Unusual Hybrid Closure of Ventricular Septal Defects

A planned combined perventricular and “open heart” surgical closure of multiple ventricular septal defects had to be modified intraoperatively due to a technical fault disabling echocardiographic guidance. Through an atriotomy, device closure of a muscular defect and patch closure of a perimembranous ventricular septal defect were performed. In unusual situations, collaboration of the surgical and interventional team is crucial

Radiative Decay of Vector Quarkonium: Constraints on Glueballs and Light Gluinos

Given a resonance of known mass, width, and J^{PC}, we can determine its gluonic branching fraction, b(R->gg), from data on its production in radiative vector quarkonium decay, V -> gamma+R. For most resonances b(R->gg) is found to be O(10%), consistent with being q-qbar states, but we find that both pseudoscalars observed in the 1440 MeV region have b(R->gg) ~ 1/2 - 1, and b(f_0^{++}->gg) ~ 1/2. As data improves, b(R->gg) should be a useful discriminator between q-qbar and gluonic states and may permit quantitative determination of the extent to which a particular resonance is a mixture of glueball and q-qbar. We also examine the regime of validity of pQCD for predicting the rate of V -> gamma+eta_gluino, the ``extra'' pseudoscalar bound state which would exist if there were light gluinos. From the CUSB limit on peaks in Upsilon -> gamma X, the mass range 3 GeV < m(eta_gluino) < 7 GeV can be excluded. An experiment must be significantly more sensitive to exclude an eta_gluino lighter than this.Comment: 36pp (inc figs),RU-94-04. (Replaces original which didn't latex correctly and didn't have figures.

Indications for stenting of coarctation of the aorta in children under 3 months of age

Introduction: Coarctation of the aorta in children under 3 months of age is usually treated surgically. However, there are clinical scenarios in which stenting of native or recurrent coarctation may become necessary in this age group. Case reports: Four cases illustrate possible indications: left ventricular dysfunction increasing the operative risk, thrombus formation after coarctation surgery, patient size (i.e. in premature babies), and retrograde arch obstruction after hybrid palliation of hypoplastic left heart syndrome. In all babies, coarctation stenting was carried out successfully without complications. Conclusion: Coarctation stenting can be carried out safely in small children. Usually, the stent has to be removed or redilated later. Results are encouraging

Acute coronary ischemia during alcohol withdrawal: a case report

<p>Abstract</p> <p>Introduction</p> <p>The potential of alcohol withdrawal to cause acute coronary events is an area that needs the urgent attention of clinicians and researchers.</p> <p>Case presentation</p> <p>We report the case of a 52-year-old heavy-alcohol-using Sri Lankan man who developed electocardiogram changes suggestive of an acute coronary event during alcohol withdrawal. Despite the patient being asymptomatic, subsequent echocardiogram showed evidence of ischemic myocardial dysfunction. We review the literature on precipitation of myocardial ischemia during alcohol withdrawal and propose possible mechanisms.</p> <p>Conclusions</p> <p>Alcohol withdrawal is a commonly observed phenomenon in hospitals. However, the number of cases reported in the literature of acute coronary events occurring during withdrawal is few. Many cases of acute ischemia or sudden cardiac deaths may be attributed to other well known complications of delirium tremens. This is an area needing the urgent attention of clinicians and epidemiologists.</p

Catheter, MRI and CT Imaging in Newborns with Pulmonary Atresia with Ventricular Septal Defect and Aortopulmonary Collaterals: Quantifying the Risks of Radiation Dose and Anaesthetic Time

