Efecto del Cigarrillo Electrónico sobre los Espermatozoides Humanos: Aproximación in vitro / Effect of Electronic Cigarette on Human Sperm: in vitro Approximation

Introducción Los cigarrillos electrónicos (E-Cig) aparecieron en el mercado hace 15 años como una alternativa para combatir el consumo de tabaco, un problema de salud pública, sin embargo, su efecto sobre la salud reproductiva no ha sido completamente evaluado. El objetivo del presente estudio, fue evaluar los efectos de los E-Cig sobre los espermatozoides humanos in vitro. Métodos Un dispositivo para incubar en contacto directo a los espermatozoides con el vapor a partir de dos esencias diferentes (TNT y Sugar Drizzle), el humo del cigarrillo o aire como control negativo fue construido. Adicionalmente, usando el mismo dispositivo, se elaboró el extracto a partir del aire, de las dos esencias con el E-Cig y con el cigarrillo Piel Roja sin filtro en medio para incubar en contacto indirecto con los espermatozoides. Resultados Se observó disminución de la movilidad con el E-Cig en más del 38% en el tiempo y una disminución de la viabilidad en más del 18% que se mantenían con el tiempo mientras que con el cigarrillo convencional afectaba la movilidad y la viabilidad en casi el 100%. Finalmente se encontró que se afecta más la movilidad de los espermatozoides con la esencia de Sugar Drizzle que contaba con menos concentración de nicotina que con la esencia de TNT. Conclusiones En conclusión, tanto el cigarrillo convencional como el E-Cig afectan los parámetros seminales (movilidad y viabilidad), y se postula que el uso del E-Cig, aunque es menos citotóxico y afecta menos que el cigarrillo convencional, también puede generar a largo plazo problemas de infertilidad.

Introduction Electronic cigarettes (E-Cig) appeared in the market 15 years ago as an alternative to combat tobacco use, a public health problem, however, its effect on reproductive health has not been fully evaluated. The objective of the present study was to evaluate the effects of E-Cig on human sperm in vitro. Methods A device to incubate sperm in direct contact with steam from two different scents (TNT and Sugar Drizzle), cigarette smoke or air as a negative control was built. Additionally, using the same device, extracts were elaborated from the air, from the two essences with the E-Cig and with the Red Skin cigarette without a filter in the medium to incubate in indirect contact with sperm cells. Results Decreased motility with E-Cig was observed in more than 38% over time and a decrease in viability in more than 18% that was maintained over time while with the conventional cigarette affected motility and viability in almost 100%. Finally, we found that sperm motility of the sperm is more affected with the essence of Sugar Drizzle that had less nicotine concentration than with TNT essence. Conclusions In conclusion, both the conventional cigarette and the E-Cig affect the seminal parameters (motility and viability) and it is postulated that the use of the E-Cig, although it is less cytotoxic and affects less than the conventional cigarette can also generate long-term infertility problems

Experimental Study to Develop a Method for Improving Sample Collection to Monitor Laryngoscopes after Reprocessing

BACKGROUND/AIMS: The microbiological surveillance of endoscopes and automated flexible endoscope reprocessing have been proven to be two of the most difficult and controversial areas of infection control in endoscopy. The purpose of this study was to standardize a sampling method for assessing the effectiveness of standard reprocessing operating procedures for flexible fiberoptic laryngoscopes (FFLs). METHODS: First, the sampling devices were directly inoculated with Bacillus atrophaeus spores; second, tissue non tissue (TNT) wipes were tested on artificially contaminated surfaces and on FFLs. RESULTS: Comparison of the sponges, cellulose, and TNT wipes indicated that the TNT wipes were more effective in releasing spores (93%) than the sponges (49%) and cellulose wipes (52%). The developed protocol provides a high efficiency for both collection and extraction from the stainless steel surface (87% of the spores were removed and released) and from the FFL (85% of the spores were removed and released), with relatively low standard deviations for recovery efficiency, particularly for the analysis of the FFL. CONCLUSIONS: TNT wipes are more efficient for sampling surface areas, thereby aiding in the accuracy and reproducibility of environmental surveillance.

