CO17 107. Experiencia inicial con la prótesis de válvula aórtica sin sutura 3f-enable de segunda generación

ObjetivosLa válvula aórtica ATS-3F-Enable™ representa una nueva generación con pericardio equino, stent de nitinol autoexpandible e implantación sin suturas. Evaluamos la técnica de implantación, la seguridad y efectividad de la válvula así como los resultados al año de implantación.Material y métodosAnálisis de resultados en una serie de 27 pacientes consecutivos con estenosis de válvula aórtica y reemplazamiento aislado de la válvula por una ATS-3F-Enable™ entre agosto de 2007 y febrero de 2009. La edad media fue 75,7±6,6 años. Diecisiete mujeres (63%). EuroSCORE mediano: 8, y medio: 7,1±1,7.ResultadosEl tamaño medio de válvula implantada fue de 23mm (franja: 19-27mm). La media de tiempo de clampaje aórtico fue de 39,8±15min (franja: 29-103min). La media de tiempo de circulación extracorpórea fue de 58,6±20min (franja: 41-127). La media de tiempo de hospitalización fue de 11 días (7-22). No hubo mortalidad durante la intervención. Al alta, los gradientes de presión transvalvular medio y alto con ecocardiografía fueron de 11,6 y 18,5mmHg, respectivamente. Dos pacientes presentaron una fuga paravalvular moderada y un paciente fue reoperado a causa de una fuga paravalvular grave. Se requirió la implantación de marcapasos en cinco pacientes (18,5%). El seguimiento al cabo de 1 año fue del 100% y la supervivencia fue del 86%.ConclusionesLa prótesis aórtica ATS-3F-Enable™ puede ser implantada con seguridad y presenta resultados hemodinámicos favorables. El stent autoexpandible y la técnica sin sutura permite una implantación rápida, sin embargo, no tan rápida como esperado. Acumulación de experiencia y algunas modificaciones en el diseño de la prótesis podrán ayudar a perfeccionar la técnica

The Olfactory Threshold of Rotundone in Brandy is Ten-fold Higher than in Wine and does not Increase with the Complexity of the Matrix

Rotundone is the only known aroma compound imparting a peppery aroma to wine. Its presence hasrecently been documented in spirits, notably those aged in oak barrels. However, the sensory contributionof rotundone in such alcoholic beverages remains hard to predict, given their high ethanol level. The aimof this study was to estimate olfactory thresholds for rotundone in brandy using three different matrices.Rotundone concentrations in the unspiked samples were 50 ng/L for wine distillate and 135 ng/L for brandy,demonstrating for the first time the presence of rotundone in such spirits and a possible endogenous origin.The olfactory detection threshold was estimated at 103 ng/L in 40% (v/v) ethanol solution, while differencethresholds were 171 ng/L and 189 ng/L in fresh wine distillate and young French brandy, respectively, bothstandardised at 40% (v/v). These thresholds were 10-fold higher than in wines and did not significantlydiffer according to the complexity of the matrix. Our results, which are still preliminary and would deserveto be validated with a larger number of samples and using a higher number of panellists, open new fieldsof investigation for a deeper exploration of the concentration range of rotundone in brandies, particularlythose that underwent a longer ageing period in barrels

Persistent sensitivity disorders at the radial artery and saphenous vein graft harvest sites: a neglected side effect of coronary artery bypass grafting procedures

Objective: The use of radial artery conduits in coronary artery bypass grafting (CABG) surgery is associated with improved long-term patency and patient survival rates as compared with saphenous vein conduits. Despite increasing popularity, relative incidence of local harvest-site complications and subjective perception of adverse long-term sequelae remain poorly described. Methods: To allow for direct comparison, we investigated a consecutive series of patients in whom both the radial artery and the saphenous vein had been harvested for isolated CABG during a 36-month period. Patients were identified from a prospective database that collects baseline clinical information. The patients' own perceptions were assessed by a standardized direct telephone survey regarding any persistent functional impairment from their arm and leg operation sites. Results: Out of 1756 CABG patients during the study period, 168 (10%) were eligible (78% men, median age: 60.1 ± 9.6 years, range: 29.6-82.4 years). Of these, 123 (73%) could be contacted and interviewed at a median follow-up time of 2.5 ± 0.9 years. Surgical wound complications at harvest sites (arms and legs) had occurred in 3% and 12%, respectively, and persistent symptoms (arms and legs) were self-reported as follows: chronic pain (5% and 8%), numbness (32% and 34%) and paresthesia/dysesthesia (14% and 7%). Overall, 39% of the patients reported persistent discomfort at the arm and 39% at the leg. Both sites were simultaneously affected in 21% (P = n.s., paired testing). Logistic regression modeling showed that patients with adverse long-term sequelae were younger (P < 0.005), had a higher body mass index (P < 0.05) and a lower EuroSCORE (P < 0.001) at the time of operation (EuroSCORE, European System for Cardiac Operative Risk Evaluation). Perioperative wound complications, however, did not predict persistence of symptoms. Conclusions: Persistent harvest-site discomfort occurs with astonishing frequency after CABG surgery and affects arms and legs equally. Although usually considered a minor complication, long-term limitation to quality of life may be substantial, particularly in younger and relatively healthy patients. Thus, harvest-site discomfort clearly belongs to the list of possible post-CABG complications of which patients need to be awar

