Comparative study on oviposition and larval preference of spotted bollworm, Earias vittella on Bt and non-Bt cotton.

Oviposition and larval preference of spotted bollworm, Earias vittella (Fabricius) was assessed on four transgenic Bt cotton hybrids, viz. MRC 6304 Bt (cry1Ac gene), JKCH 1947 Bt (modified cry1Ac gene), NCEH 6R Bt (cry1Ab/cry1Ac fused gene) and MRC 7017 BG II (cry1Ac and cry2Ab genes) in comparison to the respective isogenic cotton. The results showed that Bt toxin did not deter oviposition preference of E. vittella moths as there was no significant difference in the number of eggs laid on squares/bolls of Bt and non-Bt cotton hybrids, across different crop growth stages. There was also no behavioral change in larval preference with respect to selecting non-Bt cotton in comparison to Bt cotton. Floral bodies from Bt and the respective isogenic cotton genotypes were equally preferred by both first and third instar larvae after 24 hrs indicating that initial selection was independent of susceptibility to Bt toxin. However, E. vittella larvae showed significant difference in preference for different cotton genotypes. Studies on the relative preference indicated that third instar larvae had greater preference for bolls (7.29-7.50%) than for the squares (5.0-5.21%) and reverse was true for the first instar larvae which showed greater preference for squares (7.08-7.29%) than for the bolls (5.21-5.42%), in a multiple-choice test. It may be concluded that oviposition and larval preference of E. vittella did not differ significantly between Bt and isogenic non-Bt cotton genotypes.

Estimation and risk assessment of flubendiamide on fodder berseem clover (Trifolium alexandrinum L.) by QuEChERS methodology and LC-MS/MS.

The residues of flubendiamide from berseem were extracted and cleaned up by the QuEChERS approach and analysed by liquid chromatography/mass spectrometry (LC-MS/MS). The dissipation studies on berseem were carried out by application of flubendiamide at five different dosages i.e. 24, 36, 48, 72 and 96 g a.i. ha(-1). The residues reached below determination limit (BDL) of 0.01 mg kg(-1) in 7, 10, 10, 15 and 15 days for 24, 36, 48, 72 and 96 g.a.i. ha(-1)dosages, respectively. Half-life (t1/2) of flubendiamide on berseem was observed to be 1.08, 1.88, 1.94, 2.26 and 2.27 days, respectively, at 24, 36, 48, 72 and 96 g a.i. ha(-1). Theoretical maximum residue contributions (TMRC) values reached below the maximum permissible limit (MPI) for 3, 5 and 7 days in treatments at 24, 36 and 48 g.a.i. ha(-1), respectively, whereas in case of higher dose treatments i.e. 72 and 96 g a.i. ha(-1), the residues of flubendiamide reached below MPI after 10 days of treatment. These data could provide guidance for the proper and safe use of this pesticide on berseem in India.

Degradation pattern and risk assessment of chlorantraniliprole on berseem (Trifolium alexandrinum L.) using high performance liquid chromatography.

The persistence pattern of chlorantraniliprole on berseem leaves and its risk assessment for the safety of cattle were studied. QuEChERS method was used for the extraction and cleanup of samples and the residues of chlorantraniliprole were estimated using high performance liquid chromatography (HPLC) and confirmed by Liquid Chromatograph-Mass Spectrometer (LCMS-MS). The dissipation studies on berseem were carried out by application of chlorantraniliprole at five different dosages i.e. 11.6, 17.1, 23.1, 34.7 and 46.2 g a.i. ha(-1). Average initial deposits of chlorantraniliprole were found to be 0.47, 0.61, 0.78, 1.15 and 1.31 mg kg(-1), respectively. The residues reached below determination limit (BDL) of 0.01 mg kg(-1) in 5, 7, 7, 10 and 10 days for 11.6, 17.1, 23.1, 34.7 and 46.2 g a.i. ha(-1) dosages, respectively. Half-life (t1/2) of chlorantraniliprole on berseem was observed to be 0.93, 1.14, 1.06, 1.00 and 1.33 days, respectively, at 11.6, 17.1, 23.1, 34.7 and 46.2 g a.i. ha(-1). It was found that the theoretical maximum residue contributions (TMRC) values reached below maximum permissible intake (MPI) on 0 day in berseem samples treated with chlorantraniliprole. These studies, therefore suggest that the use of chlorantraniliprole formulation at different dosages does not seem to pose any hazards to the consumers and a waiting period of one day is suggested to reduce the risk before consumption of berseem leaves. These data could provide guidance for the proper and safe use of this pesticide on berseem in India.

