bluuebunny/crossref_metadata_2025 huggingface dataset:
Influence of Zn2+ doping on the structural and surface morphological properties of nanocrystalline Ni-Cu spinel ferrite
Authors: Awati Vidyadhar V , Rathod Sopan M , Mane Maheshkumar L , Mohite Kakasaheb C
Published: April 2013

Ni0.8-x
Cu0.2Zn
x
Fe2O4 (x = 0.0 ≤ 0.6 with steps of 0.2) ferrite nanophase was achieved by sol–gel auto-combustion technique. The as-prepared samples were thermally characterized by thermogravimetry/differential thermal analysis to obtain firing temperature of the materials. The X-ray diffraction pattern indicates the formation of a single-phase cubic spinel structure and shows strong influence of the incorporation of Zn2+ metal ions on the spinel structure. The annealing treatment does not alter the crystal structure but increases the crystallinity of the samples. The morphological investigations and nanometric sizes of the samples were studied by scanning electron microscopy and transmission electron microscopy. The crystallographic texture due to annealing and Zn2+ ion doping was systematically investigated by Fourier transform infrared spectroscopy.
MMP-2 mediates local degradation and remodeling of collagen by annulus fibrosus cells of the intervertebral disc
Authors: Rastogi Anshu , Kim Hyunchul , Twomey Julianne D , Hsieh Adam H
Published: April 2013

Introduction

Degeneration of the intervertebral disc (IVD) is characterized by marked degradation and restructuring of the annulus fibrosus (AF). Although several matrix metalloproteinases (MMPs) have been found to be more prevalent in degenerate discs, their coordination and function within the context of the disease process are still not well understood. In this study, we sought to determine whether MMP-2 is associated with degenerative changes in the AF and to identify the manner by which AF cells use MMP-2.

Methods

Two established animal models of disc degeneration, static compression and transannular needle puncture of rodent caudal discs, were examined for MMP-2 immunopositivity. With lentiviral transduction of an shRNA expression cassette, we screened and identified an effective shRNA sequence for generating stable RNA interference to silence MMP-2 expression in primary rat AF cells. Gelatin films were used to compare gelatinase activity and spatial patterns of degradation between transduced cells, and both noninfected and nonsense shRNA controls. The functional significance of MMP-2 was determined by assessing the ability for cells to remodel collagen gels.

Results

Both static compression and 18-g annular puncture of rodent caudal discs stimulated an increase in MMP-2 activity with concurrent lamellar disorganization in the AF, whereas 22-g and 26-g needle injuries did not. To investigate the functional role of MMP-2, we established lentivirus-mediated RNAi to induce stable knockdown of transcript levels by as much as 88%, and protein levels by as much as 95% over a 10-day period. Culturing transduced cells on gelatin films confirmed that MMP-2 is the primary functional gelatinase in AF cells, and that MMP-2 is used locally in regions immediately around AF cells. In collagen gels, transduced cells demonstrated an inability to remodel collagen matrices.

Conclusions

Our study indicates that increases in MMP-2 observed in human degenerate discs are mirrored in experimentally induced degenerative changes in rodent animal models. AF cells appear to use MMP-2 in a very directed fashion for local matrix degradation and collagen remodeling. This suggests that MMP-2 may have a functionally significant role in the etiology of degenerative disc disease and could be a potential therapeutic target.
Changes in hospital mortality for United States intensive care unit admissions from 1988 to 2012
Authors: Zimmerman Jack E , Kramer Andrew A , Knaus William A
Published: April 2013

Introduction

A decrease in disease-specific mortality over the last twenty years has been reported for patients admitted to United States (US) hospitals, but data for intensive care patients are lacking. The aim of this study was to describe changes in hospital mortality and case-mix using clinical data for patients admitted to multiple US ICUs over the last 24 years.

Methods

We carried out a retrospective time series analysis of hospital mortality using clinical data collected from 1988 to 2012. We also examined the impact of ICU admission diagnosis and other clinical characteristics on mortality over time. The potential impact of hospital discharge destination on mortality was also assessed using data from 2001 to 2012.

Results

For 482,601 ICU admissions there was a 35% relative decrease in mortality from 1988 to 2012 despite an increase in age and severity of illness. This decrease varied greatly by diagnosis. Mortality fell by > 60% for patients with chronic obstructive pulmonary disease, seizures and surgery for aortic dissection and subarachnoid hemorrhage. Mortality fell by 51% to 59% for six diagnoses, 41% to 50% for seven diagnoses, and 10% to 40% for seven diagnoses. The decrease in mortality from 2001 to 2012 was accompanied by an increase in discharge to post-acute care facilities and a decrease in discharge to home.

Conclusions

Hospital mortality for patients admitted to US ICUs has decreased significantly over the past two decades despite an increase in the severity of illness. Decreases in mortality were diagnosis specific and appear attributable to improvements in the quality of care, but changes in discharge destination and other confounders may also be responsible.
Inhibition of pulmonary nuclear factor kappa-B decreases the severity of acute Escherichia coli pneumonia but worsens prolonged pneumonia
Authors: Devaney James , Curley Gerard F , Hayes Mairead , Masterson Claire , Ansari Bilal , O'Brien Timothy , O'Toole Daniel , Laffey John G
Published: April 2013

Introduction

Nuclear factor (NF)-κB is central to the pathogenesis of inflammation in acute lung injury, but also to inflammation resolution and repair. We wished to determine whether overexpression of the NF-κB inhibitor IκBα could modulate the severity of acute and prolonged pneumonia-induced lung injury in a series of prospective randomized animal studies.

