Nitric Oxide Treatment Research Articles

Synergy of Nitric Oxide and 1-Methylcyclopropene Treatment in Prolong Ripening and Senescence of Peach Fruit.

Peach is a putrescible fruit thus drastically restricting its postharvest storage life. In recent years, the application of 1-methylcyclopropene (1-MCP) and nitric oxide (NO) in postharvest fruit quality control has received considerable attention and investigative efforts due to the advantages of using relatively low concentrations and short-time treatment duration. In the present study, the effects of various 1-MCP and NO treatments on peach fruit (Prunus persica L. cv. Xiahui-8) stored at 25 °C were evaluated and compared. Results indicated that the combination treatment with both chemical agents (MN) was most effective in postponing peach ripening and preserving fruit quality, followed by 1-MCP and NO treatment alone. We also demonstrated that NO could delay fruit senescence mainly by stimulating antioxidant enzymes, while 1-MCP overly outperformed NO in the treatment of ‘Xiahui-8′ peach in slowing down respiration rate, inhibiting ethylene production, maintaining high firmness and reducing ROS content. NO treatment showed a greater influence on phenolic compounds than 1-MCP especially anthocyanins, flavanones and flavones according to LC/MS analysis. The phenolic change in MN group were highly associated to NO treatment. Through this study we provide informative physiological, biochemical and molecular evidence for the beneficial effects of the combined 1-MCP and NO treatment on peach fruit based on a functional synergy between these two chemical agents.

Postharvest nitric oxide treatment induced the alternative oxidase pathway to enhance antioxidant capacity and chilling tolerance in peach fruit

Nitric oxide (NO) is an important regulator of plant response to cold stress. In this study, NO treatment delayed the development of chilling injury (CI), inhibited the increase in H2O2 content, O2− production rate and decrease in firmness of postharvest peach fruit. Meanwhile, through RNA-seq analysis, NO treatment up-regulated gene expression of PpG-6-PDH, Pp6-PGDH and PpAOX while it down-regulated the expression of PpGPI and PpHK, suggesting that the pentose phosphate respiratory pathway and cyanide-resistant respiratory pathway were promoted and the glycolysis pathway was inhibited. Furthermore, the PpAOX expression was consistent with the trend of PpPOD1/2 expression and H2O2 content, indicating that AOX may play a role in reducing oxidative damage of peach fruit by scavenging H2O2. Thus, it was concluded that NO treatment could induce the cyanide-resistant respiration pathway to enhance antioxidant ability and chilling tolerance in post-harvest peach fruit.

HspX-mediated survival pathways of pathogenic mycobacteria.

Objectives:To optimize an enzyme-linked immunosorbent assay (ELISA) for measuring the HspX protein (α-crystallin) levels and then evaluate its correlation with the accumulation of lipid bodies in Mycobacterium bovis (M. bovis) during hypoxia and exposure to nitric oxide.Methods:This study was conducted at Prince Sultan Military Medical City, Riyadh, Saudi Arabia between 2016 and 2017. We first optimized ELISA conditions for the detection of HspX. The optimization protocol focused on minimizing concentrations of the capture antibody, detection antibody, and conjugated secondary antibody, and determining the minimum detection limit of the antigen, HspX. Bacteria were grown either in shaking culture or in stationary flasks mimicking hypoxic environments. A standard Bradford assay was used to determine the total protein and HspX was detected using the optimized ELISA protocol. The effect of hypoxic environment and nitric oxide on the levels of HspX and lipid bodies, detected by staining with Nile red, was also evaluated.Results:An optimized ELISA protocol was established for the detection of HspX from M. bovis. Exposure to nitric oxide and hypoxic conditions led to an increase in the levels of HspX protein. The increase in HspX associated with nitric oxide treatment and hypoxic conditions correlated with higher levels of lipid bodies mainly found in pathogenic mycobacteria.Conclusions:The optimized ELISA protocol in this study can detect HspX protein levels in M. bovis growing in normal and hypoxic environments. Importantly, hypoxia led to enhanced expression of HspX protein, which correlated with the enhanced production of lipid bodies. Lipid body production is a survival strategy of pathogenic mycobacteria.

