bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcome of Patients Treated with Engager Transapical Aortic Valve Implantation
Authors: Sündermann Simon H. , Grünenfelder Jürg , Corti Roberto , Rastan Ardawan J. , Linke Axel , Lange Rüdiger , Falk Volkmar , Bleiziffer Sabine 
Published: December 2013

Objective The aim of this study was to investigate the short-term and midterm outcome of the Engager transcatheter aortic valve implantation (TAVI) system, a transapical self-expanding valve device with anatomic orientation. Methods Transapical aortic valve implantation with the Engager valve prosthesis was performed in 10 patients. Endpoints were defined according to the Valve Academic Research Consortium recommendations for reporting outcomes of TAVI in clinical trials. Follow-up has been completed after 30 days and 1 year. Results All patients underwent the implantation procedure successfully. No device-related or delivery system–related complications were observed. One patient died of non–device-related reasons at postoperative day 23 in multiorgan failure. At 30-day follow-up, no more than mild transvalvular and paravalvular aortic regurgitation were seen. After 1 year, no transvalvular regurgitation was observed as assessed by transthoracic echocardiography. None of the patients had more than mild paravalvular leakage. The mean ± SD gradient was 15.3 ± 4.2 mm Hg. New York Heart Association class decreased one degree in mean and sustained until 1-year follow-up. No more patients died until 1-year follow-up. Conclusions Application of the Engager TAVI system is safe and reliable. Prosthesis deployment in an anatomically correct position was facilitated by the design of the valve prosthesis and successful in all patients. No device-related or delivery system–related complications occurred. Procedural, short-term, and midterm results up to 1 year concerning the aortic valve performance are promising, with stable mean gradients and low rates of even mild regurgitation.
Epicardial Surgical Ligation of the Left Atrial Appendage is Safe, Reproducible, and Effective by Transesophageal Echocardiographic Follow-up
Authors: Zapolanski Alex , Johnson Christopher K. , Dardashti Omid , O'Keefe Ryan M. , Rioux Nancy , Ferrari Giovanni , Shaw Richard E. , Brizzio Mariano E. , Grau Juan B. 
Published: December 2013

Objective The left atrial appendage (LAA) is the source of 90% of thrombi in patients with atrial fibrillation. Our double LAA ligation (LLAA) technique was shown to be 96% successful in a small study. However, the outcomes of these patients have yet to be compared with a set of nonligated patients. Methods From 2005 to 2012, a total of 808 patients received LAA using our double ligation technique using both a polydioxanone (PDS) II endosnare and a running 4-0 Prolene pledgeted suture. The 30-day outcomes of these patients were compared with that of nonligated patients. Fifty-six of the ligated patients had a postoperative transesophageal echocardiography (TEE). An echocardiographer reviewed the follow-up TEEs for LAA remnant and/or residual flow into the LAA using color Doppler imaging. The patients with LAA flow and/or remnant depth of 1 cm or greater were deemed to have an unsuccessful exclusion. Results The ligated group had a trend of less postoperative atrial fibrillation (19.4% vs 22.9%, P = 0.07) and an overall significantly lower in-hospital mortality (0.7% vs 3.0%, P < 0.001) and lower 30-day mortality (0.7% vs 3.4%, P < 0.0001). The LAA was successfully excluded in 53 (94.7%) of the 56 patients with TEE. Conclusions Double LAA ligation correlates with lower rates of in-hospital and 30-day mortality. This advantage comes without an increase in perioperative complications. This technique can easily be performed off or on pump, is very reproducible, and comes at a very low cost compared with LAA occlusion devices. Stroke has a multifactorial etiology; successful LLAA removes one potential source of thrombi perioperatively and in the long-term.
Survival, Predictive Factors, and Causes of Mortality following Transcatheter Aortic Valve Implantation
Authors: Alassar Aiman , Roy David , Valencia Oswaldo , Brecker Stephen , Jahangiri Marjan 
Published: December 2013

