Hybrid-procedures for the Treatment of Thoracoabdominal Aortic Aneurysms and Dissections

AimThe conventional open repair of thoracoabdominal aneurysms and dissections remains complex and demanding and is associated with significant morbidity and mortality. We present our experience of hybrid open and endovascular treatment of thoracoabdominal aneurysms and dissections.MethodsWithin an experience of 226 aortic stent-grafts between 1998 and April 2006, 6 of the patients (median age 60 years, range 35 to 68 years) with thoracoabdominal aneurysms (Crawford type I, II, III, and V) were treated with a combined endovascular and open surgical approach. Five men and one woman, with median aneurysm diameter of 75mm (range 70–100mm), received revascularization of the renal arteries, the superior mesenteric artery, and the coeliac trunk accomplished via transperitoneal bypass grafting. Aneurysmal exclusion was then performed by stent-graft deployment.ResultsThe entire procedure was technically successful in all patients. The patients were discharged a median of 9 days after the operation, while the postoperative studies revealed the patency of the vessels and no evidence of type I endoleak or secondary rupture of the aneurysm. During follow up (1 to 22 months) spiral-CT scanning revealed distinct shrinkage of the aneurysm, no graft migration or endoleak and patency of all revascularised vessels, except one renal artery in two patients. No patient experienced any temporary or permanent neurological deficit, and no dialysis was necessary.ConclusionThe combined endovascular and open surgical approach is feasible, without cross clamping of the aorta and with minimized ischemia time for renal and visceral arteries, and seems to be an appropriate strategy for patients with a thoraco-abdominal aortic aneurysm or dissection

In Vitro Photodynamic Therapy with Chlorin e6 Leads to Apoptosis of Human Vascular Smooth Muscle Cells

Percutaneous coronary intervention has become the most common and widely implemented method of heart revascularization. However, the development of restenosis remains the major limitation of this method. Photodynamic therapy (PDT) recently emerged as a new and promising method for the prevention of arterial restenosis. Here the efficacy of chlorin e6 in PDT was investigated in vitro using human vascular smooth muscle cells (TG/HA-VSMCs) as one of the cell types crucial in the development of restenosis. PDT-induced cell death was studied on many levels, including annexin V staining, measurement of the generation reactive oxygen species (ROS) and caspase-3 activity, and assessment of changes in mitochondrial membrane potential and fragmentation of DNA. Photosensitization of TG/HA-VSMCs with a 170 μM of chlorin e6 and subsequent illumination with the light of a 672-nm diode laser (2 J/cm2) resulted in the generation of ROS, a decrease in cell membrane polarization, caspase-3 activation, as well as DNA fragmentation. Interestingly, the latter two apoptotic events could not be observed in photosensitized and illuminated NIH3T3 fibroblasts, suggesting different outcomes of the model of PDT in various types of cells. The results obtained with human VSMCs show that chlorin e6 may be useful in the PDT of aerial restenosis, but its efficacy still needs to be established in an animal model

Hg 5d and 6s: Multichannel quantum-defect analysis of experimental data

Schäfers F, Heckenkamp C, Müller M, Radojevic V, Heinzmann U. Hg 5d and 6s: Multichannel quantum-defect analysis of experimental data. Physical Review, A: Atomic, Molecular and Optical Physics. 1990;42(5):2603-2613.Experimental spin-polarization data for the Hg 6s Cooper minimum and dipole-transition amplitudes and phase-shift differences for photoionization of the Hg 5d and 6s shells (eight channels) in the photon-energy region from the 2D3/2 threshold up to 35 eV (kinetic energies from 0 to 20 eV) are presented and compared with new relativistic random-phase approximation calculations. The data were evaluated from an experimental data set, quantum mechanically complete, consisting of cross-section and photoelectron spin-polarization data. For the 5d subshells the results show strong interchannel coupling between the outgoing p and f continuum channels. The results for Hg 6s could be used for an independent determination of the photoelectron angular distribution parameter [Beta] in the Cooper-minimum region. This region is shown to be perturbed by numerous two-electron excitations, which might be a possible explanation for the controversy on its location

Cancer therapy and cardiotoxicity: The need of serial Doppler echocardiography

Cancer therapy has shown terrific progress leading to important reduction of morbidity and mortality of several kinds of cancer. The therapeutic management of oncologic patients includes combinations of drugs, radiation therapy and surgery. Many of these therapies produce adverse cardiovascular complications which may negatively affect both the quality of life and the prognosis. For several years the most common noninvasive method of monitoring cardiotoxicity has been represented by radionuclide ventriculography while other tests as effort EKG and stress myocardial perfusion imaging may detect ischemic complications, and 24-hour Holter monitoring unmask suspected arrhythmias. Also biomarkers such as troponine I and T and B-type natriuretic peptide may be useful for early detection of cardiotoxicity. Today, the widely used non-invasive method of monitoring cardiotoxicity of cancer therapy is, however, represented by Doppler-echocardiography which allows to identify the main forms of cardiac complications of cancer therapy: left ventricular (systolic and diastolic) dysfunction, valve heart disease, pericarditis and pericardial effusion, carotid artery lesions. Advanced ultrasound tools, as Integrated Backscatter and Tissue Doppler, but also simple ultrasound detection of "lung comet" on the anterior and lateral chest can be helpful for early, subclinical diagnosis of cardiac involvement. Serial Doppler echocardiographic evaluation has to be encouraged in the oncologic patients, before, during and even late after therapy completion. This is crucial when using anthracyclines, which have early but, most importantly, late, cumulative cardiac toxicity. The echocardiographic monitoring appears even indispensable after radiation therapy, whose detrimental effects may appear several years after the end of irradiation

Winkel- und Spin-aufgeloeste Photoelektronenspektroskopie mit zirkular polarisierter Synchrotronstrahlung an freien Xenonatomen

SIGLECopy held by FIZ Karlsruhe; available from UB/TIB Hannover / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekDEGerman

A rotatable electron spectrometer system for spin- and angle-resolved photoemission experiments with circularly polarized synchrotron radiation

Heckenkamp C, Eyers A, Schäfers F, Schönhense G, Heinzmann U. A rotatable electron spectrometer system for spin- and angle-resolved photoemission experiments with circularly polarized synchrotron radiation. Nuclear Instruments and Methods in Physics Research A: Accelerators, Spectrometers, Detectors and Associated Equipment. 1986;246(1-3):500-503.An electron-optical system is described which has been especially designed for spin- and angle-resolved photoelectron spectroscopy with circularly polarized synchrotron radiation. One hv- and one uhv-type of this system (for studies at atoms/molecules and solids/adsorbates, respectively) are in operation at the storage ring BESSY. The system employs, thus, a light source and an electron spin detector (high energy Mott detector) both fixed in space. This is realized by a rotatable electron spectrometer and a 90° deflector by which the electron beam is directed along the axis of rotation of the spectrometer, independent of the emission angle chosen

Spurenanalytische Bestimmung von Blei, Cadmium und Chrom in Gewebeteilen von Bronchialkarzinompatienten mittels Atomabsorptionsspektroskopie und inverser Voltammetrie

SIGLECopy held by FIZ Karlsruhe; available from UB/TIB Hannover / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekDEGerman