Electrocardiographic manifestation of the middle fibers/septal fascicle block: a consensus report

There are fibers in the left ventricle (LV) (LV middle network) that in around one third of cases may be considered a true septal fascicle that arises from the common left bundle. Its presence and the evidence that there are 3 points of activation onset in the LV favor the quadrifascicular theory of the intravantricular activation of both ventricles. Since the 70s, different authors have suggested that the block of the left middle fibers (MS)/left septal fascicle may explain different electrocardiographic (ECG) patterns. The 2 hypothetically based criteria that are in some sense contradictory include: a) the lack of septal "q" wave due to first left and later posteriorly shifting of the horizontal plane loop and b) the presence of RS in lead V-2 (V-1-V-2) due to some anterior shifting of the horizontal plane vectorcardiogram loop. However, there are many evidence that the lack of septal q waves can be also explained by predivisional first-degree left bundle-branch block and that the RS pattern in the right precordial leads may be also explained by first-degree right bundle-branch block. The transient nature of these patterns favor the concept that some type of intraventricular conduction disturbance exists but a doubt remains about its location. Furthermore, the RS pattern could be explained by many different normal variants. To improve our understanding whether these patterns are due to MF/left septal fascicle block or other ventricular conduction disturbances (or both), it would be advisable: 1) To perform more histologic studies (heart transplant and necropsy) of the ventricular conduction system; 2) To repeat prior experimental studies using new methodology/technology to isolate the MF; and 3) To change the paradigm: do not try to demonstrate if the block of the fibers produces an ECG change but to study with new electroanatomical imaging techniques, if these ECG criteria previously described correlate or not with a delay of activation in the zone of the LV that receives the activation through these fibers or in other zones. (C) 2012 Elsevier Inc. All rights reserved.

Percutaneous sciatic nerve block with tramadol induces analgesia and motor blockade in two animal pain models

Local anesthetic efficacy of tramadol has been reported following intradermal application. Our aim was to investigate the effect of perineural tramadol as the sole analgesic in two pain models. Male Wistar rats (280-380 g; N = 5/group) were used in these experiments. A neurostimulation-guided sciatic nerve block was performed and 2% lidocaine or tramadol (1.25 and 5 mg) was perineurally injected in two different animal pain models. In the flinching behavior test, the number of flinches was evaluated and in the plantar incision model, mechanical and heat thresholds were measured. Motor effects of lidocaine and tramadol were quantified and a motor block score elaborated. Tramadol, 1.25 mg, completely blocked the first and reduced the second phase of the flinching behavior test. In the plantar incision model, tramadol (1.25 mg) increased both paw withdrawal latency in response to radiant heat (8.3 +/- 1.1, 12.7 +/- 1.8, 8.4 +/- 0.8, and 11.1 +/- 3.3 s) and mechanical threshold in response to von Frey filaments (459 +/- 82.8, 447.5 +/- 91.7, 320.1 +/- 120, 126.43 +/- 92.8 mN) at 5, 15, 30, and 60 min, respectively. Sham block or contralateral sciatic nerve block did not differ from perineural saline injection throughout the study in either model. The effect of tramadol was not antagonized by intraperitoneal naloxone. High dose tramadol (5 mg) blocked motor function as well as 2% lidocaine. In conclusion, tramadol blocks nociception and motor function in vivo similar to local anesthetics.

Global and Regional Ventricular Repolarization Study by Body Surface Potential Mapping in Patients with Left Bundle-Branch Block and Heart Failure Undergoing Cardiac Resynchronization Therapy

Background: The controversial effects promoted by cardiac resynchronization therapy (CRT) on the ventricular repolarization (VR) have motivated VR evaluation by body surface potential mapping (BSPM) in CRT patients. Methods: Fifty-two CRT patients, mean age 58.8 +/- 12.3 years, 31 male, LVEF 27.5 +/- 9.2, NYHA III-IV heart failure with QRS181.5 +/- 14.2 ms, underwent 87-lead BSPM in sinus rhythm (BASELINE) and biventricular pacing (BIV). Measurements of mean and corrected QT intervals and dispersion, mean and corrected T peak end intervals and their dispersion, and JT intervals characterized global and regional (RV, Intermediate, and LV regions) ventricular repolarization response. Results: Global QTm (P < 0.001) and QTcm (P < 0.05) were decreased in BIV; QTm was similar across regions in both modes (P = ns); QTcm values were lower in RV/LV than in Intermediate region in BASELINE and BIV (P < 0.001); only RV/Septum showed a significant difference (P < 0.01) in the BIV mode. QTD values both of BASELINE (P < 0.01) and BIV (P < 0.001) were greater in the Intermediate than in the LV region. CRT effect significantly reduced global/regional QTm and QTcm values. QTD was globally decreased in RV/LV (Intermediate: P = ns). BIV mode significantly reduced global T peak end mean and corrected intervals and their dispersion. JT values were not significant. Conclusions: Ventricular repolarization parameters QTm, QTcm, and QTD global/regional values, as assessed by BSPM, were reduced in patients under CRT with severe HF and LBBB. Greater recovery impairment in the Intermediate region was detected by the smaller variation of its dispersion.

