M, Lupascu L, Purcarea F, Calin C, Gurzun M, Ginghina C, Dulgheru R, Ciobanu A, Magda S, Mihaila S, Rimbas R, Margulescu A, Cinteza M, Vinereanu D, Sumin AN, Arhipov O, Yoon J, Moon J, Rim S, Nyktari E, Patrianakos A, Solidakis G, Psathakis E, Parthenakis F, Vardas P, Kordybach M, Kowalski M, Kowalik E, Hoffman P, Nagy KV, Kutyifa V, Edes E, Apor A, Merkely B, Gerlach A, Rost C, Schmid M, Rost M, Flachskampf F, Daniel W, Breithardt O, Altekin E, Karakas S, Yanikoglu A, Er A, Baktir A, Demir I, Deger N, Klitsie L, Hazekamp M, Roest A, Van Der Hulst A, Gesink- Van Der Veer B, Kuipers I, Blom N, Ten Harkel A, Farsalinos K, Tsiapras D, Kyrzopoulos S, Avramidou E, Vasilopoulou D, Voudris V, Werner B, Florianczyk T, Ivanovic B, Tadic M, Kalinowski M, Szulik M, Streb W, Rybus-Kalinowska B, Sliwinska A, Stabryla J, Kukla M, Nowak J, Kukulski T, Kalarus Z, Florescu M, Mihalcea D, Magda L, Suran B, Enescu O, Mincu R, Cinteza M, Vinereanu D, Salerno G, Scognamiglio G, D'andrea A, Dinardo G, Gravino R, Sarubbi B, Disalvo G, Pacileo G, Russo M, Calabro R, Liao JN, Sung S, Chen C, Park S, Shin S, Kim M, Shim S, Yildirimturk O, Helvacioglu F, Ulusoy O, Duran C, Tayyareci Y, Yurdakul S, Aytekin S, Kirschner R, Simor T, Moreo A, Ambrosio G, De Chiara B, Tran T, Raman S, Vidal Perez RC, Carreras F, Leta R, Pujadas S, Barros A, Hidalgo A, Alomar X, Pons-Llado G, Olofsson M, Boman K, Ledakowicz-Polak A, Polak L, Zielinska M, Fontana A, Schirone V, Mauro A, Zambon A, Giannattasio C, Trocino G, Dekleva M, Dungen H, Inkrot S, Gelbrich G, Suzic Lazic J, Kleut M, Markovic Nikolic N, Waagstein F, Khoor S, Balogh N, Simon I, Fugedi K, Kovacs I, Khoor M, Florian G, Kocsis A, Szuszai T, O'driscoll J, Saha A, Smith R, Gupta S, Sharma R, Lenkey Z, Gaszner B, Illyes M, Sarszegi Z, Horvath IG, Magyari B, Molnar F, Cziraki A, Elnoamany MF, Badran H, Ebraheem H, Reda A, Elsheekh N. Poster Session 5: Saturday 10 December 2011, 08:30-12:30 * Location: Poster Area. European Journal of Echocardiography 2011. [DOI: 10.1093/ejechocard/jer218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Kogoj P, Ambrozic J, Zorman D, Bunc M. OP-108: PERCUTANEOUS CORONARY INTERVENTION AND BALLOON AORTIC VALVULOPLASTY IN SEVERE AORTIC STENOSIS AND CORONARY ARTERY DISEASE IN ELDERLY. Int J Cardiol 2011. [DOI: 10.1016/s0167-5273(11)70191-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Vrtovec B, Poglajen G, Sebestjen M, Okrajsek R, Bunc M, Cernelc P, Sever M, Domanovic D, Torre-Amione G. 157: Early Benefits of Intracoronary CD34+ Stem Cell Transplantation in Patients with Dilated Cardiomyopathy Are Sustained over Time. J Heart Lung Transplant 2009. [DOI: 10.1016/j.healun.2008.11.164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Stor Z, Jelenc F, Juvan R, Omejc M, Bunc M, Repse S. Improved outcome of patients with colorectal cancer: the Ljubljana University Medical Centre experience. Dig Surg 2008; 25:158-63. [PMID: 18463413 DOI: 10.1159/000129722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2007] [Accepted: 12/08/2007] [Indexed: 12/10/2022]
Abstract
BACKGROUND/AIMS Analysis of outcome in patients undergoing resection for colorectal carcinoma. METHODS Between 1/1/1991 and 31/12/2000, 1,478 patients with a colon and rectal carcinoma underwent a potentially curative resection. The results were analyzed for two groups of patients given different treatment regimens during two consecutive 5-year periods. The 5-year survival rate was estimated by the Kaplan-Meier method. RESULTS Over a period of 10 years, 1,478 patients were treated by resection. The 5-year survival rate for R0 resected patients with stage I and stage III colon cancer in the period 1996-2000 was significantly higher than for patients operated on between 1991 and 1995 (stage I: 86 vs. 70%; stage III: 58 vs. 40%). Similarly, the 5-year survival rate for R0 resected patients with stage III rectal cancer between 1996 and 2000 was significantly better than that for patients operated on during the early period (58 vs. 31%). CONCLUSIONS Patients who underwent R0 resection for colorectal cancer during the period 1995-2000 showed a significantly improved 5-year survival rate compared to those operated on between 1991 and 1995. Improved survival in these patients is to a great extent attributable to improvements in clinical practice combining surgery and adjuvant therapy.
