Response of barley plants to Fe deficiency and Cd contamination as affected by S starvation.

Both Fe deficiency and Cd exposure induce rapid changes in the S nutritional requirement of plants. The aim of this work was to characterize the strategies adopted by plants to cope with both Fe deficiency (release of phytosiderophores) and Cd contamination [production of glutathione (GSH) and phytochelatins] when grown under conditions of limited S supply. Experiments were performed in hydroponics, using barley plants grown under S sufficiency (1.2 mM sulphate) and S deficiency (0 mM sulphate), with or without Fe(III)-EDTA at 0.08 mM for 11 d and subsequently exposed to 0.05 mM Cd for 24 h or 72 h. In S-sufficient plants, Fe deficiency enhanced both root and shoot Cd concentrations and increased GSH and phytochelatin levels. In S-deficient plants, Fe starvation caused a slight increase in Cd concentration, but this change was accompanied neither by an increase in GSH nor by an accumulation of phytochelatins. Release of phytosiderophores, only detectable in Fe-deficient plants, was strongly decreased by S deficiency and further reduced after Cd treatment. In roots Cd exposure increased the expression of the high affinity sulphate transporter gene (HvST1) regardless of the S supply, and the expression of the Fe deficiency-responsive genes, HvYS1 and HvIDS2, irrespective of Fe supply. In conclusion, adequate S availability is necessary to cope with Fe deficiency and Cd toxicity in barley plants. Moreover, it appears that in Fe-deficient plants grown in the presence of Cd with limited S supply, sulphur may be preferentially employed in the pathway for biosynthesis of phytosiderophores, rather than for phytochelatin production.

Development of Fe-deficiency responses in cucumber (Cucumis sativus L.) roots: involvement of plasma membrane H(+)-ATPase activity.

One of the mechanisms through which some strategy I plants respond to Fe-deficiency is an enhanced acidification of the rhizosphere due to proton extrusion. It was previously demonstrated that under Fe-deficiency, a strong increase in the H(+)-ATPase activity of plasma membrane (PM) vesicles isolated from cucumber roots occurred. This result was confirmed in the present work and supported by measurement of ATP-dependent proton pumping in inside-out plasma membrane vesicles. There was also an attempt to clarify the regulatory mechanism(s) which lead to the activation of the H(+)-ATPase under Fe-deficiency conditions. Plasma membrane proteins from Fe-deficient roots submitted to immunoblotting using polyclonal antibodies showed an increased level in the 100 kDa polypeptide. When the plasma membrane proteins were treated with trypsin a 90 kDa band appeared. This effect was accompanied by an increase in the enzyme activity, both in the Fe-deficient and in the Fe-sufficient extracts. These results suggest that the increase in the plasma membrane H(+)-ATPase activity seen under Fe-deficiency is due, at least in part, to an increased steady-state level of the 100 kDa polypeptide.

[Cardiac asystole during dobutamine stress echocardiography]. / Assistolia durante ecocardiograma de estresse com dobutamina.

We report a case of cardiac asystole during dobutamine stress echocardiography in a 59 year-old woman presenting with chest pain and a positive treadmill test for ischemia. Cardiac asystole was not associated with myocardial ischaemia and was probably related to a powerful cardioinhibitory reflex caused by dobutamine stimulation.

The Ross procedure: Is it the ideal operation for the young with aortic valve disease?

BACKGROUND: Aortic valve prosthesis with adequate hemodynamic performance should allow more complete left ventricular mass regression and normalize left ventricular function. This possibly affects long-term prognosis after aortic valve replacement. OBJECTIVE: Assessment of hemodynamic performance of pulmonary autograft in the aortic position and the regression of left ventricular mass after the Ross procedure. METHODS: Between May 1995 and March 1996, 45 patients with mean age of 27.1 years underwent a Ross procedure. Doppler echocardiography and cardiac catheterization were performed on all patients before hospital discharge to evaluate the hemodynamic performance of auto- and homografts, as well as to evaluate left ventricular mass and function. Fourteen patients with follow-up longer than six months were submitted to dobutamine stress echocardiography to study the hemodynamic performance of auto- and homografts during exercise. RESULTS: Hospital mortality was 6%. After a mean follow-up of 12.8 months (1-23 months) there was one late sudden death. No valve-related event was observed during this period. Immediate and late hemodynamic performance of the pulmonary autografts were normal with an average mean gradient of 1.8 +/- 0.6 mmHg and an average maximum instantaneous gradient of 2.9 +/- 0.9 mmHg. Valvular insufficiency was insignificant. Even during exercise, gradients did not increase significantly with an average mean gradient of 4.3 +/- 2.5 mmHg and an average maximum gradient of 10.4 +/- 6.1 mmHg. Homografts used for right ventricular reconstruction showed excellent immediate hemodynamic performance. However, at late follow-up an increase in flow speed was observed with an average to mean gradient of 10 +/- 7.1 mmHg at rest and 26 +/- 13.2 mmHg during exercise. Left ventricular mass index was normal at rest and during exercise in the majority of patients. CONCLUSION: Given the normal hemodynamic function of pulmonary autografts, the reduction of ventricular mass and normalization of left ventricular function, in addition to the excellent late follow-up of the patients, the Ross procedure is considered the operation of choice for young patients requiring aortic valve replacement.

