bluuebunny/crossref_metadata_2025 huggingface dataset:
Overexpression of plant chitin receptors in wheat confers broad‐spectrum resistance to fungal diseases
Authors: Wang Lirong , He Yi , Guo Ge , Xia Xiaobo , Dong Yifan , Zhang Yicong , Wang Yuhua , Fan Xing , Wu Lei , Zhou Xinli , Zhang Zhengguang , Li Gang
Published: September 2024

Wheat (Triticum aestivum L.) is a globally staple crop vulnerable to various fungal diseases, significantly impacting its yield. Plant cell surface receptors play a crucial role in recognizing pathogen‐associated molecular patterns (PAMPs) and activating PAMP‐triggered immunity, boosting resistance against a wide range of plant diseases. Although the role of plant chitin receptor CERK1 in immune recognition and defense has been established in Arabidopsis and rice, its function and potential agricultural applications in enhancing resistance to crop diseases remain largely unexplored. Here, we identify and characterize TaCERK1 in Triticeae crop wheat, uncovering its involvement in chitin recognition, immune regulation, and resistance to fungal diseases. By a comparative analysis of CERK1 homologs in Arabidopsis and monocot crops, we demonstrate that AtCERK1 in Arabidopsis elicits the most robust immune response. Moreover, we show that overexpressing TaCERK1 and AtCERK1 in wheat confers resistance to multiple fungal diseases, including Fusarium head blight, stripe rust, and powdery mildew. Notably, transgenic wheat lines with moderately expressed AtCERK1 display superior disease resistance and heightened immune responses without adversely affecting growth and yield, compared to TaCERK1 overexpression transgenics. Our findings highlight the significance of plant chitin receptors across diverse plant species and suggest potential strategies for bolstering crop resistance against broad‐spectrum diseases in agricultural production through the utilization of plant immune receptors.
Impact of Neurotransmitters on the Fatty Acid Composition and the Pigments of the Green Microalga Scenedesmus quadricauda
Authors: Cao B. , Chivkunova O. B. , Solovchenko A. E. , Lobakova E. S. , Oleskin A. V.
Published: September 2024

Apart from their functions in the nervous system of animals, neurotransmitters operate as regulatory agents and signals in diverse kingdoms of life. Some neurotransmitters have recently been revealed to exert specific effects on microalgae, predominantly functioning as algal growth stimulators. This article presents new data on the effects of such neurotransmitters as serotonin, norepinephrine, dopamine, histamine, and acetylcholine on the fatty acid and pigment composition of the green microalga Scenedesmus quadricauda (Turp.) Breb. K-1149. It was established that acetylcholine and, to a lesser extent, histamine increased the total fatty acid content of S. quadricauda cells, whereas serotonin and dopamine decreased the fatty acid content. Acetylcholine, histamine, and norepinephrine elevated the percentage of polyunsaturated fatty acids; in contrast, serotonin and dopamine increased the share of saturated fatty acids. Acetylcholine and, to a lesser extent, norepinephrine increased the total chlorophyll content per gram of dry weight in S. quadricauda, while histamine decreased the chlorophyll content. Histamine also increased the chlorophyll a/chlorophyll b and carotenoid/chlorophyll ratios, which were decreased by dopamine. The data obtained are of biotechnological and ecological interest. The stimulation of fatty acid accumulation and the increase in the percentage of polyunsaturated species was caused by the neurotransmitters acetylcholine and histamine at low (1–10 μM) concentrations, which potentially enables facilitating the biotechnological production of health-promoting preparations for therapeutic and cosmetic purposes. However, other neurotransmitters (dopamine and serotonin) tested increased the relative content of saturated fatty acids; therefore, they apparently can be used to stimulate biofuel production, since saturated fatty acid-rich lipids are advantageous raw materials for biodiesel production. The impact of neurotransmitters on microalgal fatty acid composition and photosystem components may be considered in terms of ongoing chemical interaction between microalgae and other aquatic ecosystem components that are known to produce neurotransmitters.
The Effect of Space Flight Factors on the Interaction of Escherichia coli with Bacteriophage T7
Authors: Sykilinda N. N. , Lukyanova A. A. , Lavrikova V. V. , Kutnik I. V. , Panin N. V. , Staritsyn N. A. , Miroshnikov K. A.
Published: September 2024

For the first time, data on the effect of space flight factors on the interaction of a bacteriophage with a host bacterium have been obtained. The research was carried out on the Russian segment of the ISS using the E. coli—bacteriophage T7 model system. It was found that the lysis of cells by bacteriophage in space experiments, which were carried out in the first 2 days of exposure to microgravity on microorganisms, was 1.5 times faster than in terrestrial ones. With a longer exposure to microgravity on E coli, they acquired resistance to bacteriophage T7, which persisted for 2 days after returning to Earth. Sensitivity to the bacteriophage was fully restored by 4–5 days after the return of cells from the ISS.
Engineering of Recombinant Endolysin LysSi3 to Increase its Antibacterial Properties
Authors: Antonova N. P. , Grigoriev I. V. , Lendel A. M. , Usacheva O. V. , Klimova A. A. , Usachev E. V. , Gushchin V. A. , Vasina D. V.
Published: September 2024

