Expedient synthesis of conjugated triynes via alkyne metathesis

The first synthesis of conjugated triynes by molybdenum-catalysed alkyne metathesis is reported. Strategic to the success of this approach is the utilization of sterically-hindered diynes that allowed for the site-selective alkyne metathesis to produce the desired conjugated triyne products. The steric hindrance of the alkyne moiety was found to be crucial in preventing the formation of diyne byproducts. This novel synthetic strategy was amenable to self- and cross-metathesis providing straightforward access to the corresponding symmetrical and dissymmetrical triynes with high selectivity.

The first synthesis of symmetrical and dissymmetrical conjugated triynes by self- and cross-metathesis was successfully achieved thanks to the use of hindered diynes.

Identification of immunorelevant genes from greater wax moth (Galleria mellonella) by a subtractive hybridization approach

In this study we have analyzed bacterial lipopolysaccharide (LPS) induced genes in hemocytes of the Lepidopteran species Galleria mellonella using subtractive hybridization, followed by suppressive PCR. We have found genes that show homologies to molecules, such as gloverin, peptidoglycan recognition proteins and transferrin known to be involved in immunomodulation after bacterial infection in other species. In addition, a few molecules previously not described in the innate immune reactions were detected, such as a RNA binding molecule and tyrosine hydroxylase. Furthermore, the full-length cDNA of a LPS-induced molecule with six toxin-2-like domains is described to be a promising candidate to further elucidate the relationship between toxin- and defensin-like domains in arthropod host defense.

Angiotensin AT(1) receptor stimulates heat shock protein 27 phosphorylation in vitro and in vivo

The angiotensin type 1 receptor (AT(1)) exerts a variety of its signaling and cellular actions through its effects on protein phosphorylation. Phosphoproteomic analysis of angiotensin (Ang) II-stimulated aortic smooth muscle cells revealed that heat shock protein 27 (HSP27) represents a major protein phosphorylation target of the AT(1) signaling pathway. Stimulation of cells with Ang II resulted in 1.7-fold (P<0.05) and 5.5-fold (P<0.001) increases in HSP27 phosphoisoforms at pI 5.7 and pI 5.4, respectively. This was accompanied by a 54% (P<0.01) decrease in the nonphosphorylated HSP27 isoform, located at pI 6.4. Treatment of samples with alkaline phosphatase reversed this redistribution of HSP27 phosphoisoforms. Ang II-stimulated HSP27 phosphorylation was completely blocked by pretreatment of cells with the AT(1) antagonist CV11974. Phosphoamino acid analysis demonstrated that Ang II-induced phosphorylation of both HSP27 phosphoisoforms occurred exclusively on serine. Protein kinase C inhibition completely blocked phorbol ester-induced HSP27 phosphorylation but did not impair Ang II-stimulated phosphorylation of HSP27, suggesting that AT(1) increased HSP27 phosphorylation by a protein kinase C-independent pathway. Intrajugular infusion of Ang II in rats increased HSP27 in aorta by 1.7-fold (P<0.02), and this response was inhibited by CV11974. These results suggest that Ang II-induced HSP27 phosphorylation is a physiologically relevant AT(1) signaling event. Because serine phosphorylation of HSP27 blocks its ability to cap F-actin, Ang II/AT(1)-induced HSP27 phosphorylation may play a key role in actin filament remodeling required for smooth muscle cell migration and contraction.

Cyclic stretch and hypertension induce retinal expression of vascular endothelial growth factor and vascular endothelial growth factor receptor-2: potential mechanisms for exacerbation of diabetic retinopathy by hypertension

