Femto to millisecond observations of indole-based squaraine molecules photodynamics in solution.

We present femto-to-millisecond studies of the photodynamics of seven types of indole-based squaraine molecules (SQs) in solvents of different H-bonding ability and viscosity. These SQs can be classified into two families: SQs with two carboxylic groups in the side indole groups (symmetrical SQs) and with only one carboxylic group (asymmetrical SQs). Steady-state absorption and fluorescence techniques show narrow absorption and emission bands, with a small Stokes shift (about 300 cm(-1)). The femtosecond transient absorption spectra give a very short (∼100 fs) dynamics (assigned to IVR) and the associated spectra show two excited species assigned to two stereoisomers. A trans-cis photoisomerization occurs in a very fast time through a conical intersection. Pico-to-nanosecond emission experiments also reveal the presence of two fluorescing trans stereoisomers whose lifetimes show similar sensitivities to the nature of solvent. For example, lifetimes of 1.72, 0.46 and 0.29 ns were determined for the trans photoisomer of the SQ 41 in triacetin, dichloromethane and acetonitrile, respectively, reflecting the short decay of the S(1) state in highly polar and low viscous solvents. Flash photolysis experiments gave the transient absorption signals of the cis photoisomer that is formed after the twisting process at S(1). The cis-to-trans photoisomerization at the ground state happens in the µs time scale (1-4 µs), and it depends on the H-bonding ability and viscosity of the solvent. Thus, combining fs-ns and ns-µs experiments suggests that in the conical intersection region, only a small fraction of the twisted trans isomers are converted to the cis ones in the excited states. These results bring detailed and global insight into the large time window photodynamics of this family of SQs in solution.

A hypocalcemic and lympnocyte-stimulating substance isolated from thymus extracts, and its physicochemical properties.

Two kinds of active protein fraction, TP1 and TP2, were isolated from bovine thymus extracts. Both these fractions showed a single band in polyacrylamide gel disc electrophoresis. Though these two fractions showed a difference in potency, they both lowered serum calcium in rabbits and increased lymphocytes in mice. Molecular weight determination by SDS polyacrylamide gel electrophoresis gave the values of 68,000 for TP1 and 57,000 for TP2. Amino acid composition of TP1 did not show marked characteristics but was clearly different from that of bovine serum albumin. Isoelectric focusing showed the isoelectric point at pH 5.65 for TP1 and pH 5.4 for TP2. Dose-response relation in serum calcium-lowering activity was examined with a sample purified from the extracts, and a linear dependence of the response to log dose was recognized over a moderate range of doses. The time-course measurement of the hypocalcemic activity showed that the action of TP1 is somewhat different from that of calcitonin.

Quasi-solid dye sensitised solar cells filled with ionic liquid--increase in efficiencies by specific interaction between conductive polymers and gelators.

Photo-energy conversions for quasi-solid dye sensitised solar cells increased when gel electrolytes were combined with conductive polymers as counter electrodes and the conversion surpassed that for DSSCs equipped with conventional Pt counter electrodes.

High-performance capillary electrophoresis of hyaluronic acid: determination of its amount and molecular mass.

The amount and the molecular mass of hyaluronic acid (HA) were determined by high-performance capillary electrophoresis. HA was observed at around 15 min by using an untreated fused-silica capillary (75 microns I.D.) of 58 cm length (effective length, 50 cm) at 20 kV in 50 mM phosphate buffer (pH 4.0). Calibration curves showed good linearity from 0.01 mg/ml to 3.3 mg/ml for all HA samples examined. The lower limit of detection by monitoring the absorbance at 185 nm was 1.0 microgram/ml at the signal-to-noise ratio of 5. HA samples were examined in a buffer containing pullulan (PU) as an additive for the matrix formation material. The HA samples showed marked peak-broadening when analyzed in the buffer solution containing PU with a specified molecular mass. The peak broadening was based on the dispersion of the molecular mass of the HA sample analyzed.

Analysis of glucuronolactone and glucuronic acid in drug formulations by high-performance liquid chromatography.

Glucuronolactone and glucuronic acid in drug formulations and beverages are determined as 1-phenyl-3-methyl-5-pyrazolone (PMP) derivatives using high-performance liquid chromatography. Intra-ester linkage (i.e., the lactone of glucuronolactone) is spontaneously hydrolyzed to free-acid form and is analyzed as the PMP derivative of glucuronic acid. By omitting three evaporation steps in the original derivatization procedure, the total analysis time is shortened to approximately 40 min. Reproducibility of determination is within 4.0% for all drug formulations. The present method satisfies the requirements for routine analysis in the quality control of drug formulations containing glucuronolactone or glucuronic acid.

Myocardial SPECT and left ventricular performance study using a single Tc-99m teboroxime injection. Comparison with thallium-201 myocardial SPECT.