Performance Evaluation of the Point-of-Care Cardiac Troponin T Assay

BACKGROUND: The point-of-care (POC) troponin T assay has been used in various clinical settings. Recently, a POC troponin T assay with an extended measurable range (40 ng/L-2,000 ng/L) was introduced. We aimed to evaluate the analytical performance of the Roche Cardiac POC Troponin T assay (POC TnT, Roche Diagnostics, Switzerland) using the cobas h 232 POC system. METHODS: The repeatability and within-laboratory imprecision of the POC TnT assay were evaluated using the Roche Cardiac POC Troponin T level 2 control. Repeatability was also assessed using patient samples. Linearity of the POC TnT assay was evaluated using patient samples containing five different concentrations of troponin T. Performance of the Elecsys Troponin T high sensitivity assay (hs-TnT) was compared with that of the POC TnT assay using 40 patient samples. RESULTS: The repeatability (%CV), and within-laboratory imprecision (%CV) using the level 2 control solution (mean troponin T, 441.6 ng/L) were 8.5% and 8.6%, respectively. The repeatability of patient samples containing 88.7 ng/L and 454.6 ng/L TnT was 7.5% and 7.2%, respectively. The POC TnT assay was confirmed to produce linear data between 54.0 ng/L and 1,347.7 ng/L. Relative to the hs-TnT assay, the Passing-Bablok linear regression equation (correlation coefficient) was y=0.8933x+6.24 (r=0.988). At a troponin T concentration of 40 ng/L, the estimated bias of the POC TnT assay was 1.972 ng/L (4.93%). CONCLUSIONS: Our data suggest that the Roche Cardiac POC Troponin T assay is reliable in cases where POC troponin T testing is required.

Measurement of Succinylacetone Using HPLC-Tandem Mass Spectrometry and Establishment of a Cut-off Value

BACKGROUND: Newborn screening of tyrosinemia type 1 is important for identifying infants at risk for developing this disease before life-threatening symptoms occur. It is difficult to differentiate between tyrosinemia type 1 and transient neonatal tyrosinemia (TNT) by analyzing tyrosine alone. Thus, succinylacetone must be analyzed. In this study, we measured succinylacetone in dried blood spot (DBS) by HPLC-tandem mass spectrometry (HPLC-MS/MS) and established cut-off values. METHODS: We used the hydrazine derivatization method to measure succinylacetone in 127 DBSs showing normal results in the newborn screening test and 93 DBSs showing increased tyrosine levels. We established cut-off values using the 99.9th percentile value or median+5 standard deviation value. RESULTS: Succinylacetone levels determined by our method were well-correlated with the results recommended by the Centers for Disease Control and Prevention for proficiency testing (r=0.9968). The succinylacetone levels in normal newborn DBSs were significantly lower than those in DBSs with high tyrosine levels (P < 0.001). The cut-off values were calculated to be 1.3 µM from the results of 127 normal DBS samples and 2.2 µM from 220 DBSs, including in 93 newborns with TNT. CONCLUSIONS: Measurement of succinylacetone in DBSs by HPLC-MS/MS is useful in individuals with increased tyrosine concentrations and can be used for rapid differential diagnosis of tyrosinemia when an appropriate cut-off value is established.

Degradation of 2,4,6-trinitrotoluene by P. aeruginosa and characterization of some metabolites

Degradation of 2,4,6-trinitrotoluene (TNT), a nitroaromatic explosive found in the soil and ground water, was investigated using Pseudomonas aeruginosa in in vitro experiments. Biodegradable abilitiy of this bacteria was performed with 50 and 75 mg L−1 TNT concentrations in a defined liquid medium for 96 h time period. Treatment of TNT in supernatant samples taken at 0, 6, 12, 24, 48, 72 and 96 h from agitated vessels was followed by reverse-phase high-performance liquid chromatography (HPLC). In cultures supplemented with 50 and 75 mgL−1 TNT, after 96 h of incubation 46% and 59% reduction were detected respectively. Two metabolites as degradation intermediates with nitrite release into the medium, 2,4-dinitrotoluene (2,4-DNT) and 4-aminodinitrotoluene (4-ADNT), were elucidated by thin layer chromatography (TLC) and gas chromatography-mass spectrometry (GC-MS). These findings clearly indicate that Pseudomonas aeruginosa can be used in bioremediation of TNT contaminated sites.

