First-in-man transcatheter aortic valve implantation of a 20-mm Edwards SAPIEN XT valve: one step forward for the treatment of patients with severe aortic stenosis and small aortic annulus.

We present the case of an 85-year-old woman diagnosed with severe aortic stenosis, porcelain aorta, and a small aortic annulus (17.3 mm), who underwent successful transfemoral transcatheter aortic valve implantation (TAVI) with a 20-mm Edwards SAPIEN XT valve using the NovaFlex+ delivery system. At 1-month follow-up the patient was in NYHA functional class I, and Doppler echocardiography showed a mean residual gradient of 15 mm Hg and trivial paravalvular aortic regurgitation.

A switch in the neuromodulatory effects of dopamine in the oval bed nucleus of the stria terminalis associated with cocaine self-administration in rats.

Chronic exposure to drugs of abuse alters brain reward circuits and produces functional changes in the dopamine (DA) system. However, it is not known whether these changes are directly related to drug-driven behaviors or whether they simply are adaptive responses to long-term drug exposure. Here, we combined the rat model of cocaine self-administration with brain slice electrophysiology to identify drug-use related alterations in the neuromodulatory effects of DA in the oval bed nucleus of the stria terminalis (ovBST), a robust DA terminal field.

An MR-compliant phased-array HIFU transducer with augmented steering range, dedicated to abdominal thermotherapy.

A novel architecture for a phased-array high intensity focused ultrasound (HIFU) device was investigated, aiming to increase the capabilities of electronic steering without reducing the size of the elementary emitters. The principal medical application expected to benefit from these developments is the time-effective sonication of large tumours in moving organs. The underlying principle consists of dividing the full array of transducers into multiple sub-arrays of different resonance frequencies, with the reorientation of these individual emitters, such that each sub-array can focus within a given spatial zone.

The effects of modeling simplifications on craniofacial finite element models: the alveoli (tooth sockets) and periodontal ligaments.

Several finite element models of a primate cranium were used to investigate the biomechanical effects of the tooth sockets and the material behavior of the periodontal ligament (PDL) on stress and strain patterns associated with feeding. For examining the effect of tooth sockets, the unloaded sockets were modeled as devoid of teeth and PDL, filled with teeth and PDLs, or simply filled with cortical bone. The third premolar on the left side of the cranium was loaded and the PDL was treated as an isotropic, linear elastic material using published values for Young's modulus and Poisson's ratio.

Fatigue failure and molecular machine design.

Sophisticated molecular machines have evolved in nature, and the first synthetic molecular machines have been demonstrated. With our increasing understanding of individual operating cycles, the question of how operation can be sustained over many cycles comes to the forefront. In the design of macroscale machines, performance and lifetime are opposing goals.

Incidence, predictive factors, and prognostic value of myocardial injury following uncomplicated transcatheter aortic valve implantation.

Objectives: This study sought to: 1) determine the incidence, degree, and timing of the rise in serum cardiac markers of myocardial injury associated with uncomplicated transcatheter aortic valve implantation (TAVI); and 2) evaluate the predictive factors and prognostic value of myocardial injury associated with TAVI.

Background: Very few data exist on the occurrence and clinical relevance of myocardial injury during TAVI procedures.

Methods: A total of 101 patients who underwent successful TAVI (transfemoral [TF] approach, n = 38; transapical [TA] approach, n = 63) were included.

Exercise capacity in patients with severe symptomatic aortic stenosis before and six months after transcatheter aortic valve implantation.

Few data exist on the use of the 6-minute walk test (6MWT) to measure the exercise capacity of patients with severe symptomatic aortic stenosis considered at very high surgical risk. The objectives of the present prospective study were (1) to determine the feasibility and safety of the 6MWT as a measure of exercise capacity before and after transcatheter aortic valve implantation (TAVI), and (2) to determine the clinical and hemodynamic parameters associated with the exercise capacity changes in such patients. A total of 64 patients (age 80 ± 8 years, logistic European System for Cardiac Operative Risk Evaluation score 21 ± 15%, Society of Thoracic Surgeons' score 7.

