Effect of the prosthesis–patient mismatch on long-term clinical outcomes after isolated aortic valve replacement for aortic stenosis: A prospective observational study

BackgroundThe effect of prosthesis–patient mismatch (PPM) on clinical outcomes after aortic valve replacement remains controversial. We evaluated effect of PPM on long-term clinical outcomes after isolated aortic valve replacement in patients with predominant aortic stenosis.MethodsWe analyzed data from patients with predominant aortic stenosis who underwent isolated aortic valve replacement between January 1995 and July 2010. The indexed effective orifice area, obtained by dividing the in vivo effective orifice area by the patient’s body surface area, was used to define PPM as clinically nonsignificant (group I, 224 patients), mild (group II, 52 patients), moderate (group III, 39 patients), and severe (group IV, 36 patients).ResultsEarly survival was not significantly different among the groups, but overall survival was decreased gradually in group IV. Overall survival at 12 years was lower in group IV than in group I (92.8% ± 2.7% vs 67.0 ± 10.1, respectively; P = .001). Cardiac-related-death-free survival at 12 years was lower in patients with severe PPM. Left ventricular mass index decreased during the follow-up period in all groups. But left ventricular mass index was less decreased in group IV compared with groups I, II, and III. Age, severe PPM, and ejection fraction <40%, and New York Heart Association Functional Class IV were independent risk factors of overall survival on multivariate analysis. Severe PPM was an independent risk factor for cardiac-related death.ConclusionsSevere PPM showed an adverse effect on long-term survival, and was an independent risk factor for cardiac-related death. In addition, patients with severe PPM showed less decreasing left ventricular mass index during follow-up

Auxin response factor 2 (ARF2) plays a major role in regulating auxin-mediated leaf longevity

Auxin regulates a variety of physiological and developmental processes in plants. Although auxin acts as a suppressor of leaf senescence, its exact role in this respect has not been clearly defined, aside from circumstantial evidence. It was found here that ARF2 functions in the auxin-mediated control of Arabidopsis leaf longevity, as discovered by screening EMS mutant pools for a delayed leaf senescence phenotype. Two allelic mutations, ore14-1 and 14-2, caused a highly significant delay in all senescence parameters examined, including chlorophyll content, the photochemical efficiency of photosystem II, membrane ion leakage, and the expression of senescence-associated genes. A delay of senescence symptoms was also observed under various senescence-accelerating conditions, where detached leaves were treated with darkness, phytohormones, or oxidative stress. These results indicate that the gene defined by these mutations might be a key regulatory genetic component controlling functional leaf senescence. Map-based cloning of ORE14 revealed that it encodes ARF2, a member of the auxin response factor (ARF) protein family, which modulates early auxin-induced gene expression in plants. The ore14/arf2 mutation also conferred an increased sensitivity to exogenous auxin in hypocotyl growth inhibition, thereby demonstrating that ARF2 is a repressor of auxin signalling. Therefore, the ore14/arf2 lesion appears to cause reduced repression of auxin signalling with increased auxin sensitivity, leading to delayed senescence. Altogether, our data suggest that ARF2 positively regulates leaf senescence in Arabidopsis

Adsorptive removal of CO2 from CO2-CH4 mixture using cation-exchanged zeolites

Raw natural gas and landfill gas contains methane as its major component, but it also contains considerable amounts of contaminants such as CO2 and H2S (i.e. acid gases) that can cause corrosion and fouling of the pipeline and equipment during transportation and liquefaction. Amine-based CO2 gas removal processes have been employed in the gas industry, but these processes have disadvantages including high regeneration energy requirements and inefficiencies; these issues have not been adequately solved to date. Currently, adsorptive acid gas removal technologies have received significant interest because of the simplicity of adsorbent regeneration by thermal or pressure variation1). Numerous micro- and mesoporous adsorbents including zeolites [2-3], titanosilicates[4], activated carbons[5-6], metal-organic-framework (MOF) [7], and silica-alumina materials[8-9] were studied for this type of application. However, the CO2/CH4 selectivity of the aforementioned adsorbents was not high enough for commercial applications.In this study, different cation-exchanged zeolites were synthesized, physicochemically characterized, and evaluated for adsorptive removal of CO2 from CO2-CH4 mixtures. The adsorption isotherms of CO2 and CH4 in the pressure and temperature ranges 0 − 3MPa and 10 – 40 oC, respectively, for different cation-exchanged zeolites were measured and compared. The ideal-adsorbed solution theory (IAST) was employed for the estimation of CO2/CH4 selectivity for the different cation-exchanged zeolites. References 1) D. Aaron, C. Tsouris, Separ. Sci. Technol. 2005, 40, 321–348 2) J. Collins, US Patent No. 3,751,878. 1973. 3) M. W. Seery, US Patent No. 5,938,819. 1999 4) W. B. Dolan, M.J. Mitariten, US Patent No. 6,610,124 B1. 2003 5) A. Kapoor, R.T. Yang, Chem. Eng. Sci. 1989, 44, 1723–1733 6) A. Jayaraman, Chiao, A. S.; Padin, J.; Yang, R. T.; Munson, C. L., Separ. Sci. Technol. 2002 37, 2505–2528 7) L. Hamon, E. Jolimaitre, G. Pringruber , Ind. Eng. Chem. Res. 2010, 49, 7497-7503 8) W.B. Dolan, M.J. Mitariten, US patent No. 2003/0047071, 2003 9) G. Bellussi, P. Broccia, A. Carati, R. Millini, P. Pollesel, C. Rizzo, M. Tagliabue, Micropor. Mesopor. Mat., 2011, 146, 134–14

