Symptomatic recurrent carotid stenosis and aneurysmal degeneration after endarterectomy

BACKGROUND: Aneurysmal degeneration of a carotid reconstruction was not recognized until the patient, who was known to have recurrent carotid artery stenosis, had a thromboembolic stroke. This sequelae of carotid endarterectomy is a serious complication, associated with a high morbidity and mortality rate. This review was conducted to establish the risk of transient ischemic attack and stroke for patients found to have recurrent carotid stenosis associated with aneurysmal degeneration of the carotid artery after endarterectomy. METHODS: A case is reported, and 100 literature references of aneurysmal degeneration of the carotid artery after endarterectomy were reviewed. RESULTS: False aneurysm from anastomotic disruption was the most common presentation identified in the cases reviewed. Nineteen of the patients had a significant neurologic event; however, three (50%) of six patients with aneurysm and recurrent carotid artery stenosis had a transient ischemic attack or stroke. CONCLUSIONS: The incidence of neurologic symptoms is markedly increased when recurrent carotid artery stenosis is associated with carotid aneurysm. During postoperative surveillance after endarterectomy, the identification of recurrent carotid artery stenosis requires evaluation for aneurysmal degeneration of the carotid artery with duplex scanning. These patients are at significant risk for transient ischemic attack and stroke. This rare complication merits operative repair.     

Current options in prosthetic vascular graft infection

Debate continues over which procedure is the best treatment for prosthetic graft infections. We retrospectively reviewed the medical records at our institution for all vascular graft infections that occurred from 1985 to 1995 to evaluate their occurrence, treatment, and outcome. Twenty-four patients had prosthetic graft infections. The average patient age was 62 years, and 67 per cent of the patients studied were men. The initial operation was for treatment of occlusive disease in 92 per cent of the patients, and aortofemoral bypasses were the most common procedures performed (15 of 24 patients, 63%). The average interval from graft implantation to presentation of infection was 29 months. In lower-extremity bypasses, the site of infection was most commonly in the groin (87%). Gram-positive organisms, including coagulase-negative Staphylococcus (32%) and Staphylococcus aureus (28%), were the most frequently isolated bacteria. Thirty procedures were performed for management of the graft infections. Extra-anatomic bypass was associated with no recurrent graft infections. Graft preservation was successful in two cases of early S. aureus infection (less than 1 year after original procedure), and in situ graft replacement was successful in all four cases of late-appearing coagulase-negative Staphylococcus infection (more than 1 year after original procedure). Both treatments failed in all five cases of Gram-negative infection (P = 0.008 by Fisher's exact test). The overall mortality and amputation rates were 17 per cent and 21 per cent, respectively, without significant differences between the treatment modalities. Extra-anatomic bypass remains the best treatment for prosthetic graft infection. In situ replacement and graft preservation treatments should be selective and based on presentation of the infection and the type of pathogenic organism.     

Characterization of Apo-Form Selective Inhibition of Indoleamine 2,3-Dioxygenase**

Indoleamine-2,3-dioxygenase 1 (IDO1) is a heme-containing enzyme that catalyzes the rate-limiting step in the kynurenine pathway of tryptophan (TRP) metabolism. As it is an inflammation-induced immunoregulatory enzyme, pharmacological inhibition of IDO1 activity is currently being pursued as a potential therapeutic tool for the treatment of cancer and other disease states. As such, a detailed understanding of the mechanism of action of IDO1 inhibitors with various mechanisms of inhibition is of great interest. Comparison of an apo-form-binding IDO1 inhibitor (GSK5628) to the heme-coordinating compound, epacadostat (Incyte), allows us to explore the details of the apo-binding inhibition of IDO1. Herein, we demonstrate that GSK5628 inhibits IDO1 by competing with heme for binding to a heme-free conformation of the enzyme (apo-IDO1), whereas epacadostat coordinates its binding with the iron atom of the IDO1 heme cofactor. Comparison of these two compounds in cellular systems reveals a long-lasting inhibitory effect of GSK5628, previously undescribed for other known IDO1 inhibitors. Detailed characterization of this apo-binding mechanism for IDO1 inhibition might help design superior inhibitors or could confer a unique competitive advantage over other IDO1 inhibitors vis-à-vis specificity and pharmacokinetic parameters.     

Software assessment using metrics: A comparison across large C++ and Java systems

This paper presents an assessment method to evaluate the quality of object oriented software systems. The assessment method is based on source code abstraction, object–oriented metrics and graphical representation. The metrics used and the underlying model representing the software are presented. The assessment method experiment is part of an industrial research effort with the Bell Canada Quality Engineering and Research Group. It helps evaluators assess the quality and risks associated with software by identifying code fragments presenting unusual characteristics. The assessment method evaluates object–oriented software systems at three levels of granularity: system level, class level and method level. One large C++ and eight Java software systems, for a total of over one million lines of code, are presented as case studies. A critical analysis of the results is presented comparing the systems and the two languages.     