The potential of new genetically modified recombinant endolysins as antimicrobial agents against Gram-negative bacteria was investigated. A series of enzymes based on LysSi3 lysozyme-like muramidase was obtained by modifying its sequence with antimicrobial peptides of different families, and recombinant expression in E. coli was demonstrated. Modification of LysSi3 resulted in increased bacteriolytic activity against the model isolate of A. baumannii and a higher kinetics rate compared to the native enzyme. The cytotoxic properties of the newly engineered lysins were investigated with the HEK293 and HaCaT cell lines, and it was shown that modification of LysSi3 with antimicrobial peptides does not significantly increase the toxic properties in vitro.
Development of a Bio-Selecting Agent Based on Immobilized Bacterial Cells with Amidase Activity for Bio-Detection of Acrylamide
Authors: Protasova E. M. , Maksimova Yu. G.
Published: September 2024

Actinobacteria cells Rhodococcus erythropolis 4-1 and Rhodococcus erythropolis 11-2 and Proteobacteria Alcaligenes faecalis 2, which have amidase activity, were immobilized by entrapping barium alginate and agarose into the gel structure, as well as by obtaining biofilms on thermally expanded graphite (TEG). The operational stability of such immobilized biocatalysts after storage in frozen and dehydrated form was determined, and a prototype of a conductometric acrylamide biosensor based on such a bioselective agent was developed. The most preferred method for storing immobilized cells was freezing at temperatures from –20 to –80°C; long-term storage is also possible wet at 4–25°C. It was shown that these cells were most preferable for the biodetection of acrylamide A. faecalis 2, immobilized in an agarose gel structure. An agarose gel with bacterial cells immobilized in its structure had greater mechanical strength and stability during successive cycles of conversion of acrylamide into acrylic acid compared to barium alginate gel. The mechanical strength of barium alginate gel can be enhanced by the addition of carbon nanomaterials during cell immobilization. Growing biofilms on carbon materials used for manufacturing electrodes is also promising. Biofilms of R. erythropolis 11-2 on TEG are capable of converting acrylamide into acrylic acid in more than 20 reaction cycles while maintaining at least 50% amidase activity.
An Inducible Whole-Cell Biosensor for Detection of Formate Ions
Authors: Cherenkova A. A. , Yuzbashev T. V. , Melkina O. E.
Published: September 2024

Ten strains of the yeast Yarrowia lipolytica were constructed, the genomes of which contain the hrGFP gene under regulation of the formate dehydrogenase promoters. The resulting strains can act as whole-cell biosensors for the detection of formate ions in various media. By visual assessment of the biomass fluorescence, we selected the three most promising yeast strains. The main biosensor characteristics (threshold sensitivity, amplitude, and response time) of the selected strains were measured. As a result, in terms of characteristics, the B26 strain was recognized as the most suitable for the detection of formate ions. A carbon source for the nutrient medium that does not reduce the activation of the biosensor was selected. Furthermore, we showed that unlike formate and formaldehyde, methanol practically does not induce the biosensor fluorescence response.
Short-Range Order in Gallium Solid Solutions in α-Iron
Authors: Ershov N. V. , Kleinerman N. M. , Gornostyrev Yu. N. , Lukshina V. A. , Shishkin D. A. , Timofeeva A. V. , Naumov S. P. , Svirid A. E.
Published: September 2024

Short-range order in soft magnetic FeGa alloys containing from 3 to 25 at % Ga was studied using nuclear gamma resonance (Mössbauer) spectroscopy. The Mössbauer spectra were analyzed via fitting with subspectra corresponding to different configurations of the neighborhoods of the Fe atoms with Ga in the first and second coordination shells. It has been shown that in samples of alloys containing from 3 to 17 at % gallium, the short-range order is almost independent of the heat treatment conditions (quenching from a paramagnetic state or exposure in a ferromagnetic state) and is characterized by the presence of pairs of Ga atoms in the position of the second neighbors (B2-type clusters). At a Ga content of 17 to 21 at %, the portion of B2 clusters turns out to be significantly higher after quenching than after annealing, which correlates with the observed effect of heat treatment on the magnitude of magnetostriction. As the Ga concentration (21–25 at %) further increases, the observed features in the distribution of Ga atoms indicate the appearance and growth of D03 phase regions.
Wigner Function Method for Describing Electromagnetic Field in Plasma-Like Media with Spatial Dispersion and Resonant Dissipation
Authors: Gospodchikov E. D. , Balakin A. A. , Shalashov A. G.
Published: September 2024

The paper gives a systematic presentation of the Wigner function method (Weyl formalism) for modeling the propagation and absorption of electromagnetic waves in anisotropic and gyrotropic dissipative media with spatial dispersion. A general kinetic equation for the Wigner function (tensor) is formulated, and its asymptotic expansion up to the second order for smoothly inhomogeneous and weakly dissipative media is constructed. As a result, a modification of the method of the kinetic equation for rays is proposed, based on the stochastic description of rays, making it possible to increase the accuracy of numerical modeling of wave problems with strong transverse inhomogeneity of the absorption coefficient without increasing the amount of calculations. The technique developed can be used to describe the propagation, absorption, and scattering of electron-cyclotron waves in high-temperature plasma of magnetic traps for controlled fusion in cases where standard modeling methods do not provide the necessary accuracy.
All genera of the world: Subfamilies Prototroginae, Cretoscarabaeinae, Dynamopodinae, Electrorubesopsinae, Phaenomeridinae, Orphninae, Allidiostomatinae, Aclopinae, Lichniinae, Melolonthinae, Oncerinae, Podolasiinae, Sericinae, Sericoidinae (Animalia: Arthropoda: Insecta: Coleoptera: Scarabaeidae)
Authors: ALLSOPP PETER G. , SCHOOLMEESTERS PAUL
Published: September 2024

