Three-year experience with the White-Yu Endovascular GAD Graft for transluminal repair of aortic and iliac aneurysms

PURPOSE: To report a > 3-year experience with a modular, balloon-expandable endovascular graft used for aneurysm exclusion in the aorta and other arteries. METHODS: The customized White-Yu Endovascular GAD Graft, a woven polyester prosthesis with an intrinsic Elgiloy wire graft attachment system along the body of the graft, is a flexible endograft design available in straight, tapered, and bifurcated versions that can be delivered transluminally through 18F to 24F sheaths. RESULTS: Since July 1993, 93 patients have received the White-Yu endograft for treatment of 76 abdominal aortic, 3 thoracic aortic, 13 iliac, and 1 popliteal aneurysms. Of the 79 aortic procedures, 39 involved straight tube grafts, 20 were tapered aortoiliac models, and 20 were bifurcated devices. Success rates for tube grafts were 81% in the abdominal aorta and 100% for the thoracic aorta; 5 primary endoleaks (14%) and 2 conversions to surgery (5.6%) occurred with this graft type. Aortoiliac grafts were deployed successfully in 95% (19/20) of cases with 1 conversion (5%) due to thrombosis. Seventy-five percent of the bifurcated endograft procedures were successful, with 4 conversions (20%) for technical failures and 1 graft thrombosis. Four additional endografts were deployed to treat two primary and two secondary endoleaks in tube graft patients. Two access-related arterial injuries were treated surgically. There was one case of embolus to the distal femoral artery but no microembolization. Overall perioperative (30-day) mortality was 3.1%. Over a mean 18-month follow-up (range 2 to 39), no late graft thrombosis, stenosis, or graft migration has been seen on CT scans or X ray. Endoleak has not been detected in any aortoiliac or bifurcated graft. Aneurysm size has diminished consistently in successfully treated cases. CONCLUSIONS: The White-Yu endograft appears to offer a safe, efficacious, and minimally invasive means of excluding aneurysms from the circulation. Improvements in patient selection, surgical techniques, and equipment have reduced the incidence of endoleak and conversion to open repair over the course of the evaluation.     

On the mechanism of the selective oxidation of n-butane, but-1-ene and but-1,3-diene to maleic anhydride over a vanadyl pyrophosphate catalyst

The mechanism of the selective partial oxidation of n-butane, but-1-ene and but-1,3-diene over a vanadyl phosphate catalyst has been investigated by temperature-programmed desorption (TPD) and by anaerobic temperature-programmed oxidation (TPO). TPD showed lattice oxygen to be desorbed in two states at 998 and 1023 K. The anaerobic TPO of n-butane produced butene and butadiene at 1020 K; anaerobic TPO of but-1-ene produced butadiene and furan at 990 K and dehydrofuran at 965 K, while anaerobic TPO of but-1,3-diene produced dehydrofuran at 970 K, furan at 1002 K and maleic anhydride at 1148 K. The total amount of oxygen removed from the lattice in these anaerobic selective partial oxidations was the same as that evolved from the vanadyl phosphate catalyst by TPD. This, and the fact that the selective oxidation reactions occurred at the same temperature at which the oxygen evolves from the lattice, suggests that the lattice oxygen is uniquely selective when it appears at the surface of the catalyst. (Under identical conditions of flow rate, weight of catalyst, heating rate etc., the reaction of n-butane or of but-1,3-diene in air produced only CO₂ and H₂O.) This revised version was published online in July 2006 with corrections to the Cover Date.     

Local overexpression of thrombomodulin for in vivo prevention of arterial thrombosis in a rabbit model

