Intracellular distribution and stability of a luminescent rhenium(i) tricarbonyl tetrazolato complex using epifluorescence microscopy in conjunction with X-ray fluorescence imaging.

Optical epifluorescence microscopy was used in conjunction with X-ray fluorescence imaging to monitor the stability and intracellular distribution of the luminescent rhenium(i) complex fac-[Re(CO)3(phen)L], where phen = 1,10-phenathroline and L = 5-(4-iodophenyl)tetrazolato, in 22Rv1 cells. The rhenium complex showed no signs of ancillary ligand dissociation, a conclusion based on data obtained via X-ray fluorescence imaging aligning iodine and rhenium distributions. A diffuse reticular localisation was detected for the complex in the nuclear/perinuclear region of cells, by either optical or X-ray fluorescence imaging techniques. X-ray fluorescence also showed that the rhenium complex disrupted the homeostasis of some biologically relevant elements, such as chlorine, potassium and zinc.

Quantitative elemental analysis of bovine ovarian follicles using X-ray fluorescence imaging.

The X-ray Fluorescence Micro-spectroscopy (XFM) beamline at the Australian Synchrotron was used to image 97 follicle histological sections from 45 different bovine ovaries focusing on healthy antral follicles ranging from small (<4 mm) up to preovulatory sizes (>16 mm) and on antral follicles undergoing atresia. This analysis identified five elements (Cu, Fe, Zn, Se and Br) consistently present within the ovarian tissue with Fe, Zn and Se localised to specific structures. GeoPIXE v6.4g was subsequently used to extract quantitative information pertaining to the elemental concentrations surrounding each of these follicles. Statistical analysis suggested that significant elemental differences were evident between follicle groups sorted according to their health status (Fe and Br), and their size (Se). Se appeared to be the element which most greatly distinguished large antral follicles from smaller counterparts. The ability to use synchrotron radiation to measure trace element distributions in bovine follicles at such high resolutions could have a significant impact on understanding the mechanisms of follicular development. This research is intended to form a baseline study of healthy cycling ovaries which could later be extended to disease states, thereby improving our current understanding of infertility and endocrine diseases involving the ovary.

Correction: X-Ray fluorescence imaging and other analyses identify selenium and GPX1 as important in female reproductive function.

Correction for 'X-Ray fluorescence imaging and other analyses identify selenium and GPX1 as important in female reproductive function' by M. J. Ceko et al., Metallomics, 2014, DOI: .

X-Ray fluorescence imaging and other analyses identify selenium and GPX1 as important in female reproductive function.

Studies of selenium (Se) status indicate that Se is necessary for fertility but how precisely is not known. We aimed to show that Se was important in bovine female reproductive function. The elemental distribution in the bovine ovary (n = 45 sections) was identified by X-ray fluorescence (XRF) imaging. Se was consistently localized to the granulosa cell layer of large (>10 mm) healthy follicles. Inductively Coupled Plasma - Mass Spectrometry revealed tenfold higher Se in the bovine follicle wall compared to corpora lutea. Gene expression analysis of selenoprotein genes GPX1, GPX3, VIMP and SELM in bovine granulosa cells revealed that only GPX1 was significantly up-regulated in large healthy follicles compared to the small healthy or atretic follicles (P < 0.05). Western immunoblotting identified GPX1 protein in bovine granulosa cells of large healthy follicles, but not of small healthy follicles. To assess if GPX1 was important in human follicles, cumulus cells from women undergoing IVF/ICSI with single embryo transfer were collected. Oocytes and embryos were cultured and transferred independently in 30 patients undergoing elective single embryo transfer. Gene expression of GPX1 was significantly higher in human cumulus cells from cumulus-oocyte complexes yielding a pregnancy (P < 0.05). We present the first XRF imaging of mammalian ovaries showing that Se is consistently localized to the granulosa cells of large healthy follicles. We conclude that Se and selenoproteins are elevated in large healthy follicles and may play a critical role as an antioxidant during late follicular development.

Use of the inferior epigastric artery as a free graft for myocardial revascularization.

