Palliation of complex cardiac anomalies with subaortic obstruction: New operative approach

AbstractThe modified Fontan operation for complex cardiac anomalies associated with subaortic obstruction entails a high surgical risk. It is likely that ventricular hypertrophy secondary to chronic pressure overload plays a significant role. This problem was approached with a new type of palliative operation comprising both a proximal pulmonary artery to ascending aorta anastomosis and a bidirectional cavopulmonary anastomosis.This operation was performed in six children ranging in age from 26 to 63 months. There was one intraoperative death due to hemorrhage. In one patient, a pulmonary to aorta conduit caused compression of the right coronary artery; the problem was solved by lengthening the conduit with a second period of cardiopulmonary bypass.The five survivors experienced an uneventful postoperative course. Repeat cardiac catheterization in these five patients showed low pressure in the cavopulmonary system (mean 10 mm Hg), absence of a gradient at rest between the systemic ventricle and aorta and fair arterial oxygenation (mean 82%). A technetium-99m perfusion lung scan visualized a slight prevalence of pulmonary blood flow ipsilateral to the shunt in three cases, whereas in one case preferential flow to the right lung was associated with a narrowing at the site of the cavopulmonary anastomosis. Mild hypoperfusion of the anterior pulmonary segments was observed in two cases.Both pressure and volume overload are abolished with this procedure and a satisfactory oxygenation is provided. Low venous pressure in the coronary, hepatic and renal areas as well as the short bypass time may explain the smoothness of the postoperative course in our patients. It is conceivable that oxygenation can be improved by a modified Fontan operation at a lower operative risk than is obtained with a single stage procedure because of regression of ventricular hypertrophy. Long-term follow-up indicates the value of this operation as a form of definitive palliation

Synthesis, Production, and Biotechnological Applications of Exopolysaccharides and Polyhydroxyalkanoates by Archaea

Extreme environments, generally characterized by atypical temperatures, pH, pressure, salinity, toxicity, and radiation levels, are inhabited by various microorganisms specifically adapted to these particular conditions, called extremophiles. Among these, the microorganisms belonging to the Archaea domain are of significant biotechnological importance as their biopolymers possess unique properties that offer insights into their biology and evolution. Particular attention has been devoted to two main types of biopolymers produced by such peculiar microorganisms, that is, the extracellular polysaccharides (EPSs), considered as a protection against desiccation and predation, and the endocellular polyhydroxyalkanoates (PHAs) that provide an internal reserve of carbon and energy. Here, we report the composition, biosynthesis, and production of EPSs and PHAs by different archaeal species

Total repair of pulmonary atresia with ventricular septal defect and major aortopulmonary collaterals: An integrated approach

AbstractBackground: Predicting postrepair right ventricular/left ventricular pressure ratio has prognostic relevance for patients undergoing total repair of pulmonary atresia, ventricular septal defect, and major aortopulmonary collateral arteries. To this purpose, we currently rely on 2 novel parameters: (1) preoperative total neopulmonary arterial index and (2) mean pulmonary artery pressure changes during an intraoperative flow study. Methods: Since January 1994, 15 consecutive patients (aged 64 ± 54 months) with pulmonary atresia, ventricular septal defect, and major aortopulmonary collaterals were managed according to total neopulmonary arterial index. Seven patients with hypoplastic pulmonary arteries and a total neopulmonary arterial index less than 150 mm2/m2 underwent palliative right ventricular outflow tract reconstruction followed by secondary 1-stage unifocalization and ventricular septal defect closure. The other 8 patients with a preoperative index of more than 150 mm2/m2 underwent primary single-stage unifocalization and repair. The ventricular septal defect was closed in all cases (reopened in 1). In 9, such decision was based on an intraoperative flow study. Results: Patients treated by right ventricular outflow tract reconstruction had a significant increase of pulmonary artery index (P = .006) within 22 ± 6 months. Repair was successful in 14 cases (postrepair right ventricular/left ventricular pressure ratio = 0.47 ± 0.1). One hospital death occurred as a result of pulmonary vascular obstructive disease, despite a reassuring intraoperative flow study. Accuracy of this test in predicting the postrepair mean pulmonary artery pressure was 89% (95% CI: 51%-99%). At follow-up (18 ± 12 months), all patients are free of symptoms, requiring no medications. Conclusion: The integrated approach to total repair of pulmonary atresia, ventricular septal defect, and major aortopulmonary collaterals by preoperative calculation of total neopulmonary arterial index, right ventricular outflow tract reconstruction (when required), and intraoperative flow study may lead to optimal intermediate results. (J Thorac Cardiovasc Surg 1998;116:914-23

