Persistent atrial fibrillation over 3 years is associated with higher recurrence after catheter ablation.

INSTRUCTION: Longer atrial fibrillation (AF) durations have higher recurrence rates after rhythm control. However, there is limited data on the effect of the AF duration on recurrence after atrial fibrillation catheter ablation (AFCA). In the present study, we investigated the rhythm outcome of AFCA according to the AF duration based on the first electrocardiogram (ECG) diagnosis. METHODS AND RESULTS: We included 1005 patients with AF (75% male, 59 ± 11 years old) who underwent AFCA and whose first ECG diagnosis time point was evident. The clinical characteristics and rhythm outcomes were compared based on the AF duration (≤3 years, n = 537; >3 years, n = 468) and AF burden (paroxysmal atrial fibrillation [PAF], n = 387; persistent atrial fibrillation [PeAF], n = 618). Longer AF durations were associated with older age (P = .020), larger left atrial size (P = .009) and a higher number of patients with hypertension (P < .001) or PeAF (P < .001). During 24 ± 22 months of follow-up, the postablation clinical recurrence rate was higher in patients with a longer AF duration (logrank P = .002). The AF recurrence rate was significantly higher in PeAF patients with an AF duration >3 years (logrank P = 0.009), but not in subjects with PAF (logrank P = .939). In a multivariate Cox regression analysis, a longer AF duration was significantly associated with a higher clinical recurrence rate after AFCA in PeAF patients (adjusted hazard ratio, 1.06; range, 1.03-0.10; P = 0.001), but not PAF. CONCLUSION: Although longer AF duration was associated with higher clinical recurrence rates after AFCA, the rate was significant in patients with PeAF lasting >3 years, but not in PAF patients.

Long-term fine particulate matter exposure and cardiovascular mortality in the general population: a nationwide cohort study.

BACKGROUND: Although eastern Asian countries are exposed to high levels of air pollution, the impact of long-term exposures to fine particulate matter (PM2.5) air pollution on all-cause and cardiovascular mortality is not well identified. We assessed the relationship between long-term PM2.5 exposure and all-cause/cardiovascular mortalities. METHODS: We included 436,933 subjects who received national health examinations from the Korean National Health Insurance Service-based National Sample Cohort. We matched subjects' residential-address areas with hourly-measurements of PM2.5 concentration data. We estimated the risk of mortality with average PM2.5 exposure during the study period using a Cox proportional-hazards model. RESULTS: During 1,683,271 person·years, all-cause and cardiovascular mortalities were observed in 6432 and 1603 subjects (382 and 95 per 100,000 person·years, respectively). An increase in 10 µg/m3 in PM2.5 was associated with increases in all-cause and cardiovascular mortalities by 3.4 % [2.7-4.1] and 4.7 % [3.6-5.8], respectively (each p < 0.001). PM2.5 was linearly and significantly correlated with these all-cause and cardiovascular mortalities above 18 µg/m3 of PM2.5 (p < 0.001), but it was not significant below 18 µg/m3 of PM2.5. To investigate the specific PM2.5 concentration for raising cardiovascular mortality more, we analyzed the sensitivities/specificities for different PM2.5 levels, and 18 µg/m3 showed the highest Youden's index (sensitivity + specificity-1) with c-index of 0.85 (0.84-0.86). PM2.5 effect on all-cause mortality was more profound in subjects with previous myocardial infarction compared to the opposite population. CONCLUSIONS: In the Korean general population exposed to high-air pollution, long-term PM2.5 exposure was linearly associated with increased risk for all-cause and cardiovascular mortality, especially above 18 µg/m3 of PM2.5.

Fucoidan Extracted from Hijiki Protects Brain Microvessel Endothelial Cells Against Diesel Exhaust Particle Exposure-Induced Disruption.

