Relevant correlation of Galectin-3 with a novel morphological classification system for LAA closure – the end of echocardiographic follow up after occluder implantation?

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
F Haertel ◽  
A Hamadanchi ◽  
S Ijuin ◽  
P Lustermann ◽  
K Gruen ◽  
...  
Keyword(s):  
Classification System ◽  
Tissue Remodeling ◽  
Type A ◽  
Serum Levels ◽  
Significant Negative Correlation ◽  
Type B ◽  
Cardiovascular Tissue ◽  
Device Type ◽  
Galectin 3 ◽  
Type C

Abstract Introduction Echocardiographic detection of residual peri-device leakage (PDL) after percutaneous left atrial appendage closure (LAAC) remains crucial. Significance of PDL and cardiac tissue remodeling after LAAC are still poorly understood but might have diagnostic implications. This study aims to characterize and verify if a novel echocardiographic classification system to asses the success of LAAC in combination with quantifiable biomarkers of cardiovascular tissue remodeling can help in the prediction of PDL. Methods Patients eligible for LAAC were included. Serum levels of the cardiac remodeling marker Galectin-3 were determined before device implantation (baseline), 45 days (45d) and 6 months (6M) after LAAC using ELISAs. Transesophageal echocardiography (TEE) was carried out to assess success of the LAAC procedure. All echo images were retrospectively evaluated by two independent investigators. Based on the amount of echodensity and luceny inside the devices after LAAC, three types can be distinguished that grade the degree of closure of the LAA. Type A has complete homogenous echodensity in 0, 45, 90 and 135°, indicating completely thrombosed device. Type B shows inhomogeneous echo-lucencies (<50% of device). Type C describes a partially thrombosed device with echo-lucencies >50%. Novel classification according to Hamadanchi, Jena, Germany (Fig. 1). Results We included 44 patients (characteristics listed in Table 1). Complete LAAC (without any residual flow) was achieved in 64% (28 patients) after 45 days and in 80% (35 patients) after 6 months. Mean PDL diameter was 3.5±1.5mm. Type A showed the lowest rate of PDL after 45d (Type A: 22% vs. Type B: 33% vs. Type C: 88%; p=0.007) and after 6M (Type A: 12% vs. Type B: 28% vs. Type C: 100%; p=0.002). Galectin-3 levels did not show a relevant difference regarding the type of AF at baseline (paroxysmal AF: 11.7±5.4 ng/ml vs. permanent AF: 12.1±6.3 ng/ml; p=0.45). We observed a significant increase and distribution of serum levels of Galectin-3 [ng/ml] after 45 days among the three types (Baseline: 13.1±5.8; 45d: 16.3±7.2 (Type A) vs. 19.2±8.6 (Type B) vs. 25.8±9.4 (Type C); p=0.031) followed after 6 months by a drop of Galectin-3 for type A and B toward and below baseline levels (6M: 8.9±3.1 (Type A) vs. 12.4±5.5 (Type B)) whereas type C persisted in showing elevated Galectin-3 levels compared to all other types (6M: 17.5±4.5 (Type C); p<0.001), Fig. 2. Correlation analysis shows a significant negative correlation trend between Galectin-3 and mean PDL diameter (−0.51; p=0.016) after 45 days and a relevant positive correlation after 6 months (0.58; p=0.017). Conclusion After LAAC, Galectin-3 levels are elevated, as a marker of myocardial fibrosis in the LAA. Depending on the degree of closure of the LAA, Galectin-3 decreases to the baseline level or stays elevated in case of relevant PDL and could therefore be considered as a new biomarker for closure success. Funding Acknowledgement Type of funding source: None

scholarly journals Dynamics of Galectin-3 serum levels after percutaneous occlusion of the left atrial appendage: a new surrogate parameter for successful LAA closure?

