Pulmonary valve reconstruction for acquired pulmonary regurgitation in patients with treated congenital heart disease.

OBJECTIVES: Pulmonary valve regurgitation is a common problem after relief of right ventricular outflow tract (RVOT) obstruction with a transannular patch. Pulmonary valve replacement with a homograft or xenograft is the routine treatment. Longevity of biological valves and the availability of homografts are limited. Alternatives to restore RVOT competence are evaluated. The goal of this study was to present intermediate-term results for pulmonary valve reconstruction (PVr) in patients with severe regurgitation. METHODS: PVr was performed in 24 patients (August 2006‒July 2018). We analysed perioperative data, pre- and postoperative cardiac magnetic resonance (CMR) imaging studies, freedom from valve replacement and risk factors for pulmonary valve dysfunction. RESULTS: The underlying diagnoses were tetralogy of Fallot (n = 18, 75%), pulmonary stenosis (n = 5, 20.8%) and the double outlet right ventricle post banding procedure (n = 1, 4.2%). The median age was 21.5 (14.8-23.7) years. Main (n = 9, 37.5%) and branch pulmonary artery procedures (n = 6, 25%) and surgery of the RVOT (n = 16, 30.2%) were often part of the reconstruction. The median follow-up after the operation was 8.0 (4.7-9.7) years. Freedom from valve failure was 96% at 2 and 90% at 5 years. The mean longevity of the reconstructive surgery was 9.9 years (95% confidence interval: 8.8-11.1 years). CMR before and 6 months after surgery showed a reduction in the regurgitation fraction [41% (33-55) vs 20% (18-27) P = 0.00] and of the indexed right ventricular end-diastolic volume [156 ml/m2 (149-175) vs 116 ml/m2 (100-143), P = 0.004]. Peak velocity across the pulmonary valve (determined by CMR) half a year after surgery was 2.0, unchanged. CONCLUSIONS: PVr can be achieved with acceptable intermediate-term results and may delay pulmonary valve replacement.

Modeling the Dynamic Behavior of Radiocesium in Grazing Reindeer.

Radiocesium contamination in Norwegian reindeer and the factors influencing contamination levels have been studied for more than 50 years, providing significant amounts of data. Monitoring contamination in reindeer is of utmost importance for reindeer husbandry and herders in Norway and will need to be studied for many years because of the persistent contamination levels due to the 1986 Chernobyl fallout. This paper presents a novel dynamic model that takes advantage of the large data sets that have been collected for reindeer monitoring to estimate 137Cs in reindeer meat at any given time. The model has been validated using detailed 137Cs data from one of the herds most affected by the fallout. The model basis includes detailed 137Cs soil data from aerial surveys, GPS-based knowledge of reindeer migration, and local soil-to-vegetation 137Cs transfer information. The validation exercise shows that the model satisfactorily predicts both short- and long-term changes in 137Cs concentrations in reindeer meat and suggests that the model will be a useful tool in estimating seasonal changes and evaluating possible remedial actions in case of a future fallout event.

Airborne radiometric survey of a Chernobyl-contaminated mountain area in Norway - using ground-level measurements for validation.

An airborne radiometric survey can be an efficient way to investigate contamination of large areas after nuclear accidents. In the current study, a helicopter borne gamma ray spectrometry survey was carried out in a vast mountainous area in Norway, where the contamination from the 1986 Chernobyl accident still affects animal husbandry more than 30 years after the fallout occurred. The 137Cs activity densities provided by the aerial survey was validated using various independent ground-based measurements - including soil samples and in situ measurements (at 1 m above ground). Despite considerable small-scale heterogeneity, demonstrated by the ground-based measurements, strong correlations were obtained between the results from the aerial survey - after introducing more detailed instrument calibration and spectre analysis - and the ground-level data. Adjusted R2 values were around 0.9, and linear correlation coefficients close to unity.

Modelling Environmental Impacts of Cesium-137 Under a Hypothetical Release of Radioactive Waste.

Waste tanks at the nuclear facility located at Sellafield, UK, represent a nuclear source which could release radionuclides to the atmosphere. A model chain which combines atmospheric transport, deposition as well as riverine transport to sea has been developed to predict the riverine activity concentrations of 137Cs. The source term was estimated to be 9 × 104 TBq of 137Cs, or 1% of the assumed total 137Cs inventory of the HAL (Highly Active Liquid) storage tanks. Air dispersion modelling predicted 137Cs deposition reaching 127 kBq m-2 at the Vikedal catchment in Western Norway. Thus, the riverine transport model predicted that the activity concentration of 137Cs in water at the river outlet could reach 9000 Bq m-3 in the aqueous phase and 1000 Bq kg-1 in solid phase at peak level. The lake and river reaches showed different transport patterns due to the buffering effects caused by dilution and slowing down of water velocity.

Atmospheric transport of radioactive debris to Norway in case of a hypothetical accident related to the recovery of the Russian submarine K-27.

The Russian nuclear submarine K-27 suffered a loss of coolant accident in 1968 and with nuclear fuel in both reactors it was scuttled in 1981 in the outer part of Stepovogo Bay located on the eastern coast of Novaya Zemlya. The inventory of spent nuclear fuel on board the submarine is of concern because it represents a potential source of radioactive contamination of the Kara Sea and a criticality accident with potential for long-range atmospheric transport of radioactive particles cannot be ruled out. To address these concerns and to provide a better basis for evaluating possible radiological impacts of potential releases in case a salvage operation is initiated, we assessed the atmospheric transport of radionuclides and deposition in Norway from a hypothetical criticality accident on board the K-27. To achieve this, a long term (33 years) meteorological database has been prepared and used for selection of the worst case meteorological scenarios for each of three selected locations of the potential accident. Next, the dispersion model SNAP was run with the source term for the worst-case accident scenario and selected meteorological scenarios. The results showed predictions to be very sensitive to the estimation of the source term for the worst-case accident and especially to the sizes and densities of released radioactive particles. The results indicated that a large area of Norway could be affected, but that the deposition in Northern Norway would be considerably higher than in other areas of the country. The simulations showed that deposition from the worst-case scenario of a hypothetical K-27 accident would be at least two orders of magnitude lower than the deposition observed in Norway following the Chernobyl accident.