Is elevated triglyceride high density lipoprotein cholesterol ratio a risk factor that causes acute coronary syndrome to appear earlier?

BACKGROUND: The purpose of this study was to assess the relationship between the triglyceride/high density lipoprotein cholesterol ratio and the risk of acute myocardial infarction in young adults. PATIENTS AND METHODS: A total of 621 patients, who underwent coronary angiography (CAG) due to Myocardial Infarction (MI) at our hospital were included in this study. Demographic characteristics, risk factor profile, laboratory test results, electrocardiographic and CAG findings were assessed in the selected groups. RESULTS: Total cholesterol, triglyceride/high density lipoprotein cholesterol (Tg/HDL) ratio, Tg levels, were higher in younger patients with MI, while glucose and high-density lipoprotein levels were lower. Using propensity score matching in the matched population comparing young patients to the older ones, serum triglyceride levels [179 (145-231) vs 148 (101-197)] and triglyceride to high density lipoprotein cholesterol ratio [5.8 (4.1-9.1) vs 3.0 (1.8-4.6)] were significantly higher, whereas high density lipoprotein levels were observed dramatically lower (32.6 ± 8.2 vs 41.7 ± 8.8). CONCLUSION: This study demonstrated that Tg/HDL ratio may be an important predictor for an acute coronary syndrome in the young adult population. Tg/HDL ratio can be used to prevent MI in young adults (Tab. 3, Fig. 1, Ref. 32.).

Development of Solid-Phase Extraction and HPLC Method for Simultaneous Estimation of Ilaprazole and Glimepiride in Rat Plasma: Application to Pharmacokinetic Studies.

A novel, simple and mass spectrometry (MS) compatible high-performance liquid chromatography (HPLC) method is reported for the simultaneous estimation of ilaprazole (ILA) and glimepiride (GLM) in rat plasma. The bio-analytical procedure involves extraction of ILA, GLM and internal standard (IS) from rat plasma with a solid-phase extraction (SPE) process. The chromatographic analysis was performed on Waters-600 system using an isocratic mobile phase comprising methanol:water (80:20 % v/v) with pH of water modified to three using formic acid at a flow rate of 1.0 mL/min and Kinetex C18 column maintained at 30 ± 1°C. The signals were monitored using a PDA detector set at 225 nm. IS, ILA and GLM eluted at 2.04, 4.7 and 7.4 min, respectively, and the total run time was 10 min. Method validation was performed as per US Food and Drug Administration guidelines and the results met the acceptance criteria. The calibration curve was linear over a concentration range of 10-600 ng/mL (r2 = 0.999). The intra- and inter-day precisions for ILA and GLM were (%RSD values) in the range of 1.52-9.74 and 1.52-11.76%, respectively, in rat plasma. The method was successfully applied in pharmacokinetic studies followed by oral administration of GLM and ILA in rats.

Neutrophil-lymphocyte ratio may predict in-hospital mortality in patients with acute type A aortic dissection.

INTRODUCTION: Inflammation has been reported to be associated with aortic dissection (AD), from the development to the prognosis of AD. In this study we aimed to find the role of the neutrophil-lymphocyte ratio (NLR) in the prediction of clinical events in patients with acute AD type A. PATIENTS AND METHODS: The study comprised 37 patients who were hospitalized at our center between 2009 and 2013 with the diagnosis of acute AD type A. RESULTS: The mean NLR was significantly higher in patients with pericardial effusion than those without effusion (15.6 ± 11.4 vs. 7.5 ± 4.8, p = 0.005). An NLR value > 8.51 yielded an area under the curve (AUC) value of 0.829 [95 % confidence interval (CI) 0.674-0.984, p = 0.004], which demonstrated a sensitivity of 77 % and specificity of 74 % for the prediction of mortality. CONCLUSIONS: The novel inflammatory marker NLR could be used to predict pericardial effusion and in-hospital mortality in patients with acute AD type A.

Gradient HPLC-DAD determination of paracetamol, phenylephrine hydrochloride, cetirizine in tablet formulation.

