806-1 Left Ventricular Ejection Fraction After Myocardial Infarction: Importance of Both Infarct Site and Size

Left ventricular ejection fraction (LVEF) is an important prognostic variable after myocardial infarction (MI). While the extent of MI is known to affect the subsequent global LVEF, it is not clear whether anatomical site per se affects LVEF. Therefore, 48 consecutive patients (pts) who did not receive lytic therapy or undergo early revascularization were studied byechocardiography one week after Q wave MI. Using a previously validated endocardial mapping technique, the size of abnormal wall motion (AWM) in relation to the total endocardial surface area and the site of AWM were quantitated, LVEF was measured by Simpson's method using 2 apical views.ResultsNineteen pts had anterior MI (ANT) and 29 had inferior MI (INF). The mean LVEF was similar in both groups (ANT 46.9±14.7% vs INF 51.7±9.4%, pNS). The mean %AWM was greater in ANT MI (29.7±14.5) than in INF MI (21.3±13.8) (p=0.05). After accounting for differences in infarct size by multivariate regression analysis, both infarct size (p=0.0001) and infarct site (p=0.007) were significant independent determinants of LVEF. This effect was most pronounced in larger ANT Mis (%AWM>25%) where the LVEF was significantly lower than in smaller Mis. In INF MI, despite a similar range of sizes. increasing %AWM had minimal effect on LVEF.ConclusionIn addition to infarct size, the site of AWM is an important determinant of global LVEF. This observation may reflect site-dependent differences in the biomechanical responses to regional ventricular dysfunction

Invariant and polynomial identities for higher rank matrices

We exhibit explicit expressions, in terms of components, of discriminants, determinants, characteristic polynomials and polynomial identities for matrices of higher rank. We define permutation tensors and in term of them we construct discriminants and the determinant as the discriminant of order $d$, where $d$ is the dimension of the matrix. The characteristic polynomials and the Cayley--Hamilton theorem for higher rank matrices are obtained there from

Automated flow rate calculation based on digital analysis of flow convergence proximal to regurgitant orifice

AbstractObjectives. The purpose of the study was to develop and validate an automated method for calculating regurgitant flow rate using color Doppler echocardiography.Background. The proximal flow convergence method is a promising approach to quantitate valvular regurgitation noninvasively because it allows one to calculate regurgitant flow rate and regurgitant orifice area; however, defining the location of the regurgitant orifice is often difficult and can lead to significant error in the calculated flow rates. To overcome this problem we developed an automated algorithm to locate the orifice and calculate flow rate based on the digital Doppler velocity map.Methods. This algorithm compares the observed velocities with the anticipated relative velocities, cos ϑ/μt2. The orifice is localized as the point with maximal correlation between predicted and observed velocity, whereas flow rate is specified as the slope of the regression line. We validated this algorithm in an in vitro model for flow through circular orifices with planar surroundings and a porcine bioprosthesis.Results. For flow through circular orifices, flow rates calculated on individual Doppler maps and on an average of eight velocity maps showed excellent agreement with true flow, with r = 0.977 and ΔQ = −3.7 ± 15.8 cm3/s and r = 0.991 and ΔQ = −4.3 ± 8.5 cm3/s, respectively. Calculated flow rates through the bioprosthesis correlated well but underestimated true flow, with r = 0.97, ΔQ = −10.9 ± 12.5 cm3/s, suggesting flow convergence over an >2π. This systematic underestimation was corrected by assuming an effective convergence angle of 212 δ.Conclusions. This algorithm accurately locates the regurgitant orifice and calculates regurgitant flow rate for circular orifices with planar surroundings. Automated analysis of the proximal flow field is also applicable to more physiologic surfaces surrounding the regurgitant orifice; however, the convergence angle should be adjusted. This automated algorithm should make quantification of regurgitant flow rate and regurgitant orifice area more reproducible and readily available in clinical cardiology practice

Unusual sequelae after percutaneous mitral valvuloplasty: A Doppler echocardiographic study

AbstractPercutaneous mitral valvuloplasty is a promising new technique for the treatment of mitral stenosis, with a relatively low complication rate reported to date. To assess the sequelae of this procedure, Doppler echocardiographic studies were prospectively performed before and after percutaneous mitral valvuloplasty in a series of 172 patients (mean age 53 ± 17 years). After balloon dilation, mitral valve area increased from 0.9 ± 0.3 to 2 ± 0.8 cm2(p < 0.0001), mean gradient decreased from 16 ± 6 to 6 ± 3 mm Hg (p < 0.0001) and mean left atrial pressure decreased from 24 ± 7 to 14 ± 6 mm Hg (p < 0.0001).Although most patients were symptomatically improved, six (4%) were identified who had unusual sequelae evident on Doppler echocardiographic examination immediately after percutaneous mitral valvuloplasty. These included rupture of a posterior mitral valve leaflet, producing a flail distal leaflet portion with severe mitral regurgitation detected on Doppler color flow mapping (n = 1); asymptomatic rupture of the chordae tendineae attached to the anterior mitral valve leaflet with systolic anterior motion of the ruptured chordae into the left ventricular outflow tract (n = 1); a double-orifice mitral valve (n = 1); and evidence of a tear in the anterior mitral valve leaflet (n = 3), producing on both pulsed Doppler ultrasound and color flow mapping a second discrete jet of mitral regurgitation in addition to regurgitation through the main mitral valve orifice. All six patients made a satisfactory recovery and none has required mitral valve replacement.In a small percent of cases, percutaneous mitral valvuloplasty may produce unusual disruption of the mitral valve and supporting apparatus that may be readily detected by Doppler echocardiographic studies

Designer diatom episomes delivered by bacterial conjugation.