Methods

Adult male Sprague-Dawley rats were randomized to undergo intratracheal instillation of (a) 5 × 109 adenoassociated virus (AAV) vectors encoding the IκBα transgene (5 × 109 AAV-IκBα); (b) 1 × 1010 AAV-IκBα; (c) 5 × 1010 AAV-IκBα; or (d) vehicle alone. After intratracheal inoculation with Escherichia coli, the severity of the lung injury was measured in one series over a 4-hour period (acute pneumonia), and in a second series after 72 hours (prolonged pneumonia). Additional experiments examined the effects of IκBα and null-gene overexpression on E. coli-induced and sham pneumonia.

Results

In acute pneumonia, IκBα dose-dependently decreased lung injury, improving arterial oxygenation and lung static compliance, reducing alveolar protein leak and histologic injury, and decreasing alveolar IL-1β concentrations. Benefit was maximal at the intermediate (1 × 1010) IκBα vector dose; however, efficacy was diminished at the higher (5 × 1010) IκBα vector dose. In contrast, IκBα worsened prolonged pneumonia-induced lung injury, increased lung bacterial load, decreased lung compliance, and delayed resolution of the acute inflammatory response.

Conclusions

Inhibition of pulmonary NF-κB activity reduces early pneumonia-induced injury, but worsens injury and bacterial load during prolonged pneumonia.
PGI2 signaling inhibits antigen uptake and increases migration of immature dendritic cells
Authors: Toki Shinji , Goleniewska Kasia , Huckabee Matthew M , Zhou Weisong , Newcomb Dawn C , FitzGerald Garret A , Lawson William E , Peebles R Stokes
Published: April 2013

PGI2 signaling through IP inhibits allergen-induced inflammatory responses in mice. We reported previously that PGI2 analogs decreased proinflammatory cytokine and chemokine production by mature BMDCs. However, whether PGI2 modulates the function of immature DCs has not been investigated. We hypothesized that PGI2 negatively regulates immature DC function and investigated the effect of PGI2 analogs on immature BMDC antigen uptake and migration in vitro and in vivo. Immature BMDCs were obtained from WT and IPKO mice, both on a C57BL/6 background. The PGI2 analog cicaprost decreased FITC-OVA uptake by immature BMDCs. In addition, cicaprost increased immature BMDC podosome dissolution, pro-MMP-9 production, cell surface CCR7 expression, and chemotactic migration toward CCL19 and CCL21, as well as chemokinesis, in an IP-specific fashion. These in vitro results suggested that cicaprost promotes migration of immature DCs from mucosal surface to draining LNs. This concept was supported by the finding that migration of immature GFP+ BMDCs to draining LNs was enhanced by pretreatment with cicaprost. Further, migration of immature lung DCs labeled with PKH26 was enhanced by intranasal cicaprost administration. Our results suggest PGI2-IP signaling increases immature DC migration to the draining LNs and may represent a novel mechanism by which this eicosanoid inhibits immune responses.
What's your age again? Determination of human neutrophil half-lives revisited
Authors: Tak Tamar , Tesselaar Kiki , Pillay Janesh , Borghans José A M , Koenderman Leo
Published: April 2013

Neutrophils are the most abundant white blood cells and are indispensable for host defense. Recently, they have also been implicated in immune regulation and suppression. The latter functions seem hard to reconcile with the widely held view that neutrophils are very short-lived, with a circulatory half-life of <7 h. To reopen the discussion on the average neutrophil half-life, we review and discuss experiments performed in the 1950s, 1960s, and 1970s, as well as recent in vivo labeling experiments. We reappraise the current knowledge on neutrophil half-lives, including their production in the bone marrow, their residency in the circulation and marginated pool, and their exit from the circulation.
At the Bench: Preclinical rationale for CTLA-4 and PD-1 blockade as cancer immunotherapy
Authors: Intlekofer Andrew M , Thompson Craig B
Published: April 2013

Tumors can avoid immune surveillance by stimulating immune inhibitory receptors that function to turn off established immune responses. By blocking the ability of tumors to stimulate inhibitory receptors on T cells, sustained, anti-tumor immune responses can be generated in animals. Thus, therapeutic blockade of immune inhibitory checkpoints provides a potential method to boost anti-tumor immunity. The CTLA-4 and PD-1Rs represent two T cell-inhibitory receptors with independent mechanisms of action. Preclinical investigations revealed that CTLA-4 enforces an activation threshold and attenuates proliferation of tumor-specific T lymphocytes. In contrast, PD-1 functions primarily as a stop signal that limits T cell effector function within a tumor. The unique mechanisms and sites of action of CTLA-4 and PD-1 suggest that although blockade of either has the potential to promote anti-tumor immune responses, combined blockade of both might offer even more potent anti-tumor activity. See related review At the Bedside: CTLA-4 and PD-1 blocking antibodies in cancer immunotherapy.
Introduction to this special section: Arctic/ATC
Authors: Goodway William , Enachescu Michael
Published: April 2013

The Arctic has been the focus of oil and gas exploration since the 1960s. However, aside from this long history, specifically in areas such as Alaska, Norway, and Russia, Arctic exploration is still a slow and costly venture. Consequently, the region remains one of the world's last petroleum E&P frontiers. Recently, the USGS estimated that 25% of the Earth's remaining petroleum reserves (13% of the world's undiscovered oil and 30% of its gas) are contained in 17 known Arctic basins, some of which have had little or no exploration. These estimates vary because of the paucity of geologic and geophysical data, but the size of the prize remains consistently large.
Seismic and well-log inference of gas-hydrate accumulations on Richards Island, Northwest Territories, Canada
Authors: Bellefleur Gilles , Riedel Michael , Brent Tom
Published: April 2013