Analysis of eye ultrasonography in patients with trinitrotoluene cataract / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To evaluate the diagnostic value of ultrasonography for trinitrotoluene (TNT) cataract.</p><p><b>METHODS</b>The morphology and internal echoes of 90 lenses of 45 TNT cataract patients and 120 lenses of 60 healthy adults were observed and compared using ultrasonography and slit lamp, and the hemodynamic parameters of the post-ophthalmic artery were also measured. The findings of the slit-lamp microscope were regarded as diagnostic criteria, and the sensitivity, specificity, and accordance rate of ultrasonography in the diagnosis of TNT cataract were calculated.</p><p><b>RESULTS</b>The sensitivity, specificity, and accordance rate of ultrasonography in the diagnosis of TNT cataract were 93.33%, 100.00%, and 97.14%, respectively; the positive and negative predictive values were 100% and 95.23%, respectively; the positive and negative likelihood ratios were 93.33 and 0.67, especuvey. With the progression TNT cataract, utrasonography showed that the lenses demonstrated morphological changes (spindle-shaped, spherical, and discoid morphologies), and the arc echoes of the posterior capsule were thickened and enhanced. The TNT cataract patients showed significantly lower peak systolic velocity and end-diastolic velocity of the ophthalmic artery (OA) and central retinal artery (P<0.01) and a significantly higher resistance index (P<0.05) than the healthy adults.</p><p><b>CONCLUSION</b>The sensitivity of ultrasonography in the diagnosis of TNT cataract is similar to that of slit lamp. Ultrasonography can demonstrate objectively the shape, range, and degree of lens opacity in an efficient manner, which is conducive to the diagnosis and staging of TNT cataract by slit lamp, and can also provide hemodynamic information of the OA, thus providing new ideas for clinical physicians in evaluating the disease and clinical efficacy as well as exploring therapies.</p>

Factors Related to Subarachnoid Hemorrhage as a Cause of Out-of-Hospital Cardiac Arrest

PURPOSE: Subarachnoid hemorrhage (SAH) is a common cause of out-of-hospital cardiac arrest (OHCA). Early identification of patients with SAH induced OHCA may be helpful to emergency physicians when making therapeutic decisions. We conducted an investigation of the incidence and characteristics of patients with OHCA caused by non-traumatic SAH. METHODS: We conducted a retrospective review of cases of 236 OHCA survivors who had visited the emergency department (ED) of an urban tertiary care university hospital from January 2004 to December 2010. We excluded patients for whom there was an obvious cause or trauma. Clinical characteristics of SAH induced OHCA survivors were compared with those of SAH negative OHCA survivors. RESULTS: A total of 26 patients (19.11%) had been diagnosed with SAH. Compared with SAH negative survivors, SAH positive survivors were more likely to be female (odds ratio OR, 1.262; 95% confidence interval CI, 1.300-9.605), not to have Diabetes mellitus (OR, 0.180; 95% CI, 0.037-0.879), and to have a short duration of CPR time (OR, 1.074; 95% CI, 1.003-1.150). Results of the Cardiac Troponin T assay were less likely to be positive in patients with SAH induced OHCA, compared to those with SAH negative OHCA (OR, 0.071; 95% CI, 0.008-0.526). CONCLUSION: SAH is a more frequent cause of OHCA than originally believed. Immediate brain CT scan is useful in diagnosis of SAH when patient characteristics include: female, non diabetes mellitus, short duration of CPR time, or negative TnT.