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
F Haertel ◽  
S Ijuin ◽  
P Lustermann ◽  
K Gruen ◽  
A Hamadanchi ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Tissue Remodeling ◽  
Serum Levels ◽  
Atrial Appendage ◽  
Left Ventricular Ejection ◽  
Bleeding Complications ◽  
Tenascin C ◽  
Galectin 3

Abstract Introduction Left atrial cardiac tissue remodeling following left atrial appendage closure (LAAC) is a scientifically neglected phenomenon until now but might have impact on functional outcome of patients suffering from atrial fibrillation (AF). Thus, our study is focused on quantification of key biomarkers reflecting fibrosis development as a major component within cardiovascular tissue remodeling. Methods Patients (CHA2DS2VASC score ≥1, HASBLED score ≥3) with bleeding complications under anticoagulation therapy and therefore eligible for LAAC were included in the present study. Serum levels of biomarkers of cardiac fibrosis and remodeling (Galectin-3, ST2/IL-2, ST2/IL-1, B domain containing Tenascin-C (B+ Tn-C), C domain containing Tenascin- C (C+ Tn-C)) were determined before device implantation (baseline), 45 days (45d) and 6 months (6M) after LAAC using commercially available ELISAs. To quantify functional outcome, all patients performed a 6-minutes walk test (6- MWT). Transesophageal echocardiography (TEE) was carried out to assess success of the LAAC procedure regarding peri-device leakage (PDL). Results We included 33 patients (age: 73.5±6.7 years; 21 men (64%) and 12 women (36%); BMI: 29.1±5.1 kg/m2; CHA2DS2VASC score: 4.2±1.2; left ventricular ejection fraction: 61.1±9.3%; mean occluder size: 25.9±3.9 mm; type of AF: 46% paroxysmal (15 patients), 55% permanent (18 patients)). Complete LAAC (without any residual low) was achieved in 60% (19 patients) after 45 days and in 87% (29 patients) after 6 months. At baseline, Galectin-3 levels did not show a relevant difference regarding the type of AF (paroxysmal AF: 14.7±5.4 ng/ml vs. permanent AF: 13.1±6.3 ng/ml; p=0.45). We observed a significant increase of serum levels of Galectin-3 [ng/ml] after 45 days vs. baseline (baseline: 13.3±5.8 vs. 45d: 18.3±10.6; p=0.005) with a return to baseline levels after 6 months (baseline: 13.3±5.8 vs. 6M: 12.5±5.4; p=0.28). Compared to patients with successful LAAC, patients with PDL had a trend towards higher levels of Galectin-3 after 6 months (11.3±5.5 ng/ml vs. 16.1±4.1 ng/ml, p=0.09). Measurements of other fibrosis markers were statistically not significantly different. The walking distance measured by the 6-MWT increased significantly from 298.5±89.5 meters at baseline to 335.5±95.1 meters (p=0.04) after 45d and remained significantly elevated after 6M (346.7±122.7 meters; p=0.02). Conclusion The implantation of an LAA occluder device is accompanied by significantly increased circulating levels of the fibrosis biomarker Galectin-3 after 45 days in patients with AF. The regression in serum levels after 6 months probably reflects a successful fibrotic remodeling in the left atrial appendage over time and might be used as surrogate parameter for LAAC success. Increased and stable exercise tolerance after 45 days can be observed. Funding Acknowledgement Type of funding source: None

scholarly journals The effectiveness of TiO2 additions to mortar to maintain initial conditions in terms of its reflectance to solar radiation

2017 ◽  
Vol 17 (3) ◽  
pp. 39-56 ◽  
Author(s):  
Sérgio Roberto Andrade Dantas ◽  
Fulvio Vittorino ◽  
Kai Loh
Keyword(s):  
Solar Radiation ◽  
Ultraviolet Radiation ◽  
Initial Conditions ◽  
Type A ◽  
Just Noticeable Difference ◽  
Type B ◽  
Climate Conditions ◽  
Type D ◽  
Type C ◽  
Over Time

Abstract Contact of facades with degradation agents and direct incidence of ultraviolet radiation on external coatings make them more opaque over time, affecting their colour and reflectance characteristics. This study evaluated the effect of adding different TiO2 contents to mortars applied in concrete substrates in order to verify the reflectance maintenance on surfaces after exposure over time. Mortar with different concentrations of TiO2 (1%, 5%, 10%) were produced in relation to the total dry premix, added as a powder and compared to unpainted mortar without TiO2 (type "A") and painted mortar without TiO2 (type "B"), both used as a reference for colour and reflectance. Exposed over 16 months to climate conditions in São Paulo, regarding the maintenance of reflectance and solar radiation, the results showed that type "B" (0%TiO2) painted mortar presented the best performance. Type "C" (1%TiO2) and type "D" (5%TiO2) unpainted mortar remained more stable. Type "A" (0%TiO2) and type "E" (10%TiO2) unpainted mortar showed greater differences according to the Just Noticeable Difference (JND) range caused by dirt pick up.

