Left ventricular free wall rupture caused by myocardial ischemia without treatable atherosclerotic coronary disease: a case series.

Background: The clinical presentation of left ventricular free wall rupture (LVFWR) varies ranging from uneventful condition to congestive heart failure. Here we report two cases of LVFWR with different clinical presentation and notable outcome. A 53-year-old male presenting emergently with signs of myocardial infarction received immediate coronary angiography and thoracic CT-scan showing occlusion of the first marginal coronary branch without possibility of revascularization and minimal pericardial extravasation.

Mechanical modeling of mechanosensitive insect strain sensors as a tool to investigate exoskeletal interfaces.

During walking, sensory information is measured and monitored by sensory organs that can be found on and within various limb segments. Strain can be monitored by insect load sensors, campaniform sensilla (CS), which have components embedded within the exoskeleton. CS vary in eccentricity, size, and orientation, which can affect their sensitivity to specific strains.

Subsets of leg proprioceptors influence leg kinematics but not interleg coordination in Drosophila melanogaster walking.

Legged locomotion in terrestrial animals is often essential for mating and survival, and locomotor behavior must be robust and adaptable to be successful. This adaptability is largely provided by proprioceptors monitoring positions and movements of body parts and providing feedback to other components of locomotor networks. In insects, proprioceptive chordotonal organs span joints and encode parameters of relative movement between segments.

Ultra high-resolution biomechanics suggest that substructures within insect mechanosensors decisively affect their sensitivity.

Insect load sensors, called campaniform sensilla (CS), measure strain changes within the cuticle of appendages. This mechanotransduction provides the neuromuscular system with feedback for posture and locomotion. Owing to their diverse morphology and arrangement, CS can encode different strain directions.

Risk factors for postoperative delirium after cardiac surgical procedures with cardioplegic arrest.

Objectives: The pathophysiology of delirium after cardiac surgery is complex. The present study aims to determine perioperative risk factors and construct a scoring system for postoperative delirium based on the type of surgery.

Methods: Three hundred patients undergoing coronary artery bypass grafting (CABG; n = 150) or valve and/or aortic surgery ± CABG (n = 150) were retrospectively evaluated.

Video-assisted minimal access surgery for complicated mitral valve endocarditis, tricuspid valve insufficiency and progressive coronary disease after previous CABG - in the time of COVID-19: a case report.

Background: The timing for heart surgery following cerebral embolization after cardiac valve vegetation is vital to postoperative recovery being uneventful, additionally Covid-19 may negatively affect the outcome. Minimally invasive methods and upgraded surgical instruments maximize the benefits of surgery also in complex cardiac revision cases with substantial perioperative risk.

Case Presentation: A 68 y.

Gradients in mechanotransduction of force and body weight in insects.

Posture and walking require support of the body weight, which is thought to be detected by sensory receptors in the legs. Specificity in sensory encoding occurs through the numerical distribution, size and response range of sense organs. We have studied campaniform sensilla, receptors that detect forces as strains in the insect exoskeleton.

Location and arrangement of campaniform sensilla in Drosophila melanogaster.

Sensory systems provide input to motor networks on the state of the body and environment. One such sensory system in insects is the campaniform sensilla (CS), which detect deformations of the exoskeleton arising from resisted movements or external perturbations. When physical strain is applied to the cuticle, CS external structures are compressed, leading to transduction in an internal sensory neuron.

Feasibility and precision of subcutaneous continuous glucose monitoring in patients undergoing CABG surgery.

Objectives: To evaluate if subcutaneous continuous glucose monitoring (sCGM) is feasible in cardiac surgery and if reliable glucose values are reported under hypothermic extracorporeal circulation.

Design: Feasibility trial.

Setting: University hospital.

[Undesired side effects of tapentadol in comparison to oxycodone. A meta-analysis of randomized controlled comparative studies].

Objective: Tapentadol is a new centrally acting analgesic with a dual mode of action as an agonist of the µ-opioid receptor and as a norepinephrine reuptake inhibitor. The aim of the present study was to evaluate the results from randomized controlled trials investigating the relative amount of adverse effects using tapentadol or oxycodone for the treatment of pain.

Methods: A quantitative systematic review was carried out according to the PRISMA recommendations on randomized controlled trials comparing tapentadol and oxycodone in pain treatment.

[Osteoporosis pain management].

Osteoporosis is a chronic disease with an enormous impact on health care costs. Approximately 8 Mio. people are affected in Germany.

Distribution of extracellular matrix components in normal and degenerated canine tricuspid valve leaflets.

The aim of the present study was to investigate the composition and distribution of various extracellular matrix (ECM) components in normal canine tricuspid valves (TVs) and in TVs affected by chronic valvular disease (CVD). The parietal (pTV) and septal (sTV) leaflets of the TVs from 27 dogs were investigated immunohistochemically for expression of collagen types I, III, IV and VI, elastin, laminin, fibronectin and heparan sulphate. Normal pTV consisted mainly of elastin and collagen VI in the atrialis, fibronectin in the thin spongiosa and mixed collagens in the fibrosa.