Rest and exercise hemodynamics after the Ross procedure: an echocardiographic study.

BACKGROUND: Aortic prosthetic valves with superior hemodynamic performance are associated with more complete regression of left ventricular hypertrophy and better left ventricular function postoperatively. The near normal function of the pulmonary autografts at rest is well documented, however, exercise data has been seldom reported. The purpose of this study is to evaluate the hemodynamic performance of pulmonary autografts in the aortic position and the homografts used to reconstruct the right ventricular outflow tract during conditions of high cardiac output by means of dobutamine stress echocardiography. METHODS: Between May 1995 and February 1998, 67 patients were submitted to a Ross operation at our institution. Twenty of these patients had a mean age of 28.6+/-8.3 years and a mean follow-up time of 15.7+/-5.9 months. They were studied by dobutamine stress echocardiography to evaluate rest and exercise hemodynamics of the pulmonary autografts as well as of the aortic and pulmonary homografts used to reconstruct the right ventricular outflow tract. Dobutamine infusion was started at 5 microg/kg with incremental doses up to 40 microg/kg in every case. RESULTS: With dobutamine infusion, heart rate increased from 71+/-10 to 142+/-11 beats/min, left ventricular systolic volume from 86.8+/-33.9 mL to 115.9+/-52.6 mL, and cardiac output from 6.3+/-2.9 L/min to 16.8+/-7.4 L/min. Left ventricular function was considered satisfactory at rest and during exercise in all patients. The mean gradient across the autograft increased from 1.03+/-0.95 mmHg to 4.03+/-2.05 mmHg and maximal instantaneous gradient from 2.45+/-2.21 mmHg to 9.54+/-4.85 mmHg. The mean effective orifice area for the autografts were 3.5+/-1.3 cm2 at rest and 3.3+/-1.4 cm2 during exercise. The patients with mild aortic insufficiency at rest had no increase in the degree of regurgitation with exercise. In the right ventricular outflow tract, the mean gradient across the homograft increased from 9.06+/-5.29 mmHg to 17.55+/-9.76 mmHg and maximal instantaneous gradient from 21.4+/-12.5 mmHg to 41.5+/-23.1 mmHg. CONCLUSIONS: Pulmonary autografts exhibit normal hemodynamic performance at rest and during exercise after the Ross operation. However, mild-to-moderate gradients are common at the right ventricular outflow tract and should be carefully monitored.

Sintomas, complicaçöes e alteraçöes hemodinâmicas associadas a ecocardiografia de estresse com dobutamina / Symptoms, complications and hemodynamic effects related to dobutamine stress echocardiography

OBJETIVO - Avaliar a segurança e efeitos hemodinâmicos da ecocardiografia de estresse com dobutamina. MÉTODOS - Estudo prospectivo de 735 pacientes consecutivos, submetidos a ecocardiografia de estresse com dobutamina, para avaliar doença coronária e ou miocardiopatia. Inicialmente, a dobutamina foi administrada via endovenosa com doses progressivas de 5, 10, 20, 30µg/ kg/min a intervalos de 3min. O protocolo foi modificado para atingir a dose máxima de 40µg/kg/min, e, finalmente, até o limite de 50µg/kg/min. RESULTADOS - A dobutamina aumentou significantemente a frequência cardíaca (FC) (de 72ñ12bpm para 117ñ23bpm, p<0,0005) a pressão sistólica (133ñ21pbm para 157ñ29mmHg, p<0,0005) e o duplo produto (de 9,635ñ2,100 para 18,400ñ4,050, p<0,0001) do estado basal para o pico de infusão, respectivamente. Observou-se aumento significativo (p<0,05) da FC em cada estágio de infusão de dobutamina até dose de 40µg/kg/min, além do qual se mantém inalterado. Não ocorreram morte, infarto do miocárdio ou episódios de taquicardia ventricular. Os efeitos colaterais mais comuns foram náusea, ansiedade, tremor, apreensão e cefaléia em 55 (7,4 por cento) pacientes. Angina de peito ocorreu em 10 (1,4 por cento). As arritmias mais comuns foram extra-sístoles ventriculares em 138 (18,7 por cento) pacientes e extra-sistolia supraventricular 36 (4,9 por cento). Houve 4 pacientes que apresentaram taquicardia ventricular não sustentada, sem repercussão hemodinâmica. CONCLUSÄO - Ecocardiografia de estresse com dobutamina é um método seguro e bem tolerado.Doses de infusão de dobutamina > 40µg/kg/min não provocam resposta cronotrópica adicional, o que torna questionável a validade do protocolo de ecocardiografia de estresse com doses de dobutamina > 40µg/kg/min.