Myocardial SPECT using teboroxime was compared to thallium SPECT in 26 patients undergoing cardiac catheterization. Agreement between thallium SPECT and teboroxime SPECT for the identification of myocardial segments was 209/235 (89%). A significant correlation was found in 15 patients between the left ventricular ejection fraction by teboroxime first-pass study and the ejection fraction by contrast ventriculography. In nine patients with myocardial infarction and/or multivessel coronary artery disease, the ejection fraction revealed a mean decrease from 0.52 at rest to 0.46 at exercise. Teboroxime makes it possible to perform an exercise first-pass study of left ventricular ejection fraction followed by myocardial perfusion imaging.

[Vasodilator therapy utilizing nitroprusside and nitroglycerin after coronary artery surgery].

The hemodynamic effects of combined therapy utilizing sodium nitroprusside (SNP) and nitroglycerin (TNG) were compared with those of TNG therapy in patients who underwent coronary artery bypass grafting (CABG). Of 58 patients who received catecholamine infusion to maintain hemodynamics after CABG, 17 had perioperative myocardial infarction (PMI (+) cases) and the other 41 had not PMI (PMI (-) cases). 26 of 41 patients (PMI (-) cases) received nitroglycerin therapy (NTG group) and the other 15 patients received combined therapy (SNP + NTG group). 11 of 17 patients (PMI (+) cases) received NTG therapy and the other 6 patients received combined therapy. The hemodynamic valuables, which were studied, were as follows; cardiac index, stroke volume index, left ventricular stroke work index, systemic vascular resistance index, pulmonary vascular resistance index, and deep core temperature. SNP + TNG group revealed significantly lower systemic vascular resistance index and pulmonary vascular resistance index than TNG group in PMI (-) cases. In PMI (+) cases, SNP + TNG group revealed significantly higher cardiac index, stroke volume index, left ventricular stroke work index, and significantly lower pulmonary vascular resistance index than TNG group. These findings demonstrate that combined therapy can obtain more secure vasodilation than TNG therapy.

[A case of two-chambered right ventricle complicating infective endocarditis and tricuspid regurgitation].

A 31-year-old male of two-chambered right ventricle with ventricular septal defect, complicating infective endocarditis and tricuspid regurgitation, was presented. Two-dimensional echocardiographic study demonstrated tricuspid vegetations and a hypertrophied, anomalous muscle bundle in the right ventricle. Cardiac catheterization revealed 58 mmHg pressure gradient between inflow chamber and outflow chamber of the right ventricle. It seems that tricuspid regurgitation was resulted from infective endocarditis. He underwent resection of anomalous muscle bundle, repair of ventricular septal defect, and tricuspid valve replacement with satisfactory result. It has not been reported in Japan so far that tricuspid valve replacement was performed for the treatment of tricuspid regurgitation due to infective endocarditis in the patient with two-chambered right ventricle. In our case, cardiac catheterization was performed after subsidence of infective endocarditis. As echocardiography can detect vegetations and anomalous muscle bundle precisely, surgical intervention would be performed without cardiac catheterization in the case of infective endocarditis intractable to medical therapy.

[A case of completely unroofed coronary sinus with persistent left superior vena cava].

A 34-year-old female presented with exertional dyspnea. Investigation by echocardiography and cardiac catheterization showed completely unroofed coronary sinus with persistent left superior vena cava (PLSVC) (coronary sinus atrial septal defect, absence of the coronary sinus, and PLSVC-left atrium connection) combined with tricuspid valve regurgitation. Angiocardiography made by injection into the PLSVC demonstrated that the PLSVC was connected to the hemiazygos vein before it drained into the left atrium and the left innominate vein was absent. Although jugular vein pressure rose up to 18 mmHg when the PLSVC was temporarily occluded, it remained unchanged. Therefore, simple ligation of the PLSVC was selected for therapy. Patch closure of the atrial septal defect, tricuspid valve repair, and ligation of the PLSVC was performed successfully.

[Invasive treatment of ischemic events after coronary artery bypass grafting].

PTCA or reCABG was performed for ischemic events after CABG in 32 patients. Since 6 patients were operated on initially elsewhere, the incidence of reCABG among our own patients was 1.2% and that of PTCA was 4.5%. Only one patient of 15 patients, in whom internal thoracic artery (ITA) was utilized at the initial CABG, underwent reCABG and the other patients were treated by PTCA. The use of ITA reduced the necessity for re-CABG because of the superior long-term patency of ITA. PTCA was performed for 32 lesions (19 in saphenous vein grafts (SVG), 4 in ITA grafts, and 9 in native coronary arteries) of 23 patients with success rate of 88%. The rate of restenosis was 36%. There were no complications following PTCA. No patients were referred for emergent surgery. Intracoronary thrombolysis and PTCA for total occlusion of SVG were performed successfully if they were done early after the occurrence of ischemic events. Coronary angiography should be performed as soon as possible. Ten patients underwent re-CABG utilizing ITA in 9 patients and gastro-epiploic artery (GEA) in 3. One patient died of arrhythmia due to spasm. The other 9 patients were discharged and class I or II of NYHA functional classification. The coronary angiography, which was performed at the late follow-up period, showed occlusion of SVG and patency of ITA. The arterial conduits should be applied for reCABG because of the low long-term patency of SVG.