Regression of coronary atherosclerosis through healthy lifestyle in coronary artery disease patients--Mount Abu Open Heart Trial.

AIMS: To evaluate the efficacy of a unique healthy and happy lifestyle (HLS) program in regression of coronary atherosclerosis and reduction in cardiac events in an open trial. METHODS: One hundred and twenty three angiographically documented moderate to severe coronary artery disease (CAD) patients were administered HLS comprising of low-fat, high-fiber vegetarian diet, moderate aerobic exercise and stress-management through Rajyoga meditation. Its most salient feature was training in self-responsibility (heal+thy) and self-empowerment through inner-self consciousness (swasth; swa=innerself, sth=consciousness) approach using Rajyoga meditation. Following a seven day in-house sojourn, patients were invited for six month follow-up for reassessment and advanced training. At the end of two years, all patients were asked to undergo repeat angiography. RESULTS: Three hundred and sixty coronary lesions were analysed by two independent angiographers. In CAD patients with most adherence, percent diameter stenosis regressed by 18.23 +/- 12.04 absolute percentage points. 91% patients showed a trend towards regression and 51.4% lesions regressed by more than 10 absolute percentage points. The cardiac events in coronary artery disease patients were: 11 in most adherence, and 38 in least adherence over a follow-up period of 6.48 yrs. (risk ratio; most vs least adherence: 4.32; 95% CI: 1.69-11.705; P < 0.002). CONCLUSION: Overall healthy changes in cardiovascular, metabolic and psychological parameters, decline in absolute percent diameter coronary stenosis and cardiac events in patients of CAD were closely related to HLS adherence. However, more than 50% adherence is essential to achieve a significant change.

First-in-man experience of percutaneous aortic valve replacement using self-expanding corevalve prosthesis.

OBJECTIVE: Percutaneous aortic valve replacement is a new emerging method for nonsurgical replacement of aortic valve in patients with severe aortic stenosis. We report the first-in-man case of percutaneous aortic valve replacement with self-expanding Core Valve aortic prosthesis. METHODS AND RESULTS: The procedure was performed on 12 July 2004 on a 62 years patient with severe aortic stenosis (peak systolic gradients across aortic valve being 90 mm Hg), moderately severe aortic regurgitation and preserved left ventricular systolic function. The patient had associated morbidities like renal failure (raised blood urea nitrogen and serum creatinine levels) and end-stage carcinoma of lung. Valve implantation was performed under general anesthesia with extracorporeal support using the retrograde approach. The patient was adequately screened prior to the procedure. The device was implanted successfully with post implantation peak systolic gradient across aortic valve being only 16 mm Hg. However, this patient died after four days due to renal failure and bleeding diathesis leading to multiorgan failure. CONCLUSIONS: Percutaneous implantation of self-expanding CoreValve prosthesis in patients with severe aortic stenosis with or without aortic regurgitation is feasible. Long-term studies will determine its future.

Successful closure of coronary artery perforation using non-conventional embolic material.

Coronary perforation during percutaneous coronary interventions is a rare but dreadful complication. While coronary perforation involving large vessels are managed successfully by covered stents, small distal vessel perforation is usually managed by prolonged balloon inflation or embolization of gel foam/thrombogenic metallic coils. We describe a case, where perforation of a small ventricular branch of the right coronary artery was successfully occluded by packing it with pieces of thrombogenic floppy tips of used coronary angioplasty guidewires instead of conventional metallic coils.

Quantification of regional nonuniformity and paradoxical intramural mechanics in hypertrophic cardiomyopathy by high frame rate ultrasound myocardial strain mapping.

This study tested the hypothesis that linear mapping of regional myocardial strain comprehensively assesses variations in regional myocardial function in hypertrophic cardiomyopathy. Hypertrophic cardiomyopathy is characterized by disorganized myocardial architecture that results in spatial and temporal nonuniformity of regional function. Left ventricular deformation was quantified in 20 patients with hypertrophic cardiomyopathy and compared with 25 age- and sex-matched control subjects. Abnormalities in subendocardial strain ranged from reduced longitudinal shortening to paradoxical systolic lengthening and delayed regional longitudinal contractions that were often located in small subsegmental areas. These variations were underestimated significantly by arbitrary measurements compared with linear mapping, in which a region of interest was moved across the longitudinal length of left ventricle (difference of peak and least strain, 10.7% +/- 5.1% vs 17% +/- 5.5%; P < .001). Echocardiographic assessment of variations in regional strain requires careful mapping and may be inappropriately assessed if left ventricular segments are sampled at arbitrary focal locations.

