In recent years, the potential of oral care in preventing aspiration pneumonia has been recognized.Consuming drinks is thought to be an easy and effective method of oral care, and the antibacterial activities of various drinks have been examined.However, the side effects associated with, for example, caffeine as an ingredient in tea (e.g.sleep disorders) need to be taken into consideration.As yet, a safe caffeine-free tea to be taken orally to prevent aspiration pneumonia has not been reported.Thus, in the present study we evaluated the antibacterial effects of hot water extracts of four teas, namely Hypericum erectum, Crataegus cuneata, Rosa canina, and Matricaria rectita, thought to be caffeine-free.The effects of the extracts against 19 bacteria and 1 fungus were investigated by the dilution plate technique.In addition, the components of the teas were analyzed by HPLC analysis.The strongest antibacterial activity was observed for the hot water extract of H. erectum, which exhibited signi cant activity against oral bacteria, including Streptococcus oralis.However, the H. erectum extract did not kill microbiota, such as Escherichia coli and Lactobacillus casei.Neither hypericin nor caffeine, both of which have notable side effects, were detected in the H. erectum extract following HPLC analysis.These results suggest that H. erectum tea may be a good candidate for simple, safe oral care to prevent aspiration pneumonia in the elderly.
Background— Left atrial (LA) remodeling is a factor in atrial fibrillation (AF) recurrence after pulmonary vein catheter ablation (CA), but right atrium (RA) remodeling has not been investigated for possible associations to AF recurrence. Methods and Results— Using 64-slice multidetector computed tomography, RA and LA volumes were measured 3-dimensionally before CA in 65 patients with initially proven idiopathic paroxysmal AF (mean age, 60±10 years, 81.5% men). The CA procedure was guided by CARTO Merge atrial electroanatomic mapping. Sixteen patients (24.6%) had AF recurrence within the 6-month period after the CA. The recurrence was associated with a large RA volume [odds ratio, 1.04; 95% confidence interval (CI), 1.02 to 1.07, P <0.0001], a large LA volume with 1.04 [95% CI, 1.01 to 1.06, P =0.002], and low LA mean voltage with 1.03 [95% CI, 1.01 to 1.05, P =0.002]. After adjustment for potential confounding variables, RA and LA volumes remained predictive of AF recurrence. Large atrial volumes (mL) (RA ≥87 or LA ≥99) predicted AF recurrence (sensitivity of RA volume: 81.3% in 13 of 16 patients with AF recurrence; specificity: 75.5% in 37 of 49 patients without AF recurrence; sensitivity of LA volume: 81.3% in 13 of 16 patients with AF recurrence; specificity: 69.4% in 34 of 49 patients without AF recurrence), and the combined estimate of both atrial volumes was incremental and additive prognostic power (sensitivity: 75% in 12 of 16 patients with AF recurrence; specificity: 93.9% in 46 of 49 patients without AF recurrence). Conclusions— Both LA and RA remodeling are equally associated with post-CA AF recurrence.
The aim of this study was to evaluate the relationship between congestive heart failure (CHF) and atrial fibrillation (AF) using iodine-123 metaiodobenzylguanidine (MIBG) scintigraphic imaging. Ninety-two AF patients (47 male and 45 female patients ; mean age, 67±13 years) who did not suffer from structural heart disease or myocardial ischemia underwent MIBG scintigraphy. Global MIBG uptake was assessed by measuring the heart-to-mediastinal ratio (H/M) and washout rate (WR) on planar images, and the abnormal score (AS) was calculated on delayed MIBG single photon emission computed tomography images. Echocardiography was performed within a week after MIBG scintigraphy, to measure left ventricular ejection fraction (EF) and deceleration time (DT) . The AF patients were divided into four groups : patients with permanent AF with (n = 23, group A) or without (n = 19, group B) a history of CHF, and patients with paroxysmal AF with (n =19, group C) or without (n = 39, group D) a history of CHF. Results : The H/M ratio was significantly lower in group A than in other groups (2.0 ± 0.6 vs. group B : 2.7 ± 0.6, group C : 2.3 ± 0.5, and group D : 2.6 ± 0.8, P < 0.05), and in group C than in group D (P < 0.05) . Similarly, the WR was significantly higher in group A than in groups B and C (45.9 ±2.0 vs. group B : 38.9 ± 1.9 and group C : 38.4 ± 2.3, P < 0.05) . The AS was the highest in group A (19.7 ± 8.2 vs. group B : 7.1 ± 6.6, P < 0.01; group C : 11.6 ± 10.6 and group D : 13.5 ± 9.0, P < 0.05) . The DT was significantly longer in group A than in groups B and D (222.0 ± 59.4 vs. group B : 179.5 ± 49.1, P < 0.05 and group D : 177.9 ± 37.1, P < 0.01), but did not differ between groups A and C (222.0 ± 59.4 vs. 197.4 ± 51.1) . There was no difference in EF among the groups. Although CHF with AF is associated with diastolic dysfunction, the progression to permanent AF from paroxysmal AF with CHF might be caused mainly by sympathetic nerve abnormality.
