Influence of Diabetes Mellitus on Left Ventricular Function in Patients Undergoing Coronary Artery Bypass Grafting

Objectives. Left ventricular function was assessed by two-dimensional echocardiography before and one year after coronary artery bypass grafting CABG in a series of patients with severe coronary artery disease with diabetes mellitus DM and without DM non-DM . Methods. Twenty-three patients with DM and 50 patients without DM, all with no previous myocardial infarction, underwent two-dimensional echocardiography before CABG and one year after CABG, in a non-matched study. For a matched study, 31 patients without DM who had almost the same left ventricular function as DM patients at the baseline were selected to and compare the rate of improvement in left ventricular function between the DM group and the matched non-DM group. Results. In the non-matched study, patient characteristics were not significantly different between the 2 groups except for the incidence of congestive heart failure within one year before CABG, which was significantly higher in the DM group. Fractional shortening was significantly lower in the DM group at the baseline p 0.05 and also one year after CABG p 0.0001 . Significant improvement in fractional shortening was seen in the non-DM group p 0.001 , but not in the DM group. The left ventricular enddiastolic diameter LVDd was significantly larger in the DM group at the baseline p 0.01 , and was still significantly larger in the DM group at one year after CABG p 0.01 . No improvement in LVDd was seen in the DM group. In the matched study, fractional shortening of the non-DM group also showed significant improvement after CABG p 0.001 . Moreover, the rate of improvement in fractional shortening was higher in the non-DM group than in the DM group p 0.05 . LVDd tended to be larger in the DM group p NS . Conclusions. Left ventricular dysfunction and left ventricular impaired improvement were seen in the patients with DM, and CABG improved left ventricular function in the patients without DM with poor left ventricular function. These findings indicate that CABG therapy may be inadequate for improving left ventricular function in patients with DM and severe left ventricular dysfunction at the baseline.

Real-time observation of X-ray-induced intramolecular and interatomic electronic decay in CH2I2

The increasing availability of X-ray free-electron lasers (XFELs) has catalyzed the development of single-object structural determination and of structural dynamics tracking in realtime. Disentangling the molecular-level reactions triggered by the interaction with an XFEL pulse is a fundamental step towards developing such applications. Here we report real-time observations of XFEL-induced electronic decay via short-lived transient electronic states in the diiodomethane molecule, using a femtosecond near-infrared probe laser. We determine the lifetimes of the transient states populated during the XFEL-induced Auger cascades and find that multiply charged iodine ions are issued from short-lived (similar to 20 fs) transient states, whereas the singly charged ones originate from significantly longer-lived states (similar to 100 fs). We identify the mechanisms behind these different time scales: contrary to the short-lived transient states which relax by molecular Auger decay, the long-lived ones decay by an interatomic Coulombic decay between two iodine atoms, during the molecular fragmentation

Omecamtiv mecarbil in chronic heart failure with reduced ejection fraction, GALACTIC‐HF: baseline characteristics and comparison with contemporary clinical trials

Aims: The safety and efficacy of the novel selective cardiac myosin activator, omecamtiv mecarbil, in patients with heart failure with reduced ejection fraction (HFrEF) is tested in the Global Approach to Lowering Adverse Cardiac outcomes Through Improving Contractility in Heart Failure (GALACTIC‐HF) trial. Here we describe the baseline characteristics of participants in GALACTIC‐HF and how these compare with other contemporary trials. Methods and Results: Adults with established HFrEF, New York Heart Association functional class (NYHA) ≥ II, EF ≤35%, elevated natriuretic peptides and either current hospitalization for HF or history of hospitalization/ emergency department visit for HF within a year were randomized to either placebo or omecamtiv mecarbil (pharmacokinetic‐guided dosing: 25, 37.5 or 50 mg bid). 8256 patients [male (79%), non‐white (22%), mean age 65 years] were enrolled with a mean EF 27%, ischemic etiology in 54%, NYHA II 53% and III/IV 47%, and median NT‐proBNP 1971 pg/mL. HF therapies at baseline were among the most effectively employed in contemporary HF trials. GALACTIC‐HF randomized patients representative of recent HF registries and trials with substantial numbers of patients also having characteristics understudied in previous trials including more from North America (n = 1386), enrolled as inpatients (n = 2084), systolic blood pressure < 100 mmHg (n = 1127), estimated glomerular filtration rate < 30 mL/min/1.73 m2 (n = 528), and treated with sacubitril‐valsartan at baseline (n = 1594). Conclusions: GALACTIC‐HF enrolled a well‐treated, high‐risk population from both inpatient and outpatient settings, which will provide a definitive evaluation of the efficacy and safety of this novel therapy, as well as informing its potential future implementation

