Role of exercise echocardiography in decision making of balloon valvuloplasty in moderate mitral valve stenosis

Assessment of value of exercise echocardiography using in patients with rheumatic moderate mitral valve stenosis in interventional decision making [percutenous balloon mitral valvuloplasty]. 30 patients with moderate mitral stenosis were participated in the study. All patients were subjected to exercise echocardiography and were divided into two groups. Group I: 20 patients with good exercise tolerance and group II: 10 patients with poor exercise tolerance and mitral valvuloplasty was done, and then reevaluated with exercise echocardiography one month after valvuloplasty. In group [I] mean pressure gradient across mitral valve at peak of exercise was ranged between 12 and 16 mmHg with mean of 134.78 +/- 1.33 mmHg, while in group[II] mean pressure gradient across mitral valve at peak of exercise was ranged between 17 and 20 mmHg with mean of 18.30 +/- 1.25 mmHg. In group [I] pulmonary artery pressure at peak of exercise ranged between 25 and 40 mmHg with mean of 30.00 +/- 5.38 mmHg, while in group [II] it was ranged between 35 and 40 mmHg with mean of 39.00 +/- mmHg at peak of exercise. All members of group II had subvalvular affection [high score] and 50% of them had high score for calcification with poor exercise tolerance while non of group I had subvalvular affection and only 10% of them had law calcific score]. Exercise echocardiography plays an important role in evaluating true symptomatic patients and assesses the hemodynamic severity in patients with moderate mitral stenosis

Relation of angiotensin converting enzyme activity and gene polymorphism to restenosis after percutaneous transluminal coronary angioplasty

Early restenosis in up to 30% of cases limits the benefits of percutaneous transluminal coronary angioplasty [PTCA]. The mechanisms that underlie restenosis are uncertain, although experimental evidence suggests that the renin-angiotensin system is involved in the vascular response to angioplasty. The ACE gene is one of the major genes of the renin-angiotensin and kallikrein-kinin systems and is a candidate gene for several cardiovascular diseases for which a genetic predisposition has been established. The ACE gene contains a common insertion deletion polymorphism termed I and D, respectively. The three possible genotypes are DD, ID and II, and the plasma level of ACE is highest with the DD genotype. This work aimed to investigate whether ACE gene polymorphism influences the risk of restenosis after PTCA to explore a relation between the total ACE level and restenosis and to compare the ACE genotypes of the patients of the study with those of a control group of healthy subjects. This study included 53 patients with CAD, 48 males and 5 females, their age ranged from 36 to 63 years. All patients were compared to 46 control subjects with age and sex matched. The patients were divided into two groups: group [A][40 patients with no restenosis] and group [B][13 patients with restenosis]. All patients were subjected to: full history and clinical examination, laboratory investigations which include estimation of serum angiotensin converting enzyme levels and detection of genotypes of the ACE gene I/D polymorphism, 12-lead electrocardiogram, treadmill exercise stress testing, coronary angiography and PTCA. The distribution of ACE genotype [DD] was not significantly different in-group B patients with restenosis compared with group A patients with no restenosis [8 out of 13, versus 15 out of 40 respectively, P> 0.05]. Plasma ACE levels did not differ between patients and control subjects [P value > 0.05]. Although plasma ACE levels were significantly higher in relation to ACE genotypes [P value < 0.05], plasma ACE levels were insignificant in relation to restenosis [P value > 0.05]. Since there was no evidence that variation at the ACE gene defined by the I/D polymorphism influences the extent of restenosis, it could be concluded that determination of ACE I/D genotypes is unlikely to be useful in identifying patients at higher risk of restenosis after PTCA and continued studies with clinically different subsets of patients is warranted

Puriffication and characterization of L-asparaginase produced by Streptomyces phaeochromogenes FS-39

An L-asparaginase [EC.3.5.1.1] produced by Streptomyces phaeochromogenes FS-39 was purified and characterized. After initial ammonium sulfate fractionation [50-70% saturation], the enzyme was purified by consecutive column chromatography on ion exchange [DEAE-Cellulose] and Sephadex G-200 filtration. The 67.2 fold purified enzyme thus obtained has the specific activity of 179.14 units mg protein super [-1] with an over all recovery of 17.7%. The enzyme was characterized by demonstration of optimum activity at 35°C and pH 8.5. It was stable for 180 min. at 30-35°C and 7 days at 4°C [refrigerator] and pH range from 8.0 to 9.0. The enzyme activity was slightly stimulated by Mg supper [2+], Fe super [2+] and Ca super [2+] cations, but Na-azid and EDTA did not exert any effect on the enzyme activity. Hg super [2+], Ag super [+] and Cu super [2 +] cations as well as L-cysteine, iodine, KCN and iodoacetic acid strongly inhibited the enzyme, but Zn super [2+], KMnO4 and super [2+] potentially slightly inhibited the enzyme activity. L-aspartic acid was competitive inhibitor