Impact of High-Dose Statin Pretreatment in Patients with Stable Angina during Off-Pump Coronary Artery Bypass

BACKGROUND: Periprocedural treatment with high-dose statins is known to have cardioprotective and pleiotropic effects, such as anti-thrombotic and anti-inflammatory actions. We aimed to assess the efficacy of high-dose rosuvastatin loading in patients with stable angina undergoing off-pump coronary artery bypass grafting (OPCAB). MATERIALS AND METHODS: A total of 142 patients with stable angina who were scheduled to undergo surgical myocardial revascularization were randomized to receive either pre-treatment with 60-mg rosuvastatin (rosuvastatin group, n=71) or no pre-treatment (control group, n=71) before OPCAB. The primary endpoint was the 30-day incidence of major adverse cardiac events (MACEs). The secondary endpoint was the change in the degree of myocardial ischemia as evaluated with creatine kinase-myocardial band (CK-MB) and troponin T (TnT). RESULTS: There were no significant intergroup differences in preoperative risk factors or operative strategy. MACEs within 30 days after OPCAB occurred in one patient (1.4%) in the rosuvastatin group and four patients (5.6%) in the control group, respectively (p=0.37). Preoperative CK-MB and TnT were not different between the groups. After OPCAB, the mean maximum CK-MB was significantly higher in the control group (rosuvastatin group 10.7+/-9.75 ng/mL, control group 14.6+/-12.9 ng/mL, p=0.04). Furthermore, the mean levels of maximum TnT were significantly higher in the control group (rosuvastatin group 0.18+/-0.16 ng/mL, control group 0.39+/-0.70 ng/mL, p=0.02). CONCLUSION: Our findings suggest that high-dose rosuvastatin loading before OPCAB surgery did not result in a significant reduction of 30-day MACEs. However, high-dose rosuvastatin reduced myocardial ischemia after OPCAB.

Biodegradation of 2,4,6-Trinitrotoluene by White-Rot Fungus Irpex lacteus

White-rot fungus Irpex lacteus degraded TNT significantly in proportion to the culture time. After 48 h incubation, about 95% of TNT was degraded. Two reduced metabolites were identified as 4-amino-2,6-dinitrotoluene (4-ADNT) and 2-amino-4,6-dinitrotoluene (2-ADNT) which was further degraded.

Changes of C-reactive Protein are Associated With Myocardial Injury After Successful Percutaneous Coronary Intervention

BACKGROUND AND OBJECTIVES: Myocardial injury after percutaneous coronary intervention (PCI) occurs frequently and it is associated with an adverse clinical outcome. Mechanical factors have been implicated in this complication and the role of inflammation has not yet been clearly determined. We evaluated the effect of an inflammatory response during PCI on periprocedural myocardial injury. SUBJECTS AND METHODS: We prospectively studied 231 patients (mean age: 62.8+/-10.6 years, males: 60.6%) who underwent elective coronary stenting. For the exclusion of mechanical injury to the myocardium, we excluded those patients who developed complications during PCI. Blood samples for measuring the high sensitivity C-reactive protein (hsCRP) and troponin T (TnT) were obtained before the procedure and at 6 hours and 24 hours after PCI. The inflammatory response to PCI was calculated as the difference between the peak postprocedural hsCRP level and the preprocedural hsCRP level (delta CRP). We divided the patients according to the median value of delta CRP: Group I or =2.2 mg/dL. RESULTS: Postprocedural TnT elevation was were observed in 72 (31.2%) patients. The baseline clinical and angiographic characteristics were not difference between the two groups. The incidence of any TnT elevations was higher in the Group II than that in Group I (19.8% vs 42.6%, respectively, p<0.001). The incidences of TnT levels over 3 times the upper normal limit and 5 times the upper normal limit were also higher in Group II than in Group I (11.2% vs 21.7%, respectively, p=0.031, for a TnT level 3 times the upper normal limit, and 6.0% vs 13.9%, respectively, for a TnT level 5 times the upper normal limit). Multivariate analysis revealed that postprocedural hsCRP elevation and complex lesion were the significant independent predictors of postprocedural TnT elevation. CONCLUSION: Elevated hsCRP levels were associated with a higher risk of postprocedural troponin elevation in patients undergoing uncomplicated PCI. These results emphasized the role of inflammation in the pathogenesis of periprocedural myocardial injury.

Phytoremediation of soil contaminated with cadmium and/or 2,4,6-trinitrotoluene.

