The Gore Hybrid Vascular Graft in renovisceral debranching for complex aortic aneurysm repair

Objective This study reports our initial experience with the Gore Hybrid Vascular Graft (GHVG; W. L. Gore & Associates, Flagstaff, Ariz) for staged hybrid open renovisceral debranching and endovascular aneurysm repair in patients affected by thoracoabdominal aortic aneurysms and pararenal abdominal aortic aneurysms (PAAAs). Methods Between December 2012 and December 2013, we analyzed outcomes of 13 patients who underwent open surgical debranching of renovisceral vessels for thoracoabdominal aortic aneurysm and PAAAs. All patients were considered at high risk for conventional surgery. Inclusion criterion was treatment by open surgical debranching of at least one visceral artery (renal artery, superior mesenteric artery [SMA], or celiac trunk [CT]) using the GHVG. In a second step, the aortic stent graft was implanted to exclude the aneurysm. If required, parallel grafts to the remaining visceral arteries were deployed in the same procedure. One patient had a symptomatic descending thoracic aortic aneurysm and another had a ruptured PAAA. Perioperative measured outcomes were immediate technical success rate, mortality, and morbidity. Median follow-up was 24.8 months (range, 0-15; mean, 8.2; standard deviation, 4 months). Results All open surgical debranching of renovisceral vessels were completed as intended. GHVG was used to revascularize 20 visceral vessels in 13 patients with a mean of 1.54 vessels per patient. Six renal arteries (30%; 2 right and 4 left), 9 SMAs (45%), and 5 CTs (25%) were debranched. In nine of 13 (66%) patients, other renovisceral arteries were addressed with chimney/periscope, Viabahn Open Revascularization Technique, and end-to-side anastomosis. Two of 13 patients (15%) died of bowel ischemia. Neither patient had GHVG revascularization to the SMA or CT. Perioperative complications occurred in three patients (23%; 1 renal hematoma, 1 respiratory insufficiency, and 1 small-bowel ischemia related to a SMA GHVG thrombosis). At 24 months, estimated survival was 85%, and estimated primary and secondary patency were 94% and 100%, respectively. Conclusions This limited series extracted from a more consistent hybrid procedure experience showed a mortality rate similar to most recent reports. Technical feasibility and the short-term patency rate of the GHVG for renovisceral debranching during staged hybrid open and endovascular procedures were satisfactory. Use of GHVGs may represent a useful revascularization adjunct to minimize visceral ischemia in these challenging patients

Use of the STAT (Sutureless Telescoping Anastomosis Technique) to facilitate supraaortic revascularization: Mid-term Results

Not availabl

Dual-Element Isotope Analysis of Desphenylchloridazon to Investigate its Environmental Fate in a Systematic Field Study-A Long-Term Lysimeter Experiment

Desphenylchloridazon (DPC), the main metabolite of the herbicide chloridazon (CLZ), is more water soluble and persistent than CLZ and frequently detected in water bodies. When assessing DPC transformation in the environment, results can be nonconclusive if based on concentration analysis alone because estimates may be confounded by simultaneous DPC formation from CLZ. This study investigated the fate of DPC by combining concentration-based methods with compound-specific C and N stable isotope analysis (CSIA). Additionally, DPC formation and transformation processes were experimentally deconvolved in a dedicated lysimeter study considering three scenarios. First, surface application of DPC enabled studying its degradation in the absence of CLZ. Here, CSIA provided evidence of two distinct DPC transformation processes: one shows significant changes only in 13C/12C, whereas the other involves changes in both 13C/12C and 15N/14N isotope ratios. Second, surface application of CLZ mimicked a realistic field scenario, showing that during DPC formation, 13C/12C ratios of DPC were depleted in 13C relative to CLZ, while 15N/14N ratios remained constant. Finally, CLZ depth injection simulated preferential flow and demonstrated the importance of the topsoil for retaining DPC. The combination of the lysimeter study with CSIA enabled insights into DPC transformation in the field that are superior to those of studies of concentration trends

Long-term results of simplified frozen elephant trunk technique in complicated acute type A aortic dissection: A case–control study

Aim: To describe the long-term experience of a simplified frozen elephant trunk technique (sFETT) used in complicated acute type A aortic dissection (AAAD) treatment. Methods and results: Between January 2001 and December 2012, 34 patients (mean age 59.9 ± 11.0 years) with complicated AAAD (DeBakey I) underwent an emergency surgery including sFETT. sFETT consisted in gluing the dissected aortic arch wall layers with gelatine-resorcinol adhesive and video-assisted antegrade open arch aortic stent-graft deployment in the arch or proximal descending aorta. In addition to sFETT, the aortic root was addressed with standard techniques. A 30-day mortality was 14.7% (five patients) due to bleeding (1), multiple organ failure (2), and colon ischemia (2). Postoperative morbidity included neurological (2), renal (1) and cardio-pulmonary complications (4), as well as wound infection (1). Mean follow-up was 74.4 ± 45.0 months. Actual survival rates were 73.5% at 1 year, 70.2% at 5 years, and 58.5% at 13 years of follow-up. Six patients died during long-term follow-up from heart failure (1) and unknown reasons (5). Five patients required reoperation for aortic arch (3) or aorto-iliac (2) progression of aneurysm during the mid- and long-term follow-up. The remaining patients showed favorable evolution of the dissected aorta with false lumen occlusion in most cases and stable aortic diameters. Conclusions: In AAAD patients, sFETT as used in our series is an easy and safe technique to repair the aortic arch. Long-term results after sFETT showed false lumen occlusion and stable aortic diameter in up to 13 years of follow-up