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Affiliation(s)
- Z Stor
- Department of Abdominal Surgery, University Medical Centre Ljubljana, Ljubljana, Slovenia.
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Abstract
1-Propanol and 2-propanol are isomers of an alcohol with three carbons. They are colorless liquids with a sweet odor. 1-Propanol is metabolized by alcohol dehydrogenase to propionic acid and presents with metabolic acidosis and elevated anion gap, whereas 2-propanol is metabolized by alcohol dehydrogenase to acetone and presents with rapidly developing (within 3-4 h after exposure) ketosis and ketonuria but without metabolic acidosis. We report a patient who simultaneously ingested a lethal dose of 1-propanol and 2-propanol as a hand disinfectant in hospital. The patient lost consciousness and stopped breathing within half an hour after ingestion. He was intubated and artificially ventilated. Initial laboratory results showed mixed acidosis with elevated anion gap, but ketonuria appeared only 12 h after admission and 6 h following the regaining of consciousness. Therefore, laboratory results in simultaneous poisoning with two isomers of alcohol are not just a sum of laboratory results obtained in isolated poisoning with each isomer because they influence each other's metabolism: 1-propanol retards the metabolism of 2-propanol to acetone. In conclusion, 1-propanol and 2-propanol poisoning presents early with mixed acidosis and elevated anion gap and only later with ketonuria.
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Affiliation(s)
- M Vujasinovic
- Department of Internal Medicine, Topolsica Hospital, Topolsica, Slovenia
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Vrtovec B, Zemljic G, Bunc M, Yazdanbakhsh A. 82. J Heart Lung Transplant 2006. [DOI: 10.1016/j.healun.2005.11.086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Abstract
The superficial regions of the left vagus nerves of a dog were selectively stimulated with 39-electrode spiral cuffs having 13 circumferential groups of three electrodes (GTE) to modulate the function of the innervated internal organs and glands. Under general anaesthesia, the cuffs were chronically implanted around the nerve in the neck in two adult Beagle dogs and remained viable for 16 months. The regions were stimulated with biphasic, rectangular current pulses (2 mA, 200 micros, 20 Hz) delivered to the group of GTE lying close to the region innervating the specific internal organs or glands. The results showed that specific electrode configurations had actions on the heart (GTE 9), lungs (GTE 4) and pressure in the urinary bladder (GTE 1). It was also shown that GTE no. 10 significantly modified the endocrine function of the pancreas. The results of this study clearly demonstrate that internal organs and glands can be selectively stimulated via the selective stimulation of innervating superficial regions of the autonomous peripheral nerve.
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Affiliation(s)
- J Rozman
- ITIS d.o.o. Ljubljana, Center for Implantable Technology and Sensors, Lepi pot 11, 1000 Ljubljana, Republic of Slovenia.
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Rozman J, Bunc M, Zorko B. Modulation of hormone secretion by functional electrical stimulation of the intact and incompletely dysfunctional dog pancreas. Braz J Med Biol Res 2004; 37:363-70. [PMID: 15060704 DOI: 10.1590/s0100-879x2004000300012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The purpose of the present study was to modulate the secretion of insulin and glucagon in Beagle dogs by stimulation of nerves innervating the intact and partly dysfunctional pancreas. Three 33-electrode spiral cuffs were implanted on the vagus, splanchnic and pancreatic nerves in each of two animals. Partial dysfunction of the pancreas was induced with alloxan. The nerves were stimulated using rectangular, charge-balanced, biphasic, and constant current pulses (200 micros, 1 mA, 20 Hz, with a 100-micros delay between biphasic phases). Blood samples from the femoral artery were drawn before the experiment, at the beginning of stimulation, after 5 min of stimulation, and 5 min after the end of stimulation. Radioimmunoassay data showed that in the intact pancreas stimulation of the vagal nerve increased insulin (+99.2 microU/ml) and glucagon (+18.7 pg/ml) secretion and decreased C-peptide secretion (-0.15 ng/ml). Splanchnic nerve stimulation increased insulin (+1.7 microU/ml), C-peptide (+0.01 ng/ml), and glucagon (+50 pg/ml) secretion, whereas pancreatic nerve stimulation did not cause a marked change in any of the three hormones. In the partly dysfunctional pancreas, vagus nerve stimulation increased insulin (+15.5 microU/ml), glucagon (+11 pg/ml), and C-peptide (+0.03 ng/ml) secretion. Splanchnic nerve stimulation reduced insulin secretion (-2.5 microU/ml) and increased glucagon (+58.7 pg/ml) and C-peptide (+0.39 ng/ml) secretion, and pancreatic nerve stimulation increased insulin (+0.2 microU/ml), glucagon (+5.2 pg/ml), and C-peptide (+0.08 ng/ml) secretion. It was concluded that vagal nerve stimulation can significantly increase insulin secretion for a prolonged period of time in intact and in partly dysfunctional pancreas.
