Arm-leg pressure gradients on late follow-up after coarctation repair: Possible causes and implications

Seventeen years after coarctation repair, 36 patients were studied by magnetic resonance imaging and exercise testing to measure residual anatomical stenosis and hormonal response to exercise, and to evaluate their effect on arm-leg gradients and on exercise hypertension. The systolic arm pressure, leg pressure and arm-leg gradient were measured at rest and during exercise. Active renin and catecholamines were measured in the plasma at rest and after peak exercise. On magnetic resonance imaging 18 patients had residual stenosis of less than 30% (group I) and 18 had residual stenosis of equal to or more than 30% (group II). At peak exercise, the arm pressure was 235 (133-296) mmHg in group I and 241 (157-286) mmHg in group II (ns), the leg pressure was 138 (111-173) mmHg in group I and 114 (75-154)mmHg in group II (P=0·002). The adrenalin increase from rest to exercise was 32·7 ± 9·1 pg . ml −1 in the patients with exercise hypertension and 3·1 ± 4·7 pg. ml−1 in the patients who remained normotensive during exercise (P=0·02). In conclusion, residual anatomical stenosis leads to a pressure drop in the legs, which influences the arm-leg gradient. Arm hypertension is not related to anatomical narrowing but to interaction of enhanced sympathetic nerve activity and structural and functional abnormality of the precoarctation vessels. (Eur Heart J 1996; 17: 1572-1575

Direct and Indirect Effects of Soluble Extracts of Schistosoma mansoni Eggs on Fibroblast Proliferation In Vitro

The possibility that soluble products of Schistosoma mansoni eggs might participate in the pathogenesis of hepatic fibrosis in schistosomiasis was investigated. Both crude saline extracts of eggs (soluble egg antigen [SEA]) and a partially purified SEA fraction contained activity which stimulated guinea pig and human dermal fibroblasts to proliferate in vitro, as measured by uptake of [3H]thymidine. Maximum activity was present in fractions which eluted from Sephacryl S-200 with an apparent molecular weight of less than or equal to 12,500 and in fractions which had an estimated pI 8, as determined by preparative isoelectric focusing of partially purified SEA. Activity in crude SEA was not removed by chromatography on concanavalin A-Sepharose 4B. When concanavalin A-binding glycoproteins lacking intrinsic fibroblast-stimulating activity were incubated with spleen cells from infected or uninfected mice, fibroblasts-stimulating activity was detected in the culture supernatants. Thus, SEA contains two functionally distinct molecular species. One of these directly stimulates fibroblasts, whereas the other induces the release of a fibroblast-stimulating activity from lymphocytes or macrophages or both. Since these fibroblast-stimulating factors might be elaborated in the livers of infected individuals, these observations suggest a potential role of soluble schistome products in the pathogenesis of hepatic fibrosis in schistosomiasis

Final State Interactions and Khuri-Treiman Equations in η → 3π decays

Using extended Khuri-Treiman equations, we evaluate the final state interactions due to two-pion rescatterings to the decays η → (π^0)(π^+)(π^-) and η → (π^0)(π^0)(π^0). As subtraction to the dispersion relation we take the one-loop chiral perturbation theory result of Gasser and Leutwyler. The calculated corrections are moderate and amount to about 14% in the amplitude at the center of the decay region. A careful analysis of the errors inherent to our approach is given. As a consequence, the experimental rate of the decay can only be reproduced if the double quark mass ratio Q^(-2) ≡ (m_d - m_u)/(m_s - m̂) * (m_d + m_u)/(m_s + m̂) is increased from the usual value of 1/(24.1)^2 to 1/(22.4 ± 0.9)^2. We have also calculated the ratio of the rates of the two decays and various Dalitz Plot parameters. In particular, the linear slope a in the charged decay is different from the one-loop value and agrees better with experiment

Dimensional Reduction without Extra Continuous Dimensions

We describe a novel approach to dimensional reduction in classical field theory. Inspired by ideas from noncommutative geometry, we introduce extended algebras of differential forms over space-time, generalized exterior derivatives and generalized connections associated with the "geometry" of space-times with discrete extra dimensions. We apply our formalism to theories of gauge- and gravitational fields and find natural geometrical origins for an axion- and a dilaton field, as well as a Higgs field.Comment: 23 page

Efficiency of spinal anesthesia versus general anesthesia for lumbar spinal surgery: a retrospective analysis of 544 patients.

