Clinical impact of diastolic dysfunction and atrial fibrillation before and after initiating hemodialysis in patients with end-stage kidney disease.

BACKGROUND: Diastolic dysfunction with left ventricular hypertrophy and myocardial fibrosis is an important characteristic of uremic cardiomyopathy in end-stage kidney disease (ESKD). Few studies explored the relationship between changes in diastolic dysfunction and the risk of mortality or cardiovascular outcome in patients with ESKD. We investigated the clinical impact of diastolic dysfunction and atrial fibrillation (AF) on patients starting hemodialysis (HD). METHODS: A total of 718 patients who started HD between 2010 and 2020 were included. We classified patients according to the pre- and post-HD diastolic dysfunction grades (DDG) evaluated by echocardiography. Patients with AF were classified separately. The primary outcome was a composite outcome of all-cause mortality and cardiac complication. RESULTS: The median age was 63 years, and 61.4% were male. Patients were divided into four groups based on pre-HD echocardiography findings. After initiating HD, the patients were classified according to changes in DDG and AF. Composite outcomes were significantly higher in the pre-HD AF groups. However, after adjusting for age and history of ischemic heart disease, pre-HD AF did not affect the composite outcomes. Patients with normal post-HD diastolic function had better outcomes than those with diastolic dysfunction or AF. Furthermore, the deterioration of diastolic dysfunction after HD was associated with an increased risk of composite outcomes. CONCLUSIONS: The deterioration of diastolic dysfunction and newly development of AF after initiating HD were identified as risk factors for mortality and cardiac complications, supporting the clinical importance of the appropriate management of diastolic dysfunction and AF in patients with ESKD.

Layer-by-Layer Engineered Flexible Functional Film Fabrication with Spreadability Control in Roll-to-Roll Manufacturing.

A roll-to-roll manufacturing system performs printing and coating on webs to mass-produce large-area functional films. The functional film of a multilayered structure is composed of layers with different components for performance improvement. The roll-to-roll system is capable of controlling the geometries of the coating and printing layers using process variables. However, research on geometric control using process variables is limited to single-layer structures only. This study entails the development of a method to proactively control the geometry of the upper coated layer by using the lower-layer coating process variable in the manufacture of a double-coated layer. The correlation between the lower-layer coating process variable and upper coated layer geometry was examined by analyzing the lower-layer surface roughness and spreadability of the upper-layer coating ink. The correlation analysis results demonstrate that tension was the dominant variable in the upper coated layer surface roughness. Additionally, this study found that adjusting the process variable of the lower-layer coating in a double-layered coating process could improve the surface roughness of the upper coating layer by up to 14.9%.

The impact of preoperative kidney replacement therapy on kidney outcome and survival in patients with left ventricular assist device.

Left ventricular assist device (LVAD) has been highlighted as a new treatment option in the end-stage heart failure (HF). Kidney outcome after LVAD in severe cardiorenal syndrome (CRS) patients requiring kidney replacement therapy (KRT) is unclear. We investigated the impact of preoperative KRT on kidney function and survival in LVAD patients with severe CRS. A total of 50 patients followed up for at least 1 year after LVAD implantation was analyzed. The primary outcomes were estimated glomerular filtration rate and survival rate. Patients were divided into two groups depending on in-hospital KRT before LVAD implantation: the control group (n = 33) and the KRT group (n = 17). Postoperative KRT was performed for 76.5% of patients in the KRT group, and all of them discontinued KRT before discharge. There were no statistically significant differences in the degree of eGFR decline in survivors according to preoperative KRT. Although there were no statistically significant differences in the degree of eGFR decline in survivors regardless of preoperative KRT, old age (ß -0.94, p < 0.01), preexisting chronic kidney disease (ß -21.89, p < 0.01), and high serum creatinine (ß -13.95, p < 0.01) were identified as independent predictors of post-LVAD eGFR decline. Mortality rate was higher, and more patients progressed to end-stage kidney disease in KRT group than control group. However, LVAD still can be considered as the treatment option in end-stage HF patients with severe CRS requiring KRT, especially in those with young age and previous normal kidney function.

Web Wrinkle Defects due to Temperature Profile in Roll-to-Roll Manufacturing Systems.

The roll-to-roll manufacturing system is extensively used for mass producing products made of plastic, paper, and fabric in several traditional industries. When flexible substrates, also known as webs, are heated and transported inside the dryer, an inconsistent temperature distribution occurs on the material in the machine direction (MD) and cross-machine direction (CMD). If rollers are not aligned in parallel on the same plane in the roll-to-roll web handling process, or if roller misalignment exists, strain deviation occurs in the web, resulting in lateral displacement and web wrinkles. Therefore, this study examined a wrinkle, which is a thermal deformation that occurs when an inconsistent web temperature distribution is formed on the material inside a dryer. The changes in the elastic modulus and thermal expansion of the web were also examined. Experiments were conducted using a PET film, and its elastic modulus and thermal expansion were examined. The results showed that the presence of a web wrinkle defect can cause a thickness deviation in the functional layer manufactured on the web. Moreover, an appropriate operating speed should be set to reduce the CMD temperature deviation, thereby reducing instances of wrinkle defects.

Comparative analysis of mesenchymal stem cell surface marker expression for human dental mesenchymal stem cells.

AIM: Human dental mesenchymal stem cells (hDMSCs) have been isolated from extracted human teeth and proven to have different proliferation and differentiation abilities among the subtypes. Despite increasing interest in the clinical use of hDMSCs, a well-defined specific marker has been absent for these stem cells. In this study, a comparative analysis with known mesenchymal stem cell surface markers such as STRO-1, CD90, CD146, CD34 and TfR (CD71) was performed. MATERIALS & METHODS: Four subtypes of the hDMSCs were obtained and cultured. The hDMSCs were processed by flow cytometric analysis, fluorescence immunocytostaining for in vitro study and in situ immunohistochemical staining for in vivo study. RESULTS & CONCLUSION: The previously known positive and negative MSC markers, such as STRO-1, CD90, CD146 and CD34 showed comparative expression profiles of hDMSC subtypes. TfR was highly positive in hDMSCs compared with the control cells; therefore, TfR was suggested as a new marker for hDMSCs in this study.