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Affiliation(s)
- J Rozman
- ITIS doo Ljubljana, Center for Implantable Technology and Sensors, University of Ljubljana, Republic of Slovenia.
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Kuhar CG, Bunc M, Drevensek G, Budihna MV, Suput D. Nicardipine dose dependently reduces the effect of equinatoxin II on coronary flow in isolated rat heart. Pflugers Arch 2002; 442:R198-9. [PMID: 11678338 DOI: 10.1007/s004240100023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Equinatoxin II (EqT II) decreases coronary flow in guinea-pig and rat heart. It increases cytosolic Ca2+ activity and is supposed to form cation selective membrane pores. In the present study we tried to evaluate the influence of the L-type Ca2+ channel antagonist nicardipine upon the vasoconstrictory effect of EqT II on coronary vessels in isolated heart of the rat. Coronary flow was measured during the experiment. Ten min after bolus injection of EqT II the coronary flow decreased to 17.2 +/- 4.3% in experiments without nicardipine, and to 39.4 +/- 4.5% in the group with 0.1 microM nicardipine (p < 0.05). Our results indicate the possibility that L-type Ca2+ channels could be involved in the effects of EqT II on coronary flow in the rat heart.
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Affiliation(s)
- C G Kuhar
- Department of Pharmacology and Experimental Toxicology, Medical Faculty, Ljubljana, Slovenia
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Abstract
Electroneurograms (ENGs) from the vagus, splanchnic and pancreatic nerves innervating the pancreas of a dog, were recorded with chronically implanted silicone multi-electrode circular cuffs in an intact pancreas and in a pancreas partly disabled with alloxan. The cuffs contained 33 platinum electrodes (0.6x1.5 mm) arranged in three parallel circular groups integrated into the inner surface of the cuff. Each circular group contained 11 electrodes at a distance of 0.5 mm apart, with 6 mm between the circular groups. The cuffs had an inner diameter of 2.5 mm and the length of 18 mm. In a 2-year study, the cuffs were implanted into two adult Beagle dogs (one female and one male). In the vagus nerve, the cuff was installed on the nerve at the neck, whilst in the splanchnic nerve, the cuff was installed on the nerve before the celiac ganglion, and in the pancreatic nerve, the cuff was installed on the nerve just before it enters the pancreas. In each of the three implanted cuffs, the electrodes of the central circular group were connected to each other and this signal provided one input to a multi-channel ENG amplifying system. The electrodes of each of the two outer spiral groups were connected to each other and then both these groups were short-circuited. This signal then provided another input to the multi-channel ENG amplifying system. The ENG amplifying system was designed to amplify the ENGs 100000 times and to pass frequencies of between 500 and 10 kHz. In our study, three recordings in each animal were conducted. Recordings in the intact pancreas were conducted 2 and 6 months after the implantation, while the recording in the partly disabled pancreas, was conducted 10 months after the implantation and 10 days after the disablement. Due to the fact that the results obtained in both animals were actually quite similar, we present the results of the recordings obtained in one animal. In both animals the cuffs were left implanted for more than 1 year and were used for pancreatic stimulation, although this is not in this paper. The results show that cuffs implanted chronically on the nerves innervating the pancreas of a dog could reliably record the ENGs. This information could be used effectively in further study of pancreatic innervation and its function. Moreover, the results suggest that cuffs could also be useful in recording the ENGs from other nerves of the autonomic nervous system that innervate various glands and internal organs.
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Affiliation(s)
- J Rozman
- ITIS d. o. o. Ljubljana, Centre for Implantable Technology and Sensors, Lepi pot 11, 1000, Ljubljana, Slovenia.
