The effectiveness of infrainguinal percutaneous transluminal angioplasty in the treatment of critical limb ischaemia

Critical chronic lower limb ischaemia (CLI) is the most severe form of peripheral arterial disease. Even though the treatment of CLI has evolved during the last decade, CLI is still associated with considerable morbidity, mortality and a decreased quality of life, in addition to a large financial impact on society. ---- Bypass surgery has traditionally been considered the approach of choice to treat CLI patients in order to avoid amputation. However, there are increasing data on the efficacy of endovascular revascularization procedures, such as percutaneous transluminal angioplasty (PTA), to achieve good leg salvage rates as well. Data gathered on all the 2,054 CLI patients revascularized at the Helsinki University Central Hospital between 2000 and 2007 were retrospectively analyzed. This patient cohort was used to compare the results of infrainguinal PTA and bypass surgery as well as to investigate predictors of failure after PTA. This study showed that infrainguinal PTA and bypass surgery yielded rather similar results in terms of survival, amputation-free survival and freedom from any re-intervention. When the femoropoliteal segment was treated, leg salvage was significantly better in the bypass surgery group, whereas no significant difference was observed between the two treatment methods when the revascularization extended to the infrapopliteal segment. PTA resulted in a significantly lower freedom from surgical re-interventions when compared to surgical revascularization. In this study the most important predictors of poor outcome after PTA for CLI were cardiac morbidity, nonambulatory status upon hospital arrival, and gangrene as a manifestation of CLI. Thus, when feasible, PTA seems to be a valid alternative for bypass surgery in the treatment of CLI provided that active redo-surgery is utilized. The optimal revascularization strategy should always be sought for each CLI patient individually considering the clinical state of the leg, the occlusive lesions to be treated, co-morbidities, life-expectancy, and the availability of a suitable vein for bypass.

Catalytic hydrogen combustion for treatment of combustible gases from fuel cell processors

Catalytic combustion of H-2 was carried out over combustion synthesized noble metal (Pd or Pt) ion-substituted CeO2 based catalysts using a feed stream that simulated exhaust gases from a fuel cell processor The catalysts showed a high activity for H-2-combustion and complete conversion was achieved below 200 C over all the catalysts when O-2 was used in a stoichiometric amount With higher amounts of O-2 the reaction rates Increased and complete conversions were possible below 100 C The reaction was also carried out over Pd-impregnated CeO2 The conversions of H-2 with stoichiometric amount of O-2 were found to be higher over Pd-substituted compound The mechanism of the reaction over noble metal-substituted compounds was proposed on the basis of X-ray photoelectron spectroscopy studies The redox couples between Ce and metal ions were established and a dual site redox mechanism was pi posed for the reaction (C) 2010 Elsevier B V All rights reserved

Myoblast Sheet Transplantation for Treatment of Heart Failure after Myocardial Infarction

Heart failure is a common, severe, and progressive condition associated with high mortality and morbidity. Because of population-aging in the coming decades, heart failure is estimated to reach epidemic proportions. Current medical and surgical treatments have reduced mortality, but the prognosis for patients has remained poor. Transplantation of skeletal myoblasts has raised hope of regenerating the failing heart and compensating for lost cardiac contractile tissue. In the present work, we studied epicardial transplantation of tissue-engineered myoblast sheets for treatment of heart failure. We employed a rat model of myocardial infarction-induced acute and chronic heart failure by left anterior descending coronary artery ligation. We then transplanted myoblast sheets genetically modified to resist cell death after transplantation by expressing antiapoptotic gene bcl2. In addition, we evaluated the regenerative capacity of myoblast sheets expressing the cardioprotective cytokine hepatocyte growth factor in a rat chronic heart failure model. Furthermore, we utilized in vitro cardiomyocyte and endothelial cell culture models as well as microarray gene expression analysis to elucidate molecular mechanisms mediating the therapeutic effects of myoblast sheet transplantation. Our results demonstrate that Bcl2-expression prolonged myoblast sheet survival in rat hearts after transplantation and induced secretion of cardioprotective, proangiogenic cytokines. After acute myocardial infarction, these sheets attenuated left ventricular dysfunction and myocardial damage, and they induced therapeutic angiogenesis. In the chronic heart failure model, inhibition of graft apoptosis by Bcl-2 improved cardiac function, supported survival of cardiomyocytes in the infarcted area, and induced angiogenesis in a vascular endothelial growth factor receptor 1- and 2-dependent mechanism. Hepatocyte growth factor-secreting myoblast sheets further enhanced the angiogenic efficacy of myoblast sheet therapy. Moreover, myoblast-secreted paracrine factors protected cardiomyocytes against oxidative stress in an epidermal growth factor receptor- and c-Met dependent manner. This protection was associated with induction of antioxidative genes and activation of the unfolded protein response. Our results provide evidence that inhibiting myoblast sheet apoptosis can enhance the sheets efficacy for treating heart failure after acute and chronic myocardial infarction. Furthermore, we show that myoblast sheets can serve as vehicles for delivery of growth factors, and induce therapeutic angiogenesis in the chronically ischemic heart. Finally, myoblasts induce, in a paracine manner, a cardiomyocyte-protective response against oxidative stress. Our study elucidates novel mechanisms of myoblast transplantation therapy, and suggests effective means to improve this therapy for the benefit of the heart failure patient.