Present work describes the development and validation of a simple and reliable high-performance liquid chromatography-diode array detection (HPLC-DAD) procedure for the analysis of phenylephrine hydrochloride (PHE), paracetamol (PAR) and cetirizine dihydrochloride (CET), in pharmaceutical mixture. The method was applied successfully on tablet dosage form. Effective chromatographic separation of PHE, PAR and CET was achieved using a Kinetex-C18 (4.6, 150 mm, 5 mm) column with gradient elution of the mobile phase composed of 10 mM phosphate buffer (pH 3.3) and acetonitrile. The elution was a 3 step gradient elution program step-1 started initially with 2% (by volume) acetonitrile and 98% phosphate buffer (pH 3.3) for first 2 min. In step-2 acetonitrile concentration changed linearly to 20% upto 12 min the analysis was concluded by step-3 changing acetonitrile to 2% upto 20 min. The reliability and analytical performance of the proposed HPLC procedure were statistically validated with respect to linearity, ranges, precision, accuracy, selectivity and robustness. Calibration curves were linear in the ranges 5-15, 250-750 and 2.5-7.5 µg/ml for PHE, PAR and CET, with correlation coefficients >0.9996. The validated HPLC method was applied to a pharmaceutical mixture of a marketed preparation tablet in which the analytes were successfully quantified with good recovery values with no interfering peaks from the excipents.

Development and validation of RP-HPLC method for sildenafil citrate in rat plasma-application to pharmacokinetic studies.

Sildenafil citrate (SIL) is used in the treatment of erectile dysfunction and other chronic disorders. For the pharmacokinetic investigation of SIL we developed a simple and sensitive method for the estimation of SIL in rat plasma by reverse phase high-performance liquid chromatography (RP-HPLC). The drug samples were extracted by liquid-liquid extraction with 300 µl of acetonitrile and 5 ml of diethyl ether. Chromatographic separation was achieved on C18 column using methanol:water (85:15 v/v) as mobile phase at a flow rate of 1 ml/min and UV detection at 230 nm. The retention time of SIL was found to be 4.0 min having a separation time less than 5 min. The developed method was validated for accuracy, precision, linearity and recovery. Linearity studies were found to be acceptable over the range of 0.1-6 µg/ml. The method was successfully applied for the analysis of rat plasma sample for the application in pharmacokinetic study, drug interaction, bioavailability and bioequivalence.

Development and validation of RP-HPLC method for simultaneous estimation of glimepiride and sildenafil citrate in rat plasma-application to pharmacokinetic studies.

A simple and sensitive method was developed for simultaneous estimation of Glimepiride (GLIM) and Sildenafil citrate (SIL) in rat Plasma by reverse phase high performance liquid chromatography (RP-HPLC). The drug samples were extracted by liquid-liquid extraction with 300 µl of acetonitrile and 5 ml of diethyl ether. Chromatographic separation was achieved on C18 column using methanol: water (85:15 v/v) as mobile phase at a flow rate of 1 ml/min and UV detection at 230 nm. The retention time of GLIM and SIL was found to be 2.5 and 4.0 min respectively with total run time of 7 min. The developed method was validated for accuracy, precision, linearity and recovery. The method was linear and found to be acceptable over the range of 100-12 000 ng/ml. The method was successfully applied for the analysis of rat plasma sample for application to pharmacokinetic.

Reversible myocardial stunning due to carbon monoxide exposure.

We report on a 37-year-old patient who suffered from myocardial stunning after exposure to carbon monoxide, despite having normal coronary arteries. As myocardial ischaemia may be asymptomatic in these patients, close monitoring with serial electrocardiography and of serum cardiac enzymes and troponins is recommended.

Pharmacokinetics of sulfadimethoxine and ormetoprim in a 5:1 ratio following intraperitoneal and oral administration, in the hybrid striped bass (Morone chrysops x Morone saxitalis).