BACKGROUND: Previous studies have shown varying results in selected outcomes when directly comparing spinal anesthesia to general in lumbar surgery. Some studies have shown reduced surgical time, postoperative pain, time in the postanesthesia care unit (PACU), incidence of urinary retention, postoperative nausea, and more favorable cost-effectiveness with spinal anesthesia. Despite these results, the current literature has also shown contradictory results in between-group comparisons. MATERIALS AND METHODS: A retrospective analysis was performed by querying the electronic medical record database for surgeries performed by a single surgeon between 2007 and 2011 using procedural codes 63030 for diskectomy and 63047 for laminectomy: 544 lumbar laminectomy and diskectomy surgeries were identified, with 183 undergoing general anesthesia and 361 undergoing spinal anesthesia (SA). Linear and multivariate regression analyses were performed to identify differences in blood loss, operative time, time from entering the operating room (OR) until incision, time from bandage placement to exiting the OR, total anesthesia time, PACU time, and total hospital stay. Secondary outcomes of interest included incidence of postoperative spinal hematoma and death, incidence of paraparesis, plegia, post-dural puncture headache, and paresthesia, among the SA patients. RESULTS: SA was associated with significantly lower operative time, blood loss, total anesthesia time, time from entering the OR until incision, time from bandage placement until exiting the OR, and total duration of hospital stay, but a longer stay in the PACU. The SA group experienced one spinal hematoma, which was evacuated without any long-term neurological deficits, and neither group experienced a death. The SA group had no episodes of paraparesis or plegia, post-dural puncture headaches, or episodes of persistent postoperative paresthesia or weakness. CONCLUSION: SA is effective for use in patients undergoing elective lumbar laminectomy and/or diskectomy spinal surgery, and was shown to be the more expedient anesthetic choice in the perioperative setting

Neutrinoless Double Beta Decay and CP Violation

We study the relation between the Majorana neutrino mass matrices and the neutrinoless double beta decay when CP is not conserved. We give an explicit form of the decay rate in terms of a rephasing invariant quantity and demonstrate that in the presence of CP violation it is impossible to have vanishing neutrinoless double beta decay in the case of two neutrino generations (or when the third generation leptons do not mix with other leptons and hence decouple).Comment: 9 pages, UTPT-93-1

Phenomenology of Mirror Fermions in the Littlest Higgs Model with T-Parity

Little Higgs models are an interesting alternative to explain electroweak symmetry breaking without fine-tuning. Supplemented with a discrete symmetry (T-parity) constraints from electroweak precision data are naturally evaded and also a viable dark matter candidate is obtained. T-parity implies the existence of new (mirror) fermions in addition to the heavy gauge bosons of the little Higgs models. In this paper we consider the effects of the mirror fermions on the phenomenology of the littlest Higgs model with T-parity at the LHC. We study the most promising production channels and decay chains for the new particles. We find that the mirror fermions have a large impact on the magnitude of signal rates and on the new physics signatures. Realistic background estimates are given.Comment: 13 p

Healthy Dietary Interventions and Lipoprotein (a) Plasma Levels: Results from the Omni Heart Trial

Background: Increased lipoprotein(a) [Lp(a)] levels are associated with atherosclerotic cardiovascular disease. Studies of dietary interventions on changes in Lp(a) are sparse. We aimed to compare the effects of three healthy dietary interventions differing in macronutrient content on Lp(a) concentration. Methods: Secondary analysis of a randomized, 3-period crossover feeding study including 155 (89 blacks; 66 whites) individuals. Participants were given DASH-type healthy diets rich in carbohydrates [Carb], in protein [Prot] or in unsaturated fat [Unsat Fat] for 6 weeks each. Plasma Lp(a) concentration was assessed at baseline and after each diet. Results: Compared to baseline, all interventional diets increased mean Lp(a) by 2 to 5 mg/dl. Unsat Fat increased Lp(a) less than Prot with a difference of 1.0 mg/dl (95% CI, −0.5, 2.5; p = 0.196) in whites and 3.7 mg/dl (95% CI, 2.4, 5.0; p<0.001) in blacks (p-value between races = 0.008); Unsat Fat increased Lp(a) less than Carb with a difference of −0.6 mg/dl, 95% CI, −2.1, 0.9; p = 0.441) in whites and −1.5 mg/dl (95% CI, −0.2, −2.8; p = 0.021) in blacks (p-value between races = 0.354). Prot increased Lp(a) more than Carb with a difference of 0.4 mg/dl (95% CI, −1.1, 1.9; p = 0.597) in whites and 2.2 mg/dl (95%CI, 0.9, 3.5; p = 0.001) in blacks (p-value between races = 0.082). Conclusion: Diets high in unsaturated fat increased Lp(a) levels less than diets rich in carbohydrate or protein with greater changes in blacks than whites. Our results suggest that substitutions with dietary mono- and polyunsaturated fatty acids in healthy diets may be preferable over protein or carbohydrates with regards to Lp(a). Trial Registration Clinicaltrials.gov NCT0005135

Minimal Informationally Complete Measurements for Pure States

We consider measurements, described by a positive-operator-valued measure (POVM), whose outcome probabilities determine an arbitrary pure state of a D-dimensional quantum system. We call such a measurement a pure-state informationally complete (PSI-complete) POVM. We show that a measurement with 2D-1 outcomes cannot be PSI-complete, and then we construct a POVM with 2D outcomes that suffices, thus showing that a minimal PSI-complete POVM has 2D outcomes. We also consider PSI-complete POVMs that have only rank-one POVM elements and construct an example with 3D-2 outcomes, which is a generalization of the tetrahedral measurement for a qubit. The question of the minimal number of elements in a rank-one PSI-complete POVM is left open.Comment: 2 figures, submitted for the Asher Peres festschrif