There are about 1275 genus-group names available in the 14 scarab subfamilies treated here by the end of August 2024. Of these, 917 refer to currently accepted genera, mainly in the Melolonthinae (611), Sericinae (168) and Sericoidinae (96). A further >390 genus-group names are given subgeneric rank, placed in synonymy or are unavailable. The chronology of descriptions of currently valid genera shows similar patterns in each of the three subfamilies with many described in the 1840s, a large group in the late 1800s and early 1900s and a steady increase in numbers following World War 2. We predict that discovery of new genera, as well as the potential for further splitting of mega-genera with elevation of subgenera to full generic level, will continue the upward trend, albeit somewhat balanced by combining the numerous monobasic genera. Type species are designated for Monochelus Le Peletier de Saint-Fargeau & Audinet-Serville, 1828, Lepischiza Moser, 1914 and Trichoschiza Moser, 1917.
Immediate Effects of Custom Foot Orthoses on Postural Balance and Pain in Obese Middle-Aged Women With Plantar Fasciitis
Authors: Hammami Ameni , Jouira Ghada , Sahli Sonia
Published: September 2024

Given the prevalence of plantar fasciitis (PF) among middle-aged women, we investigated the immediate impact of custom foot orthoses (CFO) on pain and static and dynamic postural balance, addressing a critical gap in understanding the potential benefits of CFO in managing PF-related pain and postural instability. Nine middle-aged women with PF and obesity were evaluated for pain levels and center of pressure (CoP) values in bipedal, unipedal with a non-affected foot, and unipedal with an affected foot on the Timed Up and Go (TUG) test, while they were barefoot, wearing standard insoles (SI), and wearing CFO. We found that CFO significantly and immediately reduced pain ( p < .01) improved CoP values ( p < .01) in the unipedal stance with the affected foot, and enhanced TUG test scores ( p < .001). The results demonstrated a significant ( p < .01) improvement in CoParea values and TUG test scores with CFO, compared to SI. These findings underscore the immediate benefits of CFO in alleviating pain and improving postural balance in obese middle-aged women with PF, highlighting their potential as a valuable intervention.
Beyond the ‘hubris of the zero point’: Methods for resisting epistemic oppression
Authors: Fugo Justin I.
Published: September 2024

This paper examines the epistemic dimension of dominant group ideologies in order to disrupt oppressive epistemic norms; specifically, the aspiration to ‘neutral’ knowledge, and as a result, what is given the status of knowledge, and who is considered to be producers of said knowledge. It aims to offer evidence that we are under the influence of a longstanding, oppressive, and dominative epistemological system, which leaves us facing clear structural and ideological barriers to epistemic justice. Following this structural critique, it offers measures for ‘changing the structures of knowledge’, alongside alternative norms for cultivating epistemic justice; most centrally, an alternative conception of objectivity understood as a product of democratically inclusive intersubjective and dialogical processes. In summary, this paper aims to: (1) highlight the centrality of structural oppression to epistemic injustice; (2) identify specific structures of epistemic oppression today; and (3) offer strategies for resisting epistemic oppression in order to cultivate epistemic justice.
Impact of internal lattice structures on the weight and natural frequencies of a low pressure turbine blade
Authors: Safdar Muhammad U , Shen Xing , Saheby Eiman B
Published: September 2024

Vibration characteristics play a crucial role in the overall performance of Low-pressure (LP) turbine blades and different techniques are developed to enhance vibrational response by increasing natural frequencies. The present analysis aims to develop a new technique based on the investigation of improvement in natural frequencies and mass reduction of a topology-optimized blade design through location-based integration of lattice structures inside the blades. FE models are developed for three different lattice locations based on mode shape behavior obtained through modal analysis of two different nickel-based alloys at stressed and unstressed conditions. The results show that the internal BCC lattice at specific locations showed better vibrational characteristics compared to other incorporated lattice structures, and validates the location-based integration scheme for enhancement of natural frequencies and reduced mass in applied conditions. By this method, 5.7% mass reduction was achieved from an already 35% mass-reduced blade along with enhancement in the first and second natural frequencies by 8.2% and 5.9% respectively when unstressed. At stressed condition, the natural frequencies increased by ≈7.7% and ≈6.6%.
Postoperative Acute Refractory Right Ventricular Failure: Incidence, Pathogenesis, Management and Prognosis
Authors: Kaul T.K. , Fields B.L.
Published: September 2024