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18
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Abstract
Idiopathic hypereosinophilic syndrome (HES) is empirically defined as the presence of prolonged eosinophilia without an identifiable underlying cause, and with evidence of end-organ dysfunction. Virtually any organ system may be involved, most frequently the heart, the central and peripheral nervous system, the lungs and the skin. We report on two clinical cases where the diagnosis of HES, with all the conventional criteria met, was proposed. In the first patient with HES, cardiac and pulmonary involvement was present. Skin changes and lung involvement were observed in the second reported patient with HES. In both patients there was prompt improvement of all clinical signs and symptoms of HES soon after treatment with methylprednisolone was begun. In the first patient long-term methylprednisolone therapy was healed successfully. For 2 years he has shown no clinical signs or symptoms of HES. The second patient is still undergoing long-term therapy with 4 mg of methylprednisolone daily. The histologic findings of the skin biopsy in the second patient were not typical for HES, but skin changes completely healed after corticosteroid therapy. This could mean that that the described skin changes were one of the HES skin manifestations. The other possibility is that the skin changes emerge in coincidence with HES.
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Affiliation(s)
- M Bunc
- Institute for Pathophysiology, School of Medicine, Ljubljana, Slovenia
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19
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Abstract
In planning the optimum treatment for patients with neuromuscular diseases (NMD), it is essential to know as much as possible about their functional state. Assessment of the strength of certain muscles is the most direct measure of motor deficiency. In the development of normative data needed for patients with NMD, the use of torque measurements is required. Forty-nine patients (31 men and 18 women),f rom 18 to 54 years (mean age 33 +/- 8.9 years), were included in the study. Five groups of patients, each having one of five different NMDs, were formed. We tested unilaterally the biceps brachii muscle that normally generates the highest torque. For this purpose an eletronic brace enabling isometric measurements of torque during elbow flexion was designed. The patients produced three maximum voluntary elbow flexions that lasted about 3 s and separated by a pause of about 3 s. Force development was rapid with continuous build-up and isometric. About 15 s later the patients produced the last maximum voluntary elbow flexion, keeping it as stable aspossible for a period of 30 s. Patients with mitochondrial myopathy (MM), having the shortest mean half fatigue time (4.3 s), elicited the highest mean torque in both short maximum voluntary elbow flexions (1.34 Nm) as well as in the 30 s-long maximum voluntary elbow flexions. In contrast, patients with facioscapulohumeral muscular dystrophy (MD-FSH), having the longest mean half-fatigue time (15.4 s), elicited the lowest mean torque in both the short maximum voluntary (0.29 Nm) as well as in 30 s-long maximum voluntary elbow flexions. Patients with Becker muscular dystrophy (MD-B), having a mean half-fatigue time (11.1 s) slightly shorter than the patients with MD-FSH, elicited a higher mean torque in both the short (0.82 Nm) and the 30 s-long elbow flexions. Finally, patients with limb-girdle muscular dystrophy (MD-RM) and spinal muscular atrophy type 3 (SMA3), having a similar mean half-fatigue time (6.9 s for patients with MD-RM and 7.4 s for patients with SMA3), also elicited similar torque in both short (0.45 Nm for patients with MD-RM and 0.65 Nm for patient with SMA3) and 30 s-long elbow flexions. The results of the study show that the methodology developed to quantitative measure the torque of elbow flexions in patients with NMD enables the characteristics and natural course of NMD to be more objectively documented. Accordingly, the optimum treatmentforpatients with NMD could be restored.
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Affiliation(s)
- J Rozman
- ITIS doa Ljubljana, Center for Implantable Technology and Sensors, Republic of Slovenia
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20
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Abstract
Equinatoxin III is the most hemolytic, and the least lethal of the three basic proteins isolated from the sea anemone Actinia equina (L.). Its LD50 in mice is 83 microg/kg. Preliminary results on Wistar rats have suggested cardiorespiratory arrest as a putative cause of death, but the mechanism of its action has not yet been studied. So far only equinatoxin II has been investigated more thoroughly. As equinatoxin II is less lythic, but more toxic, than equinatoxin III (its LD50 in mice=35 microg/kg), it may be assumed that haemolysis with a consequent rise in plasma potassium level is not the major factor in the lethality of equinatoxins. To assess the relative contribution of hyperkalemia in the lethality of the toxin in rat, the effects of equinatoxin III were compared to the effects of hyperkalemia caused by the injection of KCl giving the same final concentration of K+ in the plasma as that observed after an i.v. injection of 3LD50 of equinatoxin III. As coronary vasoconstriction may be an important mechanism of the cardiotoxic action of equinatoxins, the effect of EqT III on isolated porcine coronary arteries was studied by measurements of smooth muscle tension in the presence of 1-100 nM equinatoxin III. The results revealed that animals survive the elevated K+ plasma concentration caused by an i.v. application of KCl. This suggests that equinatoxin III induced haemolysis is not the major mechanism of equinatoxin III lethality. However, equinatoxin III increases the potassium induced contractions of coronary smooth muscle for 289+/-29%, suggesting that coronary vasoconstriction may be an important factor in the cardiotoxic effects of equinatoxin III.
