Disaster Averted: Surgical Treatment of Paradoxical Embolus in Transit.

A 46-year-old woman presented with a syncopal episode and was found to have a large thrombus traversing an atrial septal defect extending across the mitral valve. She was taken to the operating room for emergent thrombectomy. We present the case, imaging, and a review of published cases.

Institutional Marfan syndrome surgical volume influences mitral valve surgical strategy in patients with Marfan syndrome.

Background/aim: The goal of this study was to evaluate trends in mitral valve (MV) operations performed on patients with Marfan syndrome (MfS) and determine the influence of an institution's MfS and MV surgical volume on MV surgical strategy in the US.

Methods: The Nationwide Inpatient Sample was queried from 1998 to 2011 and a total of 1126 patients with MfS were identified who underwent MV operations meeting our inclusion criteria. Linear regression was performed to assess trends of MV repair (MVr) rates over time.

Long-term failure of Amplatzer plugs in the treatment of aortic pathology.

We present two cases of Amplatzer® device deployment that exhibited long-term failure necessitating surgical correction. The first case illustrates recanalization of a ruptured Valsalva aneurysm with worsening aortic insufficiency after percutaneous repair with the Amplatzer Vascular Plugs and Amplatzer duct occluder, while the second case illustrates recanalization after deployment of the Amplatzer septal occluder in a patient with a pseudoaneursym in a bovine aorta after type I aortic dissection repair. These two cases illustrate the potential long-term complications and limitations in durability with these devices.

Concomitant repair for mild aortic insufficiency and continuous-flow left ventricular assist devices.

Objectives: Aortic insufficiency (AI) after continuous-flow left ventricular assist device (CF-LVAD) implantation has become a highly relevant subject. However, management of pre-existing mild AI is unknown. We examined the fate of pre-existing mild AI during CF-LVAD support.

Regeneration and experimental orthotopic transplantation of a bioengineered kidney.

Approximately 100,000 individuals in the United States currently await kidney transplantation, and 400,000 individuals live with end-stage kidney disease requiring hemodialysis. The creation of a transplantable graft to permanently replace kidney function would address donor organ shortage and the morbidity associated with immunosuppression. Such a bioengineered graft must have the kidney's architecture and function and permit perfusion, filtration, secretion, absorption and drainage of urine.

Coronary artery calcification and coronary atherosclerotic disease.

The presence of coronary artery calcium is closely associated with the presence of atherosclerotic lesions in the coronary vasculature. Detection of coronary calcium by imaging techniques has evolved over the last few decades and has become especially more sophisticated with advanced imaging technology. Whereas the status of coronary artery calcium as a marker of increased cardiovascular risk is well established, the indication for testing continues to be a topic of debate.

Single incision laparoscopic surgery ovarian cystectomy in large benign ovarian cysts using conventional instruments.

We describe a technique for the management of large benign ovarian cysts by single incision laparoscopic surgery (SILS) through the umbilicus. The paucity of intra-abdominal working space in large ovarian cysts poses a technical challenge. Moreover, difficult convergence of operating instruments and competition for operating space outside the abdomen during the SILS makes the procedure quite demanding, especially with the conventional instruments.

Enhanced in vivo function of bioartificial lungs in rats.

Background: More than 11 million Americans live with chronic lung disease; in search for an alternative to donor organs, we attempted to regenerate lungs based on perfusion decellularized lung scaffolds that can be transplanted similar to a donor organ.

Methods: Cadaveric rat lungs were decellularized by detergent perfusion. Resulting scaffolds were mounted in bioreactors and seeded with endothelial and fetal lung cells.

Organ engineering based on decellularized matrix scaffolds.

End-organ failure is one of the major healthcare challenges in the Western world. Yet, donor organ shortage and the need for immunosuppression limit the impact of transplantation. The regeneration of whole organs could theoretically overcome these hurdles.

Bumblebees exhibit the memory spacing effect.

Associative learning is key to how bees recognize and return to rewarding floral resources. It thus plays a major role in pollinator floral constancy and plant gene flow. Honeybees are the primary model for pollinator associative learning, but bumblebees play an important ecological role in a wider range of habitats, and their associative learning abilities are less well understood.

Ser18 and Ser23 phosphorylation plays synergistic roles in activating p53-dependent neuronal apoptosis.

Tumor suppressor p53 is required for the neuronal apoptosis in response to DNA double-stranded break (DSB) damage. Posttranslational modifications such as phosphorylation play important roles in activating p53-dependent apoptosis after DNA damage. In support of this notion, our recent studies indicate that Ser18 and Ser23 phosphorylation together plays critical roles in activating p53 apoptotic activities in vivo.