Objective Transcatheter aortic valve implantation (TAVI) is considered the standard of care for patients with severe symptomatic aortic stenosis unsuitable for surgery. However, short- and long-term mortality after TAVI are still relatively high. The aim of this study was to establish survival, predictive factors, and causes of mortality after TAVI at early and midterm follow-up. Methods Between December 2007 and May 2012, a total of 119 patients with symptomatic severe aortic stenosis underwent 121 TAVI procedures. The mean ± SD age was 81 ± 9 years, and 59% were men. The mean ± SD logistic European System for Cardiac Operative Risk Evaluation was 22 ± 15. Seventy-five patients (63%) were in New York Heart Association functional class III to IV. The transfemoral approach was used in 76% of the patients. One hundred ten patients (91%) had the CoreValve prosthesis, and 11 (9%) had an Edwards SAPIEN valve. Baseline characteristics, procedural complications, and outcomes were collected prospectively. Clinical outcomes were defined according to the Valve Academic Research Consortium criteria. Follow-up was completed for 100% of the patients at a median of 1.3 years (range, 0–4.5). Results The total number of deaths was 36 (30%). One-month mortality was 4.2%. Actuarial survival was 83.2%, 76.5%, and 68.2% at 1, 2, and 3 years, respectively. Acute kidney injury occurred in 12.3% of the patients, none of whom required dialysis during hospitalization. Twenty-one patients (17.6%) had new conduction abnormalities that required permanent pacemaker implantation before hospital discharge. The incidence of major vascular injury and stroke was 2.4% and 4.1%, respectively. Survival was significantly adversely affected by preprocedural left ventricular dysfunction ( P = 0.04), history of atrial fibrillation ( P = 0.03), prior heart block ( P < 0.01), and critical preoperative state ( P < 0.01). Twelve (33%) of the 36 deaths were due to bronchopneumonia. In 12 (33%) of the 36 patients who died, mortality was related to cardiac causes. When a death occurred within the first 30 days, it was mainly cardiac in nature (80%). Twelve patients (34%) died because of a variety of other reasons such as pulmonary embolism, stroke, cancer, renal failure, and sepsis. Conclusions Preprocedural left ventricular dysfunction, atrial fibrillation, and heart block are independent predictive factors of all-cause mortality. Early mortality was mainly cardiac in origin. Most of the late deaths were caused by noncardiac reasons, with bronchopneumonia being reported as the most common cause of late mortality.
Design Characteristics of a Three-Dimensional Geometric Aortic Valve Annuloplasty Ring
Authors: Crooke Philip S. , Beavan L. Alan , Griffin Charles D. , Mazzitelli Domenico , Rankin J. Scott 
Published: December 2013

Objective A full geometric annuloplasty ring could facilitate aortic valve repair. The purpose of this report was to document the design of such a ring using mathematical analyses of normal human aortic valve computed tomographic angiograms. Methods One-millimeter axial slices of high-resolution computed tomographic angiograms from 11 normal aortic roots were used to generate high-density x, y, and z coordinates of valve structures in Mathematica. Three-dimensional least squares regression analyses of leaflet-sinus coordinates were used to assess geometry of aortic valve and root structures. Results Normal valve geometry could be represented as three leaflet-sinus general ellipsoids nested within an elliptical aortic root. Minor-major diameter ratio of the valve base was 0.60 ± 0.07, and elliptical geometry extended vertically up the commissures. By contrast, leaflet-sinus horizontal circumferences were fairly circular (diameter ratios, 0.82–0.87), and the left coronary/noncoronary commissural post was located at the posterior base minor diameter-circumference junction, with the center of the right coronary leaflet opposite. Post location on the circumference was symmetrical, with a deviation of only ±2% to ±3% from 33.3% symmetry. Commissural posts flared outward by 5 to 10 degrees, and leaflet areas were statistically equivalent ( P > 0.10). From end diastole to midsystole, the aortic root became less elliptical (diameter ratio increased by 0.15), but root area expanded minimally (less than +5%). A one-piece rigid annuloplasty ring was designed with 2:3 base ellipticality, three 10-degree outwardly flaring symmetrical posts, and post height = base circumference/2π. Conclusions A three-dimensional aortic annuloplasty ring was designed that could prove useful for enhancing applicability and stability of aortic valve repair.
Gibberellic Acid-Induced Aleurone Layers Responding to Heat Shock or Tunicamycin Provide Insight into theN-Glycoproteome, Protein Secretion, and Endoplasmic Reticulum Stress
Authors: Barba-Espín Gregorio , Dedvisitsakul Plaipol , Hägglund Per , Svensson Birte , Finnie Christine 
Published: December 2013