Doppler tissue imaging improves assessment of abnormal interventricular septal and posterior wall motion in constrictive pericarditis.

We hypothesized that Doppler tissue imaging in the short axis would provide enhanced quantitative information for differentiating the pattern and extent of abnormal septal and posterior wall motion in constrictive pericarditis (CP). Using quantitative pulsed wave and color M-mode Doppler tissue imaging, we quantified the pattern of abnormal septal and posterior wall motion and studied its incremental advantage over conventional M-mode and 2-dimensional echocardiography in 40 patients with surgically proven CP. The pattern and extent of abnormalities were compared with 35 age- and sex-matched control subjects and 20 patients with abnormal septal motion of other causes. In 33 patients (82.5%) with CP, the interventricular septum showed high-velocity (>7 cm/s) early diastolic biphasic motion with or without multiple recoil waves (polyphasic diastolic septal fluttering). In the posterior wall, the early diastolic wave was normal but the late diastolic wave was reduced in 24 patients (60%) and absent in 7 (17.5%). In comparison, M-mode and 2-dimensional echocardiography identified abnormal septal or posterior wall motion in 24 patients (60%) ( P = .003). The pattern of abnormal septal motion in CP could be differentiated from abnormal septal motion of other causes in 16 patients (80%). The overall sensitivity and specificity of high-velocity polyphasic septal flutter for differentiating CP from control cases and other diseases was 82.5% and 92.7%, respectively. In CP, Doppler tissue imaging in the short axis provides unique diagnostic information and reliably differentiates CP from control cases and most other causes of abnormal septal motion.

Regional myocardial function in an arrhythmogenic milieu: tissue velocity and strain rate imaging in a patient who had hypertrophic cardiomyopathy with recurrent ventricular tachycardia.

We report the use of tissue velocity and strain rate imaging for detecting marked segmental variations and asynchrony in left ventricular systolic and diastolic functions of a 40-year-old patient with hypertrophic obstructive cardiomyopathy who died of an intractable ventricular tachycardia. These newer techniques have advantages for identifying heterogeneity in regional myocardial function in hypertrophic cardiomyopathy.

Does chronic mitral regurgitation influence Doppler pressure half-time-derived calculation of the mitral valve area in patients with mitral stenosis?

BACKGROUND: In patients with mitral stenosis (MS), Doppler pressure half-time (PHT) may be influenced by hemodynamic variables other than the anatomic mitral valve orifice narrowing. This study was undertaken to assess whether the presence of concomitant mitral regurgitation (MR) affects mitral valve area (MVA) estimation by PHT. METHODS: Consecutive patients (n = 166) with noncalcific MS, in sinus rhythm, were studied. Group 1 (n = 106) had no or mild MR, and group 2 (n = 60) had moderate or severe MR. MVA was assessed by using the PHT method and planimetry. RESULTS: There was a strong correlation between planimetry and PHT MVA in both groups (group 1: r = 0.86, P <.001; group 2: r = 0.73, P <.001). However, compared with planimetry MVA, PHT underestimated MVA by > or =20% in 18 patients (17%) in group 1 and 21 patients (35%) in group 2 (P <.01). Overestimation by > or =20% occurred in 12 patients (11%) in group 1 and in 7 (12%) in group 2. Group 2 subanalysis (group 2A: moderate MR, n = 16; group 2B: severe MR, n = 44) revealed that linear regression weakened with increasing severity of MR (group 2A: r = 0.824, P <.001, group 2B: r = 0.70, P <.001). PHT underestimation of MVA occurred in 31% and 36% of patients in Groups IIA and IIB, respectively (P = NS). CONCLUSIONS: PHT appears to be reliable for estimating MVA in most patients with MS, even in the presence of MR. However, the presence of significant MR reduces the reliability of PHT-derived MVA, with underestimation of MVA in a significant number of subjects. The severity of MR has a direct impact on PHT-derived MVA.

Comparison of echocardiographic features of noncompaction of the left ventricle in adults versus idiopathic dilated cardiomyopathy in adults.

