Risk stratification in nonischemic dilated cardiomyopathy: Current perspectives

The clinical goals of risk stratification of sudden death are to identify subjects who are at high risk of, and eventually to reduce the incidence of, sudden death. Numerous studies have described risk stratification techniques for serious cardiac events in patients following myocardial infarction. However, relatively little information is available regarding nonischemic dilated cardiomyopathy. A number of diagnostic methods have been used for risk stratification of patients with nonischemic dilated cardiomyopathy, including presence of syncope, ambulatory electrocardiographic monitoring, programmed ventricular stimulation, QRS duration, QT interval dispersion, QT interval dynamicity, signal-averaged ECG, heart rate variability, heart rate turbulence, baroreflex sensitivity, heart rate recovery, exercise recovery ventricular ectopy, fragmented QRS and cardiac magnetic resonance imaging. In this review, existing data regarding risk stratification of sudden cardiac death in nonischemic dilated cardiomyopathy will be summarized and its implications in clinical practice will be reviewed. (Cardiol J 2010; 17, 3: 219-229

Phase-field modeling of vapor bubble growth in a microchannel

Anumerical model based on Cahn–Hilliard phase-field method is introduced for thefirst time in the literature to investigate the hydrodynamics and heat transfercharacteristics of a vaporized elongated bubble in a rectangular microchannel. In thesimulations, the initially nucleated bubble starts growing as it comes in contact withsuperheated water. The effects of the water inlet velocity and the bubble contact angleon the temporal evolution of the average heat transfer coefficient are also reported.Both qualitative and quantitative comparisons indicated that the numerically obtainedbubble shape and the growth rate are in very good agreement with the experimentalresults available in the literature

Wastewater Treatment Using Imprinted Polymeric Adsorbents

In twenty-first century, numbers of synthetic dyes are used in many industries, for example paper, textile, cosmetic, leather for coloring, vs. The dyeing industries wastes is the most found contaminant to be recognized in wastewater. There are various treatment methods including oxidation processes, biological degradation, membrane filtration and coagulation/flocculation have been studied to treat dyeing wastewater. Unfortunately, these methods are high operational costs, complicated operations and possibility of producing more toxic products. Molecularly imprinted polymers (MIPs) are interesting and alternative polymeric adsorbents that can be applied in wastewater treatment for sample preparation and for the quantification of dyes present in wastewater. Molecular imprinting is a process in which functional and crosslinking monomers are co-polymerized in the presence of the target analyte, the imprint molecule. Initially, the functional monomer forms a complex and, after polymerization, their functional groups are held by the highly crosslinking polymeric structure. Upon leaching of the imprint molecule from the polymer matrix, a polymer with binding sites complementary in size and shape to the imprint molecule is created. MIPs can function under extreme conditions of pH, temperature and complex environment. Also, MIPs present wide recognition due to their stability, ease of production and low-cost potential

Optik atrofi, maküler incelme ve arkuat skotom gibi atipik klinik bulgular gösteren çoklu geçici beyaz nokta sendromu olgusu

A 57-year-old man presented with a sudden loss of vision, central scotoma, and photopsia in the left eye. Grayish-white spots localized in the deep retina around the macula and optic disc were observed in the left eye on funduscopic examination. We observed a hyperfluorescence in a wreath-like pattern with late staining in retinal lesions during the early stage of fundus fluorescein angiography. Disruption was observed in an ellipsoid zone in optical coherence tomography. Multiple evanescent white dot syndrome was diagnosed based on findings and followed up without medication. The visual acuity of the left eye improved from 1/20 to 6/10 after a 7-week follow-up. Dilated fundus examination showed optic atrophy, and visual field examination revealed an arcuate scotoma.Elli yedi yaşında erkek hasta, sol gözde ani görme kaybı, santral skotom ve fotopsi şikâyetleri ile kliniğimize başvurdu. Funduskopik muayenesinde, sol gözde makula ve optik disk etrafında, retinanın derin katlarında lokalize olmuş grimsi beyaz lezyonlar gözlendi. Fundus floresan anjiyografi erken dönemi boyunca retinal lezyonlarda gözlenen çelenk benzeri hiperfloresans, geç boyanma ile devam etti. Optik koherens tomografide, fotoreseptör iç ve dış segment tabakasında harabiyet görüldü. Mevcut bulgular eşliğinde hastaya, çoklu geçici beyaz nokta sendromu teşhisi kondu ve ilaçsız takip edildi. Yedi haftalık takip sonrası hastanın görme keskinliği 1/20’den 6/10’a yükseldi. Dilate fundus muayenesinde, optik atrofi ve görme alanında arkuat skotom oluştuğu gözlendi