Probabilistic topic models for sequence data

Probabilistic topic models are widely used in different contexts to uncover the hidden structure in large text corpora. One of the main (and perhaps strong) assumption of these models is that generative process follows a bag-of-words assumption, i.e. each token is independent from the previous one. We extend the popular Latent Dirichlet Allocation model by exploiting three different conditional Markovian assumptions: (i) the token generation depends on the current topic and on the previous token; (ii) the topic associated with each observation depends on topic associated with the previous one; (iii) the token generation depends on the current and previous topic. For each of these modeling assumptions we present a Gibbs Sampling procedure for parameter estimation. Experimental evaluation over real-word data shows the performance advantages, in terms of recall and precision, of the sequence-modeling approaches.     

Comparison between low-cost marker-less and high-end marker-based motion capture systems for the computer-aided assessment of working ergonomics

The paper deals with the comparison between a high-end marker-based acquisition system and a low-cost marker-less methodology for the assessment of the human posture during working tasks. The low-cost methodology is based on the use of a single Microsoft Kinect V1 device. The high-end acquisition system is the BTS SMART that requires the use of reflective markers to be placed on the subject's body. Three practical working activities involving object lifting and displacement have been investigated. The operational risk has been evaluated according to the lifting equation proposed by the American National Institute for Occupational Safety and Health. The results of the study show that the risk multipliers computed from the two acquisition methodologies are very close for all the analysed activities. In agreement to this outcome, the marker-less methodology based on the Microsoft Kinect V1 device seems very promising to promote the dissemination of computer-aided assessment of ergonomics while maintaining good accuracy and affordable costs.     

Three-dimensional crack propagation with distance-based discontinuous kernels in meshfree methods

Distance fields are scalar functions defining the minimum distance of a given point in the space from the boundary of an object. Crack surfaces are geometric entities whose shapes can be arbitrary, often described with ruled surfaces or polygonal subdivisions. The derivatives of distance functions for such surfaces are discontinuous across the surface, and continuous all around the edges. These properties of the distance function were employed to build intrinsic enrichments of the underlying mesh-free discretisation for efficient simulation of three-dimensional crack propagation, removing the limitations of existing criteria (reviewed in this paper). Examples show that the proposed approach is able to introduce quite convoluted crack paths. The incremental nature of the developed approach does not require re-computation of the enrichment for the entire crack surface as advancing crack front extends incrementally as a set of connected surface facets. The concept is based on purely geometric representation of discontinuities thus addressing only the kinematic aspects of the problem, such to allow for any constitutive and cohesive interface models to be used.     

Disposable potentiometric citrate sensor based on polypyrrole‐doped films for indirect determination of sildenafil in pharmaceuticals formulations

A new sensitive and selective disposable potentiometric sensor based on polypyrrole (PPy) films for determination of sildenafil citrate (SC) was proposed. The pyrrole polymerization was performed in presence of citrate ions under galvanostatic conditions which resulted in a membrane of PPy doped with citrate anion at graphite pencil electrode surface. Experimental conditions (e.g., pH and conditioning time) and instrumental parameters (e.g., current density and electrical charge) were evaluated in order to reach the best potentiometric response for the proposed sensor. Under optimized conditions, the device presented a linear dynamic range (LDR) for citrate ions concentrations varying from 0.034 to 1.7 mmol L^?1 with a Nernstian slope of 57.2 mV dec^?1 and a limit of detection (LOD) of 30 µmol L^?1. The developed potentiometric sensor was applied for sildenafil citrate (SC) determination (pharmaceutical formulations) and results compared with an official spectrophotometric method indicating a good agreement for a confidence level of 95%. Effect of concomitants species on the potentiometric response of the proposed device and morphologic characterization using microscopy of atomic force (AFM) were realized. The surface roughness of PPy films (synthesized in citrate solution and chloride) showed poorly affected by changing the doping anion, probably because the polypyrrole nodules grow three‐dimensionally simultaneously. © 2016 Wiley Periodicals, Inc. J. Appl. Polym. Sci. 2016 , 133, 43762.     

The Roles of Coenzyme Q in Disease: Direct and Indirect Involvement in Cellular Functions

Coenzyme Q (CoQ) is a key component of the respiratory chain of all eukaryotic cells. Its function is closely related to mitochondrial respiration, where it acts as an electron transporter. However, the cellular functions of coenzyme Q are multiple: it is present in all cell membranes, limiting the toxic effect of free radicals, it is a component of LDL, it is involved in the aging process, and its deficiency is linked to several diseases. Recently, it has been proposed that coenzyme Q contributes to suppressing ferroptosis, a type of iron-dependent programmed cell death characterized by lipid peroxidation. In this review, we report the latest hypotheses and theories analyzing the multiple functions of coenzyme Q. The complete knowledge of the various cellular CoQ functions is essential to provide a rational basis for its possible therapeutic use, not only in diseases characterized by primary CoQ deficiency, but also in large number of diseases in which its secondary deficiency has been found.