Right ventricular diastolic function in post-surgical Tetralogy of Fallot patients: A pilot study to make a comparison between echocardiography and cardiac MRI

Background: right ventricular (RV) systolic dysfunction is associated with poor outcomes in Tetralogy of Fallot (ToF) patients. Conversely, the influence of diastolic dysfunction in this setting is poorly known. In addition, evaluation of RV diastolic function by cardiac MRI is rarely performed.Materials and methods: twenty-four surgically treated ToF patients were enrolled in the study (54% males; median age at study: 28 (18–50) years; median age at surgery: 1.9 (0.4–8.2) years. They were studied by echocardiography to assess RV diastolic function in terms of traditional and TDI-derived parameters. At cardiac MRI, RV diastolic function was assessed by using phase-contrast analysis of flow through the tricuspid valve in short axis view. Diastolic dysfunction was graded as impaired relaxation, pseudo-normal, or restrictive physiology.Results: fifteen (62.5%) ToF subjects had echocardiographic evidence of diastolic dysfunction and eleven (45.8%) at cardiac MRI. Statistically significant correlation between echocardiographic and cardiac MRI parameters of diastolic dysfunction was weak (p < 0.05). The degree of RV diastolic dysfunction (expressed as E/E' at TDI) was associated with right atrial volume indexed for body surface area at cardiac MRI (p < 0.0001). Greater number of interim palliative procedures was associated with higher E/E' (RV diastolic dysfunction) at echocardiography (p < 0.0003).Conclusions: diastolic dysfunction, as determined by echocardiography and cardiac MRI-derived measures, is prevalent in ToF. These measures are weakly associated with each other. Notwithstanding the limitations of this pilot study, the development of cardiac MRI parameters capable of correlating with RV relaxation is needed in ToF setting

LTalpha and LTbeta gene expression in organs of sheep showing different lymphoproliferative changes induced by maedi-visna virus

In lung and mammary gland of sheep, Maedi-Visna virus (MVV) causes lymphoproliferative inflammation often with follicular structures (lymphofollicular inflammation). The aim of this work was to define whether Limphotoxin α and β (LTα, LTβ) play a role in the formation of these peculiar lesions in sheep experimentally infected with MVV

Additional polymorphisms of the <i>PRNP</i> gene significantly decrease the susceptibility to scrapie of ARQ/ARQ sheep

The aim of this work was to investigate the risk of scrapie of the ARQ/ARQ genotype carrying at least one point mutation at codons 112, 137, 141, 142, 154 and 176 in comparison with the ARQ/ARQ without any point mutations

PrP^Sc deposition in mammary gland of sheep experimentally coinfected with scrapie and Maedi-Visna virus

Scrapie, a fatal neurodegenerative disorder of sheep, is characterized by deposition of an abnormal isoform of prion protein (PrPSc) in the central nervous system (CNS) and within the lymphoreticular system (LRS). Recent studies in mice transgenically engineered to develop organ specific inflammation demonstrated the cooccurrence of PrPSc in the inflamed organs (kidney, pancreas and liver)

Intraepithelial and Interstitial Deposition of Pathological Prion Protein in Kidneys of Scrapie-Affected Sheep

Prions have been documented in extra-neuronal and extra-lymphatic tissues of humans and various ruminants affected by Transmissible Spongiform Encephalopathy (TSE). The presence of prion infectivity detected in cervid and ovine blood tempted us to reason that kidney, the organ filtrating blood derived proteins, may accumulate disease associated PrPSc. We collected and screened kidneys of experimentally, naturally scrapie-affected and control sheep for renal deposition of PrPSc from distinct, geographically separated flocks. By performing Western blot, PET blot analysis and immunohistochemistry we found intraepithelial (cortex, medulla and papilla) and occasional interstitial (papilla) deposition of PrPSc in kidneys of scrapie-affected sheep. Interestingly, glomerula lacked detectable signals indicative of PrPSc. PrPSc was also detected in kidneys of subclinical sheep, but to significantly lower degree. Depending on the stage of the disease the incidence of PrPSc in kidney varied from approximately 27% (subclinical) to 73.6% (clinical) in naturally scrapie-affected sheep. Kidneys from flocks without scrapie outbreak were devoid of PrPSc. Here we demonstrate unexpectedly frequent deposition of high levels of PrPSc in ovine kidneys of various flocks. Renal deposition of PrPSc is likely to be a pre-requisite enabling prionuria, a possible co-factor of horizontal prion-transmission in sheep

Percutaneous stabilization of lumbar spine: a literature review and new options in treating spine pain