[Symptoms, complications and hemodynamic changes related to dobutamine stress echocardiography]. / Sintomas, complicações e alterações hemodinâmicas associadas a ecocardiografia de estresse com dobutamina.

PURPOSE: This study focuses on the safety and hemodynamic effects of dobutamine stress echocardiography. METHODS: Seven hundred and thirty five consecutive patients underwent dobutamine stress echocardiography for the evaluation of coronary artery disease and or cardiomyopathy. Dobutamine was administered intravenously at incremental doses of 5, 10, 20, 30 micrograms/kg/min, at 3 min intervals. The maximal dose was 40 or 50 micrograms/kg/min. RESULTS: Dobutamine significantly (p < 0.0005) increased the heart rate (from 72 +/- 12 bpm to 117 +/- 23 bpm), systolic blood pressure (from 133 +/- 21 to 157 +/- 29 mmHg) and the rate-pressure product (from 9.635 +/- 2.100 to 18.400 +/- 4.050, p < 0.0001) from baseline to peak infusion rate, respectively. There was a significant increase in heart rate (p < 0.05) at each infusion step, except for the 50 micrograms/kg/min dose, when the heart became stable. There were no deaths myocardial infarctions, or episodes of sustained ventricular tachycardia. Common non cardiac side effects included nausea, anxiety, headache, tremors and urgency in 55 (7.4%) of the patients. Angina pectoris occurred in 10 (1.4%) of the patients. The most common arrhythmias were usually mild. CONCLUSION: Dobutamine stress echocardiography is safe, and well tolerated. In this study complications such as myocardial infarction, death, ventricular tachycardia or fibrillation did not occur. There was no additional increase in heart rate with doses greater than 40 micrograms/kg/min. The advantage of stress echocardiography protocol with peak doses of 50 micrograms/kg/min is questionable.

[Aortic valve replacement with pulmonary autograft (Ross procedure). Initial experience]. / Substituição da valva aórtica com auto-enxerto pulmonar (cirurgia de Ross). Experiência inicial.

PURPOSE: Report the initial surgical experience with four cases utilizing a pulmonary autograft for aortic valve replacement. METHODS: Four patients, all males, white, age between 23 and 46 years having aortic valve disease were submitted to aortic valve replacement with a pulmonary autograft using the root replacement technique. Right ventricular outflow tracts were reconstructed with antibiotic sterilized pulmonary or aortic homografts. All patients had control bidimensional eco-doppler (ECO) and hemodynamic study to evaluate the function of the implanted auto and homografts. RESULTS: All patients had an excellent post-operative recovery, without the necessity of inotropic drugs. All presented in normal sinus rhythm. Post-operative ECO and hemodynamic studies revealed excellent function of the implanted autografts, without gradients in three and with a 15mmHg mean residual gradient in one case. There was no regurgitation in three cases and only trace aortic insufficiency in one. The right sided homografts also showed good function, with no gradient in two cases and mean systolic gradient of 6 and 8mmHg in the other two. CONCLUSION: The pulmonary autograft procedure should be implemented definitely in our country.

Substituição da valva aórtica com auto-enxerto pulmonar (cirurgia de Ross). Experiência inicial / Aortic valve replacement with pulmonary autograft (Ross procedure). Initial experience

Objetivo - Relatar a experiência cirúrgica inicial de 4 casos com a utilizaçäo do auto-enxerto pulmonar para substituiçäo da valva aórtica. Métodos - Quatro pacientes masculinos, brancos, com idades entre 23 e 46 anos, portadoras de valvopatia aórtica, forma submetidos a substituiçäo da valva aórtica pelo auto-enxerto pulmonar pela técnica de substituiçäo total da raiz aórtica. Para a reconstituiçäo da via de saída do ventrículo direito foram utilizados homo-enxertos pulmonares e aórtico conservad em soluçäo de antibióticos. Todos tiveram controle pós-operatório com eco-doppler (ECO) e estudo hemodinâmica para a avaliaçäo da funçäo dos auto e homo-enxertos implantados. Resultados - Todos apresentaram excelentes evoluçäo pós-operatória, sem necessidade de drogas inotrópicas e em ritmo sinusal. Os resultados obtidos através do ECO e estudo hemodinâmico revelaram excelente fuçäo dos auto-enxertos implantados sem gradiente em 3 casos e gradiente médio residual de 15 mmHg em um. Näo se observou reguriaçäo aórtica em 3 casos e insuficiência leve no 4o. ano. Os homo-enxertos implantados no lado direito do coraçäo apresentaram excelentes funcäo, sem gradiente em 2 anos e gradiente médio de 6 e 8 mmHg nos outros dois. Conclusäo - A cirurgia do auto-enxerto pulmonar deve ser implantada de forma definitiva em nosso meio

