A working cardiac valve phantom for radiographic assessment of prosthetic heart valves

RATIONALE AND OBJECTIVES: A working valve phantom (WVP) that both exercises the valve occluder and simulates movements of the mitral annulus is described. It was designed to develop a method for radiographic detection of a single broken leg of the two-legged Bj?rk-Shiley convexo-concave (C/C) heart valve outlet strut. METHODS: The WVP consists of a pneumatically driven left ventricular assist device immersed in 22 cm of water. Left ventricular assist device annulus movements are generated by systolic turgor and diastolic relaxation of the aortic outflow graft within limits set by the holding fixture design. RESULTS: WVP images were comparable in attenuation, valve motion, and diagnostic sensitivity to clinical C/C valve images and were effective in assessing leaflet excursions in another valve model. Techniques developed in the WVP have proved successful in the clinical detection of C/C valves that have a single broken leg but that show normal function in all other tests. CONCLUSION: The WVP can be a useful tool for developing refined radiographic assessments of prosthetic heart valves.     

Validation of a telephone questionnaire for Parkinson''s disease

Unfractionated as well as low-molecular-weight heparins (LMWH) are known to cause an increase in blood levels of tissue factor pathway inhibitor (TFPI). To study the effect of a newly developed supersulfated LMWH (IK-SSH, Iketon Farmaceutici) on TFPI concentrations in human plasma, the compound was injected into volunteers at doses of 0.14, 0.33 and 0.66 mg/kg intravenously or 0.33, 0.66 and 1.0 mg/kg subcutaneously. At certain known times blood was drawn and plasma levels of both total and free TFPI were measured using enzyme-linked immunosorbent assay methodology. Baseline plasma concentrations of TFPI were 72.2+/-3.1 ng/ml for total and 10.8+/-0.8 ng/ml for free TFPI. Intravenous or subcutaneous injection of IK-SSH led to a strong and long-lasting rise in TFPI levels which were increased more than 5-fold for total TFPI and more than 30-fold for free TFPI. Maximum TFPI levels were reached 5-10 min after intravenous and 60 min after subcutaneous administration. IK-SSH caused prolongation of ex-vivo clotting times in the APTT and Heptest assay, whereas thrombin time was not affected. Anticoagulant actions of IK-SSH showed a significant correlation to plasma concentrations of TFPI and they are thought to be based at least partially on the release of TFPI from vascular sites.     

Identification and cloning of the membrane-associated serine protease, hepsin, from mouse preimplantation embryos

Previous studies have suggested the existence of a membrane-associated serine protease expressed by mammalian preimplantation embryos. In this study, we have identified hepsin, a type II transmembrane serine protease, in early mouse blastocysts. Mouse hepsin was highly homologous to the previously identified human and rat cDNAs. Two isoforms, differing in their cytoplasmic domains, were detected. The tissue distribution of mouse hepsin was similar to that seen in humans, with prominent expression in liver and kidney. In mouse embryos, hepsin expression was observed in the two-cell stage, reached a maximal level at the early blastocyst stage, and decreased subsequent to blastocyst hatching. Expression of a soluble form of hepsin revealed its ability to autoactivate in a concentration-dependent manner. Catalytically inactive soluble hepsin was unable to autoactivate. These results suggest that hepsin may be the first serine protease expressed during mammalian development, making its ability to autoactivate critical to its function.