Prenatal diagnosis and postnatal follow-up of congenitally corrected transposition of the great arteries and recurrent supraventricular tachycardia

The prenatal sonographic diagnosis of congenitally corrected transposition of the great arteries (ccTGA), a rare form of congenital heart disease is very difficult. A24-year-old woman was referred to our center at 28 weeks’ gestation because of suspected fetal cardiac anomalies. This article reports a case of ccTGA with supraventricular tachycardia, ventricular septal defect, pulmonary valve stenosis, tricuspid valvar displacement and moderate tricuspid regurgitation during her pregnancy. The combined presence of SVT and ccTGA are occasionally present in the literature.peer-reviewe

Tuning Electronic Properties of Monolayer Hexagonal Boron Phosphide with Group III-IV-V Dopants

An extensive study on doping of two-dimensional (2D) hexagonal boron phosphide (h-BP) which is a direct band gap semiconductor was performed by using ab initio methods based on spin-polarized density functional theory. The interaction of group III-IV-V elements with h-BP is explored, considering both adsorption and substitution cases, and the resulting structural and electronic properties are examined. The variation of adsorption (substitution) energies and band gap values are systematically analyzed and trends are identified. Upon adsorption, the most of the elements bound on top of P atom forming dumbbell geometry which generates characteristic spin-polarized impurity states. The substitution of B or P by group III-IV-V elements can produce extra electrons/holes which lead to n-type and p-type doping for adequate cases. Additionally, doping can further generate impurity resonant states. Functionalization of h-BP with adatoms can tune the electronic structure and would be useful for nanoelectronic applications in low-dimensions. © 2017 American Chemical Society

Determination of the effects of pulmonary arterial hypertension and therapy on the cardiovascular system of rats by impedance cardiography

Aim To evaluate the effects of bosentan, sildenafil, and combined therapy on the cardiovascular system using impedance cardiography (ICG) in rats with monocrotaline (MCT)-induced pulmonary arterial hypertension (PAH). Methods Seventy male Wistar-albino rats were randomized into five groups. A single dose of MCT was given to all rats, except to the control group. After 4 weeks, bosentan, sildenafil, and combined treatment was started and lasted for 3 weeks. The last group that developed PAH did not receive any medication. Echocardiographic evaluation was performed to determine the PAH development. Thoracic fluid content index (TFCI), stroke volume index (SI), heart rate (HR), cardiac index (CI), and myocardial contractility index (IC) were determined. All procedures were performed at the baseline and after 4 and 7 weeks. Results Echocardiographic parameters showed that the all MCT-injected rats developed PAH. There were no significant inter- and intra-group differences in TFCI, SI, and IC (P > 0.05), but at the 7th week, CI value in the sildenafil- treated PAH rats was significantly higher than in other groups and HR of PAH rats with combined therapy was significantly lower than in other groups. Conclusion PAH did not have an effect on LV function of rats, or if it did, the effect was compensated by physiological processes. Also, sildenafil treatment deteriorated the LV cardiac index

Changes in the Brain Microstructure of Children with Primary Monosymptomatic Nocturnal Enuresis: A Diffusion Tensor Imaging Study

Background: Primary monosymptomatic nocturnal enuresis (PMNE) is a common disorder in school-aged children. Previous studies have suggested that a developmental delay might play a role in the pathology of children with PMNE. However, microstructural abnormalities in the brains of these children have not been thoroughly investigated. Methodology/Principal Findings: In this work, we evaluated structural changes in the brains of children with PMNE using diffusion tensor imaging (DTI). Two groups consisting of 26 children with PMNE and 26 healthy controls were scanned using magnetic resonance DTI. The diffusion parameters of fractional anisotropy (FA) and mean diffusivity (MD) were subjected to whole-brain, voxel-wise group comparisons using statistical parametric mapping (SPM). When compared to healthy subjects, children with PMNE showed both a decrease in FA and an increase in MD in the thalamus. MD also increased in the frontal lobe, the anterior cingulate cortex and the insula; these areas are all involved in controlling micturition. The significant changes seen in the thalamus could affect both urine storage and arousal from sleep. Conclusions/Significance: The microstructure abnormalities were observed in the thalamus, the medial frontal gyrus, the anterior cingulate cortex and the insula, which are involved in micturition control network. This indicates developmenta

Essays On Corporate Finance

This dissertation, empirically examines ownership structure and its impacts on shareholder wealth. In the first chapter I examine the relation between ownership structure and M&A target selection when family firms purse acquisitions, focusing on the factors that influence family selection of targets. My results indicate that family firm acquirers select targets that are smaller and have low growth potential. I focus on short- and long-run stock market reactions to merger and acquisition announcements of family versus nonfamily bidders and their associated targets. I find that acquirers with family ownership have better cumulative average abnormal returns in the short run and higher buy-and-hold abnormal returns up to one year after the acquisition. Family firms also take a greater share of the merger synergy than do nonfamily bidders while the overall merger synergy is invariant to ownership structure. These results suggest that family firms pick different targets than nonfamily firms and benefit minority shareholders when they acquire. This chapter provides evidence that family ownership does not destroy value during M&A transactions; instead, the analysis indicates that family owners appear to choose better targets. In the second chapter I examine firms with dual class structures. Firms with limited voting shares, dual class firms, persist over time in spite of the widespread view that they embody a “corruption of the governance system” (Calpers, 2011). I find that founders and their heirs control 89% of dual class firms, making it difficult to disentangle family control and voting rights. I document that family owners hold 30% greater economic exposure in dual class firms than in single class family firms. Investors place lower values on both single and dual class family firms relative to non-family firms. In contrast, non-family dual class firms exhibit a 19% premium relative to single class firms. Further analysis shows that 8 industries contain 58% of these limited voting share firms - industries that require high brand maintenance and intangible assets. Strikingly, I find that outside shareholders of dual class firms earn excess returns of about 350 basis points per year relative to single class nonfamily firms. Additional tests reveal that institutional investors hold more of the floated equity of dual class family firms than found in single class nonfamily firms. Exploring a succession risk premium perspective, I discover these lower values and greater excess returns primarily occur in descendent-controlled firms. Overall, my analysis suggests that limited voting shares provide an important mechanism used by controlling shareholders that arise in industries with specific characteristics.Business Administration/Financ