The Mackenzie Delta in Canada's Northwest Territories hosts many permafrost-related gas-hydrate accumulations that were indirectly discovered or inferred from conventional hydrocarbon exploration programs. In particular, gas-hydrate intervals characterized with high saturation show high resistivity and high P- and S-wave velocity on well-log data, and are typically found in sand-rich horizons. The acoustic impedance contrast between nonhydrate and hydrate-bearing sediments usually produces strong amplitude reflections on seismic data. Such a signature was previously observed onshore at Mallik, Northwestern Territories (Collett et al., 1999), and on the North Slope of Alaska (Collett et al., 2011). Here, we use 2D and 3D seismic reflection data acquired by industry on Richards Island to map and characterize gas-hydrate accumulations beneath a thick permafrost area of the Mackenzie Delta (Figure 1). Specifically, we show new seismic evidences of gas-hydrate accumulations above the Ya Ya and Umiak conventional gas fields.
Up-Regulation of the Fetal Baboon Hypothalamo-Pituitary-Adrenal Axis in Intrauterine Growth Restriction: Coincidence with Hypothalamic Glucocorticoid Receptor Insensitivity and Leptin Receptor Down-Regulation
Authors: Li Cun , Ramahi Emma , Nijland Mark J. , Choi Jaeyhek , Myers Dean A. , Nathanielsz Peter W. , McDonald Thomas J.
Published: April 2013

Intrauterine growth restriction (IUGR) is an important fetal developmental problem resulting from 2 broad causes: maternal undernutrition and/or decreased fetal nutrient delivery to the fetus via placental insufficiency. IUGR is often accompanied by up-regulation of the hypothalamo-pituitary-adrenal axis (HPAA). Sheep studies show fetal HPAA autonomy in late gestation. We hypothesized that IUGR, resulting from poor fetal nutrient delivery, up-regulates the fetal baboon HPAA in late gestation, driven by hypothalamo-pituitary glucocorticoid receptor (GR) insensitivity and decreased fetal leptin in peripheral plasma. Maternal baboons were fed as ad libitum controls or nutrient restricted to produce IUGR (fed 70% of the control diet) from 0.16 to 0.9 gestation. Peripheral ACTH, cortisol, and leptin were measured by immunoassays. CRH, arginine vasopressin (AVP), GR, leptin receptor (ObRb), and pro-opiomelanocortin peptide expression were determined immunohistochemically. IUGR fetal peripheral cortisol and ACTH, but not leptin, were increased (P < .05). IUGR increased CRH peptide expression, but not AVP, in the fetal hypothalamic paraventricular nucleus (PVN) and median eminence (P < .05). PVN ObRb peptide expression, but not GR, was decreased (P < .05) with IUGR. ObRb and pro-opiomelanocortin were robustly expressed in the anterior pituitary gland, but ∼1% of cells showed colocalization. We conclude that (1) CRH, not AVP, is the major releasing hormone driving ACTH and cortisol secretion during primate IUGR, (2) fetal HPAA activation was aided by GR insensitivity and decreased ObRb expression in the PVN, and (3) the anterior pituitary is not a site for ObRb effects on the HPAA.
Effects of Recombinant Human Growth Hormone for 1 Year on Body Composition and Muscle Strength in Children on Long-Term Steroid Therapy: Randomized Controlled, Delayed-Start Study
Authors: Simon Dominique , Alberti Corinne , Alison Marianne , Le Henaff Loïc , Chevenne Didier , Boizeau Priscilla , Canal Aurélie , Ollivier Gwenn , Decostre Valérie , Jacqz-Aigrain Evelyne , Carel Jean-Claude , Czernichow Paul , Hogrel Jean-Yves
Published: April 2013

Context:

Recombinant human GH (rhGH) improves growth and body composition in glucocorticoid-treated children. Its effects on muscle strength are poorly evaluated.

Objectives:

Our objective was to evaluate rhGH effects on muscle strength in children receiving long-term glucocorticoid therapy; effects on height SD score (SDS) and body composition were assessed also.

Design and Setting:

A randomized, controlled, delayed-start study of rhGH for 12 months was started after randomization (baseline) or 6 months later (M6).

Patients:

Patients included 30 children with various diagnoses.

Intervention:

rhGH was administered at 0.065 mg/kg/d for 6 months and then in the dosage maintaining serum IGF-I levels below +2 SDS for chronological age.

Main Outcome Measures:

The primary criterion was the between-group difference in composite index of muscle strength (CIMS) change at M6. Secondary criteria included between-group differences in CIMS SDSheight, lean mass (LM), thigh muscle area (MA), and height SDS changes at M6; these parameters were also assessed in the overall population after 1 year of rhGH therapy.

Results:

At M6, rhGH therapy did not significantly affect changes in CIMS or CIMS SDSheight (+17.6% vs +7.5% and +0.14 ± 0.38 vs +0.11 ± 0.62, respectively); the rhGH-treated group had significantly larger changes in height SDS (+0.2 [0.3] vs −0.2 [0.3]; P = 0.003), LM (+7.3% [+3.7%; +21.6%] vs 0% [−4.7%; +3.2%]; P = 0.002), and MA (+8.8% [+5%; +15.6%] vs. −0.6% [−6.3%; +7.7%]; P = 0.01) compared with the untreated group. After 1 year of rhGH, height SDS, LM, and MA increased significantly, CIMS increased by 24.7% (+5.8%; +34.2%), and CIMS SDSheight remained within the normal range.

