252 research outputs found

    Prognostic value of the ratio between prothesis area and indexed annulus area measured by multiSlice-CT for transcatheter aortic valve implantation procedures

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    Background Postprocedural aortic regurgitations following transcatheter aortic valve implantation (TAVI) procedures remain an is- sue. Benefit of oversizing strategies to prevent them isn’t well established. We compared different level of oversizing in our cohort of con- secutive patients to address if severe oversizing compared to normal sizing had an impact on post-procedural outcomes. Methods From January 2010 to August 2013, consecutive patients were referred for TAVI with preoperative Multislice-CT (MSCT) and the procedures were achieved using Edwards Sapien® or Corevalve devices®. Retrospectively, according to pre-procedural MSCT and the valve size, pa- tients were classified into three groups: normal, moderate and severe oversizing; depending on the ratio between the prosthesis area and the annulus area indexed and measured on MSCT. Main endpoint was mid-term mortality and secondary endpoints were the Valve Academic Research Consortium (VARC-2) endpoints. Results Two hundred and sixty eight patients had a MSCT and underwent TAVI procedure, with mainly Corevalve®. While all-cause and cardiovascular mortality rates were similar in all groups, post-procedural new pacemaker (PM) implantation rate was significantly higher in the severe oversizing group (P = 0.03), while we observed more in-hospital congestive heart-failure (P = 0.02) in the normal sizing group. There was a trend toward more moderate to severe aortic regurgitation (AR) in the normal sizing group (P = 0.07). Conclusions Despite a higher rate of PM implantation, oversizing based on this ratio reduces aortic leak with lower rates of post-procedural complications and a similar mid-term survival

    Temperature measurement and stabilization in a birefringent whispering gallery resonator

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    Temperature measurement with nano-Kelvin resolution is demonstrated at room temperature, based on the thermal dependence of an optical crystal anisotropy in a high quality whispering gallery resonator. As the resonator's TE and TM modes frequencies have different temperature coefficients, their differential shift provides a sensitive measurement of the temperature variation, which is used for active stabilization of the temperature

    A catalogue of young runaway Hipparcos stars within 3kpc from the Sun

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    Traditionally runaway stars are O and B type stars with large peculiar velocities.We want to extend this definition to young stars (up to ~50 Myr) of any spectral type and identify those present in the Hipparcos catalogue applying different selection criteria such as peculiar space velocities or peculiar one-dimensional velocities. Runaway stars are important to study the evolution of multiple star systems or star clusters as well as to identify origins of neutron stars. We compile distances, proper motions, spectral types, luminosity classes, V magnitudes and B-V colours and utilise evolutionary models from different authors to obtain star ages and study a sample of 7663 young Hipparcos stars within 3 kpc from the Sun. Radial velocities are obtained from the literature. We investigate the distributions of the peculiar spatial velocity, the peculiar radial velocity as well as the peculiar tangential velocity and its one-dimensional components and obtain runaway star probabilities for each star in the sample. In addition, we look for stars that are situated outside any OB association or OB cluster and the Galactic plane as well as stars of which the velocity vector points away from the median velocity vector of neighbouring stars or the surrounding local OB association/ cluster although the absolute velocity might be small. We find a total of 2547 runaway star candidates (with a contamination of normal Population I stars of 20 per cent at most). Thus, after subtraction of those 20 per cent, the runaway frequency among young stars is about 27 per cent. We compile a catalogue of runaway stars which will be available via VizieR.Comment: 12 pages, 8 figures, 7 tables, accepted for publication in MNRAS old version replaced due to change of the title after journal proof-readin

    The course of traumatic pancreatitis in a patient with pancreas divisum: a case report