From March 1990 through January 1991, 47 patients undergoing myocardial revascularization had one (37) or both (10) inferior epigastric arteries (IEA) used as a conduit for bypass with 62 distal anastomoses. The internal thoracic artery (ITA) was used bilaterally in 41 patients and unilaterally in 6 with 100 distal anastomoses. Five patients had a single saphenous vein graft. In total, 167 anastomoses (3.55 per patient) were performed. Single IEA grafts were harvested through a paramedian incision and bilateral grafts, a midline incision. Harvest time was 36.5 minutes for IEA grafts and 29.6 minutes for ITA grafts (p less than 0.0001). Graft length was 11.9 cm for IEA grafts and 16.5 cm for ITA grafts (p less than 0.0001). Distal graft diameter was 2.0 mm for IEA grafts and 2.1 mm for ITA grafts (p less than 0.01). Graft flow was 49.7 mL/min for IEA grafts and 48.7 mL/min for ITA grafts. Microscopic assessment of segments of both the IEA and ITA from 14 patients revealed similar internal elastic laminae and an equal number of fenestrations. Combined intimal and medial thickness was comparable in both conduits. Medial elastic tissue was more prominent in ITA grafts and lacking in eight of the 14 IEA grafts. Gross plaque formation was noted in the proximal 1 to 3 cm of 50% of IEA grafts, but the lumen was not compromised and microscopic thickening was minimal. An unexpected finding was medial calcifications (Mönckeberg's disease) in two of the 14 IEAs without associated atherosclerosis. There was one hospital death, one abdominal wound infection, and one instance of fat necrosis superficial to the sternum.(ABSTRACT TRUNCATED AT 250 WORDS)

Aortic valve decalcification.

Ultrasonic decalcification of the aortic valve was performed in 22 elderly patients with critical aortic stenosis (aortic valve areas less than 0.8 cm2) as an alternative to prosthetic valve replacement. All of the patients had symptoms. The mean New York Heart Association class was 3.3 +/- 0.9. Adequate decalcification with restoration of leaflet mobility was achieved in all patients, including seven with bicuspid aortic valves. Leaflet perforation occurred and was successfully repaired in five patients. Ten patients underwent concomitant myocardial revascularization. There were two operative deaths (9%) and three late deaths. Echocardiograms were obtained preoperatively, postoperatively, and at 6 months. The mean aortic valve area increased significantly from 0.72 +/- 0.17 to 1.42 +/- 0.31 cm2 (p less than 0.001) and the peak gradient decreased from 74 +/- 34 to 25 +/- 13 mm Hg (p less than 0.001). At 6 months the aortic valve area (1.29 +/- 0.48 cm2) and peak gradient (31 +/- 12 mm Hg) continued to be significantly better than the preoperative measurements (p less than 0.001), but the 6-month aortic valve area was slightly decreased and the gradient increased when compared with the immediate postoperative values (p less than 0.02). The prevalence of mild to moderate aortic insufficiency increased from 50% of the patients preoperatively to 87% at 6 months (p less than 0.05). Two patients subsequently required aortic valve replacement for restenosis and aortic insufficiency. Ultrasonic decalcification is effective in relieving aortic stenosis, but subsequent restenosis and insufficiency may limit its application.

Reoperation in the intensive care unit.

From July 1, 1984, through June 30, 1989, after 1,259 open heart operations, 110 patients (8.7%) underwent 162 early reoperations either in the intensive care unit (144 procedures) or in the operating room (26 procedures). Reexploration for bleeding (49 procedures) (3.9%) and intraaortic balloon removal (50 procedures) (4.0%) were the two most common procedures. Ninety percent and 96% of these procedures, respectively, were performed in the intensive care unit. Mediastinal infections occurred in 4 (6.1%) of 66 patients undergoing repeat mediastinal operations for all indications. No infection occurred after reexploration for bleeding nor did mediastinal infection occur after reoperation in the intensive care unit. Postoperative death in these 110 patients was not related to reoperation except possibly in the case of 1 patient (0.9%). Average transit time to and from the operating room for patients returned there for reoperation was 89.7 minutes. Charges for procedures performed in the operating room were at least twice as great as for those performed in the intensive care unit. This experience supports expanded use of reoperation in the intensive care unit, as it is safe, effective, economical, and convenient.

Coronary artery bypass grafting for unstable angina pectoris: risk analysis.

Unstable angina pectoris is a broad, nonspecific diagnosis encompassing a wide variety of clinical syndromes. The intravenous administration of nitroglycerin preoperatively is indicative of a more acute clinical situation, and allows for selection and analysis of a more homogeneous patient population. We reviewed the results of coronary artery bypass grafting for unstable angina defined as angina necessitating intravenous administration of nitroglycerin preoperatively. There were 129 patients (83 men and 46 women) with a mean age of 63.2 years (range, 36 to 86 years). Complications included operative death in 6.2%, postoperative low cardiac output in 11%, and perioperative myocardial infarction in 9%. Twenty perioperative variables were analyzed to identify risk factors for these end points. For operative death, age (p less than 0.05), cross-clamp time (p less than 0.05), and cardiopulmonary bypass time (p less than 0.001) were significant in the univariate analysis, but only age (p less than 0.05, F = 4.6) was an independent predictor using multivariate analysis (stepwise linear regression). For low cardiac output, univariate analysis demonstrated that cross-clamp time (p less than 0.01), preoperative use of an intraaortic balloon for angina (p less than 0.05), left ventricular score (p less than 0.05), number of diseased coronary vessels (p less than 0.05), and cardiopulmonary bypass time (p less than 0.001) were significant variables. However, only use of an intraaortic balloon for angina (p less than 0.0001, F = 14.3) and left ventricular score (p less than 0.005, F = 11.1) were significant independent predictors in the multivariate model. For perioperative myocardial infarction, only diabetes requiring insulin (p less than 0.005) was a significant predictor.