Judgments of Grammatically by Normal and Language-Disordered Children

1977 ◽  
Vol 42 (2) ◽  
pp. 199-209 ◽  
Author(s):  
Betty Z. Liles ◽  
Martin D. Shulman ◽  
Susan Bartlett
Keyword(s):  
Word Order ◽  
Sentence Type ◽  
Type A ◽  
Order Type ◽  
Specific Reference ◽  
Type B ◽  
Normal Children ◽  
Grammatical Errors ◽  
Type C

Fifteen linguistically normal children and 15 linguistically deviant children were presented with three types of agrammatical sentences. The subjects were asked to judge the sentences as right or wrong and to change the sentences judged as wrong, rendering them correct. The three types of agrammatical sentences represented rule violations of syntactic agreement (Type A), lexical restrictions (Type B), and word order (Type C). The two groups of children were compared in terms of the number of sentences of each type that were recognized as agrammatical. Those productions which represented the child’s correction of agrammatical sentences were subjected to descriptive analyses (percentages) with specific reference to the number of attempted changes and the number of those changes which demonstrated corrections of the specific deviation from well formedness. Results indicated that the two groups of subjects were significantly different in their ability to recognize grammatical errors in sentence Types A and C, but did not differ in their ability to recognize errors in sentence Type B. The descriptive comparison of the groups' verbal corrections reflected this trend, in that the language-disordered subjects made corrections specific to the error on more of the Type B sentences (for example, “The dog writes the food.”) than on Types A (for example, “'She will pick some flowers last week.”) or C (for example, “Get and come your dinner.”). Linguistically normal children accurately corrected 90.7% of the sentences judged as agrammatical; this percentage did not vary more than 1% across sentence types.

scholarly journals Structural and fractal characterization of adsorption pores of middle–high rank coal reservoirs in western Yunnan and eastern Guizhou: An experimental study of coals from the Panguan syncline and Laochang anticline

2018 ◽  
Vol 37 (1) ◽  
pp. 251-272 ◽  
Author(s):  
Junjian Zhang ◽  
Chongtao Wei ◽  
Gaoyuan Yan ◽  
Guanwen Lu
Keyword(s):  
Specific Surface ◽  
Surface Area ◽  
Specific Surface Area ◽  
Pore Volume ◽  
Pore Diameter ◽  
Structural Parameters ◽  
Total Pore Volume ◽  
Type A ◽  
Type B ◽  
Type C

To better understand the structural characteristic of adsorption pores (pore diameter < 100 nm) of coal reservoirs around the coalbed methane production areas of western Yunnan and eastern Guizhou, we analyzed the structural and fractal characteristics of pore size range of 0.40–2.0 nm and 2–100 nm in middle–high rank coals ( Ro,max = 0.93–3.20%) by combining low-temperature N2/CO2 adsorption tests and surface/volume fractal theory. The results show that the coal reservoirs can be divided into three categories: type A ( Ro,max < 2.15%), type B (2.15% <  Ro,max <2.50%), and type C ( Ro,max > 2.15%). The structural parameters of pores in the range from 2 to 100 nm are influenced by the degree of coal metamorphism and the compositional parameters (e.g., ash and volatile matter). The dominant diameters of the specific surface areas are 10–50 nm, 2–50 nm, and 2–10 nm, respectively. The pores in the range from <2 nm provide the largest proportion of total specific surface area (97.22%–99.96%) of the coal reservoir, and the CO2-specific surface area and CO2-total pore volume relationships show a positive linear correlation. The metamorphic degree has a much greater control on the pores (pore diameter less than 2 nm) structural parameters than those of the pore diameter ranges from 2 to 100 nm. Dv1 and Dv2 can characterize the structure of 2–100 nm adsorption pores, and Dv1 (volume heterogeneity) has a positive correlation with the pore structural parameters such as N2-specific surface area and N2-total pore volume. This parameter can be used to characterize volume heterogeneity of 2–10 nm pores. Dv2 (surface heterogeneity) showed type A > type B > type C and was mainly affected by the metamorphism degree. Ds2 can be used to characterize the pore surface heterogeneity of micropores in the range of 0.62–1.50 nm. This parameter has a good correlation with the pore parameters (CO2-total pore volume, CO2-specific surface area, and average pore size) and is expressed as type C < type B < type A. In conclusion, the heterogeneity of the micropores is less than that of the meso- and macropores (2–100 nm). Dv1, Dv2, and Ds2 can be used as effective parameters to characterize the pore structure of adsorption pores. This result can provide a theoretical basis for studying the pore structure compatibility of coal reservoirs in the region.

