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1.
J Exp Bot ; 74(21): 6677-6691, 2023 11 21.
Article in English | MEDLINE | ID: mdl-37668473

ABSTRACT

The vasculature along conifer needles is fundamentally different from that in angiosperm leaves as it contains a unique transfusion tissue inside the bundle sheath. In this study, we used specific tracers to identify the pathway of photoassimilates from mesophyll to phloem, and the opposing pathway of nutrients from xylem to mesophyll. For symplasmic transport we applied esculin to the tip of attached pine needles and followed its movement down the phloem. For apoplasmic transport we let detached needles take up a membrane-impermeable contrast agent and used micro-X-ray computed tomography to map critical water exchange interfaces and domain borders. Microscopy and segmentation of the X-ray data enabled us to render and quantify the functional 3D structure of the water-filled apoplasm and the complementary symplasmic domain. The transfusion tracheid system formed a sponge-like apoplasmic domain that was blocked at the bundle sheath. Transfusion parenchyma cell chains bridged this domain as tortuous symplasmic pathways with strong local anisotropy which, as evidenced by the accumulation of esculin, pointed to the phloem flanks as the preferred phloem-loading path. Simple estimates supported a pivotal role of the bundle sheath, showing that a bidirectional movement of nutrient ions and assimilates is feasible and emphasizing the role of the bundle sheath in nutrient and assimilate exchange.


Subject(s)
Tracheophyta , Tracheophyta/metabolism , Esculin/metabolism , Biological Transport , Plant Leaves/metabolism , Nutrients , Water/metabolism , Phloem/metabolism
3.
Acta Orthop ; 94: 141-151, 2023 04 05.
Article in English | MEDLINE | ID: mdl-37039064

ABSTRACT

BACKGROUND AND PURPOSE: Hip precautions are routinely prescribed to patients with osteoarthritis to decrease dislocation rates after total hip arthroplasty (THA) using a posterior approach. However, recommendations have been based on very low certainty of evidence. We updated the evidence on the influence of hip precautions on early recovery following THA by this systematic review. MATERIALS AND METHODS: We performed systematic searches for randomized controlled trials (RCT) and non-randomized (NRS) studies in MEDLINE, Embase, PEDro, and CINAHL published from 2016 to July 2022. 2 reviewers independently included studies comparing postoperative precautions with minimal or no precautions, extracted data, and assessed the risk of bias. Random effects meta-analyses were used to synthesize the results. The certainty of the evidence was rated by the Grading of Recommendations Assessment and Evaluation approach. The critical outcome was the risk of hip dislocations within 3 months of surgery. Other outcomes were long-term risk of dislocation and reoperation, self-reported and performance-based assessment of function, quality of life, pain, and time to return to work. RESULTS: 4 RCTs and 5 NRSs, including 8,835 participants, were included. There may be no or negligible difference in early hip dislocations (RCTs: risk ratio [RR] 1.8, 95% confidence interval [CI] 0.6-5.2; NRS: RR 0.9, CI 0.3-2.5). Certainty in the evidence was low for RCTs and very low for NRSs. Finally, precautions may reduce the performance-based assessment of function slightly, but the evidence was very uncertain. For all other outcomes, no differences were found (moderate to very low certainty evidence). CONCLUSION: The current evidence does not support routinely prescribing hip precautions post-surgically for patients undergoing THA to prevent hip dislocations. However, the results might change with high-quality studies.