Eukaryotic microalgae hold great promise for the bioproduction of fuels and higher value chemicals. However, compared with model genetic organisms such as Escherichia coli and Saccharomyces cerevisiae, characterization of the complex biology and biochemistry of algae and strain improvement has been hampered by the inefficient genetic tools. To date, many algal species are transformable only via particle bombardment, and the introduced DNA is integrated randomly into the nuclear genome. Here we describe the first nuclear episomal vector for diatoms and a plasmid delivery method via conjugation from Escherichia coli to the diatoms Phaeodactylum tricornutum and Thalassiosira pseudonana. We identify a yeast-derived sequence that enables stable episome replication in these diatoms even in the absence of antibiotic selection and show that episomes are maintained as closed circles at copy number equivalent to native chromosomes. This highly efficient genetic system facilitates high-throughput functional characterization of algal genes and accelerates molecular phytoplankton research

Four lectures on secant varieties

This paper is based on the first author's lectures at the 2012 University of Regina Workshop "Connections Between Algebra and Geometry". Its aim is to provide an introduction to the theory of higher secant varieties and their applications. Several references and solved exercises are also included.Comment: Lectures notes to appear in PROMS (Springer Proceedings in Mathematics & Statistics), Springer/Birkhause

Triangulations and Severi varieties

We consider the problem of constructing triangulations of projective planes over Hurwitz algebras with minimal numbers of vertices. We observe that the numbers of faces of each dimension must be equal to the dimensions of certain representations of the automorphism groups of the corresponding Severi varieties. We construct a complex involving these representations, which should be considered as a geometric version of the (putative) triangulations

Influence of and Optimal Insulin Therapy for a Low–Glycemic Index Meal in Children With Type 1 Diabetes Receiving Intensive Insulin Therapy

OBJECTIVE—The purpose of this study was to quantify the effects of glycemic index on postprandial glucose excursion (PPGE) in children with type 1 diabetes receiving multiple daily injections and to determine optimal insulin therapy for a low–glycemic index meal

Heterologous Expression of Alteromonas macleodii and Thiocapsa roseopersicina [NiFe] Hydrogenases in Synechococcus elongatus

Oxygen-tolerant [NiFe] hydrogenases may be used in future photobiological hydrogen production systems once the enzymes can be heterologously expressed in host organisms of interest. To achieve heterologous expression of [NiFe] hydrogenases in cyanobacteria, the two hydrogenase structural genes from Alteromonas macleodii Deep ecotype (AltDE), hynS and hynL, along with the surrounding genes in the gene operon of HynSL were cloned in a vector with an IPTG-inducible promoter and introduced into Synechococcus elongatus PCC7942. The hydrogenase protein was expressed at the correct size upon induction with IPTG. The heterologously-expressed HynSL hydrogenase was active when tested by in vitro H2 evolution assay, indicating the correct assembly of the catalytic center in the cyanobacterial host. Using a similar expression system, the hydrogenase structural genes from Thiocapsa roseopersicina (hynSL) and the entire set of known accessory genes were transferred to S. elongatus. A protein of the correct size was expressed but had no activity. However, when the 11 accessory genes from AltDE were co-expressed with hynSL, the T. roseopersicina hydrogenase was found to be active by in vitro assay. This is the first report of active, heterologously-expressed [NiFe] hydrogenases in cyanobacteria

Editing of the urease gene by CRISPR-Cas in the diatom Thalassiosira pseudonana

Background: CRISPR-Cas is a recent and powerful addition to the molecular toolbox which allows programmable genome editing. It has been used to modify genes in a wide variety of organisms, but only two alga to date. Here we present a methodology to edit the genome of Thalassiosira pseudonana, a model centric diatom with both ecological significance and high biotechnological potential, using CRISPR-Cas. Results: A single construct was assembled using Golden Gate cloning. Two sgRNAs were used to introduce a precise 37 nt deletion early in the coding region of the urease gene. A high percentage of bi-allelic mutations (≤61.5%) were observed in clones with the CRISPR-Cas construct. Growth of bi-allelic mutants in urea led to a significant reduction in growth rate and cell size compared to growth in nitrate. Conclusions: CRISPR-Cas can precisely and efficiently edit the genome of T. pseudonana. The use of Golden Gate cloning to assemble CRISPR-Cas constructs gives additional flexibility to the CRISPR-Cas method and facilitates modifications to target alternative genes or species