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Affiliation(s)
- D Suput
- Medical Faculty, Institute of Pathophysiology, Zaloska 4, 1104, Ljubljana, Slovenia.
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21
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Bunc M, Starc R, Podbregar M, Bruĉan A. Conversion of atrial fibrillation into a sinus rhythm by coronary angioplasty in a patient with acute myocardial infarction. Eur J Emerg Med 2001; 8:141-5. [PMID: 11436911 DOI: 10.1097/00063110-200106000-00011] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Atrial tachyarrhythmias are important complications occurring in more than 8% of acute myocardial infarctions (AMI). Atrial fibrillation (AFi) during the early phase of AMI is caused by atrial ischaemia, atrial distension due to the left ventricular failure or significant diastolic left ventricular dysfunction. AFi in patients with inferior and posterior AMI indicates at least two vessel coronary diseases, a circumflex coronary artery (CX) occlusion before taking off of the left atrial branches as well as significant stenosis or occlusion of the right coronary artery (RCA). In this article the case of a 67-year-old woman with an acute infero-posterior AMI is described. AMI was complicated with a left heart failure, acute AFi with tachyarrhythmia, transient arterial hypotension and ischaemic mitral regurgitation. Emergency coronary angiography disclosed occlusion of the CX, myocardial infarct related artery, and significant stenoses of the RCA. After opening the occluded CX during the PTCA, AFi with a tachyarrhythmia of 160 beats per minute (bpm) immediately converted into a sinus rhythm with 80 bpm, followed by a normalization of blood pressure and cardiac recompensation. Our case report supports the opinion that AFi in patients with inferior and posterior AMI indicates at least a two-vessel coronary disease. Reopening of the occluded atrial coronary branches during urgent medical treatment was casual and effective treatment of both ischaemic heart disease and consequent AFi.
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Affiliation(s)
- M Bunc
- Institute of Pathophysiology, School of Medicine, Ljubljana, Slovenia
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22
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Bunc M, Bregar R, Suput D. The importance of hemolysis in the lethal effects of equnatoxin II, a protein from the sea anemone Actinia equina (L.). Pflugers Arch 2001; 440:R151-2. [PMID: 11005650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Equinatoxin II (EqT II) is one of the three isotoxins isolated from the sea anemone Actinia equina (L). The cause of death due to i.v. application of Eq T II was attributed to its hemolytic activity and hiperkaliemia, and the direct cardio-respiratory effects of the toxin. The toxin also binds to plasma lipids and forms toxic conglomerates with them. In our study we tried to evaluate the importance of interaction of the toxin with blood components in the toxin lethality. Anaesthetized male Wistar rats were used. The respiratory activity, ECG and animal serum ionic composition were monitored. To simulate isolated effects of the toxin hemolytic activity, hemolysed erythrocytes, KCl and mixture of rat serum with the toxin were injected i.v.. It was shown that neither the lysed erythrocytes nor the mixture of rat serum with the toxin were lethal for the experimental animals. Even KCl, in concentrations detected in serum of rats killed by the toxin, did not cause the death of experimental animals. Our results indicate that either a combination of the tested effects of the toxin on blood components or more probably the direct effects of the toxin on vital organs are responsible for the toxin lethality.
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Affiliation(s)
- M Bunc
- Institut of Patophysiology, School of Medicine, Ljubljana, Slovenia
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Drevensek G, Budihna MV, Suput D, Bunc M. Nicardipine dose-dependently reduces the effect of equinatoxin II on coronary flow in isolated porcine heart. Pflugers Arch 2001; 440:R145-6. [PMID: 11005647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Death after i.v. administration of equinatoxin II (EqT II) has been attributed to the circulatory failure resulting from cardiotoxic effects. The mechanism of action is unknown. The aim of the present work was to study the effects of the toxin on vascular tone in the isolated porcine coronary artery and on coronary flow in the isolated pig heart. EqT II caused concentration-dependent contractions of rings of the isolated epicardial porcine coronary artery with an EC50 value of 89+/-5 nM (n=5-6) and maximal effect of about 140% of the contraction induced by 20 nM KCl. On Langendorffs porcine heart preparation EqT II caused a dose-dependent decrease of coronary flow. At EqT II doses lower than 0.05 micromol/100 g of heart weight there were no measurable effects of the toxin. At dose 0.5 micromol/100 g the toxin decreased coronary flow to less than 9.8+/-2.5% of the control value. The constrictory effect of the toxin on isolated porcine coronary arteries was diminished by the L-type calcium channel antagonist nicardipine (NC). NC in 1 microM concentration almost completely abolished the effect of EqT II on coronary flow. Our results confirmed involvement of L-type calcium channels in the vasoconstrictory effects of EqT II on epicardial coronary arteries.
