Prevalence of donor-transmitted atherosclerosis—Clinical utility of intracoronary ultrasound early after heart transplantation. A single-center study

AbstractIntroductionCoronary allograft vasculopathy (CAV) is one of the main factors limiting long-term survival following orthotopic heart transplantation (HTx). Whether or not and, if so, how donor-transmitted atherosclerosis (DCA) affects the post-transplant course of the allograft recipient is still unclear. Conventional coronary angiography is a moderately accurate technique for DCA detection as it will reveal only the more gross morphological lesions. By contrast, intravascular ultrasound (IVUS) has been shown to be a much more sensitive technique for CAV and DCA detection. In our study we sought to determine the prevalence of DCA in our HTx patient population and identify main risk factors of DCA based on donor characteristics.Patients and methodsWe performed a retrospective analysis of data of 119 patients (92 men, 27 women) undergoing transplantation in our center from August 2006 through September 2012, who had survived their first post-transplant month and had coronary angiography and IVUS.ResultsDCA was present in 39 patients, and not documented in 80 patients. The main risk factors for DCA included donor age, cigarette smoking, and hypertension; the other parameters were not shown to be statistically significant. In-hospital mortality was low in both groups (DCA positive and DCA negative), with one patient dying in either group. One-year mortality rates post-HTx were likewise almost identical in both groups (15.4% and 15% in DCA positive and negative, respectively).ConclusionThe prevalence of DCA in our patients was 32.8%, with major risk factors for DCA including donor age, cigarette smoking, and hypertension. As age seems to be the strongest predictor, coronary angiography should be a routine examination in individuals aged over 40 years; the examination should be considered in younger individuals with a cluster of several of risk factors. The 1-year survival in this selected patient population was identical in both groups, the implication being that the diagnosis of DCA had no effect on 1-year survival post-HTx

Heart transplantation for cardiac light chain amyloidosis with subsequent autologous stem cell transplantation

AbstractOur report describes a case of 57-year-old man with manifest heart failure on the basis of cardiac amyloidosis, which was detected by endomyocardial biopsy. Due to the heart failure, the patient was unable to undergo myeloablative therapy. We changed our previous decision for conservative therapy of heart failure and the patient underwent heart transplantation. Autologous stem cell transplantation was performed 6 months later. After the successful stem cell transplantation, the serum free light chain lambda levels promptly decreased. One year later, their levels started again to increase. Chemotherapy was therefore initiated. The patient has now completed the seventh cycle of chemotherapy in good condition. The graft function is normal and the latest endomyocardial biopsy revealed no amyloid

Stimulated structural changes of Se in nanolayered composite films

International audienceAmorphous selenium (a-Se) is the simplest model material for investigation of the well-known photoinduced structural and optical transformations in amorphous chalcogenides. Since a lot of parameters and characteristics of materials essentially change at nanoscale, we applied nanostructuring to a -Se in nanomultilayers, obtained by pulsed laser deposition. The enhancement of photo- and thermally-induced crystallization was observed in a-Se/aluminosilicate nanomultilayers due to the initially heterogeneous state of Se in such samples, in comparison with single a -Se layers

Modeling of Spinel Settling in Waste Glass Melter

Each 1% increase of waste loading (W), defined as the high-level waste (HLW) mass fraction in glass, can save the U.S. Department of Energy (DOE) over a half billion U.S. dollars for vitrification and disposal. For a majority of Hanford and Savannah River waste streams, W is limited by spinel precipitation and settling in waste glass melters. Therefore, a fundamental understanding of spinel behavior is crucial for economy and the low-risk operation of HLW vitrification. The goal of this research is to develop a basic understanding of the dynamics of spinel formation and motion in velocity, temperature, and redox fields that are characteristic for the glass-melting process. This goal is being achieved by directly studying spinel formation and settling in molten glass and by developing a mathematical tool for predicting the spinel behavior and accumulation rate in the melter. The main potential benefit of this study is achieving a lower waste-glass volume, which translates into a shorter cleanup time, a smaller processing facility, a smaller repository space, and, hence, a reduced investment of time and money to reach acceptable technical risks. Additional benefits include (1) more accurately assessing sensible limits for problem constituents (such as chromium) in the melter feed, (2) reducing the blending requirements, and (3) comparing cost and risk with other options (pretreatment, blending or diluting the waste) to determine the best path forward. The results of this study will allow alternate melter designs and operating conditions to be evaluated. The study will also address the option of removing the settled sludge from the melter

Surface patterning in Ge-Se amorphous layers

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Réalisation de structures optiques verticales en verres de chalcogénure pour des applications dans le proche et moyen infrarouge

National audienceDes structures verticales que sont des miroirs de Bragg et des microcavités ont été élaborées en verres de chalcogénure. Une étude préliminaire a permis d'étudier l'indice de réfraction des différentes couches de verres massifs de chalcogénure ainsi que la vitesse de formation de ces couches déposées par PLD. L'objectif de ce travail est de réaliser des microcavités actives en dopant la couche séparatrice par des ions Erbium émettant à 1,53 et à 4,65 µm

Structure, nonlinear properties, and photosensitivity of (GeSe2)​100-​x(Sb2Se3)​x glasses

International audienceChalcogenide glasses from (GeSe2)​100-​x(Sb2Se3)​x system were synthesized, with x varying from 5 to 70, in order to evaluate the influence of antimony selenide addn. on nonlinear optical properties and photosensitivity. Nonlinear refractive index and two photon absorption coeffs. were measured both at 1064 nm in picosecond regime using the Z-​scan technique and at 1.55 μm in femtosecond regime using an original method based on direct anal. of beam profile change while propagating in the chalcogenide glasses. The study of their photosensitivity at 1.55 μm revealed highly glass compn. dependent behavior and quasi-​photostable compns. have been identified in femtosecond regime. To better understand these characteristics, the evolution of the glass transition temp., d. and structure with the chem. compn. were detd