Aortic dissection associated with cogans's syndrome: deleterious loss of vascular structural integrity is associated with GM-CSF overstimulation in macrophages and smooth muscle cells

<p>Abstract</p> <p>Background</p> <p>Cogan's syndrome is a rare disorder of unknown origin characterized by inflammatory ocular disease and vestibuloauditory symptoms. Systemic vasculitis is found in about 10% of cases.</p> <p>Case presentation</p> <p>A 46-year-old female with Cogans's syndrome and a history of arterial hypertension presented with severe chest pain caused by an aneurysm of the ascending aorta with a dissection membrane located a few centimeters distal from the aortic root. After surgery, histopathological analysis revealed that vascular matrix integrity and expression of the major matrix molecules was characterized by elastolysis and collagenolysis and thus a dramatic loss of structural integrity. Remarkably, exceeding matrix deterioration was associated with massively increased levels of granulocyte macrophage colony stimulating factor (GM-CSF).</p> <p>Conclusion</p> <p>Our data suggest that the persistently increased secretion of the inflammatory mediator GM-CSF by resident inflammatory cells but also by SMC may be the trigger of aortic wall structural deterioration.</p

Initial experience with magnetic resonance imaging-safe pacemakers: A review

Due of its superior soft tissue imaging capabilities, magnetic resonance imaging (MRI) has become the imaging modality of choice in many clinical situations, as illustrated by the tremendous growth in the number of MRIs performed over the past 2 decades. In parallel, the number of patients who require pacemakers or implantable cardiac defibrillators is increasing as indications for these devices broaden and the population ages. Taken together, these phenomena present an important clinical issue, as MR scans are generally contraindicated—except in urgent situations—in patients who have implanted cardiovascular devices. Potentially deleterious interactions between the magnetic fields and radio frequency (RF) energy produced by MR equipment and implantable devices have been identified, including inhibition of pacing, asynchronous/high-rate pacing, lead tip heating, and loss of capture. New devices that incorporate technologies to improve MR safety in patients with pacemakers have recently received approval in Europe and are under evaluation in the United States. Initial data from these devices suggest that these devices are safe in the MRI environment

Prosodic sensitivity and phoneme awareness as predictors of reading fluency in German

There are contradictory findings in the literature about prosodic sensitivity's contribution to reading. In this study, we examined whether prosodic sensitivity makes a unique contribution to different reading outcomes in German after controlling for the effects of phonological awareness. Word reading, nonword reading and sentence reading as well as phonological awareness (PA), prosodic sensitivity (PS), and nonverbal IQ were assessed in a sample of N = 207 8- to 10-year-old German-speaking children in third grade. Results showed that after controlling for PA, PS was predictive of only sentence reading. A commonality analysis further showed that PS and PA share about 22% of the explained variance (R-2 = .13) in sentence reading, while PS uniquely contributes 18% and PA 60% of this variance. The results indicate that PS is more strongly related to reading tasks with semantic demands