Rupture recurrence after surgical repair of postinfarction ventricular septal rupture. Influence of early thrombolysis

OBJECTIVES: The aim of this study was to identify factors causing rupture recurrence after surgical repair of postinfarction ventricular septal rupture and to evaluate the indication for reoperation. PATIENTS: Recurrence of rupture was analysed in 25 out of a series of 109 patients who underwent surgical repair for postinfarction ventricular septal rupture between 1980 and 1992 in our institution. RESULTS: The mean interval between initial operation and recurrence was 3.6 days with a median of 2 days. Multivariate logistic regression analysis identified early thrombolysis after infarction (P = 0.0085) as a risk factor for recurrence of the rupture. Rupture recurrence occurred more in the anterior then in the posterior infarction site, although non-significant. Reoperation was indicated in 15 patients, in 13 for postrecurrent cardiac failure. The main determinant of cardiac failure was a large postrecurrent shunt (P = 0.05). The mean interval between initial operation and reoperation was 136 days with a median of 101 days. In 6 patients a combined apical ventricular septal rupture recurrence and anterior ventricular aneurysm was found, in 9 patients the recurrent rupture was proximally located, without concomitant aneurysm formation. Of 15 patients who were reoperated, one died in hospital and three after the in-hospital period. Of 10 patients treated conservatively, one died in hospital and two after the in-hospital period. One residual ventricular septal rupture closed spontaneously. CONCLUSIONS: Rupture recurrence is mainly determined by early thrombolysis. Postrecurrent cardiac failure, as the main indication for reoperation, is dependent on postrecurrent shunt size.     

Results of irradiation treatment in patients with non-resectable oesophageal cancer

Forty-eight patients with non-resectable cancer of the oesophagus and oesophagogastric junction (Group A: Stage I/II, 32; Group B: Stage III/IV, 16) underwent intraluminal Iridium-192 high dose-rate afterloading therapy (5-7 Gy/session, total dose: 5-21 Gy, mean: 12.4 Gy) and external beam irradiation (Karnofsky > or = 80% 50-60 Gy/2 Gy per day; Karnofsky 60-79%: 30 Gy/3 Gy per day). Durable satisfactory palliation (intake of at least semi-solid food) was demonstrated in 96% of patients. The mean survival for group A was 19.1 months and that for group B, 6.9 months, with a 12-month survival rate of 66% (group A) and 0% (group B) (P < 0.001). Local tumour response and complication rate were significantly dose-related with a predicted response rate of 70.5%, and a complication rate of 50% at ERD 129.3 Gy.     

Mutations in the EXT1 and EXT2 genes in hereditary multiple exostoses

In an in-vitro preparation of gastric mucosae of Rana pipiens, the effect of adding melittin to a concentration of 5x10-6 M in the secretory solution on the transepithelial potential difference (PD), resistance (R) and short-circuit current (Isc) was studied. In 20 min, melittin decreased the PD by 9.3 mV and R by 148 ohm cm2. These changes can be explained by a decrease in the resistance, RP, of the paracellular pathway. To determine whether specific-ion pathways were responsible for the decrease in R, the effect of melittin on the partial conductances of Cl-, K+ and Na+ was also studied using the ion substitution method. Melittin decreased the PD response to changes in nutrient Na+, K+ and Cl- and the PD response to changes in secretory Cl-, but did not affect PD responses to changes in secretory Na+ or K+. Therefore, melittin decreased the nutrient membrane partial conductances of Cl-, K+ and Na+ and secretory membrane partial conductance of Cl-, without affecting the secretory partial conductances of Na+ or K+. Initially, melittin increased Isc in regular and Cl--free but not in Na+-free solutions. There was a delayed decrease in Isc. The results indicate that melittin decreases RP, increases the Na+ conductance of the secretory membrane and inhibits, eventually, the Na+/K+-ATPase pump.     

Familial transmission of a serious disease--producing group A streptococcus clone: case reports and review

Invasive group A streptococcus (GAS) infections are emerging diseases; however, person-to-person transmission of invasive GAS producing life-threatening infection has been observed rarely. We report a small intrafamilial cluster of life-threatening GAS infections. A previously healthy 47-year-old father developed necrotizing fasciitis of the neck. Two days later, his 16-year-old daughter developed streptococcal angina, pneumonia, and pleural empyema. Both patients had signs of streptococcal toxic shock syndrome. Pulsed field gel electrophoresis revealed that the M6 strains of GAS isolated from the father and daughter had identical patterns. Cases of person-to-person transmission of invasive GAS infection reported in the literature are also reviewed.     

我国成功研制机载大气污染探测系统

正中国科学院合肥物质科学研究院安徽光学精密机械研究所成功研制出1种用于机载、可快速获取区域环境大气污染成分的环境大气成分探测系统,并通过了安徽省科技成果转化服务中心组织的科技成果鉴定。该机载环境大气成分探测系统由大气环境激光雷达、差分吸收光谱仪和多角度偏振辐射计及主控管理器等4个子系统组成。研究人员研制出了国内首台探测气溶胶和云的双波长偏振航空遥感激光雷达。     

NMR-measurements for determination of local moisture content of coated wood

Local increased moisture content (MC) in wood constructions may result in different kinds of mechanical and, especially, biological degrading problems. Therefore, it is of great importance to control the MC of the material. However, there is at present no appropriate method for determining local MC in wood without destroying the product itself. Nondestructive measurements of local MC in wood is significant for the possibility of, for instance, monitoring the in situ MC in wood constructions over time, and thereby predicting potential problems. The nuclear magnetic resonance (NMR) technique has been shown to be valuable for the measurement of MC in wood. In this study, the possibility of utilizing this technique for local MC measurement in wood has been tested on wood samples exposed to water absorption for 72 h. The samples came from three different wood species treated with paint systems available on the market. In the wood samples an artificial “crack” had been created in the paint to introduce an area where the water could easily gain access to the wood. The results show the possibility of using the NMR technique for local MC measurements in wood. The measurement area, however, must be related to the properties of the material. In the case of wood, the measurement spot must be related to the early/latewood proportions. Further, a calibration of the NMR measurement must be made in relation to the expected density variations of the material.     

