Design, synthesis and biological evaluation of water soluble and non-aggregated silicon phthalocyanines, naphthalocyanines against A549, SNU-398, SK-MEL128, DU-145, BT-20 and HFC cell lines as potential anticancer agents

Cancer has become an important public problem in worldwide since cancer incidence and mortality are growing rapidly. In this study, water soluble and non-aggregated silicon (IV) phthalocyanines and naphthalocyanines containing (3,5-bis{3-[3-(diethylamino)phenoxy]propoxy}phenyl)methoxy groups have been synthesized and characterized to investigate their anticancer potential. Their DNA binding/nuclease, topoisomerases inhibition were investigated using UV-Vis absorption, thermal denaturation and agarose gel electrophoresis. The in vitro cytotoxic properties of the compounds on human lung (A549), breast (BT-20), liver (SNU-398), prostate (DU-145), melanoma (SK-Mel 128) carcinoma and human fibroblast (HFC) normal cell lines were evaluated by using MTT assay. In order to determine the mechanism of cancer cell growth suppression, cell cycle analysis was carried out using flow cytometer on A549 cell line. The K_b values of SiPc1a and SiNc2a were 6.85 ± (0.35) × 10⁶ and 1.72 ± (0.16) × 10⁴ M^-1 and T_m values of ct-DNA were calculated as 82.02 °C and 78.07 °C, respectively in the presence of both compounds. The Δ_Tm values of SiPc1a and SiNc2a were calculated as 6.45 and 2.50 °C, respectively. The nuclease effects of SiPc1a and SiNc2a with supercoiled plasmid pBR322 DNA demonstrated that both compounds did not trigger any DNA nuclease effects at the lowest concentrations without irradiation whereas both compounds in the presence of activating agent (H₂O₂) showed significant plasmid DNA nuclease actions under irradiation (22.5 J/cm²). SiPc1a and SiNc2a inhibited to topoisomerase I on increasing concentrations whilst they had lower inhibition action toward topoisomerase II that of topoisomerase I. The in vitro cytotoxicity studies displayed that SiPc1a had the highest cytotoxic effects among the tested compounds against A549, SNU-398, SK-MEL128, DU-145, BT-20 and HFC cell lines with CC₅₀ values ranged from 0.49 to 2.99 µM. Furthermore, SiPc1a inhibited cell proliferation by cell cycle arrest in G₀/G₁ phase. All of these results suggested that SiPc1a is a promising candidate as an anticancer agent.

Triazole substituted metal-free, metallo-phthalocyanines and their water soluble derivatives as potential cholinesterases inhibitors: Design, synthesis and in vitro inhibition study

In this study, 1,2,3-triazole substituted metal-free and metallo phthalocyanines (4, 5, 6) and their water soluble derivatives (4a, 5a, 6a) were designed, synthesized for the first time and tested in vitro on acetylcholinesterase (AChE) and butyrylcholinesterase (BChE) enzymes. Most phthalocyanines exhibited good inhibitory activities on these enzymes. Among the six phthalocyanines and starting compounds, 4a showed the most interesting profile as a submicromolar selective inhibitor of AChE (IC₅₀ = 0.040 µM) and 5a showed the most effective inhibitor of BChE (IC₅₀ = 0.1198 µM).

The usefulness of left atrial volume index and left ventricular mass index in determining subclinical cardiac involvement in patients with early-stage sarcoidosis

BACKGROUND AND AIM

Sarcoidosis is a multi-systemic granulomatous disease of unknown etiology. The present study has been designed to evaluate the importance of diastolic dysfunction with left atrial volume index (LAVi) and left ventricular mass index (LVMi) in determining subclinical cardiac involvement in subjects with stage I-II pulmonary sarcoidosis.

METHODS

A total of 54 patients under follow-up for sarcoidosis without cardiac involvement and 56 healthy subjects were included in the study. The echocardiographic assessment of the patients revealed no significant difference between the two groups regarding left ventricular end-systolic and end-diastolic diameters, ejection fraction (LVEF) and annular velocity determined by tissue Doppler evaluation.

