Five-year follow-up of left ventricular diastolic function in systemic sclerosis patients: determinants of mortality and disease progression.

OBJECTIVES: In systemic sclerosis (SSc), left ventricular diastolic dysfunction reflects primary myocardial involvement of the disease. We aimed to assess the abnormalities of the diastolic function, analyze the characteristics of the disease progression, and investigate the prognostic value of diastolic dysfunction in SSc patients. PATIENTS AND METHODS: A total of 34 SSc patients (57 ± 12 years, 31 female) were involved in the study. The following traditional or tissue Doppler parameters of left ventricular diastolic function were obtained: E/A, lateral E', E/E', left ventricular mass index (LVM index), and maximal left atrial (LA) volume index. Measurements were repeated after 5.5 years. RESULTS: At baseline, diastolic dysfunction was found in 62% of the SSc patients. Follow-up time was 5.4 ± 1.2 years. A total of 6 patients died of heart failure. In univariate Cox regression analysis, age (HR = 1.08, p < 0.05), LVM index (HR = 1.07, p < 0.01), lateral E' (HR = 1.57, p = 0.05), and LA volume index (HR = 1.11, p < 0.01) were predictors of survival. During the follow-up, significant increase in LA volume index (27.5 ± 9.7 vs. 35.4 ± 10.6 cm(3)/m(2), p < 0.001) and E/E' was found (7.6 ± 2.5 vs. 8.7 ± 3.8, p < 0.05) while E' did not change (9.6 ± 2.6 vs. 9.2 ± 1.9 cm/s, NS). The increase in LA volume index showed positive correlation (r = 0.46, p < 0.05) while the decrease in E' values showed negative correlation (r = -0.54, p < 0.01) with the duration of the SSc. CONCLUSION: In SSc patients, left ventricular diastolic dysfunction is highly prevalent and is associated with increased risk of mortality. Our data suggest that in the advanced phase of the disease, the myocardial fibrotic processes burns out while the increase of the filling pressure progresses continuously.

Adsorption of 137Cs on titanium ferrocyanide and transformation of the sorbent to lithium titanate: a new method for long term immobilization of 137Cs.

Dynamic adsorption of radiocesium on titanium ferrocyanide grains from reactor coolant simulating solution containing salts at moderate concentrations has been investigated. Effective decontamination of the neutral solutions has been achieved, in the amounts of a more than 20 thousand bed volumes. After adsorption the titanium ferrocyanide was transferred to titanates and calcined at 900 °C. The leaching test of the obtained lithium titanates indicates that the loaded adsorbent can serve as an effective primary barrier in nuclear waste repositories.

Impact of cardiac involvement on the risk of mortality among patients with systemic sclerosis: a 5-year follow-up of a single-center cohort.

Cardiac involvement is among the leading causes of mortality in patients with systemic sclerosis (SSc). Previously, we demonstrated in a single-center, cross-sectional study the frequent coexistence of different forms of cardiac involvement in systemic sclerosis including pulmonary arterial hypertension (PAH), coronary artery disease (CAD), and microvascular dysfunction (MVD). The aim of the present study was to investigate the prognostic significance of cardiac involvement. One hundred twenty patients with SSc were enrolled. All cases underwent a non-invasive cardiovascular protocol. In 30 patients with suspected cardiac involvement, right heart catheterization and intra-coronary pressure-wire-supplemented coronary angiography were performed. Clinical follow-up was 5 years. Patients with CAD at the baseline showed a trend for higher cardiovascular mortality while in patients with MVD this difference was significant (26.7 % versus 9.5 %, p = 0.077 and 30 % versus 10.1 %, p < 0.05, respectively). Cardiovascular mortality of PAH cases was higher but, however, did not reach statistical significance 21.4 % versus 10.4 %, p = 0.261. Cardiovascular event-free survival was significantly lower among patients with combinations of two or three disorders (p < 0.05). Multivariate analysis of organ involvements and comorbidities showed that the diffuse cutaneous subset, the presence of kidney involvement, the velocity of the tricuspid regurgitation, as well as diabetes mellitus were independent predictors of overall mortality. MVD and CAD alone or in combination with PAH significantly affected the 5-year cardiovascular mortality. These findings highlight the prognostic importance of coronary disease in patients with SSc [ www.clinicaltrials.gov (Reg. Nr.: NCT00843102)].

Search of ligands suitable for 212Pb/212Bi in vivo generators.

The short half-life of 212Bi and 213Bi limits the application of these radionuclides in α radionuclide therapy. The labeling of biomolecules with 212Pb (mother nuclide of 212Bi) instead of 212Bi or 213Bi has the advantage of obtaining a conjugate with a half-life of 10.6 h, compared with of 60 min for 212Bi or 46 min for 213Bi. Previous attempts to prepare a potential in vivo generator with 212Pb complexed by the DOTA chelator failed, because about 36 % of Bi was reported to escape as a result of the radioactive decay [Formula: see text]. Herein, we report studies on the stability of the 212Pb complexes with eight selected polydentate ligands, which demonstrate high affinity for 3+ metal cations. From the ligand studied DOTP and BAPTA show a sufficient 212Pb labeling yields but only 212Pb-DOTP complex is stable in isotonic solution of sodium chloride making this way radioactivity level of released 212Bi is below the limit of detection. It should be emphasized that the DOTP complex is stable only in the case when the concentration of free DOTP exceeds 10-4 M.

Separation of fission produced 106Ru from simulated high level nuclear wastes for production of brachytherapy sources.

An effective and simple process for the isolation of 106Ru from high-level liquid wastes was developed. Radioactive ruthenium was oxidized by H5IO6 in HNO3 solution and was extracted to CCl4 phase in the form of RuO4. In order to obtain ruthenium in the suitable form for production of brachytherapy sources, RuO4 in organic phase was reduced and re-extracted to aqueous phase. The efficiency of extraction of 103Ru to organic phase was 86 %, re-extraction to aqueous solution was near 100 %, so the overall recovery of 103Ru is estimated at more than 80 %.