Data from 213 cases of simultaneous carotid endarterectomy and coronary artery bypass grafting (CEN/CABG) were analyzed (1980-1996). There were 154 males (72.3%), and 59 females (27.7%), (mean age: 65. 6 years, range: 42-83). One hundred and thirty-two patients (62.0%) had angina, 58 (37.2%) had myocardial infarction, and 23 (10.8%) had congestive heart failure. Symptomatic cerebrovascular disease was present in 89 patients (41.7%). One hundred and twenty-two patients (57.2%) had three-vessel coronary artery disease, 41 (19.2%) had left main disease, and 27 (12.6%) had a low ejection fraction (ejection fraction /=75% diameter reduction) stenosis was present in 168 (78.8%) of the operated carotid arteries. The contralateral internal carotid artery was severely stenosed or occluded in 35 patients (16.4%). The hospital mortality rate was 5. 6% (12 patients). The cause of death was cardiac in ten patients (4. 6%), and neurologic in two (1%). Eleven patients (5.1%) developed a stroke postoperatively; eight strokes were ipsilateral to the operated artery, and six were permanent. Myocardial infarction occurred in five patients (2.3%). Independent predictors of early mortality were age >62 years, hypertension, and postoperative stroke (p < 0.05). Male sex was the only independent predictor of neurologic morbidity (p < 0.05). Late follow-up data were obtained for 163 (81.0%) patients (mean: 54.8 months, range: 1-168). Four (9. 3%) out of the 43 late deaths were attributed to strokes. There were three (1.8%) late ipsilateral strokes, and five (3.1%) contralateral strokes. The 5- and 10-year survival probabilities were 75 +/- 4%, and 52 +/- 6.9%. The freedom from late ipsilateral neurologic morbidity at 5 and 10 years were 97 +/- 1.7% and 90 +/- 4.0%, respectively. Taken together, the results indicate that combined carotid endarterectomy and coronary artery bypass grafting can be performed safely in this high-risk group of patients. Excellent long-term freedom from stroke can be expected.     

Characterization of the microheterogeneities of PIXY321, a genetically engineered granulocyte-macrophage colony-stimulating factor/interleukin-3 fusion protein expressed in yeast

PIXY321, a human cytokine analog genetically engineered by the fusion of granulocyte-macrophage colony-stimulating factor (GM-CSF) and interleukin-3 (IL-3), was expressed in yeast under the control of the alcohol dehydrogenase 2 (ADH2) promoter and the alpha-mating factor expression system. To provide the material necessary for the evaluation of PIXY321 in clinical trials, the production was scaled up to the 1200-1 scale and the PIXY321 molecule isolated by four successive steps of ion-exchange chromatography. Multiple heterogeneities, due to the presence of different patterns of glycosylation as well as multiple amino acid sequences at both N and C termini, were characterized on the purified molecule using complementary analytical techniques including electrophoresis, liquid chromatography and electrospray mass spectrometry. Four different N-terminal sequences were identified but simplified to a reproducible ratio of two sequences, the mature form and a form starting at Ala3, by adjustment of the process conditions. Molecules lacking 1-6 residues at the C-terminus were identified and their relative frequencies quantified. Amino acid modifications, such as three oxidized Met residues at positions 79, 141 and 187 and one deamidated Asn residue at position 176, were detected at low level. Microheterogeneities in glycosylation were characterized on four different sites, one located in the GM-CSF portion and three in the IL-3 portion of the molecule. The sites were shown to be differentially occupied and to carry 0-10 mannose residues according to their location in the sequence. Precise measurement of the heterogeneities at the molecular level were used to tune the process conditions and ensure reproducibility of the clinical product between lots.     

Bismuth-Modified Vanadyl Pyrophosphate Catalysts

A 1 bismuth-doped VPO catalyst was prepared by refluxing Bi(NO₃)₃ and VOPO₄ 2H₂O in isobutanol. The incorporation of Bi into the VPO lattice lowered the overall V oxidation state from 4.24 to 4.08. It also lowered both the peak maximum temperature for the desorption of oxygen from the lattice from 1001K (undoped) to 964K with a shoulder at 912K and the peak maxima for H₂ temperature-programed reduction from 863, 1011 and 1143K (undoped) to 798, 906 and 1151K. The total oxygen desorbed from the Bi-doped catalyst was only one-fourth that of the undoped catalyst, while the amount of oxygen removed by TPR was roughly the same for both catalysts. These results suggest that in anaerobic oxidation, the Bi-doped catalyst will have roughly the same activity as in undoped catalyst in C₄ hydrocarbon oxidation but will have a higher selectivity to products such as olefins and maleic anhydride.     

The relationship between longitudinal growth strain and the occurrence of gelatinous fibers in 10 and 11-year-old<Emphasis Type="Italic"> Eucalyptus globulus</Emphasis> Labill.