RESULTS

The LVEF calculated was 61.8 ± 7.8 % in the sarcoidosis group versus 64.1 ± 2.7 % in the control group (p = 0.04). Left ventricular interventricular septum thickness, posterior wall thickness, and relative wall thickness were significantly higher in the sarcoidosis group compared to the control group (p < 0.001). The sarcoidosis group had higher LVM and LVMi values compared to the control group (145 ± 18.1 and 79 ± 14 g/m(2), 135 ± 27.7 and 74 ± 14.2 g/m(2); p = 0.020 and p = 0.021, respectively). Left atrial end-systolic volume and LAVi were higher in the sarcoidosis group (28.7 ± 18.5; 15.6 ± 10.2) compared to the control group (16.6 ± 10.9; 8.9 ± 5.5) with a statistically significant difference (p < 0.001).

CONCLUSION

The present study indicates diastolic dysfunction and increased LVMi despite normal systolic function in patients with early-stage sarcoidosis without cardiac involvement. Also, the diastolic parameters were normal without showing any significant difference compared to the control group while there was a statistically significant increase in LAVi. This finding suggests that LAVi may be the earliest marker of diastolic dysfunction in patients with early-stage sarcoidosis without cardiac involvement.

Predictors and incidence of access site complications in transcatheter aortic valve implantation with the use of new delivery systems

Objectives:

The aim of this single-center study was to assess the incidence and predictors of in-hospital access site complications related to transcatheter aortic valve implantation (TAVI) performed with new delivery systems in our hospital which has the largest case series in Turkey.

Materials and method:

We performed successful TAVI with the Edwards Sapien XT valve to 127 (46 male) patients via a transfemoral (121), trans-subclavian (5) and transapical (1) approach. Access site complications were defined according to the Valve Academic Research Consortium (VARC) end-point definitions.

Results:

Vascular complications occurred in 10.1% of patients. There was negative correlation between vascular complications and diameter of the common femoral artery (r = − 0.301, p=0.004), external iliac artery (r = − 0.327, p=0.004) and common iliac artery (r = − 0.324, p=0.004), but positive correlation between diabetes (r =0.240, p=0.008), sheath to femoral artery ratio (SFAR), sheath to external iliac artery ratio (SEIAR), procedure time, discharge time and the Society of Thoracic Surgeons (STS) score (respectively; r=0.339, 0.001, 0.527, 0.361, 0.289, p=0.003, 0.001, 0.001, 0.001, 0.002). The incidence of vascular complications was significantly higher in patients with diabetes and a high STS score. VARC bleeding complications occurred in 11.7 % of patients. The learning curve pointing out the importance of experience was significantly important in decreasing both bleeding and vascular complications.

Conclusions:

In this study, we demonstrated that major vascular complications related to TAVI decrease with the use of smaller delivery systems and experience and increase with high-risk scores (STS) and the presence of diabetes. In addition, VARC major vascular complications, observed mostly in patients with diabete mellitus (DM) and high STS scores, were associated with vascular diameters. These results further underline the importance of experience and a multidisciplinary team in patient selection and management for TAVI.

The relationship between acute coronary syndrome and stress hyperglycemia

BACKGROUND AND OBJECTIVE

Hyperglycemia on admission is associated with increased mortality and morbidity in acute coronary syndrome (ACS) irrespective of presence of diabetes mellitus. To the best of our knowledge, no evidence on the relationship between stress hyperglycemia (SH) and the extent of coronary artery disease is found in the literature. Our objective in this study is to assess the relationship of SH with the prognosis of acute coronary syndrome, extent of coronary artery disease (CAD), development of arrhythmia, and major adverse cardiac events.

METHOD

89 patients who were hospitalized in the coronary intensive care unit with diagnosis of ACS between January 2010 and June 2010 were enrolled in the study. The patients were separated into 2 groups as having stress hypergly-cemia or not, according to their blood glucose levels on admission. TIMI and GRACE risk scores were obtained and GENSINI scoring was performed to assess CAD extent for all the patients. Major adverse cardiac events (MACE) (death, MI, re-revascularization, stroke) were recorded for all patients while in the hospital and at 1st and 6th months.

RESULTS

In our study, MACE, GENSINI scores at 6 months and development of in-hospital arrhythmia rates were statistically significantly higher and left ventricular ejection fractions were statistically significantly lower in the group with SH. The association of TIMI, GRACE, GENSINI, New York Heart Association (NYHA) and Killip classifications with blood glucose, fasting blood glucose and HbA1c on admission was confirmed.

CONCLUSION

Prognostic course happens to be worse and CAD is more extensive in patients with SH. In addition, blood glucose values may have to be estimated lower compared to the samples in the literature, in order to diagnose SH.