A Label-Free Fluorescent Array Sensor Utilizing Liposome Encapsulating Calcein for Discriminating Target Proteins by Principal Component Analysis

A new fluorescent arrayed biosensor has been developed to discriminate species and concentrations of target proteins by using plural different phospholipid liposome species encapsulating fluorescent molecules, utilizing differences in permeation of the fluorescent molecules through the membrane to modulate liposome-target protein interactions. This approach proposes a basically new label-free fluorescent sensor, compared with the common technique of developed fluorescent array sensors with labeling. We have confirmed a high output intensity of fluorescence emission related to characteristics of the fluorescent molecules dependent on their concentrations when they leak from inside the liposomes through the perturbed lipid membrane. After taking an array image of the fluorescence emission from the sensor using a CMOS imager, the output intensities of the fluorescence were analyzed by a principal component analysis (PCA) statistical method. It is found from PCA plots that different protein species with several concentrations were successfully discriminated by using the different lipid membranes with high cumulative contribution ratio. We also confirmed that the accuracy of the discrimination by the array sensor with a single shot is higher than that of a single sensor with multiple shots

Specific clones of Staphylococcus lugdunensis may be associated with colon carcinoma

Staphylococcus lugdunensis produces a tannase with activity that may be associated with the onset of colon carcinoma. To clarify this feature of colon carcinoma-associated S. lugdunensis, we obtained isolates from healthy subjects and patients with colon adenomas and carcinomas and analyzed their genetic backgrounds. In total, 40 S. lugdunensis isolates from 288 rectal swabs collected between 2002 and 2008 were used. These isolates were classified into four groups according to the diseases of the subjects: healthy (n = 13), colon carcinoma (n = 13), colon adenoma (n = 9), and unknown (n = 5). The isolates were also classified by pulsed-field gel electrophoresis (PFGE) and multi-locus sequence typing. In addition, an antimicrobial susceptibility test and detection of resistance genes were performed for all isolates. According to the PFGE analysis, 40 isolates could be classified into five groups. Among the groups, carcinoma and colon adenoma patients were significantly more frequently (40.9%) classified into group D (p < 0.05), whereas healthy subjects were more frequently (38.5%) classified into group A. All isolates in group D were typed as ST27, which was clearly different than isolates in the other groups. All isolates were susceptible to the antimicrobial agents tested, including β-lactams, although seven strains produced β-lactamase. Our data suggest that a specific clone of S. lugdunensis might be associated with colon carcinoma and colon adenoma. This clone showed high susceptibility to many antimicrobial agents. Therefore, eradication therapy may lead to a decreased risk of colon carcinoma. Keywords: Staphylococcus lugdunensis, Colon carcinoma, Pulsotype, Multilocus sequence typin

Endocardial Substrate Mapping for Monomorphic Ventricular Tachycardia Ablation in Ischemic and Non-Ischemic Cardiomyopathy

We investigated the differences in the endocardial substrates between ischemiccardiomyopathy (ICM) and non-ICM (NICM) by using electro-anatomical mappingand pace-mapping. We studied 18 patients (ICM and NICM, 9 each) withmonomorphic ventricular tachycardia (VT) documented by 12-leads ECG. Low voltagearea was defined by signal amplitude 10 of the 12-leads ECG was regarded as a pace-map match. Andconduction delay during pace-mapping was defined as the stimulus to QRS interval &#8805;40ms. Low voltage area was 53.8 ± 21.5 and 20.8 ± 16.7 cm2 in ICM and NICM patients,respectively (P = 0.002). Pace-mapping was assessed in 6 ICM and 9 NICM. Pace-mapmatch with conduction delay were obtained in all the 6 ICM patients. But in NICMpatients, pace-map match with conduction delay was obtained in 3 patients. Pace-mapmatch sites where conduction delay was not observed were obtained in 5 patients.Pace-map match could not be obtained in 1 patient. We attempted ablation in 6 ICMand 7 NICM patients. Subsequently, VT recurrence was not observed in ICM but itwas observed in 6 of 7 NICM patients (log-rank P = 0.0016). In NICM patients, thearrhythmogenic substrate that represented the abnormal electrogram and conductiondelay was observed less within the endocardial surface when compared with thatobserved in ICM. VT recurrence rate subsequent to endocardial ablation was higher inNICM than in ICM patients