Effects of nitric oxide treatment on lignin biosynthesis and texture properties at wound sites of muskmelons

Lignin is an important component of the healing tissue in fruits. In this study, we treated muskmelon (Cucumis melo L. cv. “Manao”) fruit with exogenous nitric oxide (NO) donor sodium nitroprusside (SNP) to observe and analyze its effect on lignin synthesis and accumulation during healing. Results showed that SNP treatment enhanced the contents of endogenous NO and H2O2, increased the activities of phenylalanine ammonia lyase, cinnamate 4 hydroxylase, cinnamyl alcohol dehydrogenase, and peroxidase, and raised the contents of sinapyl alcohol, coniferyl alcohol, coumaryl alcohol, and lignin. SNP augmented the hardness of the healing tissue and decreased its resilience, springiness, and cohesiveness. In addition, SNP treatment effectively reduced the weight loss and disease index of wounded muskmelons. All these results suggest that lignin metabolism mediated by NO play a crucial role in wound healing of muskmelons.

Asphyxia and Neonatal Respiratory Distress Syndrome Are Independent Predictors of the Non-response to Inhaled Nitric Oxide in the Newborns With PPHN.

Aim: Not all the neonates respond with improvement in oxygenation following inhaled nitric oxide treatment (iNO) treatment. The aim of this study was to assess the independent risk factors associated with non-response to iNO during the 2 weeks of postnatal treatment in neonates diagnosed with persistent pulmonary hypertension (PPHN).Materials and Methods: This retrospective cohort study included all newborns with PPHN who received iNO treatment for more than 24 h. Demographic, obstetric, perinatal data and clinical complications were extracted from the hospitalization records. Subjects were divided into two groups according to their response to iNO inspiration during the first 24 h of iNO treatment. No response was defined as an increase in SpO2 < 5% or the inability to sustain saturation levels in the first 24 h of iNO treatment. For descriptive statistics, χ2 and t-test analysis were used to compare categorical and continuous variables between the two groups. To evaluate independent risk factors of non-responsiveness to iNO treatment, binary logistic regression analysis were performed.Results: A total of 75 newborns were included in the study. Sixty-two cases were in the responders group, and 13 cases were in the non-responders group. Univariate analysis showed that asphyxia, neonatal respiratory distress syndrome (NRDS), pulmonary surfactant administration, meconium aspiration syndrome (MAS), the severity of pulmonary hypertension (PH), and high-frequency oscillatory ventilation (HFOV) therapy were the high-risk factors affecting the response to iNO treatment in the newborns with PPHN. The binary logistic regression analysis indicated that asphyxia and NRDS incidence were independent predictors of non-responsiveness to iNO treatment [asphyxia: OR 4.193, 95% CI 1.104–15.927, P = 0.035; NRDS: OR 0.154, 95% CI 0.036–0.647, P = 0.011]. The patients in the non-responders group had shorter iNO inspiration followed by MV duration, supplemental oxygen and hospital stay, and higher mortality. There were no significant differences in IVH, PVL, and BPD between two groups.Conclusion: In the newborns with PPHN, asphyxia and NRDS resulted as the independent risk factors of non-responsiveness to iNO therapy. Asphyxia in the newborns with PPHN is detrimental to the response to iNO treatment, while NRDS is beneficial.

Valine-Glutamine Proteins in Plant Responses to Oxygen and Nitric Oxide.