Beliefs about the Minds of Others Influence How We Process Sensory Information

Attending where others gaze is one of the most fundamental mechanisms of social cognition. The present study is the first to examine the impact of the attribution of mind to others on gaze-guided attentional orienting and its ERP correlates. Using a paradigm in which attention was guided to a location by the gaze of a centrally presented face, we manipulated participants' beliefs about the gazer: gaze behavior was believed to result either from operations of a mind or from a machine. In Experiment 1, beliefs were manipulated by cue identity (human or robot), while in Experiment 2, cue identity (robot) remained identical across conditions and beliefs were manipulated solely via instruction, which was irrelevant to the task. ERP results and behavior showed that participants' attention was guided by gaze only when gaze was believed to be controlled by a human. Specifically, the P1 was more enhanced for validly, relative to invalidly, cued targets only when participants believed the gaze behavior was the result of a mind, rather than of a machine. This shows that sensory gain control can be influenced by higher-order (task-irrelevant) beliefs about the observed scene. We propose a new interdisciplinary model of social attention, which integrates ideas from cognitive and social neuroscience, as well as philosophy in order to provide a framework for understanding a crucial aspect of how humans' beliefs about the observed scene influence sensory processing

Modelling the probability of microhabitat formation on trees using cross-sectional data

The rate of TreM formation per unit diameter growth was modelled as a function of tree diameter at breast height (DBH), and the model was calibrated considering cross-sectional observations TreMs on trees of different sizes. The model predicted realistic TreM formation rates at the tree and stand levels in forests dominated by Abies alba and Fagus sylvatica. This approach opens new perspectives to the analysis of forest biodiversity conservation strategies

An 8-mm diameter fibre robot positioner for massive spectroscopy surveys

This article has been accepted for publication in Monthly Notices of Royal Astronomical Society © 2015 The Authors. Published by Oxford University Press on behalf of the Royal Astronomical Society. All rights reservedMassive spectroscopic survey are becoming trendy in astrophysics and cosmology, as they can address new fundamental knowledge such as understanding the formation of the Milky Way and probing the nature of the mysterious dark energy. To enable massive spectroscopic surveys, new technology has been developed to place thousands of optical fibres at a given position on a focal plane. This technology needs to be: (1) accurate, with micrometer positional accuracy; (2) fast to minimize overhead; (3) robust to minimize failure; and (4) low cost. In this paper, we present the development, properties, and performance of a new single 8-mm in diameter fibre positioner robot, using two 4-mm DC-brushless gearmotors, that allows us to achieve accuracies up to 0.07 arcsec (5 μm). This device has been developed in the context of the Dark Energy Spectroscopic InstrumentWe acknowledge support from the Spanish MICINNs Consolider-Ingenio 2010 Program me under grant MultiDark CSD2009-00064, HEPHACOS S2009/ESP-1473, and MINECO Centro de Excelencia Severo Ochoa Programme under grant SEV-2012-0249. We also thank the support from a CSIC-AVS contract through MICINN grant AYA2010-21231-C02- 01, and CDTI grant IDC-20101033; and support from the Spanish MINECO research grants AYA2012-31101 and FPA2012-34694. JPK, PH and LM acknowledge support from the ERC advanced grant LIDA and from an SNF Interdisciplinary grant

An 8-mm diameter fibre robot positioner for massive spectroscopy surveys

Massive spectroscopic survey are becoming trendy in astrophysics and cosmology, as they can address new fundamental knowledge such as understanding the formation of the Milky Way and probing the nature of the mysterious dark energy. To enable massive spectroscopic surveys, new technology has been developed to place thousands of optical fibres at a given position on a focal plane. This technology needs to be: (1) accurate, with micrometer positional accuracy; (2) fast to minimize overhead; (3) robust to minimize failure; and (4) low cost. In this paper, we present the development, properties, and performance of a new single 8-mm in diameter fibre positioner robot, using two 4-mm DC-brushless gearmotors, that allows us to achieve accuracies up to 0.07arcsec (5 μm). This device has been developed in the context of the Dark Energy Spectroscopic Instrument.

The Expression and Localization of N-Myc Downstream-Regulated Gene 1 in Human Trophoblasts

The protein N-Myc downstream-regulated gene 1 (NDRG1) is implicated in the regulation of cell proliferation, differentiation, and cellular stress response. NDRG1 is expressed in primary human trophoblasts, where it promotes cell viability and resistance to hypoxic injury. The mechanism of action of NDRG1 remains unknown. To gain further insight into the intracellular action of NDRG1, we analyzed the expression pattern and cellular localization of endogenous NDRG1 and transfected Myc-tagged NDRG1 in human trophoblasts exposed to diverse injuries. In standard conditions, NDRG1 was diffusely expressed in the cytoplasm at a low level. Hypoxia or the hypoxia mimetic cobalt chloride, but not serum deprivation, ultraviolet (UV) light, or ionizing radiation, induced the expression of NDRG1 in human trophoblasts and the redistribution of NDRG1 into the nucleus and cytoplasmic membranes associated with the endoplasmic reticulum (ER) and microtubules. Mutation of the phosphopantetheine attachment site (PPAS) within NDRG1 abrogated this pattern of redistribution. Our results shed new light on the impact of cell injury on NDRG1 expression patterns, and suggest that the PPAS domain plays a key role in NDRG1's subcellular distribution. © 2013 Shi et al