Effect of thrombus aspiration on angiography and outcome in patients undergoing primary coronary angioplasty

Thrombus exerts a major impact on the performance and outcome of primary and rescue interventions in acute ST-elevation myocardial infarction. Although the optimal treatment of thrombotic lesions is still controversial, thrombus aspiration provides an effective method to achieve successful reperfusion during primary angioplasty. We compared clinical and angiographic outcomes in 286 patients with acute ST-elevation myocardial infarction undergoing primary percutaneous transluminal coronary angioplasty (PTCA) and thrombus aspiration with those who underwent conventional PTCA without thrombus aspiration. Thrombus aspiration during primary percutaneous coronary intervention in patients with high thrombus burden resulted in better Thrombolysis in Myocardial Infarction (TIMI) 3 flow in the infarct-related artery and helped achieve faster ST-segment resolution on the electrocardiogram compared with conventional angioplasty without thrombus aspiration

Field-tunable magnetic phases in a semiconductor-based two-dimensional Kondo lattice

We show the existence of intrinsic localized spins in mesoscopic high-mobility GaAs/AlGaAs heterostructures. Non-equilibrium transport spectroscopy reveals a quasi-regular distribution of the spins, and indicates that the spins interact indirectly via the conduction electrons. The interaction between spins manifests in characteristic zero-bias anomaly near the Fermi energy, and indicates gate voltage-controllable magnetic phases in high-mobility heterostructures. To address this issue further, we have also designed electrostatically tunable Hall devices, that allow a probing of Hall characteristics at the active region of the mesoscopic devices. We show that the zero field Hall coefficient has an anomalous contribution, which can be attributed to scattering by the localized spins. The anomalous contribution can be destroyed by an increase in temperature, source drain bias, or field range.Comment: To be published in PhysicaE EP2DS proceedin

An Integrated approach for Proteomic and Immunological analysis of Cell wall and Cell membrane proteins of Mycobacterium tuberculosis.

Mycobacterium cell wall and cell membrane proteins serve as key modulators in the host immune response. Some of these proteins, like MPT63, are known as immunodominant antigens, and others, such as LpqS and LpqH, are being explored as subunit vaccine candidates. However, due to their hydrophobic nature, conventional separation methods are not able to solubilize and isolate these proteins individually, leading to limited research on their systematic separation and immunological characterization. In this study, we successfully employed a combination of Preparative Isoelectric focusing and Preparatory SDS-PAGE to separate mycobacterial cell wall and membrane proteins into 234 fractions. These fractions were pooled based on the proteins molecular weight, resulting in 24 pooled fractions labelled as Ag1 to Ag24. Immunological analyses on these pooled fractions were carried out in 3 different study groups (subjects with latent tuberculosis infection (LTBI, N=20), tuberculosis-diseased patients (PTB, N=20), and healthy subjects (HC, N=20). In these study groups, Interferon-γ and TNF-α responses against these antigens were analysed using the cytokine ELISA method. Notably, one pooled fraction (Ag24 - Cell wall high molecular weight proteins pool) induced significantly higher IFN gamma response in LTBI compared to PTB, while also triggering significantly higher TNF-alpha response in PTB compared to LTBI. Additionally, three other pooled fractions (Ag6 - Cell Membrane Medium molecular weight proteins Pool, Ag11 - Cell Membrane high molecular weight proteins Pool, Ag23 - Cell wall high molecular weight proteins pool) induced significantly higher IFN gamma response in LTBI compared to PTB. Proteomic analysis of the Ag24 fraction identified four proteins (ACN, KatG, Rv2623, and Rv0404). Among them, KatG and Rv0404 were previously reported as immunodominant T-cell antigens. On the other hand, ACN lacks immunological information, and limited information is available on protein Rv2623. In conclusion, extensive immunological studies on these four proteins could enhance their development as tuberculosis prognostic biomarkers, while our systematic 2-dimensional separation method shows promising potential for characterizing cell wall and membrane proteins in other pathogen