Multigene families coding for valine-glutamine (VQ) proteins have been identified in all kind of plants but chlorophytes. VQ proteins are transcriptional regulators, which often interact with WRKY transcription factors to regulate gene expression sometimes modulated by reversible phosphorylation. Different VQ-WRKY complexes regulate defense against varied pathogens as well as responses to osmotic stress and extreme temperatures. However, despite these well-known functions, new regulatory activities for VQ proteins are still to be explored. Searching public Arabidopsis thaliana transcriptome data for new potential targets of VQ-WRKY regulation allowed us identifying several VQ protein and WRKY factor encoding genes that were differentially expressed in oxygen-related processes such as responses to hypoxia or ozone-triggered oxidative stress. Moreover, some of those were also differentially regulated upon nitric oxide (NO) treatment. These subsets of VQ and WRKY proteins might combine into different VQ-WRKY complexes, thus representing a potential regulatory core of NO-modulated and O2-modulated responses. Given the increasing relevance that gasotransmitters are gaining as plant physiology regulators, and particularly considering the key roles exerted by O2 and NO in regulating the N-degron pathway-controlled stability of transcription factors, VQ and WRKY proteins could be instrumental in regulating manifold processes in plants.

Pediatrik Akut Respiratuar Distres Sendromu Tanılı Hastalarda İnhale Nitrik Oksit Kullanımının Değerlendirilmesi

Objective: Nitric oxide therapy is not routinely used in the treatment of pediatric acute respiratory distress syndrome (PARDS), but it is recommended to be used as an adjunctive therapy in some selected cases. In our study, we aimed to discuss patients with PARDS who were treated with inhaled nitric oxide (iNO) therapy. Methods: The data of patients who were hospitalized in the pediatric intensive care unit with a diagnosis of PARDS and received iNO treatment between January 2016 and January 2018 were retrospectively analyzed. Age, gender, length of stay, mortality, number of days on mechanical ventilation, use of vasoactive drugs, mortality scores, lactate levels, OI (oxygenation index), PaO2/FiO2, methemoglobin levels, iNO administration time, echocardiographic findings and underlying primary diseases were recorded. Results: It was determined that 9 patients who were followed up with the diagnosis of PARDS were given iNO treatment. Except for one patient, they were diagnosed with pneumonia developing on the basis of chronic disease and PARDS secondary to septic shock. Five patients died while receiving iNO therapy. Seven patients were ventilated with iNO in addition to conventional mechanical ventilation methods. Two patients who died were ventilated with HFOV (high frequency oscillatory ventilation). In 3 of 9 patients, inhaled nitric oxide treatment was successful. Conclusion: Although inhaled nitric oxide treatment is a known treatment used in different diseases, the level of its effect in PARDS patients continues to be investigated. We think that this treatment can be beneficial when applied in selected patients and experienced centers.

Composition and origin of lung fluid proteome in premature infants and relationship to respiratory outcome.

BackgroundInfants born at extremely low gestational age are at high risk for bronchopulmonary dysplasia and continuing lung disease. There are no early clinical biomarkers for pulmonary outcome and limited therapeutic interventions.ObjectivesWe performed global proteomics of premature infant tracheal aspirate (TA) and plasma to determine the composition and source of lung fluid proteins and to identify potential biomarkers of respiratory outcome.MethodsTA samples were collected from intubated infants in the TOLSURF cohort before and after nitric oxide treatment, and plasma was collected from NO CLD infants. Protein abundance was assayed by HPLC/tandem mass spectrometry and Protein Prospector software. mRNA abundance in mid-gestation fetal lung was assessed by RNA sequencing. Pulmonary morbidity was defined as a need for ventilatory support at term and during the first year.ResultsAbundant TA proteins included albumin, hemoglobin, and actin-related proteins. 96 of 137 detected plasma proteins were present in TA (r = 0.69, p<0.00001). Based on lung RNAseq data, ~88% of detected TA proteins in injured infant lung are derived at least in part from lung epithelium with overrepresentation in categories of cell membrane/secretion and stress/inflammation. Comparing 37 infants at study enrollment (7–14 days) who did or did not develop persistent pulmonary morbidity, candidate biomarkers of both lung (eg., annexin A5) and plasma (eg., vitamin D-binding protein) origin were identified. Notably, levels of free hemoglobin were 2.9-fold (p = 0.03) higher in infants with pulmonary morbidity. In time course studies, hemoglobin decreased markedly in most infants after enrollment coincident with initiation of inhaled nitric oxide treatment.ConclusionsWe conclude that both lung epithelium and plasma contribute to the lung fluid proteome in premature infants with lung injury. Early postnatal elevation of free hemoglobin and heme, which are both pro-oxidants, may contribute to persistent lung disease by depleting nitric oxide and increasing oxidative/nitrative stress.