Aortic valve endocarditis with aortic wall thickening requires close follow-up for a possible abscess formation

A 67-year-old woman was admitted with aortic valve endocarditis and aortic wall thickening (AWT). Physical examination and laboratory findings yielded infective endocarditis. Echocardiography revealed several small vegetations on the aortic valve, leading to moderate aortic insufficiency together with a small ventricular septal defect. We also became aware of the AWT on and over the aortic root by transesophageal echocardiography (Figure 1). At the one month follow-up period, we also noticed an abscess formation originating from the AWT, which grew into a mature abscess form, day by day (Figure 2). The aortic valve endocarditis, with destruction of the aortic annulus and abscess formation, in this patient, is considered as a grave condition which, essentially, requires an aggressive combined surgical and medical approach. We would like to intimate here with this patient that AWT needs to be considered seriously important in aortic valve endocarditis and, even if the detected vegetations are small, a close follow-up for a possible abscess formation is essential.

Traumatic ventricular septal defect and mitral insufficiency after a Kebab's shish wound to the chest

Transthoracic echocardiography has an important role in the assessment of patients with penetrating chest trauma. We report the case of 19-year-old boy who sustained a kebab's shish wound to the chest. Transthoracic echocardiography revealed a defect in the interventricular septum and a defect in the anterior mitral valve. Both of them were closed with direct sutures.

Increased nitric oxide in exhaled air in patients with rheumatic heart disease

BACKGROUND

Endogenous production of nitric oxide and its presence in exhaled air was observed in humans. Prior studies have yielded contrasting information about the production of nitric oxide in patients with heart failure.

AIMS

The aim of this study was to measure nitric oxide in the exhaled air of patients with chronic rheumatic heart disease with and without pulmonary hypertension.

METHODS

Seventy-four patients (6 patients had isolated mitral stenosis; 13 patients had combined mitral stenosis and mitral regurgitation; 1 patient had isolated mitral regurgitation; 54 patients had combined mitral and aortic valve disease) and 27 healthy subjects were entered in the study. The nitric oxide concentration in exhaled air was determined with a chemiluminescence analyser. Echocardiography was performed in all patients to assess the severity of the valve disease and for the measurement of pulmonary artery pressure.

RESULTS

The level of exhaled nitric oxide was significantly greater in patients with rheumatic heart disease than in controls. The value of nitric oxide concentration in exhaled air was significantly increased in patients with pulmonary hypertension, as compared with patients who had normal pulmonary artery systolic pressure.

CONCLUSION

We found increased nitric oxide in the exhaled air in patients with rheumatic heart disease, especially in those with pulmonary hypertension, compared with healthy patients.

Septal myectomy in hypertrophic obstructive cardiomyopathy: late results with stress echocardiography

BACKGROUND

This study was performed to assess the functional capacity of the survivors of septal myectomy for the treatment of hypertrophic obstructive cardiomyopathy in long-term follow-up as assessed by dobutamine stress echocardiography.

METHODS

Sixty-nine patients with hypertrophic obstructive cardiomyopathy underwent septal myectomy between 1975 and 1996. The mean age was 25.4 +/- 13.6 years (range, 6-58 years), and 10 of the patients were women. The early mortality was 4.3%. Hospital survivors (95.7%) were followed up for a mean of 43.8 +/- 28.7 months (range, 6-114 months).

RESULTS

The postoperative mean functional capacity of the group was 1.47 +/- 0.56. No late deaths were reported. Forty-nine patients (74.2%) were evaluated with standard echocardiographic techniques, and 29 (43.9%) patients underwent dobutamine stress echocardiography. There was a significant decrease in the thickness of the interventricular septum after surgery. The mean preoperative and postoperative septal thickness was 1.99 +/- 0.59 cm (range, 1.3-3.8 cm) and 1.55 +/- 0.41 cm (range, 0.96-2.8 cm), respectively (p < 0.004). The mean posterior wall thickness was significantly less than the preoperative value (p = 0.008) and the left ventricular end-diastolic diameter was slightly greater in the postoperative measurements, but the difference was not significant (p = 0.162). Postoperative left ventricular outflow systolic gradients were reduced significantly when compared with preoperative values (preoperative mean, 78.4 +/- 33.6 mm Hg, range, 50-212 mm Hg versus postoperative mean, 17.9 +/- 15.9 mm Hg: range, 0-40 mm Hg; p < 0.0001).

CONCLUSION

Septal myectomy for patients with hypertrophic obstructive cardiomyopathy is a safe procedure with excellent clinical and functional results in the long-term follow-up.