To determine the mechanism of the cardiac dilatation and reduced contractility of obese Zucker Diabetic Fatty rats, myocardial triacylglycerol (TG) was assayed chemically and morphologically. TG was high because of underexpression of fatty acid oxidative enzymes and their transcription factor, peroxisome proliferator-activated receptor-␣. Levels of ceramide, a mediator of apoptosis, were 2-3 times those of controls and inducible nitric oxide synthase levels were 4 times greater than normal. Myocardial DNA laddering, an index of apoptosis, reached 20 times the normal level. Troglitazone therapy lowered myocardial TG and ceramide and completely prevented DNA laddering and loss of cardiac function. In this paper, we conclude that cardiac dysfunction in obesity is caused by lipoapoptosis and is prevented by reducing cardiac lipids. The recent increase in juvenile-onset obesity in the United States (1) predicts that the next generation of obese Americans will have been obese longer than ever before. This portends a higher prevalence of time-dependent complications of the disease, such as insulin resistance, non-insulin-dependent diabetes mellitus, hypertension, coronary artery disease, and other cardiac disorders. The etiology of these complications, which are often grouped together under the term ''metabolic syndrome X'' (2), is not known.We have proposed that the excessive deposition of triacylglycerol (TG) in nonadipose tissues (steatosis) enlarges the intracellular pool of fatty acyl-CoA, thereby providing substrate for nonoxidative metabolic pathways, such as ceramide synthesis, that lead to cell dysfunction and death through apoptosis (3). It seemed possible that this sequence of events, established in the pancreatic islets of genetically obese Zucker Diabetic Fatty (ZDF) rats ( fa͞fa), could also take place in other tissues such as the heart. Obesity-related heart disease, the most serious complication of human obesity, generally is attributed to coexisting disorders such as coronary artery disease and hypertension. Cardiac dysfunction, arrhythmias, cardiomyopathy, and congestive heart failure are seldom ascribed to the direct consequences of obesity, i.e., fatty acid (FA) overload of cardiac myocytes, although the literature does contain clinical reports of cardiomyopathy of obesity that can be reversed by weight loss (4).This study was designed to test the possibility that the same metabolic abnormalities that cause lipotoxicity and lipoapoptosis in the pancreatic  cells of obese rats (3) might also compromise the function and viability of their myocardial cells. We used rats with obesity resulting from a loss-of-function mutation in the leptin receptor (5, 6), the ZDF ( fa͞fa) rat. We observed in their fat-laden hearts evidence of lipoapoptosis accompanied by a profound loss of cardiac function. These abnormalities were completely prevented by antisteatotic therapy. The striking benefit of such therapy on cardiac function in obese rats warrants an effort to determine whether a counterpart of this disorder ...
Carbapenems (imipenem, meropenem, biapenem, ertapenem, and doripenem) are β-lactam antimicrobial agents. Because carbapenems have the broadest spectra among all β-lactams and are primarily used to treat infections by multi-resistant Gram-negative bacteria, the emergence and spread of carbapenemases became a major public health concern. Carbapenemases are the most versatile family of β-lactamases that are able to hydrolyze carbapenems and many other β-lactams. According to the dependency of divalent cations for enzyme activation, carbapenemases can be divided into metallo-carbapenemases (zinc-dependent class B) and non-metallo-carbapenemases (zinc-independent classes A, C, and D). Many studies have provided various carbapenemase structures. Here we present a comprehensive and systematic review of three-dimensional structures of carbapenemase-carbapenem complexes as well as those of carbapenemases. We update recent studies in understanding the enzymatic mechanism of each class of carbapenemase, and summarize structural insights about regions and residues that are important in acquiring the carbapenemase activity.
BackgroundMilitary conflict has been a major challenge in the detection and control of emerging infectious diseases such as malaria. It poses issues associated with enhancing emergence and transmission of infectious diseases by destroying infrastructure and collapsing healthcare systems. The Orakzai agency in Pakistan has witnessed a series of intense violence and destruction. Military conflicts and instability in Afghanistan have resulted in the migration of refugees into the area and possible introduction of many infectious disease epidemics. Due to the ongoing violence and Talibanization, it has been a challenge to conduct an epidemiological study.Methodology/Principal FindingsAll patients were sampled within the transmission season. After a detailed clinical investigation of patients, data were recorded. Baseline venous blood samples were taken for microscopy and nested polymerase chain reaction (nPCR) analysis. Plasmodium species were detected using nested PCR (nPCR) and amplification of the small subunit ribosomal ribonucleic acid (ssrRNA) genes using the primer pairs. We report a clinical assessment of the epidemic situation of malaria caused by Plasmodium vivax (86.5%) and Plasmodium falciparum (11.79%) infections with analysis of complications in patients such as decompensated shock (41%), anemia (8.98%), hypoglycaemia (7.3%), multiple convulsions (6.7%), hyperpyrexia (6.17%), jaundice (5%), and hyperparasitaemia (4.49%).Conclusions/SignificanceThis overlooked distribution of P. vivax should be considered by malaria control strategy makers in the world and by the Government of Pakistan. In our study, children were the most susceptible population to malaria infection while they were the least expected to use satisfactory prevention strategies in such a war-torn deprived region. Local health authorities should initiate malaria awareness programs in schools and malaria-related education should be further promoted at the local level reaching out to both children and parents.
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