Ongoing transmission of hepatitis B virus in rural parts of the Netherlands, 2009-2013.

Background: Reported acute hepatitis B incidence in the Netherlands reached its nadir in 2013. However, regional signals about increased number of hepatitis B cases raised the question how hepatitis B incidence was distributed over the country. In this study, regional differences in hepatitis B epidemiology were investigated using epidemiological and molecular data.

Laser scoop desobliteration: a method for minimally invasive remote recanalization of chronically occluded superficial femoral arteries.

Stenosis and occlusion of the superficial femoral artery (SFA) are most common in arterial occlusive disease. There are numerous interventional, surgical, and combined approaches to reconstitute maximum blood supply to the lower limb; however, despite intense clinical research, the long-term success rates are still poor. We present the first results with a catheter prototype for laser-based minimal invasive endarterectomy, called laser scoop desobliteration (LSD).

Profiling of cell stress protein expression in cardiac tissue of cardiosurgical patients undergoing remote ischemic preconditioning: implications for thioredoxin in cardioprotection.

Background: Transient episodes of ischemia in a remote organ (remote ischemic preconditioning, RIPC) can attenuate myocardial ischemia/reperfusion injury but the underlying mechanisms of RIPC in the target organ are still poorly understood. Recent animal studies suggested that the small redox protein thioredoxin may be a potential candidate for preconditioning-induced organprotection. Here we employed a human proteome profiler array to investigate the RIPC regulated expression of cell stress proteins and particularly of thioredoxin in heart tissue of cardiosurgical patients with cardiopulmonary bypass (CPB).

In vitro study of coronary flow occlusion in transcatheter aortic valve implantation.

Background: Transcatheter aortic valve implantation (TAVI) has been developed recently for patients with high morbidities and who are believed to be not tolerate standard surgical aortic valve replacement. Nevertheless, the TAVI is associated with complications such as potential obstruction of coronary ostia, mitral valve insufficiency, and stent migration although it seems promising. Impairment of the coronary blood flow after TAVI is catastrophic and it was believed to be associated with the close position of the coronary orifice and the aortic leaflets and valve stent.

German Heart Report 2013.

Objectives: The 25th German Heart Report provides a comprehensive analysis of morbidity and mortality in patients with selected heart diseases as well as services and care in cardiology and cardiac surgery in Germany during the period 2011-2012. It is the result of a multidisciplinary collaboration between the German Heart Foundation, the German Cardiac Society, the German Society for Thoracic and Cardiovascular Surgery, and the German Society of Pediatric Cardiology and is based on data from different sources. In addition, trends of the period from 1995 to 2012 are presented.

German Heart Report 2013.

Objectives: The 25th German Heart Report provides a comprehensive analysis of morbidity and mortality in patients with selected heart diseases as well as services and care in cardiology and cardiac surgery in Germany during the period 2011-2012. It is the result of a multidisciplinary collaboration between the German Heart Foundation, the German Cardiac Society, the German Society for Thoracic and Cardiovascular Surgery, and the German Society of Pediatric Cardiology and is based on data from different sources. In addition, trends of the period from 1995 to 2012 are presented.

Outcome after surgery for acute aortic dissection type A in the elderly: a single-center experience.

Objectives: Despite improvements in surgical and perfusion techniques, surgery for acute aortic dissection type A (AADA) remains associated with high mortality rates. The aim of this study was to evaluate outcome after surgery for AADA in elderly in comparison with the outcome in younger patients.

Methods: Between January 2004 and December 2012, 204 patients underwent operation for AADA.

Neurotransmitter receptor density changes in Pitx3ak mice--a model relevant to Parkinson's disease.

Parkinson's disease (PD) is the second most common neurodegenerative disorder, characterized by alterations of nigrostriatal dopaminergic neurotransmission. Compared to the wealth of data on the impairment of the dopamine system, relatively limited evidence is available concerning the role of major non-dopaminergic neurotransmitter systems in PD. Therefore, we comprehensively investigated the density and distribution of neurotransmitter receptors for glutamate, GABA, acetylcholine, adrenaline, serotonin, dopamine and adenosine in brains of homozygous aphakia mice being characterized by mutations affecting the Pitx3 gene.

[Commentary by the German Society for Thoracic and Cardiovascular Surgery on the positions statement by the German Cardiology Society on quality criteria for transcatheter aortic valve implantation (TAVI)].