Fractional exhaled nitric oxide and asthma treatment adherence.

Despite increased clinician awareness, nonadherence to inhaled corticosteroid treatment presents a major challenge to successful asthma management and risks inappropriate treatment escalation, particularly in severe disease. In patients with Type-2 mediated biology, fractional exhaled nitric oxide (FeNO) has a role in assessment and monitoring of adherence to inhaled corticosteroids. Asthmatic patients with elevated FeNO are at an increased risk of exacerbation. High FeNO is often secondary to suboptimal adherence to inhaled corticosteroid treatment, whether intentional or nonintentional. FENO-suppression can 'unmask' underlying adherence issues and is a useful test in the presence of Type-2 biology in the 'difficult-to-control' asthma population. Identification of nonadherence can improve asthma control and prevent inappropriate commencement of costly biologic therapies. Assessment of adherence and FeNO response to monitored inhaled corticosteroid in Type-2 biomarker high asthmatic individuals may prevent unnecessary escalation to biologic therapy. Establishing an 'optimised' FeNO may alert clinicians to the possibility of underlying nonadherence at future clinical assessments.

Abstract 16196: Nitric Oxide Delivery During Cardiopulmonary Bypass Reduces Acute Kidney Injury: Randomized Trial

Introduction: Acute kidney injury (AKI) is a serious complication of cardiac surgery with cardiopulmonary bypass (CPB). Postoperative AKI develops in 30% to 52% of cardiac surgery patients and 2% to 5% of these patients require renal replacement therapy. Hypothesis: We hypothesized that nitric oxide treatment during cardiac surgery with CPB can decrease AKI incidence in adult patients. The aim of study was to evaluate the effects of nitric oxide supplementation to CPB circuit on the development of cardiac surgery-associated AKI. Methods: A prospective randomized controlled study included 96 patients with moderate risk of renal complications who underwent elective cardiac surgery with CPB. The study protocol was registered at www.clinicaltrials.gov (#NCT03527381). Patients were randomly assigned to either the nitric oxide supplementation to CPB circuit (NO-treatment group, n = 48) or the usual care (control group, n = 48). 40-ppm nitric oxide was administered in NO-treatment group during the entire CPB period. The primary outcome was AKI incidence. Results: Nitric oxide treatment was associated with a significant decrease in AKI incidence (10 (20.8%) versus 20 (41.6%); RR 0.5 (95% CI 0.26-0.95; p =0.023) and a higher urine output during CPB (2.6 [2.1;5.08] versus 1.7 [0.80;2.50] mL/kg/h; p = 0.0002). Urinary neutrophil gelatinase-associated lipocalin levels were significantly lower in NO-treatment group 4 h after surgery: 1.12 [0.75;5.8] versus 4.62 [2.02;34.55] ng/mL; p = 0.005. Concentrations of nitric oxide metabolites in NO-treatment group significantly increased at 5 min post-clamping, 5 min after declamping, and at the end of surgery. The concentrations of proinflammatory and anti-inflammatory mediators and free plasma hemoglobin did not significantly differ between groups. Conclusions: Nitric oxide administration to patients at moderate risk of renal complications undergoing elective cardiac surgery with CPB was associated with a decrease in AKI incidence. The implications of study for clinical practice expand the array of methods, which may be used for prevention of AKI in cardiac surgery patients.