scholarly journals Postsurgical residual lung complications following left upper trisegmentectomy

2019 ◽  
Author(s):  
Yutaro Koike ◽  
Aritoshi Hattori ◽  
Takeshi Matsunaga ◽  
Kazuya Takamochi ◽  
Shiaki Oh ◽  
...  
Keyword(s):  
Surgical Intervention ◽  
Type A ◽  
X Rays ◽  
Limited Information ◽  
Type B ◽  
Type D ◽  
Thoracic Computed Tomography ◽  
Isolated Segment ◽  
Type C ◽  
Lung Torsion

AbstractOBJECTIVESSegmentectomy has become an increasingly popular surgical procedure for small-sized lung lesions. Left upper trisegmentectomy (LUTS) is one of the most common segmentectomies performed because of its relative ease and simplicity; however, limited information is currently available on the specific postoperative complications associated with this procedure.METHODSAmong 2060 surgically resected cases in our institute between 2009 and 2016, 129 (6.2%) underwent LUTS. Postoperative chest X-rays and/or thoracic computed tomography (CT) scans were retrospectively assessed for all cases to assess postsurgical residual lung complications following LUTS. We categorized cases into 4 groups: type A (atelectasis of the lingular segment), type B (lung torsion of the lingular segment), type C (necrosis of the ‘isolated segment’) and type D (haematoma along stapling lines).RESULTSPostsurgical lung complications following LUTS were observed in 17 (13.1%) patients (type A: n = 7, type B: n = 1, type C: n = 4 and type D: n = 5). Three patients (2.3%) required surgical intervention because of type B (n = 1) and type C (n = 2), namely, decreased permeability and remaining ground glass opacities in the residual lung, showing an exacerbated systemic inflammatory response. In contrast, type A and D cases were successfully observed by chest CT without any surgical intervention, and patients recovered within a few months of surgery.CONCLUSIONSWe identified several postoperative residual lung complications following LUTS. Lung torsion or necrosis of the residual segment may require intensive care, including reoperation. Potentially serious complications always need to be ruled out after LUTS when radiological consolidation is detected postoperatively.

Research on Flow Units of Extra-Low Permeability Reservoirs in Fault Block Sheng554 of Shengping Oilfield

2013 ◽  
Vol 295-298 ◽  
pp. 3162-3165
Author(s):  
Lu Lu Zhou ◽  
Zi Nan Li ◽  
Jun Gang Liu ◽  
Yan Yun Zhang ◽  
Guang Qiang Shu
Keyword(s):  
Fluid Flow ◽  
Water Injection ◽  
Type A ◽  
Low Permeability ◽  
Type B ◽  
Flow Units ◽  
Fault Block ◽  
Remaining Oil ◽  
Type C ◽  
Low Permeability Reservoirs

Taking the example of the fourth member of the Lower Cretaceous Quantou formation reservoirs in fault block Sheng554 of Sanzhao sag, this article discusses the methodology of flow units in extra-low permeability reservoirs. The research on flow units in such reservoirs can be divided into two ranks, one is to determine the distribution of seepage barriers and inner connected sands， the other is to analyze the differentia of fluid flow in the inner connected sands so as to subdivide the flow units. The result shows that the pelitic barriers are rather developed in fault block Sheng554. Through the analysis of differentia of fluid flow, according to the value of flow zone index (FZI), the inner connected sands can be classified into three types of flow units, among which type A with FZI value greater than 1.0 has better permeable property and higher intensity of water injection, and the ability of permeability and water injection of type B with FZI value between 0.5 and 1.0 takes the second place, and type C is the worst flow unit with the worst permeable property and intensity of water injection with FZI value less than 0.5. Among the three types of flow units, type A poorly develops, while type B and type C develops well. The research on flow units can provide reliable geologic bases for forecasting the distribution of remaining oil in extra-low permeability reservoirs and for developing remaining oil in the study area.