The Relation between Birth Weight and Insulin Resistance in Korean Adolescents

Low birth weight is associated with insulin resistance and type 2 diabetes in adults. The fetal programming hypothesis has shown that insulin resistance and its associated metabolic disturbances result from a poor gestational environment, for which low birth weight is a surrogate. An at-home questionnaire survey was performed on 660 middle school students (12-15 years) in Seoul, Korea, and 152 cases were randomly selected based on their birth weight. Subjects were divided into three groups according to birth weight. We recorded their birth weight and measured their current anthropometric data, blood pressure, lipid profile, HOMA-IR, and HOMA-β, and compared these parameters among the groups. The relation of birth weight to physiological characteristics in adolescence was examined. Systolic blood pressure, lipid profiles, and fasting plasma glucose, HOMA-β were not significantly different among the groups, but diastolic blood pressure was lower in the third tertile. Insulin, C-peptide, and HOMA-IR were higher in the lower birth weight tertile. After adjustment for confounding factors, birth weight was inversely related to diastolic blood pressure, insulin, C-peptide, and HOMA-IR. We conclude that low birth weight may predict the risk of the insulin resistance and its progression over age, and that adequate gestational nutrition is therefore necessary to prevent low birth weight

Breakdown of the interlayer coherence in twisted bilayer graphene

Coherent motion of the electrons in the Bloch states is one of the fundamental concepts of the charge conduction in solid state physics. In layered materials, however, such a condition often breaks down for the interlayer conduction, when the interlayer coupling is significantly reduced by e.g. large interlayer separation. We report that complete suppression of coherent conduction is realized even in an atomic length scale of layer separation in twisted bilayer graphene. The interlayer resistivity of twisted bilayer graphene is much higher than the c-axis resistivity of Bernal-stacked graphite, and exhibits strong dependence on temperature as well as on external electric fields. These results suggest that the graphene layers are significantly decoupled by rotation and incoherent conduction is a main transport channel between the layers of twisted bilayer graphene.Comment: 5 pages, 3 figure

Profiling age-related epigenetic markers of stomach adenocarcinoma in young and old subjects

The purpose of our study is to identify epigenetic markers that are differently expressed in the stomach adenocarcinoma (STAD) condition. Based on data from The Cancer Genome Atlas (TCGA), we were able to detect an age-related difference in methylation patterns and changes in gene and miRNA expression levels in young (n = 14) and old (n = 70) STAD subjects. Our analysis identified 323 upregulated and 653 downregulated genes in old STAD subjects. We also found 76 miRNAs with age-related expression patterns and 113 differentially methylated genes (DMGs), respectively. Our further analysis revealed that significant upregulated genes (n = 35) were assigned to the cell cycle, while the muscle system process (n = 27) and cell adhesion-related genes (n = 57) were downregulated. In addition, by comparing gene and miRNA expression with methylation change, we identified that three upregulated genes (ELF3, IL1??, and MMP13) known to be involved in inflammatory responses and cell growth were significantly hypomethylated in the promoter region. We further detected target candidates for age-related, downregulated miRNAs (hsa-mir-124-3, hsa-mir-204, and hsa-mir-125b-2) in old STAD subjects. This is the first report of the results from a study exploring age-related epigenetic biomarkers of STAD using high-throughput data and provides evidence for a complex clinicopathological condition expressed by the age-related STAD progression. &amp;copy; the authors, publisher and licensee Libertas Academica Limitedopen