Trigeminal nociceptors express prostaglandin receptors.

Orofacial inflammation is associated with prostaglandin release and the sensitization of nociceptive receptors such as the transient receptor potential subtype V(1) (TRPV(1)). We hypothesized that certain PGE(2) receptor subtypes (EP1-EP4) are co-expressed with TRPV(1) in trigeminal nociceptors and sensitize responses to a TRPV(1) agonist, capsaicin. Accordingly, combined in situ hybridization was performed with immunohistochemistry on rat trigeminal ganglia. We next evaluated the effects of specific EP2 and EP3 agonists (butaprost and sulprostone) in cultured trigeminal ganglia neurons. The results showed that EP2 and EP3 are expressed in trigeminal neurons (58% and 53% of total neurons, respectively) and are co-expressed in TRPV(1)-positive neurons (64% and 67 % of TRPV(1)-positive neurons, respectively). Moreover, most of the cells expressing EP2 or EP3 mRNA were of small to medium diameter (< 30 microm). The application of butaprost and sulprostone triggered neuropeptide exocytosis, and butaprost sensitized capsaicin responses. Analysis of these data, collectively, supports the hypothesis that prostaglandins regulate trigeminal TRPV(1) nociceptors via activation of the EP2 and EP3 receptors.

Ablation surgery for atrial fibrillation: "freeze it or buzz it; just do it and cure it".

Patients in normal sinus rhythm have lesser stroke rate, better functional class and quality of life than those in atrial fibrillation. Adding a surgical procedure to cure atrial fibrillation in patients needing correction of structural heart disease has been shown to be a safe option, which benefits the majority in restoration of sinus rhythm. Age is no bar to implement this option. The same does not hold true for lone atrial fibrillation. The affirm trial has shown that there is need for improved treatment strategies for patients in atrial fibrillation, although young patients were not represented in sizable proportion. There is need to develop curative treatment for patients with lone atrial fibrillation. And there are technological advances in the form of ablative energy sources and hardware for applying these with minimal invasion. "Between tomorrow's dream and yesterday's regret is today's opportunity". Let's make the best of it!

Intraoperative radiofrequency microbipolar coagulation to replace incisions of maze III procedure for correcting atrial fibrillation in patients with rheumatic valvular disease.

OBJECTIVE: Radiofrequency catheter ablation of atrial tachycardias and flutter is an established technique. The same modality in the microbipolar mode is effective in producing full thickness coagulation injury. Cox's maze procedure is highly successful in curing atrial fibrillation (AF) surgically. However, it consumes relatively long cross clamp time and cardiopulmonary bypass time. In this study, radiofrequency microbipolar coagulation was used as an adjunct to corrective valve surgery, as an intraoperative ablative modality to replace Cox's maze III incisions, thus remarkably shortening the procedure. The results of this procedure are compared historically with those of 26 patients who underwent corrective valve surgery alone. METHODS: Radiofrequency microbipolar coagulation was used to produce conduction blocks along the Cox's maze III incision lines as an adjunct to valve surgery in 18 patients in atrial fibrillation undergoing surgery for rheumatic valvular disease. A bayonet type bipolar forceps with an active tip length of 7 mm drawing current from a microbipolar port of Valleylab Force 4 electrosurgical unit (Valleylab, Boulder, CO) was used for microbipolar coagulation. A 3-mm retinal handheld cryoprobe working on nitrous oxide gas was used for cryoablation. RESULTS: A total of 15 survivors in the coagulation maze group were followed from 43 to 224 days (149.7 +/- 73.1 mean +/- S.D.). Twelve of the 15 survivors (80%) converted to normal sinus rhythm (70% confidence limit: 64.7-90.6%). Atrial transport function studies with pulsed wave doppler, showed presence of a wave in all the 12 (100%) patients in tricuspid valve flow and in nine (75%) patients in mitral valve flow. The procedure took 11.62 +/- 3.86 min of elective cardioplegic arrest time for the left atrial portion and 18.71 +/- 4.25 min of cardiopulmonary bypass time during reperfusion for the right atrial portion. Of the 23 survivors out of 26 patients who underwent the valve procedure alone, only one patient (4.3%) converted to normal sinus rhythm (70% confidence limit: 0.6-14%). CONCLUSION: Thus, our modification considerably shortened the time taken for creating the maze in comparison to the Cox's maze procedure and was effective in restoring normal sinus rhythm in 80% of the patients.

Left main coronary block in a nineteen-year-old woman.

A 19-year-old woman had angina on exertion, which had existed for 4 years. An exercise test was strongly positive, and selective coronary angiography showed 95% block of the left main coronary artery at its ostium. The patient underwent a successful aortocoronary bypass to the left anterior descending coronary artery. After 1 year and 10 months, she continues to be asymptomatic.

Percutaneous transluminal coronary angioplasty (PTCA) in unstable angina.