Isolated acute refractory right ventricular failure is extremely uncommon. There are greater prospects of seeing a right dominant biventricular failure, as the two ventricular chambers are contiguous. The overall clinical spectrum is determined by the relative ischemic involvement of the right or left ventricle. The postoperative acute refractory right ventricular failure that develops after cardlotomy, heart transplant, or during a left ventricular assist device support, may have somewhat dissimilar elements of origin, but the resultant clinical picture and the management are essentially similar. In this collective review, the authors have summarized the incidence, pathogenesis, management and prognosis of postoperative acute refractory right ventricular failure, in adult cardiac surgical practice. The incidence of post-cardiotomy acute refractory right ventricular failure ranges from 0.04 to 0.1%. Acute refractory right ventricular failure has also been reported in 2–3% patients after a heart transplant and in almost 20–30% patients who receive a left ventricular assist device support. The main contributor to this problem is a disproportionate ischemic involvement of the right ventricle. Other pertinent contributors to this problem are pulmonary hypertension and an altered interventricular balance. The latter component is predominant in recipients of a left ventricular assist device support. Postoperative acute refractory right ventricular failure has been successfully managed with conventional pulmonary vasodilators, mechanical support with a pulmonary artery balloon pump, a right ventricular assist device, or cavopulmonary diversion. Unfortunately, the reported initial salvage rate is only 25–30%. This problem is often underestimated. Support measures are often started late or terminated prematurely. These factors have contributed to a poor initial salvage rate in this group of patients.
Comparative Results of Staged and Simultaneous Bilateral Carotid Endarterectomy: A Clinical Study and Surgical Treatment
Authors: Dimakakos Panos B. , Kotsis Thomas E. , Tsiligiris Basil , Antoniou Aris , Mourikis Dimitris
Published: September 2024

Objective:

Bilateral carotid stenoses are actually managed by staged endarterectomy. The present study compares the results of the above surgical procedure with simultaneous bilateral carotid endarterectomy.

Methods:

Sixty-four carotid endarterectomies were carried out on two groups of thirty-two patients with bilateral carotid stenoses. Fifteen patients (group A) were subjected to staged and 17 patients (group B) who were subjected to simultaneous bilateral carotid endarterectomies.

Results:

The mortality rate was zero in both groups; no statistically significant difference was found concerning complications related to the heart, neurological deficit and postoperative hypertension.

Conclusions:

Simultaneous carotid endarterectomy is a challenging and technically demanding operation but with limited indications in strictly selected patients. The development of methods of more effective monitoring and protection of the cerebral cells might broaden the indications of such a surgical tactic in the future. Staged carotid endarterectomy, however, remains the method of choice for the management of bilateral carotid occlusive disease.
Importance of Cardiovascular Interventions before Surgery for Abdominal Aortic Aneurysms
Authors: Busch T. , Sirbu H. , Aleksic I. , Friedrich M. , Dalichau H.
Published: September 2024

Preoperative screening, and interventional and surgical therapy of cardiovascular diseases are of pivotal importance for successful outcome after abdominal aortic aneurysm surgery. In a retrospective study, all patients who underwent surgery for abdominal aortic aneurysm were reevaluated by preoperative diagnostic and therapeutic interventions for cardiovascular disease. Two study periods (1980–1989 and 1990–1996) were compared. Of 603 patients operated upon for abdominal aortic aneurysm between 1980 and 1996, 449 had surgery on an elective basis and 154 as an emergency. Preoperative diagnostic studies for coronary artery disease were performed on elective patients and were positive in 76.8% (1980–1989, 76.1%, 1990–1996, 77.5%). Coronary angiography was performed in 108 patients (29.6%). Medical therapy of coronary artery disease declined by 2.3%, and interventional procedures by 18.8%. In contrast, myocardial revascularization with subsequent aneurysm resection increased by 26.6% and 12 patients (16%) required urgent simultaneous cardiac and aortic surgery. Early mortality after abdominal aortic aneurysm surgery decreased from 4.2 to 2.9%, and the frequency of primary cardiac failure as the cause of death was reduced from 33.3 to 22.2% ( P < 0.05). It was concluded that 42.6% more cardiac surgical procedures were performed before abdominal aortic aneurysm surgery since 1990 compared with the period 1980–1989. In contrast, the number of interventional procedures fell by 18.8%. Surgical therapy of cardiac disease reduces early mortality after elective abdominal aortic aneurysm surgery.
Intensive Care is Cost-Effective in Carotid Endarterectomy
Authors: Ross S. D. , Tribble C. G. , Parrino P. E. , Shockey K. S. , Kern J. A. , Kron I. L.
Published: September 2024

The purpose of this study was to analyze the utilization, cost profile, and predictors of intensive care unit (ICU) services after carotid endarterectomy. A retrospective medical record review of all patients undergoing isolated carotid endarterectomy by a vascular surgery service at one university hospital during a 12-month period was performed. Eighty-four patients undergoing 91 carotid endarterectomies were identified for review. All carotid endarterectomy patients at the authors' institution were routinely admitted to an ICU postoperatively. Sixty-five of the 91 patients (71.4%) required ICU interventions, the majority of which were intravenous antihypertensive therapy. There were no deaths in the group. There was one non-fatal stroke (1.1%), and one non-fatal myocardial infarction (1.1%). There were three reoperations (3.3%): two for hematoma and one for a change in neurological status. One patient required reintubation. Five of the six major adverse events after carotid endarterectomy occurred within 12 hours postoperatively. No preoperative factors predicted a significant risk for complications following carotid endarterectomy. There is no reliable predictor that carotid endarterectomy patients will require postoperative interventions or develop adverse outcomes. Mandatory intensive care immediately after carotid endarterectomy upholds high safety standards, avoids the uncertainty of preoperative ICU planning, and avoids the high cost of a recovery room stay to determine the need for intensive care. In addition, costs may be further reduced as the ICU length of stay may be decreased if there are no necessary interventions or complications after 12 hours of intensive care.
Is There Carotid Artery Aneurysm Formation following Saphenous Vein Patch Endarterectomy?
Authors: Wheeler J.M.D. , Wright I. , Pugh N. , Lane I.F.
Published: September 2024