Phytotoxicity, microbial activity, plant uptake and microbial degradation were examined using Rumex crispus in TNT and/or cadmium contaminated columns (TNT: 100 mg/kg of soil and Cd: 10 mg/kg of soil). The growth of plants was significantly inhibited by TNT, but not by Cd. The microbial activity was highly increased by plant root growth, decreased by Cd, and slightly reduced by TNT. The plant uptake of Cd was relatively well in Cd-contaminated column, but lowered by TNT in TNT+Cd-contaminated column. The microbial degradation of TNT occurred much faster in planted columns than in unplanted columns with minor effect of Cd (less 2-ADNT was produced). Therefore, it may be effective to treat TNT first and then Cd using phytoremediation in the TNT plus Cd contaminated sites.

Biodegradation of nitro-explosives.

Environmental contamination by nitro compounds is associated principally with the explosives industry. However, global production and use of explosives is unavoidable. The presently widely used nitro-explosives are TNT (Trinitrotoluene), RDX (Royal Demolition Explosive) and HMX (High Melting Explosive). Nevertheless, the problems of these nitro-explosives are almost parallel due to their similarities of production processes, abundance of nitro-explosives and resembling chemical structures. The nitro-explosives per se as well as their environmental transformation products are toxic, showing symptoms as methaemoglobinaemia, kidney trouble, jaundice etc. Hence their removal/degradation from soil/water is essential. Aerobic and anaerobic degradation of TNT and RDX have been reported, while for HMX anaerobic or anoxic degradation have been described in many studies. A multisystem involvement using plants in remediation is gaining importance. Thus the information about degradation of nitro-explosives is available in jigsaw pieces which needs to be arranged and lacunae filled to get concrete degradative schemes so that environmental pollution from nitro-explosives can be dealt with more successfully at a macroscale. An overview of the reports on nitro-explosives degradation, future outlook and studies done by us are presented in this review.

Nitrocompuestos aromáticos explosivos: biotransformación, toxicidad y remediación / Nitro Compounds explosive aromatics

La contaminación del suelo y de las aguas subterráneas con explosivos representa un problema para la salud pública y para el ambiente. Entre las varias clases de explosivos, el trinitrotolueno (TNT) constituye un importante contaminante. También ha ocasionado toxicidad en trabajadores expuestos. El TNT puede hallarse acompañado por impurezas y recientemente se ha tomado conocimiento de que la disposición del mismo puede generar variados productos de degradación. Uno de los propósitos de este trabajo es proveer al lector de un mejor conocimiento de las interacciones nocivas con los sistemas biológicos del TNT y de todos los compuestos asociados con el mismo (TNT-AC), los cuales incluyen impurezas y productos de degradación y biotransformación. Existen evidencias de que el TNT y algunos TNT-AC son tóxicos y pueden ser cancerígenos. Por otro lado, la remediación de los sitios contaminados con TNT constituye a nivel mundial, un problema que espera una solución. Para lograr la misma, se necesitan tecnologías biológicas, químicas o físicas adecuadas, además de un conocimiento exhaustivo del destino del TNT y los TNT-AC en diversos ecosistemas. Un requisito adicional asociado a esta problemática, es el de disponer de métodos adecuados para la evaluación ecotoxicológica de un sitio dado o tratamiento de remediación

Study on effects of trinitrozotoluen on the cytochrome P450 enzyme system on Vietnamese

The content and the activity of the cytP450 system, peroxydase activity, free SH group in blood of patient intoxicated with trinitrotoluene (TNT) exposure was determined. Results showed that after its invasion into blood, a majority of trinitrotoluene was metabolized and excreted through urine, and deposited partly in organ tissues especially in bone marrow, liver, kidney, fatty and nervous tissues. Aniline hydrolase activity and Cyt P450 content enhanced, peroxydase acitivty, Cyt b5 and free SH group in TNT exposed patients decreased in comparing with healthy subjects. Therefore, it's necessary to strengthen the health of the subjects regularly exposed to TNT