Implication of inhaled nitric oxide for the treatment of critically ill COVID-19 patients with pulmonary hypertension.

AimsThis study aims to analyse whether inhaled nitric oxide (iNO) was beneficial in the treatment of coronavirus disease 2019 (COVID‐19) patients with pulmonary hypertension.Methods and resultsFive critically ill COVID‐19 patients with pulmonary hypertension designated Cases 1–5 were retrospectively included. Clinical data before and after iNO treatment were serially collected and compared between patients with or without iNO treatment. The five cases experienced pulmonary artery systolic pressure (PASP) elevation (≥50 mmHg) at 30, 24, 33, 23, and 24 days after illness onset (d.a.o), respectively. Cases 1–3 received iNO treatment on the 24th, 13th, and 1st day after the first elevation of PASP, with concentrations varied from 10 to 20 ppm based on the changes of PASP and blood pressure for 10, 9, and 5 days, respectively. Upon iNO treatment, PASP of Cases 1 and 2 returned to normal on the 10th day and 1st day, and maintained between 50 and 58 mmHg in Case 3. Pa02/Fi02 increased from 88 to 124, 51 to 118, and 146 to 244, respectively. SPO2 increased from 91% to 97% for Case 1 and maintained a high level above 97% for Case 2. Cardiac function remained normal in the three patients after treatment. Moreover, Cases 1 and 3 survived from severe acute respiratory syndrome coronavirus 2 infection, while Case 2 finally died on the 36th day after the first elevation of PASP due to severe complications. Both cases who did not receive iNO treatment experienced a sudden decrease of PASP and Pa02/Fi02 due to right heart failure and then died.ConclusionsInhaled nitric oxide treatment was beneficial in reducing and stabilizing the PASP and might also reduce the risk of right heart failure in COVID‐19 with pulmonary hypertension.

Rescue Treatment With High-Dose Gaseous Nitric Oxide in Spontaneously Breathing Patients With Severe Coronavirus Disease 2019.

Retrospective evaluation of coronavirus disease 2019 patients in respiratory distress receiving nitric oxide gas as rescue therapy. Massachusetts General Hospital, between March 18, 2020, and May 20, 2020, during the local coronavirus disease 2019 surge. Coronavirus disease 2019 patients at high risk for acute hypoxemic respiratory failure with worsening symptoms despite use of supplemental oxygen and/or awake proning. Patients received nitric oxide at concentrations of 160 ppm for 30 minutes twice per day via a face mask until resolution of symptoms, discharge, intubation, or the transition to comfort measures only. Between March 18, 2020, and May 20, 2020, five patients received nitric oxide inhalation as a rescue therapy for coronavirus disease 2019 at Massachusetts General Hospital. All received at least one dosage. The three patients that received multiple treatments (ranging from five to nine) survived and were discharged home. Maximum methemoglobin concentration after 30 minutes of breathing nitric oxide was 2.0% (1.7-2.3%). Nitrogen dioxide was below 2 ppm. No changes in mean arterial pressure or heart rate were observed during or after nitric oxide treatment. Oxygenation and the respiratory rate remained stable during and after nitric oxide treatments. For two patients, inflammatory marker data were available and demonstrate a reduction or a cessation of escalation after nitric oxide treatment. Nitric oxide at 160 ppm may be an effective adjuvant rescue therapy for patients with coronavirus disease 2019.

