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Objectives: Our study aimed to correlate pulse wave parameters such as augmentation index (AI) and heart rate variability with traditional Chinese medicine (TCM) constitution for evaluating health status.Design: Out of 177 subjects, 69 healthy subjects were enrolled in the present study, and others were excluded because of cardiovascular, liver, kidney, or other diseases. Each subject was invited to complete pulse wave examination and the Constitution in Chinese Medicine Questionnaire. Independent Student's t-tests, Mann-Whitney tests, and binary logistic regression analysis were used to analyse the correlation between pulse wave parameters and TCM constitution.Results: Qi-deficient individuals had higher AI (p=0.006) and lower diastolic blood pressure (p=0.011); yang-deficient individuals had lower dP/dt max (p=0.030), systolic blood pressure (p=0.020), and pulse pressure (p=0.048); and damp-heat individuals had higher subendocardial viability index (SEVI) scores (p=0.011). We then categorized the phlegm dampness and yang-deficiency individuals into the cold group and those with damp-heat and yin-deficiency into the heat group. A comparison of the two constitution groups showed higher AI in the cold group (p=0.026). Binary logistic regression analysis demonstrated that only AI was a determinant, as evidenced by the finding that an increase of one unit in AI corresponded to an increase of 5% in the odds ratio for individuals to have a cold constitution (p=0.026).Conclusions: Individuals with qi-deficient and cold constitutions had higher AI and lower SEVI, potentially reflecting an increase in arterial stiffness. This study can provide a basis for further investigation of the physiological indicators of TCM constitutions in modern medicine. [ABSTRACT FROM AUTHOR]

Abstract: Percutaneous transluminal angioplasty (PTA) for thrombosed dialysis graft is both difficult and time-consuming that may increase radiation exposure. A predictor of PTA success and procedure time has not been identified yet. Sonography data and the PTA results of 88 grafts were reviewed retrospectively. The echogenicity of the majority of the intra-graft thrombus and the presence/absence of thrombus free space in the grafts were examined. The association between the sonography findings and PTA procedure success and procedure time was analyzed. The echogenicity of the intra-graft thrombus and presence/absence of thrombus free space were the major determinants of procedure success and procedure time. Higher intra-graft echogenicity and lack of thrombus free space were associated with more procedure failures (p < 0.01 vs. p = 0.04) and longer procedure times (p = 0.03 vs. p < 0.01). Thrombi from occluded dialysis grafts may differ in resistance to mechanical/pharmacological thrombolysis. Sonography characteristics of the intra-graft thrombus may help to differentiate them. [Copyright &y& Elsevier]

Increased expression of connexin43 gap junctions in smooth muscle cells (SMC) is implicated in the response to primary arterial injury and in the early stages of human coronary atherosclerosis, but the relevance of these findings to restenosis is unknown. Here we investigated the expression of connexin43 gap junctions in restenotic aortas of cholesterol-fed double injured rabbits. Immunofluorescence confocal microscopy was used to evaluate temporal and spatial expression patterns and to characterize the major expressing cell type. Parallel studies were conducted by electron microscopy, in situ hybridization and Northern blot analysis. Connexin43 gap junctions- and connexin43 mRNA-expressing cells were abundant in the media of non-injured control aorta. Following primary injury and 6 weeks cholesterol diet, connexin43 gap junctions were found distributed throughout the primary intimal layer; although medial expression was reduced, the overall mRNA expression level remained similar to that of non-injured controls. After secondary injury, no major change in distribution pattern of connexin43 gap junctions occurred up to day 10, when marked neointimal labeling was observed. This overall pattern persisted, though with some diminution, at later stages. On the mRNA level total connexin43 mRNA expression declined to about 40% of control values within 4 days after secondary injury (P&#60;0.05), but subsequently increased fourfold, attaining levels double that of non-injured controls in the 10-day group (P&#60;0.005 versus control and 4 days). At later stages mRNA expression levels returned to values similar to those of non-injured controls. At all stages, connexin43 gap junctions were localized to the SMC, not to macrophages. We conclude that the enhanced gap junction formation may contribute to the coordination of the response of SMC after secondary injury, particularly in the early phase of restenosis. [Copyright &y& Elsevier]