The use of saphenous vein patching following carotid endarterectomy is reported to produce aneurysmal dilatation with the risk of thrombosis and possible rupture. The authors have studied patients who have had saphenous vein patch angioplasty following carotid endarterectomy to assess whether there is any progressive arterial dilatation. Thirty-five patients who had undergone saphenous vein patch carotid endarterectomy were age- and sex-matched with 31 subjects that had direct closure endarterectomy. All participants underwent carotid duplex scanning. The external diameters of the mid common carotid artery, the bulb and the proximal internal carotid artery were measured bilaterally. The diameters of the endarterectomized carotid were compared with the contralateral side using a paired t-test. Using an unpaired t-test the saphenous vein angioplasty group was compared with the directly closed group A graph was plotted of the ratio of internal carotid artery diameter of the saphenous vein angioplasty group (endarterectomized artery to the contralateral artery) against the length of follow-up, and the Pearson correlation coefficient was calculated. When the saphenous vein angioplasty group was compared with the directly closed group there was a significant difference between the carotid bulb (11.6 versus 9.7 mm. P < 0.001) and internal carotid artery diameters (9.0 versus 7.0 mm. P < 0.001). Longitudinal analysis of the saphenous vein angioplasty group showed that the increased diameter of the endarterectomized internal carotid artery progressed with time after surgery ( r = 0.51. P < 0.005. and r = 0.56 P < 0.001). Vein patching increases the diameter of the internal carotid artery, and this may further increase with time possibly predisposing to aneurysm formation. Further longitudinal studies of paired data are required.
Open Saphenectomy Complications following Lower Extremity Revascularization
Authors: Dalman R. L. , Abbruzzese T. , Bushnik T. , Harris E. J.
Published: September 2024

A review of saphenectomy site complications following lower extremity revascularization was conducted. Leg incisions used for 133 consecutive infrainguinal bypass procedures were categorized by location. Patient and procedural risk factors were analyzed for risk of wound complications. Procedure, limb and patient outcome were reported via life table analysis. Incisional wound complications followed 32/133 procedures (24%), including 15 groin, eight saphenectomy, five distal and four vein/distal incisions. There were five grade I and three grade II saphenectomy complications. Only weight (body mass index) predicted the likelihood of wound complication ( P < 0.05). The 6-month primary patency rate was 79% (mean follow-up 22 months). Four-year assisted primary patency, limb salvage and survival rates were 75.87 and 57%, respectively. Most bypass-related wound complications (24/32, 75%) involve arterial access incisions. Incisional complications are related to body mass index. Only 6% of GS vein bypass procedures develop saphenectomy site complications. Limiting saphenectomy size may not significantly reduce incisional morbidity following bypass grafting. Published by Elsevier Science Ltd.
Two Different Techniques of Retrograde Cerebral Perfusion for Thoracic Aortic Surgery through a Left Thoracotomy
Authors: Ogino H. , Ueda Y. , Sugita T. , Sakakibara Y. , Matsubayashi K. , Nomoto T.
Published: September 2024

The authors used profound hypothermic circulatory arrest and continuous retrograde cerebral perfusion for aortic surgery that involved the distal arch through a left thoracotomy. For the first seven patients, oxygenated blood from cardiopulmonary bypass was perfused retrogradely through a venous cannula positioned into the right atrium. In the last 11 cases, venous blood, provided by a perfusion from the lower body, was circulated passively in the brain with the descending aorta clamped. The period of profound hypothermic circulatory arrest was 34.6 ± 11.1 min, and continuous retrograde cerebral perfusion was 31.3 ± 11.1 min. Seventeen patients survived, but there was one early death. Two patients with a severely atherosclerotic aneurysm developed permanent neurological dysfunction. The combination of profound hypothermic circulatory arrest, continuous retrograde cerebral perfusion and open aortic anastomosis through a left thoracotomy protects the brain adequately, and facilitates evacuation of debris and air in the aortic arch. It produces satisfactory results for aortic surgery that involves the distal arch.
Ischaemic Complications with Intra-Aortic Balloon Counter-Pulsation: Incidence and Management
Authors: Sirbu H. , Busch T. , Aleksic I. , Friedrich M. , Dalichau H.
Published: September 2024