Subject(s)
Arthroplasty, Replacement, Hip , Hip Dislocation , Osteoarthritis, Hip , Humans , Arthroplasty, Replacement, Hip/adverse effects , Osteoarthritis, Hip/surgery , Hip Dislocation/prevention & control , Reoperation , Quality of Life
4.
Sci Rep ; 13(1): 3834, 2023 Mar 07.
Article in English | MEDLINE | ID: mdl-36882517

ABSTRACT

Thermomechanical processing such as annealing is one of the main methods to tailor the mechanical properties of materials, however, much is unknown about the reorganization of dislocation structures deep inside macroscopic crystals that give rise to those changes. Here, we demonstrate the self-organization of dislocation structures upon high-temperature annealing in a mm-sized single crystal of aluminum. We map a large embedded 3D volume ([Formula: see text] [Formula: see text]m[Formula: see text]) of dislocation structures using dark field X-ray microscopy (DFXM), a diffraction-based imaging technique. Over the wide field of view, DFXM's high angular resolution allows us to identify subgrains, separated by dislocation boundaries, which we identify and characterize down to the single-dislocation level using computer-vision methods. We demonstrate how even after long annealing times at high temperatures, the remaining low density of dislocations still pack into well-defined, straight dislocation boundaries (DBs) that lie on specific crystallographic planes. In contrast to conventional grain growth models, our results show that the dihedral angles at the triple junctions are not the predicted 120[Formula: see text], suggesting additional complexities in the boundary stabilization mechanisms. Mapping the local misorientation and lattice strain around these boundaries shows that the observed strain is shear, imparting an average misorientation around the DB of [Formula: see text] 0.003 to 0.006[Formula: see text].

5.
Nord J Psychiatry ; 77(4): 329-335, 2023 May.
Article in English | MEDLINE | ID: mdl-35916656

ABSTRACT

BACKGROUND: Social cognitive impairment is common in schizophrenia, but it is unclear if it is present in individuals with high IQ. This study compared theory of mind (ToM) in schizophrenia participants with low or high IQ to healthy controls. METHODS: One hundred and nineteen participants (71 healthy controls, 17 high IQ (IQ ≥115), and 31 low IQ (IQ ≤95) schizophrenia participants) were assessed with the Movie for the Assessment of Social Cognition, providing scores for total, cognitive, and affective ToM, along with overmentalizing, undermentalizing, and no-mentalizing errors. IQ was measured with Wechsler Abbreviated Scale of Intelligence; clinical symptoms with the Positive and Negative Syndrome Scale. RESULTS: Healthy controls performed better than the low IQ schizophrenia group for all ToM scores, and better than the high IQ schizophrenia group for the total score and under- and no-mentalizing errors. The high IQ group made fewer overmentalizing errors and had better total and cognitive ToM than the low IQ group. Their number of overmentalizing errors was indistinguishable from healthy controls. CONCLUSION: Global ToM impairment was present in the low IQ schizophrenia group. Overmentalizing was not present in the high IQ group and appears related to lower IQ. Intact higher-level reasoning may prevent the high IQ group from making overmentalizing errors, through self-monitoring or inhibition. We propose that high IQ patients are chiefly impaired in lower-level ToM, whereas low IQ patients also have impaired higher-level ToM. Conceivably, this specific impairment could help explain the lower functioning reported in persons with intact IQ.


Subject(s)
Cognitive Dysfunction , Intellectual Disability , Schizophrenia , Theory of Mind , Humans , Schizophrenia/diagnosis , Theory of Mind/physiology , Intelligence , Schizophrenic Psychology , Neuropsychological Tests
6.
Cells ; 11(24)2022 12 12.
Article in English | MEDLINE | ID: mdl-36552775

ABSTRACT

Autologous chondrocyte implantation (ACI) is a cell therapy to repair cartilage defects. In ACI a biopsy is taken from a non-load bearing area of the knee and expanded in-vitro. The expansion process provides the benefit of generating a large number of cells required for implantation; however, during the expansion these cells de-differentiate and lose their chondrocyte phenotype. In this review we focus on examining the de-differentiation phenotype from a mechanobiology and biophysical perspective, highlighting some of the nuclear mechanics and chromatin changes in chondrocytes seen during the expansion process and how this relates to the gene expression profile. We propose that manipulating chondrocyte nuclear architecture and chromatin organization will highlight mechanisms that will help to preserve the chondrocyte phenotype.


