Symptoms of advanced heart failure—A case for radiofrequency catheter ablation?

A sixty-year-old man with previous history of coronary artery disease was admitted due to progressive worsening of dyspnoea at exertion (NYHA III functional class) and no angina. Coronary angiography confirmed occlusion of the right coronary artery which was naturally bypassed by homocollaterals with TIMI 3 flow to the peripheral branches. The lesion was not technically suitable for percutaneous angioplasty. The left coronary artery was without stenosis. On echocardiography, both the left ventricle and the left atrium were dilated and hemodynamically significant mitral regurgitation was present. Surface ECG showed a left bundle branch block with repeated runs of monomorphic ventricular ectopic beats (PVC). Radiofrequency catheter ablation of the focus in the posteroseptal region of the left ventricle underneath the mitral valve was performed using electroanatomical mapping system. After the procedure, mitral regurgitation decreased and reverse remodeling of the left ventricle and the left atrium occurred with concomitant significant clinical improvement of the patient. The authors discuss several treatment strategies: mitral valve repair surgery combined with revascularization, implantation of a biventricular ICD system or elimination of the focus of monomorphic VT runs by radiofrequency catheter ablation as a possible causal approach in the treatment of PVC-induced cardiomyopathy.     

Interface Behavior and Interface Tensile Strength of a Hardened Concrete Mixture with a Coarse Aggregate for Additive Manufacturing

3D concrete printing technology (3DCP) is a relatively new technology that was first established in the 1990s. The main weakness of the technology is the interface strength between the extruded layers, which are deposited at different time intervals. Consequently, the interface strength is assumed to vary in relation to the time of concrete casting. The proposed experimental study investigated the behavior of a hardened concrete mixture containing coarse aggregates that were up to 8 mm in size, which is rather unusual for 3DCP technology. The resulting direct tensile strength at the layer interface was investigated for various time intervals of deposition from the initial mixing of concrete components. To better understand the material behavior at the layer interface area, computed tomography (CT) scanning was conducted, where the volumetric and area analysis enabled validation of the pore size and count distribution in accordance with the layer deposition process. The analyzed CT data related the macroscopic anisotropy and the resulting crack pattern to the temporal and spatial variability that is inherent to the additive manufacturing process at construction scales while providing additional insights into the porosity formation during the extrusion of the cementitious composite. The observed results contribute to previous investigations in this field by demonstrating the causal relationships, namely, how the interface strength development is determined by time, deposition process, and pore size distribution. Moreover, in regard to the printability of the proposed coarse aggregate mixture, the specific time interval is presented and its interplay with interface roughness and porosity is discussed.     

Fundamental Improvement of Creep Resistance of New-Generation Nano-Oxide Strengthened Alloys via Hot Rotary Swaging Consolidation

New-generation oxide dispersion-strengthened (ODS) alloys with a high volume fraction of nano-oxides of 5% are intended to become the leading creep- and oxidation-resistant alloys for applications at 1100–1300 °C. Hot consolidation of mechanically alloyed powders by intensive plastic deformation followed by heat treatment of the alloys are the key aspects for achieving top creep properties, typically ensured by a coarse-grained microstructure strengthened with homogeneously dispersed, very stable yttrium nano-oxides. The rotary swaging method proves to be favourable for hot consolidation of the new-generation ODS alloy presented. Compared to specimens consolidated by hot rolling, consolidation by hot rotary swaging predetermines the formation of coarse grains with a very high aspect ratio during subsequent secondary recrystallization. Such a grain morphology increases the creep strength of the new-generation ODS alloy considerably.     

Active chi-like sequences are present in the ITS1 region of polyembryonic adult Collyriclum faba trematodes encysted in pairs

Collyriclum faba (Plagiochiida: Collyriclidae) adults occur in pairs within subcutaneous cysts. Here, we tested the extensive C. faba infrapopulation for five DNA loci known to display variability among Central European C. faba individuals. The infrapopulation tested shared 100 % similarity in four of the five mitochondrial and nuclear DNA loci tested. Contrariwise, the internal transcribed spacer 1 (ITS1) loci in all but one individual differed from each other. We found only 0.0–1.5 base substitutions per 1,000 sites within the cysts, while we found 0.7–9.0 substitutions between the cysts of the single host and 3.0–9.0 substitutions when comparing C. faba individuals isolated from different host individuals. We observed the most of the ITS1 variability within 48 bp repetitive sequences featured by the chi-like sequence 5′-GCTTGTCTGCC-3′ at their beginning. Similarly to the extensive C. faba infrapopulation examined, we determined the presence of highly variable number of repetitive sequences within the ITS1 locus of C. faba isolated from multiple host species and from various geographic locations. While similar variability was observed earlier in mutually unrelated specimens of several Schistosomatidae and Microphallidae species, here, we for the first time document it among multiple individuals of a single infracommunity possessing single mitochondrial haplotype. Lower ITS1 evolutionary divergence rates observed between individuals within the cysts when compared to those between the cysts suggest that the recombination occurs at multiple stages of the life cycle. We propose DNA recombination involving chi-like sequences to serve as a general feature shared by multiple families of digenetic trematodes to increase genetic diversity of their polyembryonic populations infecting their definitive hosts.     

