P1577 Mitral regurgitant "splay": an important clue to severity of regurgitation

Background Visual assessment of mitral regurgitation (MR) severity by color Doppler can be difficult, especially in eccentric jets. Examination of the proximal flow acceleration signal (PISA) on the ventricular side of the mitral valve can be helpful but, is not always intuitive. We describe a color signal ("splay") on the atrial side of the valve that can often be helpful in recognizing significant MR. Methods Clinical echocardiograms were reviewed to obtain two data sets: 100 patients with reported mild MR and another 100 with reported severe MR. All echocardiograms were reviewed to confirm that MR was truly mild or severe. Splay was defined as a non-physiologic arc of color (figure) centered at the point where the MR jet emerges into the atrium. Results Splay was present in the large majority of severe MR cases (table). It was seen across 3 vendors’ machines and was present with normal and reduced EF as well as primary and secondary MR. Color scale and transducer frequency did not differ according to presence or absence of splay, but gain was higher when splay was present (57.5 ± 6.8 vs 55.2 ± 6.1, p = 0.04). In mild MR patients, splay was present on fewer frames and had lesser dimensions vs severe MR. Splay was particularly prevalent in patients with wall hugging jets (28/30, 93%). Conclusions The splay signal occurs as a side lobe artifact, at the point where a high energy MR jet emerges into the left atrium. Its presence often indicates significant MR and may be a useful clue in highly eccentric jets which are otherwise difficult to grade. Table 1 Mild MR Severe MR P value Splay Present (%) 18 82 <0.0001 No. of Frames 2 ± 1.6 3.6 ± 1.3 <0.0001 Width of Splay (cm) 2.2 ± 0.5 3.2 ± 0.9 <0.0001 Depth of Splay (cm) 0.36 ± 0.11 0.47 ± 0.16 0.01 Abstract P1577 Figure. Splay Image

Research of properties of traditional Carpathian cheeses

The purpose of the work was to investigate the organoleptic, physico-chemical and microbiological indices of traditional Carpathian cheeses, in particular, brynza, butz and vurda, made directly on the mountain valleys with traditional technology in Rakhiv district of the Transcarpathian region. Of 16 samples of cheese, 13 samples were cheese butz (samples 1, 2, 3, 5, 6, 7, 8, 9, 10, 11, 12, 13, 15); vurda cheese (samples 4 and 16) and cheese of brynza a year ago (sample 14). Experimental studies of organoleptic, physico-chemical and microbiological parameters of cheese samples were carried out in the laboratory of the milk and milk products department and in the department of biotechnology at Rzeszow University (Poland). In samples of cheese, organoleptic parameters were studied in accordance with GOST 7616-85; active acidity – by potentiometric method using the pH meter of the ARN-9 brand; titrated acidity – titrarily (in degrees Turner) according to GOST 3624-67. The mass fraction of salt in the cheese was determined by titration of the extract with nitric oxide silver (GOST 3627-81). The detection of bacteria of the genus Staphylococcus aureus was determined by sowing on a solid Gissa with mannitol, with further detection and confirmation of the belonging of the grown colonies to Staphylococcus aureus (GOST 30347-97). The detection of bacteria of the genus Salmonella was determined by sowing on the Endo solid medium (GOST 31659-2012). The bacteria of the intestinal stem group were determined by sowing on a Kessler liquid medium (GOST 9225-84). Cultivation of microorganisms was carried out at temperature +37 °С for 48 h. According to researches of organoleptic parameters of cheeses it was found that samples of cheese butz were characterized by sour milk, and samples of 3 and 5 sour taste and aroma, a dense humus consistency and from gray to white color. Figure – with single small and large bodies of irregular shape. According to studies of organoleptic parameters of cheese, the taste and aroma of the product should be given – light sour milk, salted, which is confirmed by the salt content – 4.6%. Consistency was crumbly, the color was yellow. Samples of cheese vurda were characterized by delicate butter, sour milk taste and smell, paste, crumbly consistency and white color. Analyzing the acidity of butz cheese it was that it was high particularly in samples 3, 8 and 14, which was reflected in organoleptic parameters. In the samples of vurda titrated acidity was 75 °T in sample 4 (pH 5.7) and 16 °T in sample 16 (pH 6.4), while brynza was characterized by the highest acidity – 260 °T (pH 4.9). According to microbiological parameters, all specimens were characterized by the presence of pathogenic microflora. In particular, 1, 3, 5–9, 11–15 samples showed Staphylococcus aureus, 10 sample of Staphylococcus epidermis, 2 sample of bacteria of the genus Salmonella, 16 sample of Enterobacter aerogenes, and 4 samples of mold.