Subject(s)
Chondrocytes , Cues , Chondrocytes/metabolism , Cell Differentiation , Knee Joint , Phenotype
7.
Mol Metab ; 64: 101566, 2022 10.
Article in English | MEDLINE | ID: mdl-35940556

ABSTRACT

OBJECTIVE: The mitochondrial fission protein Drp1 was proposed to promote NAFLD, as inhibition of hepatocyte Drp1 early in life prevents liver steatosis induced by high-fat diet in mice. However, whether Drp1-knockdown in older mice can reverse established NASH is unknown. METHODS: N-acetylgalactosamine-siRNA conjugates, an FDA approved method to deliver siRNA selectively to hepatocytes, were used to knockdown hepatocyte-Drp1 in mice (NAG-Drp1si). NASH was induced in C57BL/6NTac mice by Gubra-Amylin-NASH diet (D09100310, 40% fat, 22% fructose and 2% cholesterol) and treatment with NAG-Drp1si was started at week 24 of diet. Circulating transaminases, liver histology, gene expression of fibrosis and inflammation markers, and hydroxyproline synthesis determined NASH severity. Liver NEFA and triglycerides were quantified by GC/MS. Mitochondrial function was determined by respirometry. Western blots of Oma1, Opa1, p-eIf2α, as well as transcriptional analyses of Atf4-regulated genes determined ISR engagement. RESULTS: NAG-Drp1si treatment decreased body weight and induced liver inflammation in adult healthy mice. Increased hepatic Gdf15 production was the major contributor to body-weight loss caused by NAG-Drp1si treatment, as Gdf15 receptor deletion (Gfral KO) prevented the decrease in food intake and mitigated weight loss. NAG-Drp1si activated the Atf4-controlled integrated stress response (ISR) to increase hepatic Gdf15 expression. NAG-Drp1si in healthy mice caused ER stress and activated the mitochondrial protease Oma1, which are the ER and mitochondrial triggers that activate the Atf4-controlled ISR. Remarkably, induction of NASH was not sufficient to activate Oma1 in liver. However, NAG-Drp1si treatment was sufficient to activate Oma1 in adult mice with NASH, as well as exacerbating NASH-induced ER stress. Consequently, NAG-Drp1si treatment in mice with NASH led to higher ISR activation, exacerbated inflammation, fibrosis and necrosis. CONCLUSION: Drp1 mitigates NASH by decreasing ER stress, preventing Oma1 activation and ISR exacerbation. The elevation in Gdf15 actions induced by NAG-Drp1si might represent an adaptive response decreasing the nutrient load to liver when mitochondria are misfunctional. Our study argues against blocking Drp1 in hepatocytes to combat NASH.


Subject(s)
Liver , Mitochondrial Dynamics , Animals , Diet, High-Fat/adverse effects , Fibrosis , Inflammation/metabolism , Liver/metabolism , Mice , Mice, Inbred C57BL , Mitochondria/genetics , RNA, Small Interfering/metabolism , Weight Loss
8.
J Med Imaging (Bellingham) ; 9(3): 034504, 2022 May.
Article in English | MEDLINE | ID: mdl-35789704

ABSTRACT

Purpose: Photon counting imaging detectors (PCD) has paved the way for spectral x-ray computed tomography (spectral CT), which simultaneously measures a sample's linear attenuation coefficient (LAC) at multiple energies. However, cadmium telluride (CdTe)-based PCDs working under high flux suffer from detector effects, such as charge sharing and photon pileup. These effects result in the severe spectral distortions of the measured spectra and significant deviation of the extracted LACs from the reference attenuation curve. We analyze the influence of the spectral distortion correction on material classification performance. Approach: We employ a spectral correction algorithm to reduce the primary spectral distortions. We use a method for material classification that measures system-independent material properties, such as electron density, ρ e , and effective atomic number, Z eff . These parameters are extracted from the LACs using attenuation decomposition and are independent of the scanner specification. The classification performance with the raw and corrected data is tested on different numbers of energy bins and projections and different radiation dose levels. We use experimental data with a broad range of materials in the range of 6 ≤ Z eff ≤ 15 , acquired with a custom laboratory instrument for spectral CT. Results: We show that using the spectral correction leads to an accuracy increase of 1.6 and 3.8 times in estimating ρ e and Z eff , respectively, when the image reconstruction is performed from only 12 projections and the 15 energy bins approach is used. Conclusions: The correction algorithm accurately reconstructs the measured attenuation curve and thus gives better classification performance.