We investigated whether right atrial (RA) volume could be used to predict the recurrence of atrial fibrillation (AF) after pulmonary vein catheter ablation (CA). We evaluated 65 patients with paroxysmal AF (mean age, 60+10 years, 81.5% male) and normal volunteers (57 ± 14 years, 41.7% male). Sixty-four-slice multi-detector computed tomography was performed for left atrial (LA) and RA volume estimations before CA. The recurrence of AF was assessed for 6 months after the ablation. Both left and right atrial volumes were larger in the AF patients than the normal volunteers (LA: 99.7+33.2ml vs. 59.7+17.4ml; RA: 82.9+35.7ml vs. 43.9+12ml; P<0.0001 for both). A total of 16 patients (24.6%) showed recurrence of AF, involving both atrial volumes (LA: 125.8+36.9ml in patients AF recurrence vs. 91.1+27.1ml in 49 patients with no recurrence, P = 0.001; RA: 117.5+ 40.9ml vs. 71.6+25.5ml, P<0.0001). The sensitivity with large LA volumes (>100ml) for predicting the recurrence of AF was 81.3% in 13 of 16 patients with AF recurrence, and the specificity was 69.4% in 34 of 49 patients without recurrence. The sensitivity with large RA volumes (>87ml) was 81.3% in 13 of 16 patients with AF recurrence, and the specificity was 75.5% in 37 of 49 patients without recurrence. RA volume is a useful predictor of the recurrence of AF, similar to LA volume.
Our data shows the regional coronary artery calcium scores (lesion CAC) on multidetector computed tomography (MDCT) and the cross-section imaging on MDCT angiography (CTA) in the target lesion of the patients with stable angina pectoris who were scheduled for percutaneous coronary intervention (PCI). CAC and CTA data were measured using a 128-slice scanner (Somatom Definition AS+; Siemens Medical Solutions, Forchheim, Germany) before PCI. CAC was measured in a non-contrast-enhanced scan and was quantified using the Calcium Score module of SYNAPSE VINCENT software (Fujifilm Co. Tokyo, Japan) and expressed in Agatston units. CTA were then continued with a contrast-enhanced ECG gating to measure the severity of the calcified plaque condition. We present that both CAC and CTA data are used as a benchmark to consider the addition of rotational atherectomy during PCI to severely calcified plaque lesions.
This study compared steady-state free precession (SSFP) with Fast Low Angle Shot (FLASH) at 3.0 T cardiac Cine MRI with respect to contrast to noise ratio (CNR) and visual image quality assessment. All images were acquired on a 3.0-T Siemens MAGNETOM trio. Seven healthy volunteers (all males, mean age 32.5 ± 7.1 years) underwent magnetic resonance imaging using SSFP and FLASH sequence on the same day. For both SSFP and FLASH imaging, 8-mm thick short axis and long axis views were acquired with equal matrix size (192 × 192). CNR calculations were performed on the short axis images acquired at end systole time points. Three radiologists independently assessed image quality. SSFP images were superior to FLASH images with respect to CNR (SSFP: 7.14 ± 2.16, FLASH: 3.57 ± 1.83, P < 0.001). In image quality, SSFP images were superior to FLASH in both short and long axis views (P < 0.01). Although SSFP images contained dark blood artifacts in 3 cases, these images were improved by frequency offset. SSFP sequences provided higher quality images than FLASH sequences, and would be available for cardiac cine MRI at 3.0 T.
In the previous study, we determined the in vivo binding parameters of valproic acid to serum proteins in seven healthy young adults at steady-state. In this study, we determined the effects of serum protein binding on hepatic elimination with the use of observed data obtained from our previous study of valproic acid. A regression analysis between the binding parameters and the pharmacokinetic parameters was performed. In addition, the relationship between each pharmacokinetic parameter was also analyzed. The order of association constant (K) for valproic acid-serum protein was 10(-2) l/mumol. No significant correlation was found between the binding parameters and the rate of elimination. On the other hand, the average unbound serum concentration was found to be a significantly negative correlation with the unbound (intrinsic) clearance (p = 0.0082). The product of association constant and concentration of free protein (P) correlated positively with the unbound clearance (p = 0.0233) and negatively with the average unbound and total serum concentrations (p = 0.0021 and p = 0.0029, respectively). The results indicate that the membrane permeability of valproic acid is high and that the increase of unbound clearance accompanies directly the decrease of the average unbound and total serum concentrations. Consequently, the KP values are proportional to the unbound clearance due to the rapid changes of the concentration of free protein. Therefore, the dissociation of the valproic acid-serum protein complex is not a rate-limiting factor for hepatic elimination and hence the serum protein binding cannot limit the ability of the liver to extract drug from blood.