The potential for using growth strain measured at the stem periphery of standing plantation-grown Eucalyptus globulus Labill. trees as a non-destructive detection method for tension wood was assessed. Two trials were conducted 12 months apart in a 10 to 11 year-old provenance trial of E. globulus located in the Mt. Gambier region of south-eastern Australia. The relationship between the occurrence of gelatinous fibers over varying radial depths of wood tissue and growth strain measured at breast height was investigated. The percentage of gelatinous fibers in wood tissue laid down in approximately the two years prior to taking the growth strain measurement was found to correlate best with growth strain. In an expansion of this work, growth strain was found to be a good indicator of the presence of gelatinous fibers in wood tissue taken from the immediate position where growth strain was measured. Thresholds were found at approximately 800 uε, above which gelatinous fibers were common, and 1,200 uε where gelatinous fibers were always present in each of the three provenances assessed. Tension wood was found to increase in occurrence over the 12 month period in line with a trend of increasing occurrence and severity of tension wood found in earlier work in the plantation.     

SEM and raman spectroscopy of multiwalled carbon nanotubes grown by novel technique of ash supported catalysts

Multiwalled carbon nanotubes (MWCNTs) were grown on a novel ASC catalyst and on catalyst deposited by SCC method on silicon wafer, by thermal CVD of acetylene. Fe and Ni were used as catalyst for ASC. Samples were analyzed by SEM and Raman spectroscopy. SEM analysis shows that CNTs grown on ASC have narrower diameter distribution (64+/-6 nm) compared to CNTs grown on SCC (67+/-10.5 nm). However, SEM and Raman spectroscopy studies show CNTs grown on SCC are of better quality. The same samples were studied after standard purification procedure of oxidation after annealing at high temperatures. SEM and Raman spectroscopy show that overall quality of ensemble of CNTs has improved. After annealing, diameter decreases for larger diameter approximately 200 nm nanotubes while it increases for CNTs of smaller diameter approximately 70 nm. To explain the increase in diameter of approximately 70 nm CNT's, a phenomenological model has been proposed. The results of Raman spectroscopy and SEM corroborate the proposed model.     

Interaction of CO2 laser-modified nylon with osteoblast cells in relation to wettability

It has been amply demonstrated previously that CO₂ lasers hold the ability to surface modify various polymers. In addition, it has been observed that these surface enhancements can augment the biomimetic nature of the laser irradiated materials. This research has employed a CO₂ laser marker to produce trench and hatch topographical patterns with peak heights of around 1 μm on the surface of nylon 6,6. The patterns generated have been analysed using white light interferometry, optical microscopy and X-ray photoelectron spectroscopy was employed to determine the surface oxygen content. Contact angle measurements were used to characterize each sample in terms of wettability. Generally, it was seen that as a result of laser processing the contact angle, surface roughness and surface oxygen content increased whilst the apparent polar and total surface energies decreased. The increase in contact angle and reduction in surface energy components was found to be on account of a mixed intermediate state wetting regime owing to the change in roughness due to the induced topographical patterns. To determine the biomimetic nature of the modified and as-received control samples each one was seeded with 2 × 10⁴ cells/ml normal human osteoblast cells and observed after periods of 24 h and 4 days using optical microscopy and SEM to determine mean cell cover densities and variations in cell morphology. In addition, a haemocytometer was used to show that the cell count for the laser patterned samples had increased by up to a factor of 1.5 compared to the as-received control sample after 4 days of incubation. Significantly, it was determined that all laser-induced patterns gave rise to better cell response in comparison to the as-received control sample studied due to increased preferential cell growth on those surfaces with increased surface roughness.     

Comments on “The effect of ZnO in methanol synthesis catalysts on Cu dispersion and the specific activity” [by T. Fujitani and J. Nakamura]

Fujitani and Nakamura recently reported on the effect of ZnO on Cu/ZnO methanol synthesis catalysts (Catal. Lett. 56 (1998) 119). Having measured the methanol synthesis activity of a series of Cu/ZnO catalysts of different Cu/ZnO ratios, they reported a linear relationship between the copper metal area and the methanol yield (implying a fixed value of the copper specific activity) and paradoxically they also reported a volcano-type relationship between the copper specific activity in methanol synthesis and the ZnO content. This paradox is resolved by showing that their Cu/ZnO catalysts fall into two groups: (i) the low-surface-area copper catalysts which have a specific activity of 10 mg CH₃OH/m²-Cu h and (ii) the high-surface-area copper catalysts which have specific activity of 14.8 mg CH₃OH/m²-Cu h. These different specific activities derive from different surface morphologies of the copper in these catalysts. This revised version was published online in November 2006 with corrections to the Cover Date.