Right ventricular myocardial infarction in the era of primary percutaneous coronary intervention.

Right ventricular involvement (RVMI) is a relatively frequent complication in patients developing ST-elevation acute myocardial infarction. The initial diagnosis is most often established using electrocardiography or echocardiography. The gold standard among imaging techniques is cardiac magnetic resonance, which allows to distinguish between reversible and irreversible myocardial damage. The key treatment strategy is emergent revascularization by primary percutaneous coronary intervention whereas patients with hypotension and cardiogenic shock due to the RVMI require fluid replacement and catecholamine therapy. In cases where the shock state progresses despite an adequate management, short- or, possibly, long-term mechanical assist device should be implanted either percutaneously or surgically. Despite appreciable advances in the diagnosis and management, RVMI remains an independent predictor of early as well as late complications (Fig. 6, Ref. 62). Keywords: right ventricle myocardial infarction, primary PCI, CMR, mechanical circulatory support, echocardiography.

Phosphorus-nitrogen compounds: part 30. Syntheses and structural investigations, antimicrobial and cytotoxic activities and DNA interactions of vanillinato-substituted NN or NO spirocyclic monoferrocenyl cyclotriphosphazenes.

The gradual Cl replacement reactions of NN (1-3) or NO spirocyclic monoferrocenyl cyclotriphosphazenes (4 and 5) with the potassium salt of 4-hydroxy-3-methoxybenzaldehyde (potassium vanillinate) resulted in the mono (1a-5a), geminal (gem-1b-5b), non-geminal (cis-5b and trans -1b-4b), tri (1c, 3c-5c) and tetra-vanillinato-substituted phosphazenes (1d-5d). All the phosphazene derivatives have stereogenic P-center(s), except tetra-substituted ones. The vanillinatophosphazenes have reversible voltammograms with one-electron anodic and cathodic peaks which are attributed to ferrocenyl redox probe. The structures of the new phosphazene compounds were determined by FTIR, MS, (1)H, (13)C{(1)H} and (31)P{(1)H} NMR spectral data. The solid-state structure of cis -5b was examined by single-crystal X-ray diffraction techniques. In addition, the compounds were tested in HeLa cancer cell lines using MTT assay. The 12 phosphazene derivatives were screened for antimicrobial activity, and 3c was very effective against S. aureus even at 4.88 µM concentration, taking into account the MIC values. Besides, interactions between the phosphazenes and pBR322 plasmid DNA were also investigated.

Phosphorus-nitrogen compounds. Part 29. Syntheses, crystal structures, spectroscopic and stereogenic properties, electrochemical investigations, antituberculosis, antimicrobial and cytotoxic activities and DNA interactions of ansa-spiro-ansa cyclotetraphosphazenes.

A number of novel ansa-spiro-ansa (asa) cyclotetraphosphazenes (1a-5b) was prepared in the range of 63-90 % yields. The structures of the compounds were verified by MS, FTIR, (1)H, (13)C{(1)H} and (31)P{(1)H} NMR, heteronuclear single quantum coherence (HSQC), and heteronuclear multiple-bond correlation (HMBC) techniques. The crystal structures of 1b, 2c and 5a were determined by X-ray crystallography. The compound 2c was analyzed by the changes in the (31)P{(1)H}NMR spectrum in addition of the chiral solvating agent; (R)-(+)-2,2,2-trifluoro-1-(9'-anthryl)-ethanol (CSA), to investigate its stereogenic properties. The result supports that compound 2c was found to be in the racemic mixture. Cyclic voltammetric and chronoamperometric data of the mono-ferrocenyl-spiro-asa-cyclotetraphosphazenes exhibited electrochemically reversible one-electron oxidation of Fe redox centres. The mono-ferrocenyl-spiro-asa compounds (3a-5b) were evaluated for antituberculosis activity against reference strain Mycobacterium tuberculosis H37Rv and M. tuberculosis clinical strain, which is resistant to rifampicin and isoniazid. These compounds appear not to be good candidates for being antituberculosis agents to clinical strains. All of the compounds were screened for antibacterial activities against G(+) and G(-) bacteria, and for antifungal activities against yeast strains. They seem to be more active against Gram positive bacteria than Gram negative. The interactions of the phosphazenes with plasmid DNA and the evaluations for cytotoxic activity against MCF-7 breast cancer cell lines were investigated. The compounds 1b, 2b, 3a and 4a were found to be more effective than Cisplatin against MCF-7 breast cancer cell lines at lower concentrations.

Phosphorus-nitrogen compounds part 27. Syntheses, structural characterizations, antimicrobial and cytotoxic activities, and DNA interactions of new phosphazenes bearing secondary amino and pendant (4-fluorobenzyl)spiro groups.