Surgical aortic valve replacement is still considered the first-line treatment for patients suffering from severe aortic valve stenosis. In recent years, transcatheter aortic valve implantation (TAVI) has emerged as an alternative for selected high-risk patients. According to the latest results of the German external quality assurance program, mandatory by law, the initially very high mortality and procedural morbidity have now decreased to approximately 6 and 12%, respectively.

TAVI for low-flow, low-gradient severe aortic stenosis with preserved or reduced ejection fraction: a subgroup analysis from the German Aortic Valve Registry (GARY).

Aims: The study analyses the outcome of patients undergoing transcatheter aortic valve implantation (TAVI) for different subtypes of severe aortic stenosis (AS) based on data from the GARY registry.

Methods And Results: Low-EF, low-gradient (LEF-LGAS: EF ≤40%, MPG <40 mmHg), paradoxical low-gradient (PLF-LGAS: EF ≥50%, MPG <40 mmHg) and high-gradient AS (HGAS: MPG ≥40 mmHg) were observed in 11.7% (n=359), 20.

In vivo quantification of the apical fixation forces of different mitral valved stent designs in the beating heart.

The aim of this study was the quantification of the apical fixation forces of mitral valved stents for the first time. A test set-up was developed to measure the forces acting on the apical fixation of mitral valved stents. Twenty pigs received a self-expanding valved stent in the mitral position via a transapical approach in an off-pump procedure.

Development of a new deuterium-deuterium (D-D) neutron generator for prompt gamma-ray neutron activation analysis.

A new deuterium-deuterium (D-D) neutron generator has been developed by Adelphi Technology for prompt gamma neutron activation analysis (PGNAA), neutron activation analysis (NAA), and fast neutron radiography. The generator makes an excellent fast, intermediate, and thermal neutron source for laboratories and industrial applications that require the safe production of neutrons, a small footprint, low cost, and small regulatory burden. The generator has three major components: a Radio Frequency Induction Ion Source, a Secondary Electron Shroud, and a Diode Accelerator Structure and Target.

Off-pump tricuspid valved stent implantation: real-time three-dimensional transesophageal echocardiography for guidance and assessment.

In this case report, the value of real-time three-dimensional transesophageal echocardiography (TEE) for guidance and assessment of orthotopic tricuspid valved stent implantation in the beating heart is assessed in four pigs. A full two-dimensional TEE evaluation of standardized parameters was conducted. Three-dimensional TEE provided dependable imaging of anatomical structures of the right side of the heart, the delivery system, and the valved stent, allowing easier orientation and more accurate views for the surgical team.

Telemedicine-guided, very low-dose international normalized ratio self-control in patients with mechanical heart valve implants.

Aim: To study in patients performing international normalized ratio (INR) self-control the efficacy and safety of an INR target range of 1.6-2.1 for aortic valve replacement (AVR) and 2.

Grain sorghum proteomics: integrated approach toward characterization of endosperm storage proteins in kafirin allelic variants.

Grain protein composition determines quality traits, such as value for food, feedstock, and biomaterials uses. The major storage proteins in sorghum are the prolamins, known as kafirins. Located primarily on the periphery of the protein bodies surrounding starch, cysteine-rich β- and γ-kafirins may limit enzymatic access to internally positioned α-kafirins and starch.

Monte Carlo simulation of explosive detection system based on a Deuterium-Deuterium (D-D) neutron generator.

An explosive detection system based on a Deuterium-Deuterium (D-D) neutron generator has been simulated using the Monte Carlo N-Particle Transport Code (MCNP5). Nuclear-based explosive detection methods can detect explosives by identifying their elemental components, especially nitrogen. Thermal neutron capture reactions have been used for detecting prompt gamma emission (10.

Comparison of different resection tools for human calcified aortic valves.

Objective: Symptomatic severe aortic valve stenosis is a disease primarily found in patients of advanced age. The standard therapy is the aortic valve replacement. Transcatheter aortic valve implantation (TAVI) is a treatment for patients ineligible for conventional aortic valve replacement.

Transapical mitral valved stent implantation: enhanced survival and decreased paravalvular leakages.

Background/objectives: This study presents the recent results of transapical implantation of a new design of a mitral valved stent with up to three months follow-up.

Methods: A self-expanding re-designed mitral valved stent was implanted via transapical approach into the beating heart of eight pigs. Echocardiographic- and hemodynamic parameters were assessed before (n=8), at 1h (n=8), at one month (n=6), at two months (n=2), and at three months (n=1) after implantation and a cardiac CT was conducted.