Increased serum concentration of netrin-1 after intravitreal bevacizumab injection: is it a compensatory mechanism to counteract drug side effects?

Background To evaluate alterations in the serum concentrations of vascular endothelial growth factor (VEGF) and netrin-1 after intravitreal bevacizumab (BCZ) injection for the treatment of diabetic macular edema (DME). Methods This prospective case-control study included a total of 50 participants assigned to one of three groups, including 10 individuals with DME and non-proliferative diabetic retinopathy (NPDR), 13 with DME, and proliferative diabetic retinopathy (PDR), and 27 healthy individuals as a control group. Serum VEGF and netrin-1 concentrations were measured by enzyme-linked immunosorbent assays (ELISAs) immediately before, as well as 1 week and 1 month after, intravitreal BCZ injection. Results The mean VEGF serum concentrations in the PDR and NPDR groups were 388.4 and 196.9 pg/mL at baseline, respectively. After 1 week, these concentrations changed to 193.41 and 150.23 pg/mL, respectively (P = 0.001 and P = 0.005, respectively); after 1 month, the concentrations were 97.89 and 76.46 pg/mL, respectively (P = 0.001 and P = 0.009, respectively). The mean netrin-1 serum concentrations in the PDR patients and NPDR groups were 318.2 and 252.7 pg/mL at baseline, respectively. After 1 week, these concentrations increased to 476.6 and 416.3 pg/mL, respectively (P = 0.033 and P = 0.005, respectively), and after 1 month, they were 676.6 and 747.5 pg/mL, respectively (P = 0.001 and P = 0.005, respectively). The correlation analysis revealed a significant inverse relationship between changes in serum VEGF and netrin-1 concentrations in both the PDR and NPDR groups (r = - 0.685, P = 0.029). Conclusions Intravitreal BCZ injections work systemically to significantly decrease serum VEGF levels, leading to a significant upregulation in the concentration of another angiogenic mediator, netrin-1

Larinks skuamöz hücreli karsinom kökenli optik disk ve koroid metastazlı bir olgu

A 67-year-old male patient was presented with loss of vision, which he noticed in his left eye one week ago. He had undergone total laryngectomy due to laryngeal squamous cell carcinoma 3 years ago. His fundus examination revealed an elevated yellow mass on the optic disc. Magnetic resonance imaging (MRI) and computed tomography (CT) were performed with suspicion of laryngeal cancer metastasis. The MRI showed metastatic lesions in the brain, optic disc, and the surrounding choroid. The CT demonstrated diffuse metastasis in both lungs. The patient received radiotherapy for the brain, optic disc, and choroidal metastases. Unfortunately, the patient died within 2.5 months after the diagnosis because of systemic complications that developed due to extraocular causes. Metastasis of laryngeal cancer to the optic disc and choroid is rare. Although the majority of optic disc tumors are primary, a systemic investigation should be performed in cases of a mass on the disc with the suspicion of distant organ metastasis, albeit rare.T Altmış yedi yaşında erkek hasta, 1 hafta önce sol gözünde fark ettiği görme kaybı şikâyeti ile başvurdu. Üç yıl önce laringeal skuamöz hücreli karsinom nedeniyle total larenjektomi geçirdiği öğrenildi. Fundus muayenesinde, optik diskte sarı bir kitle görüldü. Larinks kanseri metastazı şüphesi ile manyetik rezonans görüntüleme (MRG) ve bilgisayarlı tomografi (BT) yapıldı. MRG’de beyin, optik disk ve çevreleyen koroidde, metastatik lezyonlar tespit edildi. BT’de her iki akciğerde yaygın metastaz saptandı. Hasta beyin, optik disk ve koroid metastazları için radyoterapi aldı. Ekstraoküler nedenlere bağlı gelişen sistemik komplikasyonlar nedeniyle tanı konulduktan sonraki 2,5 ay içinde ne yazık ki hasta kaybedildi. Larinks kanserinin, optik disk ve koroide metastazı nadirdir. Optik disk tümörlerinin çoğunluğu primer olmakla birlikte, nadir de olsa uzak organ metastazı şüphesi ile diskte kitle olması durumunda sistemik inceleme yapılmalıdır