Geometrical embedding governs a dramatic variation of electron paramagnetic resonance hyperfine coupling constants of disulfide radical anions.

Among the large variety of experimental techniques amenable to probe disulfide radical anions, electron paramagnetic resonance (EPR) spectroscopy provides the most definitive assignment of these versatile transient intermediates in biochemistry [Stubbe et al. Proc. Natl.

The Hadropithecus conundrum reconsidered, with implications for interpreting diet in fossil hominins.

The fossil 'monkey lemur' Hadropithecus stenognathus has long excited palaeontologists because its skull bears an astonishing resemblance to those of robust australopiths, an enigmatic side branch of the human family tree. Multiple lines of evidence point to the likelihood that these australopiths ate at least some 'hard', stress-limited food items, but conflicting data from H. stenognathus pose a conundrum.

Performance-based functional assessment of patients undergoing transcatheter aortic valve implantation.

Background: Very few data exist on the functional evaluation of patients with severe symptomatic aortic stenosis undergoing transcatheter aortic valve implantation (TAVI). The aims of this prospective study were (1) to evaluate the Duke Activity Status Index (DASI) as a measure of functional status pre-TAVI and post-TAVI, (2) to determine the clinical parameters associated with DASI changes after TAVI, and (3) to compare functional status as evaluated by DASI and the New York Heart Association (NYHA) class with exercise capacity as evaluated by the 6-minute walk test (6MWT) in such patients.

Methods: A total of 76 patients (80 ± 8 years old) who underwent successful TAVI were included.

Burrowing and subsurface locomotion in anguilliform fish: behavioral specializations and mechanical constraints.

Fish swimming is probably one of the most studied and best understood locomotor behaviors in vertebrates. However, many fish also actively exploit sediments. Because of their elongate body shape, anguilliform fishes are not only efficient swimmers but also very maneuverable.

A proteomic approach to decipher chilling response from cold acclimation in pea (Pisum sativum L.).

Two pea lines (Pisum sativum L.) with contrasted behaviours towards chilling and subsequent frost were studied by a proteomic approach to better understand cold acclimation. Following a chilling period, the Champagne line becomes tolerant to frost whereas Terese remains sensitive.

An efficient method of modeling material properties using a thermal diffusion analogy: an example based on craniofacial bone.

The ability to incorporate detailed geometry into finite element models has allowed researchers to investigate the influence of morphology on performance aspects of skeletal components. This advance has also allowed researchers to explore the effect of different material models, ranging from simple (e.g.

Usefulness of TEE as the primary imaging technique to guide transcatheter transapical aortic valve implantation.

Objectives: The aim of this study was to: 1) determine the usefulness of transesophageal echocardiography (TEE) as the primary technique to guide transapical (TA) transcatheter aortic valve implantation (TAVI); and 2) to compare TEE with angiography as the primary imaging modality for TA-TAVI guidance.

Background: TEE has been routinely used as an adjunct to angiography during TA-TAVI procedures, but very few data exist on the use of TEE as the primary imaging technique guiding TA-TAVI.

Methods: One hundred consecutive high-risk patients (mean age 79 ± 9 years, mean logistic EuroSCORE: 25.

Cerebral embolism following transcatheter aortic valve implantation: comparison of transfemoral and transapical approaches.

Objectives: The objective of this study was to compare the incidence of cerebral embolism (CE) as evaluated by diffusion-weighted magnetic resonance imaging (DW-MRI) following transapical (TA) transcatheter aortic valve implantation (TAVI) versus transfemoral (TF) TAVI.

Background: The TA-TAVI approach avoids both the manipulation of large catheters in the aortic arch/ascending aorta and the retrograde crossing of the aortic valve, and this avoidance might lead to a lower rate of CE.

Methods: This was a prospective multicenter study including 60 patients who underwent cerebral DW-MRI the day before and within the 6 days following TAVI (TF approach: 29 patients; TA approach: 31 patients).

Transcatheter aortic valve implantation in patients with bicuspid aortic valve stenosis.

Objectives: We evaluated transcatheter aortic valve implantation (TAVI) in high-risk patients with bicuspid aortic valve (BAV) stenosis.