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Affiliation(s)
- G Drevensek
- Dept. of Pharmacol. & Exp. Toxicol., Ljubljana, Slovenia
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Bunc M, Sepcic K, Turk T, Suput D. In vivo effects of head-to-tail 3-alkylpiridinium polymers isolated from the marine sponge Raniera sarai. Pflugers Arch 2001; 440:R173-4. [PMID: 11005659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Water soluble polymeric 3-alkylpyridinium salts (poly APS; MW 18900 and 5520 Da) were isolated from the marine sponge Raniera sarai. In vitro it strongly inhibited acetyl cholinesterase (AChE) from different species (electric eel, horse serum, human erythrocytes). In our experiments the importance of anti AChE activity in the toxin lethality was evaluated. In vivo experiments were performed on male Wistar rats and ECG, blood pressure and breathing pattern were monitored. After i.v. application of lethal doses of the toxin ECG showed signs of hypo perfusion. Arterial blood pressure fell to mid-circulatory pressure, and breathing stopped after a few breaths At sublethal doses the toxin caused an increase of residual volume, prolongation of expiration, and bradycardia. Patho-anatomical examination revealed that the plugs in lung circulation may cause the death of experimental animals due to cardiorespiratory failure.
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Affiliation(s)
- M Bunc
- Department of Pathophysiology, Medical Faculty, Ljubljana, Slovenia
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25
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Rozman J, Zorko B, Seliskar A, Bunc M. Selective recording of neuroelectric activity from the peripheral nerve. Pflugers Arch 2001; 440:R157-9. [PMID: 11005653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Electroneurograms (ENGs) from superficial regions of the sciatic nerve of a dog, innervating the tibialis anterior (TA) and gastrocnemius muscles (GM), arising mainly from muscle spindles and Golgi tendon organs were recorded selectively with an implanted 33-electrode spiral cuff (cuff). Relative positions of superficial regions within the cuff were defined by delivering stimulating pulses on groups of three electrodes (GTEs) within the cuff which were in contact with them. It was found that GTEs eliciting maximum contractions of muscles were GTE No. 3 for the TA muscle and GTE No. 8 for the GM muscle. In the first experiment the implanted leg was mounted into a special electronic brace. Extending forces were applied to the ankle rotating it by up to +/-37 degrees according to the neutral position, thus eliciting torques in the TA muscle of up to 1.2 Nm. Channel 1 of the 4-channel preamplifier was connected to GTE No. 8, channel 2 to GTE No. 2, channel 3 to GTE No. 11 and channel 4 to GTE No. 5. Results show that only ENG recorded with GTE No. 8, being close to the region innervating the TA muscle, correspond to the mechanical load. In the second experiment the calcanean tendon (CT) of an implanted leg was dissected. The proximal end of the CT was connected to a force transducer and repetitive pull forces (about 12 N) were applied to the CT. Channel 1 of the preamplifier was connected to GTE No. 5, channel 2 to GTE No. 1, channel 3 to the GTE No. 11 and channel 4 to GTE No. 8. Results show that only ENG recorded with GTE No. 5, being close to the region innervating the GM muscle, correspond to the mechanical load applied on CT.
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Affiliation(s)
- J Rozman
- ITIS d.o.o. Ljubljana, Centre for Implantable Technology and Sensors, University of Ljubljana, Slovenia
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26
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Šarc L, Jamšek M, Bunc M. 22. A contemporary poisoning with paracetamol and carbamazepine. Eur J Emerg Med 2000. [DOI: 10.1097/00063110-200012000-00037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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27
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Rozman J, Zorko B, Bunc M. Selective recording of electroneurograms from the sciatic nerve of a dog with multi-electrode spiral cuffs. Jpn J Physiol 2000; 50:509-14. [PMID: 11120917 DOI: 10.2170/jjphysiol.50.509] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Electroneurograms (ENGs) from superficial regions of the sciatic nerve of a Beagle dog were recorded selectively with a chronically implanted 33-electrode spiral cuff (cuff). By delivering stimulating pulses to groups of three electrodes (GTEs) within the cuff we could define the relative positions of the particular superficial regions that selectively innervated the tibialis anterior (TA) and gastrocnemius muscles (GM). GTEs with and without contractions of the TA and GM muscles were selected and connected to a 4-channel ENG system designed to amplify ENGs by 100,000 times and to pass frequencies between 500 Hz and 10 kHz. In our study, 12 experiments were conducted on three Beagle dogs with a cuff implanted for up to 2 years. We present the results obtained in four experiments conducted on one animal. With the implanted leg mounted in a special electronic brace we applied extending forces to the ankle, rotating it by up to 37 degrees according to the neutral position, eliciting torque to stretch the TA muscle. Only the ENG from a GTE eliciting maximum contraction of the TA muscle showed activities corresponding to the trajectory of the mechanical load of the muscle. Next, we dissected the calcanean tendon (CT) of the implanted leg and applied repetitive pull forces to the CT. Only the ENG from the GTE eliciting maximum contraction of the GM muscle was activated in correspondence to the trajectory of the mechanical load applied on the CT. The results suggest that the cuff, implanted chronically on the sciatic nerve, is useful to record ENGs of the afferent fibers from TA and GM muscles selectively and that the technique could be extended for human use in the field of rehabilitation for paralysis.