Vertebral fracture (VF) is a common condition with >160,000 patients affected every year in North America and most of them with affected lumbar vertebrae. The management of VF is well known and defined by many protocols related to associated clinical neurological symptoms, especially in case of the presence or absence of myelopathy or radicular deficit. In this article, we will explore the percutaneous stabilization of the lumbar spine by showing the newest approaches for this condition

Diffusion-weighted MRI assessment of adjacent disc degeneration after thoracolumbar vertebral fractures

Objective: The purpose of this study was to assess, by the mean apparent diffusion coefficient (ADC), if a relationship exists between disc ADC and MR findings of adjacent disc degeneration after thoracolumbar fractures treated by anatomic reduction using vertebral augmentation (VAP). Materials and Methods: Twenty non-consecutive patients (mean age 50.7 years; range 45–56) treated because of vertebral fractures, were included in this study. There were 10 A3.1 and 10 A1.2 fractures (AO classification). Surgical treatment using VAP was applied in 14 cases, and conservative in 6 patients. MRI T2-weighted images and mapping of apparent diffusion coefficient (ADC) of the intervertebral disc adjacent to the fractured segment were performed after a mean follow-up of 32 months. A total of 60 discs, 3 per patient, were analysed: infra-adjacent, supra-adjacent and a control disc one level above the supra-adjacent. Results: No differences between patients surgically treated and those following a conservative protocol regarding the average ADC values obtained in the 20 control discs analysed were found. Considering all discs, average ADC in the supra-adjacent level was lower than in the infra-adjacent (1.35 ± 0.12 vs. 1.53 ± 0.06; p < 0.001). Average ADC values of the discs used as a control were similar to those of the infra-adjacent level (1.54 ± 0.06). Compared to surgically treated patients, discs at the supra-adjacent fracture level showed statistically significant lower values in cases treated conservatively (p < 0.001). The variation in the delay of surgery had no influence on the average values of ADC at any of the measured levels. Conclusions: ADC measurements of the supra-adjacent discs after a mean follow-up of 32 months following thoracolumbar fractures, showed that restoration of the vertebral collapse by minimally invasive VAP prevents posttraumatic disc degeneration

Midterm clinical and radiologic outcomes after percutaneous interspinous spacer treatment for neurogenic intermittent claudication

Purpose To evaluate the midterm clinical and radiologic outcome of percutaneous interspinous process spacer (IPS) treatment for neurogenic intermittent claudication (NIC) in patients who fail conservative treatment. Methods Consecutive patients with NIC, lumbar spinal stenosis confirmed on magnetic resonance imaging, failure of conservative management for at least 6 months, and treatment with percutaneous IPS were included. Visual analog scale (VAS) and Oswestry Disability Index (ODI) scores were recorded at baseline, 1 month, 1 year and 3 years after treatment. Spinal canal and foraminal cross-sectional areas were calculated from multidetector computed tomography at baseline and 1 year. Results There were 80 patients treated with 94 IPS devices; 83% of patients received a single IPS; 78% of IPS devices were placed at L4-L5. An IPS dislocation was the single periprocedural major complication. VAS score of 8.1 ± 2 before treatment was reduced to 4.4 ± 2 at 1 month after treatment (P =.0001); ODI score of 23.3 ± 10 before treatment was reduced to 11.7 ± 8.5 at 1 month after treatment (P =.0001). These significant reductions were durable at 1-year and 3-year follow-up evaluations (P <.01). Spinal canal and foraminal cross-sectional area increased by 15% at 1 year (P =.0001). Conclusions Patients with NIC who failed conservative treatment and were treated with percutaneous IPS achieved significant gains in pain relief and reduced disability that remained durable at 3-year clinical follow-up evaluation. This outcome was accompanied by significant increases in spinal canal and foraminal cross-sectional areas at the treated level

Sheep with Scrapie and Mastitis Transmit Infectious Prions through the Milk▿

Prions are misfolded proteins that are infectious and naturally transmitted, causing a fatal neurological disease in humans and animals. Prion shedding routes have been shown to be modified by inflammation in excretory organs, such as the kidney. Here, we show that sheep with scrapie and lentiviral mastitis secrete prions into the milk and infect nearly 90% of naïve suckling lambs. Thus, lentiviruses may enhance prion transmission, conceivably sustaining prion infections in flocks for generations. This study also indicates a risk of prion spread to sheep and potentially to other animals through dietary exposure to pooled sheep milk or milk products

Heteroleptic NIR-Emitting YbIII/Anilate-Based Neutral Coordination Polymer Nanosheets for Solvent Sensing

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