AbstractThe growing relevance of plants for the production of recombinant proteins makes understanding the secretory machinery, including the identification of glycosylation sites in secreted proteins, an important goal of plant proteomics. Barley (Hordeum vulgare) aleurone layers maintained in vitro respond to gibberellic acid by secreting an array of proteins and provide a unique system for the analysis of plant protein secretion. Perturbation of protein secretion in gibberellic acid-induced aleurone layers by two independent mechanisms, heat shock and tunicamycin treatment, demonstrated overlapping effects on both the intracellular and secreted proteomes. Proteins in a total of 22 and 178 two-dimensional gel spots changing in intensity in extracellular and intracellular fractions, respectively, were identified by mass spectrometry. Among these are proteins with key roles in protein processing and secretion, such as calreticulin, protein disulfide isomerase, proteasome subunits, and isopentenyl diphosphate isomerase. Sixteen heat shock proteins in 29 spots showed diverse responses to the treatments, with only a minority increasing in response to heat shock. The majority, all of which were small heat shock proteins, decreased in heat-shocked aleurone layers. Additionally, glycopeptide enrichment and N-glycosylation analysis identified 73 glycosylation sites in 65 aleurone layer proteins, with 53 of the glycoproteins found in extracellular fractions and 36 found in intracellular fractions. This represents major progress in characterization of the barley N-glycoproteome, since only four of these sites were previously described. Overall, these findings considerably advance knowledge of the plant protein secretion system in general and emphasize the versatility of the aleurone layer as a model system for studying plant protein secretion.
In vitro functional interactions of acetylcholine esterase inhibitors and muscarinic receptor antagonists in the urinary bladder of the rat
Authors: Killi Uday K , Wsol Vladimir , Soukup Ondrej , Kuca Kamil , Winder Michael , Tobin Gunnar 
Published: December 2013

Summary

Obidoxime, a weak acetylcholine‐esterase (AChE) inhibitor, exerts muscarinic receptor antagonism with a significant muscarinic M2 receptor selective profile.

The current examinations aimed to determine the functional significance of muscarinic M2 receptors in the state of AChE inhibition, elucidating muscarinic M2 and M3 receptor interaction.

In the in vitro examinations, methacholine evoked concentration‐dependent bladder contractile and atrial frequency inhibitory responses. Although atropine abolished both, methoctramine (1 μmol/L) only affected the cholinergic response in the atrial preparations.

However, in the presence of methoctramine, physostigmine, an AChE inhibitor, increased the basal tension of the bladder strip preparations (+68%), as well as the contractile responses to low concentrations of methacholine (< 5 μmol/L; +90–290%). In contrast to physostigmine, obidoxime alone raised the basal tension (+58%) and the responses to low concentrations of methacholine (< 5 μmol/L; +80–450%). Physostigmine concentration‐dependently increased methacholine‐evoked responses, similarly to obidoxime at low concentrations. However, at large concentrations (> 5 μmol/L), obidoxime, because of its unselective muscarinic receptor antagonism, inhibited the methacholine bladder responses.

In conclusion, the current results show that muscarinic M2 receptors inhibit muscarinic M3 receptor‐evoked contractile responses to low concentrations of acetylcholine in the synaptic cleft. The muscarinic M2 and M3 receptor crosstalk could be a counteracting mechanism in the treatment of AChE inhibition when using reactivators, such as obidoxime.
The Influence of Deep Frying Using Various Vegetable Oils on Acrylamide Formation in Sweet Potato (Ipomoea batatas L. Lam) Chips
Authors: Lim P.K. , Jinap S. , Sanny M. , Tan C.P. , Khatib A. 
Published: December 2013

AbstractThe objective of this study was to evaluate the precursors of acrylamide formation in sweet potato (SP) (Ipomoea batatas L. Lam) chips and to determine the effect of different types of vegetable oils (VOs), that is, palm olein, coconut oil, canola oil, and soya bean oil, on acrylamide formation. The reducing sugars and amino acids in the SP slices were analyzed, and the acrylamide concentrations of SP chips were measured. SP chips that were fried in a lower degree of unsaturation oils contained a lower acrylamide concentration (1443 μg/kg), whereas those fried with higher degree of unsaturated oils contained a higher acrylamide concentration (2019 μg/kg). SP roots were found to contain acrylamide precursors, that is, 4.17 mg/g glucose and 5.05 mg/g fructose, and 1.63 mg/g free asparagine. The type of VO and condition used for frying, significantly influenced acrylamide formation. This study clearly indicates that the contribution of lipids in the formation of acrylamide should not be neglected.
Real‐Time PCR of cytomegalovirus and Epstein–Barr virus in adult Egyptian patients with systemic lupus erythematosus
Authors: Mohamed Aly E. , Hasen Amany M. , Mohammed Ghada F. A. , Elmaraghy Nermin N. 
Published: December 2013