The most important limitation of the use of the intra-aortic balloon pump is the risk of vascular complications. The aim of this study was to identify risk factors and aspects of diagnosis and management that may decrease the risk of vascular morbidity associated with intra-aortic balloon pumps. Risk factors, surgical techniques, complications and other variables were retrospectively evaluated in 524 patients who had an intra-aortic balloon pump inserted between January 1988 and December 1998. Of the total, 140 (26.7%) patients with an intra-aortic balloon pump had ischaemic complications that needed surgery. The mean age was 65.2 ± 12.3 years (66.7% men and 27.5% women). The mortality rate was 28.1%. The mortality for patients with ischaemic vascular complications was significantly higher than in those patients without (59.6 versus 30.1%. P = 0.001). One-hundred and eight (77.2%) ischaemic complications occurred during therapy with an intra-aortic balloon pump and 32 (22.8%) complications after intra-aortic balloon pumping had been stopped. Thromboembolectomy was required in 71 (50.7%) patients. Associated surgical procedures were performed in 69 (49.3%) patients. A history of peripheral vascular disease (43.6 versus 23.6%, P < 0.05) and the presence of diabetes mellitus (49.2 versus 16.9%. P < 0.05) increased the risk of limb ischaemia significantly. Limb ischaemia remains the major complication after intra-aortic balloon pump insertion. Independent predictors for vascular complications included peripheral vascular disease and diabetes. Intra-aortic balloon pump removal and thrombectomy is usually sufficient to provide revascularization. Identification of subclinical disease may aid in the management of subsequent acute limb ischaemia.
Complex Traumatic Dissection of Right Vertebral and Bilateral Carotid Arteries: A Case Report and Literature Review
Authors: Busch T. , Aleksic I. , Sirbu H. , Kersten J. , Dalichau H.
Published: September 2024

A 27-year-old female motorcycle passenger was admitted with bruises and concussion after a motor-vehicle accident. After a lucid interval of several hours she became stuporous and progressed to an acute comatose state. Computed tomography demonstrated extensive cerebral ischaemia in the territory of the right middle cerebral artery. Angiography after transfer to the authors' hospital revealed dissections of both carotid arteries and of the right vertebral artery. The patient underwent surgical reconstruction of the left internal carotid artery with saphenous vein. The management of this patient is discussed and the literature reviewed.
Emergency Repair of Type a Aortic Dissection in Type IV Ehlers—Danlos Syndrome
Authors: Ascione R. , Gomes W.J. , Bates M. , Shannon J.L. , Pope F.M. , Angelini G.D.
Published: September 2024

Ehlers—Danlos syndrome type IV is a distinctive syndrome in which thin and fragile skin, premature ageing, bruising and scarring are combined with lethal or life-threatening arterial weakness Aortic rupture either at the aortic root and arch, or sometimes lower down the artery, are Darticularly characteristic. Even quite minor injury can produce dangerous vascular tearing and damage Technical difficulties encountered in arterial repair or venous ligature are particularly worrvinq The authors report the treatment of a ruptured type A aortic dissection associated with Ehlers—Danlos syndrome where the extreme fragility of the tissues and tendency to bleed posed a difficult task for the surgeon.
Fatal Fungal Infection Complicating Aortic Dissection following Coronary Artery byPass Grafting
Authors: Rassl D. M. , Suvarna S. K. , Cooper G. J.
Published: September 2024

The case of a 52-year-old man with severe coronary atheroma/ischaemic heart disease, who underwent successful triple vessel coronary artery bypass grafting is described. One month later this was complicated by aortic dissection arising at the aortic cannulation site. An emergency resection and Dacron graft placement were performed. Five weeks later he represented with haemoptysis. Despite inconclusive investigations the patient went on to suffer a massive fatal haemoptysis. Autopsy revealed Candida infection of the graft with a secondary aortobronchial fistula.
Potential Risks in Coronary Artery Bypass Grafting via Mini-Thoracotomy: A Case Report
Authors: Yorgancioğlu C. , Tezcaner T. , Çatav Z. , Zorlutuna I. Y.
Published: September 2024

This paper describes a patient with an occluded left internal thoracic artery, possibly as a result of the proximal ‘steal phenomena’, following coronary artery bypass grafting via mini-thoracotomy without cardiopulmonary bypass.
Non-Atherosclerotic Saccular Aneurysmal Degeneration of a Saphenous-Vein Graft Inserted for Repair of a Popliteal Aneurysm
Authors: Taurino Maurizio , Bernucci Paola , Rizzo Luigi , Sbarigia Enrico , Speziale Francesco , Fiorani Paolo
Published: September 2024

The Authors describe a case of a saccular aneurysm formation in a femoropopliteal autologous saphenous vein graft, inserted 12 years before. The patient was initially treated for a popliteal aneurysm. The graft revealed no microscopic signs of atherosclerosis. In spite of the widespread use of the autologous saphenous vein as arterial substitute, this complication is extremely rare.
Surgical Management of Extensive Lipomatous Hypertrophy of the Right Atrium
Authors: Christiansen S. , Stypmann J. , Baba H.A. , Hammel D. , Scheld H.H.
Published: September 2024

Lipomatous hypertrophy of the right atrium is a rare lesion that is usually limited to the interatrial septum. The authors report on a patient that suffered from an extensive lipomatous hypertrophy, which protruded into the right and left atrium as well as the superior vena cava and caused inflow obstruction. Therapeutic management is discussed.
Harmonization of Vascular Surgical Training in Europe. A Task for the European Board of Vascular Surgery (EBVS)
Authors: Buth J. , Harris P. L. , Maurer P. C. , Nachbur B. , van Urk H.
Published: September 2024