Single-wall carbon nanotube interactions with copper-oxamato building block of molecule-based magnets probed by resonance Raman spectroscopy

The electronic interactions between the [Cu(opba)]2- anions (where opba is orthophenylenebis (oxamato)) and single-wall carbon nanotubes (SWCNTs) were investigated by resonance Raman spectroscopy. The opba can form molecular magnets, and the interactions of opba with SWCNTs can produce materials with very different magnetic/electronic properties. It is observed that the electronic interaction shows a dependence on the SWCNT diameter independent of whether they are metallic or semiconducting, although the interaction is stronger for metallic tubes. The interaction also is dependent on the amount of complex that is probably adsorbed on the carbon surface of the SWCNTs. Some charge transfer can be also occurring between the metallic complex and the SWCNTs. Copyright (c) 2012 John Wiley & Sons, Ltd.

Frequency of human platelet antigens in oncohematological patients with thrombocytopenia and the probability of incompatibility to platelet transfusions

OBJECTIVE: The objective of this study was to evaluate the frequencies of human platelet antigens in oncohematological patients with thrombocytopenia and to analyze the probability of their incompatibility with platelet transfusions. METHODS: Platelet antigen genotyping was performed by sequence-specific primer polymerase chain reaction (SSP-PCR) for the HPA-1a, HPA-1b, HPA-2a, HPA-2b, HPA-3a, HPA-3b, HPA-4a, HPA-4b, HPA-5a, HPA-5b; HPA-15a, HPA-15b alleles in 150 patients of the Hematology Service of the Hospital das Clínicas (FMUSP). RESULTS: The allele frequencies found were: HPA-1a: 0.837; HPA-1b: 0.163; HPA-2a: 0.830; HPA-2b: 0.170; HPA-3a: 0.700; HPA-3b: 0.300; HPA-4a: 1; HPA-4b: 0; HPA-5a: 0.887; HPA-5b: 0.113; HPA-15a: 0.457 and HPA-15b: 0.543. CONCLUSIONS: Data from the present study showed that the A allele is more common in the population than the B allele, except for HPA-15. This suggests that patients homozygous for the B allele are more predisposed to present alloimmunization and refractoriness to platelet transfusions by immune causes. Platelet genotyping could be of great value in the diagnosis of alloimmune thrombocytopenia and to provide compatible platelet concentrates for these patients.

Clay-containing block copolymer nanocomposites with aligned morphology prepared by extrusion

Clay-containing nanocomposites of polystyrene-b-poly(ethylene-co-butylene)-b-polystyrene (SEBS) copolymers having cylindrical domains were obtained by melt extrusion using a tape die. One type of sample (SEBS-MA) had maleic anhydride attached to the middle block. Two types of organoclays were added, namely Cloisite 20A and Cloisite 30B. Small angle X-ray scattering and transmission electron microscopy (TEM) analyses showed that the addition of 20A clay to SEBS and SEBS-MA resulted in nanocomposites with intercalated and partially exfoliated structures, respectively. The addition of 30B clay to SEBS and SEBS-MA promoted the formation of composites containing relatively large micron-sized and partially exfoliated clay particles, respectively. Our TEM analysis revealed that clay particles embedded in SEBS are preferably in contact with the polystyrene cylindrical domains, while in SEBS-MA they are in contact with the maleated matrix. The extrusion processing promoted alignment of the axes of the polystyrene cylinders along the extrusion direction in all samples, and the basal planes of the clay particles were mostly parallel to the main external surfaces of the extruded tapes. © 2013 Society of Chemical Industry.