9.
Cells ; 11(11)2022 05 30.
Article in English | MEDLINE | ID: mdl-35681483

ABSTRACT

The nuclear envelope (NE) has emerged as a nexus for cellular organization, signaling, and survival. Beyond its role as a barrier to separate the nucleoplasm from the cytoplasm, the NE's role in supporting and maintaining a myriad of other functions has made it a target of study in many cellular processes, including senescence. The nucleus undergoes dramatic changes in senescence, many of which are driven by changes in the NE. Indeed, Lamin B1, a key NE protein that is consistently downregulated in senescence, has become a marker for senescence. Other NE proteins have also been shown to play a role in senescence, including LINC (linker of nucleoskeleton and cytoskeleton) complex proteins. LINC complexes span the NE, forming physical connections between the cytoplasm to the nucleoplasm. In this way, they integrate nuclear and cytoplasmic mechanical signals and are essential not only for a variety of cellular functions but are needed for cell survival. However, LINC complex proteins have been shown to have a myriad of functions in addition to forming a LINC complex, often existing as nucleoplasmic or cytoplasmic soluble proteins in a variety of isoforms. Some of these proteins have now been shown to play important roles in DNA repair, cell signaling, and nuclear shape regulation, all of which are important in senescence. This review will focus on some of these roles and highlight the importance of LINC complex proteins in senescence.


Subject(s)
Nuclear Envelope , Nuclear Proteins , Cell Nucleus/metabolism , Cytoskeleton/metabolism , Membrane Proteins/metabolism , Microtubules/metabolism , Nuclear Envelope/metabolism , Nuclear Proteins/metabolism
10.
Aging Cell ; 21(2): e13555, 2022 02.
Article in English | MEDLINE | ID: mdl-35045206

ABSTRACT

Hutchinson-Gilford Progeria Syndrome (HGPS) is an extremely rare genetic disorder caused by mutations in the LMNA gene and characterized by premature and accelerated aging beginning in childhood. In this study, we performed the first genome-wide methylation analysis on blood DNA of 15 patients with progeroid laminopathies using Infinium Methylation EPIC arrays including 8 patients with classical HGPS. We could observe DNA methylation alterations at 61 CpG sites as well as 32 significant regions following a 5 Kb tiling analysis. Differentially methylated probes were enriched for phosphatidylinositol biosynthetic process, phospholipid biosynthetic process, sarcoplasm, sarcoplasmic reticulum, phosphatase regulator activity, glycerolipid biosynthetic process, glycerophospholipid biosynthetic process, and phosphatidylinositol metabolic process. Differential methylation analysis at the level of promoters and CpG islands revealed no significant methylation changes in blood DNA of progeroid laminopathy patients. Nevertheless, we could observe significant methylation differences in classic HGPS when specifically looking at probes overlapping solo-WCGW partially methylated domains. Comparing aberrantly methylated sites in progeroid laminopathies, classic Werner syndrome, and Down syndrome revealed a common significantly hypermethylated region in close vicinity to the transcription start site of a long non-coding RNA located anti-sense to the Catenin Beta Interacting Protein 1 gene (CTNNBIP1). By characterizing epigenetically altered sites, we identify possible pathways/mechanisms that might have a role in the accelerated aging of progeroid laminopathies.