A number of partly (7-9) and fully (10a-12d, Scheme 1) substituted mono(4-fluorobenzyl)spiro cyclotriphosphazenes was prepared. The structures of the compounds were determined by MS, FTIR, 1D and 2D NMR techniques. The crystal structures of 9, 11b and 12b were verified by X-ray diffraction analysis. In vitro cytotoxic activity of the phosphazenes (10a-12d) against HeLa cervical cancer cell lines was evaluated. Compound 12c was found to be the most effective, as it is a cytotoxic reagent that might activate apoptosis by altering mitochondrial membrane potential. Compounds 10b, 11b and 12b showed very good activity against yeast strains Candida tropicalis and Candida albicans. BamHI and HindIII digestion results demonstrate that the compounds (10a-12a, 10b-12b, 10d-12d), and (9, 10c-12c) bind with G/G and A/A nucleotides, respectively.

Phosphorus-nitrogen compounds. Part 24. Syntheses, crystal structures, spectroscopic and stereogenic properties, biological activities, and DNA interactions of novel spiro-ansa-spiro- and ansa-spiro-ansa-cyclotetraphosphazenes.

The reactions of octachlorocyclotetraphosphazene, N(4)P(4)Cl(8), with N(2)O(2) donor-type aminopodands (1a, 1b, 1g, and 1h) afforded two kinds of derivatives, namely, spiro-ansa-spiro (sas) (2a, 2b, 2g, and 2h) and ansa-spiro-ansa (asa) (3a and 3b) phosphazenes. The partly substituted sas phosphazenes (2a and 2b) reacted with excess pyrrolidine and morpholine in tetrahydrofuran to produce the tetrapyrrolidino (2c and 2d) and morpholino (2e and 2f) derivatives. The reactions of the asa phosphazenes (3a and 3b) with excess pyrrolidine and morpholine produced gem-2-trans-6-dichloropyrrolidinophosphazenes (3c and 3d) and -morpholinophosphazenes (3e and 3f). However, the fully substituted products were not obtained in these solvents. In addition, the expected fully substituted compound was not obtained from the reaction of 3a with excess pyrrolidine by standard or microwave-assisted methods. The reaction of the long-chain starting compound (1g) with N(4)P(4)Cl(8) gave sas (2g) and the interesting 2,6-ansa-spiro-bicyclo product (bicyclo-2,6-as; 4g), while the reaction of 1h with N(4)P(4)Cl(8) yielded only sas (2h). The structural investigations of the compounds were verified by elemental analyses, mass spectrometry, Fourier transform infrared, and DEPT, HSQC, HMBC, (1)H, (13)C, and (31)P NMR techniques. The crystal structures of 2b, 3a, 3b, 3e, and 4g were determined by X-ray crystallography. Compounds 2a-2h, 3a-3f, and 4g had two stereogenic P atoms. Compound 3b had one enantiomer according to the Flack parameter, and 3f was a racemic mixture, as shown by chiral high-performance liquid chromatography and chiral-solvating-agent, (R)-(+)-2,2,2-trifluoro-1-(9'-anthryl)ethanol, experiments. Furthermore, compounds 2a, 2c, and 2d exhibited weak antibacterial activity against (G+) bacterium, and 3c and 3d displayed moderate antifungal activity against Candida tropicalis. Gel electrophoresis data demonstrated that 2e, 3c, and 3e promoted the formation of DNA cleavage. The prevention of BamHI digestion by 2a-2f and 3a-3f, except 2b and 2e, disclosed binding with GG nucleotides in DNA.

Phosphorus-nitrogen compounds. 18. Syntheses, stereogenic properties, structural and electrochemical investigations, biological activities, and DNA interactions of new spirocyclic mono- and bisferrocenylphosphazene derivatives.

The reactions of hexachlorocyclotriphosphazatriene, N(3)P(3)Cl(6), with mono- (1 and 2) and bisferrocenyldiamines (3-5), FcCH(2)NH(CH(2))(n)NHR(1) (R(1) = H or FcCH(2)-), produce mono- (6 and 7) and spirocyclic bisferrocenylphosphazenes (8-10). The fully substituted phosphazenes (11-15 and 18-21) are obtained from the reactions of corresponding partly substituted phosphazenes (6-10) with excess pyrrolidine and NH(2)(CH(2))(3)ONa, respectively. The reactions of 6 with 1-aza-12-crown-4 afford geminal (16) and tris (17) crown ether-substituted phosphazenes. The structural investigations of the compounds have been verified by elemental analyses, mass spectrometry, Fourier transform IR, (1)H, (13)C, and (31)P NMR, and DEPT, COSY, HETCOR, and HMBC techniques. The crystal structures of 7, 10, 11, and 15 have been determined by X-ray crystallography. In 16 and 17, there are one and two stereogenic P atoms, respectively, and they are expected to be in enantiomeric mixtures. The structures of 18-21 look similar to a propeller. In 20 and 21, there are two stereogenic P atoms, and they exist as cis (meso; 20a and 21a) and trans (racemic; 20b and 21b) geometric isomers, according to the chiral solvating agent (S)-(+)-2,2,2-trifluoro-1-(9'-anthryl)ethanol experiments. Moreover, the compounds 18 and 19 have three stereogenic P atoms, and they exist as enantiomeric mixtures. Cyclic voltammetric investigations of compounds 6-21a reveal that ferrocene redox centers undergo oxidation concurrently at the same potential with basically reversible peaks, and these compounds appear to be quite robust electrochemically. The compounds 11-15 have been screened for antibacterial activity against gram positive and gram negative bacteria and for antifungal activity against yeast strains.The compounds 11, 12, 14, and 15 are evaluated for antituberculosis activity against reference strain Mycobacterium tuberculosis H37Rv (ATCC 27294). Interactions between compounds 11-15 and pBR322 plasmid DNA are studied by agarose gel electrophoresis. These compounds induce conformational changes in the DNA helix.