Noncompaction of left ventricular myocardium (NCLV), or "spongy myocardium," in adults represents an arrest in endomyocardial morphogenesis and occurs as an isolated cardiomyopathy. Because NCLV can be readily mistaken for idiopathic dilated cardiomyopathy, echocardiographic features other than the structural features of the myocardial wall need to be carefully defined for distinguishing the 2 conditions. This study was therefore designed to characterize the echocardiographic features that could be useful for differentiating NCLV from idiopathic dilated cardiomyopathy.

Effects of percutaneous mitral commissurotomy on longitudinal left ventricular dynamics in mitral stenosis: quantitative assessment by tissue velocity imaging.

OBJECTIVE: We hypothesized that mitral annular velocities would improve immediately after relief of mitral stenosis and that serial assessment could be used as an index for quantifying functional changes after percutaneous mitral commissurotomy (PMC). METHODS: Longitudinal left ventricular annular velocities were quantified by spectral pulsed wave Doppler tissue velocity imaging in 25 patients (16 women; mean age [+/-SD], 29.2 +/- 8.6 years) who had isolated mitral stenosis and were in sinus rhythm, and were compared with 30 age- and sex-matched control subjects. Echocardiography was performed 1 to 24 hours before PMC and 48 to 72 hours after, and changes in velocities from the lateral and septal corners of the mitral annulus in early diastole, late diastole, isovolumic contraction, and ejection were recorded. RESULTS: Systolic and diastolic mitral annular velocities were significantly less in patients with mitral stenosis than in control subjects. After PMC, peak annular velocity of systolic excursion in ejection and peak annular velocity in early diastole showed significant improvement. The change in peak annular velocity in early diastole in the lateral wall correlated well with improvement in the mitral valve orifice area by planimetry (ratio of mitral valve orifice area, 1.92 +/- 0.42; ratio of peak annular velocity in early diastole, 1.36 +/- 0.22; r = 0.65; P <.001). CONCLUSION: Serial evaluation of changes in mitral annular velocities by Doppler tissue imaging aids clinical assessment of immediate improvement in left ventricular function after PMC.

Transcatheter closure of congenital muscular ventricular septal defect.

The success with occlusion devices for the closure of atrial septal defects and patent ductus arteriosus prompted the transcatheter closure of single and multiple muscular ventricular septal defects (VSD). The procedure for VSD was first attempted by Lock et al. in 1988 and devices originally designed for the closure of other intracardiac defects (Rashkind umbrella device, Lock clamshell, Cardioseal, coils, Sideris buttoned device etc.) were used with a variable success rate and a residual shunt. Recently, specially designed Amplatzer muscular VSD occluder and Sideris device are in use. The Amplatzer muscular VSD occluder has been undergoing clinical trial since 1998 after the animal experiments had shown 100% occlusion and complete endothelization at 3 months. The procedure was first attempted in August 1995 using the Rashkind umbrella device and since April 1998 only the Amplatzer muscular VSD occluder has been used. Of the149 patients who underwent transcatheter closure of VSD, 50 had muscular trabecular defects in various locations: mid-muscular, anterior, posterior, or apical. All cases were selected by detailed transthoracic and/or transesophageal echocardiography (TTE) and aneurysm of the muscular septum was observed in three of them. The age range was 3-28 years and the diameter of VSD was 4-11 mm. In all but one patient, the device was deployed from the venous side. Simultaneous TTE was done for proper positioning of the device and continuous electrocardiographic monitoring was also done for any arrhythmia/conduction defects. All patients were followed up every 3 months and received 3-5 mg/kg aspirin for 6 months. The procedure was successful in all patients. The Rashkind umbrella device (17 mm) was used in two and Amplatzer muscular VSD occluder (6-14 mm) in 48 patients. Forty-four devices were delivered by antegrade transvenous approach and six by the transjugular route. None had residual shunt, new aortic regurgitation, or tricuspid regurgitation. Transient complete heart block after 24 hours was noticed in one patient. On a follow-up of 2-90 months, the device was in position in all patients. There was no embolization of the device, and no late-conduction defects, infective endocarditis, or hemolysis. Transcatheter closure of muscular VSD is safe and efficacious, and should be considered as a procedure of choice as an alternative to surgery that avoids cardiopulmonary bypass.

Transcatheter closure of ruptured sinus of valsalva aneurysm.

