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Minimally Invasive Procedure versus Conventional Redo Sternotomy for Mitral Valve Surgery in Patients with Previous Cardiac Surgery: A Systematic Review and Meta-Analysis

  • Muhammad Ali Tariq;Minhail Khalid Malik;Qazi Shurjeel Uddin;Zahabia Altaf;Mariam Zafar
    • Journal of Chest Surgery
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    • v.56 no.6
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    • pp.374-386
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    • 2023
  • Background: The heightened morbidity and mortality associated with repeat cardiac surgery are well documented. Redo median sternotomy (MS) and minimally invasive valve surgery are options for patients with prior cardiac surgery who require mitral valve surgery (MVS). We conducted a systematic review and meta-analysis comparing the outcomes of redo MS and minimally invasive MVS (MIMVS) in this population. Methods: We searched PubMed, EMBASE, and Scopus for studies comparing outcomes of redo MS and MIMVS for MVS. To calculate risk ratios (RRs) for binary outcomes and weighted mean differences (MDs) for continuous data, we employed a random-effects model. Results: We included 12 retrospective observational studies, comprising 4157 participants (675 for MIMVS; 3482 for redo MS). Reductions in mortality (RR, 0.54; 95% confidence interval [CI], 0.37-0.80), length of hospital stay (MD, -4.23; 95% CI, -5.77 to -2.68), length of intensive care unit (ICU) stay (MD, -2.02; 95% CI, -3.17 to -0.88), and new-onset acute kidney injury (AKI) risk (odds ratio, 0.34; 95% CI, 0.19 to 0.61) were statistically significant and favored MIMVS (p<0.05). No significant differences were observed in aortic cross-clamp time, cardiopulmonary bypass time, or risk of perioperative stroke, new-onset atrial fibrillation, surgical site infection, or reoperation for bleeding (p>0.05). Conclusion: The current literature, which primarily consists of retrospective comparisons, underscores certain benefits of MIMVS over redo MS. These include decreased mortality, shorter hospital and ICU stays, and reduced AKI risk. Given the lack of high-quality evidence, prospective randomized control trials with adequate power are necessary to investigate long-term outcomes.

Study on analytical method of fluoroquinolone residues in eggs by LC/MS/MS (LC/MS/MS를 이용한 식용란 중 fluoroquinolone계 항균물질의 분석법에 관한 연구)

  • Choi, You-Jeong;Yun, I-Ran;Nam, Sang-Yun;Park, Young-Ho;Kim, Byeong-Hun;Son, Seong-Gi
    • Korean Journal of Veterinary Service
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    • v.30 no.1
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    • pp.13-21
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    • 2007
  • An atmospheric pressure chemical ionization (APcI) LC/MS/MS method was developed for the simultaneous analysis of fluoroquinolones (norfloxacin, ciprofloxacin, enrofloxacin, danofloxacin) residues in eggs. The spiked and blank samples were extracted from whole eggs using 50mM phosphate buffer (pH 7.4). The extract was cleaned up by passage though $Oasis^{(R)}$ MAX extraction cartridge for solid-phase extraction followed by elution with 4% formic acid in methanol. The extract of sample was separated on a Waters $Atlantis^{TM}$ $dC_{18}$ reversed-phase column ($4.6{\times}150mm,\;5{\mu}m$) and analyzed by APcI positive mode mass spectrometry. The mobile phase consists of aqueous 0.2% nonafluoropentanoic acid (NFPA) and methanol. Multiple reaction monitoring (MRM) using the precursor to product ion combinations of m/z $320\;{\dashrightarrow}\;302,\;332\;{\dashrightarrow}\;314,\;360\;{\dashrightarrow}\;342$ and m/z $358\;{\dashrightarrow}\;340$ were used to quantify norfloxacin (NOR), ciprofloxacin (CIP), enrofloxacin (ENR) and danofloxacin (DAN), respectively. The limits of quantification (LOQ) were 7.8ppb for NOR, 8.5ppb for CIP, 8.9ppb for ENR, and 4.8ppb for DAN. Average recoveries of fortified sample at levels of 0.025 to 0.1 ppm were estimated 71.29% for NOR, 75.27% for CIP, 85.51% for ENR and 81.22% for DAN. These results could be applied for the confirmation and quantification in eggs.

