A system using immobilized enzyme according to Oki et al., [Biol. Pharm. Bull. ,-(3) +*2.ῌ+*21 (,***)], which mimics the small intestinal membrane, was applied to the screening of several kinds of vegetables, fruits and herbs in terms of their inhibitory e#ects on a-glucosidase (AGH). AGH was partially purified from hog intestinal membrane by salting out, followed by immobilization on CNBr-activated Sepharose .B as a matrix. As substrate, p-nitrophenyl-aD -glucopyranoside (PNPG) was employed, producing p-nitrophenol (p-NP) by enzymic hydrolysis. Seven vegetables (Japanese radish, cabbage, onion, Chinese cabbage, tomato, cucumber, and carrot), / fruits (mandarin, apple, watermelon, melon, and grapefruit) and. herbs (Italian parsley, rucola, mache, and dill) were subjected to evaluations of the inhibitory e#ect on AGH. All of the test samples exerted an inhibitory e#ect on immobilized AGH (iAGH). Raw Chinese cabbage and boiled tomato among vegetables, mandarin among fruits and dill among herbs exerted the strongest inhibitory e#ect on iAGH.
BACKGROUND:The relationships between possible physiological properties of insoluble fibre and the viscosity of digesta are poorly understood. The aim of this study was to investigate the effect of insoluble fibres with different water-holding capacity, swelling, oil-holding capacity and cation exchange capacity on gastric, small intestinal and caecal contents in rats fed a semi-purified diet containing either no fibre (control), 50 g kg −1 tossa jute fibre or 50 g kg −1 shiitake fibre.
Purposes
We examined how changes in left ventricular (LV) global longitudinal strain (GLS) were associated with prognosis in patients with preserved LV ejection fraction (LVEF) after congestive heart failure (HF) admission.
Methods
We studied 123 consecutive patients (age 70 ± 15 years, 55% male) who had been hospitalized due to congestive HF with preserved LVEF (> 50%). The exclusion criteria were atrial fibrillation and inadequate echo image quality for strain analyses. The patients underwent speckle-tracking echocardiography and measurement of plasma NT-ProBNP levels on the same day at the time of hospital admission as well as in the stable condition after discharge. Differences in GLS, LVEF and NT-ProBNP (delta GLS, LVEF and NT-ProBNP ; 2nd – 1st measurements) were calculated. The study end points were all-cause mortality and cardiac events.
Results
Mean periods of echo performance after hospitalization were 2 ±1days (1st echo) and 240 ± 289 days (2nd echo), respectively. During the follow-up (974 ± 626 days), 12 patients died and 25 patients were hospitalized because of HF worsening. In multivariate analysis, delta GLS and follow-up GLS were prognostic factors, whereas baseline and follow-up LVEF, NT-ProBNP, changes in LVEF and NT-ProBNP could not predict cardiac events. Delta GLS (p = 0.002) turned out to be the best independent prognosticator. Receiver operating characteristics analysis revealed that -0.6% of delta GLS was the optimal cut-off value to predict cardiac events and mortality (sensitivity 76%, specificity 67%, AUC 0.75). Kaplan-Meier analysis showed that patients with delta GLS more than -0.6% experienced significantly less cardiac events during the follow-up period (p < 0.0001, log-rank).
Conclusion
A change in LV GLS after congestive HF admission was a predictor of the prognosis in patients with preserved LVEF. It would be useful to check the changes in GLS in those with preserved LVEF after discharge.
Background: While the number of patients with aortic regurgitation (AR)
has been increasing in the aging society, its etiologies remain to be
fully elucidated. Methods: We studied consecutive 126 patients with
chronic moderate or severe AR who underwent TEE. After the study
subjects were divided into 2 groups by the age of 65 years, AR etiology
was examined in each group. Results: In the older group (n = 85), cusp
bending was the most frequent cause of AR (48.2%), and right coronary
cusp (RCC) was the most common (90.2%). In the younger group (n=41),
bicuspid valve was the most frequent cause (36.5%), and cusp bending
was less frequent (16.5%). Multivariate analysis revealed that age was
the only factor associated with cusp bending. Conclusion: Cusp bending
of RCC was the most frequent etiology of AR in the elderly. Because AR
caused by cusp bending has a possibility to be mended by aortic plasty,
it is important to detect it by TEE especially in the older patients.
An 81-year-old man was transferred to our institution by ambulance because of poor feeding, general fatigue and slight disorientation lasting for a week. On arrival, he was awake and able to speak, however, his blood pressure was low at 61/43 mmHg in spite of his medical history of hypertension. His ECG showed abnormal Q waves and ST elevation in II, III, aVF leads. The echo exam detected severe hypokinesis in the left ventricular inferior wall and reduced ejection fraction at 30%. Pericardial effusion was not observed in the first echo exam. The patient was diagnosed as cardiogenic shock due to recent inferior myocardial infarction. Coronary angiography was performed, which detected total occlusion of mid right coronary artery, followed by a successful percutaneous coronary intervention (PCI) with a drug-eluting stent under the support of intra-aortic balloon pumping. Nevertheless, his blood pressure remained low and intravenous adrenaline administration was necessary during and even after PCI. To detect the cause of prolonged low blood pressure, echo was performed again immediately after PCI. The echo exam detected new findings: right ventricular posterior free wall was dissected and abnormal shunt flows were obviously observed from left ventricle to right atrium through the dissection cavity during systole. An urgent surgical repair was considered as the only option for his survival, however, his family did not accept it because the operation itself was too risky. On the next day of his admission, he passed away. Right ventricular free wall dissection is a very rare but fatal complication after inferior myocardial infarction, nevertheless, we could detect it by echocardiography with clearly recorded images.
Abstract P251 Figure.
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