A New Classification of Cochleovestibular Malformations and Implications for Predicting Speech Perception Ability after Cochlear Implantation

2015 ◽  
Vol 20 (2) ◽  
pp. 90-101 ◽  
Author(s):  
Sung-Wook Jeong ◽  
Lee-Suk Kim
Keyword(s):  
Speech Perception ◽  
Cochlear Implantation ◽  
Test Scores ◽  
Type A ◽  
Cochlear Nerve ◽  
Type B ◽  
New Classification ◽  
Type D ◽  
Type C

Objectives: The aims of this study were to introduce a new classification of cochleovestibular malformation (CVM) and to investigate how well this classification can predict speech perception ability after cochlear implantation in children with CVM. Methods: Fifty-nine children with CVM who had used a cochlear implant for more than 3 years were included. CVM was classified into 4 subtypes based on the morphology of the cochlea and the modiolus on temporal bone computed tomography (TBCT): normal cochlea and normal modiolus (type A, n = 16), malformed cochlea and partial modiolus (type B, n = 31), malformed cochlea and no modiolus (type C, n = 6), and no cochlea and no modiolus (type D, n = 6). Speech perception test scores were compared between the subtypes of CVM using analysis of covariance with post hoc Bonferroni test. Univariate and multivariate regression analyses were used to identify the significant predictors of the speech perception test scores. Results: The speech perception test scores after implantation were significantly better in children with CVM type A or type B than in children with CVM type C or type D. The test scores did not differ significantly between the implanted children with CVM type A or type B and those without CVM. In univariate regression analysis, the type of CVM was a significant predictor of the speech perception test scores in implanted children with CVM. Multivariate regression analysis revealed that the age at cochlear implantation, cochlear nerve size and preimplantation speech perception test scores were significant predictors of the postimplantation speech perception test scores. The chance of cochlear nerve deficiency increased progressively from CVM type A to type D. Conclusion: The new classification of CVM based on the morphology of the cochlea and the modiolus is simple and easy to use, and correlated well with postimplantation speech perception ability and cochlear nerve status. This simple classification of CVM using TBCT with cochlear nerve assessment by magnetic resonance imaging is helpful in the preoperative evaluation of children with CVM.

scholarly journals Variability of repairable bicuspid aortic valve phenotypes: towards an anatomical and repair-oriented classification†

2019 ◽  
Vol 56 (2) ◽  
pp. 351-359 ◽  
Author(s):  
Laurent de Kerchove ◽  
Stefano Mastrobuoni ◽  
Lennart Froede ◽  
Saadallah Tamer ◽  
Munir Boodhwani ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Bicuspid Aortic Valve ◽  
Classification System ◽  
Type A ◽  
Aortic Insufficiency ◽  
Aortic Dilatation ◽  
Valve Repair ◽  
Type C ◽  
Anatomical Parameters ◽  
Repair Techniques

AbstractOBJECTIVESThe bicuspid aortic valve (BAV) exists in a wide variety of valve phenotypes. The aim of this study was to assess the anatomical characteristics of the different phenotypes and develop a classification system to aid surgical repair.METHODSIn 178 consecutive patients operated on for aortic insufficiency or aortic dilatation in 2 centres, 11 anatomical parameters of BAV were measured by echocardiography and intraoperatively. All BAV judged potentially repairable were included in the study.RESULTSCommissural orientation correlated positively with fusion length (R2 = 0.6, P < 0.001) and negatively with non-functional commissure height (R2 = 0.45, P < 0.001). The cohort was divided into 3 groups according to their commissural orientation (type A: symmetrical, 160–180°, n = 73; type B: asymmetrical, 140–159°, n = 74; and type C: very asymmetrical, 120–139°, n = 31). The patterns of cusp fusion, annulus and aortic size were similar among the groups. Fusion length and the geometric height of the cusps decreased from type A to C; non-functional commissure height increased from type A to C (P < 0.05). Patient age increased from type A to type C. Isolated aortic dilatation was more frequent in type A, and severe aortic insufficiency was more frequent in types B and C (P < 0.05). Valve repair techniques and management of commissural orientation varied among the 3 groups (P < 0.05). Aortic valve replacement and residual aortic insufficiency after repair were more frequent in type C (P < 0.05).CONCLUSIONSThe BAV phenotypes follow a continuous spectrum that extends from symmetrical to very asymmetrical BAV. We describe the main anatomical parameters (including commissure orientation, length of fusion and non-functional commissure height) and their variation across this spectrum. We propose a new repair-oriented classification system based on those parameters that can be used to predict valve repair techniques. This classification needs further validation with regards to surgical techniques and long-term outcomes.