Role of lipid peroxidation in impairment of mitochondrial function at complex I by methyl isocyanate treatment of rats in vivo

The subcutaneous administration of methyl isocyanate (MIC) in 1.0 LD50 dose in rats caused a significant effect on hepatic mitochondrial function only at complex I region of the respiratory chain. MIC administration at 1.0 LD50 dose also resulted in significant increases in malondialdehyde and ferrous ion concentration in liver mitochondria. It is suggested that the augmented lipid peroxidation in hepatic mitochondria, catalyzed by iron, possibly mobilized from intracellular stores leads to the inhibition of enzymes of mitochondrial respiration at complex I region, in vivo, in rats receiving a lethal dose of MIC subcutaneously.

Effective drug dosage design for treatment of infectious diseases using dynamic inversion

A generic nonlinear mathematical model describing the human immunological dynamics is used to design an effective automatic drug administration scheme. Even though the model describes the effects of various drugs on the dynamic system, this work is confined to the drugs that kill the invading pathogen and heal the affected organ. From a system theoretic point of view, the drug inputs can be interpreted as control inputs, which can be designed based on control theoretic concepts. The controller is designed based on the principle of dynamic inversion and is found to be effective in curing the �nominal model patient� by killing the invading microbes and healing the damaged organ. A major advantage of this technique is that it leads to a closed-form state feedback form of control. It is also proved from a rigorous mathematical analysis that the internal dynamics of the system remains stable when the proposed controller is applied. A robustness study is also carried out for testing the effectiveness of the drug administration scheme for parameter uncertainties. It is observed from simulation studies that the technique has adequate robustness for many �realistic model patients� having off-nominal parameter values as well.

Self-consistent microscopic treatment of the effects of self-motion of the probe on ionic and dipolar solvation dynamics

A simple but self-consistent microscopic theory for the time dependent solvation energy of both ions and dipoles is presented which includes, for the first time, the details of the self-motion of the probe on its own solvation dynamics. The theory leads to several interesting predictions. The most important of them is that, for dipolar solvation, both the rotational and the translational motions of the dipolar solute probe can significantly accelerate the rate of solvation. In addition, the rotational self-motion of the solute can also give rise to an additional mechanism of nonexponentiality in solvation time correlation functions in otherwise slow liquids. A comparison between the present theoretical predictions and the recent experimental studies of Maroncelli et al. on solvation dynamics of aniline in l-propanol seems to indicate that the said experiments have missed the initial solvent response up to about 45 ps. After mapping the experimental results on the redefined time scale, the theoretical results can explain the experimental results for solvation of aniline in 1-propanol very well. For ionic solvation, the translational motion is significant for light solutes only. For example, for Li+ in water, translational motion speeds up the solvation by about 20%. The present theory demonstrates that in dipolar solvation the partial quenching of the self-motion due to the presence of specific solute-solvent interactions (such as H-bonding) may lead to a much slower solvation than that when the self-motion is present. This point has been discussed. In addition, we present the theoretical results for solvation of aniline in propylene carbonate, Here, the solvation is predicted to be complete within 15-20 ps.

Treatment of electroplating effluent through emulsion-free liquid embrane

Separation of dissolved heavy metals such-as Cr(VI) and Cu(II) from electroplating effluents using a new technique of emulsion-free liquid membrane (EFLM) has been studied. Experimental results show that nearly 95% extraction is obtained resulting in stripping phase enrichment up to 50 times relative to feed. It is also found that emulsion-free liquid membranes are highly efficient and superior to other types of liquid membranes.

