Neglected Partial Anomalous Pulmonary Venous Return during Atrial Septal Defect Device Closure.

Partial anomalous pulmonary venous return (PAPVR) is a rare congenital heart malformation in which 1 or more pulmonary veins drain into the systemic venous circulation or directly into the right atrium instead of the left atrium. It may occur alongside other congenital heart defects, including atrial septal defect (ASD). All patients with newly diagnosed ASD must be evaluated thoroughly for the likelihood of PAPVR to select surgical or percutaneous procedures. Here, we describe a 10-year-old girl with PAPVR who underwent percutaneous device closure of her secundum ASD with her PAPVR neglected at 3 years of age. We had to correct the anomalous venous connection by removing the device during an intricate procedure. The typical connection of the pulmonary veins to the left atrium was reported on her postoperative echocardiography 1 day after surgery. The patient was discharged without complications, and her first follow-up visit 7 days after discharge was unremarkable. While the most accurate diagnostic tools for PAPVR are cardiovascular magnetic resonance imaging and computed tomographic angiography, a careful examination of the pulmonary veins during pulmonary angiography or transesophageal echocardiography in children helps identify PAPVR in patients with ASD.

Association of Abnormal Serum L-Carnitine Levels with Idiopathic Changes in Left Ventricular Geometry in Pediatric and Adolescent Patients.

Background: There is no compelling evidence to prove an association between serum free L-carnitine levels and changes in left ventricular (LV) geometry. The present study aimed to evaluate a possible association between these parameters. Methods: In a cross-sectional study, 504 outpatients were randomly selected among those registered at Sanandaj Pediatric Heart Clinic (Sanandaj, Iran) during 2014-2020. The patients aged one to 25 years and were presented with cardiac complaints. The serum L-carnitine levels of all patients were evaluated and associated with changes in LV geometry measured by echocardiography. The association was assessed using the Chi squared test, Fisher's exact test, and one-way ANOVA with post hoc Tukey test. Data were analyzed using SPSS software (version 22.0). P≤0.05 was considered statistically significant. Results: The mean serum L-carnitine levels in the normal, low, and high serum groups were 52.69, 14.16, and 178.67 nmol/dL, respectively. There was a significant statistical association between abnormal serum levels of free L-carnitine and changes in LV geometry (P<0.001). Conclusion: Our findings are indicative of an association between abnormal serum L-carnitine levels and changes in LV geometry in pediatric and adolescent patients.

The Effects of L-Carnitine on Echocardiographic Changes in Patients With ß-Thalassemia Major and Intermedia.

INTRODUCTION: Heart failure, fatal arrhythmias, and cardiac dilatation because of anemia are common causes of ß-thalassemia major-related deaths. The aim of this study was to determine the effect of L-carnitine on echocardiographic changes in ß-thalassemia major and intermedia patients in Besat Hospital in Sanandaj, Iran. METHODS: In a randomized clinical trial, 60 ß-thalassemia patients who were eligible for L-carnitine administration were randomly divided into 2 placebo and study drug groups. The duration of the study was 6 months. Using echocardiography and blood tests, cardiac parameters including left ventricular dilatation, left ventricular hypertrophy, and a number of cardiac blood indices were examined before and after the intervention. The data were analyzed using SPSS V.23 software, χ, and covariance statistical tests. RESULTS: There was no significant difference between the 2 groups in terms of age and sex. Patients treated with L-carnitine have a reduced rate of left ventricular dilatation, left ventricular hypertrophy, and systolic blood pressure compared with controls (P<0.05). Cardiac output increased from 43.5 to 56.5 (P=0.002). CONCLUSIONS: The results of this study showed that the drug has a positive effect on the improvement of cardiac indices in ß-thalassemia patients. Therefore, we suggest that further studies with more samples and other diagnostic modalities of the drug's effect be investigated.

Hypomagnesaemia and other electrolytes imbalances in open and closed pediatrics cardiac surgery.

OBJECTIVE AND BACKGROUND: During the past decade, many researchers have indicated that open cardiac surgery, using cardiopulmonary bypass, could be an essential factor to induce post-operative electrolyte imbalances which may be followed by life threatening complications such as arrhythmia. Nevertheless, by this time there may be a few researches about comparing of hypomagnesaemia and other electrolyte imbalances between open, on pump, and closed, off pump, heart operation. METHODS: In this cohort study conducted at Rajaie Heart Center in Tehran from December 2014 to August 2015, we evaluated hypomagnesaemia, hypocalcemia, hypokalemia and hyponatremia in 205 children aged under 15 years who underwent open (101 children) and closed (104 children) cardiac surgery. Repeated measures ANOVA, paired t test and Chi-square/Fisher exact test were used for analysis the data in SPSS version 21. RESULTS: According to our study the frequency of electrolyte imbalances including hypomagnesaemia after pediatric heart surgery is relatively high (28.7% hypomagnesaemia at the second day) with more occurrence in closed cardiac operations. There was no significant relationship between hypomagnesaemia and pump time duration (P>0.05). On the other hand, this research indicated that there is significant relationship between post-operative hypomagnesaemia and some other variables including cyanotic heart disease (P=0.01) and concurrent electrolyte imbalance such as hypocalcaemia and hypokalemia (P<0.05). CONCLUSION: Early evaluation and correction of hypomagnesaemia should be considered after both closed and open heart operation.