Control of systemic inflammation through early nitric oxide supplementation with nitric oxide releasing nanoparticles

Amelioration of immune overactivity during sepsis is key to restoring hemodynamics, microvascular blood flow, and tissue oxygenation, and in preventing multi-organ dysfunction syndrome. The systemic inflammatory response syndrome that results from sepsis ultimately leads to degradation of the endothelial glycocalyx and subsequently increased vascular leakage. Current fluid resuscitation techniques only transiently improve outcomes in sepsis, and can cause edema. Nitric oxide (NO) treatment for sepsis has shown promise in the past, but implementation is difficult due to the challenges associated with delivery and the transient nature of NO. To address this, we tested the anti-inflammatory efficacy of sustained delivery of exogenous NO using i.v. infused NO releasing nanoparticles (NO-np). The impact of NO-np on microhemodynamics and immune response in a lipopolysaccharide (LPS) induced endotoxemia mouse model was evaluated. NO-np treatment significantly attenuated the pro-inflammatory response by promoting M2 macrophage repolarization, which reduced the presence of pro-inflammatory cytokines in the serum and slowed vascular extravasation. Combined, this resulted in significantly improved microvascular blood flow and 72-h survival of animals treated with NO-np. The results from this study suggest that sustained supplementation of endogenous NO ameliorates and may prevent the morbidities of acute systemic inflammatory conditions. Given that endothelial dysfunction is a common denominator in many acute inflammatory conditions, it is likely that NO enhancement strategies may be useful for the treatment of sepsis and other acute inflammatory insults that trigger severe systemic pro-inflammatory responses and often result in a cytokine storm, as seen in COVID-19.

Exogenous nitric oxide reduces postharvest anthracnose disease and maintains quality of custard apple (Annona squamosa L.) fruit during ripening

Custard apple is the most delicious fruit of tropical and subtropical areas. The storage life of custard apple is very limited due to fast ripening and attack of several diseases after harvesting. Anthracnose caused by the fungus Colletotrichum gloeosporioides is the most damaging postharvest disease of custard apple. The effects of postharvest nitric oxide (NO) treatment on anthracnose disease and quality of custard apple were investigated in this study. The fruit were dipped in 50, 100 and 200 µM sodium nitroprusside (SNP), the NO-donor compound, and stored for 8 days at 25 °C. The results showed that custard apple treated with 100 µM SNP treatment significantly reduced anthracnose disease incidence (97.25%) and disease severity (92.88%) after 8 days of storage. However, SNP did not exhibit substantial effect on mycelial growth and spore germination of C. gloeosporioides. Custard apple treated with SNP effectively reduced weight loss and total soluble solids. SNP treatment retained a higher level of firmness, titratable acidity, ascorbic acid and total phenolics compared to the control fruit. Additionally, the same treatment enhanced DPPH and FRAP antioxidant activities of custard apple. These results indicated that exogenous NO treatment could be a promising approach to increase resistance against fungal pathogens and maintain postharvest quality of custard apple.

Effects of nitric oxide treatment on flavour compounds and antioxidant enzyme activities of button mushroom (Agaricus bisporus) during storage

Abstract Button mushroom (Agaricus bisporus) is sold well for its unique flavour and nutritional benefits. However, the mushroom flavour deteriorates quickly during storage because of its delicate structure and high moisture. In this study, the effects of nitric oxide (NO) application on flavour compounds and antioxidant enzyme activities of stored button mushrooms were investigated. The button mushrooms were immersed in the NO donor sodium nitroprusside (15 μmol/L) for 3 min and then stored under the condition of 4 °C, 90% relative humidity for 12 days. Results showed that the treated mushrooms have reduced weight loss rate, uniform white colour, and higher firmness during storage. Compared to the control, the ketones, alcohols, esters, and aldehydes in the NO-treated button mushroom increased sharply at 3 days of storage and then showed a continuing decline trend, except ester compounds which reached the peak value at 6 days of storage. In addition, NO treatment increased the total phenolics and catalase activity and inhibited the polyphenol oxidase activity in the stored button mushroom. These results indicated that NO treatment is an alternative storage technology to enhance antioxidant capacity and maintain flavour and consumer acceptance of stored button mushroom.

