47 research outputs found

    Intraoperative high resolution duplex imaging during carotid endarterectomy: Which abnormalities require surgical correction?

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    Objectives:This study evaluates high resolution, duplex ultrasound imaging for quality control of carotid endarterectomy in order to determine which technical factors were linked to residual stenosis and to define duplex criteria for reexploration.Design, material and methods:A consecutive series of 100 patients undergoing carotid endarterectomy were evaluated. Duplex imaging was performed prior to wound closure and repeated at 6–8 weeks postoperatively. Stenoses were classified as non-significant, moderate or severe based on duplex criteria. Intimal flaps, shelves, kinks, clamp damage and fronds were identified by ultrasound imaging.Results:Five moderate stenoses were noted in the proximal endarterectomy site (PES), and at follow-up three had resolved. Adherent fronds were detected in 83% of vessels and resolved in all but three cases. At the distal endarterectomy site there were 10 severe and 12 moderate stenoses. Intimal flaps were associated with an increased incidence of residual stenosis (p = 0.010).Conclusions:We conclude that severe stenoses with an intimal flap should be corrected immediately. Further data is required to establish the significance of kinks. Residual intimal flaps in the PES appear to remodel. The role of completion duplex may lie in the modification of surgical technique to eradicate anatomical and haemodynamic imperfections

    Speleothem U-series constraints on scarp retreat rates and landscape evolution: an example from the Severn valley and Cotswold Hills gull-caves, UK

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    Modelling landscape evolution requires quantitative estimates of erosional processes. Dating erosional landscape features such as escarpments is usually difficult because of the lack of datable deposits. Some escarpments and valley margins are associated with the formation of mass-movement caves, sometimes known as ‘gull’ or ‘crevice’ caves, which are typically restricted to within 0.5 km of the valley margin or scarp edge. As in other caves, these mass-movement cavities may host speleothems. As gull-caves develop only after valley incision, uranium-series dating of speleothems within them can provide a minimum age for the timing of valley excavation and scarp formation. Here we present data from several gull-caves in the Cotswold Hills, which form the eastern flank of the Severn valley in southern England. U-series ages from these gull-caves yield estimates for both the minimum age of the Cotswold escarpment and the maximum scarp retreat rate. This is combined with data from geological modelling to propose a model for the evolution of the Severn valley and the Cotswold Hills. The data suggest that the location of the escarpment and regional topography is determined not by valley widening and scarp retreat, but by the in situ generation of relief by differential erosion

    Multi-trait genome-wide association study identifies new loci associated with optic disc parameters

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    A new avenue of mining published genome-wide association studies includes the joint analysis of related traits. The power of this approach depends on the genetic correlation of traits, which reflects the number of pleiotropic loci, i.e. genetic loci influencing multiple traits. Here, we applied new meta-analyses of optic nerve head (ONH) related traits implicated in primary open-angle glaucoma (POAG); intraocular pressure and central corneal thickness using Haplotype reference consortium imputations. We performed a multi-trait analysis of ONH parameters cup area, disc area and vertical cup-disc ratio. We uncover new variants; rs11158547 in PPP1R36-PLEKHG3 and rs1028727 near SERPINE3 at genome-wide significance that replicate in independent Asian cohorts imputed to 1000 Genomes. At this point, validation of these variants in POAG cohorts is hampered by the high degree of heterogeneity. Our results show that multi-trait analysis is a valid approach to identify novel pleiotropic variants for ONH

    Genome-wide association meta-analysis of corneal curvature identifies novel loci and shared genetic influences across axial length and refractive error.

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    Corneal curvature, a highly heritable trait, is a key clinical endophenotype for myopia - a major cause of visual impairment and blindness in the world. Here we present a trans-ethnic meta-analysis of corneal curvature GWAS in 44,042 individuals of Caucasian and Asian with replication in 88,218 UK Biobank data. We identified 47 loci (of which 26 are novel), with population-specific signals as well as shared signals across ethnicities. Some identified variants showed precise scaling in corneal curvature and eye elongation (i.e. axial length) to maintain eyes in emmetropia (i.e. HDAC11/FBLN2 rs2630445, RBP3 rs11204213); others exhibited association with myopia with little pleiotropic effects on eye elongation. Implicated genes are involved in extracellular matrix organization, developmental process for body and eye, connective tissue cartilage and glycosylation protein activities. Our study provides insights into population-specific novel genes for corneal curvature, and their pleiotropic effect in regulating eye size or conferring susceptibility to myopia

    Structural and functional analysis of Ras and Ruo-related small GTP-binding proteins

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    Available from British Library Document Supply Centre-DSC:DXN022315 / BLDSC - British Library Document Supply CentreSIGLEGBUnited Kingdo

    FLAVOR VOLATILES OF SOME COOKED VEGETABLES

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