Background: TAVI shows promise in the treatment of severe stenosis of triscupid aortic valves, especially in high-risk patients. However, BAV stenosis has been considered a contraindication to TAVI.

Double-dissociation of the catecholaminergic modulation of synaptic transmission in the oval bed nucleus of the stria terminalis.

The bed nucleus of the stria terminalis (BST) is a cluster of nuclei within the extended amygdala, a forebrain macrostructure with extensive projection to motor nuclei of the hindbrain. The subnuclei of the BST coordinate autonomic, neuroendocrine, and somato-motor functions and receive robust neuromodulatory monoaminergic afferents, including 5-HT-, noradrenaline (NA)-, and dopamine (DA)-containing terminals. In contrast to 5-HT and NA, little is known about how DA modulates neuronal activity or synaptic transmission in the BST.

Comparison between transcatheter and surgical prosthetic valve implantation in patients with severe aortic stenosis and reduced left ventricular ejection fraction.

Background: Patients with severe aortic stenosis and reduced left ventricular ejection fraction (LVEF) have a poor prognosis with conservative therapy but a high operative mortality when treated surgically. Recently, transcatheter aortic valve implantation (TAVI) has emerged as an alternative to surgical aortic valve replacement (SAVR) for patients considered at high or prohibitive operative risk. The objective of this study was to compare TAVI and SAVR with respect to postoperative recovery of LVEF in patients with severe aortic stenosis and reduced LV systolic function.

Moderate aortic stenosis in coronary artery bypass grafting patients more than 70 years of age: to replace or not to replace?

Background: Moderate aortic stenosis in coronary artery bypass graft surgery (CABG) patients more than 70 years old is not unusual. The risk-benefit of performing a concomitant aortic valve replacement (AVR) is often difficult to assess. To stratify the risk-benefit ratio, we reviewed outcomes of CABG patients more than 70 years old with preoperative moderate aortic stenosis (valve area 1.

Target-specific encoding of response inhibition: increased contribution of AMPA to NMDA receptors at excitatory synapses in the prefrontal cortex.

Impulse control suppresses actions that are inappropriate in one context, but may be beneficial in others. The medial prefrontal cortex (mPFC) mediates this process by providing a top-down signal to inhibit competing responses, although the mechanism by which the mPFC acquires this ability is unknown. To that end, we examined synaptic changes in the mPFC associated with learning to inhibit an incorrect response.

Sternal reentry in a patient with previous deep sternal wound infection managed with horizontal titanium plate fixation.

Redo open-heart surgery and sternal reentry in patients with previous deep sternal wound infection (DSWI) and absence of sternal integrity can be a delicate and morbid task due the lack of a dissection plane between the heart and the surrounding soft tissues. Delayed sternal reconstruction and osteosynthesis with horizontal titanium plating fixation (Synthes) following vacuum assisted therapy (KCI) has recently been proposed and adopted for the treatment of DSWI. We present such a case of a patient who was successfully reoperated for valve replacement three years after coronary artery bypass grafting complicated by DSWI and initially treated with titanium plate fixation.

Minocycline inhibits apoptotic cell death in a murine model of partial flap loss.

For breast reconstruction, the deep inferior epigastric perforator (DIEP) flap has become standard therapy. A feared complication is partial or even total flap loss. In a novel murine model of partial DIEP flap loss, the contribution of apoptotis to flap loss was investigated.

Transcatheter aortic valve implantation with "no touch" of the aortic arch for the treatment of severe aortic stenosis associated with complex aortic atherosclerosis.

We present the case of an 80-year-old woman diagnosed with severe aortic stenosis and complex aortic atherosclerotic plaques who underwent transapical TAVI guided by transesophageal echocardiography and fluoroscopy with no catheter/wire manipulation across the aortic arch to avoid any systemic embolism.

Finite element analysis of performance in the skulls of marmosets and tamarins.

Reliance on plant exudates is a relatively rare dietary specialization among mammals. One well-studied example of closely related exudate feeders is the New World marmosets and tamarins. Whereas marmosets actively gouge tree bark with their incisors to stimulate the flow of sap, tamarins are opportunistic exudate feeders that do not gouge bark.