Salivary sialic acid, protein, salivary flow rate, pH, buffering capacity and caries indices in subjects with Down's syndrome.

OBJECTIVES: The aim of this study was to compare salivary sialic acid, protein, salivary flow rate, pH and buffering capacity and caries indices between subjects with Down's Syndrome and healthy controls. METHODS: Unstimulated mixed saliva was collected from 26 Down's syndrome subjects and 25 healthy subjects of age range 6-24 years. Total protein was determined by the method of Lowry and total sialic acid using Ehrlich reagent. Laemmli SDS-polyacrylamide gel electrophoresis was also carried out. RESULTS: Buffering capacity and pH were quite similar for both groups. For permanent dentition subjects pH was significantly higher (P = 0.03) in the Down's syndrome group. The salivary flow rate of the Down's syndrome subjects was significantly lower (P < 0.01) than that of healthy controls and the Down's syndrome subjects' salivary protein and sialic acid levels were significantly higher (P < 0.001). The ratios of total sialic acid to total protein were significantly higher (P < 0.001) in the Down's syndrome group. However, salivary sialic acid expectoration rates, a means of compensating for flow rate differences, were significantly lower (P = 0.01) in the Down's syndrome subjects than in controls. Electrophoresis revealed no significant differences between the protein bands of the groups. There were no significant differences in caries indices between groups, even when compensated for age, nor in the salivary parameters within groups between sexes. CONCLUSIONS: Total salivary sialic acid in Down's syndrome subjects, higher in terms of levels but lower in terms of expectoration rates, was significantly different from that of controls of similar caries indices.

Salivary sialic acid and cancer.

In this preliminary study the salivary sialic acid levels in 56 randomly selected cancer patients of different ages were compared with those of 70 healthy controls of similar age distribution. The cancer patients consisted of 25 women and 31 men. Twenty were suffering from lung cancer. Unstimulated whole saliva was collected by expectoration. The mean sialic acid levels were 185 +/- 22.8 mg/dl in the cancer group and 6.2 +/- 3.72 mg/dl in the controls and the difference between them was significant (p < 0.0001). The subjects were also grouped according to age and cancer type. However there were no significant differences in sialic acid levels between these.

[Determination of length, width and height of the human skull by critical use of roentgenologic craniometry methods]. / Zur Bestimmung von Länge, Breite und Höhe des menschlichen Schädels unter kritischer Anwendung der Methoden der röntgenologischen Kraniometrie.

X-ray craniometry has gained in importance for scientific and clinical examination. It enables accurate measurement of shape and structure of the human skull, its characterisation and an accurate description of the type and cause of changes of its shape and components. Roentgenological craniometry is closely related to craniometry of anatomists and anthropologists, but in a few essential points it does differ from it--rather fundamentally, in fact. On using the roentgenological method, the general laws of x-ray imaging must be strictly observed and measurements must be effected only if they are conducted from such points which are roentgenologically clearly defined. Measurements must be definite, repeatable at any time and suitable for comparative purposes. The influence exercised by these conditions becomes noticeable already on determining the three principal dimensions of the cranium. Whereas the x-ray determination of the length and breadth of the cranium is easy to perform and does not present any problem, determination of the "height" of the cranium causes considerable difficulties that are mainly based on the statement of suitable points of measurement. Detailed studies and deliberations have shown that the distance between the vault and the base of the skull can supply a suitable measure for assessing the height of the skull. On lateral x-ray film the distance between the "endobregma" and the "bony floor of the hypophyseal cavity" is a suitable criterion, whereas on the sagittal x-ray films of the skull the criterion is the distance between "bregma" and "hypophyseal basis". The "lateral hypophyseal height of the skull" and the "sagittal hypophyseal height" are largely equal, clearly defined and always repeatable.(ABSTRACT TRUNCATED AT 250 WORDS)