Systemic hypertension exacerbates diabetic retinopathy and other coexisting ocular disorders through mechanisms that remain largely unknown. Increased vascular permeability and intraocular neovascularization characterize these conditions and are complications primarily mediated by vascular endothelial growth factor (VEGF). Because systemic hypertension increases vascular stretch, we evaluated the expression of VEGF, VEGF-R2 (kinase insert domain-containing receptor [KDR]), and VEGF-R1 (fms-like tyrosine kinase [Flt]) in bovine retinal endothelial cells (BRECs) undergoing clinically relevant cyclic stretch and in spontaneously hypertensive rat (SHR) retina. A single exposure to 20% symmetric static stretch increased KDR mRNA expression 3.9 +/- 1.1-fold after 3 h (P = 0.002), with a gradual return to baseline within 9 h. In contrast, BRECs exposed to cardiac-profile cyclic stretch at 60 cpm continuously accumulated KDR mRNA in a transcriptionally mediated, time-dependent and stretch-magnitude-dependent manner. Exposure to 9% cyclic stretch increased KDR mRNA expression 8.7 +/- 2.9-fold (P = 0.011) after 9 h and KDR protein concentration 1.8 +/- 0.3-fold (P = 0.005) after 12 h. Stretched-induced VEGF responses were similar. Scatchard binding analysis demonstrated a 180 +/- 40% (P = 0.032) increase in high-affinity VEGF receptor number with no change in affinity. Cyclic stretch increased basal thymidine uptake 60 +/- 10% (P < 0.001) and VEGF-stimulated thymidine uptake by 2.6 +/- 0.2-fold (P = 0.005). VEGF-NAb reduced cyclic stretch-induced thymidine uptake by 65%. Stretched-induced KDR expression was not inhibited by AT1 receptor blockade using candesartan. Hypertension increased retinal KDR expression 67 +/- 42% (P < 0.05) in SHR rats compared with normotensive WKY control animals. When hypertension was reduced using captopril or candesartan, retinal KDR expression returned to baseline levels. VEGF reacted similarly, but Flt expression did not change. These data suggest a novel molecular mechanism that would account for the exacerbation of diabetic retinopathy by concomitant hypertension, and may partially explain the principal clinical manifestations of hypertensive retinopathy itself. Furthermore, these data imply that anti-VEGF therapies may prove therapeutically effective for hypertensive retinopathy and/or ameliorating the deleterious effects of coexistent hypertension on VEGF-associated disorders such as diabetic retinopathy.

Retinal expression, regulation, and functional bioactivity of prostacyclin-stimulating factor

Prostacyclin-stimulating factor (PSF) acts on vascular endothelial cells to stimulate the synthesis of the vasodilatory molecule prostacyclin (PGI2). We have examined the expression, regulation, and hemodynamic bioactivity of PSF both in whole retina and in cultured cells derived from this tissue. PSF was expressed in all retinal cell types examined in vitro, but immunohistochemical analysis revealed PSF mainly associated with retinal vessels. PSF expression was constitutive in retinal pericytes (RPCs) but could be modulated in bovine retinal capillary endothelial cells (RECs) by cell confluency, hypoxia, serum starvation, high glucose concentrations, or inversely by soluble factors present in early vs. late retinopathy, such as TGF-beta, VEGF, or bFGF. In addition, RPC-conditioned media dramatically increased REC PGI2 production, a response inhibited by blocking PSF with a specific antisense oligodeoxynucleotide (ODN). In vivo, PGI2 increased retinal blood flow (RBF) in control and diabetic animals. Furthermore, the early drop in RBF during the initial weeks after inducing diabetes in rats, as well as the later increase in RBF, both correlated with levels of retinal PSF. RBF also responded to treatment with RPC-conditioned media, and this effect could be partially blocked using the antisense PSF ODN. We conclude that PSF expressed by ocular cells can induce PGI2, retinal vascular dilation, and increased retinal blood flow, and that alterations in retinal PSF expression may explain the biphasic changes in RBF observed in diabetes.

Vascular endothelial growth factor-induced retinal permeability is mediated by protein kinase C in vivo and suppressed by an orally effective beta-isoform-selective inhibitor

Increased vascular permeability and excessive neovascularization are the hallmarks of endothelial dysfunction, which can lead to diabetic macular edema and proliferative diabetic retinopathy in the eye. Vascular endothelial growth factor (VEGF) is an important mediator of ocular neovascularization and a known vasopermeability factor in nonocular tissues. In these studies, we demonstrate that intravitreal injection of VEGF rapidly activates protein kinase C (PKC) in the retina at concentrations observed clinically, inducing membrane translocation of PKC isoforms alpha, betaII, and delta and >threefold increases in retinal vasopermeability in vivo. The effect of VEGF on retinal vascular permeability appears to be mediated predominantly by the beta-isoform of PKC with >95% inhibition of VEGF-induced permeability by intravitreal or oral administration of a PKC beta-isoform-selective inhibitor that did not inhibit histamine-mediated effects. These studies represent the first direct demonstration that VEGF can increase intraocular vascular permeability through activation of PKC in vivo and suggest that oral pharmacological therapies involving PKC beta-isoform-selective inhibitors may prove efficacious for the treatment of VEGF-associated ocular disorders such as diabetic retinopathy.

Amelioration of vascular dysfunctions in diabetic rats by an oral PKC beta inhibitor

The vascular complications of diabetes mellitus have been correlated with enhanced activation of protein kinase C (PKC). LY333531, a specific inhibitor of the beta isoform of PKC, was synthesized and was shown to be a competitive reversible inhibitor of PKC beta 1 and beta 2, with a half-maximal inhibitory constant of approximately 5 nM; this value was one-fiftieth of that for other PKC isoenzymes and one-thousandth of that for non-PKC kinases. When administered orally, LY333531 ameliorated the glomerular filtration rate, albumin excretion rate, and retinal circulation in diabetic rats in a dose-responsive manner, in parallel with its inhibition of PKC activities.

Efficacy of loratadine versus placebo in the prophylactic treatment of seasonal allergic rhinitis

The efficacy of loratadine as prophylactic therapy for seasonal allergic rhinitis was evaluated in a randomized, double-blind, parallel group, placebo-controlled study. One hundred eighteen subjects received either loratadine, 10 mg once daily, or placebo for 6 weeks. Treatment was begun prior to the onset of grass pollen seasonal symptoms of allergic rhinitis. Total symptom-free days occurred more frequently in subjects receiving loratadine. More loratadine than placebo subjects (65% versus 49%) had no symptoms or mild rhinitis at the end of the study. In contrast, the differences between loratadine and placebo in symptom scores did not achieve significance. The incidence of sedation and anticholinergic effects were comparable between the groups. Prophylactic loratadine therapy was effective in suppressing symptoms of seasonal allergic rhinitis and providing patients with symptom-free days throughout the pollen season.

Comparative study of SCH 434 and CTM-D in the treatment of seasonal allergic rhinitis

The efficacy and safety of an extended-release combination of loratadine plus pseudoephedrine sulfate (SCH 434) was compared with that of a tablet containing chlorpheniramine maleate plus pseudoephedrine sulfate (CTM-D) in 131 patients with symptomatic seasonal allergic rhinitis. Patients were randomly assigned to receive either SCH 434 (loratadine 5 mg and pseudoephedrine sulfate 120 mg) or CTM-D (chlorpheniramine maleate 12 mg and pseudoephedrine sulfate 120 mg) twice daily for 2 weeks. Evaluations were made after 3, 7, and 14 days of treatment. Demographics (age, race, sex, and duration of seasonal allergic rhinitis) and baseline total symptom scores were comparable between groups. Both combination products were effective in relieving the symptoms of allergic rhinitis. Improvement in total symptom scores was 54% on day 3 and 65% on day 14 in the SCH 434 group versus 57% on day 3 and 64% on day 14 in the CTM-D group. Individual symptom scores (nasal discharge, stuffiness, nasal itching, sneezing, and ocular symptoms) responded similarly. A smaller proportion of patients in the SCH 434 group reported side effects, especially dry mouth (7% vs 19%, P = 0.07), fatigue (6% vs 25%, P < 0.01), and sedation (7% vs 22%, P < 0.03). In conclusion, the combination of loratadine plus pseudoephedrine sulfate was equally as effective as a classic antihistamine (chlorpheniramine maleate) plus pseudoephedrine sulfate but had a lower incidence of side effects.

[Digital arteriography of the lower limbs by sequential, automatic table translation. Feasibility. Preliminary results]

Digital subtraction angiography (DSA) as a method of evaluating lower limb arteries required examination of one limb at a time up to now. Moreover repeated injections of contrast material were necessary. This problem was mainly due to the relative small image intensifier field available and to the difficulty of repositioning the patient between mask and image acquisition. The authors report the preliminary results obtained with 24 patients studied on angiographic unit equipped with: A DSA system (DG 300-CGR) using 512 X 512 matrix size, an angiographic table (Angix M 200) allowing an automatic sequential translation, a removable image intensifier using a 16 inch field below the table. Thus, all those characteristics allow DSA of lower limb arteries. Only one injection of contrast material (Ioxaglate: 80 ml at 8-10 ml/second) was used per procedure. This, usually, allows good quality examination of lower limb arteries.

Embolization of the systemic arteries of the lung

Embolization of the systemic arteries of the lung (described by Remy and colleagues in 1973) is now a useful method for the treatment of hemoptysis or hemorrhagic lesions of the lung prior to surgical treatment, or for local treatment of hemoptysis when surgery is contraindicated or unnecessary. The technique is based on the anatomy of the different divisions of the systemic circulation (bronchial and extrabronchial), which for various physiologic reasons may develop hypervascularization. The results, complications, and contraindications of systemic embolization have previously been described and the technique is now commonly practiced.

[Contribution of digital venous angiography to the evaluation of arterial hypertension. Cost evaluation]

Concerning 100 intravenous digital subtraction angiographies (IV DSA) performed for the study of arterial hypertension, the results are discussed according to two different achievements: diagnostic and economic. One hundred patients have been examined after the intravenous (IV) injection of contrast material, seventy times in peripheral and thirty times in central venous system. Out of 94 examinations that could be interpreted, 10 revealed stenosis of renal arteries higher than 50 per cent, one revealed fibromuscular dysplasia. IV DSA generally permits the correct study of renal arteries and compared to conventional angiography it gives only a small number of false negative results. However, the reliable study of intrarenal vascularisation can be obtained only by renal arteriography. The renal arteriography remains therefore necessary: when renal IV DSA gives insufficient data; to estimate the degree of stenosis in fibro-muscular dysplasia; to evaluate intrarenal vascularisation before renovascular surgery or angioplasty. To estimate the economic validity of renal IV DSA for the study of arterial hypertension, we have investigated: the actual cost of the examination for a department of radiology, compared with the cost of conventional examination; on the other hand, the influence of this examination on the duration of hospitalisation for evaluation of arterial hypertension. According to our investigation, this examination allows the average reduction of expenses for 180 F per patient with arterial hypertension, and shortens the time of hospitalisation for about one day. Owing to this diagnostic and economic contribution, renal IV DSA is becoming the first examination to be done for the evaluation of renovascular hypertension.

Cine-angiography during percutaneous transluminal angioplasty of the lower limbs

In the treatment with percutaneous transluminal angioplasty of 65 atheromatous stenosis of the lower limbs including 50 iliac and 15 femoro-popliteal lesions, the authors insist on the value of cine-angiography during the dilatation. Cine-angiography increases the security and the velocity of the examination. The anatomic data of this technic are as precise as those obtained with seriography and a special hemodynamic investigation is obtained with the direction of the flow of the contrast medium in the collateral branches and in the main artery. The cost is less expansive than with seriography.

[Angiography in bypass grafts of the left anterior descending coronary artery with the left internal mammary artery. Apropos of 100 control examinations with a maximum follow-up of 6 years and 8 months]

Ninety three patients underwent 100 angiographic control studies of a left internal mammary artery bypass of the left anterior descending artery. The controls were carried out between 11 days and 6 years 8 months after surgery. Seven patients underwent two control studies. The patients were divided into three groups:--60 early control angiographic studies (before 2 years);--16 late control angiographic studies (between 2 and 5 years);--24 very late systematic control angiographic studies (after 5 years). The patency rate of the arterial grafts was 99%. From the anatomical point of view, the arterial walls of the internal mammary artery appeared smooth and regular except in one case. There was no cases of bypass graft disease. The ratio of the diameters of the internal mammary and left anterior descending arteries was greater than or equal to 1 in 93% of cases. The adaptation of the diameter of the internal mammary artery to that of the left anterior descending artery is an early phenomenon as shown by statistical and repeat control studies. The number of remaining collateral vessels does not appear to have an effect on the diameter of the internal mammary artery. Stenosis at the site of anastomosis was observed in 16% of cases. This seemed to be favoured when the angle subtended by the two vessels reached 90 degrees. The haemodynamic changes of the coronary circulation (competition of flow, competition of flow in the distal vessels, reflux in the internal mammary graft) were comparable to those observed in aorto-coronary saphenous vein bypass.