This study was performed to evaluate the protective effects of fucoidan against the decreased function of primary cultured bovine brain microvessel endothelial cells (BBMECs) after exposure to diesel exhaust particles (DEPs). BBMECs were extracted from bovine brains and cultured until confluent. To evaluate the function of BBMECs, we performed a permeability test using cell-by-cell equipment and by Western blot analysis for zonular occludens-1 (ZO-1), which is a tight junction protein of BMECs, and evaluated oxidative stress in BBMECs using the DCFH-DA assay and the CUPRAC-BCS assay. The increased oxidative stress in BBMECs following DEP exposure was suppressed by fucoidan. In addition, permeability of BBMECs induced by DEP exposure was decreased by fucoidan treatment. Our results showed that fucoidan protects against BBMEC disruption induced by DEP exposure. This study provides evidence that fucoidan might protect the central nervous system (CNS) against DEP exposure.

Effects of combination therapy of statin and N-acetylcysteine for the prevention of contrast-induced nephropathy in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention.

BACKGROUND: Acute myocardial infarction (AMI) is a risk factor for contrast-induced nephropathy (CIN). We investigated whether pretreatment with statin, N-acetylcysteine (NAC) and sodium bicarbonate (NaHCO3) reduces the risk of CIN. METHODS: We conducted a prospective trial and enrolled a total of 334 ST-segment elevation myocardial infarction (STEMI) patients. Patients were divided into four groups: Group I (statin 40mg), Group II (statin 80mg), Group III (statin 80mg plus NAC 1200mg) and Group IV (regimen of group III plus NaHCO3 154mEq/L). CIN was defined as ≥25% or ≥0.5mg/dL increase in serum creatinine from the baseline within the 72h after PCI. RESULTS: CIN occurred in 72 (21.6%) patients. The incidence of CIN was the lowest in the group III (14.3%), and multivariate analysis showed the lower incidence of CIN in group III compared to Group I [odds ratio (OR) 0.29, 95% confidence interval (CI) 0.13-0.64, p=0.002]. Admission hyperglycemia [(AHG)>198mg/dL] (OR 2.20, 95% Cl 1.20-3.68, p=0.011) and the use of intra-aortic balloon pump (IABP) (OR 4.20, 95% CI 1.38-12.78, p=0.016) were independent predictors for CIN. The CIN (OR 9.00, 95% CI 1.30-62.06, p=0.026) was an independent predictor for in-hospital mortality. CONCLUSIONS: Combination of high-dose statin plus NAC was associated with lower incidence of CIN in patients with STEMI who underwent primary PCI compared to statin only.

Full-scale biological treatment of tannery wastewater using the novel microbial consortium BM-S-1.

In order to develop a more effective and eco-friendly treatment technology, a full-scale tannery wastewater treatment plant with a sludge digestion system was augmented with a novel microbial consortium (BM-S-1). The aim of this study was to determine if the BM-S-1 could successfully treat the tannery wastewater in a full-scale treatment system without chemical pretreatment and to investigate effect of the augmentation on sludge production. Chemical oxygen demand (COD), total nitrogen (TN), total phosphorus (TP), chromium (Cr) and mixed liquor suspended solids (MLSS) were measured to monitor treated water quality and treatment efficiency. Microbial community structures in the treatment were also examined using pyrosequencing analysis of 16S rRNA gene and quantitative PCR (qPCR) of the nitrous oxide reductase gene (nosZ). The removal efficiencies of COD, TN, TP, and Cr were estimated to be 98.3%, 98.6%, 93.6%, and 88.5%, respectively, while the system without a continuous augmentation was broken down. The pyrosequencing analysis showed Brachymonas denitrificans to be the most dominant microbial population in the buffering tank (B; 37.5%). Potential polymeric substance degraders (Clostridia), sulfate reducers (Desulfuromonas palmitatis), and sulfur oxidizers (uncultured Thiobacillus) were dominant in the sludge digestion (SD) tank. The denitrifiers assayed by nosZ qPCR were dominant in B and SD. These microbial communities appeared to play important roles in removing nutrients and odor, and reducing sludge in the wastewater treatment plant without chemical pretreatment.