The competence of vascular surgeons defined as the level of skill, knowledge and experience necessary to safely perform vascular surgical procedures is determined to a high degree by the quality of the preceding training. In Europe, quality assurance of vascular surgical training, unlike in the USA, is not uniform and is not the responsibility of a centralized European authority, but is a matter in which the different countries have autonomous regulations. Consequently, different targets for duration, contents and general principles for training in vascular surgery have been set. Although in the past this may not have been a problem, the unification of countries in the European Community (EC), at present known as the European Union (EU), has changed this perspective because there is increasing impetus towards a mutual recognition of trade and education between member states. In 1975, EC directive 75/362 was adopted, which insured ‘freedom of migration’ for medical doctors along with many other professional trades (Publications of the European Communities no. L167, 30-6-1975, p. 1). This directive implicated that certificates, diplomas and other documents issued by the national competent authorities proving medical qualification allowed physicians to practice in any EU country. In order to make this law practical it seems essential that specialist training programmes throughout the EU should conform to certain agreed basic standards. The objective of this article is to present an overview on the current pattern of vascular surgical training in Europe. In addition, the structures that were established during the recent years to promote uniformly high standards of training in vascular surgery throughout the EU will be discussed.
The Australian Experience in Training and Certification of Vascular Surgery
Authors: May J.
Published: September 2024

Training in vascular surgery in Australia and New Zealand has been closely related to the policies and politics of the Royal Australasian College of Surgeons. It has evolved from being part of the training for General Surgery through a two year post Fellowship training program in Vascular Surgery commencing in 1985 to the establishment in 1996, by the College, of a Board in Vascular Surgery responsible for training and examining in Vascular Surgery as specialty independent of the Board in General Surgery.
The Influence of Gender on Outcome following Peripheral Vascular Surgery: A Review
Authors: Norman P.E. , Semmens J.B. , Lawrence-Brown M. , Holman C.D.J.
Published: September 2024

There is considerable evidence that outcome following intervention for coronary artery disease in women may be worse than it is for men. The influence of gender on outcome following peripheral vascular surgery has received less attention and is the subject of this review. The incidence of most vascular procedures in women is 20–40% that of men. Women appear to have a greater risk of dying following surgery for abdominal aortic aneurysm, a higher risk of stroke and death following carotid endarterectomy, and poorer patency rates following infrainguinal bypass. The causes may include delayed diagnosis and referral, increased co-morbidity and possibly the effect of smaller arteries in women.
Early Carotid Endarterectomy after Stroke
Authors: Parrino P.E. , Lovelock M. , Shockey K.S. , King C. , Tribble C.G. , Kron I.L.
Published: September 2024

The authors sought to determine if patients with stroke and a high-grade carotid stenosis benefited from a delay before carotid endarterectomy. A retrospective study of 45 patients undergoing carotid endarterectomy after stroke is presented. The patients were divided into two groups: group I (early group, n = 20), composed of patients who had carotid endarterectomy less than 6 weeks after stroke, and group II (late group, n = 25), comprised of patients who had carotid endarterectomy more than 6 weeks after stroke. As assessed by cerebral angiography, 100% of patients in group I and 64% of patients in group II had carotid artery stenoses > 76% ( P < 0.001). The median interval from stroke to carotid endarterectomy was 14 days in group I and 129 days in group II. There was no mortality in either group. No patients in either group demonstrated any neurological deterioration. The authors conclude that, in select patients, carotid endarterectomy may be done safely less than 6 weeks after stroke in order to avoid new events or carotid occlusion while awaiting surgery.
The Association of Platelet-Derived Growth Factor Receptor Expression, Plaque Morphology and Histological Features with Symptoms in Carotid Atherosclerosis
Authors: Irvine C.D. , George S.J. , Sheffield E. , Johnson J.L. , Davies A.H. , Lamont P.M.
Published: September 2024

Platelet-derived growth factor may influence smooth muscle cell migration and proliferation and, therefore, carotid plaque composition and stenosis. Platelet-derived growth factor receptor expression and histological features were compared in carotid plaques from symptomatic and asymptomatic patients, Immunocytochemistry and histology determined platelet-derived growth factor-α and -β receptor expression, white blood cell infiltration, smooth muscle cell, elastin, cholesterol, collagen and intraplaque haemorrhage in carotid artery plaques removed at surgery or the post-mortem. Plaques with > 70% stenosis from asymptomatic ( n = 10) and symptomatic patients ( n = 27) had higher expression of platelet-derived growth factor and β receptors and higher scores for macrophages and intraplaque haemorrhage than plaques with < 70% stenosis from asymptomatic patients ( n = 33). Plaques with > 70% stenosis from symptomatic patients had significantly lower α receptor expression than plaques with > 70% stenosis from asymptomatic patients. The reduction of α receptor expression, which may inhibit smooth muscle cell migration, suggests that differential expression of platelet-derived growth factor receptor subunits in plaques may be related to symptoms.
Venous Physiology in the Different Patterns of Recurrent Varicose Veins and the Relationship to Clinical Severity
Authors: Jiang P. , van Rij A.M. , Christie R.A. , Hill G.B. , Thomson I.A.
Published: September 2024

Venous function measured by air-plethysmography (APG) was compared to anatomical patterns of reflux assessed by duplex scanning and associated clinical features in 253 limbs with recurrent varicose veins following previous superficial venous surgery. The results showed that a previous history of deep venous thrombosis, previous procedure with preservation of the long saphenous vein, and a history of healed ulcer or current ulcer were each associated with worse venous function. Patterns of reflux which included multiple sites of reflux and presence of deep incompetence were also associated with worse venous function. Where there was reflux in the groin, limbs with a wide recurrent saphenofemoral junction presented the worst venous filling time and venous filling index, whereas those with reflux unrelated to the common femoral vein had nearly normal venous physiology and occurred almost exclusively in females. The other patterns of recurrence in the groin were physiologically indistinguishable from each other. In conclusion, certain patterns of reflux, clinical and operative features are associated with worse venous physiology in limbs with recurrent varicose veins. These features of recurrence with more severe physiological disturbance may necessitate a higher priority for surgical intervention.
The Effect of Intraoperative Autotransfusion on Antibiotic Pharmacokinetics during Elective Abdominal Aortic Aneurysm Repair
Authors: Aiono S. , Stacey A. , Magee T. R. , Galland R. B.
Published: September 2024

