Infective endocarditis of the tricuspid valve. Surgical treatment with pericardial cylinder implantation.

Introduction: Infective endocarditis (IE) on the tricuspid valve usually requires the complete resection of the infected tissue and implantation of a valve prosthesis. Aim: We assumed that total elimination of artificial material and implantation of the entirely patient-derived biological material would reduce the recurrence of IE. Material and methods: The group consisted of 7 consecutive patients who underwent implantation of a cylindrical valve created from the patient's own pericardium in the tricuspid orifice. There were only men aged 43 to 73 years. Isolated tricuspid valve reimplantation with a pericardial cylinder was performed in 2 patients. Five (71%) patients needed additional procedures. The postoperative follow-up ranged from 2 to 32 months (median: 17 months). Results: In patients who underwent isolated tissue cylinder implantation, the average extracorporeal circulation (ECC) time was 77.5 minutes and aortic cross-clamp time was 58 minutes. In cases where additional procedures were performed the ECC and X-clamp times were 197.4 and 156.2 minutes, respectively. The function of the implanted valve was examined after weaning from the ECC by transesophageal echocardiogram, followed by transthoracic echocardiogram on day 5-7 after surgery revealed normal function of the prosthesis in all patients. There was no operative mortality. Two late deaths were observed. Conclusions: In the follow-up period none of the patients had a recurrence of IE within the pericardial cylinder. Degeneration with subsequent stenosis of the pericardial cylinder occurred in 3 patients. One patient was reoperated on; one had a transcatheter valve-in-valve cylinder implantation.

Sphingolipids metabolism in the salivary glands of rats with obesity and streptozotocin induced diabetes.

Diabetes is considered a major public health problem affecting millions of individuals worldwide. Remarkably, scientific reports regarding salivary glands sphingolipid metabolism in diabetes are virtually non-existent. This is odd given the well-established link between the both in other tissues (e.g., skeletal muscles, liver) and the key role of these glands in oral health preservation. The aim of this paper is to examine sphingolipids metabolism in the salivary glands in (pre)diabetes (evoked by high fat diet feeding or streptozotocin). Wistar rats were allocated into three groups: control, HFD-, or STZ-diabetes. The content of major sphingolipid classes in the parotid (PSG) and submandibular (SMSG) glands was assessed via chromatography. Additionally, Western blot analyses were employed for the evaluation of key sphingolipid signaling pathway enzyme levels. No changes in ceramide content in the PSG were found, whereas an increase in ceramide concentration for SMSG of the STZ group was observed. This was accompanied by an elevation in SPT1 level. Probably also sphingomyelin hydrolysis was increased in the SMSG of the STZ-diabetic rats, since we observed a significant drop in the amount of SM. PSG and SMSG respond differently to (pre)diabetes, with clearer pattern presented by the later gland. An activation of sphingomyelin signaling pathway was observed in the course of STZ-diabetes, that is, metabolic condition with rapid onset/progression. Whereas, chronic HFD lead to an inhibition of sphingomyelin signaling pathway in the salivary glands (manifested in an inhibition of ceramide de novo synthesis and accumulation of S1P).

Myriocin treatment affects lipid metabolism in skeletal muscles of rats with streptozotocin-induced type 1 diabetes.

PURPOSE: The aim of this work was to assess the effect(s) of de novo ceramide synthesis inhibition on lipid metabolism in skeletal muscle tissue of type 1 diabetic rats. The latter seems to be of vital importance, since previous works have shown its positive influence on lipid metabolism and glucose homeostasis in the case of its counterpart - type 2 diabetes. MATERIALS/METHODS: The animals were randomly assigned to one of the following groups: C - control, M - myriocin (ceramide de novo synthesis inhibitor), D - diabetes (induced by streptozotocin injections); D+M - diabetes+myriocin. We have evaluated intracellular concentration of key sphingolipid species, via chromatography (GC and HPLC), and the activity of their most important enzymes, using radiometric approach. The aforementioned assessments were evaluated in respect to the three different types of muscle tissue representing different spectra of muscle metabolism (soleus - oxidative, red gastrocnemious - oxidative-glycolytic, white gastrocnemious - glycolytic). RESULTS: Interestingly, our therapeutic intervention not only lowered the level of ceramide, its precursors (sphinganine) and derivatives (sphingosine and sphingosine-1-phosphate), but also reduced other lipid species (triacylglycerols, diacylglycerols and free fatty acids) content, thus improving glucose homeostasis in type 1 diabetic animals. CONCLUSIONS: In the light of the results ensuing from this study, it seems conceivable that the reduction of intramuscular ceramide production and accumulation could bestow an insulin-sensitizing effect. If so, then SPT inhibition could find potential future applications as a therapeutic intervention aimed to mitigate the effects of insulin resistance.

Effect of streptozotocin-induced diabetes on lipids metabolism in the salivary glands.

BACKGROUND: Diabetes is one of the most common metabolic diseases. Moreover, previous studies indicate that diabetes may cause changes in the salivary glands phenotype and in the composition of saliva itself. Therefore, the main objective of this study was to determine the effects of streptozotocin induced diabetes on lipid profile of the rat salivary glands. METHODS: Male Wistar rats were divided into two groups: control and STZ-induced diabetes. At the end of the experiment all animals were sacrificed and samples of the parotid and submandibular salivary glands were excised. Major lipid fractions concentrations were determined by means of chromatography (TLC and GC). RESULTS: We observed a significant increase (∼3.5 fold) in the level of triacylglycerol in both the parotid and submandibular salivary glands of diabetic rats. The abovementioned changes were accompanied by significant, although less dramatic (i.e. from -60% to -90%), decrements in the levels of other lipid classes (phospholipids, free fatty acids and diacylglycerol). CONCLUSIONS: In our study we have showed, presumably for the first time, that streptozotocin induced diabetes causes decrement in PH content with subsequent atrophy and malfunction in both parotid and submandibular salivary glands. Another novel finding of our research is that diabetic rats were characterized by an increased TG accumulation in both parotid and submandibular salivary glands. The later one could be a clinical manifestation of diabetes.

Insulin Resistance and Obesity Affect Lipid Profile in the Salivary Glands.

In today's world wrong nutritional habits together with a low level of physical activity have given rise to the development of obesity and its comorbidity, insulin resistance. More specifically, many researches indicate that lipids are vitally involved in the onset of a peripheral tissue (e.g., skeletal muscle, heart, and liver) insulin resistance. Moreover, it seems that diabetes can also induce changes in respect of lipid composition of both the salivary glands and saliva. However, judging by the number of research articles, the salivary glands lipid profile still has not been sufficiently explored. In the current study we aim to assess the changes in the main lipid fractions, namely, triacylglycerols, phospholipids, free fatty acids, and diacylglycerols, in the parotid and the submandibular salivary glands of rats exposed to a 5-week high fat diet regimen. We observed that the high caloric fat diet caused a significant change in the salivary glands lipid composition, especially with respect to PH and TG, but not DAG or FFAs, classes. The observed reduction in PH concentration is an interesting phenomenon frequently signifying the atrophy and malfunctions in the saliva secreting organs. On the other hand, the increased accumulation of TG in the glands may be an important clinical manifestation of metabolic syndrome and type 2 diabetes mellitus.