Percutaneous transcatheter closure of ruptured sinus of valsalva aneurysm was attempted in eight patients between January 1995 and March 2003 as an alternative strategy to surgery as this technique at present is an accepted therapeutic modality for various intracardiac defects. The age range was 14-35 years, all were male, seven in symptomatic class III and one in class IV on medical treatment. Two-dimensional and color Doppler echocardiography revealed rupture of an aneurysm of right coronary sinus into right ventricle in five and noncoronary sinus into right atrium in three and none had associated ventricular septal defect. The echo estimated size of the defect was 7-12 mm. On cardiac catheterization left ventricular end-diastolic pressure ranged from 20 to 40 mmHg and the calculated Qp/Qs ratio was 2-3.5. In all patients the defect was crossed retrogradely from the aortic side and over an arterio-venous wire loop after balloon sizing, devices were successfully deployed by antegrade venous approach (Rashkind umbrella device in two and Amplatzer occluders in six, which included Amplatzer duct occluder in five and Amplatzer septal occluder in one). One patient who had residual shunt developed hemolysis on the next day and was taken up for reintervention. That patient continued to have intermittent hemolysis and was sent for surgical repair. On follow-up (2-96 months), there was no device embolization, infective endocarditis, and aortic regurgitation. One patient died of progressive congestive heart failure while other six are asymptomatic. These data highlight that transcatheter closure is feasible and effective, especially safe with the available Amplatzer devices. Definitely, it has the advantage of obviating open heart surgery but complete occlusion is mandatory to prevent hemolysis and infective endocarditis.

Accuracy and pitfalls of early diastolic motion of the mitral annulus for diagnosing constrictive pericarditis by tissue Doppler imaging.

Mitral annular velocities are reportedly useful in diagnosing constrictive pericarditis (CP); however, their exact efficacy in larger clinical settings remains unevaluated. This study reexamined the role of longitudinal tissue Doppler imaging in diagnosing CP in clinical practice. Tissue velocity imaging (GE Vingmed System Five) was performed in 122 subjects (87 referred with clinically suspected CP and 35 age- and sex-matched controls). Of the 87 subjects with suspected CP, 45 (51.7%) had CP confirmed at surgery, 11 (12.6%) had restrictive heart disease, 20 (23.0%) had right heart failure due to cor pulmonale, and the other 11 (12.6%) had old pericardial effusions and no hemodynamic evidence of constriction on follow-up echocardiography. Of the 45 patients with CP, mitral early diastolic (Ea) annular velocities from septal and lateral regions were normal (>/=8 cm/s) in 40 (88.9%) and decreased (<8 cm/s) in 1 or both regions in 5 (3 with left ventricular systolic dysfunction, 2 with extensive mitral annular calcification). Of 11 patients with restrictive cardiomyopathy, 8 (72.7%) had reduced Ea (<8 cm/s) and 3 showed normal Ea velocity in 1 or both corners of the mitral annulus. All except 2 patients with right-sided heart failure from cor pulmonale and those with previous pericardial effusion had normal Ea velocities. A normal Ea velocity improved recognition of CP, particularly in the presence of nondiagnostic 2-dimensional or transmitral flow-Doppler imaging. The overall sensitivity and specificity for diagnosing CP using tissue Doppler incrementally with M-mode, 2-dimensional, and transmitral flow Doppler were 88.8% and 94.8%, respectively. Mitral annular velocities help with diagnosis and differentiation of CP in most cases, except in the presence of extensive annular calcification, left ventricular systolic dysfunction, or segmental nonuniformity in myocardial velocities.

Regional dyssynergy of the interventricular septum after septal artery occlusion in hypertrophic obstructive cardiomyopathy: use of quantitative Doppler tissue and strain rate imaging.

We report the regional myocardial mechanics of the interventricular septum in a patient with hypertrophic obstructive cardiomyopathy undergoing therapeutic septal artery occlusion. Myocardial velocities improved across the entire septum; however, strain rate imaging showed the presence of severe regional dyssynergy.

A constricting band: an unusual cause of incomplete expansion of Amplatzer septal occluder device.

Various problems and complications have been reported during transcatheter closure of ostium secundum atrial septal defect with Amplatzer septal occluder. We report an unusual problem that was responsible for incomplete expansion of the waist of the device, not yet reported in world literature. A polyester band in continuation with the polyester mesh was found constricting the waist of the device, which after being cut led to successful redeployment of the device.

Transcatheter closure of perimembranous ventricular septal defect in a patient with situs inversus and dextrocardia.

Successful transcatheter closure of a perimembranous ventricular septal defect with an Amplatzer device has been reported in patients with levocardia. We report a case in which the device could be deployed successfully in a child with isolated perimembranous ventricular septal defect with situs inversus and dextrocardia.