Selected pharmacokinetic parameters for sulfadimethoxine and ormetoprim, administered in a 5:1 ratio, via the oral and intraperitoneal (i.p.) routes were determined in the hybrid striped bass (Morone chrysops x Morone saxitalis). Plasma concentrations of both drugs were determined by high-performance liquid chromatography. A first-order one-compartment model adequately described plasma drug disposition. The elimination half-lives for sulfadimethoxine following i.p. and oral administration were 26 and 10.5 h, respectively. The half-lives for ormetoprim administered via i.p. and oral routes were 7.5 and 3.9 h, respectively. Cmax for sulfadimethoxine via the i.p. and oral routes were calculated to be 27.7 (+/-9.0) microg/mL at 3.6 h and 3.2 (+/-1.2) microg/mL at 1.2 h, respectively. Cmax for ormetoprim via the i.p. route was calculated to be 1.2 (+/-0.5) microg/mL at 9.1 h and 1.58 (+/-0.7) microg/mL at 5.7 h for the oral route. The oral availability of sulfadimethoxine relative to the i.p. route was 4.6%, while the oral availability of ormetoprim relative to the i.p. route was 78.5%. Due to the nonconstant ratio of these drugs in the plasma of the animal, the actual drug ratio to use for determining minimum inhibitory concentration (MIC) is unclear. Using the ratio of the total amount of each drug that is absorbed as a surrogate for the mean actual ratio may be the best alternative to current methods. Using this ratio as determined in these studies, (2.14:1 sulfadimethoxine:ormetoprim) to determine the MICs the single 50 mg/kg oral dose of the 5:1 combination of sulfadimethoxine and ormetoprim appears to provide plasma concentrations high enough to inhibit the growth of Yersinia ruckeri, Edwardsiella tarda, and Escherichia coli.

The successful long-term treatment of age related erectile dysfunction with hSlo cDNA in rats in vivo.

PURPOSE: We have previously reported that 1 intracorporeal injection of 100 microg hSlo/pcDNA reversed the effect of aging on erectile function in a rat model in vivo for at least 2 months. We report our further investigations of the amplitude, duration and physiological relevance of this novel gene transfer approach. MATERIALS AND METHODS: A total of 191 retired breeder Sprague-Dawley rats were given a single intracavernous injection of phosphate buffered saline, 1,000 microg pcDNA, or 10, 100 or 1,000 microg pcDNA/hSlo. The animals were studied 1 to 6 months after injection. The intracorporeal pressure (ICP) response to cavernous nerve stimulation and immunostaining as well as hematoxylin and eosin staining were done to evaluate effector nerve integrity and tissue histology, respectively. RESULTS: Gene transfer prevented an age related decrease in resting ICP and a physiologically relevant, significant effect on normalizing erection in vivo, as determined by submaximal (0.5 mA) and maximal (4.0 mA) cavernous nerve stimulation. The effects were observed 1 month after transfection and sustained for 6 months at the 100 and 1,000 microg doses of pcDNA/hSlo (p <0.026). CONCLUSIONS: The physiological manifestations of gene transfer were detected as an amelioration of the age related decrease in resting ICP, and parallel increase in the magnitude of the cavernous nerve stimulated an ICP response to a level at which visible erections were again observed in this rat model of aging in vivo.

Surgical removal of an undifferentiated abdominal sarcoma from a koi carp (Cyprinus carpio).

An undifferentiated abdominal sarcoma was removed surgically from a koi carp. The diagnostic procedures, including radiography and computed tomography, and the procedures for general anaesthesia and the surgical approach for a celiotomy in a fish are described. The gross and microscopic appearance of the tumour is described and illustrated.

Imaging a spinal fracture in a Kohaku Koi (Cyprinus carpio): techniques and case history report.

An ornamental pet fish was diagnosed with a spinal fracture and subluxation involving truncal vertebrae 5 and 6 (T5-T6) using conventional radiography, nuclear scintigraphy, and computed tomography. Attempts to evaluate the dynamic nature of the lesion using conventional fluoroscopy in the unanesthetized, moving patient were unsuccessful. Adaptation of imaging techniques to accommodate a fish patient was not difficult and diagnostic images were obtained. The use of multiple imaging techniques was useful in the diagnosis and determination of the treatment plan of the spinal fracture in this patient.

Orbital exenteration and placement of a prosthesis in fish.

OBJECTIVE: To develop a procedure for orbital exenteration and prosthesis placement in fish. DESIGN: Prospective study. ANIMALS: 5 cultured hybrid striped bass (Morone saxatilis x M chrysops) ranging from 30 to 50 cm in length. PROCEDURE: Exenteration was performed, using a dorsal approach in which blunt dissection was performed in the circumorbital sulcus. The orbit was then dried, and simple interrupted sutures were placed, leaving 2 suture loops within the orbit. The orbit was filled with polyvinylsiloxane, and a prosthetic glass eye was seated in the polyvinylsiloxane. RESULTS: All fish retained the prosthesis and had satisfactory cosmetic results at the end of the 8-week study period. CLINICAL IMPLICATIONS: The increase in popularity of pet fish and abundance of valuable aquarium and show fish have led to heightened awareness of piscine ocular disease. Aquarium fish are often euthanatized because of disfiguring ocular problems. The technique described here for surgical exenteration and cosmetic orbital prosthesis placement in fish may extend the captive life of public display fish.