Subject(s)
Progeria , Werner Syndrome , Aging/genetics , DNA/genetics , DNA/metabolism , DNA Methylation/genetics , Humans , Lamin Type A/genetics , Lamin Type A/metabolism , Mutation , Progeria/genetics , Progeria/metabolism , Werner Syndrome/genetics
11.
Sci Rep ; 11(1): 10133, 2021 05 12.
Article in English | MEDLINE | ID: mdl-33980926

ABSTRACT

KASH5 is the most recently identified member of the KASH domain family of tail anchored, outer nuclear membrane (ONM) and endoplasmic reticulum (ER) proteins. During meiosis prophase I, KASH5 and SUN1 form a complex that spans the nuclear envelope and which links the telomeres of meiotic chromosomes to cytoplasmic dynein. This connection is essential for homologous chromosome dynamics and pairing. A recent study identified a variant in human KASH5 (L535Q) that correlated with male infertility associated with azoospermia. However, no molecular mechanism was described. Here, we report that this amino acid substitution, within the KASH5 transmembrane domain (TMD) has no predicted effects on secondary structure. However, the overall hydrophobicity of the L535Q TMD, is calculated to be lower than the wild-type KASH5, based on the GES (Goldman-Engelman-Steitz) amino acid hydrophobicity scale. This change in hydrophobicity profoundly affects the subcellular localization of KASH5. Through a series of amino acid substitution studies, we show that the L535Q substitution perturbs KASH5 localization to the ER and ONM and instead results in mistargeting to the mitochondria membrane. We suggest that this mislocalization accounts for the infertility and azoospermia phenotype in patients.


Subject(s)
Cell Cycle Proteins/genetics , Cell Cycle Proteins/metabolism , Genetic Variation , Infertility/genetics , Infertility/metabolism , Mitochondria/metabolism , Alleles , Amino Acid Substitution , Amino Acids/chemistry , Cell Cycle Proteins/chemistry , Female , Fluorescent Antibody Technique , Humans , Hydrophobic and Hydrophilic Interactions , Male , Membrane Proteins/metabolism , Protein Transport
12.
Arch Biochem Biophys ; 702: 108829, 2021 05 15.
Article in English | MEDLINE | ID: mdl-33716002

ABSTRACT

How cells respond to mechanical forces from the surrounding environment is critical for cell survival and function. The LINC complex is a central component in the mechanotransduction pathway that transmits mechanical information from the cell surface to the nucleus. Through LINC complex functionality, the nucleus is able to respond to mechanical stress by altering nuclear structure, chromatin organization, and gene expression. The use of specialized devices that apply mechanical strain to cells have been central to investigating how mechanotransduction occurs, how cells respond to mechanical stress, and the role of the LINC complexes in these processes. A large variety of designs have been reported for these devices, with the most common type being cell stretchers. Here we highlight some of the salient features of cell stretchers and suggest some key parameters that should be considered when using these devices. We provide a brief overview of how the LINC complexes contribute to the cellular responses to mechanical strain. And finally, we suggest that stretchers may be a useful tool to study aging.


Subject(s)
Cell Nucleus/metabolism , Cytoskeleton/metabolism , Mechanotransduction, Cellular , Animals , Humans
13.
Biol Open ; 10(2)2021 02 10.
Article in English | MEDLINE | ID: mdl-33563607

ABSTRACT

Cells respond to mechanical cues from their environment through a process of mechanosensing and mechanotransduction. Cell stretching devices are important tools to study the molecular pathways responsible for cellular responses to mechanobiological processes. We describe the development and testing of a uniaxial cell stretcher that has applications for microscopic as well as biochemical analyses. By combining simple fabrication techniques with adjustable control parameters, the stretcher is designed to fit a variety of experimental needs. The stretcher can be used for static and cyclic stretching. As a proof of principle, we visualize stretch induced deformation of cell nuclei via incremental static stretch, and changes in IEX1 expression via cyclic stretching. This stretcher is easily modified to meet experimental needs, inexpensive to build, and should be readily accessible for most laboratories with access to 3D printing.


