Surgical repair of a left subclavian artery aneurysm causing stenosis of a left internal mammary graft-a case report

Subclavian artery aneurysms are extremely rare, accounting for approximately 0.1% of peripheral artery aneurysms. We present a case of a proximal left subclavian arterial aneurysm in a patient status post previous coronary artery bypass grafting; the aneurysm was complicated by involvement of the left internal mammary artery that had been previously utilized to revascularize the left anterior descending artery. Ostial stenosis of the internal mammary artery secondary to the aneurysm was present. Simultaneous reoperative coronary bypass surgery and repair of the left subclavian aneurysm was performed, with a good result. This is the second case reported in the literature of concomitant subclavian artery aneurysm repair and coronary revascularization.     

Set-up and routine use of a database of 10 555 genotyped blood donors to facilitate the screening of compatible blood components for alloimmunized patients

Background and Objectives  Large-scale genotyping of blood donors for red blood cell and platelet antigens has been predicted to replace phenotyping assays in the screening of compatible blood components for alloimmunized patients. Although several genotyping platforms have been described, novel procedures and processes are needed to perform genotyping efficiently and to maximize its benefits for blood banks.
Materials and Methods  Here we describe the processes and procedures developed to introduce large-scale genotyping in our routine operations.
Results  Preliminary cost–benefit analysis indicated that genotyping must target frequent blood donors (> 3 donations/year) to be efficiently used. A custom-designed computer application was developed to manage the whole project. It selects frequent donors among recent donations, prints coded labels to identify blood samples sent to the external genotyping laboratory, and stores genotyping results. It can search for donors compatible for any combination of the 22 genotyped antigens as well as consult the current inventory for the presence of the corresponding blood components. The phenotype of recovered components is confirmed by standard serology techniques prior to shipment to hospitals.
Conclusion  Since October 2007, 10 555 blood donors have been genotyped. The database is used on a regular basis to find compatible blood components with a genotype–phenotype concordance of 99·6%.     

Executive control and dimensions of problem behaviors in preschool children

Background: Despite the widespread recognition of the importance of executive control (EC) in externalizing psychopathology, the relation between EC and problem behavior has not been well characterized, particularly in typically developing preschoolers. Method: Using the sample, battery of laboratory tasks, and latent variable modeling methods described in Wiebe, Espy, and Charak (2008) , systematic latent dimensions of parent‐rated problem behavior, measured by integrating scales from developmental and clinical traditions, were determined empirically, and then were related to EC. Results: Substantial relations between EC and problem behaviors were revealed by extracting the common variance of interest and eliminating extraneous variance, which were robust to estimated child intelligence and differed somewhat in preschool boys and girls. Conclusion: Preschool EC measured by laboratory tasks appears to tap abilities that strongly and robustly support broad control processes enabling behavioral regulation across cognitive and emotional domains.     

Schlemm’s canal: more than meets the eye,lymphatics in disguise

Schlemm’s canal (SC) is a unique vascular structure that functions to maintain fluid homeostasis by draining aqueous humor from the eye into the systemic circulation. The endothelium lining the inner wall of SC has both blood and lymphatic vascular characteristics, thus prompting exploration of the development and regulation of this unique channel. In this issue of the JCI, back-to-back papers by Aspelund et al. and Park et al. detail the mechanisms of SC development, which includes a lymphatic reprogramming that is necessary to maintain proper function. Furthermore, both groups exploit the lymph-like qualities of this canal: they identify VEGF-C as a potential therapeutic for glaucoma and suggest that expression of PROX1, a marker of lymphatic fate, could also serve as a biosensor for monitoring SC integrity. These studies provide substantial insight into the molecular and cellular pathways that govern SC development and reveal that ocular pathology is associated with deregulation of the lymph-like characteristics of SC.     

Phase Diagrams Map the Properties of Antiviral Agents Directed against Hepatitis B Virus Core Assembly

Assembly effectors are small molecules that induce inappropriate virus capsid assembly to antiviral effect. To identify attributes of hepatitis B virus (HBV) assembly effectors, assembly reaction products (normal capsid, noncapsid polymer, intermediates, and free dimeric core protein) were quantified in the presence of three experimental effectors: HAP12, HAP13, and AT-130. Effectors bound stoichiometrically to capsid protein polymers, but not free protein. Thermodynamic and kinetic effects, not aberrant assembly, correlate with maximal antiviral activity.