Tetramine Analysis using Liquid Chromatography-Tandem Mass Spectrometry and Ion Chromatography (LC-MS/MS와 Ion Chromatography를 이용한 테트라민 분석)

  • Song, Ki-Cheol;Lee, Ka-Jeong;Kim, Ji-Hoe;Yoon, Ho-Dong;Yu, Hong-Sik;Mok, Jong-Soo
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.44 no.1
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    • pp.45-49
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    • 2011
  • As a first step toward identifying a new method for testing sea snail tissue for toxins, and thus prevent food poisoning due to the ingestion of contaminated snails, we measured the tetramine [$(CH_3)_4N^+$] contents of sea snails from the Korean coast using both liquid chromatography-tandem mass spectrometry (LC-MS/MS) and ion chromatography. For tetramine tested, good linearity ($r^2$ = 0.9996) was observed between the amounts in the injected samples and the peak areas of standard toxins, which ranged from 0.1 to 100 ng. The recovery (%) of tetramine from spiked tissue and mid-gut gland samples ranged from 84.0 to 95.3%. The quantitative results for tetramine using this method were in good agreement with the theoretical values. LC-MS/MS has both high sensitivity and selectivity, which makes it possible to measure trace quantities of tetramine in samples.

Effect of Artificial Soils and Aqueous Solutions for Plantlet Acclimatization of Somatic Embryos of Aralia elata (두릅나무 체세포배 유래 소식물체의 순화에 미치는 배양토 및 공급액의 효과)

  • 문흥규;배찬호;김용욱;이재순;이재선
    • Korean Journal of Plant Tissue Culture
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    • v.28 no.5
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    • pp.273-276
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    • 2001
  • In order to develop effective acclimatization methods for Aralia elata plantlets regenerated from somatic embryos, various acclimatizing conditions were compared regarding both survival rate and growth of the plantlets. The plantlets were transplanted into plastic boxes containing artificial soil in the presence of either several levels of MS liquid media, distilled water, 2% sucrose or 0.1% hyponex solution. They were then cultured by spraying of distilled water twice a week and maintained in the normal tissue culture room. Perlite was proved to be better than vermiculite on survival rate and growth of the plantlets. As the size of perlite (larger than 0.2 cm in diameter) increased, both the survival rate and growth of the plantlets improved. Among the various MS liquid media and different aqueous solutions tested, distilled water appeared to result in the best survival rate and growth. MS media were also effective in increasing survival rate and supporting growth when diluted to 1/4 and/or 1/8. The acclimatized plantlets could be transplanted directly onto the nursery bed and grown normally. The above results suggest that plantlets regenerated from somatic embryos of Aralia elata be effectively acclimatized using a plastic box containing perlite with distilled water treatment.

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Rapid Determination of Caffeine in Forensic Aqueous Sample by Dilute and Shoot LC-MS/MS (시료 희석 직접 주입 LC-MS/MS를 이용한 법화학 수용액 시료 중 카페인 신속 분석)

  • Choi, Yun Jeong;Kim, Hee Seung;In, Moon Kyo;Kim, Jin Young
    • YAKHAK HOEJI
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    • v.60 no.3
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    • pp.112-117
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    • 2016
  • A liquid chromatography-tandem mass spectrometry (LC-MS/MS) method was developed and validated for the determination of caffeine in forensic aqueous sample. The centrifuged sample ($100{\mu}l$) was diluted 50-fold with distilled water. The diluted sample ($400{\mu}l$) was then diluted further with $200{\mu}l$ of 0.1% formic acid solution and $400{\mu}l$ of acetonitrile containing 500 ng of caffeine-(3-methyl-$^{13}C_3$) prior to LC-MS/MS analysis. The mobile phase was composed of 0.1% formic acid in distilled water (A) and acetonitrile (B). Chromatographic separation was performed by using a Zorbax SB-C18 ($100mm{\times}2.1mm$ i.d., $3.5{\mu}m$) column and caffeine was eluted within 1.1 min. Linear least-squares regression with a 1/x weighting factor was used to generate a calibration curve with the coefficients of determination ($r^2=0.9983$). The lower limit of quantification was $25ng/ml$ for the analyte. The process efficiency was 98.6~100.1%. Intra- and inter-day precisions were not more than 2.1% and 1.7%, while intra- and inter-day accuracies were ranged from -6.8 to 4.5%, respectively. The suitability of the method was examined by analyzing unknown forensic aqueous samples.