Subject(s)
Biophysics/methods , Mechanotransduction, Cellular/physiology , Models, Biological , Printing, Three-Dimensional , Biophysics/instrumentation , Cells, Cultured
14.
Eur J Neurol ; 28(1): 81-89, 2021 01.
Article in English | MEDLINE | ID: mdl-32888367

ABSTRACT

BACKGROUND AND PURPOSE: Little is known about the epidemiological features of amyotrophic lateral sclerosis (ALS) in sub-Saharan Africa, and data from the region are limited to clinical series or case reports. The aim of the study was to investigate the incidence rate and presentation of ALS in an ethnically diverse region of South Africa. METHODS: We performed a 4-year prospective incidence study in the Western Cape Province of South Africa between 1 July 2014 and 30 June 2018, and used a two-source capture-recapture method for case ascertainment. Age- and sex-adjusted incidence rates (ASAIRs) were calculated using the 2010 US population as the reference. RESULTS: A total of 203 incident cases were identified over the study period, resulting in a crude incidence rate (IR) of 1.09 [95% confidence interval (CI) 0.94-1.24] per 100 000 person-years in the at-risk population (aged >15 years). Capture-recapture analysis resulted in an estimated IR of 1.11 (95% CI 1.01-1.22) per 100 000 person-years. The ASAIR was 1.67 (95% CI 1.09-2.26) overall; 1.99 (95% CI 1.60-2.39) for men and 1.37 (95% CI 1.06-1.68) for women. When analysed separately, there was a substantial difference in ASAIRs between the different population groups, with the highest in the European ancestry group (2.62; 95% CI 2.49-2.75), the lowest in the African ancestry group (0.56, 95% CI 0.0-1.23), and an ASAIR in between these two in the mixed ancestry group (1.09, 95% CI 0.80-1.37). CONCLUSION: The overall incidence of ALS in the Western Cape Province of South Africa appears to be lower than in North African and Western countries, but higher than in Asian countries. As suggested by previous epidemiological studies, ALS may be less frequent in people of African ancestry.


Subject(s)
Amyotrophic Lateral Sclerosis , Motor Neuron Disease , Amyotrophic Lateral Sclerosis/epidemiology , Female , Humans , Incidence , Male , Motor Neuron Disease/epidemiology , Prospective Studies , South Africa/epidemiology
15.
J Card Surg ; 35(11): 3173-3175, 2020 Nov.
Article in English | MEDLINE | ID: mdl-32740953

ABSTRACT

BACKGROUND: The current coronavirus (COVID-19) pandemic is associated with severe pulmonary and cardiovascular complications. CASE PRESENTATION: This report describes a young patient with COVID-19 without any comorbidity presenting with severe cardiovascular complications, manifesting with pulmonary embolism, embolic stroke, and right heart failure. CONCLUSION: Management with short-term mechanical circulatory support, including different cannulation strategies, resulted in a successful outcome despite his critical cardiovascular status.


Subject(s)
COVID-19/complications , Extracorporeal Membrane Oxygenation , Heart Failure/therapy , Ventricular Dysfunction, Right/therapy , Adult , Embolectomy , Embolic Stroke/therapy , Embolic Stroke/virology , Heart Failure/virology , Humans , Male , Pulmonary Embolism/surgery , Pulmonary Embolism/virology , Thrombosis/therapy , Thrombosis/virology , Ventricular Dysfunction, Right/virology
16.
J Inverse Ill Posed Probl ; 28(6): 923-932, 2020 Dec.
Article in English | MEDLINE | ID: mdl-34690436

ABSTRACT

We present the comparative study of the analytical forward model and the statistical simulation of the Compton single scatter in the Positron Emission Tomography. The formula of the forward model has been obtained using the Single Scatter Simulation approximation under simplified assumptions and therefore we calculate scatter projections using independent Monte Carlo simulation mimicking the scatter physics. The numerical comparative study has been performed using a digital cylindrical phantom filled in with water and containing spherical sources of emission activity located at the central and several displaced positions. Good fits of the formula-based and statistically generated profiles of scatter projections are observed in the presented numerical results.