Non-iatrogenic trauma of the coronary arteries and myocardium: contribution of angiography--report of six cases and literature review

Six patients with coronary and myocardial trauma had selective coronary arteriography and left ventriculography. Of these, three patients with penetrating cardiac trauma presented with an occlusion of one coronary artery, including one fistula. Of three patients with blunt chest trauma, normal coronary arteries were observed in one patient, and obstruction of one artery in another; repeat coronary arteriography showed resolution of the previous obstruction in one patient. A review of the last 15 years of experience summarizes 38 angiography reports after coronary artery trauma. An analysis of the angiographic aspect of coronary artery damage is considered as an aid to understanding the traumatic lesion, its causes and its manifestations under the conditions of total or partial parietal damage of the artery, or parietal integrity.

[Hydatid cyst of the heart diagnosed with bidimensional echography. Apropos of a case]

A hydatid cyst of the left ventricular posterior wall was diagnosed by 2D echocardiography in a 36 year old North African patient presenting with exertional dyspnoea and atypical chest pain. Clinical examination was negative but the surface ECG showed inverted T-waves in the infero-lateral leads. Postero-anterior and lateral chest X rays were initially interpreted as normal but 2D echocardiography immediately revealed a cystic cardiac tumour which very probably was hydatid, given the patient's origin. Thorough investigation showed no other localisations and hydatid serology was also negative. Left ventricular and selective coronary angiography were performed to determine the vascular relationships of the cyst: ablation was carried out under cardiopulmonary bypass and pathological examination confirmed the diagnosis of hydatid disease.

Post-traumatic-shock lung: postmortem microangiographic and pathologic correlation

In post-traumatic-shock lung, increased pulmonary vascular resistance and pulmonary hypertension are prominent features. The explanation for them was sought by postmortem microangiography of the lungs of 17 patients dying of respiratory failure after trauma. The 10 patients with thoracic injury died earlier (1-8 days). Extravasation of contrast material due to alveolar capillary rupture was present in all but one specimen and occupied 20% of the sampled area. Pulmonary artery thrombi lay proximal to these extravasations. Hypovascular areas due to infection and hemorrhagic alveolitis were found in all patients and involved 40% of the surface area. The small pulmonary arteries were poorly filled and contained many microthrombi. Some patients had hematomas, cavities, and areas of interstitial edema occupying about 5% of the lung area and associated with compressed or occluded vessels. Several mechanisms including pulmonary trauma may be responsible for the antemortem rupture and obstruction of small blood vessels. In the post-traumatic-shock lung, small artery occlusion and compression are associated with pulmonary hemorrhage, infarction, and infection and are important contributors to perfusion abnormalities and respiratory failure.

[Resection of left ventricular aneurysm for clinical heart failure. Long-term results and prognostic factors (author's transl)]

Between 1970 and 1980, 46 resections of left ventricular aneurysm were carried out in patients with clinical evidence of heart failure but without associated septal perforation or severe mitral regurgitation. Aortocoronary bypass was simultaneously performed in 28% of the cases. The mean post-operative follow-up was 67 months. The early (1 mont) post-operative mortality rate was 15.2%. The actuarial survival rate (taking into account the early post-operative mortality rate) was 52.4% at 5 years and 32.9% at 10 years. Most early and late deaths were of cardiac origin. Among long-term survivors, 48.5% had no post-operative heart failure and 67% had no residual angina pectoris. In a statistical analysis of the factors involved in overall post-operative survival, no significant influence could be found for sex and age (within the limits of the study), risk factors associated with atheroma, duration of the myocardial necrosis responsible for the aneurysm, location of the aneurysm, time taken for the post-infarction heart failure to develop, presence of pre-operative angina on ECG, number of coronary arteries stenosed, extent of the aneurysm as determined by cineventriculography, cardiac index, left ventricular end-systolic pressure and associated aortocoronary bypass. In contrast, a significant prognostic value was demonstrated for the ejection fraction of the contractile area of the left ventricle (p less than 0.02), the maximal cardiac dysfunction observed prior to surgery (P less than 0.02), the presence of pre-operative dysrhythmias (P less than 0.1) and the quality of cardiac performance recovered immediately after the operation (P less than 0.001).