AbstractObjectiveInfections may act as environmental triggers for induction of systemic lupus erythematosus (SLE). We sought to explore the relative frequencies of Epstein–Barr virus (EBV) and human cytomegalovirus (CMV) in adult Egyptian patients with SLE and their correlation with disease activity and damage.MethodsThirty‐three consecutive adult patients satisfying the 1997 American College of Rheumatology (ACR) Classification Criteria for SLE and 30 healthy controls were included in this case–control study. All patients were subjected to complete clinical and laboratory evaluation to determine the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) and the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SLICC/ACR). Sera from both groups were analyzed for immunoglobulin M (IgM) and IgG antibodies against CMV and EBV. Qualitative real time polymerase chain reaction (PCR) for both viruses was performed for all SLE patients.ResultsAlmost all SLE patients 32/33 (96.9%) were positive for IgG anti‐CMV antibodies versus 20/30 in the control group (66.6%) (P = 0.002). All SLE patients were positive for IgG anti‐EBV antibodies compared to 25 in the control group (100% vs. 83.3%, P = 0.02). CMV and EBV DNA were detected by PCR in 30.3% and 51.5% of SLE patients, respectively. A statistically significant lower SLEDAI was found in PCR positive patients for EBV compared to negative patients (9.6 ± 5.2 vs. 13.1 ± 3.1, respectively P = 0.041).ConclusionsAdult Egyptian patients with SLE had higher frequencies of anti‐CMV and EBV IgG compared to healthy controls. Furthermore, our single point assessment of SLEDAI suggested that exposure to EBV infection might be associated with a lower disease activity.
Phylogenetic divergence between the obligate luminous symbionts of flashlight fishes demonstrates specificity of bacteria to host genera
Authors: Hendry Tory A. , Dunlap Paul V. 
Published: December 2013

SummaryThe luminous bacterial symbionts of anomalopid flashlight fishes, which appear to be obligately dependent on their hosts for growth, share several evolutionary patterns with unrelated obligate bacteria. However, only one flashlight fish symbiont species has been characterized in detail, and it is therefore not known if the bacteria from other anomalopid species are highly divergent (a pattern common to obligate symbionts). Unlike most obligate symbionts, the bacteria symbiotic with anomalopids are extracellular and spend time outside their hosts in the environment, from which they are thought to colonize new host generations. Environmental acquisition might decrease the likelihood of bacterial divergence between host species. We used phylogenetic analysis to determine the relatedness of symbionts from different anomalopid host species. The symbionts of hosts in the genus Photoblepharon were resolved as a new species, for which we propose the name ‘Candidatus Photodesmus blepharus’. Furthermore, different genera of anomalopids were found to harbour different species of bacteria, even when the hosts overlapped in geographic range. This finding suggests that the divergence between bacterial species is not the result of geographic isolation. The specificity of symbionts to host genera is consistent with obligate dependence on the host and has implications for symbiont transmission.
Ventriculomegaly associated with ependymal gliosis and declines in barrier integrity in the aging human and mouse brain
Authors: Shook Brett A. , Lennington Jessica B. , Acabchuk Rebecca L. , Halling Meredith , Sun Ye , Peters John , Wu Qian , Mahajan Amit , Fellows Douglas W. , Conover Joanne C. 
Published: December 2013

SummaryAge‐associated ventriculomegaly is typically attributed to neurodegeneration; however, additional factors might initiate or contribute to progressive ventricular expansion. By directly linking postmortem human MRI sequences with histological features of periventricular tissue, we show that substantial lateral ventricle surface gliosis is associated with ventriculomegaly. To examine whether loss of ependymal cell coverage resulting in ventricle surface glial scarring can lead directly to ventricle enlargement independent of any other injury or degenerative loss, we modeled in mice the glial scarring found along the lateral ventricle surface in aged humans. Neuraminidase, which cleaves glycosidic linkages of apical adherens junction proteins, was administered intracerebroventricularly to denude areas of ependymal cells. Substantial ependymal cell loss resulted in reactive gliosis rather than stem cell‐mediated regenerative repair of the ventricle lining, and the gliotic regions showed morphologic and phenotypic characteristics similar to those found in aged humans. Increased levels of aquaporin‐4, indicative of edema, observed in regions of periventricular gliosis in human tissue were also replicated in our mouse model. 3D modeling together with volume measurements revealed that mice with ventricle surface scarring developed expanded ventricles, independent of neurodegeneration. Through a comprehensive, comparative analysis of the lateral ventricles and associated periventricular tissue in aged humans and mouse, followed by modeling of surface gliosis in mice, we have demonstrated a direct link between lateral ventricle surface gliosis and ventricle enlargement. These studies highlight the importance of maintaining an intact ependymal cell lining throughout aging.
Reductions in serum IGF‐1 during aging impair health span
Authors: Gong Zhenwei , Kennedy Oran , Sun Hui , Wu YingJie , Williams Garry A , Klein Laura , Cardoso Luis , Matheny Ronald W. , Hubbard Gene B. , Ikeno Yuji , Farrar Roger P. , Schaffler Mitchell B , Adamo Martin L , Muzumdar Radhika H , Yakar Shoshana 
Published: December 2013