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    BACKGROUND: The peculiar anatomy of pancreatic ducts in pancreas divisum (PD) may interfere with the development of acute chronic pancreatitis. In the presented case, PD influenced the evolution of lesions after pancreatic trauma. CASE PRESENTATION: A 38 years old patient refferred to our hospital with recurrent episodes of mild pancreatitis during the last two years. The first episode occurred four months after blunt abdominal trauma. Endoscopic Retrograde Cholangiopancreatography, Magnetic Resonance Imaging of upper abdomen and Magnetic Resonance Cholangiopancreatography disclosed pancreas divisum, changes consistent with chronic pancreatitis in the dorsal pancreatic duct, atrophy in the body and tail of the pancreas and a pseudocyst in the pancreatic head, that was drained endoscopically. CONCLUSION: Pancreas Divisum may interfere with the evolution of posttraumatic changes in the pancreas after blunt abdominal trauma

    IFN-Lambda (IFN-λ) Is Expressed in a Tissue-Dependent Fashion and Primarily Acts on Epithelial Cells In Vivo

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    Interferons (IFN) exert antiviral, immunomodulatory and cytostatic activities. IFN-α/β (type I IFN) and IFN-λ (type III IFN) bind distinct receptors, but regulate similar sets of genes and exhibit strikingly similar biological activities. We analyzed to what extent the IFN-α/β and IFN-λ systems overlap in vivo in terms of expression and response. We observed a certain degree of tissue specificity in the production of IFN-λ. In the brain, IFN-α/β was readily produced after infection with various RNA viruses, whereas expression of IFN-λ was low in this organ. In the liver, virus infection induced the expression of both IFN-α/β and IFN-λ genes. Plasmid electrotransfer-mediated in vivo expression of individual IFN genes allowed the tissue and cell specificities of the responses to systemic IFN-α/β and IFN-λ to be compared. The response to IFN-λ correlated with expression of the α subunit of the IFN-λ receptor (IL-28Rα). The IFN-λ response was prominent in the stomach, intestine and lungs, but very low in the central nervous system and spleen. At the cellular level, the response to IFN-λ in kidney and brain was restricted to epithelial cells. In contrast, the response to IFN-α/β was observed in various cell types in these organs, and was most prominent in endothelial cells. Thus, the IFN-λ system probably evolved to specifically protect epithelia. IFN-λ might contribute to the prevention of viral invasion through skin and mucosal surfaces

    Neurons are MHC Class I-Dependent Targets for CD8 T Cells upon Neurotropic Viral Infection

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    Following infection of the central nervous system (CNS), the immune system is faced with the challenge of eliminating the pathogen without causing significant damage to neurons, which have limited capacities of renewal. In particular, it was thought that neurons were protected from direct attack by cytotoxic T lymphocytes (CTL) because they do not express major histocompatibility class I (MHC I) molecules, at least at steady state. To date, most of our current knowledge on the specifics of neuron-CTL interaction is based on studies artificially inducing MHC I expression on neurons, loading them with exogenous peptide and applying CTL clones or lines often differentiated in culture. Thus, much remains to be uncovered regarding the modalities of the interaction between infected neurons and antiviral CD8 T cells in the course of a natural disease. Here, we used the model of neuroinflammation caused by neurotropic Borna disease virus (BDV), in which virus-specific CTL have been demonstrated as the main immune effectors triggering disease. We tested the pathogenic properties of brain-isolated CD8 T cells against pure neuronal cultures infected with BDV. We observed that BDV infection of cortical neurons triggered a significant up regulation of MHC I molecules, rendering them susceptible to recognition by antiviral CTL, freshly isolated from the brains of acutely infected rats. Using real-time imaging, we analyzed the spatio-temporal relationships between neurons and CTL. Brain-isolated CTL exhibited a reduced mobility and established stable contacts with BDV-infected neurons, in an antigen- and MHC-dependent manner. This interaction induced rapid morphological changes of the neurons, without immediate killing or impairment of electrical activity. Early signs of neuronal apoptosis were detected only hours after this initial contact. Thus, our results show that infected neurons can be recognized efficiently by brain-isolated antiviral CD8 T cells and uncover the unusual modalities of CTL-induced neuronal damage
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