17.
Physiol Rep ; 7(22): e14289, 2019 11.
Article in English | MEDLINE | ID: mdl-31782241

ABSTRACT

Injured tendons heal through the formation of a fibrovascular scar that has inferior mechanical properties compared to native tendon tissue. Reducing inflammation that occurs as a result of the injury could limit scar formation and improve functional recovery of tendons. Prostaglandin D2 (PGD2 ) plays an important role in promoting inflammation in some injury responses and chronic disease processes, and the inhibition of PGD2 has improved healing and reduced disease burden in animal models and early clinical trials. Based on these findings, we sought to determine the role of PGD2 signaling in the healing of injured tendon tissue. We tested the hypothesis that a potent and specific inhibitor of hematopoietic PGD synthase (HPGDS), GSK2894631A, would improve the recovery of tendons of adult male rats following an acute tenotomy and repair. To test this hypothesis, we performed a full-thickness plantaris tendon tenotomy followed by immediate repair and treated rats twice daily with either 0, 2, or 6 mg/kg of GSK2894631A. Tendons were collected either 7 or 21 days after surgical repair, and mechanical properties of tendons were assessed along with RNA sequencing and histology. While there were some differences in gene expression across groups, the targeted inhibition of HPGDS did not impact the functional repair of tendons after injury, as HPGDS expression was surprisingly low in injured tendons. These results indicate that PGD2 signaling does not appear to be important in modulating the repair of injured tendon tissue.


Subject(s)
Achilles Tendon/injuries , Achilles Tendon/metabolism , Prostaglandin D2/metabolism , Recovery of Function/physiology , Signal Transduction/physiology , Achilles Tendon/drug effects , Animals , Biomechanical Phenomena/drug effects , Biomechanical Phenomena/physiology , Enzyme Inhibitors/pharmacology , Hindlimb/drug effects , Hindlimb/injuries , Hindlimb/metabolism , Male , Prostaglandin D2/antagonists & inhibitors , Rats , Rats, Sprague-Dawley , Recovery of Function/drug effects , Signal Transduction/drug effects , Tendon Injuries/metabolism
18.
Opt Express ; 27(5): 7120-7138, 2019 Mar 04.
Article in English | MEDLINE | ID: mdl-30876283

ABSTRACT

X-ray microscopy at photon energies above 15 keV is very attractive for the investigation of atomic and nanoscale properties of technologically relevant structural and bio materials. This method is limited by the quality of X-ray optics. Multilayer Laue lenses (MLLs) have the potential to make a major impact in this field because, as compared to other X-ray optics, they become more efficient and effective with increasing photon energy. In this work, MLLs were utilized with hard X-rays at photon energies up to 34.5 keV. The design, fabrication, and performance of these lenses are presented, and their application in several imaging configurations is described. In particular, two "full field" modes of imaging were explored, which provide various contrast modalities that are useful for materials characterisation. These include point projection imaging (or Gabor holography) for phase contrast imaging and direct imaging with both bright-field and dark-field illumination. With high-efficiency MLLs, such modes offer rapid data collection as compared with scanning methods as well as a large field of views.