Study on the relationship between the opacity of lens and the levels of 2, 6-dinitro-4-amino-toluene (DNAT) in the urine of workers exposed to trinitrotoluene(TNT) / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To find out the relationship between the opacity in lens and the contents of 2,6-dinitro-4-amino-toluene(DNAT) in the urine of exposed workers.</p><p><b>METHODS</b>Testing the exposed worker's lens and measuring the contents of DNAT in the urine after work.</p><p><b>RESULTS</b>When the opacity of the lens occurred, the contents of DNAT in the urine(2.38 mg/L) of workers exposed to TNT were significantly higher than those without opacity in lens(1.44 mg/L) (P < 0.05).</p><p><b>CONCLUSION</b>The severity of opacity of lens increased with the contents of DNAT raised in the urine. The threshold value suggested by ILO is not applicable to Chinese occupational population, which recommends the contents of DNAT(30 mg/L) in the urine for the workers exposed to TNT as biological occupational exposed limits.</p>

The retrospective survey of malignant tumor in weapon workers exposed to 2,4,6-trinitrotoluene / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To investigate the occupational health risk level of workers exposed to 2,4,6-trinitrotoluene (TNT) in arms industry, so as to provide basis for revising the standard of diagnosis for chronic TNT poisoning, and making protective measures for workers.</p><p><b>METHODS</b>The retrospective study about the morbidity of total malignant tumor was taken on the male workers exposed to TNT over one year from eight military factories during 1970 to 1995.</p><p><b>RESULTS</b>The morbidity of total malignant tumor in male TNT exposed workers were markedly higher than that of controls, and the relative risk (RR) was 2.32. Compared with the total malignant tumor mortality of male populations in large and medium cities in 1973 to 1975 and 1990 to 1992, the standardized mortality ratio(SMR) were 71.8 and 179.6 respectively, the CI of 99% was 71.8-144.2, indicating that the morbidity of malignant tumor of male workers exposed to TNT was higher than that of normal populations. Liver cancer morbidity was 31.91% of the total malignant tumor, and its mortality was 3.97 times of the controls. Compared with the liver cancer mortality of male populations in large and medium cities in 1973 to 1975 and 1990 to 1992, SMR were 150.5 and 381.6 respectively, these data were significantly different, and CI of 99% was 59.3-184.0. The average death age of the TNT exposed workers (51.7 years old) was younger than that of the same factory control(54.1 years old) and male populations(55.6 years old) in large and medium cities. The incidence of liver cancer was closely related to the length of service, the kinds of job in a factory and the level exposed to TNT, and alcohol consumption was synergistic with TNT carcinogenesis.</p><p><b>CONCLUSION</b>The morbidity of malignant tumor of male workers exposed to TNT was markedly higher than that of normal populations. Liver cancer was the most remarkable malignancy, and its incidence was closely related to the length of service and the kinds of job and the level exposed to TNT.</p>

The relationship between hemoglobin adducts of trinitrotoluene and exposed level / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To explore the biomarkers for monitoring trinitrotoluene (TNT) exposure, the relationship between TNT hemoglobin adducts and TNT exposed level.</p><p><b>METHOD</b>Hemoglobin adducts (4A-Hb and 2A-Hb) were determined by GC-MS in 25 TNT exposed workers. TNT exposed level was evaluated by determining skin contaminated and inhaled TNT levels. The correlation between hemoglobin adducts level and TNT exposed level was analyzed.</p><p><b>RESULTS</b>There was a correlation between total TNT exposure level, especially skin exposure level, and 4A-Hb or 2A-Hb content. No significant difference was found between the slopes and intercepts of lin ear equation of (4A-Hb) vs TNT exposed level and linear equation of (4A-Hb +2A-Hb) vs TNT exposed level (P > 0.05).</p><p><b>CONCLUSION</b>Skin contamination is the major role of TNT exposure. TNT exposed level can be evaluated by determining the content of both 4A-Hb and 2A-Hb, and 4A-Hb is more suitable for monitoring TNT exposure.</p>

Impact on Long-term Adverse Cardiac Events of Troponin T or Creatine Kinase-MB Release after Percutaneous Transluminal Coronary Angioplasty