Synergistic effect of low and high intensity ultrasonic irradiation on the direct growth of ZnO nanostructures on the galvanized steel surface: investigation of the corrosion behavior.

Considering the current interest in the preparation of modified surfaces with fixed nanostructures, in this research, the hot water treatment was chosen as a simple and efficient procedure for the direct growth of ZnO nanostructures (ZnO NSs) on the metallic surface. To improve the method and reduce the cost of experiments, the commercial galvanized steel (steel containing a thin layer of zinc) was used as the base substrate. The use of the galvanized steel as an inexpensive and available metal surface has advantages compared to the pure Zn foil (used in other researches). In addition, in the present work, the effective pretreatment of the base substrate surface by applying the chemical etching under the low intensity ultrasonic irradiation facilitated the reaction progress (Zn → ZnO) in a shorter time and relatively low temperature in comparison to many reports. To find the effect of acoustic energy on the final ZnO morphology, the hot water treatment was carried out under conventional and sonochemical conditions. Finally, as a practical application, resulting surfaces were coated with electroless Ni-P deposits and the effect of as-grown ZnO NSs (as the sublayer) on improvement in the corrosion protection of binary Ni-P deposits was evaluated by the electrochemical method.

Sonication affects the quantity and the morphology of ZnO nanostructures synthesized on the mild steel and changes the corrosion protection of the surface.

The several types of sonication methods were applied to access the different morphologies of ZnO nanostructures on the surface of mild steel. To achieve this goal, a sonictor equipped with the probe extender was used as a high intensity ultrasonic apparatus for direct sonication. Furthermore, an ultrasonic bath (low intensity) and a cup-horn system (high intensity) were applied for indirect sonication. To find the effect of the acoustic waves on the ZnO morphology, the micrographs of obtained surfaces were compared to the sample prepared by the conventional method using scanning electron microscopy (SEM). In this work, the beneficial effects of sonication were subjected on the breaking down the agglomerates to smaller size particles, metal surface activation, and on the facile approach to nanostructures synthesis. The influence of the resulting ZnO structures over the corrosion protection of the electroless Ni-P alloy coatings was evaluated by the potentiodynamic polarization technique (Tafel extrapolation).

Echocardiographic evaluation of cardiovascular complications after birth asphyxia in term neonates.

OBJECTIVES: After birth asphyxia, a variety of hemodynamic disorders may be noted in the neonatal intensive care unit; these require appropriate recognition and management. The present study was designed to demonstrate the prevalence of heart complications amongst asphyxiated newborns. METHODS: Through a cohort study, 29 asphyxiated term neonates were followed since birth until amelioration of pulmonary hypertension and compared with 31 well born neonates. Both groups were evaluated for their heart anatomy and hemodynamic with meticulous assessment through echocardiography. This study was conducted in Besat Medical Center since August 2010 until February 2012. RESULTS: Hemodynamic and anatomic disorders including myocardial dysfunction, pulmonary hypertension and patent arterial duct (PDA) were strongly associated with birth asphyxia (P< 0.05). CONCLUSION: Birth asphyxia was associated with systolic and diastolic dysfunction and pulmonary hypertension which demands precise evaluation, early recognition and appropriate management.

Modulation of JAK2, STAT3 and Akt1 proteins by granulocyte colony stimulating factor following carbon monoxide poisoning in male rat.

Carbon monoxide (CO) is an odorless, colorless, tasteless and non-irritating by-product of inefficient combustion of hydrocarbon fuels such as motor vehicle exhausted gases. It is the leading cause of mortality in the USA among all unintentional toxicants. Male rats exposed to CO poisoning in the heart has many cardiovascular effects such as, cardiomyopathy, tachycardia, arrhythmias, and ischemia and in severe cases, myocardial infarction (MI) and cardiac arrest. Cardiomyocyte apoptosis is one of the most frequent consequences in the heart. Granulocyte colony stimulating factor (G-CSF) is a cytokine that mobilizes and differentiates granulocytes from stem cells. It can stimulate many anti-apoptotic pathways such as JAK2-STAT3 and PI3-Akt kinases following cardiac ischemia. G-CSF exerts its anti-apoptotic effects through binding to its specific cell surface receptor. The purpose of this study was to elucidate the mechanism of anti-apoptotic effect of G-CSF following CO poisoning. Rats were exposed to CO 1500 or 3000 ppm for 60 min. Animals received G-CSF 100 µg/kg subcutaneously for five consecutive days after CO intoxication. Western blot analysis was used to evaluate the expression of six proteins namely JAK2, p-JAK2, STAT3, p-STAT3, Akt1 and p-Akt1 following G-CSF 100 µg/kg consecutive dose administration after CO poisoning. There was a significant difference between phosphorylated proteins including p-JAK2, p-STAT3 and p-Akt1 in the G-CSF groups and those in control groups and there were not any significant differences in total protein among the groups.