19.
Clin Res Cardiol ; 108(3): 315-323, 2019 Mar.
Article in English | MEDLINE | ID: mdl-30167808

ABSTRACT

BACKGROUND: Transcatheter aortic valve implantation (TAVI) is a standard therapy for aortic valve stenosis in patients at intermediate-to-high surgical risk. Previously, TAVI at our site was performed by a minimalist heart team (MHT), comprised of two interventional cardiologists, echocardiography staff and two cardiac catheterization laboratory nurses. After revision of German Federal Joint Committee (G-BA) guidelines in September 2015, the presence of an extended heart team (EHT; including a full cardiac surgical team) became mandatory throughout the TAVI procedure. We aimed to evaluate the impact of the EHT on clinical and economical outcomes. METHODS: Data was retrospectively extracted from the medical records of patients receiving an Edwards SAPIEN 3 valve at the University Hospital Tübingen, Germany, between 2014 and 2017 and matched with cost data from the national invoice system of hospitals (InEK). For comparison, patients were grouped according to whether they underwent TAVI with or without the EHT. RESULTS: Overall, data for 341 patients (MHT 233; EHT 118) were analysed. Baseline characteristics were largely similar between groups (mean age 81.0 years; 54.5% female), though EHT patients had a lower mean logEuroSCORE (17.5% vs. 19.8%; p = 0.011) and more prior PCI/stenting (39.0% vs. 26.9%; p = 0.022). The rate of immediate procedural death (1.7%) was comparable between groups, as was mortality at 30 days (4.2%). Overall, 1.2% of patients required conversion to surgery. The cost of the index hospitalisation (minus the prosthesis) was higher in the EHT condition (difference + €1604), largely driven by expenditure on physicians (difference + €581; p < 0.001), medical technicians (difference + €372; p < 0.001) and medical supplies (difference +€244; p = 0.001). CONCLUSION: At our site, the presence of an EHT throughout the TAVI procedure appears to substantially increase hospital expenditure without significantly improving patient outcomes. We suggest that TAVI by a minimalist HT with a surgical team on call in case of emergency may be sufficient.


Subject(s)
Aortic Valve Stenosis/surgery , Heart Valve Prosthesis , Hospital Costs , Patient Care Team/statistics & numerical data , Transcatheter Aortic Valve Replacement/methods , Aged, 80 and over , Aortic Valve Stenosis/diagnosis , Aortic Valve Stenosis/economics , Cost-Benefit Analysis , Echocardiography , Female , Follow-Up Studies , Germany , Humans , Male , Patient Satisfaction , Prosthesis Design , Retrospective Studies , Severity of Illness Index , Transcatheter Aortic Valve Replacement/economics , Treatment Outcome
20.
Front Neurol ; 9: 823, 2018.
Article in English | MEDLINE | ID: mdl-30337904

ABSTRACT

Background: Cardiac myxoma (CM) is the most frequent, cardiac benign tumor and is associated with enhanced risk for cerebrovascular events (CVE). Although surgical CM excision is the only curative treatment to prevent CVE recurrence, in recent reports conservative treatment with antiplatelet or anticoagulant agents in high-risk patients with CM-related CVE has been discussed. Methods: Case records at the University Hospital of Tübingen between 2005 and 2017 were screened to identify patients with CM-related CVE. Clinical features, brain and cardiac imaging findings, histological reports, applied treatments and long-term neurological outcomes were assessed. Results: 52 patients with CM were identified and among them, 13 patients with transient ischemic attack, ischemic stroke or retinal ischemia were included to the (to our knowledge) largest reported retrospective study of CM-related CVE. In all identified patients, CVE was the first manifestation of CM; 61% suffered ischemic stroke, 23% transient ischemic attack and 15% retinal ischemia. In 46% of the patients, CVE occurred under antiplatelet or anticoagulation treatment, while 23% of the patients developed recurrent CVE under bridging-antithrombotic-therapy prior to CM surgical excision. Prolonged time interval between CVE and CM-surgery was significantly associated with CVE recurrence (p = 0.021). One patient underwent i.v. thrombolysis, followed by thrombectomy, with good post-interventional outcome and no signs of hemorrhagic transformation. Discussion: Our results suggest that antiplatelet or anticoagulation treatment is no alternative to cardiac surgery in patients presenting with CM-related CVE. We found significantly prolonged time-intervals between CVE and CM surgery in patients with recurrent CVE. Therefore, we suggest that the waiting- or bridging-interval with antithrombotic therapy until curative CM excision should be kept as short as possible. Based on our data and review of the literature, we suggest that in patients with CM-related CVE, i.v. thrombolysis and/or endovascular interventions may present safe and efficacious acute treatments.

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