Purpose - Report the initial surgical experience with four cases utilizing a pulmonary autograft for aortic valve replacement Methods - Four patients, all males, white, age between 23 and 46 years having aortic valve disease were submitted to aortic valve replacement with a pulmonary autograft using the root replacement technique. Right ventricular out flow tracts were reconstructed with antibiotic sterilized pulmonary or aortic homografts. All patients had control bidimensional eco-doppler (ECO) and hemodynamic study to evaluate the function of the implanted auto and homografts. Results - All patients had an excelent postoperative recovery, without the necessity of inotropic drugs. All presented in normal sinus rhythm. Postoperative ECO and hemodynamic studies revealed excelent function of the implanted autografts, without gradients in three and with a 15mmHg mean residual gradient in one case. There was no regurgitation in three cases and only trace aortic insufficiency in one. The right sided homografts also showed good function, with no gradient in two cases and mean systolic gradient of 6 and 8mmHg in the other two. Conclusion - The pulmonary autograft procedure should be implemented definitelly in our country

Plasma Membrane H+-ATPase in Maize Roots Induced for NO3- Uptake.

Plasma membrane H+-ATPase was studied in maize (Zea mays L.) roots induced for NO3- uptake. Membrane vesicles were isolated by means of Suc density gradient from roots exposed for 24 h either to 1.5 mM NO3- or 1.5 mM SO4-. The two populations of vesicles had similar composition as shown by diagnostic inhibitors of membrane-associated ATPases. However, both ATP-dependent intravesicular H+ accumulation and ATP hydrolysis were considerably enhanced (60-100%) in vesicles isolated from NO3--induced roots. Km for Mg:ATP and pH dependency were not influenced by NO3- treatment of the roots. ATP hydrolysis in plasma membrane vesicles for both control and NO3--induced roots was not affected by 10 to 150 mM NO3- or Cl-. On the other hand, kinetics of NO3-- or Cl--stimulated ATP-dependent intravesicular H+ accumulation were modified in plasma membrane vesicles isolated from NO3-- induced roots. Immunoassays carried out with polyclonal antibodies against plasma membrane H+-ATPase revealed an increased steady-state level of the enzyme in plasma membrane vesicles isolated from NO3--induced roots. Results are consistent with the idea of an involvement of plasma membrane H+-ATPase in the overall response of roots to NO3-.

Regurgitant jet size by transesophageal compared with transthoracic Doppler color flow imaging.

Combined echocardiography and Doppler color flow mapping from transthoracic imaging windows has become the standard method for the noninvasive assessment of valvular regurgitation. This study compared regurgitant jet areas by Doppler color flow imaging derived from the newer transesophageal approach with measurements obtained from conventional transthoracic apical views. Maximal regurgitant jet area determinations and an overall visual estimate of lesion severity were obtained from 42 patients who underwent color flow examination by both techniques. Seventy-three regurgitant lesions were visualized by transesophageal flow imaging: 34 mitral, 22 aortic, and 17 tricuspid jets. Transthoracic studies in the same patients revealed fewer regurgitant lesions for each valve; 20 mitral, 16 aortic, and 12 tricuspid (p = 0.0009). A comparison of maximal jet areas determined by transesophageal and transthoracic studies showed a good overall correlation (r = 0.85, SEE = 2.8 cm2) and a systematic overestimation by the transesophageal technique (TEE = 0.96 TTX + 2.7). For the subgroup with mitral insufficiency, valve lesions visualized by both techniques were larger by the transesophageal approach (n = 18, 6.0 versus 3.6 cm2, p = 0.008). Semiquantitative visual grading of individual valve lesions by two independent observers revealed a higher grade of regurgitation with more jets classified as mild (38 versus 25), moderate (18 versus 13), and severe (17 versus 10) by esophageal imaging than by transthoracic imaging. Thus, transesophageal color flow mapping techniques yield a higher prevalence of valvular regurgitation than do transthoracic techniques in the same patients. Jet area and the overall estimate of regurgitant lesion severity were also greater by transesophageal color Doppler imaging compared with standard transthoracic imaging.(ABSTRACT TRUNCATED AT 250 WORDS)