Baseline aortic pre-ejection interval predicts reverse remodeling and clinical improvement after cardiac resynchronization therapy

Background: Cardiac resynchronization therapy (CRT) has been shown to reduce heart failure-related morbidity and mortality. However, approximately one in three patients do not respond to CRT. The aim of the current study was to determine the parameter(s) which predict reverse remodeling and clinical improvement after CRT. Methods: A total of 54 patients (43 male, 11 female; mean age 61.9 ± 10.5 years) with heart failure and New York Heart Association (NYHA) class III–IV symptoms and in whom left ventricular ejection fraction (LVEF) was £ 35% and QRS duration was ≥ 120 ms, despite optimal medical therapy, were enrolled. An echocardiographic examination was performed before, and six months after, CRT. An echocardiographic response was defined as a reduction of end-systolic volume ≥ 10% after six months, and a clinical response was defined as a reduction ≥ 1 in the NYHA functional class score. Results: An echocardiographic response was observed in 38 (70.4%) of the patients and a clinical response occurred in 41 (75.9%) of the patients. Of the dyssynchrony parameters, only the aortic pre-ejection interval (APEI) was observed to significantly predict the clinical response (p = 0.048) and echocardiographic response (p = 0.037). A 180.5 ms cut-off value for the APEI predicted the clinical response with a sensitivity of 92.3% and a specificity of 39%, and the echocardiographic response with a sensitivity of 93.0% and a specificity of 42%. Conclusions: APEI derived from pulsed-wave Doppler, which is available in every echocardiography machine, is a simple and practical method that could be used to select patients for CRT. (Cardiol J 2011; 18, 6: 639–647

Effect of bio-oil and epoxidized linseed oil on physical, mechanical and biological properties of treated wood

In this article, the effects of bio-oil and epoxidized linseed oil (ELO) on water absorption, tangential swelling, decay and insect resistance, thermo-gravimetric analysis, and mechanical properties of treated wood samples were studied. The bio-oil used in this article was by-product of ThermoWood thermal modification process. Linseed oil and hydrogen peroxide were used to prepare ELO. The results indicated that the samples treated with bio-oil had lower water absorption than that of the control group. The sec- ond treatment with ELO significantly reduced further the water absorption. The decay resistance of treated wood samples with 20% of bio-oil against brown (Coniophora puteana) and white rot (Trametes versicolor) fungi was very high. According to the insect test results, increasing bio-oil concentration from 10% to 20% significantly decreased surviving rate of Hylotrupes bajulus. Thermo-gravi- metric analysis showed that all treated samples had higher initial deterioration temperature than that of the control group. Regarding the wood strength, the impregnated bio-oil generally reduced the mechanical properties of wood except modulus of elasticity (MOE). VC 2013 Wiley Periodicals, Inc. J. Appl. Polym. Sci. 130: 1562–1569, 20