Fluid gels: a new feedstock for high viscosity jetting

Suspensions of gel particles which are pourable or spoonable at room temperature can be created by shearing a gelling biopolymer through its gelation (thermal or ion mediated) rather than allowing quiescent cooling – thus the term ‘fluid gel’ may be used to describe the resulting material. As agar gelation is thermoreversible this type of fluid gel is able to be heated again to melt agar gel particles to varying degrees then re-form a network quiescently upon cooling, whose strength depends on the temperature of re-heating, determining the amount of agar solubilised and subsequently able to partake in re-gelation. Using this principle, for the first time fluid gels have been applied to a high viscosity 3D printing process wherein the printing temperature (at the nozzle) is controllable. This allows the use of ambient temperature feedstocks and by altering the nozzle temperature, the internal nature (presence or absence of gel particles) and gel strength of printed droplets differs. If the nozzle prints at different temperatures for each layer a structure with modulated texture could be created

Twelve years' detection of respiratory viruses by immunofluorescence in hospitalised children: impact of the introduction of a new respiratory picornavirus assay

<p>Abstract</p> <p>Background</p> <p>Direct immunofluorescence assays (DFA) are a rapid and inexpensive method for the detection of respiratory viruses and may therefore be used for surveillance. Few epidemiological studies have been published based solely on DFA and none included respiratory picornaviruses and human metapneumovirus (hMPV). We wished to evaluate the use of DFA for epidemiological studies with a long-term observation of respiratory viruses that includes both respiratory picornaviruses and hMPV.</p> <p>Methods</p> <p>Since 1998 all children hospitalized with respiratory illness at the University Hospital Bern have been screened with DFA for common respiratory viruses including adenovirus, respiratory syncytial virus (RSV), influenza A and B, and parainfluenza virus 1-3. In 2006 assays for respiratory picornaviruses and hMPV were added. Here we describe the epidemiological pattern for these respiratory viruses detected by DFA in 10'629 nasopharyngeal aspirates collected from 8'285 patients during a 12-year period (1998-2010).</p> <p>Results</p> <p>Addition of assays for respiratory picornaviruses and hMPV raised the proportion of positive DFA results from 35% to 58% (p < 0.0001). Respiratory picornaviruses were the most common viruses detected among patients ≥1 year old. The seasonal patterns and age distribution for the studied viruses agreed well with those reported in the literature. In 2010, an hMPV epidemic of unexpected size was observed.</p> <p>Conclusions</p> <p>DFA is a valid, rapid, flexible and inexpensive method. The addition of assays for respiratory picornaviruses and hMPV broadens its range of viral detection. DFA is, even in the "PCR era", a particularly adapted method for the long term surveillance of respiratory viruses in a pediatric population.</p

Drosha drives the formation of DNA:RNA hybrids around DNA break sites to facilitate DNA repair

The error-free and efficient repair of DNA double-stranded breaks (DSBs) is extremely important for cell survival. RNA has been implicated in the resolution of DNA damage but the mechanism remains poorly understood. Here, we show that miRNA biogenesis enzymes, Drosha and Dicer, control the recruitment of repair factors from multiple pathways to sites of damage. Depletion of Drosha significantly reduces DNA repair by both homologous recombination (HR) and non-homologous end joining (NHEJ). Drosha is required within minutes of break induction, suggesting a central and early role for RNA processing in DNA repair. Sequencing of DNA:RNA hybrids reveals RNA invasion around DNA break sites in a Drosha-dependent manner. Removal of the RNA component of these structures results in impaired repair. These results show how RNA can be a direct and critical mediator of DNA damage repair in human cells

A genome-wide IR-induced RAD51 foci RNAi screen identifies CDC73 involved in chromatin remodeling for DNA repair

To identify new regulators of homologous recombination repair, we carried out a genome-wide short-interfering RNA screen combined with ionizing irradiation using RAD51 foci formation as readout. All candidates were confirmed by independent short-interfering RNAs and validated in secondary assays like recombination repair activity and RPA foci formation. Network analysis of the top modifiers identified gene clusters involved in recombination repair as well as components of the ribosome, the proteasome and the spliceosome, which are known to be required for effective DNA repair. We identified and characterized the RNA polymerase II-associated protein CDC73/Parafibromin as a new player in recombination repair and show that it is critical for genomic stability. CDC73 interacts with components of the SCF/Cullin and INO80/NuA4 chromatin-remodeling complexes to promote Histone ubiquitination. Our findings indicate that CDC73 is involved in local chromatin decondensation at sites of DNA damage to promote DNA repair. This function of CDC73 is related to but independent of its role in transcriptional elongation