Strategies and Techniques for Powering Wireless Sensor Nodes through Energy Harvesting and Wireless Power Transfer

The continuous development of the internet of things (IoT) infrastructure and applications is paving the way for advanced and innovative ideas and solutions, some of which are pushing the limits of state-of-the-art technology. The increasing demand for Wireless Sensor Nodes (WSNs) able to collect and transmit data through wireless communication channels, while often positioned in locations that are difficult to access, is driving research into innovative solutions involving energy harvesting (EH) and wireless power transfer (WPT) to eventually allow battery-free sensor nodes. Due to the pervasiveness of radio frequency (RF) energy, RF EH and WPT are key technologies with the potential to power IoT devices and smart sensing architectures involving nodes that need to be wireless, maintenance free, and sufficiently low in cost to promote their use almost anywhere. This paper presents a state-of-the-art, ultra-low power 2.5 W highly integrated mixed-signal system on chip (SoC), for multi-source energy harvesting and wireless power transfer. It introduces a novel architecture that integrates an ultra-low power intelligent power management, an RF to DC converter with very low power sensitivity and high power conversion efficiency (PCE), an Amplitude-Shift-Keying/Frequency-Shift-Keying (ASK/FSK) receiver and digital circuitry to achieve the advantage to cope, in a versatile way and with minimal use of external components, with the wide variety of energy sources and use cases. Diverse methods for powering wireless Sensor Nodes through energy harvesting and wireless power transfer are implemented providing related system architectures and experimental results

Porphyrin-Based Nanostructures for Sensing Applications

The construction of nanosized supramolecular hosts via self-assembly of molecular components is a fascinating field of research. Such intriguing class of architectures, beside their intrinsic intellectual stimuli, is of importance in many fields of chemistry and technology, such as material chemistry, catalysis, and sensor applications. Within this wide scenario, tailored solid films of porphyrin derivatives are structures of great potential for, among others, chemical sensor applications. The formation ofsupramoleculesrelays on noncovalent interactions (electrostatic, hydrogen bond, , or coordinative interactions) driven by the chemical information stored on the assembling molecules, such as shape and functional groups. This allows, for example, the formation of large well-defined porphyrin aggregates in solution that can be spontaneously transferred onto a solid surface, so achieving a solid system with tailored features. These films have been used, covering the bridge between nanostructures and microsystems, for the construction of solid-state sensors for volatiles and metal ion recognition and detection. Moreover, the variation of peripheral substituents of porphyrins, such as, for example, chiral appended functionalities, can result in the formation of porphyrin aggregates featuring high supramolecular chirality. This would allow the achievement of porphyrin layers characterised by different chiroptical and molecular recognition properties

Nonlinear absorption and gain in InGaAs/GaAs quantum wells

We present a detailed study of the excitonic nonlinearities in InGaAs/GaAs multiple quantum wells based on both stationary and transient pump-and-probe transmission spectroscopy. Bleaching of the excitonic resonance and free carrier gain have been observed. A quantitative analysis of the observed nonlinearity is provided by means of a rigorous solution of the Bethe–Salpeter equation for the investigated heterostructures

Effective nasotracheal intubation using a modified transillumination technique

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Lysyl oxidase activates the transcription activity of human collagene III promoter. Possible involvement of Ku antigen.

Lysyl oxidase is an extracellular enzyme controlling the maturation of the collagen. Because the similar behavior of lysyl oxidase and collagen III expressions in fibrotic tissues, we investigated the influence of lysyl oxidase over-expression on the promoter activity of COL3A1 gene. Our results showed that when COS-7 cells over-expressed the mature form of lysyl oxidase, COL3A1 promoter activity was significantly increased. Electrophoretic Mobility Shift Assay showed a binding activity in the region from –100 to -76, that was significantly increased by lysyl oxidase over-expression. We identified the binding activity as Ku antigen. The study suggests a new co-ordinated mechanisms that might be critical for the development of fibrosis

Congenital supravalvar mitral ring: An underestimated anomaly

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