ABSTRACT
A 48-year-old woman was admitted to the emergency department with complaints of typical chest pain, cold sweat, and dyspnea of 24 hours' duration. She had a history of hypertension, hyperlipidemia, and diabetes mellitus for many years. On admission, her electrocardiogram [ECG] revealed normal sinus rhythm and dynamic T inversion in the precordial leads. Her enzyme levels were normal. Transthoracic echocardiography showed a left ventricular ejection fraction of 60%, with mild mitral regurgitation. Because of ST depression during the peak exercise test, cardiac catheterization was suggested and then performed. Coronary angiography demonstrated normal left main coronary artery courses with normal dominant left circumflex artery and left anterior descending artery [LAD]. An anomalous right coronary artery [RCA] was seen, with a nondominant separate branch arising from the mid part of the LAD. It then coursed anteriorly down on the right atrioventricular groove [Figure 1]. Attempts for the cannulation of the RCA were unsuccessful. Aortic root angiography did not show the presence of an independent-origin RCA from the ascending aorta [Figure 2 and Figure 3]. We selected medical management of X syndrome [microvascular disease] and followed up the patient because of the nondominancy of the RCA. There was no need for revascularization or surgery. She was discharged in good condition. The prevalence of the anomalous origin of the RCA from the left system varies from 0.1% to 0.9%.[1] The risk of sudden death and the anomalous origin of the RCA from the left side has yet to be fully elucidated. Some studies have shown that the anomalous origin of the RCA is generally asymptomatic.[2] The management of patients is different, depending on their clinical presentations, anatomical details, and additional findings.[3]
ABSTRACT
Polyethylenimine [PEI], a readily available synthetic polycation which has high transfection efficiency owing to its buffering capacity was introduced for transfection a few years ago. But it has been reported that PEI is cytotoxic in many cell lines. In this study, in order to enhance the transfection efficiency of 10 kDa PEI and reduce its toxicity, hydrophobic residues were grafted on PEI. PEI polymers were modified by adding hydrophobic chains to the primary amines of PEI in different degrees of grafting using bromoacetic acid derivatives with different lengths. These polymers were complexed with plasmid DNA at different C/P ratios and the resulting nanoparticles were characterized by dynamic light scattering and EtBr-DNA binding assay to determine particle sizes and complex formation, respectively. Cytotoxicity and transfection efficiency of the polymers were also tested in cultured Neuro2a cell line. DNA condensation measurement revealed that the resulted polymers could form polyplexes with plasmid DNA and they have the ability to condense DNA in relatively low amounts of polymers. Particle size measurement of polyplexes showed that they form particles in the size range of below 190 nm. Transfection experiments showed that polymers which have been modified with hexanoic derivative could transfect pDNA as good as 25 kDa PEI with the advantage of being much less toxic. Results indicate that the structure modifications of PEI accomplished in this study play a significant role in increasing the transfection efficiency and without inducing the cytotoxicity compared to PEI itself