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.

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.

Capillary electrophoresis of N-acetylneuraminic acid polymers and hyaluronic acid: correlation between migration order reversal and biological functions.

High-resolution analysis of polymers of N-acetylneuraminic acid and hyaluronic acid was performed by capillary electrophoresis in a buffer containing a neutral polymer. Both polysaccharides having more than 100 monosaccharide residues were well separated into their molecular species by capillary electrophoresis using a combination of a chemically modified capillary and a buffer containing poly(ethylene glycol) as an additive. During optimization of the separation conditions, small oligomers of both polysaccharides were observed to migrate in the reverse order of their molecular masses on the electropherograms. However, oligomers larger than pentamer and decamer for N-acetylneuraminic acid polymers and hyaluronic acid, respectively, migrated in the order of their molecular masses. We propose that these unusual migration patterns are closely related to the stereochemical structures and the oligomer migrating the fastest is the minimum unit that forms the regular three-dimensional structure required for the biological function.

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.

[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.

Use of a binary mixture of quaternary ammonium salts in fluorometric determination of glycosaminoglycans.

The concentration of glycosaminoglycans, in an aqueous solution was determined by observing the fluorescent intensity of the ion of 2-hexadecyl-9H-pyrido[4,3b]indole at 450 nm by irradiating 253-nm light after dissolution of the insoluble salt in ethanol, which was formed by the reaction between a solution of a sample of glycosaminoglycan and an aqueous solution of the binary mixture of fluorescent 2-hexadecyl-9H-pyrido[4,3b]indolium bromide and hexadecyl pyridinium chloride. The fluorescent quaternary ammonium salt, which was slightly soluble in water, was solubilized in water by forming mixed micelles with a nonfluorescent soluble quaternary ammonium salt. The present method showed good linearity for the calibration curves between 5 and 1000 micrograms/ml in all samples of glycosaminoglycan except keratan sulfate. The relative standard deviation in determination was less than 3% for the whole calibration range.

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.

[A case report of mitral valve papillary fibroelastoma leading to embolic stroke].

A 39-year-old man presented with acute onset of left arm and left side face weakness, and mild expressive aphasia. He was referred for two-dimensional echocardiography, which demonstrated a 13 mm diameter pedunculated, mobile, echodense mass attached to the anterior leaflet of the mitral valve. At operation, the tumor was a 10 x 10 x 15 mm, rounded, and yellow-whitish mass with a short stalk arising from rough zone of the anterior leaflet of the mitral valve. The surface appeared to be sean anemone. The mitral valve with this tumor was excised and replaced with a 29 mm St Jude Medical mechanical valve. The pathological findings are typical of a papillary fibroelastoma.

[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.

[Experience of modified Bentall's procedure for annulo-aortic ectasia].

To reduce the incidence of false aneurysm formation at the suture lines, a known complication with the inclusion technique such as Bentall's procedure or Cabrol's procedure, modified Bentall's procedure (Carrel patch technique), which is identical to Inberg's procedure, has been selected as treatment for annulo-aortic ectasia since 1991. This operation was carried out in 6 consecutive patients with annulo-aortic ectasia from July 1991 to August 1992. The aortic valve and the aneurysm were resected, the coronary ostia were dissected free, mobilized, and then implanted to the composite graft. It was necessary for one patient to undergo coronary artery bypass grafting for myocardial ischemia due to injury of the right coronary ostium. Thereafter, the button of coronary ostium was cut into a big size and then trimmed just before the implantation to the composite graft in order to prevent injury of the button of the coronary ostium. There was no hospital mortality. No pseudo-aneurysm at the coronary ostia or the distal aortic anastomosis was observed at control aortography carried out 1 month after surgery. One patient died 1 year after the first operation because of low cardiac output after the re-operation for pseudo-aneurysm at the proximal aortic anastomosis and infection of the composite graft. All the other patients have been symptom free during follow-up. The use of gelatin impregnated dacron graft and the reinforcement of the suture lines by Teflon felt strips minimized bleeding. One patient underwent this operation without blood transfusion.(ABSTRACT TRUNCATED AT 250 WORDS)

[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.

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.

[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.

[Extrapleural approach for patent ductus arteriosus and coarctation of the aorta].

During the period of 1989 to 1990, 6 consecutive children with patent ductus arteriosus or coarctation of the aorta underwent operative therapy. Ligation or division of patent ductus arteriosus or subclavian flap angioplasty for coarctation of the aorta were performed by extrapleural approach with axillary or posterolateral incision. Patients' ages ranged from 9 days to 8 years. Weights ranged from 3 to 30 kg. It was very easy to have better operative field and beneficial to protect the lung against mechanical injury. Extrapleural approach was not so easy in an 8-year-old patient with firm connective tissue. Therefore, this procedure is considered to be suitable for younger children.

Comparison of thallium-201 and technetium-99m teboroxime myocardial single photon emission tomography with coronary arteriography.

Myocardial single photon emission tomography (SPET) using technetium-99m teboroxime (teboroxime) was studied and the results compared with those of thallium-201(thallium) SPET and coronary arteriography in 19 patients. Resting teboroxime SPET was performed initially. Two hours later, exercise teboroxime SPET was performed. Exercise ergometer tests for both teboroxime and thallium were carried out in a supine position. The levels of exercise achieved for both tests were similar. Agreement for the identification of myocardial segments between thallium SPET and teboroxime SPET was 147/171(86%) (NS). When a significant stenosis was defined as greater than or equal to 75% or greater than or equal to 50%, agreement between two radiopharmaceuticals for the detection of diseased vessels was 89% (NS, k = 0.601) or 88% (NS, k = 0.713), respectively. In only 2/19 cases were inferior and posterior segments (3/171) difficult to interpret in teboroxime SPET due to hepatic activity. Thus, teboroxime SPET with a short data acquisition time resulted in a rapid completion for each study and had a good correlation with thallium SPET.

[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.