Intrauterine herpes simplex infection resembling mechanobullous disease in a newborn infant.

We present a case of transplacentally acquired intrauterine herpes simplex virus infection in a newborn delivered at 36 weeks' gestation by cesarean section because of intrauterine growth retardation and maternal preeclampsia. The mother experienced a single episode of serotype 2 herpes progenitalis at 14 weeks' gestation. At birth the infant manifested clinical findings of herpes simplex virus infection, which resembled epidermolysis bullosa and aplasia cutis congenita. Preexisting cutaneous lesions and intact fetal membranes at delivery strongly support a transplacentally acquired intrauterine herpes simplex virus infection. Repeated Tzanck smears, viral cultures, and immunohistochemical studies of the skin were required to confirm the diagnosis. Intrauterine herpes simplex virus infection is associated with significant morbidity and mortality but responds to antiviral therapy. Therefore this diagnosis must be considered in the neonate born with bullous or eroded skin lesions.

Sustainable rates of sebum secretion in acne patients and matched normal control subjects.

Sustainable rates of sebum secretion were measured in twelve subjects with inflammatory acne and in twelve control subjects, matched in age and gender, who had no significant signs of acne. The measurements were made after first depleting the skin of an accumulation of previously secreted sebum by absorption into adherent layers of bentonite clay applied to the center of the forehead for 14 hours. Disks of fine Dacron mesh, embedded in fresh clay, were then applied to the forehead for 3 hours. The disks and adhering clay were then removed and extracted with ether to recover the collected lipids. The sebum recovered during the 3-hour period was measured by quantitative thin layer chromatography. The subjects with acne were found to have an average sustainable sebum secretion rate of 2.51 mg/10 cm2/3 hr, while the control group had an average of 0.81 mg/10 cm2/3 hr. Furthermore, all subjects with acne had secretion rates larger than those of their matched control subjects. The results indicate that a high sebum secretion rate is the decisive factor in inflammatory acne.

Gastroplasty for morbid obesity. Roentgen evaluation and spectrum of complications.

With the advent of autosuture devices, gastric partitioning procedures have recently become popular surgical treatment of morbid obesity. One such procedure is Gomez gastroplasty. Using an autosuture device a small gastric fundal pouch, having a reservoir capacity of 60 ml and communicating with the remaining stomach through a 12 mm stoma is created along the greater curvature of the stomach. A 3-0 polyprolene internal seromuscular suture is used to reinforce the stoma without incising the stomach. This gastroplasty is extremely attractive because of the disarming simplicity of the procedure and its noninterruption of the normal sequence of the digestive tract. This report is based on a joint review of 280 cases subjected to Gomez gastroplasty to combat morbid obesity. Postoperative radiological evaluation and the spectrum of observed complications are herein described.

Granular cell tumor of the floor of the mouth - a case report.

The granular cell tumor is an uncommon lesion and, when arising in the head and neck, principally involves the tongue and larynx. A patient with a granular cell tumor of the floor of the mouth is reported. Management is usually accomplished by complete local excision, but longterm follow-up is mandatory. Distinguishing the epithelial (pseudo-epitheliomatous) hyperplasia from a well differentiated squamous cell carcinoma is critical to avoid unnecessary radical surgery. At present the lesion is considered to be a true neoplasm, likely of Schwann cell origin, and clinically benign.

Cerebrospinal otorrhea and recurring meningitis: report of three cases.

Recurrent attacks of meningitis occurring independent of a systemic bacterial infection should be considered as a cerebrospinal leak either otorrhea or rhinorrhea. Three cases each with a different cause were diagnosed chiefly on the basis of the history and a bulging noninflammatory eardrum. Subsequent use of fluorescein intrathecally not only helped to confirm the diagnosis but was very useful at surgery in locating the leak in the dura of the oval window of the ear. Many materials have been used but autogenous temporal fascia or fascia lata seemed to be most effective in these cases. The sandwiching of the dura between two pieces of fascia is not only realistic but was found to be very effective. One piece of fascia between the arachnoid and dura and another between the dura and bone give a tight seal.