Theophylline toxicity: Successful management of a patient with distributive shock secondary to drug overdose.

Presenting a case of acute theophylline and salbutamol overdose with distributive shock. Twenty one years old lady presented with history of consumption of 3 gram of theophylline and 40 mg of salbutamol. On admission she had altered sensorium with the systolic blood pressure of 60 mmHg, unrecordable diastolic blood pressure and heart rate of 147/min. Investigations revealed severe metabolic acidosis, hypokalemia, hypocalcemia which was managed by intravenous fluids, vasopressors, infusion of injection calcium gluconate and injection potassium chloride. As her hemodynamic status did not improve, she has been initiated on 1.5 mL/kg of lipid emulsion as bolus and then 0.5 mL/kg/h as infusion. Her hemodynamic status improved gradually and she was discharged in 24 h. Lipid emulsion had been used in local anesthetics and many tablet overdoses. In this patient timely administration of lipid emulsion resulted in early recovery of shock.

Reusable nanoengineered surfaces for bacterial recruitment and decontamination.

Biofouling, or accumulation of unwanted biofilms, on surfaces is a major concern for public health and human industry. Materials either avoiding contamination (fouling resistant) and/or directly killing attached microbes (biocidal) have thus far failed to achieve the goal of eliminating biofouling; fouling resistant surfaces eventually foul and biocidal surfaces accumulate debris that eventually decrease their efficacy. Combined biocidal and fouling release materials offer the potential for both killing and removing debris and are promising candidates for reducing biofouling on manufactured materials. Interference lithography was used to create nanopatterns of initiators, which were then used to initiate atom transfer radical polymerization of the temperature-responsive polymer, poly(N-isopropylacrylamide) (PNIPAAm) as a fouling release component. Biocidal activity was conferred by subsequent layer-by-layer deposition of cationic and anionic poly(phenylene ethynylenes) into the valleys between the PNIPAAm. For both Gram positive and Gram negative model bacteria, dark-regime biocidal activity was observed that did not increase upon exposure to light, suggesting that the mode of antimicrobial activity is due to ionic disruption of the cell wall. Subsequent to killing, bacteria and cellular debris were removed upon a temperature-induced phase transition of the PNIPAAm. These materials exhibited capture, killing, and release activity over multiple cycles of use.

Conjugated Polyelectrolytes with Imidazolium Solubilizing Groups. Properties and Application to Photodynamic Inactivation of Bacteria.

This article reports an investigation of the photophysical properties and the light- and dark-biocidal activity of two poly(phenyleneethynylene) (PPE)-based conjugated polyelectrolytes (CPEs) bearing cationic imidazolium solubilizing groups. The two polymers feature the same PPE-type backbone, but they differ in the frequency of imidazoliums on the chains: PIM-4 features two imidazolium units on every phenylene repeat, whereas PIM-2 contains two imidazolium units on every other phenylene unit. Both polymers are very soluble in water and polar organic solvents, but their propensity to aggregate in water differs with the density of the imidazolium units. The polymers are highly fluorescent, and they exhibit the amplified quenching effect when exposed to a low concentration of anionic electron-acceptor anthraquinone disulfonate. The CPEs are also quenched by a relatively low concentration of pyrophosphate by an aggregation-induced quenching mechanism. The biocidal activity of the cationic imidazolium CPEs was studied against both Gram-negative Escherichia coli and Gram-positive Staphylococcus aureus bacteria in the dark and under blue-light illumination. Both polymers are effective biocides, exhibiting greater than 3 log kill with 30-60 min of light exposure at concentrations of ≤10 µg mL(-1).

Blockade of the VEGF isoforms in inflammatory corneal hemangiogenesis and lymphangiogenesis.

BACKGROUND: The VEGF-A family plays a crucial role in the induction of pathological corneal neovascularization. The role of the different VEGF-A isoforms during lymphangiogenesis is only little-known. Current anti-angiogenic therapies in the eye and other organs inhibit all VEGF-A isoforms, and have effects on both blood and lymphatic vessels. Here we investigate whether selective targeting of the isoform VEGF 165 is able to inhibit corneal lymphangiogenesis under inflammatory conditions. METHODS: The mouse model of suture-induced corneal neovascularization was used to assess the antihem- and antilymphangiogenic effect of topically applied pegaptanib. Corneal blood and lymph vascularized areas were analyzed morphometrically. Furthermore, we analyzed the proliferative effects of VEGF A 121, 165, and 189 on blood and lymphatic endothelial cells (BEC/LEC) via a cell-proliferation assay. RESULTS: Pegaptanib significantly inhibited inflammatory corneal hemangiogenesis (p < 0.01), but not lymphangiogenesis in vivo (p > 0.05), both topically as well as systemically, in the inflamed cornea. In vitro, BECs were more susceptible to pegaptanib than LECs. CONCLUSIONS: Targeting VEGF-A 165 significantly inhibits hem- but not lymphangiogenesis, suggesting VEGF-A 165 to be critical for hem-, but dispensable for lymphangiogenesis, at least in the inflamed cornea.