We performed percutaneous transluminal coronary angioplasty in 33 highly selected patients of unstable angina, a majority of whom were initially stabilized by medical therapy. All these patients had single vessel disease with type A lesion. The initial success rate was 91% with recurrence of 17% at the end of 1 year.

Relationship of growth parameters and nutrients uptake with canola (Brassica napus L.) yield and yield contribution at different nutrients availability.

A field experiment was conducted to evaluate the effect of different nutrients on canola (Brassica napus L.) growth parameters, nutrient uptake and ultimately on seed yield. For this purpose a split plot experimental design, with 10 treatments in 4 replications was carried out in 2004-2005, in silt-clay soil at Baiecola Agricultural Research Station, Mazandaran Iran. Canola seed yield, growth parameters (CGR, LAI, RGR and NAR), dry matter accumulation and HI and nutrient content of the leaf were examined. NPK fertilizers together with S and Zn, singly or in combination were applied. The results showed that at treatments T5 (NP), T8 (NPK), T9 (NPKS) and T10 (NPKZn) the higher seed yield (> 2600 kg ha(-1)) coincided with TDM > 880 g m(-2) the peak CGR > or = 13.9 g m(-2) day(-1) and the maximum LAI > or = 4.1. The higher seed yield at T5, T8, T9 and T10 coincided with higher concentrations of nutrients: N, P, K, S and Zn in leaf at flowering having > or = 3.40%, > or = 0.25%, > or = 1.53%, > or = 110 ppm and > or = 22.7 ppm, indicating substantial levels of translocation of nutrients at various stages of plant growth and higher number of pods per plant (> or = 179). Combined application of NPKZn at T10 resulted in maximum seed yield (3090 kg ha(-1)), coinciding with the maximum number of pods per plant (230), maximum TDM (1043 kg ha(-1)), maximum CGR (20.09 g m(-2) day(-1)) and maximum LAI (4.69).

Maze III replication using radiofrequency microbipolar coagulation.

BACKGROUND: The major concerns about the Cox's Maze III procedure have been the long bypass and cross-clamp times involved. We have developed a technique using microbipolar coagulation to duplicate most of the incisions described in the Maze III procedure. TECHNIQUE: This procedure is performed using standard hypothermic cardiopulmonary bypass and cold sanguineous hyperkalemic arrest. The left atrial Maze is performed using microbipolar coagulation following repair or following valve excision, prior to replacement. Cryolesions are used instead of radiofrequency at the mitral annulus to avoid injury to the circumflex coronary artery. Valve replacement is then done and the left atriotomies are closed. After rewarming, adequate deairing and removal of the aortic cross-clamp, the right atrial procedure is performed using microbipolar coagulation except ends of the radiofrequency lesion lines at the tricuspid annulus, where cryolesions are used. The rest of the surgery proceeds as usual. We used this procedure concomitantly with valve surgery in 84 patients. Sinus rhythm was restored in 86% of them. CONCLUSIONS: The use of radiofrequency energy in the microbipolar mode is safe and effective. The technique is easily reproducible and the tools involved are inexpensive and readily available. Although the cure rate is less compared to Cox's Maze III procedure and there is an attrition rate, sinus rhythm and atrial mechanical function is restored in the majority and with brief additional operative time.

Physico-chemical and biological investigations of River Umshyrpi at Shillong, Meghalaya.

River Umshyrpi is the major river in Shillong that passes across the city. Domestic waste, solid waste, agricultural run off from surrounding areas are entering into the river bodies through different drains. Water samples from various sites were collected and analysed for physico-chemical and biological parameters to assess the quality of the river system. The study reveals that physico-chemical parameters are within the permissible limit whereas the biological parameters are found to exceed the permissible limit which indicate unpotability of water for drinking purposes.

Anomalous origin of right pulmonary artery from ascending aorta with right ventricular endocardial fibroelastosis.

A case of aortic origin of the right pulmonary artery with right ventricular endocardial fibroelastosis is reported. Its diagnostic features, surgical aspects, and postmortem findings are discussed. This is a rare combination. The relevant literature is reviewed.

Blalock Taussig type shunt palliation for cyanotic infants and children.

In a period of ten years from January 1, 1979 to December 31, 1988, 54 cyanotic patients weighing less than 10 kg underwent shunt operations of Blalock Taussig type. The indications were hypercyanotic spells, failure to thrive and pulmonary arteries being too small for safe total collection. The commonest diagnosis was tetralogy of Fallot (63%). Thirty-three (64%) patients were older than 1 year but still weighed less than ten kg. Mortality was 16.67% (70% C.L. 8.94-26.60). During follow-up, there were 4(7%) late deaths. During the same period, 134 patients less than 5 years age came to autopsy without having any cardiological or surgical intervention. Ninety-seven (72.4%) of these deaths were due to cardiac causes. In order to save their lives, early identification is necessary which highlights the importance of parent and primary physician education.