Novel cardiovascular magnetic resonance oxygenation approaches in understanding pathophysiology of cardiac diseases

Cardiovascular magnetic resonance imaging (CMR) permits accurate phenotyping of many cardiac diseases. CMR’s inherent advantages are its non‐invasive nature, lack of ionizing radiation and high accuracy and reproducibility. Furthermore, it is able to assess many aspects of cardiac anatomy, structure and function. Specifically, it can characterize myocardial tissue, myocardial function, myocardial mass, myocardial blood flow/perfusion, irreversible and reversible injury, all with a high degree of accuracy and reproducibility. Hence, CMR is a powerful tool in clinical and pre‐clinical research. In recent years there have been novel advances in CMR myocardial tissue characterization. Oxygenation‐sensitive CMR (OS‐CMR) is a novel non‐invasive, contrast independent technique that permits direct quantification of myocardial tissue oxygenation, both at rest and during stress. In this review, we will address the principles of the OS‐CMR technique, its recent advances and summarize the studies in the effects of oxygenation on cardiac diseases.     

High rates of advanced disease,complications, and decline of renal function after radical nephroureterectomy

ObjectivesRecurrences remain common following radical nephroureterectomy (RNU) for locally advanced upper-tract urothelial carcinoma (UTUC). We review a cohort of RNU patients to identify the incidence of locally advanced disease, decline in renal function, complications, and utilization of adjuvant chemotherapy (AC).MethodsInstitutional databases from 7 academic medical centers identified 414 RNU patients treated between 2003 and 2012 who had not received neoadjuvant chemotherapy. Glomerular filtration rate was estimated using the Modification of Diet in Renal Disease equation. Complications were classified according to the modified Clavien system. Cox proportional hazard modeling and Kaplan-Meier analysis determined factors associated with cancer-specific survival.ResultsOf 414 patients, 177 (43%) had locally advanced disease, including 118 pT3N0/Nx, 13 pT4N0/Nx, and 46 pTanyN+. Estimated 3- and 5-year cancer-specific survival was 47% and 34%, respectively. Only 31% of patients with locally advanced UTUC received AC. Mean estimated glomerular filtration rate declined from 59 to 51 ml/min/1.73 m² following RNU, including a new-onset decline below 60 and 45 ml/min/1.73 m² in 25% and 15% of patients, respectively (P<0.001 for both). Complications occurred in 46 of 177 (26%) patients, of which one-quarter were grade III or IV. Increasing age (Hazard Ratio (HR) 1.4, P = 0.03), positive surgical margins (HR 2.1, P = 0.01), and positive lymph nodes (HR 4.3, P<0.001) were associated with an increased risk of death from UTUC, whereas receipt of AC (HR 0.85, P = 0.05) was associated with a decrease in UTUC mortality.ConclusionsUnder one-third of RNU patients with locally advanced UTUC cancers received AC. Perioperative complications and decline in renal function may have contributed to this low rate. Such data further underscore the need for continued discussion regarding the use of chemotherapy in a neoadjuvant setting for appropriately selected patients with UTUC.     

Mesoporous superacid catalysts for valorisation of refinery naphtha stream

In the current petroleum refining scenario, many refineries end up with surplus naphtha which is either absorbed into the gasoline pool or exported at unattractive prices. Therefore, several options for naphtha valorisation are currently being explored. The usage of Liquified Petroleum Gas (LPG) as a fuel in heating appliances, cooking equipment and automobiles is rapidly increasing. The high specific calorific value, high octane number, clean and efficient combustion of LPG distinguish it as an extremely promising fuel of the future. In the current work, tungstophosphoric acid (TPA) supported on four different mesoporous silica supports were investigated as mesoporous superacids for hydroconversion of refinery naphtha using n-heptane as a model feedstock. The varied levels of interactions of prepared mesoporous silica with tungstophosphoric acid catalysts were observed to have a prominent effect on the strength of the acid sites generated on silica surfaces and as a result affected heptane hydroconversion activity and selectivity of isomerized and cracked products. Interestingly, activity could be tuned towards selective cracking or isomerization-cracking by selection of a suitable topology of mesoporous silica. Hexagonal Mesoporous Silica (HMS) and plugged SBA-15 supported TPA catalysts demonstrated high n-heptane conversion activity and isomerization selectivity whereas KIT-6 and SBA-15 supported TPA catalysts demonstrated high cracking selectivity to LPG.

TPA silanol interactions in mesoporous TPA silica composites govern the strength of acid sites, activity and selectivity.     

Wavelet Analysis of High-Resolution Signal-Averaged Electrocardiograms in Postinfarction Patients with Bundle Branch Block

Time-domain analysis of the signal-averaged electrocardiogram (SAECG) can accurately predict risk of sustained ventricular tachycardia (VT) in patients with previous myocardial infarction (MI). Unfortunately, these patients often have bundle branch block (BBB) that obscures late potentials. We hypothesized that wavelet analysis might help predict VT risk in patients with BBB. We identified subjects with coronary disease and BBB who had undergone SAECG and programmed ventricular stimulation (PVS). We applied a modulated Gaussian wavelet to transform the ECG signal and looked for singularities in the wavelet coefficients. SAECG and PVS were obtained in 32 patients. Half had inducible sustained monomorphic VT by PVS and half had no inducible VT. There were no significant clinical differences between the groups. Comparing the number of singularities, we found no significant difference between the groups. Compared to previous work in patients without BBB, our patients with BBB had on average four times more singula- rities using an identical analysis technique. In the presence of BBB, abnormal myocardial activation patterns can generate ECG waveforms with time–frequency characteristics similar to those of cardiac late potentials. Wavelet-based methodologies may have limited ability to distinguish late potentials from the disordered ventricular activation occurring with BBB alone.     

Maternal administration of granulocyte colony-stimulating factor improves neonatal rat survival after a lethal group B streptococcal infection

Maternally administered recombinant human granulocyte colony- stimulating factor (rhG-CSF) has been shown to cross the placenta and induce a peripheral neutrophilia and increases in the marrow and spleen neutrophil storage pools in fetal and newborn rats. In the present study, we have used this model system to investigate the efficacy of prenatally administered rhG-CSF on neonatal defense to a lethal challenge with Group B-beta hemolytic Streptococcus (GBS). Pregnant rats were injected with rhG-CSF twice daily beginning 6 days before parturition. At birth, all pups were infected with a dose of GBS that is lethal for 90% of infected pups (LD90). Survival was monitored daily for 5 days. Survival of infected pups from saline-treated mothers beyond 60 hours after infection was 10%. No difference in survival was observed among pups from mothers treated 2 and 4 days before parturition. In contrast, we determined that survival was 82.5% among infected pups from mothers treated for 6 days before parturition with rhG-CSF. Our results demonstrate that maternal administration of rhG- CSF augments neonatal defenses against a lethal bacterial challenge.