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Affiliation(s)
- J Rozman
- ITIS d. o. o. Ljubljana, Center for Implantable Technology and Sensors, Lepi pot 11, University of Ljubljana, Republic of Slovenia.
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28
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Bunc M, Suput D, Zupanc O, Rozman J. Measurements of cardiac output of an isolated heart using a specially designed turbine. J Med Eng Technol 2000; 24:141-4. [PMID: 11105285 DOI: 10.1080/03091900050163409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Cardiac output is one of the important parameters used in evaluation of heart function. A turbine which works on mechanical principles was designed. It is also suitable for cardiac output measurements on isolated pig hearts in cases where some other equipment is not, like on doppler effect based transducers. The basic principle of measuring liquid flow through a turbine is based on measurement of the time that elapses when the rotor rotates by one degree. For this purpose, the rotor is fitted with transparent foil with a ring of 360 short black lines printed close to its circumference. Two infrared light-emitting diodes are mounted on one side of the foil and two photo-transistors, used as sensors of the transmitted infrared light, are mounted on the other. Voltage-regulated output ranging from 0 to +/- 2048 V at one revolution per second gives 500 mV at the output (changeable by programming), calculating time 2 ms, 1 mV resolution (11 bits), with an external power supply of 5 V. The turbine showed a linear response at a continuous saline flow up to 3000 ml min-1 at pressure loads of between 20 and 220 cm H2O. Pressure drop across the turbine depends on the volume flow and was 1 mm Hg at 100 ml min-1 and 3 mm Hg at 7000 ml min-1. A rotating movement 1.25 x 10(-4) kg m2 s-1 was calculated. The lowest volume change of a bolus of saline solution, detected by the turbine, was 1.6 ml.
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Affiliation(s)
- M Bunc
- Institute of Pathophysiology, School of Medicine, Ljubljana, Slovenia
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29
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Bunc M, Frangez R, Rozman J, Suput D. The effects of equinatoxin II on respiration--possible mechanism of the toxin lethality. Pflugers Arch 2000; 439:R129-30. [PMID: 10653165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
In rat an intravenous application (i.v.) of a lethal dose of the equinatoxin II (EqT II) provoked a respiratory arrest. It is not known whether the respiratory arrest is a result of a direct actions of the toxin on lung tissue, on neuromuscular junctions or the on the central nervous system. The influences of the toxin on the neuromuscular transmission and on muscular contraction were studied in isolated rat diaphragm. The effect of EqT II on end plate potentials of m. cutaneus pectoris was measured in the frog Rana esculenta. To monitor equinatoxin II effects on the central nervous system of a rat, the toxin was injected directly into the forth brain ventricle. The respiratory arrest was not the result of the toxin action on the neuromuscular junctions and peripheral nerves. The cessation of respiratory activity was most probably a result of equinatoxin II direct actions on lung tissue and on brain microcirculation.
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Affiliation(s)
- M Bunc
- Department of Pathophysiology, Medical Faculty, Ljubljana, Slovenia
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30
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Drevensek G, Bunc M, Budihna MV, Suput D. Lowering of the coronary flow in isolated rat heart by equinatoxin II depends upon extracellular Ca2+ concentration. Pflugers Arch 2000; 439:R150-1. [PMID: 10653174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
Equinatoxin II (EqT II) is a basic polypeptide toxin from the sea anemone Actinia equina (L.). Its LD50 in mice is 33 g/kg. The cause of death after intravenous application has been attributed to the circulatory failure resulting in the cardiotoxic effects. In Langendorff's rat and guinea-pig heart preparations EqT II caused dose dependent decrease in the coronary flow (CF). Morphologic changes of different cell cultures incubated with EqT II are the result of Ca2+ entry through the newly formed discrete pores. Pores in the cell membranes are composed of the toxin oligomeres. In the present study we tried to evaluate the dependence of vasoconstrictor effects of EqT II on isolated rat hearts upon the Ca2+ concentration in the perfusion solution. EqT II did not affect the CF in the group without Ca2+. The strongest effect was observed in the group with 1.5 mM Ca2+ where the CF decreased to 7.7+/-7%. The results of our experiments indicate that the effects of EqT II on CF depend on Ca2+ concentration in the extracellular solution.