[Repeated valvular surgery with minimal heart dissection].

Between April 1989 and March 1994, sixteen patients underwent the reoperation for valvular disease. In early years, complete heart dissection performed during operation (group A, n = 7). And recently, minimal necessary dissection was applied (group B, n = 9). In group B, dissection was limited to the ascending aorta, both vena cavae and right upper pulmonary vein. If the adhesion would be dense, pleural cavity would be widely opened and both caval cannula and left atrial vent tube would be cannulated through pleural adhesion. Operation time of group B was significantly decreased in comparison with group A. (group A: 569 +/- 91 min, group B: 347 +/- 65 min, p < 0.01). Post-operative course of group B was considered to be better than group A. These result suggested that minimal necessary heart dissection would be extremely effective during the repeated valvular surgery.

[A case of aortic valve-regurgitation associated with Behçet's disease].

The patient was a 37-year-old female with incomplete form of Behçet's disease combined with aortic valve regurgitation. The patients with Behçet's disease often have perivalvular leakage after valve replacement. Special technique is necessary in order to reinforce suture lines and minimize the occurrence of postoperative perivalvular leakage. The aortic valve replacement was accomplished by bolstering mattress sutures with Teflon felt strips and by inserting of sutures from outside the aorta. The latter technique was utilized around the entire circumference of the aortic annulus by opening the right ventricular outflow tract and right atrium and passing sutures from within these structures to enter the aorta. Satisfactory result was obtained with no findings of perivalvular leakage 2 years after operation. The conductive system was not damaged. The operation was performed when the inflammatory signs and findings subsided with adrenal steroids. The steroid therapy has been continued and adjusted by the values of CRP as well as the cutaneous and mucous manifestations.

[A case report of cervical aortic arch complicated with succiform aneurysm].

Left-sided cervical aortic arch in 30-year-old woman complicated with succiform arch aneurysm was reported. Aneurysm was successfully removed and arch was reconstructed by end to end anastomosis. Histological examination of aneurysm revealed atherosclerotic change and calcification.

[A case of ruptured azygos vein and diaphragmatic hernia due to blunt chest trauma].

A 47-year-old female was admitted to the emergency room following an automobile accident. She was shocked complaining of respiratory difficulty and chest pain. A chest X-ray showed right hemothorax which drained 2.5 liters of blood on insertion of chest tube. Emergency operation revealed rupture of azygos vein. The bleeding was controlled by the ligation of the azygos vein. Postoperative chest X-ray showed obscuration of the left diaphragma, and herniated stomach was identified by the gastrography. Second operation was performed and ruptured diaphragma was repaired. Her postoperative recovery was good. She was discharged from hospital at 7th week.

[Analysis of factors influencing early patency of saphenous vein grafts].

To determine factors affecting early patency of saphenous vein grafts, 140 grafts in 65 patients were studied angiographically within 2 months after operation. Twenty of the 140 grafts were occluded. Sixteen variables were extracted from the angiographic findings, intraoperative measurements, clinical characteristics, and biochemical data. The univariate and multivariate analyses were performed to assess their predictive value. Of 16 variables, 3 (coronary artery internal diameter, graft flow, and coronary artery resistance) correlated significantly with graft patency in the univariate analysis. The multivariate analysis selected coronary artery resistance, coronary artery internal diameter, and degree of proximal stenosis as predictors of early graft patency. Of these 3 factors, the coronary artery resistance influenced graft patency mostly. Therefore, the coronary artery resistance was considered to be the most reliable predictor of early graft patency.

[A case of cardiac lipoma in the ventricular septum].

