The Nose as a Route for Therapy: Part 1. Pharmacotherapy

This article reviews nasal structure and function in the light of intranasal pharmacotherapy. The nose provides an accessible, fast route for local treatment of nose and sinus diseases, with lower doses than are necessary systemically and few adverse effects. It can also be used for other medications as it has sufficient surface area protected from local damage by mucociliary clearance, absence of digestive enzymes, responsive blood flow, and provides a rapid route to the central nervous system.

Noninvasive epi-endocardial electrocardiographic imaging of ventricular septal pacing

Noninvasive epi-endocardial ElectroCardioGraphic Imaging (ECGI) allows reconstruction of electrograms and high-resolution visualization of various isoparametric maps based on multichannel ECG recordings and tomography. We aimed to verify the ECGI accuracy during septal ventricular pacing in patients with pre-implanted pacemakers using the new ECGI algorithm.Methods. Ten patients underwent epi-endocardial ECGI mapping (Amycard 01C EP Lab, Amycard LLC, Russia - EP Solutions SA, Switzerland). The iterative Equal Single Layer algorithm (ESL-iterative) and a new Fast Route algorithm in combination with the vector approach (FRA-V) were used to reconstruct isopotential and correlation similarity maps. Geodesic distance between noninvasively reconstructed early activation zone and RV reference pacing sites were measured to evaluate the ECGI accuracy.Results. The mean (SD) geodesic distance between noninvasively identified sites and reference pacing sites was 22 (15) mm for the ESL-iterative and 12 (7) for FRA-V algorithms, median (25-75% IQR) - 23 (8-29) mm and 10 (8-14) mm, respectively. The accuracy of ECGI mapping based on the FRA-V algorithm was significantly better than ESL-iterative algorithm (p=0,01). A detailed visual analysis of correlation similarity and isopotential maps showed significantly more accurate localization of early activation zones using the new FRA-V algorithm.Conclusions. Our study showed the feasibility and accuracy of a novel epi-endocardial ECGI mapping approach to identify early activation zones during septal ventricular pacing using the new FRA-V algorithm. The FRA-V algorithm is significantly better for epi-endocardial ECGI mapping and shows a significant advantage of this technique compared to other non-invasive methods of topical diagnostics. Moreover, simultaneous beat-to-beat mapping of entire ventricular septum allows using this technique for pre-ablation evaluation of unstable and polymorphic ventricular arrhythmia exit sites.

Fast responses to images of animate and inanimate objects in the nonhuman primate amygdala

Visual information reaches the amygdala through the various stages of the ventral visual stream. There is, however, evidence that a fast subcortical pathway for the processing of emotional visual input exists. To explore the presence of this pathway in primates, we recorded local field potentials in the amygdala of four rhesus monkeys during a passive fixation task showing images of ten object categories. Additionally, in one of the monkeys we also obtained multi-unit spiking activity during the same task. We observed remarkably fast medium and high gamma responses in the amygdala of the four monkeys. These responses were selective for the different stimulus categories, showed within-category selectivity, and peaked as early as 60 ms after stimulus onset. Multi-unit responses in the amygdala were lagging the gamma responses by about 40 ms. Thus, these observations add further evidence that selective visual information reaches the amygdala of nonhuman primates through a very fast route.

Noninvasive epi-endocardial electrocardiographic imaging of ventricular septal pacing

Noninvasive epi-endocardial ElectroCardioGraphic Imaging (ECGI) allows reconstruction of electrograms and high-resolution visualization of various isoparametric maps based on multichannel ECG recordings and tomography. This study shows results of ECGI accuracy verification based on septal ventricular pacing in patients with pre-implanted pacemakers using new algorithm for solving the inverse problem of electrocardiography.Methods. 10 patients in this study underwent epi-endocardial ECGI mapping (Amycard 01C EP Lab, Amycard LLC, Russia - EP Solutions SA, Switzerland). An iterative Equal Single Layer algorithm (ESL-iterative) and new Fast Route algorithm in combination with vector approach (FRA-V) were used to reconstruct isopotential and correlation similarity maps. Geodesic distance between noninvasively reconstructed early activate zone and RV reference pacing site were measured to evaluate ECGI accuracy.Results. The mean (SD) geodesic distance between noninvasively reconstructed and reference pacing site was 22 (15) mm for ESL-iterative and 12 (7) for FRA-V algorithm, median (25-75% IQR) - 23 (8-29) mm and 10 (8-14) mm respectively. Accuracy of ECGI mapping based on FRA-V algorithm was significantly better than ESL-iterative algorithm (p=0,01). Detailed visual analysis of correlation similarity and isopotential maps showed significantly more accurate localization of early activation zones using new FRA-V algorithm.Conclusions. These results showed a possibility of novel epi-endocardial ECGI mapping to detect early activation zone during septal ventricular pacing with sufficient accuracy (median 10 mm) using new FRA-V algorithm. Therefore, FRA-V algorithm is significantly better for epi-endocardial ECGI mapping and shows a significant advantage of this technique compared to other non-invasive methods of topical diagnostics. Moreover, simultaneous beat-to-beat mapping of entire ventricular septum allows using of this technique for preoperative topical diagnosis of complex unstable and polymorphic ventricular arrhythmias.

Role of ring-enlargement reactions in the formation of aromatic hydrocarbons

Ring-enlargement reactions can provide a fast route towards the formation of six-membered single-ring or polycyclic aromatic hydrocarbons (PAHs).