Behavior of Pt Atoms on Oxide Supports During Reduction Treatments at Elevated Temperatures,Characterized by Aberration Corrected Stem Imaging

Abstract  

Aberration-corrected scanning transmission electron microscopy at the sub-?ngstr?m resolution allows imaging the structure of catalytic materials at the single atom level and permits fundamental studies of the behavior of heavy metal catalytic species as a result of elevated temperature gas-treatments. The present study is aimed at understanding the development of clusters and nanoparticles of Pt on γ-alumina during reduction treatments of a pre-oxidized highly dispersed catalyst. A special built ex situ reactor and a specimen holder allowing cyclic anaerobic transfer between the reactor and microscope were used for the study. The number of atoms in a nascent cluster can be determined along with the general shape of the cluster. Reduction experiments without air exposure of the sample showed that although clusters are formed at 500 °C, many Pt atoms are not associated with the cluster and are still dispersed on the catalyst support. After a 700 °C reduction, all of the Pt atoms are associated with the clusters. Movement of the clusters on the catalyst support is different depending upon the catalyst support.     

Plasma folate levels are associated with the lipoprotein profile: a retrospective database analysis

Background

Several studies demonstrated an association of homocysteine plasma levels and the plasma lipoprotein profile. This cross-sectional pilot study aimed at analyzing whether blood levels of the two important cofactors of homocysteine metabolism, folate and vitamin B12, coincide with the lipoprotein profile.

Methods

In a retrospective single center approach, we analyzed the laboratory database (2003-2006) of the University Hospital Bonn, Germany, including 1743 individuals, in whom vitamin B12, folate and at least one lipoprotein parameter had been determined by linear multilogistic regression.

Results

Higher folate serum levels were associated with lower serum levels of low density lipoprotein cholesterol (LDL-C; Beta = -0.164; p < 0.001), higher levels of high density lipoprotein cholesterol (HDL-C; Beta = 0.094; p = 0.021 for trend) and a lower LDL-C-C/HDL-C-ratio (Beta = -0.210; p < 0.001). Using ANOVA, we additionally compared the individuals of the highest with those of the lowest quartile of folate. Individuals of the highest folate quartile had higher levels of HDL-C (1.42 ± 0.44 mmol/l vs. 1.26 ± 0.47 mmol/l; p = 0.005), lower levels of LDL-C (3.21 ± 1.04 mmol/l vs. 3.67 ± 1.10 mmol/l; p = 0.001) and a lower LDL-C/HDL-C- ratio (2.47 ± 1.18 vs. 3.77 ± 5.29; p = 0.002). Vitamin B12 was not associated with the lipoprotein profile.

Conclusion

In our study sample, high folate levels were associated with a favorable lipoprotein profile. A reconfirmation of these results in a different study population with a well defined status of health, diet and medication is warranted.     

Subsidence in impaction grafting: the effect of adding a ceramic bone graft extender to bone

The incidence of revision total hip arthroplasty is increasing dramatically and the associated demand for allograft bone is likely to exceed the available supply. In addition, allograft presents potential problems with regard to infection, antigenicity, availability, reproducibility and cost. It is therefore desirable to develop an alternative to allograft. This study investigated BoneSave, a porous tricalcium phosphate-hydroxyapatite ceramic for use in impaction grafting of the femur at revision total hip arthroplasty. The findings of an in vitro mechanical study comparing the initial stability of pure allograft, a volume mixture of 50 per cent allograft and 50 per cent BoneSave, and a volume mixture of 10 per cent allograft and 90 per cent BoneSave are reported. The BoneSave-allograft mixtures exhibit both much greater mechanical stability and reproducibility than the pure allograft (p < 0.05) at all tested loads (200-800 N). At high peak loads the high volume (90%, v/v) BoneSave mix also provided higher mechanical stability than the medium volume (50 per cent BoneSave-50 per cent allograft) mix (p < 0.05). These results demonstrate thatfrom a mechanical standpoint the tested ceramic provides adequate initial stability to be used as a bone graft extender with allograft in impaction grafting of the femur.     

The effect of Nb or Ta substitution into the M1 phase of the MoV(Nb,Ta)TeO selective oxidation catalyst

We use aberration corrected high-angle annular dark field (HAADF) imaging to systematically study, atomic column by atomic column, the effects of substituting Nb or Ta into the M1 phase of the MoV(Nb,Ta)TeO propane (amm)oxidation catalyst. The HAADF results indicate that the x,y coordinates of the metal sites within the M1 framework are unaffected by the substitution of either Nb or Ta for Mo. The HAADF analysis of the Ta-substituted catalyst demonstrated that the Ta preferentially substitutes into the pentagonal bipyramidal site, and by analogy, we anticipate that Nb substitutes similarly. Compositional analysis of the entire framework suggests that Ta/Nb behaves as a director of V among the octahedra that link the pentagonal rings, and the variable V occupancy may be correlated with variations in catalytic activities and selectivities. Finally, HAADF imaging provided evidence of coexistence of Ta-rich and Ta-poor domains. Similar phase segregation behavior may be present in Nb-substituted specimens, but would be very difficult to detect.