Wasserstoffbrücken-gebundene Netzwerke

Die supramolekularen Organisationen von 5-n-Alkoxyisophthaläuren und 2,5-Di-n-alkoxyterephthalsäuren bilden durch sekundäre Wechselwirkungen in Form van der Waals-Kräften und Wasserstoffbrückenbindungen hochgeordnete lamellare Strukturen, die sowohl mittels Röntgen-kristallgraphie als auch durch Rastertunnelmikroskopie (STM) visualisierbar sind. Diese Art der Aggregationsmuster ermöglicht den potentiell reaktiven Gruppen (Diacetylene, Zimtsäuren) in der Alkoxykette, einen optimalen Abstand und geometrische Orientierungen im Kristall einzunehmen, um lichtinduzierte Reaktionen im Festkörper durchzuführen. Einführung einer Amidgruppe an die Alkoxykette erweitert dieses Konzept, durch Erhalt einer zusätzlichen Wasserstoffbrückenbindung im hydrophoben Bereich der Organisation.Die Stabilität solche supramolekularer Aggregate kann durch Einführung semifluorierter Alkoxyketten stark beeinflußt werden, da die Inkompatibilität der pefluorierten Gruppen durch viele organische Verbindungen das Gleichgewicht nicht-kovalenter Wechselwirkung drastisch verändert. Diese Eigenschaft der semifluorierten 5-n-Alkoxyisopthalsäuren und 2,5-Di-n-alkoxyterephthalsäuren zeigt sich erstaunlicherweise jedoch nur bei einem großen Anteil des perfluorierten Alkylteils als der des nicht-perfluorierten. Da sich dann die perfluorierten Alkylteile untereinander organisieren können, erscheint die Änderung der Assoziationsstruktur von interdigitiert-lamellar zu nicht-interdigitiert-lamellar plausibel.Das gezielte Design eines neuen Organisationsmusters der 5-n-Alkoxyisophthalsäuren gelang durch Brechung der Symmetrie dieses Bausteins. Die Einführung zweier Alkoxyketten ließ die zweidimensionale Anordnung der wasserstoffbrückengebundenen Aromate unverändert, resultierte aber mit Ausbruch einer Alkoxykette aus dieser Ebene.

Coil-ring-coil block copolymers as building blocks of supramolecular hollow cylindrical brushes

This work describes the synthesis of a new class of rod-coil block copolymers, oligosubstituted shape persistent macrocycles, (coil-ring-coil block copolymers), and their behavior in solution and in the solid state.The coil-ring-coil block copolymers are formed by nanometer sized shape persistent macrocycles based on the phenyl-ethynyl backbone as rigid block and oligomers of polystyrene or polydimethylsiloxane as flexible blocks. The strategy that has been followed is to synthesize the macrocycles with an alcoholic functionality and the polymer carboxylic acids independently, and then bind them together by esterification. The ester bond is stable and relatively easy to form.The synthesis of the shape persistent macrocycles is based on two separate steps. In the first step the building blocks of the macrocycles are connected by Hagiara-Sogonaschira coupling to form an 'half-ring' as precursor, that contains two free acetylenes. In the second step the half-ring is cyclized by forming two sp-sp bonds via a copper-catalyzed Glaser coupling under pseudo-high-dilution conditions. The polystyrene carboxylic acid was prepared directly by siphoning the living anionic polymer chain into a THF solution, saturated with CO2, while the polydimethylsiloxane carboxylic acid was obtained by hydrosilylating an unsaturated benzylester with an Si-H terminated polydimethylsiloxane, and cleavage of the ester. The carbodiimide coupling was found to be the best way to connect macrocycles and polymers in high yield and high purity.The polystyrene-ring-polystyrene block copolymers are, depending on the molecular weight of the polystyrene, lyotropic liquid crystals in cyclohexane. The aggregation behavior of the copolymers in solution was investigated in more detail using several technique. As a result it can be concluded that the polystyrene-ring-polystyrene block copolymers can aggregate into hollow cylinder-like objects with an average length of 700 nm by a combination of shape complementary and demixing of rigid and flexible polymer parts. The resulting structure can be described as supramolecular hollow cylindrical brush.If the lyotropic solution of the polystyrene-ring-polystyrene block copolymers are dried, they remain birefringent indicating that the solid state has an ordered structure. The polydimethylsiloxane-ring-polydimethylsiloxane block copolymers are more or less fluid at room temperature, and are all birefringent (termotropic liquid crystals) as well. This is a prove that the copolymers are ordered in the fluid state. By a careful investigation using electron diffraction and wide-angle X-ray scattering, it has been possible to derive a model for the 3D-order of the copolymers. The data indicate a lamella structure for both type of copolymers. The macrocycles are arranged in a layer of columns. These crystalline layers are separated by amorphous layers which contain the polymers substituents.

Silicon-containing block copolymers with well-defined, branched architectures

In the past decade, block copolymers (BCPs) have attracted increasing scientific and technological interest because of their inherent capability to spontaneously self-assemble into ordered arrays of nanostructures. The importance of nanostructures in a number of applications has fostered the need for well-defined, complex macromolecular architectures. In this thesis, the influence of macromolecular architecture on the bulk morphologies of novel linear-hyperbranched and linear brush-like diblock copolymer structure is investigated. An innovative, generally applicable strategy for the preparation of these defined diblock copolymers, consisting of linear polystyrene and branched polycarbosilane blocks, is demonstrated. Furthermore, complete characterization and solid-state morphological studies are provided. Finally, the concept is extended to linear-hyperbrached and linear brush-like polyalkoxysilanes. A shift of the classical phase boundaries to higher PS weight fractions as well as the appearance of new morphologies confirms the dramatic effect that polymer topology has on the morphology of BCPs.