Mechanistic investigation of the influence of phosphoric and boric acids in the formation of homogeneous Ni-P/ZnO@SiO2 coatings.

High agglomeration of the nanoparticles and low volume fraction of nanosized inert particles within the nanocomposite thin films are found as the practical problems. In our previous work, silica coated ZnO nanoparticles (ZnO@SiO2 NPs) were synthesized to prevent dissolution of the ZnO nanoparticles (ZnO NPs) in the electrolytic Ni bath. The high agglomeration of these core-shell particles led to an unequal particle distribution in the deposit matrix. In this work, we aimed to prepare a highly homogeneous nanocomposite coating by stabilizing the nanoparticles in the medium. Adding the buffering agents, including phosphoric and boric acids to the medium, disclosed their new aspect of these inorganic acids in the prevention of particle agglomeration. The corrosion study of the resulting well-dispersed Ni-P/Zn@SiO2 nanocomposite coating confirmed a significant increase in anticorrosion performance. This increase was about 2.3 times compared to the previously prepared coating. Moreover, the probable mechanisms of phosphoric and boric acids in particle stability through the steric or/and electrostatic repulsion at the interfaces between the colloidal nanoparticles (ZnO@SiO2 NPs) and the electrolyte solution were investigated in detail.

An unusual right atrial mass in a two-month old infant.

We report a 2-month old female with a rare cardiac mass. She was evaluated echocardiographically after physical examination revealed a low grade cardiac murmur. The mass, located in right atrium, was shown to be the consequence of candida endocarditis by means of pathological study and blood culture.

The beneficial in vitro effects of lovastatin and chelerythrine on relaxatory response to acetylcholine in the perfused mesentric bed isolated from diabetic rats.

Diabetes mellitus is associated with an increased risk of cardiovascular disease. Endothelial dysfunction (i.e. decreased endothelium-dependent vasorelaxation) plays a key role in the pathogenesis of diabetic vascular disease. The present study was undertaken to determine whether diabetes induced by streptozotocin alters mesenteric responses to vasodilators and, if so, to study the acute in vitro effects of lovastatin and chelerythrine. Endothelial function was assessed in constantly perfused preparation removed from rats, 12 weeks after treatment with either saline or streptozotocin (45 mg/kg, intraperitoneally). In pre-contracted mesenteric beds (with 100 microM phenylephrine) removed from diabetic rats, the concentration response curve to acetylcholine, but not to sodium nitroprusside, was significantly reduced. Perfusion with lovastatin (10 microM for 20 min) or chelerythrine (1 microM for 20 min) significantly improved the acetylcholine-mediated relaxation in preparations removed from diabetic but not control rats. Pre-incubation of tissue with N(G)-nitro-L-argenine methyl ester hydrochloride (10 microM for 20 min) inhibited the beneficial effect of lovastatin but not chelerythrine. Pre-treatment of tissue with indomethacin (10 microM for 20 min) did not modify the effects of lovastatin or chelerythrine on acetylcholine responses. The present results demonstrate that endothelial dysfunction induced by diabetes (in a resistant vasculature, such as rat mesenteric bed) may be improved by an acute exposure to either lovastatin or chelerythrine. Furthermore, our results suggest that the beneficial effect of lovastatin is mediated via the nitric oxide pathway.

Endothelial dysfunction in aortic rings and mesenteric beds isolated from deoxycorticosterone acetate hypertensive rats: possible involvement of protein kinase C.

The main objectives of this study were to investigate the effects of deoxycorticosterone acetate (DOCA)-induced hypertension on the aortic and mesenteric vascular responses to vasodilator and vasoconstrictor agents and also to elucidate whether protein kinase C (PKC) was involved in these responses, by using chelerythrine and calphostin C, the inhibitors of protein kinase C. Hypertension was induced in male Sprague-Dawley rats (200-250 g) by DOCA-salt injection [20 mg/kg, twice weekly for 5 weeks, subcutaneously (s.c.)] and NaCl (1%) was added to their drinking water. Control rats received a saline injection (0.5 ml/kg, twice weekly for 5 weeks, s.c.), then the animals were anaesthetised [thiopental, 30 mg/kg, intraperitoneally (i.p.)] and the arterial blood pressure was measured. Mean arterial blood pressure in control and hypertensive rats were 98+/-7.5 and 163+/-3.5 mmHg, respectively (P<0.0001). In the in vitro studies, rings of descending aorta and mesenteric beds were precontracted with phenylephrine and then concentration-response curves to acetylcholine and sodium nitroprusside were constructed. In the tissue removed from hypertensive rats, the responses to acetylcholine, but not to sodium nitroprusside, were significantly reduced. However, addition of chelerythrine (10 microM) or calphostin C (100 nM) to the organ bath significantly restored these impaired responses. Our data suggest that protein kinase C plays a crucial role in the endothelial dysfunction induced by hypertension.