Which Aortic Valve Can Be Surgically Reconstructed?

Purpose of Review Preservation or repair of the aortic valve has evolved dynamically in the past 20 years. It leads to a high freedom from valve-related complications if an adequate valve durability can be achieved; it may possibly also improve survival. To date, little structured information is available about which valves can be repaired and which should better be replaced. Recent Findings For surgical decision-making, the size of the aortic root is important and the anatomy of the aortic valve must be considered. In the presence of root aneurysm, most tricuspid and bicuspid aortic valves can be preserved. In aortic regurgitation and normal aortic dimensions, the majority of tricuspid and bicuspid aortic valves can be repaired with good long-term durability. In bicuspid aortic valves, the morphologic characteristics must be taken into consideration. Unicuspid and quadricuspid aortic valves can be repaired in selected cases. Generally, cusp calcification is a sign of a poor substrate for repair; the same is true for cusp retraction and cusp destruction due to active endocarditis. They are associated with limited valve durability. Summary Using current concepts, many non-calcified aortic valves can be repaired. Modern imaging, in particular three-dimensional transesophageal echocardiography (TEE), should be able to define repairable aortic valves with a high probability

Sex Differences in Semantic Processing: Event-Related Brain Potentials Distinguish between Lower and Higher Order Semantic Analysis during Word Reading

Behavioral studies suggest that women and men differ in the strategic elaboration of verbally encoded information especially in the absence of external task demand. However, measuring such covert processing requires other than behavioral data. The present study used event-related potentials to compare sexes in lower and higher order semantic processing during the passive reading of semantically related and unrelated word pairs. Women and men showed the same early context effect in the P1-N1 transition period. This finding indicates that the initial lexical-semantic access is similar in men and women. In contrast, sexes differed in higher order semantic processing. Women showed an earlier and longer lasting context effect in the N400 accompanied by larger signal strength in temporal networks similarly recruited by men and women. The results suggest that women spontaneously conduct a deeper semantic analysis. This leads to faster processing of related words in the active neural networks as reflected in a shorter stability of the N400 map in women. Taken together, the findings demonstrate that there is a selective sex difference in the controlled semantic analysis during passive word reading that is not reflected in different functional organization but in the depth of processin

CBT Reduces CBF

Background: Imaging studies have provided evidence that cognitive‐behavioral therapy (CBT ) is able to change brain activation in phobic patients in response to threatening stimuli. The changes occurred in both emotion‐generating and modulatory regions. In this study, we use a data‐driven approach to explore resting state cerebral blood flow (CBF ) measured by arterial spin labeling (ASL ), before and after CBT. Methods: Eight female patients with spider phobia were scanned before and 1 month after an exposure‐based group therapy for spider phobia. Each MRI session consisted of an ASL resting state measurement acquired before and after a symptom provocation task involving the showing of spider pictures in the scanner. The first ASL acquisition measured anticipatory anxiety and the second measured postprocessing of phobia‐relevant stimuli. Results: Cognitive‐behavioral therapy significantly reduced spider phobic symptoms in all patients. Symptom reduction during anticipatory anxiety was accompanied by reduced bilateral CBF in the parahippocampal gyrus, ventral anterior thalamus, Brodmann area 8, and the anterior cingulate cortex. During postprocessing of phobia‐relevant stimuli, patients showed reduced CBF in the bilateral insula, components of the motor cortex, and areas associated with language functions. Conclusions: Longitudinal CBF dynamics following CBT were in concordance with results from several studies using BOLD fMRI to investigate the effects of psychotherapy on brain activity. CBF can be quantified by ASL , with the principal advantage of sensitivity to slow variations in neural activity and task independence. Therefore, ASL may be a suitable method for monitoring and evaluating the efficacy of psychotherapy or pharmacotherapy approaches

HI Distribution and Tully-Fisher Distances of Gas-Poor Spiral Galaxies in the Virgo Cluster Region

We present aperture synthesis observations in the 21 cm line of pointings centered on the Virgo Cluster region spirals NGC 4307, NGC 4356, NGC 4411B, and NGC 4492 using the Very Large Array (VLA) radiotelescope in its CS configuration. These galaxies were identified in a previous study of the three-dimensional distribution of HI emission in the Virgo region as objects with a substantial dearth of atomic gas and Tully-Fisher (TF) distance estimates that located them well outside the main body of the cluster. We have detected two other galaxies located in two of our fields and observed bands, the spiral NGC 4411A and the dwarf spiral VCC 740. We provide detailed information of the gas morphology and kinematics for all these galaxies. Our new data confirm the strong HI-deficiency of all the main targets but NGC 4411B, which is found to have a fairly normal neutral gas content. The VLA observations have also been used to discuss the applicability of TF techniques to the five largest spirals we have observed. We conclude that none of them is actually suitable for a TF distance evaluation, whether due to the radical trimming of their neutral hydrogen disks (NGC 4307, NGC 4356, and NGC 4492) or to their nearly face-on orientation (NGC 4411A and B).Comment: 32 pages, 5 figures. Accepted for publication in A

Comment on ``Evidence for Narrow Baryon Resonances in Inelastic pp Scattering''

Compton scattering data are sensitive to the existence of low-mass resonances reported by Tatischeff et al. We show that such states, with their reported properties, are excluded by previous Compton scattering experiments.Comment: One page, submitted to PR

Retrograde dye perfusion of the proximal aorta - A postmortem technical study

Introduction: Multiple cardiovascular conditions can lead to unexpected fatality, which is defined as sudden cardiac death. One of these potentially underlying conditions is aortic regurgitation, which can be caused by discrete changes of the geometry of the proximal aorta. To analyze aortic valve competency and furthermore to elucidate underlying pathological alterations of the coronary arteries and the vasa vasorum a perfusion method to simulate a diastolic state was designed. Material and methods: A postmortem approach with retrograde perfusion of the ascending aorta with methylene blue was applied to three bodies. The procedure comprised cannulation of the brachiocephalic trunk, clamping of the aortic arch between brachiocephalic trunk and left carotid artery, infusion of 250 ml of methylene blue, and optical clearing of the superficial tissue layers after perfusion. Organs were examined directly following perfusion and after optical clearing. Results: Assessment and visualization of aortic valve competency and the vasa vasorum were possible in all three instances. Visualization of the coronary perfusion was impaired by postmortem thrombus formation. Optical clearing did not provide additional information. Discussion: The method presented here is a time- and cost-efficient way of visualizing aortic valve competency and the vasa vasorum. The visualization of the vasa vasorum highlights the potential of this method in basic research on diseases of the great arteries and coronaries. However, for a time-efficient functional analysis of the coronaries, other methods must be applied