The Implication of 1,3‐Dipolar Cycloaddition of Azomethine Ylides to the Synthesis of Main‐Chain Porphyrin Oligomers

The polycycloaddition of azomethine ylides to dipolarophiles is described for the first time. Use of (cis,cis)‐bis‐aziridines as a source of azomethine ylides allows selective polyaddition to be realized, which leads to oligomers exclusively with trans‐substituted pyrrolidine rings and modest molecular weights (ca. 5–10 kDa). The fluorescent, electrochemical, electrochromic, and non‐linear optical properties of the main‐chain free‐base porphyrin oligomer, synthesized by the developed procedure, are studied. An enhancement of the optical power limiting effect in a porphyrin oligomer solution is registered against that of the monomer.

     

The role of imaging to support catheter ablation of atrial fibrillation

Atrial fibrillation (AF) ablation is a complex procedure that requires transseptal puncture and extensive manipulation with catheter(s) in the left atrium and pulmonary veins. Individual anatomy of these structures contributes to a challenge of AF ablation. The proximity of surrounding structures, such as esophagus, further increases risk of complications of this procedure. Increased risk of intracardiac thrombosis associated with AF is another factor that may complicate management of these patients. For all these reasons, imaging techniques play increasingly important role. Preprocedural imaging becomes important not only to rule out thrombus but also for assessment of anatomy of the PVs and left atrium, left atrial size and the extent of a substrate. Various forms of imaging help significantly during the procedure both with identification of anatomy and with catheter navigation. Many studies have shown increased efficacy, safety and decreased fluoroscopy times. After the procedure, imaging techniques such as echocardiography, CT or MR imaging are useful to diagnose potential complications. This paper briefly reviews clinical utility of different imaging tools for ablation of AF.     

The role of endoglin in atherosclerosis

Endoglin (CD 105, TGF-β receptor III) is a homodimeric transmembrane glycoprotein that plays a regulatory role in TGF-β signaling. Its functional role in the context of atherosclerosis has yet to be defined and should be stated here. Therefore, we focused on the role of endoglin in atherosclerosis in both humans and experimental animals. Endoglin expression was demonstrated in atherosclerotic vessels predominantly in endothelial cells and smooth muscle cells in various types of blood vessels in mice and humans, suggesting its participation in atherogenesis. Endoglin expression was also related to the expression of eNOS in endothelium, repair of the vessel wall, plaque neoangiogenesis, production of collagen and stabilization of atherosclerotic lesions. In addition, increased levels of soluble endoglin were associated with hypercholesterolemia, atherosclerosis, acute myocardial infarction and were related to inhibition of TGF-β signaling in the vessel wall. Moreover, soluble endoglin levels were significantly lowered after a series of extracorporeal eliminations in patients with familial hypercholesterolemia. Additionally, statin treatment decreased levels of soluble endoglin and increased its expression in aorta, which was related to reduced atherosclerosis in mice. In conclusion, we propose that measurement of soluble endoglin might give information about progression of the atherosclerotic process or the efficacy of therapeutic interventions, which is the task that must be answered in clinical trials.     

Conversion of the chill susceptible fruit fly larva (Drosophila melanogaster) to a freeze tolerant organism

Among vertebrates, only a few species of amphibians and reptiles tolerate the formation of ice crystals in their body fluids. Freeze tolerance is much more widespread in invertebrates, especially in overwintering insects. Evolutionary adaptations for freeze tolerance are considered to be highly complex. Here we show that surprisingly simple laboratory manipulations can change the chill susceptible insect to the freeze tolerant one. Larvae of Drosophila melanogaster, a fruit fly of tropical origin with a weak innate capacity to tolerate mild chilling, can survive when approximately 50% of their body water freezes. To achieve this goal, synergy of two fundamental prerequisites is required: (i) shutdown of larval development by exposing larvae to low temperatures (dormancy) and (ii) incorporating the free amino acid proline in tissues by feeding larvae a proline-augmented diet (cryopreservation).