[Stenosis of the left main coronary artery. Results of aorto-coronary by-pass in 67 patients (author's transl)]

Between 1970 and 1978 sixty-seven patients with > 50% stenosis of the left main coronary artery underwent aorto-coronary by-pass operation. The mean follow-up period was 54.7 months. Early and late post-operative mortality rates amounted to 3% and 9.2% respectively. Severe global alteration of left cineventriculography was the primary factor of survival (p < 0.01). The actuarial survival rates were 90.3% at 5 years and 84.5% at 9 years. All survivors had control ECGs. Late myocardial necrosis was rare (0.6 per 100 patient-years). 60.3% of the patients remained free from angina. Deterioration of the results mainly occured during the first 2 years but continued at a slower pace beyond the 8th year. Recurrence of angina was significantly less frequent in patients with isolated left main stenosis (p < 0.05) and when local conditions were not unfavourable to derivative surgery (p. < 0.01). On the other hand, the patient's age, sex, type of angina, history of previous infarction, number of risk factors and number of by-passes (the latter excluding possibly incomplete revascularisation) has no influence on the functional prognosis. Thirty-two patients had control, usually routine coronary arteriography 13.7 months on average after surgery. Overall patency was found in 85.9% and abnormal grafts in 16.7% of the cases. The main benefits of aorto-coronary by-pass, therefore, were a reduction in the spontaneous mortality rate of patients with left main coronary disease and a pronounced functional improvement.

[A review of congenital aneurysms of the coronary arteries and report on two cases (author's transl)]

The authors report on 2 cases of congenital aneurysms of the coronary arteries and review the published literature. A total of 17 cases were found, which respond to their criteria fo; congenital coronary artery aneurysms discovered in patients after selective arteriography investigation. One of their cases was found to have aneurysms of the hepatic and distal renal arteries (vascular dysplasia?).

[The radioimmunological assay of fibrinogen breakdown products with E antigen during postoperative venous thromboses. Study in 46 cases of arthroplasty for osteoarthrosis of the hip (author's transl)]

Twenty six patients (without thrombosis) had a normal 125I-fibrinogen test, among whom 15 had a normal phlebography; 18 patients (with thrombosis) had a positive 125I-fibrinogen test among whom 11 had a positive phlebography. There was a discrepancy between phlebography and 125I-fibrinogen test in 2 patients. In patients with thrombosis, there is a significantly increase of FgE levels for several days after the intervention. However the measurement of FgE is not a reliable test (4% of false positive and 38% of false negative); but it is always elevated in femoral and popliteal thrombosis.

[Arterial vascularization of the os coxae]

Study of the arterial vascularization of the coxal bone by microangiographic methods. Nutritive and periosteal blood-vessels come from Iliaca interna and Iliaca externa arteries. The ilium is vascularized by the Ilio-lumbalis artery which is a nutritive blood vessel. A eriosteal vascularization also exists. Ischium and pubis have a periosteal vascularization. Blood vessels are oriented toward the sus-acetabulum area where many anastomoses exist.

[Recurrent ventricular tachycardia due to hydatic cyst of the heart. Recovery after surgical resection. Report of one case]

Report of the case-history of a 66 year-old woman in whom the diagnosis of ventricular aneurysm was reached in 1958 during a systematic X-ray examination, while the electrocardiogram suggested a lateral-wall infarction with no anginal pain. After fifteen years of a practically asymptomatic course there were practically uninterrupted attacks of ventricular tachycardia. Coronary angiography and left ventriculography excluded the hypothesis of an aneurysm and suggested the diagnosis to cystic tumour of the left ventricle. A voluminous hydatic cyst was removed surgically. Ventricular arrhythmia did not recur since.

Emergency selective aortography for acute lesions of the thoracic aorta

Emergency selective aortography is necessary for the definitive diagnosis of acute lesions of the thoracic aorta and defines their therapeutic possibilities. Cineradiography is very helpful and is complementary fo the roentgenograms. In this paper the study of dissecting aneurysms, tears of the aortic wall, ruptured aortic aneurysms and traumatic aortic lacerations is described. A new anatomic classification of dissecting aneurysms combined with that of De Bakey et al. is presented.