A Tunable Two-impurity Kondo system in an atomic point contact

Two magnetic atoms, one attached to the tip of a Scanning Tunneling Microscope (STM) and one adsorbed on a metal surface, each constituting a Kondo system, have been proposed as one of the simplest conceivable systems potentially exhibiting quantum critical behaviour. We have succeeded in implementing this concept experimentally for cobalt dimers clamped between an STM tip and a gold surface. Control of the tip-sample distance with sub-picometer resolution allows us to tune the interaction between the two cobalt atoms with unprecedented precision. Electronic transport measurements on this two-impurity Kondo system reveal a rich physical scenario which is governed by a crossover from local Kondo screening to non-local singlet formation due to antiferromagnetic coupling as a function of separation of the cobalt atoms.Comment: 22 pages, 5 figure

Prospective validation of San Francisco Syncope Rule in Indian population

Context: The San Francisco Syncope Rule (SFSR) was proposed as a risk stratification tool for patients presenting to the emergency department (ED) with syncope. Aims: The aim of this study was to validate the SFSR in Indian population for predicting serious outcomes in patients presenting with syncope or near syncope. Secondary aim was to identify whether the admission rate can be safely reduced by applying this rule in the ED. Settings and Design: This was a prospective observational study conducted among patients attending the ED of a teaching hospital with syncope or near syncope. Subjects and Methods: Physicians prospectively applied the SFSR after usual evaluation, and patients were followed up to determine whether they had a serious outcome within 30 days of their ED visit. Statistical Analysis Used: Sensitivity, specificity, positive and negative predictive values of the rule for predicting serious outcomes were calculated. Results: A total of 210 patients were included in the study. There were 86 (41%) males and 124 (59%) females. Average age was 60.6 years. A total number of patients admitted were 110 out of 210 patients (52%). At least one SFSR predictor was positive in 90 (43%) patients out of 210. A total of 23 patients (11%) had at least one serious outcome at 30 days of ED visit. SFSR had a sensitivity of 95.65% and a specificity of 63.64% to predict serious outcome in the study population. Conclusions: The SFSR is valid in Indian population and application of the rule could reduce the hospital admission rates for syncope

Wong's anomaly – A rare variant of cor triatriatum

Cor triatriatum sinistrum is an extremely rare congenital heart disease. It is even more uncommon in adults, and clinically significant mitral valve lesion complicating cor triatriatum is distinctly rare. Wong et al reported for the first time the rare combination of cor triatriatum sinister associated with severe mitral regurgitation and abnormal tensor apparatus of the mitral valve. We report a similar case and used the term Wong's anomaly for the syndrome, having membranous type of cor triatriatum sinistrum, severe mitral regurgitation and hypoplasia of the papillary muscles and short chordae. Color Doppler Echocardiography showed peculiar ‘helmet sign’ of mitral regurgitation, wherein the mitral regurgitation color jet fills the distal atrial chamber and abruptly ends in a horizontal plane as it is halted by the intra-atrial membrane

Expression of the antiapoptotic protein bcl-2 is not dependent on the tumor suppressor p53 protein in Indian breast carcinoma

Tissue homeostasis and the maintenance of cell populations depend on a delicate balance between the rates of cell proliferation and cell death. Programmed cell death or apoptosis is believed to play a major role in physiological processes which, when defective, could contribute to the pathogenesis and progression of tumors. A role for altered programmed cell death in cancer stems from the description of alterations of tumor-associated genes involved in the regulation of apoptosis such as p53 and bcl-2. The p53 gene promotes apoptosis in cells with genetic damage, while bcl-2 is an antiapoptotic gene. It is therefore possible that the balance between p53 and bcl-2 may have significant implications for the pathobiology of breast cancer. This study was therefore undertaken to evaluate the expression of these two proteins with opposite functions and their relation to the total growth fraction of the tumor as measured by PCNA immunoreactivity. A significant correlation was observed between expression of p53 and PCNA. In contrast, bcl-2 expression did not correlate with the expression of p53. There was also no correlation observed between expression of bcl-2 and PCNA. A significant correlation was observed between expression of p53 and the grade of the tumor and stage of the disease. Our results thus support the hypothesis that accumulation of p53 is associated with a high tumor proliferation rate, an association that might be expected in view of the role of wild-type p53 as a negative regulator of cell proliferation. Another important observation was the lack of relationship between bcl-2 expression and PCNA immunoreactivity, supporting the hypothesis that bcl-2 is not a major regulator of proliferation