Development of a Sensitive Analytical Method of Polynemoraline C Using LC-MS/MS and Its Application to a Pharmacokinetic Study in Mice

  • Pang, Minyeong;Lee, Jaehyeok;Jeon, Ji-Hyeon;Song, Im-Sook;Han, Young Taek;Choi, Min-Koo
    • Mass Spectrometry Letters
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    • v.12 no.4
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    • pp.200-205
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    • 2021
  • Polynemoraline C, a pyridocoumarin alkaloid, exhibits anticholinergic, anti-inflammatory, antitumor, and antimicrobial activities. A sensitive analytical method of polynemoraline C in mouse plasma was developed and validated using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Polynemoraline C and 13C-caffeine (internal standard) in mouse plasma were extracted using a liquid-liquid extraction method coupled with ethyl acetate. This extraction method resulted in high and reproducible extraction recovery in the range of 73.49%-77.31% with no interfering peaks around the peak retention time of polynemoraline C and 13C-caffeine. The standard calibration curves for polynemoraline C were linear over the range of 0.5-200 ng/mL with r2 > 0.985. The accuracy, precision, and the stability of the data were within acceptable limits on the FDA guideline. After intravenous and oral administration of polynemoraline C at doses of 5 and 30 mg/kg, respectively, the present method was successfully applied to the pharmacokinetic study of polynemoraline C. Polynemoraline C in mouse plasma showed a multi-exponential elimination pattern with a high volume of distribution values. This compound's absolute oral bioavailability was found to be 17.0%. Polynemoraline C's newly developed LC-MS/MS method can be used for further studies on the efficacy, toxicity, and biopharmaceutics of polynemoraline C, as well as its pharmacokinetic studies.

Multi-Residue Analysis of Fipronil and Its Metabolites in Eggs by SinChERS-Based UHPLC-MS/MS

  • Han, Keguang;Hua, Jin;Zhang, Qi;Gao, Yuanhui;Liu, Xiaolin;Cao, Jing;Huo, Nairui
    • Food Science of Animal Resources
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    • v.41 no.1
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    • pp.59-70
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    • 2021
  • A method for simultaneous detection of fipronil (F) and its metabolites fipronil desulfinyl (FD), fipronil sulfide (FS), fipronil sulfone (FSO) in chicken eggs was applied and validated. It includes single-step, cheap, effective, rugged, safe-based method (SinChERS) for sample preparation and ultra high performance liquid chromatography coupled with mass spectrometry (UHPLC-MS/MS) for chemical analysis. Results suggested that formic acid enhanced the recovery of 4 target residues and 1% supplementation to acetonitrile gained higher recoveries than that of 5%. SinChERS integrated extraction and clean-up steps into one, with shorter time (1.5 h) to operate and higher recoveries (97%-100%) than HLB, Envi-Carb-NH2 and quik-easy-cheap-effective-rugged-safe method (QuEChERS), and it consumed the smallest volume of extracting solvent (10 mL) as QuEChERS. Quantitative analyses using external standard method suggested the linear ranges of 4 target compounds were 1-20 ㎍/L with R2 >0.9947. The limit of detection (S/N>3) and quantification (S/N>10) were 0.3 ㎍/kg and 1 ㎍/kg. Recoveries ranged from 89.0% to 104.4%, and the relative standard deviations (n=6) at 1, 10, and 20 ㎍/kg were lower than 6.03%. Thirty batches of domestic eggs (500 g each) were detected by the established SinChERS-based UHPLC-MS/MS and no target residues were detected in all samples. The method developed in this study is a rapid, sensitive, accurate and economic way for multi-residue analysis of fipronil and its metabolites in eggs.

Comparisons of sample preparation (acid digestion and microwave digestion) and measurement (inductively coupled plasma mass spectrometry and graphite furnace atomic absorption spectrometry) in the determination of bone lead (골중납 측정의 시료 전처리 (산분해법과 마이크로웨이브 분해법)와 측정 방법 (유도결합 플라즈마 질량분석법과 흑연로 원자 흡수 분광 광도법)의 비교)

