Double patch closure of ventricular septal defect with increased pulmonary vascular resistance

BACKGROUND: Closure of a large ventricular septal defect (VSD) in children with elevated pulmonary vascular resistance is associated with significant morbidity and mortality. Pulmonary hypertensive episodes continue to be a major cause of postoperative morbidity and mortality. We designed a fenestrated flap valve double VSD patch in an effort to decrease the morbidity and mortality associated with the closure of a large VSD with elevated pulmonary vascular resistance. METHODS: Eighteen children (mean age, 5.7 years) with a large VSD and elevated pulmonary vascular resistance (mean, 11.4 Wood units) underwent double patch VSD closure using moderately hypothermic cardiopulmonary bypass and cardioplegic arrest. The routine VSD patch was fenestrated (4 to 6 mm) and on the left ventricular side of the patch, a second, smaller patch was attached to the fenestration along its superior margin before closure of the VSD. RESULTS: All children survived operation and were weaned from inotropic and ventilator support within 48 hours postoperatively. Postoperative pulmonary artery pressures were significantly lower than preoperative values. One child died 9 months postoperatively. CONCLUSIONS: Closure of a large VSD in children with elevated pulmonary vascular resistance can be performed with low morbidity and mortality when a flap valve double VSD patch is used.     

An Experimental Workflow for Studying Barrier Integrity,Permeability, and Tight Junction Composition and Localization in a Single Endothelial Cell Monolayer: Proof of Concept

Endothelial and epithelial barrier function is crucial for the maintenance of physiological processes. The barrier paracellular permeability depends on the composition and spatial distribution of the cell-to-cell tight junctions (TJ). Here, we provide an experimental workflow that yields several layers of physiological data in the setting of a single endothelial cell monolayer. Human umbilical vein endothelial cells were grown on Transwell filters. Transendothelial electrical resistance (TER) and 10 kDa FITC dextran flux were measured using Alanyl-Glutamine (AlaGln) as a paracellular barrier modulator. Single monolayers were immunolabelled for Zonula Occludens-1 (ZO-1) and Claudin-5 (CLDN5) and used for automated immunofluorescence imaging. Finally, the same monolayers were used for single molecule localization microscopy (SMLM) of ZO-1 and CLDN5 at the nanoscale for spatial clustering analysis. The TER increased and the paracellular dextran flux decreased after the application of AlaGln and these functional changes of the monolayer were mediated by an increase in the ZO-1 and CLDN5 abundance in the cell–cell interface. At the nanoscale level, the functional and protein abundance data were accompanied by non-random increased clustering of CLDN5. Our experimental workflow provides multiple data from a single monolayer and has wide applicability in the setting of paracellular studies in endothelia and epithelia.     

Statistical Inter-Floor Radio Channel Model

Wireless Personal Communications - Statistical inter-floor radio channel model is proposed, based on extension of the existing single-floor Saleh–Valenzuela model. Instead of cluster of rays,...     

RMS Delay Spread Assessment for Indoor UWB Propagation Channels

Wireless Personal Communications - The RMS delay spread is often used to quantify the probability of inter-symbol interference in a propagation channel. A novel and straightforward procedure to...     

The influence of different components on interpenetrating polymer network's (IPN's) characteristics as automotive top coats

The aim of this study was to investigate the influence of different components of interpenetrating polymer networks (IPNs) on their behavior in dual curing automotive applications. Dual curing is one of possible ways to obtain fast curing, scratch resistant coatings for use in OEM and car refinish applications. Dual curing systems, upon hardening, represent interpenetrating networks (IPNs) [1]. IPN's were obtained using novel acrylate-terminated hyperbranched polyester with high functionality and compared to classical 2-pack polyurethane clear coat.     

Immune modulating effect of intravenous gamma globulin in a patient with overlapping syndrome

We report a 46 years old woman with a diagnosis of systemic lupus erythematosus and scleroderma overlapping syndrome. During treatment with steroids and azathioprine, the appearance of paresthesias and a progressive invalidating proximal weakness was interpreted as a steroidal myopathy. Steroidal treatment was progressively discontinued, but lupic activity and esophageal involvement exacerbated. Therefore, the use of immune modulating doses of intravenous gamma globulin (2 g/kg/total dose) was decided. The patient received this dose in two consecutive days and, 48 hours later, a notable improvement in esophageal function and general condition was verified. After six months of follow up, the disease remains inactive.