Conclusions:

rhGH increased height, LM, and MA. However, muscle strength did not improve significantly.
Circulating Levels of FGF-21 in Obese Youth: Associations With Liver Fat Content and Markers of Liver Damage
Authors: Giannini Cosimo , Feldstein Ariel E. , Santoro Nicola , Kim Grace , Kursawe Romy , Pierpont Bridget , Caprio Sonia
Published: April 2013

Objective:

Fibroblast growth factor (FGF)-21 is highly expressed in the liver and regulates glucose and lipid metabolism in rodents. The effects of obesity and fatty liver on circulating FGF-21 levels have been described mainly in adults. Herein, we measured plasma FGF-21 levels in lean and obese adolescents with low and high hepatic fat content (HFF% <5.5% and HFF% ≥5.5%, respectively) and explored their relationship with hepatic fat content, measures of hepatic apoptosis, and insulin sensitivity.

Methods:

A total of 217 lean and obese adolescents with both low and high HFF% (lean = 31; obese low HFF% = 107; and obese high HFF% = 79) underwent an oral glucose tolerance test, a fast gradient magnetic resonance imaging to measure the %HFF and abdominal fat distribution. Cytokeratin 18 levels were measured as a biomarker of liver apoptosis. A subset of adolescents underwent a 2-step hyperinsulinemic-euglycemic clamp, and a liver biopsy (N = 14), to assess insulin sensitivity and steatohepatitis, respectively.

Results:

Compared to controls, FGF-21 levels were higher in obese youth, especially in those with high HFF (P < .001). FGF-21 significantly correlated with adiposity indexes (P < .001), visceral fat (r2 = 0.240, P < .001), hepatic fat content (r2 = 0.278, P < .001), cytokeratin 18 (r2 = 0.217, P < .001), and alanine aminotransferase (r2 = .164, P < .001). In subjects with steatoheaptitis, FGF-21 levels significantly correlated with the nonalcoholic fatty liver disease activity score (r2 = 0.27, P = .04). Stepwise regression analysis indicated that these relationships are independent of body mass index, visceral fat, and insulin sensitivity. An inverse correlation was documented with insulin, hepatic resistance indexes, and adipose resistance indexes, which disappeared after adjusting for hepatic fat content.

Conclusions:

Plasma FGF-21 levels are increased in obese adolescents, particularly in those with fatty liver. FGF-21 concentrations significantly and independently correlate with hepatic fat content and markers of hepatic apoptosis in obese youths.
Im Fadenkreuz der Stasi: Westliche Spionage in der DDR
Authors: Maddrell Paul
Published: April 2013

Vorspann

Im geteilten Deutschland tobte bis 1989/90 ein verdeckter kalter Krieg der Spione und Agenten. Was dabei auf dem westlichen „Kriegs“-Schauplatz geschah, ist partiell bekannt, während die Spionagetätigkeit westlicher Dienste im Osten noch immer einem Buch mit sieben Siegeln gleicht. Der renommierte britische Historiker Paul Maddrell greift diese brisante Materie auf, wobei er sich auf neue Stasi-Quellen stützen kann. Das Ergebnis ist frappant: In der DDR wimmelte es vor Spionen, die zwar nur selten so große Scoops landeten wie die Stasispione im Westen, im Großen und Ganzen aber ähnlich erfolgreich arbeiteten.
Aromatase inhibition 2013: clinical state of the art and questions that remain to be solved
Authors: Lønning Per Eystein , Eikesdal Hans Petter
Published: April 2013

Following their successful implementation for the treatment of metastatic breast cancer, the ‘third-generation’ aromatase inhibitors (anastrozole, letrozole, and exemestane) have now become standard adjuvant endocrine treatment for postmenopausal estrogen receptor-positive breast cancers. These drugs are characterized by potent aromatase inhibition, causing >98% inhibition of estrogen synthesisin vivo. A recent meta-analysis found no difference in anti-tumor efficacy between these three compounds. As of today, aromatase inhibitor monotherapy and sequential treatment using tamoxifen followed by an aromatase inhibitor for a total of 5 years are considered equipotent treatment options. However, current trials are addressing the potential benefit of extending treatment duration beyond 5 years. Regarding side effects, aromatase inhibitors are not found associated with enhanced risk of cardiovascular disease, and enhanced bone loss is prevented by adding bisphosphonates in concert for those at danger of developing osteoporosis. However, arthralgia and carpal tunnel syndrome preclude drug administration among a few patients. While recent findings have questioned the use of aromatase inhibitors among overweight and, in particular, obese patients, this problem seems to focus on premenopausal patients treated with an aromatase inhibitor and an LH-RH analog in concert, questioning the efficacy of LH-RH analogs rather than aromatase inhibitors among overweight patients. Finally, recent findings revealing a benefit from adding the mTOR inhibitor everolimus to endocrine treatment indicate targeted therapy against defined growth factor pathways to be a way forward, by reversing acquired resistance to endocrine therapy.
Prostate cancer genomics by high-throughput technologies: genome-wide association study and sequencing analysis
Authors: Nakagawa Hidewaki
Published: April 2013