  • Yoon, Chungsik;Choi, Inja;Park, Sungkyun;Kim, Rokho
    • Analytical Science and Technology
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    • v.16 no.2
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    • pp.152-158
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    • 2003
  • This study was conducted to evaluate two sample digestion procedures and instrumental determination parameters for analysis of lead in bone. Amputated human legs were treated by acid digestion or microwave dissolution prior to spectrometric analysis. Inductively coupled plasma mass spectrometry (ICP-MS) and graphite furnace atomic absorption spectrometry (GF-AAS) were used for determining bone lead levels. Recovery efficiencies using standard reference material from acid digestion measured by ICP-MS were in good agreement with those of the certified value, but in cases of acid digestion by GF-AAS and microwave digestion by both two methods, recovery underestimated and overestimated, respectively. For the bone samples, the lead concentrations obtained by ICP-MS after acid digestionwere in good agreement with those by GF-AAS (correlation coefficient = 0.983), but GF-AAS gave systematically higher values than ICP-MS. While a good agreement between two analytical methods after microwave digestion was also obtained (correlation coefficient = 0.950), bone lead concentrations from microwave were relatively higher than those from acid digestion. In conclusion, the use of the simple nitric acid digestion procedure at an ambient temperature coupled to ICP-MS seems to be efficient for the determination of lead in bone in consideration for both the convenience and validity.

Determination of Total Aflatoxins in Foods by Parallelism of ELISA and LC/MS/MS (ELISA-LC/MS/MS 병행에 의한 식품 중 aflatoxins 분석)

  • Kim, Kyeong-Yeol;Nam, Min-Ji;Nam, Bo-Ram;Ryu, Hee-Jung;Song, Jeong-Eon;Shim, Won-Bo;Lee, Soo-Hyung;Chung, Duck-Hwa
    • Journal of Environmental Health Sciences
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    • v.36 no.1
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    • pp.52-60
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    • 2010
  • High performance liquid chromatography (HPLC) and liquid chromatography mass spectrometry (LC/MS) have been widely used to quantify aflatoxins in food, but these methods are expensive, time-consuming, unsuitable for analysis of the routine screening of large sample numbers and require derivatization and high level techniques to perform. The objective of this study is to detect aflatoxins in a large number of foods by a high efficient analytical system of combined enzyme linked immunosorbent assay (ELISA) for screening and LC/MS/MS for confirmation. The samples spiked individually with aflatoxin $B_1$ (0.5 and 1.0 ng/g) and total aflatoxins (10 ng/g) were analyzed by ELISA and LC/MS/ MS, and the recoveries for ELISA and LC/MS/MS were 71.8~119.2% and 70.8~135.3%, respectively. A total of 378 samples (grains, nuts, soybean and fermented soybean foods, pepper and fermented pepper foods) were purchased from the six major cities in Korea and analyzed by ELISA-LC/MS/MS system. Twenty two (5.8%; peanut: 11, pistachio: 2, walnut: 6, almond: 1, pepper powder: 1, pepper paste: 1) out of 378 samples were screened as aflatoxin B1 positive by ELISA, but, 4 (1.1%; peanut: 2, pistachio:1, pepper powder: 1) out of the 22 samples screened were confirmed as aflatoxins positive at levels of 1.02~52.79 ng/g by LC/MS/MS. ELISA-LC/MS/MS system provides a more rapid, accurate and cost-effective method for the detection of aflatoxins in large number of samples.

Establishment of the Analytical Method for Residual Pharmaceuticals in Raw Water Using Online Sample Preparation and High Resolution Orbitrap LC/ESI-MS (온라인 자동화 시료 전처리 및 HR Orbitrap LC/ESI-MS를 이용한 환경시료 중 잔류 의약물질 분석방법 확립)

  • Hwang, Yoonjung;Sin, Sanghee;Park, Jongsuk
    • Journal of Korean Society on Water Environment
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    • v.29 no.3
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    • pp.409-419
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    • 2013
  • In this study, the analytical method for 27 residual pharmaceuticals in raw water was developed. Online sample preconcentration/extraction and analysis with high resolution Orbitrap mass spectrometry (LC-ESI/Orbitrap MS) were performed. The calibration curves showed good linearities (above $r^2$ = 0.998) in the range of 5 ~ 1,000 ng/L. The method detection limit and the limit of quantification were 1.1 ~ 10.0 ng/L and 3.4 ~ 31.7 ng/L, respectively. Recoveries of the target compounds were between 70.1% and 115.8% (except cefadroxil, cefradine, vancomycin, and iopromide (50.2 ~ 67.0%)). The optimized analytical method can be useful to determine the residual pharmaceuticals in raw water.