A 45-year-old man was admitted because of systolic murmur after routine medical checking. Echocardiography and cardiac catheterization revealed a large mass in the ventricular septum which bulged into right ventricular cavity with pressure gradient of 29 mmHg. The diagnosis of cardiac lipoma was made by CT scanning which showed the mass with attenuation values of -94 Hounsfield units. MR imaging demonstrated the mass with high signal intensity which corresponded to that of subcutaneous fatty tissue. The tumor was resected through the right ventricular incision with the use of cardiopulmonary bypass. It was yellow, elastic soft, sized 6.5 x 4.3 x 3.5 cm, and weighed 44.7 g. On histological examination, the tumor was composed of mature fatty tissues contained with myocardial fibers. After operation, he had split of the ventricular septum, which was closed primarily after removal of the lipoma, and left-to-right shunt. Patch reinforcement was performed at the right ventricular side of the septum on the postoperative 18th day. Postoperative electrocardiogram showed left axis deviation and complete right bundle branch block. This finding seems to be resulted from injury to the anterior branch of left bundle. The postoperative course was uneventful. This patient is the second case of removal of cardiac lipoma in the ventricular septum on review of the literature in Japan.

[Carpentier's procedure for Ebstein's anomaly: successful and failed cases].

Two adult cases of Ebstein's anomaly underwent Carpentier's procedure. In the first case longitudinal plication limited to free wall of atrialized ventricle was performed and postoperative course was uneventful. In the second case preoperative echocardiography showed apparently restricted movement of anterior leaflet of the tricuspid valve which was compatible with intraoperative findings. That is, inferior edge of anterior leaflet was partly adherent to ventricular wall and systolic bulging of leaflet was significantly impaired which was left untouched but should be repaired by additional procedure. Six days after operation the tricuspid valve replacement was required for persistent right heart failure due to residual tricuspid regurgitation. In the same case longitudinal plication of atrialized ventricle reported by Carpentier and colleagues resulted in excessively small annulus. Therefore we had to reduce the plication and did not perform following atrial plication to avoid direct injury to conduction system or disturbing coronary venous return. In conclusion exact preoperative evaluation of anterior leaflet of the tricuspid valve especially subvalvular anatomy is essential to Carpentier's procedure, as Carpentier and colleagues emphasized, and conservative longitudinal plication of the atrialized ventricle limited to free wall is favorable when excessively small annulus might be concerned.

[Staged sternal closure for the case of postoperative severe cardiac failure: a convenient method in the intensive care unit].

A convenient method of staged sternal closure in the intensive care unit for a patient with severe cardiac failure was reported. According to the patient's cardiac function, optimal intersternal space can be adjusted. When using this method on a infant, the adjustment has shown to be very easy and take only a short time. However we have no experience on adults with stronger sternum.

[A case of submitral left ventricular pseudoaneurysm following mitral valve replacement for infective endocarditis].

A 25-year-old female presented with high fever and dyspnea. She was diagnosed as infective endocarditis, severe mitral regurgitation, grade II A-V block and acute left heart failure We performed emergency mitral valve replacement. At operation, mitral ring abscess was found which was extended to submitral left ventricular wall. The abscess was excised and the defect of mitral annulus was repaired with Xenomedica patch. Left ventriography at 30 days after the operation showed a submitral left ventricular pseudoaneurysm (size: 30 x 26 x 33 mm) without evidence of infection. Further examinations showed that the aneurysm extended to the annulus of tricuspid valve through interatrial septum. About 1 year after the operation, she had paroxysmal atrial fibrillation due to right atrial overloading. We decided to perform reoperation. At reoperation, the ostium of the aneurysm was closed with a Xenomedica patch after taking off the prosthetic valve. It was very difficult to close the ostium because we could not see the submitral ventricular wall directly. Although postoperative course was good, she had complete A-V block necessitating permanent pacemaker.

[Surgical treatment for ischemic mitral regurgitation in patients with poor left ventricle].

Results of CABG with and without mitral valve surgery were analyzed retrospectively in 81 patients with ischemic mitral regurgitation (MR) to determine the effects of severity of MR and surgical treatment on survival. Seven of 81 patients had severe MR (more than Sellers III degrees/IV). Of these 7 patients, 5 patients underwent mitral valve replacement and 1 patient underwent mitral annuloplasty. Only one patient did not undergo valve surgery. This patient had slight improvement of the functional classification after CABG, but died of congestive heart failure 5 years after surgery. There were 3 hospital deaths and 5 late deaths in 81 patients. Among the 29 patients with poor left ventricle (EF < or = 0.3), there were 3 hospital deaths and 2 late deaths. Postoperatively, 12 patients had Sellers II degrees/IV or III degrees/IV MR. In 4 patients of these 12, the severity of MR was aggravated in comparison with the preoperative severity. Three of these 4 patients had perioperative myocardial infarction (PMI). IABP was utilized preoperatively in patients with poor left ventricle to keep the stable hemodynamics and prevent PMI. In these patients, there were no PMI, no hospital death, or no aggravation of MR. In conclusion, patients with Sellers I degree/IV or II degrees/IV MR require CABG only, whereas those with Sellers III degrees/IV or IV degrees/IV MR need CABG combined with mitral valve surgery. Preoperative use of IABP is useful for preventing PMI and aggravation of MR in patients with poor left ventricle.