A catastrophic cause of chest pain.

Chest pain can be a manifestation of aortic pathology and must be considered in any patient with a history of chest trauma, hypertension, atherosclerosis, connective tissue disorder and/or radiographically abnormal aortic contours. Acute intramural haematoma can resemble acute myocardial infarction and can be life-threatening if not correctly diagnosed. Electrocardiogram (ECG) must be carried out in all patients as it helps distinguish acute myocardial infarction (for which antiplatelets and anticoagulants may be life-saving) from intramural haematoma (for which these drugs may be detrimental). Other imaging modalities may be considered depending upon the clinical situation.

Electrohydrodynamic jetting of mouse neuronal cells.

CAD (Cath.a-differentiated) cells, a mouse neuronal cell line, were subjected to electrohydrodynamic jetting at a field strength of 0.47-0.67 kV/mm, corresponding to an applied voltage of 7-10 kV. After jetting, the cells appeared normal and continued to divide at rates similar to those shown by control samples. Jetted cells, when placed in serum-free medium, underwent differentiation that was sustained for at least 1 month. Some of the droplets produced by jetting contained only a few cells. These results indicate that the process of jetting does not significantly perturb neuronal cells and that this novel approach might in the future be a useful way to deposit small numbers of living nerve cells on to surfaces.

Gene silencing of HIV chemokine receptors using ribozymes and single-stranded antisense RNA.

The chemokine receptors CXCR4 and CCR5 are required for HIV-1 to enter cells, and the progression of HIV-1 infection to AIDS involves a switch in the co-receptor usage of the virus from CCR5 to CXCR4. These receptors therefore make attractive candidates for therapeutic intervention, and we have investigated the silencing of their genes by using ribozymes and single-stranded antisense RNAs. In the present study, we demonstrate using ribozymes that a depletion of CXCR4 and CCR5 mRNAs can be achieved simultaneously in human PBMCs (peripheral blood mononuclear cells), cells commonly used by the virus for infection and replication. Ribozyme activity leads to an inhibition of the cell-surface expression of both CCR5 and CXCR4, resulting in a significant inhibition of HIV-1 replication when PBMCs are challenged with the virus. In addition, we show that small single-stranded antisense RNAs can also be used to silence CCR5 and CXCR4 genes when delivered to PBMCs. This silencing is caused by selective degradation of receptor mRNAs.

Cardiovascular risks of COX inhibition: current perspectives.

BACKGROUND: NSAIDs are among the most commonly used pharmacotherapeutic agents worldwide. As the long-term use of these drugs is associated with serious gastrointestinal side effects, a new subgroup of COX-2 selective NSAIDs was developed. It was thought that the therapeutic strategy underlying the development of these newer compounds would enable them to provide the same analgesic and anti-inflammatory benefits as those of their traditional counterparts but perhaps offer a much safer gastrointestinal profile. Much scientific data has accumulated over the last few years, however, raising concerns regarding the increased cardiovascular complications associated with the use of COX-2 selective NSAIDs, and perhaps of the traditional NSAIDs as well. OBJECTIVE: To review current and emerging evidence related to the cardiovascular effects of COX inhibitors and examine the clinical implications. METHOD: We studied data from basic clinical research, non-randomized analyses, and randomized trials of COX inhibitors that investigated their cardiovascular effects. CONCLUSION: Both COX-2 selective and traditional NSAIDs are associated with a moderately increased risk of cardiovascular events.

Early management of ST elevation myocardial infarction: a review of practice.

The last two decades of the 20th century witnessed continuous evolution in the understanding of the pathophysiology of ST elevation myocardial infarction. In parallel, the management of these patients developed steadily throughout this time and into the early years of the 21st century. From humble beginnings involving oxygen therapy, bed rest and analgesia, the relative merits of different strategies to open 'infarct-related arteries' (IRAs) are now being debated: pharmacological reperfusion, mechanical reperfusion or a combination of both these modalities. The current understanding of the process of thrombotic occlusion of the coronary artery has led to the appreciation of the importance of not simply opening the IRA, but also maintaining its patency once opened. Considerable attention is now being afforded to the significant minority of patients who do not achieve early, complete myocardial reperfusion, despite restoration of adequate flow down the epicardial IRA. Those patients who fail to achieve myocardial reperfusion, either due to late presentation or failure of reperfusion therapy, and are left with permanent myocardial scarring can now be considered. This article critically appraises the recent and emerging evidence and clinical implications of the contemporary management of ST elevation myocardial infarction.

Electric field driven jetting: an emerging approach for processing living cells.

This paper reports for the first time the ability to process living cellular materials by means of electrified jets at electric field strengths of up to 2 kV/mm. Bio-suspensions containing living human Jurkat cells at different concentrations were processed via this jetting approach. The jetting process was carried out at an electric field strength between 0.67 kV/mm and 2 kV/mm, corresponding to an applied voltage of 10-30 kV between two electrodes approximately 15 mm apart. The Jurkat cells were jetted under sterile conditions, collected in petri dishes and incubated for 24 and 48 hours. During and after incubation, cells were assessed for survival and structural damage; cells were found to be unharmed and to retain their integrity under all electric field strengths examined. At all field strengths jetting took place in the unstable mode. Good correlation was observed between droplet distribution plots generated by way of laser spectroscopy and estimated values from measurements of droplet relics.