Immediate- and medium-term effects of balloon pulmonary valvuloplasty in infants with critical pulmonary stenoses during the first year of life: a prospective single center study

Balloon pulmonary valvuloplasty [BPV] represents the standard of management for all patients with severe pulmonary stenosis [PS] irrespective of their age. Nevertheless neonates and infants with critical PS represent a high-risk group that needs to be studied. The study population included 72 infants with severe congenital valvular PS and four infants with imperforate pulmonary valve [PV] who were subjected to detailed history taking, full clinical examination, resting 12-lead ECG, Chest roentgenogram and transthoracic echocardiography. BPV was attempted in all infants with a peak-to-peak gradient across the PV of 50 mmHg or greater at catheterization-laboratory. Full echocardiographic evaluation was done 24 hours after the procedure as well as 3 and 6 months later. Seventy-six infants with severe PS or imperforate PV with a mean age of 5.63 +/- 2.99 months were subjected to BPV with or without wire perforation. Immediately after the procedure patients had a significant reduction of the right ventricular systolic pressure [RVSP] [104.69 +/- 24.98 mm Hg Vs 43.6 +/- 13 mm Hg, p < 0.001] and RV-PA systolic pressure gradient [PG] [82.5 +/- 23.76 mm Hg Vs 17.35 +/- 8.96 mm Hg, p < 0.001]. The immediate success rate defined as the drop in the RVSP to less than or equal to 50% of the baseline measurement was achieved in 85% of the cases. There was a progressive drop in the PG across the PV by Doppler echocardiogram throughout a follow-up period of six months from a mean of 93.3 +/- 28.2 mm Hg to a mean of 17.4 +/- 10.42 mm Hg [p < 0.001]. There was a significant increase of the mean PV annulus diameter after balloon dilatation [p < 0.001]. There was also a highly significant inverse correlation between the growth of the pulmonary annulus and the annular size at the baseline before dilatation [r = -0.74, p value <0.001]. The incidence of PR significantly increased immediately after BPV to 64% followed by a progressive decline over a 6 months period of follow-up to 20%. There was a significant decrease in the incidence of tricuspid regurgitation [TR] over the same period of follow-up [from 55.6% at baseline to less than 20% at follow-up]. BPV is safe and effective to relieve critical PS in infants during the first year of life. The balloon promotes advantageous changes in both, pulmonary annulus and PG across the RVOT. In addition, the Doppler gradient observations during the follow-up support the expectation that BPV is a "curative" therapy

Heat shockprotein70 [HSP70]: a novel biomarker for narcotic drugs and hepatotoxic agents

Heat shock protein [HSP70] was used as a good biomarker for intoxication of different hazardous chemicals. The impact of common narcotic drugs [heroin and opium], in comparison with experimentally proven hepatotoxic agents [CCl[4], ethanol and iron] on the induction of HSP70 in liver of both rat and mice was assessed. Heroin proved to be the most potent inducer of liver tissue intoxication followed by CCl[4], iron overloaded with ferric hydroxide dextran complex [Fe-HDC], ethanol, and opium. This may be related to defense mechanism against the rapidly occurring cell damage or subsequent processes of liver tissue inflammation. This is an attempt to define the incidence and severity of liver disorders among a large number of drug addicts. The expression levels of HSP70 were measured using Western dot blot technique. The obtained data demonstrate specific but statistically different significant values [P< 0.05] of HSP70 induction levels with all studied hepatotoxic agents. Heroin was the most potent inducer of [HSP70] followed by CCl[4], Fe-HDC, ethanol, and then opium. The increased levels of HSP70 in the liver tissues may be attributed to antioxidant defense mechanism against liver cell damage. In conclusion: Heat shock protein [HSP70] is a biomarker for hepatic cell injury playing an important role in tissue protection against narcotic drugs and hepatotoxic agents

Macro-and micromorphological study of calendula arvensts L grown in Egypt II the inflorescence

The macro- and micromorphological characters of the inflorescence of Calendula arvensis L. [Family Compositae] grown in Egypt were presented

Macro-and micromorphology of leaf, young stem and stem bark of calycodendron milnei

On the continuation of pharmacognostical study of Calicotome villosa Poir., a macro- and micromorphological study of leaves and stems was presented with the view of finding out the diagnostic characters for identification of these organs in both entire and powdered forms