Prostate cancer (PC) is the most common malignancy in males. It is evident that genetic factors at both germline and somatic levels play critical roles in prostate carcinogenesis. Recently, genome-wide association studies (GWAS) by high-throughput genotyping technology have identified more than 70 germline variants of various genes or chromosome loci that are significantly associated with PC susceptibility. They include multiple8q24loci, prostate-specific genes, and metabolism-related genes. Somatic alterations in PC genomes have been explored by high-throughput sequencing technologies such as whole-genome sequencing and RNA sequencing, which have identified a variety of androgen-responsive events and fusion transcripts represented by E26 transformation-specific (ETS) gene fusions. Recent innovations in high-throughput genomic technologies have enabled us to analyze PC genomics more comprehensively, more precisely, and on a larger scale in multiple ethnic groups to increase our understanding of PC genomics and biology in germline and somatic studies, which can ultimately lead to personalized medicine for PC diagnosis, prevention, and therapy. However, these data indicate that the PC genome is more complex and heterogeneous than we expected from GWAS and sequencing analyses.
Induction of avian β-defensins by CpG oligodeoxynucleotides and proinflammatory cytokines in hen vaginal cells in vitro
Authors: Sonoda Yuka , Abdel Mageed Ahmad M , Isobe Naoki , Yoshimura Yukinori
Published: April 2013

Immune function in the vagina of hen oviduct is essential to prevent infection by microorganisms colonizing in the cloaca. The aim of this study was to determine whether CpG oligodeoxynucleotides (CpG-ODN) stimulate the expression of avian β-defensins (AvBDs) in hen vaginal cells. Specific questions were whether CpG-ODN affects the expression of AvBDs and proinflammatory cytokines and whether the cytokines affect AvBDs expression in vaginal cells. The dispersed vaginal cells of White Leghorn laying hens were cultured and stimulated by different doses of lipopolysaccharide (LPS), CpG-ODN, interleukin 1β (IL1B), or IL6. The cultured cell population contained epithelial cells, fibroblast-like cells, and CD45-positive leukocytes. The immunoreactive AvBD3, -10, and -12 were localized in the mucosal epithelium in the section of the vagina. The expression of AvBDs, IL1B, and IL6 was analyzed by quantitative RT-PCR. RT-PCR analysis showed the expression of AvBD1, -3, -4, -5, -10, and -12 in the cultured vaginal cells without stimulation. Toll-like receptors (TLRs) 4 and 21, which recognize LPS and CpG-ODN respectively and IL1 and IL6 receptors (IL1R1 and IL6R) were also expressed in them. The expression of IL1B, IL6, and AvBD10 and -12 was upregulated by LPS, whereas only IL1B and IL6 were upregulated by CpG-ODN. IL1B stimulation upregulated AvBD1 and -3 expression, whereas IL6 stimulation did not cause changes in AvBDs expression. These results suggest that CpG-ODN derived from microbes upregulates the expression of IL1B and IL6 by interaction with TLR21 and then IL1B induces AvBD1 and -3 to prevent infection in the vagina.
Evaluation of Positive Inotropic Drug Effects on Thyroid Hormone Levels after Open Heart Surgery
Authors: Kervan Umit , Ozen Anil , Unal Utku , Tasoglu Irfan , Ulas Mahmut Mustafa , Cagli Kumral , Uzun Alper , Bardakci Hasmet , Cagli Kerim
Published: April 2013

Objective: The aim of this study was to examine the effects of positive inotropic drugs, including adrenaline, dopamine, and dobutamine on thyroid hormone levels following open heart surgery.

Methods: We analyzed free thyroid hormones (FT3 and FT4) and thyroid-stimulating hormones (TSH) in 200 consecutive patients undergoing open heart surgery. Patients were divided into 5 groups according to the inotropic drug administration as follows: Group A (n = 46) received dopamine alone; Group B (n = 40), dopamine and dobutamine; Group C (n = 36), dopamine, dobutamine, and adrenaline; Group D (n = 32), adrenaline alone; and Group E (n = 46), placebo. Procedural factors affecting thyroid hormones were recorded and included cardiopulmonary bypass (CPB) time, cross-clamping time, degree of hypothermia, and the duration and doses of positive inotropic drugs. Blood samples for hormone assays were collected before initiation of inotropic drug therapy (baseline) and postoperatively at 24, 72, and 120 hours after drug therapy.

Results: FT3, FT4, and TSH levels at baseline were similar in all groups. Although there was a trend showing very slight increases in thyroid hormone levels from baseline to the 24th, 72nd, and 120th postoperative hours after drug therapy, these changes were not significant, and there were also no significant differences between the groups. There was also no significant statistical difference in CPB time, cross-clamping time, degree of hypothermia, and duration and doses of positive inotropic drugs between groups.

Conclusion: Although thyroid hormone levels were affected by positive inotropic drug usage after open heart surgery, this effect was not significant and thyroid hormone levels remained within normal ranges.
Simultaneous Beating Heart Coronary Artery Bypass Surgery and Modified Radical Mastectomy
Authors: Kaya Erhan , Yerebakan Halit , Spielman Daniel , Isik Omer , Yakut Cevat
Published: April 2013

Concomitant surgeries for unrelated diseases can be performed to minimize the risks associated with surgery and general anesthesia. In treating a male patient with breast cancer and severe coronary artery disease, we used the beating heart technique for a coronary artery bypass graft to avoid the negative effects of on-pump bypass on the possible acceleration of tumor growth. In this report, we present a unique case of concomitant off-pump coronary artery bypass graft surgery and modified radical mastectomy in a 56-year-old man.
Key-Lock Type Mini-Sternotomy: An Alternative Approach for Adult Cardiac Operations
Authors: Dumantepe Mert , Tarhan Arif , Ozler Azmi
Published: April 2013