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Affiliation(s)
- G Drevensek
- Department of Pharmacology and Experimental Toxicology, Medical Faculty, Ljubljana, Slovenia
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31
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Starc R, Brucan A, Bunc M. Acute myocardial infarction induced by alcohol ingestion in an asymptomatic individual. Eur J Emerg Med 1999; 6:403-6. [PMID: 10646931 DOI: 10.1097/00063110-199912000-00019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This case report deals with a 47-year-old asymptomatic man without risk factors for coronary artery disease. He developed acute myocardial infarction 6 hours after ingestion of 0.5 litre of whisky within 30-60 minutes. The acute myocardial infarction was proved by a typical and prolonged angina pectoris, elevated enzymes typical for myocardial necrosis and ECG signs of acute anteroseptal and anterolateral myocardial infarction. A coronary angiography 3 months later revealed normal coronary arteries but marked hypokinesia of the anteroseptal and anterolateral segments of left ventricular wall. The sequence of events and objective data support our hypothesis that disturbance of coronary flow could be induced by an excessive ingestion of alcohol. The article discusses possible mechanisms of alcohol effects on arteries.
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Affiliation(s)
- R Starc
- University Department for Cardiology, Ljubljana, Slovenia
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32
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Abstract
Single channel force transducers, intended for measurement and evaluation curves of preconditioned fibres in muscles contracting synergistically during direct or indirect electric stimulation of isolated muscle, were designed, developed and experimentally tested. The force transducers were made up of a full Wheatstone bridge composed of four semiconductor strain gauges bonded on a specially designed cantilever. The transducers with a natural frequency 350 Hz and compliance of 0.25 micron g-1 represents a very linear dependence of the output voltage upon the load giving a sensitivity for the transducers of 0.5 mV mN-1 with a bridge excitation voltage of 5 V. The nominal range of each transducer is 0-70 mN. The system is able to record even a contraction of only a few muscle fibres, both single twitches as well as sustained tonic contractions.
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Affiliation(s)
- M Bunc
- Institute of Pathophysiology, School of Medicine, Ljubljana, Slovenia
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33
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Bunc M, Drevensek G, Budihna M, Suput D. Effects of equinatoxin II from Actinia equina (L.) on isolated rat heart: the role of direct cardiotoxic effects in equinatoxin II lethality. Toxicon 1999; 37:109-23. [PMID: 9920484 DOI: 10.1016/s0041-0101(98)00168-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Equinatoxin II is a lethal basic protein isolated from the sea anemone Actinia equina (L.) with LD50 in mice 35 microg/kg. The putative cause of death is cardiorespiratory arrest, but the mechanism of cardiotoxicity is poorly understood. It is not clear whether the toxin injected intravenously into an experimental animal reaches the heart in a concentration sufficient to cause direct effects on the heart. Therefore experiments were performed on rats and on isolated rat hearts in order to investigate the possible direct cardiotoxic effects of the toxin. For this reason the hearts were perfused with different concentrations of the toxin and with the effluent from the lungs collected during perfusion of the lungs with equinatoxin II. The results revealed the clear dose-dependent, direct cardiotoxic effects of the toxin and of the effluent from the lungs on Langendorff's heart preparations. The threshold concentration of equinatoxin II causing a drop in the perfusion rate, decreased left ventricular pressure, arrhythmia and increased LDH release, was found to be around 0.1 to 1 nM. With 10 nM equinatoxin II the left ventricular pressure dropped to 14+/-11% of the control, and the coronary flow to 9+/-3%. These effects were followed by arrhythmia and cardiac arrest. The concentration of equinatoxin recovered from the lungs after the perfusion with 100 nM equinatoxin II ranged between 0.8 and 5 nM. The results indicate that direct cardiotoxic effects of equinatoxin II play an important role in the lethal effects of the toxin.
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Affiliation(s)
- M Bunc
- Medical Faculty, Institute of Pathophysiology, Ljubljana, Slovenia
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34
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S̆uput D, Frangez̆ R, Bunc M, Maček P, Turk T. Cardiotoxicity of equinatoxin II: mechanisms of decrease of coronary perfusion. Toxicon 1995. [DOI: 10.1016/0041-0101(95)99293-c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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35
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Affiliation(s)
- M Bunc
- Laboratory for Cell Physiology and Toxinology, University of Ljubljana School of Medicine, Slovenia
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