Microsurgical excision of an abdominal mass in a gourami.

A female, sunset, thick-lipped gourami (Colisa labiosa) that weighed 8 g and was 5.4 cm from the snout to the end of the vertebral column was examined because of a 5-mm-diameter, midventrally located mass that had developed suddenly 1 month earlier. Cytologic examination of a sample obtained by use of fine-needle aspiration, survey radiography, positive-contrast radiography of the gastrointestinal tract, and Doppler ultrasonography were performed to evaluate the mass. These procedures were not able to provide a definitive diagnosis, but did facilitate surgical planning. The mass was excised, and the abdominal musculature was repaired, using microsurgical techniques. Redevelopment of the mass was not detected during the 5-month period after surgery. Histologic evaluation of the mass revealed an organized hematoma of undetermined cause. Successful management of this gourami illustrated that size should not be a deterrent to diagnostic evaluation and surgical intervention in diminutive fish.

Aminoacyl-tRNA synthetase and U54 methyltransferase recognize conformations of the yeast tRNA(Phe) anticodon and T stem/loop domain.

The enzyme-catalyzed posttranscriptional modification of tRNA and the contributions of modified nucleosides to tRNA structure and function can be investigated with chemically synthesized domains of the tRNA molecule. Heptadecamer RNAs with and without modified nucleosides and DNAs designed as analogs to the anticodon and T stem/loop domains of yeast tRNA(Phe) were produced by automated chemical synthesis. The unmodified T stem/loop domain of yeast tRNA(Phe) was a substrate for the E coli m5U54-tRNA methyltransferase activity, RUMT. Surprisingly, the DNA analog of the T stem/loop domain composed of d(A,U,G,C) was also a substrate. In addition, the DNA analog inhibited the methylation of unfractionated, undermodified E coli tRNA lacking the U54 methylation. RNA anticodon domains and DNA analogs differentially and specifically affected aminoacylation of the wild type yeast tRNA(Phe). Three differentially modified tRNA(Phe) anticodon domains with psi 39 alone, m1G37 and m5C40, or psi 39 with m1G37 and m5C40,stimulated phenylalanyl-tRNA synthetase (FRS) activity. However, one anticodon domain, with m5C40 as the only modified nucleoside and a closed loop conformation, inhibited FRS activity. Modified and unmodified DNA analogs of the anticodon, tDNA(PheAC), inhibited FRS activity. Analysis of the enzyme activity in the presence of the DNA analog characterized the DNA/enzyme interaction as either partial or allosteric inhibition. The disparity of action between the DNA and RNA hairpins provides new insight into the potential allosteric relationship of anticodon binding and open loop conformational requirements for active site function of FRS and other aaRSs. The comparison of the stimulatory and inhibitory properties of variously modified RNA domains and DNA analogs demonstrates that conformation, in addition to primary sequence, is important for tRNA-protein interaction. The enzyme recognition of various DNA analogs as substrate and/or inhibitors of activity demonstrates that conformational determinants are not restricted to ribose and the standard A-form RNA structure.

Postnatal neuron death in the nodose ganglia of the rat.

Developmental neuron death is well described in sensory and sympathetic ganglia derived from the neural crest. In this study, nodose ganglia were removed from 2 litters of postnatal rats (male and female; 1, 3, 5, 9, and 14 days old) in order to determine whether postnatal neuron degeneration occurs in the nodose ganglia, which is derived from ectodermal placode. The ganglia were embedded in paraffin, sectioned and stained with methylene blue. Neuronal nuclei were counted at a magnification of 100 and diameters of nodose nuclei were traced at each age. There was a significant (p < 0.001) increase in the nuclear diameter of the nodose neurons of male and female rats from birth to postnatal day 14. In male rats, this difference was most marked between postnatal day 5 and postnatal day 14. The results of the neuron counts for both male and female rats indicated a gradual, significant (p < 0.001) decrease in the neuron population from day 1 to 14. For the males a 57.2% decline was observed, while the females displayed a 49.2% decline. The numbers of neurons in male and female ganglia showed no consistent differences. The data for neuron counts suggest that developmental neuron death occurs in postnatal rats with a gradual decrease in number of nodose neurons. However, since our findings show no evidence of degenerating nodose neurons, we are unable to rule out the possibility of migration from the developing ganglion.