An alternative technique for minimally invasive aortic valve replacement and atrial septal defect repair is described. After a 5-cm skin incision, a key-lock type sternotomy is made. Excellent exposure of the right atrium and aortic valve was achieved. The configuration of the mini-sternotomy (or the lock) limits the movement of the sternal surfaces (or the key) on the lateral and craniocaudal directions.
Bleeding Outcomes Associated with Coronary Artery Bypass Graft Surgery and Recent Clopidogrel Exposure
Authors: Blais Danielle M. , Zukkoor Sarah M. , Hayes Charles , Pickworth Kerry K. , Porter Kyle , Firstenberg Michael S.
Published: April 2013

Background: Guidelines recommend discontinuing clopidogrel for at least 5 days before elective coronary artery bypass graft surgery (CABG) to limit blood transfusions and for at least 24 hours before urgent CABG to reduce major bleeding complications. Studies have produced conflicting results regarding whether recent exposure to clopidogrel increases bleeding, the need for intraoperative and postoperative blood products, postoperative complications, and hospital length of stay. We evaluated the effect of clopidogrel exposure on major bleeding at our institution within 5 days of CABG.

Methods: We conducted a retrospective review of patients who underwent CABG at a tertiary academic medical center. The primary outcome was major bleeding, defined as transfusion of 4 units of packed red blood cells (PRBCs) and/or a need for reexploration. Secondary outcomes included non-life-threatening bleeding, defined as transfusion of 2 units but <4 units of PRBCs; postoperative complications; hospital length of stay; readmission within 30 days of the procedure; and hospital mortality. Major bleeding events were analyzed with a logistic regression model that adjusted for covariates of bleeding risk factors.

Results: Of the 715 patients we reviewed, 169 patients received clopidogrel within 5 days before CABG, and 546 patients did not. A significantly higher incidence of major bleeding was observed in the clopidogrel group compared with the group not exposed to clopidogrel (32% versus 17%, P = .002). After adjusting for covariates, patients exposed to clopidogrel had significantly higher odds of major bleeding (odds ratio, 2.1; 95% confidence interval, 1.3-3.4; P = .003). The groups were similar with respect to postoperative complications, except for infection. The clopidogrel-exposed group had a significantly higher rate of leg site infections (3% versus 0.2%, P = .003).

Conclusions: Clopidogrel exposure within 5 days of CABG is associated with an increased risk of major bleeding.
Long-term Results of the Single-Patch Repair Technique for Sinus Venosus Atrial Septal Defects
Authors: Temizkan Veysel , Ugur Murat , Alp Ibrahim , Ucak Alper , Yilmaz Ahmet Turan
Published: April 2013

Background: Anomalous pulmonary venous drainage commonly accompanies sinus venosus atrial septal defects (SVASDs). Many techniques have been reported for avoiding postoperative complications, such as narrowing of the superior vena cava (SVC) or the pulmonary system, and arrhythmia. We perform a single V-Y pericardial patch plasty repair technique for SVASDs. The purpose of this study is to report on the long-term results of this surgical technique.

Methods: We retrospectively analyzed patients who had a diagnosis of ASD and who underwent their operations between 2000 and 2010 at the Gulhane Military Medical Academy Haydarpasa Training Hospital. Thirty-nine of the patients had an anomalous pulmonary return, and the single pericardial patch technique had been performed in 32 of these patients.

Results: The mean (�SD) postoperative extubation time was 5 � 1.6 hours. The mean drainage volume was 384 � 137 mL. All patients were discharged from the hospital at a mean of 4.6 � 1.1 days after their operation and were prescribed anticoagulants for 3 months. No perioperative or late-term mortality was observed. Patients were followed up for 6 months to 2 years. There were no residual shunts and no stenosis-related findings in the pulmonary venous system or the SVC.

Conclusion: Use of the single pericardial patch plasty technique might lower complication rates in patients with SVASD, especially those who have not completed their growth.
Safety and Efficacy of Cangrelor, an Intravenous, Short-Acting Platelet Inhibitor in Patients Requiring Coronary Artery Bypass Surgery
Authors: Firstenberg Michael S. , Dyke Cornelius M. , Angiolillo Dominick J. , Ramaiah Chandrashekhar , Price Matthew , Brtko Miroslav , Welsby Ian , Chandna Harish , Holmes David R. , Voeltz Michele , Tummala Pradyumna , Hutyra Martin , Manoukian Steven V. , Prats Jayne , Todd Meredith , Liu Tiepu , Chronos Nicholas , Dietrich Markus , Montalescot Gilles , Cannon Louis A. , Topo Eric J.
Published: April 2013

Objective: Oral P2Y12 platelet receptor inhibitors are a cornerstone of reducing complications in patients with acute coronary syndromes or coronary stents. Guidelines advocate discontinuing treatment with P2Y12 platelet receptor inhibitors before surgery. Cangrelor, a short-acting, reversible, intravenously administered P2Y12 platelet inhibitor is effective in achieving appropriate platelet inhibition in patients who are awaiting coronary artery bypass grafting (CABG) and require P2Y12 inhibition. The objective of this study was to assess the effects of preoperative cangrelor on the incidence of perioperative complications, which are currently unknown.

Methods: Patients (n = 210) requiring preoperative clinical administration of thienopyridine therapy were randomized in a multicenter, double-blinded study to receive cangrelor or placebo while awaiting CABG after discontinuation of the thienopyridine. Optimal platelet reactivity, which was defined as <240 P2Y12 platelet reaction units, was measured with serial point-of-care testing (VerifyNow). Pre- and postoperative outcomes, bleeding values, and transfusion rates were compared. To quantify potential risk factors for bleeding, we developed a multivariate logistic model.