Abstract: Aims: This study was designed to examine the mechanism of relaxation induced by CIJ-3-2F, a benzyl-furoquinoline antiarrhythmic agent, in rat thoracic aorta at the tissue and cellular levels. Main methods: Isometric tension of rat aortic ring was measured in response to drugs. Ionic channel activities in freshly dissociated aortic vascular smooth muscle cells (VSMCs) were investigated using a whole-cell patch-clamp technique. Key findings: CIJ-3-2F relaxed both phenylephrine (PE) and high KCl (60mM)-induced contractions with respective pEC50 (-log EC50) values of 6.91±0.07 and 6.32±0.06. Removal of endothelium or pretreatment with nitric oxide (NO)-pathway inhibitors N ω-nitro-l-arginine methyl ester (L-NAME), N G-monomethyl-l-arginine (L-NMMA), N 5-(1-iminoethyl)-l-ornithine (L-NIO), hemoglobin, methylene blue or 1H-[1,2,4]oxadiazolo[4,2-α]quinoxalin-1-one (ODQ) reduced the relaxant effect of CIJ-3-2F. Relaxation to CIJ-3-2F was also attenuated by K + channel blockers tetraethylammonium (TEA) or 4-aminopyridine (4-AP), but not by charybdotoxin plus apamin, iberiotoxin, glibenclamide, or BaCl2. CIJ-3-2F non-competitively antagonized the contractions induced by PE, Ca2+, and Bay K8644 in endothelium-denuded rings. In addition, CIJ-3-2F inhibited both the phasic and tonic contractions induced by PE but did not affect the transient contraction induced by caffeine. CIJ-3-2F reduced the Ba2+ inward current through L-type Ca2+ channel (IC50 =4.1μM) and enhanced the voltage-dependent K + (Kv) current in aortic VSMCs. Significance: These results suggest that CIJ-3-2F induced both endothelium-dependent and -independent vasorelaxation; the former is likely mediated by the NO/cGMP pathway whereas the latter is probably mediated through inhibition of Ca2+ influx or inositol 1,4,5-triphosphate (IP3)-sensitive intracellular Ca2+ release, or through activation of Kv channels. [Copyright &y& Elsevier]

Abstract: Preconditioning of gerbil brain with a sublethal forebrain ischemia is known to protect hippocampal CA1 neurons following a subsequent lethal ischemia (the second ischemia) which usually damages neurons (ischemic tolerance). Present report using a confocal laser scanning microscope demonstrated that the hippocampal cells of sham operation gerbils contained immunofluorescent NGF and BDNF and their high-affinity receptors (TrkA and TrkB). A 2-min ischemia caused little change of these proteins (ANOVA test, P <0.05). After the second lethal ischemia, in the CA1 area with ischemic preconditioning (2-min ischemia), only BDNF but not NGF and their high-affinity receptors showed a transient reduction at 4 h (ANOVA test, P <0.01) and improved from 1 day (ANOVA test, P <0.05). In the CA1 area without ischemic preconditioning (sham operation), NGF and its high-affinity TrkA receptor showed a consistent reduction from 4 h to 7 days (ANOVA test, P <0.05); BDNF and TrkB decreased transiently from 4 h to 1 day (ANOVA test, P <0.05) but were recovered in the surviving neurons from 3 days. At 3 and 7 days after the second lethal ischemia, apoptotic cell injury could be seen in the CA1 area without ischemic preconditioning but was sparsely noted in the CA1 area with ischemic preconditioning. In the ischemia-resistant CA3 and dentate gyrus areas, only BDNF decreased significantly at 7 days in the CA3 area without ischemic preconditioning (ANOVA test, P <0.01). However, no significant change occurred in NGF, TrkA and TrkB immunofluorescence from 4 h to 7 days after the second lethal ischemia in the CA3 and dentate gyrus areas with and without ischemic preconditioning. Western blot study showed that in the hippocampal formation with ischemic preconditioning, preconditioning prevented the decline of these protein levels from 1 day to 7 days after the second lethal ischemia (ANOVA test, P >0.05). Results of this study demonstrate that ischemic preconditioning recovers the initial decline in NGF and BDNF and their corresponding receptors in the vulnerable CA1 neurons after the second lethal ischemia, suggesting that growth factors might play a role in the protective mechanism of ischemic preconditioning. [Copyright &y& Elsevier]