BACKGROUND AND OBJECTIVES: The impact on long-term adverse cardiac events of troponin T (TnT) or creatine kinase-MB (CK-MB) release after percutaneous transluminal coronary angioplasty (PTCA) is not well defined. The purpose of the study is to evaluate the effect of elevated TnT or CK-MB on the late major adverse cardiac events [MACE ; Q wave myocardial infarction (MI), revascularization, or cardiac death]. SUBJECTS AND METHODS: Study population were 207 consecutive patients (M : F=148 : 59, mean 60.8+/-9.2 years) who underwent PTCA. Patients with acute MI, unstable angina with abnormal levels of TnT or CK-MB, or newly developed Q MI after PTCA were excluded. Cardiac enzyme levels were measured before and 8, 24 hours after PTCA for CK-MB, and before and 16 hours after PTCA for TnT. Group I (n=181, 87.4%) had normal levels of both after PTCA. Group II (n=26, 12.6%) had abnormal levels of CK-MB (>or=16 U/L) and/or TnT (>or=0.2 ng/mL). 1-year follow-up was available in 201 (97.1%) patients. RESULTS: Incidence of non-Q MI after PTCA was 26/207 (12.6%). Major complications such as acute coronary occlusion, side branch occlusion, and major dissection were significantly associated with elevation of TnT or CK-MB after PTCA (p=0.01). However, elevation of CK-MB or TnT was not significantly associated with late MACE by Kaplan-Meier survival curve (p=0.46). During 1-year follow-up, event free rate of group I and II were 76.6% and 69.2%, respectively. CONCLUSION: Acute coronary occlusion, side branch occlusion, or major dissection can increase the level of TnT or CK-MB after PTCA. But, elevation of CK-MB or TnT after PTCA dose not significantly influence on late MACE.

Comparison of Inflammatory Response and Myocardial injury Between Normoxic and Hyperoxic Condition during / 대한흉부외과학회지

BACKGROUND: Hyperoxemic cardiopulmonary bypass (CPB) has been recognized as a safe technique and is widely used in cardiac surgery. However, hyperoxemic CPB may produce higher toxic oxygen species and cause more severe oxidative stress and ischemia/reperfusion injury than normoxemic CPB. This study was undertaken to compare inflammatory responses and myocardial injury between normoxemic and hyperoxemic CPB and to examine the beneficial effect of normoxemic CPB. MATERIAL AND METHOD: Thirty adult patients scheduled for elective cardiac surgery were randomly divided into normoxic group (n=15), who received normoxemic CPB (about PaO2 120 mmHg), and hyperoxic group (n=15), who received hyperoxemic CPB (about PaO2 400 mmHg). Myeloperoxidase (MPO), malondialdehyde (MDA), adenosine monophosphate (AMP), and troponin-T (TnT) concentrations in coronary sinus blood were determined at pre- and post-CPB. Total leukocyte and neutrophil counts in arterial blood were measured at the before, during, and after CPB. Lactate concentration in mixed venous blood was analyzed during CPB, and cardiac index (CI) and pulmonary vascular resistance (PVR) were evaluated pre- and post-CPB. All of the parameters were compared between the groups. RESULT: Normoxic group at post-CPB had lower MDA (4.79+/-0.7 vs 5.86+/-0.65 micromol/L, p=0.04) and MPO levels (5.38+/-1.01 vs 8.73+/-0.90 ng/mL, p=0.02), decreased total leukocyte counts (10,484+/-836 vs 13,572+/-1167/mm3, p=0.04) and higher AMP concentrations(1.23+/-0.07 vs 1.00+/-0.04 nmol/L, p=0.05), as well as a reduction in PVR (90.37+/-16.36 vs 118.12+/-12.21 dyne/sec/cm5, p=0.04) compared to hyperoxic group. There were no significant differences between the two groups with regard to TnT, lactate concentrations, and CI. CONCLUSION: Normoxic CPB provides less myocardial and lung damage related to oxygen free radicals and low inflammatory responses compared to hyperoxic CPB at post-CPB. Therefore, these results suggest that normoxemic CPB is a safe and salutary technique that could be applied in all cardiac surgery.