Topical Ranibizumab inhibits inflammatory corneal hem- and lymphangiogenesis.

PURPOSE: Ranibizumab (Lucentis(®) ) is a Fab-Fragment of a recombinant, humanized, monoclonal VEGF (anti-vascular endothelial growth factor) antibody. This study analyzed the ability of topical Ranibizumab to inhibit lymphangiogenesis in addition to hemangiogenesis after acute corneal inflammation in vivo. In addition, the effect of Ranibizumab on the proliferation of human lymphatic endothelial cells (LECs) and blood endothelial cells (BECs) in vitro was studied. METHODS: The inhibitory effect of Ranibizumab on LECs and BECs was studied in vitro using a proliferation enzyme-linked immunosorbent assay (ELISA) assay. To study the in vivo effects of Ranibizumab, the mouse model of suture induced inflammatory corneal neovascularization was used. Study mice received topical Ranibizumab as eye drops. After 1 week excised corneas were stained with LYVE-1 and CD31. Hemangiogenesis and lymphangiogenesis were analyzed morphometrically by using a semiautomatic method based on the image analyzing program Cell^F. RESULTS: An antiproliferative effect of Ranibizumab was seen in vitro on both human BECs and LECs with a significance of p < 0.0001 and p < 0.0004, respectively. In vivo experiments showed that topical application of Ranibizumab significantly inhibits both hemangiogenesis (p = 0.0026) and lymphangiogenesis (p = 0.0026) in the cornea. CONCLUSION: Ranibizumab is a potent inhibitor of inflammatory corneal hemangiogenesis and lymphangiogenesis in vivo with a direct inhibitory effect on both endothelial cell types in vitro. This study for the first time demonstrates an inhibitory effect of Ranibizumab on lymphatic vessels which could have a wider range of clinical applications.

Triplet sensitization in an anionic poly(phenyleneethynylene) conjugated polyelectrolyte by cationic iridium complexes.

We describe a systematic study of triplet sensitization in a poly(phenyleneethynylene) conjugated polyelectrolyte (CPE) in methanol solution by using a series of three cationic iridium complexes with varying triplet energy. The cationic iridium complexes bind to the anionic CPE by ion-pairing, leading to singlet state quenching of the polymer, and allowing for efficient back-transfer of triplet excitation energy to the polymer. Efficient (amplified quenching) of the polymer's fluorescence is observed for each iridium complex, with Stern-Volmer quenching constants in excess of 10(5) M(-1). Triplet sensitization is confirmed for two of the iridium complexes by monitoring the relative yield of the CPE triplet state by transient absorption spectroscopy. One of the iridium complexes does not sensitize the CPE triplet, and consideration of the energies of the three complexes allows us to bracket the triplet energy of the CPE within the range 1.95-2.26 eV.

Photochemical reaction containers as energy and electron-transfer agents.

Two deep cavity cavitands, octa acid and resorcinol-capped octa acid, have been established to be good triplet energy donors in the excited state and electron donors in the ground state to excited acceptors. This property endows them the capacity to be "active" reaction containers. The above recognition provides opportunities to investigate the excited state chemistry of host-encapsulated guests without the use of secondary triplet energy and electron donors.

Photophysics and light-activated biocidal activity of visible-light-absorbing conjugated oligomers.

The photophysical properties of three cationic π-conjugated oligomers were correlated with their visible light activated biocidal activity vs S. aureus. The oligomers contain three arylene units (terthiophene, 4a; thiophene-benzotriazole-thiophene, 4b; thiophene-benzothiadiazole-thiophene, 4c) capped on each end by cationic -(CH2)3NMe3(+) groups. The oligomers absorb in the visible region due to their donor-acceptor-donor electronic structure. Oligomers 4a and 4b have high intersystem crossing and singlet oxygen sensitization efficiency, but 4c has a very low intersystem crossing efficiency and it does not sensitize singlet oxygen. The biocidal activity of the oligomers under visible light varies in the order 4a > 4b ≈ 4c.

A sensitive and selective mercury(II) sensor based on amplified fluorescence quenching in a conjugated polyelectrolyte/spiro-cyclic rhodamine system.