Are there any novel markers in acute rheumatic fever: neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and monocyte-to-lymphocyte ratio

AbstractObjective:The aim of this study was to investigate the relationship between C-reactive protein and erythrocyte sedimentation rate and neutrophil-to-lymphocyte, platelet-to-lymphocyte, and monocyte-to-lymphocyte ratios in acute rheumatic fever in children.Method:In this retrospective study, 182 patients with acute rheumatic fever and 173 controls were included. Complete blood count parameters, and neutrophil-to-lymphocyte, monocyte-to-lymphocyte, and platelet-to-lymphocyte ratios were recorded for all the patients underwent transthoracic echocardiography.Results:Neutrophil-to-lymphocyte, monocyte-to-lymphocyte, and platelet-to-lymphocyte ratios were significantly higher in patients with rheumatic heart disease than patients without cardiac involvement (p &lt; 0.05). C-reactive protein and erythrocyte sedimentation rate levels were found to have a positive correlation with neutrophil-to-lymphocyte (r = 0.228, p = 0.001; r = 0.355, p = 0.001), platelet-to-lymphocyte (r = 0.227, p = 0.01; r = 0.149, p = 0.005), and monocyte-to-lymphocyte ratios (r = 0.117, p = 0.005; r = 0.107, p = 0.044). Cardiac involvement was present in 152 (83.5%) of the patients. Neutrophil-to-lymphocyte, monocyte-to-lymphocyte, and platelet-to-lymphocyte ratios were significantly higher in patients with rheumatic heart disease than patients without cardiac involvement (p &lt; 0.05). Patients with carditis were grouped according to mitral, aortic, or both valve involvement but there was no significant difference between the groups with respect to neutrophil-to-lymphocyte, monocyte-to-lymphocyte, and platelet-to-lymphocyte ratios. In addition, neutrophil-to-lymphocyte and monocyte-to-lymphocyte ratios were significantly higher in patients with Sydenham’s chorea than without chorea (p &lt; 0.05).Conclusion:Neutrophil-to-lymphocyte, platelet-to-lymphocyte, and monocyte-to-lymphocyte ratios may help make the diagnosis of acute rheumatic fever and its prognosis by serial measurements in follow-up but none of them tell us the severity of carditis. Also, this is the first study showing the positive correlation between Sydenham’s chorea and neutrophil-to-lymphocyte and monocyte-to-lymphocyte ratios. Further studies are needed to confirm this hypothesis, as this is the first study in the literature on this topic.</jats:sec

Two-dimensional echocardiographic diagnosis of double outlet left ventricle with subaortic ventricular septal defect, pulmonary stenosis, and a hypoplastic left ventricle

Double outlet left ventricle (DOLV) is a rare congenital cardiac malformation in which both the pulmonary artery and the aorta arise exclusively or predominantly from the morphologic left ventricle. We describe a case of DOLV with situs solitus, d-loop ventricles, d-malposition of the great arteries (S, D, D), severe pulmonary stenosis, and a subaortic ventricular septal defect in which the left ventricle was also severely hypoplastic. The anatomic features were shown with 2-dimensional echocardiography, and the diagnosis was later confirmed at cardiac catheterization. Many morphologic variations of this malformation have been described but to the our knowledge DOLV with a hypoplastic left ventricle has not been reported before

Plasma leptin levels in children with cyanotic and acyanotic congenital heart disease and correlations with growth parameters

Background: Leptin has been shown to be an integral component of energy homeostasis and regulation of body weight. Leptin regulates adipose tissue mass and correlates with the fat mass, however the circulating levels are altered by energy intake. Research on the physiological function of leptin has primarily focused on its role in the pathogenesis of obesity. However, its role in the negative energy imbalance is unclear. Increased energy expenditure is a primary factor in the reduced growth in infants with cyanotic congenital heart disease. The objective of this study was to examine the possible role of leptin on growth and nutrition in children with cyanotic and acyanotic congenital heart disease. Methods and Results: In this study, plasma leptin levels, nutritional and growth status were evaluated in 28 cyanotic and 20 acyanotic patients with congenital heart disease. Although standard deviation (S.D.) of height (P<0.01), mid arm circumference (MAC) (P<0.001) and body mass index (BMI) (P<0.05) were significantly low in cyanotic group, plasma leptin levels were similar. Energy intake was high in cyanotic group. In both cyanotic and acyanotic group, plasma leptin levels were correlated with BMI (r: 0.388, P<0.05 and r: 0.789, P<0.001, respectively). In addition, leptin levels were significantly correlated with the height (r: 0.415, P<0.05), MAC (r: 0.482 P<0.05) and BMI (r: 0.377, P<0.05) S.D. in cyanotic subjects. Conclusions: Our results suggest that the leptin regulating axis is intact in cyanotic patients and leptin does not contribute to the cachexia of cyanotic heart disease. (C) 2003 Elsevier Ireland Ltd. All rights reserved