Aim:

Blood loss during aortic surgery has been reduced by the use of cell-salvage techniques (CS). Antibiotics are used routinely to prevent prosthetic graft infection. The influence of CS on antibiotic levels is unknown. This study measured antibiotic levels in serum and cell-salvage fluid during aortic reconstruction.

Methods:

Teicoplanin, a glycopeptide with activity against Gram positive bacteria was the antibiotic studied. Serial blood levels were measured after a single intravenous dose (400 mg) in five patients undergoing elective aortic aneurysm repair. Patient ages ranged from 67 to 82 yr. Cell-salvage (Dideco compact A75171) fluid was also assayed.

Setting:

District General Hospital

Results:

Serum teicoplanin levels peaked at mean 67.8 mg/l (SD 8.9 mg/l) 5 min after administration, and fell to mean 2.88 mg/l (SD 0.4 mg/l) at 720 min. This is less than levels in healthy volunteers but above the MIC90 for most Gram positive bacterial pathogens encountered in aortic surgery. Teicoplanin levels in discarded CS fluid at the end of the procedure were 0.56 mg/l (SD 0.71 mg/l).

Conclusions:

Teicoplanin blood levels are reduced during aortic surgery. Levels remain adequate for antibacterial prophylaxis for 12 h postoperatively other than for methicillin-resistant staphylococcus epidermidis (MRSE). Compared with patients undergoing arterial reconstruction without the use of a cell-salvage device there is no significant loss due to CS use.
Immunophenotypic Analysis of the Aortic Wall in Takayasu's Arteritis: Involvement of Lymphocytes, Dendritic Cells and Granulocytes in Immuno-Inflammatory Reactions
Authors: Inder SJ , Bobryshev Y.V. , Cherian S.M. , Wang A.Y. , Lord R.S.A. , Masuda K. , Yutani C.
Published: September 2024

The present study was undertaken to examine the cellular composition of the aortic wall in Takayasu's arteritis and to investigate the association of different cell types in the immuno-inflammatory reactions of this disease. Specimens of aortic wall affected by Takayasu's arteritis were obtained from 10 patients (five male, five female), aged 32 to 68 years (mean 49.5 years) at elective operation. The mean duration of disease was 6.5 years (range 2 months to 13 years). Specimens were embedded in paraffin and the sections stained with antibodies to CD3 (to identify T cells), CD20 (B cells), S-100 (dendritic cells), CD15 (granulocytes). CD68 (macrophages), alpha-SMA (smooth muscle cells) and von Willebrand factor (endothelial cells). Immunohistochemical examination demonstrated that all specimens showed histological alteration with the replacement of the muscular and elastic layers of the media and adventitia by dense fibrous tissue, and were characterized by varying degrees of inflammatory cell infiltration. In five cases, inflammatory nodules consisting of numerous T cells and B cells were observed in the adventitia. Within the inflammatory nodules, as well as around areas of neovascularization in the deep portion of the intima, lymphocytes were co-localized with dendritic cells. In addition, in the adventitia, the accumulation of a large number of granulocytes was observed. The present study demonstrates that immune inflammation is a typical feature of Takayasu's disease, and that the interactions between dendritic cells and lymphocytes may be important in the control of the immune reactions in this vascular pathology.
Impact of Malignant Hematological Disorders on Cardiac Surgery
Authors: Christiansen S. , Schmid C. , Löher A. , Scheld H. H.
Published: September 2024

Background:

Patients suffering from malignant hematological disorders may be at increased risk, when undergoing cardiac surgery. We report on our experiences with ten cardiac procedures in nine patients (3 males, 6 females. 19–85 yr old, mean age 61 yr).

Methods and Results:

There were two patients with Hodgkin's lymphoma and one patient each with Waldenström's syndrome, multiple myeloma, polycythemia, myelodysplasia, chronic lymphocytic leukemia, non-Hodgkin's lymphoma and idiopathic aplastic anemia. Cardiac diseases included coronary artery disease in six, aortic stenosis in two, and mitral insufficiency in one patient. Consecutively, cardiac procedures were coronary artery bypass grafting in six, aortic valve replacement in two, and mitral valve replacement in one patient. No patient died. Postoperatively, one patient suffered from a pericardial tamponade requiring surgical removal and 5 months later from a prosthetic endocarditis necessitating change of the bioprosthesis. One patient developed a superficial wound infection, which was treated conservatively. Four patients received no blood products. Altogether, we transfused 32 packed red blood cells, seven units of fresh frozen plasma and 16 platelet concentrates. Total drainage loss was 883 ml (250–1510 ml).

Conclusions:

Cardiac surgery in patients suffering from malignant hematological disorders may be performed, but carries an increased morbidity. Therefore, indications for cardiac procedures must be carefully considered.