Pre-storage nitric oxide treatment enhances chilling tolerance of zucchini fruit (Cucurbita pepo L.) by S-nitrosylation of proteins and modulation of the antioxidant response

Abstract Nitric oxide (NO), a major signalling molecule with various physiological functions in plants, participates in many responses to abiotic disorders such as cold stress. Chilling injury (CI) is the most costly postharvest problem in zucchini fruit (Cucurbita pepo L.), since it diminishes market acceptability and shelf life. This study investigates the effect of NO treatment on zucchini fruit during postharvest cold storage. Fruit were dipped in an aqueous solution of sodium nitroprusside (SNP; 25, 100, and 500 μM) as a NO donor and in potassium ferricyanide (a structural analogue of SNP) and distilled water, both used as controls and responding the same during postharvest cold storage. The results showed that the application of 25 μM SNP treatment reduced weight loss and CI in zucchini fruit during cold storage. S-nitrosylated proteins detected in the exocarp of NO-treated fruit were more abundant than in non-treated fruit. The application of SNP improved the quality of zucchini fruit stored at 4 °C, with a reduction of weight loss, electrolyte leakage, content of malondialdehyde and H2O2, and delayed loss of firmness during cold storage. NO-treated fruit showed a higher activity of superoxide dismutase, ascorbate peroxidase, glutathione reductase, and phenylalanine ammonia lyase during the first days of cold storage. Total antioxidant capacity was higher in the NO-treated fruit during the first days of cold storage, supported also by higher concentrations of phenols. NO appeared to play a regulatory role in the antioxidant balance in zucchini fruit, maintaining the cellular redox homeostasis and thus modulating ROS toxicity, thereby improving fruit quality during cold conservation.

Comparing the efficiency of conventional and novel methods of virus elimination using molecular techniques

Viral pathogens significantly affect pear growth and reduce annual production across the world. This study aimed to examine whether conventional virus elimination methods, including thermotherapy (0, 7, 14 and 21 d at 38 °C), meristem culture (less than 0.2 mm, between 0.2 to 0.7 mm and larger than 0.7 mm) and adventitious shoot regeneration from leaf explants can lead to virus-free pear seedlings when compared to chemotherapy (sodium nitroprusside (SNP); 0, 10, 17, 25, 50 and 70 μM). Five pear cultivars (“Abate Fetel”, “Beiruti”, “Dargazi”, “Coscia” and “Louise Bonne”) were investigated to check if those treatments are capable of eliminating three key viruses in pear, namely Apple chlorotic leaf spot virus (ACLSV), Apple stem pitting virus (ASPV) and Apple stem grooving virus (ASGV). The plant’s infection to the viruses was examined using reverse transcription polymerase chain reaction (RT-PCR), followed by applying the treatments, meristem culture and in vitro cultivation. Results surprisingly showed a direct relationship between an increase in duration of thermotherapy and virus elimination. Moreover, it was shown that small size of the cultivated meristem increased the rate of virus elimination, even though the responses were different in terms of the cultivars and viruses. Shoot regeneration had very low efficiency in leaf explants as it could only eliminate ASPV from pear explants. Interestingly, the experiment demonstrated that nitric oxide treatments were more effective in virus elimination than the other treatments. A year later, samples that were diagnosed virus-free were proliferated, rooted and transferred into pots to be used for later propagation and establishment of a mother orchard.