An eco-friendly treatment of tannery wastewater using bioaugmentation with a novel microbial consortium.

A novel microbial consortium (BM-S-1) enriched from natural soils was successfully used to treat tannery wastewater from leather manufacturing industries in Korea on a pilot scale. The objective of this study was to determine whether augmentation with a novel microbial consortium BM-S-1could successfully treat the recalcitrant wastewater without chemical pre-treatment in a tannery wastewater treatment system. Chemical oxygen demand (COD), total nitrogen (TN) and total phosphorus (TP) were monitored for water quality. The microbial population dynamics were analyzed using pyrosequencing, and denitrifying bacteria were quantified using real-time PCR (RT-PCR). The removal efficiencies for COD, TN and TP were greater than 91%, 79%, and 90%, respectively. The dominant phyla in the buffering tank (B), primary aeration (PA), secondary aeration (SA) and sludge digestion tank (SD) were Proteobacteria, Firmicutes, Bacteroidetes, Planctomycetes and Deinococcus-Thermus. Cluster analysis based on the UniFrac distance of the species in the different stages showed that the PA is similar to the SA, whereas the B is similar to the SD. qPCR of the nosZ genes showed the highest abundance of denitrifiers in B, which was increased 734-fold compared to the influent (I). It was hypothesized that anaerobic denitrifiers and the diverse microbial community may play important roles in the biological treatment of tannery wastewater. This technology may also contribute to the full-scale treatment of industrial wastewater containing food processing wastewater and marine sediment with high organic content.

Stoichiometry engineering of monoclinic to rutile phase transition in suspended single crystalline vanadium dioxide nanobeams.

Coexisting monoclinic M(1) (insulating) and rutile (metallic) domains were observed in free-standing vanadium dioxide nanobeams at room temperature. Similar domain structures have been attributed to interfacial strain, which was not present here. Annealing under reducing conditions indicated that a deficiency of oxygen stabilizes the rutile phase to temperatures as low as 103 K, which represents an unprecedented suppression of the phase transition by 238 K. In a complementary manner, oxygen-rich growth conditions stabilize the metastable monoclinic M(2) and triclinic T (or M(3)) phases. A pseudophase diagram with dimensions of temperature and stoichiometry is established that highlights the accessibility of new phases in the nanobeam geometry.

Protective effects of several components of Gastrodia elata on lipid peroxidation in gerbil brain homogenates.

Gastrodia elata (GE) Blume, a traditional herbal agent, has been used mainly in anticonvulsive treatment in Asia. Recently, extracts of GE were evaluated for their potential as neuroprotectives and antioxidants. This study was designed to examine the antioxidant effect of the ether fraction of the methanol extract (EFME) of GE along with its major constituents vanillin, vanillyl alcohol, hydroxybenzaldehyde and hydroxybenzyl alcohol. In experiment 1, gerbils were treated with EFME of GE at a dosage of 500 mg/kg/day for 2 weeks. Oxidative stress was induced with H(2)O(2) or ferrous ion, and lipid peroxidation was measured. In experiment 2, oxidative stress was induced with various concentrations of H(2)O(2) or ferrous ammonium sulfate, and lipid peroxidation was measured. To compare the antioxidant potency, the inhibitory concentration 50% (IC(50)) was determined. EFME of GE reduced auto-peroxidation and H(2)O(2)-induced lipid peroxidation. However, it did not significantly reduce ferrous ammonium sulfate-induced lipid peroxidation. The order of antioxidation potency was as follows: hydroxybenzyl alcohol > vanillyl alcohol > vanillin > hydroxybenzaldehyde. In the case of hydroxybenzaldehyde, its antioxidant effect was more potent than that of melatonin. The excellent antioxidant effects of GE and its main constituents may have potential in the treatment of lipid peroxidation-associated neurological disease.