GROUPING OF ISOLATES OF A LOW-TEMPERATURE BASIDIOMYCETE ON THE BASIS OF CULTURAL BEHAVIOR AND PATHOGENICITY

1961 ◽  
Vol 39 (2) ◽  
pp. 297-306 ◽  
Author(s):  
E. W. B. Ward ◽  
J. B. Lebeau ◽  
M. W. Cormack
Keyword(s):  
Low Temperature ◽  
Host Plants ◽  
Type A ◽  
Effect Of Temperature ◽  
Western Canada ◽  
Type B ◽  
Highly Pathogenic ◽  
Cultural Behavior ◽  
Type C ◽  
Ph Range

Isolates of an unidentified low-temperature basidiomycete, associated with snow mold in Western Canada, were divided into three types, A, B, and C, on the basis of their general cultural appearance. Support for this classification was obtained when representative isolates of each type were examined to determine: the effect of temperature and pH on growth; tolerance of antibiotics and HCN; ability to liberate HCN in culture and in the host plant; pathogenicity.Type A isolates grew slowly under most conditions and were least tolerant of the extremes of temperature and pH employed, moderately inhibited by antibiotics, and strongly inhibited by HCN. They produced HCN in large quantities in host plants and none in culture. They were moderately pathogenic on grass and highly pathogenic on alfalfa. Type B isolates grew somewhat more rapidly than type A, especially at the upper and lower temperatures, and grew over a wider pH range. These isolates were more tolerant of antibiotics and HCN. They produced smaller quantities of HCN than type A in infected alfalfa plants but released large amounts in culture. They were less pathogenic than type A on alfalfa but similarly pathogenic on grass. Type C isolates were fast-growing forms which were strongly inhibited by antibiotics and HCN. They did not liberate HCN under any conditions and were not pathogenic.

A Molecular Dynamics Simulation Study on the Relationship between Hydrogen Bond and Damping Properties of AO-70/NBR Composites

2017 ◽  
Vol 748 ◽  
pp. 29-34 ◽  
Author(s):  
Jing Zhu ◽  
Xiu Ying Zhao ◽  
Meng Song ◽  
Yue Han ◽  
Li Liu ◽  
...  
Keyword(s):  
Md Simulation ◽  
Type A ◽  
Dynamics Simulation ◽  
Butadiene Rubber ◽  
Damping Properties ◽  
Type B ◽  
Fractional Free Volume ◽  
Type C ◽  
Hindered Phenol ◽  
The Relationship

This work was try to study the number and types of hydrogen bonds (H-bonds) formed in hindered phenol AO-70/nitrile butadiene rubber (NBR) composites and their contributions to the damping properties by molecular dynamic (MD) simulation and experimental methods. MD simulation results showed that there were four types of H-bonds, namely, type A (AO-70) –OH...NC– (NBR) H-bonds in AO-70/NBR composites, type B (AO-70) –OH...O=C– (AO-70) H-bonds, type C (AO-70) –OH...OH–(AO-70) and D (AO-70) –OH...O–C– (AO-70) H-bonds, what's more, type A and type B H-Bonds formed more easily than others. Fourier transform infrared spectroscopy (FTIR) confirmed the existence of H-bonds. Meanwhile, the AO-70/NBR composites with AO-70 content of 109 phr had the largest number of H-bonds, smallest fractional free volume (FFV) and resulting in the optimistic damping performance of the composites.

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