Expression of genes encoding matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs) in normal and diseased canine mitral valves.

The pathogenesis of canine chronic valvular disease (CVD) is not fully characterized. The present study investigates the expression of genes encoding matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs) in normal and diseased mitral valves (MVs). Samples from normal (n=15) or diseased (n=10) canine MVs were subject to real-time polymerase chain reaction (PCR) for quantification of mRNA encoding MMP-1, -2, -9 and -14 and TIMP-2, -3 and -4.

[Hemostasis management in multiple trauma patients--value of near-patient diagnostic methods].

Massively transfused multiple trauma patients commonly develop a complex coagulopathy which needs immediate treatment. Near-patient diagnostic methods are available for the management of this coagulopathy and for the guidance of the therapeutic options with blood products and haemostatic drugs: conventional laboratory analysis methods adapted to the point-of-care (POC) situation (blood gas analysis, point of care PT, APTT and platelet count), and the complex whole blood methods used for near-patient coagulation monitoring (thromboelastometry and platelet function analysis). Based on the new Guidelines of the German Medical Association for the use of blood and plasma derivates, interventions with blood products and haemostatic drugs in multiple trauma patients are suggested.

Histomorphological findings and expression of matrix metalloproteinases and their tissue specific inhibitors (TIMPs) in normal tricuspid valves and in chronic tricuspid valvular disease in dogs.

The histomorphological findings and immunohistochemical expression of matrix metalloproteinases (MMPs-1, 2, 9 and 14) and their tissue inhibitors (TIMPs-2, 3 and 4) are reported in the parietal (pTV) and septal leaflets (sTV) of the tricuspid valves in normal dogs and dogs with chronic valvular disease (CVD). The layers of the normal sTV were not as well defined as in the pTV and the spongiosa of the sTV contained abundant mucopolysaccharides (MPS) and adipocytes. In CVD, there was expansion of the spongiosa of the pTV due to deposition of MPS, leading to formation of nodules along the free edge.

An immunohistochemical study of the role of matrix metalloproteinases and their tissue inhibitors in chronic mitral valvular disease (valvular endocardiosis) in dogs.

While the pathogenesis of chronic valvular disease (CVD) in dogs remains unclear, alterations in the activity of specific metalloproteinase enzymes and their inhibitors within the valve stroma are suspected of having a role. This study describes the immunohistochemical distribution pattern of matrix metalloproteinase (MMP) types 2, 9 and 14 and their tissue inhibitors, termed tissue inhibitors of metalloproteinase (TIMP), types 2 and 3, in normal canine mitral valves (MVs) (n=10) and in dogs with mild (n=7), moderate (n=14) and severe (n=9) CVD. In normal MVs, MMP-2 and -14, and TIMP-2 were expressed in isolated stromal cells.

Blood volume regulation in donors undergoing intermittent-flow plasmapheresis involving a high extracorporeal blood volume.

Background: Intermittent-flow plasmapheresis (IFP) often involves a large extracorporeal blood volume (ECV) of donors during donation. Depending on equipment and donor characteristics, ECV can exceed 20 percent of a donor's blood volume (BV). It was the aim of this study to delineate mechanisms of BV regulation associated with these volume shifts.

Postoperative analgesia and functional recovery after total-knee replacement: comparison of a continuous posterior lumbar plexus (psoas compartment) block, a continuous femoral nerve block, and the combination of a continuous femoral and sciatic nerve block.

Background And Objectives: Continuous femoral nerve block is a well-accepted technique for regional analgesia after total-knee replacement. However, many patients still experience considerable pain at the popliteal space and at the medial aspect of the knee. The goal of this study is to evaluate whether a psoas compartment catheter provides better postoperative analgesia than a femoral nerve catheter does and whether it is as effective as the combination of a femoral and a sciatic nerve catheter and, thus, improves functional outcome.

Elimination of drugs by the new polyamide hemofilter FH77H during various in vitro conditions.

Background/aims: Multiple organ failure alters the dosage of drugs during hemofiltration. To separate factors, we utilized in vitro hemofiltration to investigate different blood flows, protein concentrations and intracellular drug partition with the FH77H polyamide membrane.

Methods: One liter of warm heparinized fresh human blood was hemofiltrated in two series: (1) with digoxin, netilmycin, phenobarbital, ceftriaxone and teicoplanin, and (2) with amikacin, theophylline, ceftazidim, phenytoin and vancomycin and, in addition, with cell-free fresh frozen plasma.

[The effect of various ultrasonic tooth cleaning devices on dental filling materials].

The influence of various ultrasonic devices for cleaning teeth on the surfaces of different filling materials was studied in 300 extracted teeth. Special attention was directed to the cavity edge and the area immediately surrounding it. Alterations in surface roughness were determined and compared with an electromechanical stylus.