Abstract: Background: To analyze the relationship between intraocular pressure, metabolic variables, and components of metabolic syndrome in different age and gender groups. Methods: We examined 10,491 Taiwanese adults aged 21 to 79years and categorized according to gender and age. All participants underwent examinations, including body mass index (BMI), waist circumference, blood pressure, intraocular pressure, and blood chemistry. Multiple linear regression analyses were performed to evaluate the relationships between intraocular pressure and these variables as well as to determine the relative influence of each component of metabolic syndrome. Results: Intraocular pressure showed a significant reduction with aging in men but not in women. BMI had a positive association with intraocular pressure in young adults and middle-aged men. Systolic blood pressure was positively associated with intraocular pressure in most groups, whereas diastolic blood pressure was positively associated with intraocular pressure only in middle-aged and elderly men. Fasting blood sugar levels showed a significant association with high intraocular pressure in middle-aged and elderly adults. All participants with metabolic syndrome had higher intraocular pressure levels, and each component of metabolic syndrome had a distinct effect on the intraocular pressure, with blood pressure being the strongest predictor. Conclusion: Elevated intraocular pressure is associated with a number of metabolic variables, and each component of metabolic syndrome has a distinct impact on the intraocular pressure in individual age- and gender-specific groups. The present results may allow internal medicine specialists to manage metabolic risk factors while considering possible ocular involvement and potential treatment interactions. [Copyright &y& Elsevier]

Abstract: Recently, a T/C polymorphism of the promoter region of the APOA5 gene at position -1131 and a G/T polymorphism at position 553 were found to be associated with increased levels of plasma triglyceride. Triglyceride plays a role in coronary artery disease (CAD), so this case–control study tested for a possible link between these two APOA5 polymorphisms, their common haplotypes and the risk of CAD. The subjects included 211 CAD patients and 677 unrelated controls. A significantly higher level of triglycerides and a lower level of high-density lipoprotein cholesterol (HDL-C) were noted for carriers with -1131C than for non-carriers (P <0.001 and 0.013, respectively) among controls. Plasma triglyceride levels were significantly higher (P =0.014) in controls with genotypes that contained the c.553T allele than in homozygotes for the G allele. Subjects homozygous for the wild-type haplotype had significantly lower triglyceride levels and higher HDL-C levels than subjects with all other haplotype pairs. The -1131C homozygous carriers and c.553T heterozygous carriers were found more frequently in 211 patients with CAD than in the 317 age/sex-matched controls (P =0.008 and 0.023, respectively) in univariate analysis. The significant association between c.553T allele carriers with CAD remained in multivariate regression analysis (OR, 1.79; CI, 1.07–3.00; P =0.028), after adjustments were made for other risk factors. Notably, haplotype analysis further verified that the APOA5 -1131C and c.553T bi-loci haplotype was significantly overpresented in CAD, as compared to the controls. These results indicate that the variants of APOA5 gene modulate plasma triglyceride and may use them to predict CAD susceptibility in Taiwanese Chinese. [Copyright &y& Elsevier]

We examined the effect of 2′,5′-dihydroxychalcone on connexin43 (Cx43) expression and gap-junctional communication in human umbilical vein endothelial cells (HUVEC). The result showed that expression of Cx43 is rapidly reduced by 2′,5′-dihydroxychalcone in a dose-dependent manner, Concomitantly, the communication function, determined by fluorescence recovery after photobleaching (FRAP), is decreased. We further investigated whether the mitogen-activated protein (MAP) kinase and the degradation pathway of gap junctions are involved in these processes. Although the change of Cx43 is not affected by the level of fetal calf serum (FCS) used in the medium, activation of MAP kinase varies, depending on the FCS level. At a low level (0.5%), the chalcone inhibits the activation, like PD98059, a specific inhibitor of MAP kinase kinase. However, at a high level (20%), MAP kinase is activated. On the other hand, the chalcone''s down-regulating effect on Cx43, while is totally blocked by protease inhibitors leupeptin and N-acetyl-leucyl-norleucinal (ALLN), persists in the presence of PD98059, We concluded that 2′,5′-dihydroxychalcone down-regulates Cx43 expression and gap-junctional communication in the HUVEC via enhancement of the proteolysis pathway, and this compound possesses dual effects on MAP kinase activation. [Copyright &y& Elsevier]

Discusses the use of on-line multiplane transesophageal echocardiography (TEE) for balloon mitral commissurotomy (BMC) in the treatment of mitral stenosis. Inherent limitations of BMC; Partial replacement of fluoroscopy by on-line TEE; Utilization of a multiplane transducer.

The transcatheter closure of atrial septal defects provides an alternative to surgery, and various devices, such as the Sideris buttoned device, have been prescribed. Late complications have been rare and have not yet been reported within 2 years of implantation. This report presents a case of delayed migration of a Sideris buttoned device occurring 6 years after successful implantation. In conclusion, this report provides a reminder of the need for careful long-term follow-up of patients receiving transcatheter closure of atrial septal defects, particularly in cases involving the implantation of early-generated devices. [Copyright &y& Elsevier]