A comprehensive understanding of the native pulmonary blood supply is crucial in newborns with pulmonary atresia with ventricular septal defect and aortopulmonary collaterals (PA/VSD/MAPCA). We sought to describe the accuracy in terms of identifying native pulmonary arteries, radiation dose and anaesthetic time associated with multi-modality imaging in these patients, prior to their first therapeutic intervention. Furthermore, we wanted to evaluate the cumulative radiations dose and anaesthetic time over the study period. Patients with PA/VSD/MAPCA diagnosed at < 100 days between 2004 and 2014 were identified. Cumulative radiation dose and anaesthetic times were calculated, with imaging results compared with intraoperative findings. We then calculated the cumulative risks to date for all surviving children. Of 19 eligible patients, 2 had echocardiography only prior to first intervention. The remaining 17 patients underwent 13 MRIs, 4 CT scans and 13 cardiac catheterization procedures. The mean radiation dose was 169 mGy cm2 (47–461 mGy cm2), and mean anaesthetic time was 111 min (33–185 min). 3 children had MRI only with no radiation exposure, and one child had CT only with no anaesthetic. Early cross-sectional imaging allowed for delayed catheterisation, but without significantly reducing radiation burden or anaesthetic time. The maximum cumulative radiation dose was 8022 mGy cm2 in a 6-year-old patient and 1263 min of anaesthetic at 5 years. There is the potential to generate very high radiation doses and anaesthetic times from diagnostic imaging alone in these patients. As survival continues to improve in many congenital heart defects, the important risks of serial diagnostic imaging must be considered when planning long-term management

Deep inelastic J/ψJ/\psi production at HERA in the kTk_T-factorization approach and its consequences for the nonrelativistic QCD

In the framework of the $k_T$-factorization approach, we analyse the inclusive and inelastic production of $J/\psi$ particles in deep inelastic $ep$ scattering. We take into account both colour-singlet and colour-octet production channels. We inspect the sensitivity of theoretical predictions to the choice of model parameters. Our theoretical results agree reasonably well with recent experimental data collected by the collaboration H1 at HERA.Comment: 14 pages, 6 figure

Upsilonium polarization as a touchstone in understanding the proton dynamics in QCD

In the framework of the k_t-factorization approach, the production of $\Upsilon mesons at the Fermilab Tevatron and CERN LHC is considered, and the predictions on the spin alignment parameter$\alpha$ are presented. We argue that measuring the polarization of quarkonium states can serve as a crucial test discriminating two competing theoretical approaches to parton dynamics in QCD.Comment: 8 pages, 2 figure

Dilating and fracturing side struts of open cell stents frequently used in pediatric cardiac interventions—An in vitro study

Background: Open cell stents are frequently used in interventional therapy of congenital heart disease. Overstenting of vessel branches may necessitate strut dilation. Methods and Results: The strut size achievable in Bard Valeo and Cook Formula stents, and the pressure necessary to fracture struts was assessed. In addition, a self expanding stent (Optimed SinusflexDS) was also tested. With the original balloon at nominal pressure, in Valeo stents side struts could be dilated to approximately 90% of the nominal stent diameter, in Formula stents to approximately 80%. With larger high pressure woven balloons, strut size increased to approximately 125% in Valeo stents, and to approximately 105% in the Formula. Strut fracture can connect two adjoining struts. Pressures were dependent on the balloon utilized. Sidestruts of the Sinusflex could lastingly overdilated with large balloons only. Conclusion: Dilation and overdilation of side struts in open cell stents can be achieved. Dependent on the clinical context, the original balloon used to place the premounted stent can be used to achieve strut dilation, but woven high pressure balloons maybe safer for patients. Should a larger diameter be required, these high pressure woven balloons can achieve bigger diameters and even strut fracture

Measurement of the leptonic decay widths of the phi-meson with the KLOE detector

The phi-meson leptonic widths, Gee and Gmm, are obtained, respectively, from the e+e- forward-backward asymmetry and the muon cross section around the phi-mass energy. We find Gee=1.32&#8853;0.05&#8853;0.03 kev and sqrt(GeeGmm)= 1.320&#8853;0.018&#8853;0.017 kev. These results, compatible with Gee=Gmm, provide a precise test of lepton universality. Combining the two results gives G_lept=1.320&#8853;0.023 kev.Comment: 10 pages and 8 figures to be submitted to Phys.Lett.