Clinical Status of Inhaled Nitric Oxide Treatment in Infants with Persistent Pulmonary Hypertension of the Newborn in Korea: Post-Marketing Surveillance Results

Clinical Status of Inhaled Nitric Oxide Treatment in Infants with Persistent Pulmonary Hypertension of the Newborn in Korea: Post-Marketing Surveillance Results

Wax Apple (Syzygium samarangense (Blume) Merr. &amp; L.M. Perry): A Comprehensive Review in Phytochemical and Physiological Perspectives

Wax apple (&lt;em&gt;Syzygium samarangense&lt;/em&gt; (Blume) Merr. &amp;amp; L.M. Perry) is a tropical non-climacteric fruit and belongs to &lt;em&gt;Myrtaceae&lt;/em&gt;. It has high diversity in cultivars, metabolite content, and its biological activities. In this comprehensive review, research findings had revealed that various metabolites found in the wax apple have biological activities. The said biological activities such as: antioxidant, immunomodulatory, antibacterial, anticancer, anti-glycation, anti-inflammation, anti-hypertriglyceridemic, anti-hyperglycemic, relaxant, and spasmolytic activities. Other potential use for the metabolites also includes the treatments for neurodegenerative abnormality, analgesic, and central nervous system (CNS) depression agent. Furthermore, wax apple physiological and phytochemical characteristics can be enhanced by girdling technique, hydrogen peroxide treatment, plant growth regulators treatment, and fruit bagging treatment. Meanwhile, postharvest technology of wax apple fruit utilizes nitric oxide treatment, oxalic acid treatment, cold treatment, and &lt;em&gt;Aloe vera &lt;/em&gt;gel coating. Wax apple has also been evolved as an ointment, anti-acne cream, and nata de guava. However, environmental stress becomes a challenge in the wax apple plantation. Therefore, the development of molecular biology, chemistry, and postharvest technology will solve those challenges. This review concludes that wax apple (&lt;em&gt;S. samarangense&lt;/em&gt;) is a tropical fruit that promises to support the nutritional values and human health.

Prevalence and Outcomes of Pediatric In-Hospital Cardiac Arrest Associated With Pulmonary Hypertension.

In adult in-hospital cardiac arrest, pulmonary hypertension is associated with worse outcomes, but pulmonary hypertension-associated in-hospital cardiac arrest has not been well studied in children. The objective of this study was to determine the prevalence of pulmonary hypertension among children with in-hospital cardiac arrest and its impact on outcomes. Retrospective single-center cohort study. PICU of a quaternary care, academic children's hospital. Children (<18 yr old) receiving greater than or equal to 1 minute of cardiopulmonary resuscitation (cardiopulmonary resuscitation) for an index in-hospital cardiac arrest with an echocardiogram in the 48 hours preceding in-hospital cardiac arrest, excluding those with cyanotic congenital heart disease. None. Of 284 in-hospital cardiac arrest subjects, 57 (20%) had evaluable echocardiograms, which were analyzed by a cardiologist blinded to patient characteristics. Pulmonary hypertension was present in 20 of 57 (35%); nine of 20 (45%) had no prior pulmonary hypertension history. Children with pulmonary hypertension had worse right ventricular systolic function, measured by fractional area change (p = 0.005) and right ventricular global longitudinal strain (p = 0.046); more right ventricular dilation (p = 0.010); and better left ventricular systolic function (p = 0.001). Children with pulmonary hypertension were more likely to have abnormal baseline functional status and a history of chronic lung disease or acyanotic congenital heart disease and less likely to have sepsis or acute kidney injury. Children with pulmonary hypertension were more likely to have an initial rhythm of pulseless electrical activity or asystole and were more frequently treated with inhaled nitric oxide (80% vs 32%; p < 0.001) at the time of cardiopulmonary resuscitation. On multivariable analysis, pulmonary hypertension was not associated with event survival (14/20 [70%] vs 24/37 [65%]; adjusted odds ratio, 1.30 [CI95, 0.25-6.69]; p = 0.77) or survival to discharge (8/20 [40%] vs 10/37 [27%]; adjusted odds ratio, 1.17 [CI95, 0.22-6.44]; p = 0.85). Pulmonary hypertension physiology preceding pediatric in-hospital cardiac arrest may be more common than previously described. Among this cohort with a high frequency of inhaled nitric oxide treatment during cardiopulmonary resuscitation, pulmonary hypertension was not associated with survival outcomes.