Results: The differences between the groups in bleeding and perioperative transfusion rates were not significantly different. The rate of CABG-related bleeding was 11.8% (12/102) in cangrelor-treated patients and 10.4% (10/96) in the placebo group (P = .763). Transfusion rates for the groups were similar. Serious postoperative adverse events for the cangrelor and placebo groups were 7.8% (8/102) and 5.2% (5/96), respectively (P = .454).

Conclusions: Compared with placebo, bridging patients with cangrelor prior to CABG effectively maintains platelet inhibition without increasing post-CABG complications, including bleeding and the need for transfusions. These data suggest cangrelor treatment is a potential strategy for bridging patients requiring P2Y12 receptor inhibition while they await surgery.
Surgery on a Patient with Iatrogenic Aortic Valve Leaflet Perforation after Repair of a Congenital Ventricular Septal Defect
Authors: Zhang Tao , Jiang Shengli , Wang Yao , Cheng Mingyan , Cheng Tingting , Gao Changqing
Published: April 2013

Aortic valve regurgitation caused by a leaflet perforation occurs most often with infective endocarditis involving the aortic valve. Although rare, leaflet perforation can be caused by suture-related injury during cardiac operations, such as mitral valve replacement, ventricular septal defect (VSD) repair, and repair of an ostium primum atrial septal defect. Few reports have described this form of iatrogenic aortic valve leaflet perforation. We used a pericardial patch in a successful repair of an iatrogenic perforation in an aortic valve leaflet that occurred after simple VSD repair.
Relationship between Patient Income Level and Mitral Valve Repair Utilization
Authors: Vassileva Christina M. , Boley Theresa , Standard Joseph , Markwell Stephen , Hazelrigg Stephen
Published: April 2013

Background: The superiority of mitral valve (MV) repair is well established with respect to long-term survival, preservation of ventricular function, and valve-related complications. The relationship between patient income level and the selection of MV procedure (repair versus replacement) has not been studied.

Methods: The 2005 to 2007 Nationwide Inpatient Sample database was searched for patients ? 30 years old with MV repair or replacement; patients with ischemic and congenital MV disease were excluded. Patients were stratified into quartiles according to income level (quartile 1, lowest; quartile 4, highest). We used univariate and multivariate models to compare patients with respect to baseline characteristics, selection of MV procedure, and hospital mortality.

Results: The preoperative profiles of the income quartiles differed significantly, with more risk factors occurring in the lower income quartiles. Unadjusted hospital mortality decreased with increasing income quartile. The percentage of patients receiving MV repair increased with increasing income (35.6%, 39.6%, 48.2%, and 55.8% for quartiles 1, 2, 3, and 4, respectively; P = .0001). Following adjustment for age, race, sex, urban residency, admission status, primary payer, Charlson comorbidity index, and hospital location and teaching status, the income quartiles had similar hospital death rates, whereas the highly significant relationship between valve repair and income level persisted (P = .0008).

Conclusions: Significant disparity exists among patients in the different income quartiles with respect to the likelihood of receiving MV repair. MV repair is performed less frequently in patients with lower incomes, even after adjustment for differences in baseline characteristics. The higher unadjusted mortality rate for less affluent patients appears mostly related to their worse preoperative profiles.
Valve-in-Valve in the Tricuspid Position for a Stenosed Bioprosthesis
Authors: Beckerman Ziv , Cohen Oved , Kerner Arthur , Roguin Ariel , Ziser Avishai , Agmon Yoram , Bolotin Gil
Published: April 2013

The strategy of transcatheter valve-in-valve implantation into failing mitral and aortic bioprosthetic valves is a documented approach. It allows one to avoid performing a high-risk repeat cardiac surgery in elderly patients with multiple comorbidities. Tricuspid valve-in-valve implantation has been documented only a few times in the literature. We report the case of a 65-year-old woman with a failing bioprosthetic tricuspid valve who had undergone 3 prior open heart operations. We attempted a transatrial transcatheter approach and successfully deployed a 29-mm Edwards Sapien balloon-expandable bioprosthesis into a severely stenotic tricuspid bioprosthesis. This case demonstrates the technical feasibility and safety of this approach.
Temporary Tricuspid Valve Detachment for Ventricular Septal Defect Closure: Is It Worth Doing It?
Authors: Weymann Alexander , Georgiev Stanimir , Vogelsang Carsten , Ivad Annette , Karck Matthias , Gorenflo Matthias , Loukanov Tsvetomir
Published: April 2013

Background: Tricuspid valve detachment (TVD) may improve the access for closing certain ventricular septal defects (VSDs), but it has some potential risks. We aimed to study the benefits and drawbacks of this technique.

Methods: The midterm outcomes of all 20 patients who underwent a TVD closure for VSD were reviewed and compared with a control group of 15 patients with VSD closure without TVD.

Results: There was no significant residual shunt in either group at the last actuarial follow-up. Tricuspid regurgitation occurred in both groups (45% in the TVD group and 27% in the control group, P = .48). These lesions were considered insignificant in all patients. There were no atrioventricular blocks, and all patients were in sinus rhythm. The cardiopulmonary bypass times were significantly higher in the TVD group than in the control group (91.6 � 17.2 minutes versus 68.3 � 15.7 minutes, P ? .01), as were the aortic cross-clamping times (50.7 � 12.1 minutes versus 35.9 � 14.4 minutes, P ? .01).