Angiotensin converting enzyme inhibitors in the treatment of hypertension

Angiotensin converting enzyme (ACE) catalyses the conversion of angiotensin I (Ang I) to angiotensin II (Ang II). The ACE activity directly related to hypertension as Ang II is the blood pressure regulating hormone. Therefore, ACE inhibitors are a major class of antihypertensive drugs. Captopril, chemical name, was the first orally active ACE inhibitory antihypertensive drug, discovered in 1977. Since then, a number of such drugs have been synthesized. Enzyme-inhibitor bound crystal structural studies reveal a great deal of understanding about the interactions of the inhibitors at the active site of ACE. This can be helpful in the rational design of ACE inhibitors. With the advancement of the combination therapy, it is known that ACE inhibitors having antioxidant activity can be beneficial for the treatment of hypertension. This study describes the development of ACE inhibitors in the treatment of hypertension. Importance of ACE inhibitors having antioxidant activity is also described.

Toward More Precise Radiotherapy Treatment of Lung Tumors

A computational framework for modeling the respiratory motion of lung tumors provides a 4D parametric representation that tracks, analyzes, and models movement to provide more accurate guidance in the planning and delivery of lung tumor radiotherapy.

Pulsed plasma treatment of polluted gas using wet/low temperature corona reactors

pplication of pulsed plasma for gas cleaning is gaining prominence in recent years mainly from the energy consideration point of view. Normally, gas treatment is carried out, at or above room temperature, by a conventional dry type corona reactor. However, this treatment is still inadequate in the removal of certain stable gases present in the exhaust/flue gas mixture. The authors report some interesting results of the treatment of such stable gases with pulsed plasma at very low ambient temperature. Also reported in the paper is an improvement in DeNO/DeNOx efficiency using unconventional wet-type reactors, designed and fabricated by the authors, operating at different ambient temperatures. Apart from laboratory tests on simulated gas mixtures, field tests were also carried out on the exhaust gas of a 8 kW diesel engine. Further, an attempt was made to test the feasibility of a helical wire as a corona electrode in place of the conventional straight wire electrode. A comparative analysis of the various tests is presented together with a note on the energy consideration

Treatment of NOx from Diesel Engine Exhaust by Dielectric Barrier Discharge Method

This paper reports improved performance of discharge plasma in filtered engine exhaust treatment. Our paper deals about the removal of NOX emissions from the diesel exhaust by electric discharge plasma. For the treatment of diesel exhaust a new type of reactor referred to as crossflow dielectric barrier discharge reactor has been used, where the gas flow is perpendicular to the corona electrode. Experiments were conducted at different flow rates ranging from 2 l/min to 10 l/min. The discharge plasma assisted barrier discharge reactor has shown promising results in NOX removal at high flow rates.

Pulsed plasma treatment of polluted gas using wet/low temperature corona reactors

Application of pulsed plasma for gas cleaning is gaining prominence in recent years mainly from the energy consideration point of view. Normally, gas treatment is carried out, at or above room temperature, by a conventional dry type corona reactor. However, this treatment is still inadequate in the removal of certain stable gases present in the exhaust/flue gas mixture. The authors report some interesting results of the treatment of such stable gases with pulsed plasma at very low ambient temperature. Also reported in the paper is an improvement in DeNO/DeNOx efficiency using unconventional wet-type reactors, designed and fabricated by the authors, operating at different ambient temperatures. Apart from laboratory tests on simulated gas mixtures, field tests were also carried out on the exhaust gas of a 8 kW diesel engine. Further, an attempt was made to test the feasibility of a helical wire as a corona electrode in place of the conventional straight wire electrode. A comparative analysis of the various tests is presented together with a note on the energy consideration

Treatment of NOx from Diesel Engine Exhaust by Dielectric Barrier Discharge Method

This paper reports improved performance of advantages when compared to its counterpart as it is cost discharge plasma in filtered engine exhaust treatment. Our effective, low capital and operation costs, salable by- paper deals about the removal of NOX emissions from the diesel products, and integration with the existing systems. In this exhaust by electric discharge plasma. For the treatment of diesel paper we describe an alternate reactor geometry referred to exhaust a new type of reactor referred to as cross-flow dielectric as cross-flow DBD reactor, where the exhaust gas flow barrier discharge reactor has been used, where the gas flow is perpendicular to the wire-cylinder reaction chamber. This perpendicular to the corona electrode. Experiments were reactor is used to treat the actual exhaust of a 3.75 kW diesel- conducted at different flow rates ranging from 2 l/min to 10 l/ generator set. The main emphasis is laid on the NOX treatment min. The discharge plasma assisted barrier discharge reactor of diesel engine exhaust. Experiments were carried out at has shown promising results in NOX removal at high flow rates.