A novel fluorescence-based sensor for mercury(II) ion is described consisting of a water-soluble, anionic-conjugated polyelectrolyte (CPE) and spiro-cyclic rhodamine derivative (1). A solution containing the CPE (0.1 × 10(-6) M repeat unit concentration) and 1 (1 × 10(-6) M concentration) in aqueous solution exhibits a sensitive and selective turn-off fluorescence response to Hg(II). The Stern-Volmer quenching constant for quenching of the fluorescence of the system by Hg(II) is ≈1.5 × 10(7) M(-1) , and Hg(II) can be sensed with a detection limit <10 × 10(-9) M. A mechanism for the sensor response is proposed and it consists of efficient and selective complex formation between 1 and Hg(II), along with a very high association between the 1-Hg(II) complex and the anionic CPE.

Role of free space and conformational control on photoproduct selectivity of optically pure α-alkyldeoxybenzoins within a water-soluble organic capsule.

Optically pure α-alkyl deoxybenzoins resulting in products of Norrish Type I and Type II reactions upon excitation has been investigated within the octa acid (OA) capsule in water. The product distribution was different from that in an organic solvent and was also dependent on the length of the α-alkyl chain. Most importantly, a rearrangement product not formed in an organic solvent arising from the triplet radical pair generated by Norrish Type I reaction was formed, and its yield was dependent on the alkyl chain length. In an organic solvent, since the cage lifetime is shorter than the time required for intersystem crossing (ISC) of the triplet radical pair to the singlet radical pair the recombination with or without rearrangement of the primary radical pair (phenylacetyl and benzyl) does not occur. Recombination without rearrangement within the capsule as inferred from monitoring the racemization of the optically pure α-alkyl deoxybenzoins suggesting the capsule's stability for at least 10(-8) s (the time required for ISC) is consistent with our previous photophysical studies that showed partial opening and closing of the capsule in the time range of microseconds.

Efficacy of end-only-functionalized oligo(arylene-ethynylene)s in killing bacterial biofilms.

Cationic end-only-functionalized oligo(arylene-ethynylene)s (EO-OPEs) have recently been found to be broad-spectrum and effective antimicrobial agents because of their unique structure and optical properties. In this study, we investigated their potential use for preventing and reducing Escherichia coli (E. coli) biofilms. The Calgary biofilm device (CBD) was used to form bacterial biofilms of E. coli; in these studies, the minimum inhibitory concentration (MIC) and the minimum biofilm eradication concentration (MBEC) were determined. E. coli biofilms uniformly grow on pegs of the CBD device lid. The MIC values determined for EO-OPEs are comparable to those found for standard antibiotics such as kanamycin (MIC = 11.2 µg/mL). About 10-30 times the concentration of EO-OPEs was required to eradicate E. coli biofilms and prevent regrowth in the dark. Near-UV irradiation of EO-OPEs enhanced their efficacy in killing biofilms.

Photoinduced electron transfer between a donor and an acceptor separated by a capsular wall.

The efficient photoinduced electron transfer from a stilbene derivative incarcerated within a negatively charged organic nanocapsule to positively charged acceptors (methyl viologen and a pyridinium salt) adsorbed outside and the back electron transfer were controlled by supramolecular effects.

Aggregation-induced amplified quenching in conjugated polyelectrolytes with interrupted conjugation.

A pair of anionic conjugated polyelectrolytes that contain three-ring (phenylene ethynylene) units linked by a single -CH(2)- or -O- tether (P1 and P2, respectively) are studied. The linkers serve to interrupt the π conjugation along the polymer backbone. Fluorescence spectroscopy reveals that P2 forms a fluorescent aggregate in methanol and water; however, the fluorescence of P1 is much weaker in water, and P1 exhibits only weak aggregate fluorescence. Fluorescence quenching of the polymers was examined using methyl viologen (MV(2+)) as a cationic quencher. P1 shows only a weak amplified quenching effect, with a Stern-Volmer quenching constant of K(SV) ≈ 6 × 10(5) M(-1) in methanol. Interestingly, for P2 in methanol, the aggregate emission is strongly quenched with K(SV) ≈ 5 × 10(6) M(-1), which is comparable to the highest quenching efficiency observed for fully π-conjugated polyelectrolytes. By contrast, the monomer emission is quenched much less efficiently, with K(SV) ≈ 2 × 10(5) M(-1). The results are explained by a model in which -O- linked polymer P2 is able to fold into a helical conformation in solution, which facilitates the formation of extended π-stacked aggregates allowing long-distance exciton transport.

Antibacterial activity of conjugated polyelectrolytes with variable chain lengths.