Conclusion: Our results, along with results from other series, suggest that TVD can be used effectively and safely for closure of certain VSDs.
Graft Flow Unaffected by Full Occlusion of Left Anterior Descending Artery during Coronary Artery Bypass Grafting in a Porcine Model
Authors: Torstensson Gustav Nils Johannes , Torp Thomas Lee , Rasuli-Oskuii Nader , Kjeldsen Bo Juel
Published: April 2013

Background: We investigated in a porcine model whether measuring both the flow distal to an anastomosis and the graft transit time flow (TTF) gives a more accurate picture of the true blood flow in the left anterior descending artery (LAD) than graft TTF measurement alone.

Methods: We performed off-pump coronary artery bypass grafting (CABG)�left internal mammary artery (LIMA) to the LAD�on 5 Yorkshire-Landrace pigs. Snares were placed both proximal and distal to the anastomosis. Flow was measured with ultrasound and TTF. This was carried out on the LIMA and at 2 locations on the LAD. Measurements were performed at the following times: baseline, during proximal snaring, after proximal snare loosening, during distal snaring, after distal snare loosening, and during both proximal and distal snaring.

Results: During distal snaring, the TTF dropped (P = .047), and the pulsatile index (PI) increased (P = .025), while the ultrasound flow in the LAD dropped (P = .002). During proximal and distal snaring, the ultrasound flow dropped (P = .005), but the TTF value did not change significantly, compared with baseline.

Conclusion: A high flow and a low PI were seen in the graft, both proximal and distal to the anastomosis, despite a fully occluded LAD. This result suggests that graft TTF measurement alone is not sufficient when performing CABG, and measurement of flow distal to the anastomosis is also necessary to determine the true blood flow in the LAD.
A non representable infinite dimensional quasi-polyadic equality algebra with a representable cylindric reduct
Authors: Andréka Hajnal , Németi István , Ahmed Tarek
Published: April 2013

We construct an infinite dimensional quasi-polyadic equality algebra \documentclass{aastex}
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$\mathfrak{A}$
\end{document} such that its cylindric reduct is representable, while \documentclass{aastex}
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$\mathfrak{A}$
\end{document} itself is not representable.
Filling words in fundamental groups of Riemann surfaces
Authors: Zhang C.
Published: April 2013

The purpose of this article is to utilize some exiting words in the fundamental group of a Riemann surface to acquire new words that are represented by filling closed geodesics.
On an open problem by Nasr-Isfahani on strict inner amenability
Authors: Ghanei Mohammad , Nemati Mehdi
Published: April 2013

For two locally compact groups G and H, we show that if L1(G) is strictly inner amenable, then L1(G × H) is strictly inner amenable. We then apply this result to show that there is a large class of locally compact groups G such that L1(G) is strictly inner amenable, but G is not even inner amenable.
Characterization of multidimensional A-strong convergence
Authors: Ünver Mehmet
Published: April 2013

Recently Khan and Orhan have proved that an ordinary (single) sequence isA-strongly convergent if and only if it isA-statistically convergent andA-uniformly integrable. In this paper we consider the similar problem for multidimensional sequences whenAis a multivariable-to-single matrix. We also study the same question when A is a multivariable-to-multivariable matrix.
Characterization of the convergence of weighted averages in a more general setting
Authors: Móricz Ferenc , Stadtmüller Ulrich
Published: April 2013

Let ν be a positive Borel measure on ℝ̄+:= [0;∞) and let p: ℝ̄+ → ℝ̄+ be a weight function which is locally integrable with respect to ν. We assume that \documentclass{aastex}
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$P(t): = \int\limits_0^t {p(u)d\nu (u) \to \infty } andP(t - 0)/P(t) \to 1ast \to \infty .$
\end{document} Let f: ℝ̄+ → ℂ be a locally integrable function with respect to p dν, and define its weighted averages by \documentclass{aastex}
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$\sigma _t (f;pd\nu ): = \frac{1}{{P(t)}}\int\limits_0^t {f(u)p(u)d\nu (u)} $
\end{document} for large enough t, where P(t) > 0. We prove necessary and sufficient conditions under which the finite limit \documentclass{aastex}
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$\sigma _t (f;pd\nu ) \to Last \to \infty $
\end{document} exists. This characterization is a unified extension of the results in [5], and it may find application in Probability Theory and Stochastic Processes.
The sub-bifractional Brownian motion
Authors: El-Nouty Charles , Journé Jean-Lin
Published: April 2013

The sub-bifractional Brownian motion, which is a quasi-helix in the sense of Kahane, is presented. The upper classes of some of its increments are characterized by an integral test.
Weak convergence of random walks, conditioned to stay away from small sets
Authors: Pajor-Gyulai Zsolt , Szász Domokos
Published: April 2013

Let {Xn}n∈ℕ be a sequence of i.i.d. random variables in ℤd. Let Sk = X1 + … + Xk and Yn(t) be the continuous process on [0, 1] for which Yn(k/n) = Sk/n1/2 for k = 1, … n and which is linearly interpolated elsewhere. The paper gives a generalization of results of ([2]) on the weak limit laws of Yn(t) conditioned to stay away from some small sets. In particular, it is shown that the diffusive limit of the random walk meander on ℤd: d ≧ 2 is the Brownian motion.
Randomized Controlled Trial of Pulmonary Metastasectomy in Colorectal Cancer: PulMiCC International Is Open in Italy
Authors: Migliore Marcello , Lees Belinda , Treasure Tom , Fallowfield Lesley J.
Published: April 2013

Advocates of the Pulmonary Metastasectomy in Colorectal Cancer trial describe trial design and goals, in agreement with others that such a trial is necessary to solve the question of whether or not surgery is beneficial in patients with metastatic colorectal cancer and, ultimately, to assist patients and clinical teams in deciding for or against pulmonary metastectomy.