SummaryIn lower or simple species, such as worms and flies, disruption of the insulin‐like growth factor (IGF)‐1 and the insulin signaling pathways has been shown to increase lifespan. In rodents, however, growth hormone (GH) regulates IGF‐1 levels in serum and tissues and can modulate lifespan via/or independent of IGF‐1. Rodent models, where the GH/IGF‐1 axis was ablated congenitally, show increased lifespan. However, in contrast to rodents where serum IGF‐1 levels are high throughout life, in humans, serum IGF‐1 peaks during puberty and declines thereafter during aging. Thus, animal models with congenital disruption of the GH/IGF‐1 axis are unable to clearly distinguish between developmental and age‐related effects of GH/IGF‐1 on health. To overcome this caveat, we developed an inducible liver IGF‐1‐deficient (iLID) mouse that allows temporal control of serum IGF‐1. Deletion of liver Igf ‐1 gene at one year of age reduced serum IGF‐1 by 70% and dramatically impaired health span of the iLID mice. Reductions in serum IGF‐1 were coupled with increased GH levels and increased basal STAT5B phosphorylation in livers of iLID mice. These changes were associated with increased liver weight, increased liver inflammation, increased oxidative stress in liver and muscle, and increased incidence of hepatic tumors. Lastly, despite elevations in serum GH, low levels of serum IGF‐1 from 1 year of age compromised skeletal integrity and accelerated bone loss. We conclude that an intact GH/IGF‐1 axis is essential to maintain health span and that elevated GH, even late in life, associates with increased pathology.
Maternal Circulating Dendritic Cell Subtypes at Delivery and During the 1‐Year Postpartum Period
Authors: Lee Hye Ryun , Kim Byoung Jae , Shin Sue , Jeon Hye Won , Roh Eun Youn , Yoon Jong Hyun , Song Eun Young 
Published: December 2013

ProblemDendritic cells (DCs) play an important role in maintaining pregnancy by inducing tolerance toward the fetus. Such an immunologic change in the mother should be restored to normal after delivery, but few studies have reported postpartum maternal immune recovery, in terms of the types circulating DCs.Method of studyThe level of each DC subtype and HLA‐DR‐positive immunoreactivity of the blood from 29 pregnant women with uncomplicated labor was serially analyzed by flowcytometry at delivery and at 1.5, 6, and 12 months after delivery. DC subtypes were characterized as myeloid, lymphoid, and less differentiated (ldDC). Mean fluorescence intensity (MFI) was evaluated for HLA‐DR expression for each DC subtype.ResultsThe total number and the percentage of DCs at delivery were lower than those at 12 months postpartum. The ldDC fractions were significantly higher at delivery and at 1.5 months than at 12 months postpartum. The MFI of HLA‐DR expression on ldDCs at delivery was lower than that at 12 months postpartum. The myeloid‐to‐lymphoid DC ratio did not differ over the 1‐year postpartum period.ConclusionThe maternal alteration in DCs rapidly normalized within 1.5 months, except for the ldDC fraction, which persisted between 1.5 and 6 months after delivery.
Ward safety checklist in the acute surgical unit
Authors: Blucher Kristopher M. , Dal Pra Samuel E. , Hogan James , Wysocki Arkadiusz Peter 
Published: December 2013

AbstractBackgroundDeficiencies in daily ward rounds are increasingly identified. A ward safety checklist has recently been devised to improve the fast‐paced surgical ward round.MethodsOver 2 weeks the morning post‐take surgical ward round was evaluated using the ward safety checklist. In order to avoid the Hawthorne effect, doctors involved were not aware their performance was being observed.ResultsOne hundred patient encounters were evaluated. The three phases of the card safety checklist showed statistically significant improvement but for many components compliance was below 100%.ConclusionImplementing this simple checklist has provided our unit with a starting point in how to overcome some of the deficiencies of the post‐take surgical ward round.