Kinematics of the Sicily and Calabria Subduction System from Elastic Block Modeling of GPS Data

We use data from about 700 GPS stations in the EuroMediterranen region to investigate the present-day behavior of the the Calabrian subduction zone within the Mediterranean-scale plates kinematics and to perform local scale studies about the strain accumulation on active structures. We focus attenction on the Messina Straits and Crati Valley faults where GPS data show extentional velocity gradients of ∼3 mm/yr and ∼2 mm/yr, respectively. We use dislocation model and a non-linear constrained optimization algorithm to invert for fault geometric parameters and slip-rates and evaluate the associated uncertainties adopting a bootstrap approach. Our analysis suggest the presence of two partially locked normal faults. To investigate the impact of elastic strain contributes from other nearby active faults onto the observed velocity gradient we use a block modeling approach. Our models show that the inferred slip-rates on the two analyzed structures are strongly impacted by the assumed locking width of the Calabrian subduction thrust. In order to frame the observed local deformation features within the present- day central Mediterranean kinematics we realyze a statistical analysis testing the indipendent motion (w.r.t. the African and Eurasias plates) of the Adriatic, Cal- abrian and Sicilian blocks. Our preferred model confirms a microplate like behaviour for all the investigated blocks. Within these kinematic boundary conditions we fur- ther investigate the Calabrian Slab interface geometry using a combined approach of block modeling and χ2ν statistic. Almost no information is obtained using only the horizontal GPS velocities that prove to be a not sufficient dataset for a multi-parametric inversion approach. Trying to stronger constrain the slab geometry we estimate the predicted vertical velocities performing suites of forward models of elastic dislocations varying the fault locking depth. Comparison with the observed field suggest a maximum resolved locking depth of 25 km.

DNA block copolymers - synthesis, morphologies and applications

The last decades have witnessed significant and rapid progress in polymer chemistry and molecular biology. The invention of PCR and advances in automated solid phase synthesis of DNA have made this biological entity broadly available to all researchers across biological and chemical sciences. Thanks to the development of a variety of polymerization techniques, macromolecules can be synthesized with predetermined molecular weights and excellent structural control. In recent years these two exciting areas of research converged to generate a new type of nucleic acid hybrid material, consisting of oligodeoxynucleotides and organic polymers. By conjugating these two classes of materials, DNA block copolymers are generated exhibiting engineered material properties that cannot be realized with polymers or nucleic acids alone. Different synthetic strategies based on grafting onto routes in solution or on solid support were developed which afforded DNA block copolymers with hydrophilic, hydrophobic and thermoresponsive organic polymers in good yields. Beside the preparation of DNA block copolymers with a relative short DNA-segment, it was also demonstrated how these bioorganic polymers can be synthesized exhibiting large DNA blocks (>1000 bases) applying the polymerase chain reaction. Amphiphilic DNA block copolymers, which were synthesized fully automated in a DNA synthesizer, self-assemble into well-defined nanoparticles. Hybridization of spherical micelles with long DNA templates that encode several times the sequence of the micelle corona induced a transformation into rod-like micelles. The Watson-Crick motif aligned the hydrophobic polymer segments along the DNA double helix, which resulted in selective dimer formation. Even the length of the resulting nanostructures could be precisely adjusted by the number of nucleotides of the templates. In addition to changing the structural properties of DNA-b-PPO micelles, these materials were applied as 3D nanoscopic scaffolds for organic reactions. The DNA strands of the corona were organized by hydrophobic interactions of the organic polymer segments in such a fashion that several DNA-templated organic reactions proceeded in a sequence specific manner; either at the surface of the micelles or at the interface between the biological and the organic polymer blocks. The yields of reactions employing the micellar template were equivalent or better than existing template architectures. Aside from its physical properties and the morphologies achieved, an important requirement for a new biomaterial is its biocompatibility and interaction with living systems, i.e. human cells. The toxicity of the nanoparticles was analyzed by a cell proliferation assay. Motivated by the non-toxic nature of the amphiphilic DNA block copolymers, these nanoobjects were employed as drug delivery vehicles to target the anticancer drug to a tumor tissue. The micelles obtained from DNA block copolymers were easily functionalized with targeting units by hybridization. This facile route allowed studying the effect of the amount of targeting units on the targeting efficacy. By varying the site of functionalization, i.e. 5’ or 3’, the outcome of having the targeting unit at the periphery of the micelle or in the core of the micelle was studied. Additionally, these micelles were loaded with an anticancer drug, doxorubicin, and then applied to tumor cells. The viability of the cells was calculated in the presence and absence of targeting unit. It was demonstrated that the tumor cells bearing folate receptors showed a high mortality when the targeting unit was attached to the nanocarrier.