Cationic poly(phenylene ethynylene)- (PPE-) based conjugated polyelectrolytes (CPEs) with six different chain lengths ranging in degree of polymerization from ∼7 to ∼49 were synthesized from organic-soluble precursor polymers. The molecular weight of the precursor polymers was controlled by the amount of a monofunctional "end-capping" agent added to the polymerization reaction. Cationic CPEs were prepared by quaternization of amine groups to tetraalkylammonium groups. Their structure-property relationships were investigated by observing their photophysical properties and antibacterial activity. The polymers were found to exhibit a chain-length dependence in their photophysical properties. It has also been observed that the polymers exhibit effective antibacterial activity against both Gram-positive and Gram-negative bacteria under UV irradiation, whereas they show little antibacterial activity in the dark. An effect of chain length on the light-activated antibacterial activity was also found: The shortest polymer (n=7) exhibited the most effective antibacterial activity against both Gram-positive and Gram-negative bacteria.

Conjugated-polyelectrolyte-grafted cotton fibers act as "micro flypaper" for the removal and destruction of bacteria.

We demonstrate herein a method for chemically modifying cotton fibers and cotton-containing fabric with a light-activated, cationic phenylene-ethynylene (PPE-DABCO) conjugated polyelectrolyte biocide. When challenged with Pseudomonas aeruginosa and Bacillus atropheaus vegetative cells from liquid suspension, light-activated PPE-DABCO effects 1.2 and 8 log, respectively, losses in viability of the exposed bacteria. These results suggest that conjugated polyelectrolytes retain their activity when grafted to fabrics, showing promise for use in settings where antimicrobial textiles are needed.

Light and dark-activated biocidal activity of conjugated polyelectrolytes.

This Spotlight on Applications provides an overview of a research program that has focused on the development and mechanistic study of cationic conjugated polyelectrolytes (CPEs) that function as light- and dark-active biocidal agents. Investigation has centered on poly-(phenylene ethynylene) (PPE) type conjugated polymers that are functionalized with cationic quaternary ammonium solubilizing groups. These polymers are found to interact strongly with Gram-positive and Gram-negative bacteria, and upon illumination with near-UV and visible light act to rapidly kill the bacteria. Mechanistic studies suggest that the cationic PPE-type polymers efficiently sensitize singlet oxygen ((1)O(2)), and this cytotoxic agent is responsible for initiating the sequence of events that lead to light-activated bacterial killing. Specific CPEs also exhibit dark-active antimicrobial activity, and this is believed to arise due to interactions between the cationic/lipophilic polymers and the negatively charged outer membrane characteristic of Gram-negative bacteria. Specific results are shown where a cationic CPE with a degree of polymerization of 49 exhibits pronounced light-activated killing of E. coli when present in the cell suspension at a concentration of 1 µg mL(-1).

Role of free space and weak interactions on geometric isomerization of stilbenes held in a molecular container.

Photochemical geometric isomerization of olefins is long known to depend on the medium in which it occurs. Highest selectivity occurs in flexible biological systems as well as in inflexible crystals. We present results in this report that suggest the isomerization is selective even in an isotropic flexible aqueous medium provided it occurs within an isolated water-soluble inflexible reaction cavity. By examining the photochemistry of twelve stilbenes (trans and corresponding cis isomers) included in an organic cavitand octa acid we have been able to probe the role of 'free volume', 'weak interactions' and 'supramolecular steric effects' on the geometric isomerization process. Geometric isomerization becomes selective when the olefin's mobility is restricted by the medium through weak interactions, supramolecular steric effects and controlled free space (free volume).

Light-induced antibacterial activity of symmetrical and asymmetrical oligophenylene ethynylenes.

The light-induced antibacterial activity of symmetric and asymmetric oligophenylene ethynylenes (OPEs) was investigated against Gram-positive (Staphylococcus aureus and Staphylococcus epidermidis) and Gram-negative (Escherichia coli) bacteria. To understand the light-induced biocidal effect better, the transient absorption and triplet lifetime of OPEs were studied in methanol and water. A higher triplet lifetime was observed for OPE samples in water than in methanol. The magnitudes of the changes in optical density (ΔOD) of the S-OPE-n(H) series of symmetric oligomers are much higher than that of the asymmetric OPE-n series in water and are generally correlated with the singlet oxygen yield. It was found that the antibacterial activity against both Gram-positive and Gram-negative bacteria is size-, concentration-, and time-dependent. The light-induced antibacterial activity may result from the coordinated interactions of membrane disruption and interfacial or intracellular singlet oxygen generation, and the dominant factor is most likely the latter. The results obtained in this study will aid in the design of more efficient biocides in the future.