Novel percutaneous technique for creation of porcine model of tricuspid regurgitation via two routes.

OBJECTIVE: To develop an experimental porcine model of tricuspid regurgitation using two induction routes: the inferior vena cava and superior vena cava. METHODS: Tricuspid regurgitation was generated using the loop wire cutting method. The tricuspid regurgitation jet direction was controlled by accessing the valve through the inferior (n = 7) or superior (n = 6) vena cava. The occurrence, direction, and progression of tricuspid regurgitation were assessed postoperatively, and echocardiography was performed at 4 to 6 weeks. Right heart dilatation was assessed using computed tomography after 6 weeks. RESULTS: Moderate to severe or torrential tricuspid regurgitation occurred immediately after the procedure in 12 of 13 animals. The jet was directed toward the septum in five of seven animals in the inferior vena cava group and toward the posterolateral side in four of six animals in the superior vena cava group. The dimensions of the right heart (right atrium, ventricle, and tricuspid valve annulus) were significantly enlarged at the 4- to 6-week follow-up echocardiographic examination and confirmed to be enlarged by computed tomography, independent of the route used. CONCLUSION: The loop wire cutting method successfully induced a disease model of tricuspid regurgitation while controlling the regurgitation jet direction via two procedural routes.

The Clinical Outcomes of Marginal Donor Hearts: A Single Center Experience.

BACKGROUND AND OBJECTIVES: Although the shortage of donor is a common problem worldwide, a significant portion of unutilized hearts are classified as marginal donor (MD) hearts. However, research on the correlation between the MD and the prognosis of heart transplantation (HTx) is lacking. This study was conducted to investigate the clinical impact of MD in HTx. METHODS: Consecutive 73 HTxs during 2014 and 2021 in a tertiary hospital were analyzed. MD was defined as follows; a donor age >55 years, left ventricular ejection fraction <50%, cold ischemic time >240 minutes, or significant cardiac structural problems. Preoperative characteristics and postoperative hemodynamic data, primary graft dysfunction (PGD), and the survival rate were analyzed. Risk stratification by Index for Mortality Prediction after Cardiac Transplantation (IMPACT) score was performed to examine the outcomes according to the recipient state. Each group was sub-divided into 2 risk groups according to the IMPACT score (low <10 vs. high ≥10). RESULTS: A total of 32 (43.8%) patients received an organ from MDs. Extracorporeal membrane oxygenation was more frequent in the non-MD group (34.4% vs. 70.7, p=0.007) There was no significant difference in PGD, 30-day mortality and long-term survival between groups. In the subgroup analysis, early outcomes did not differ between low- and high-risk groups. However, the long-term survival was better in the low-risk group (p=0.01). CONCLUSIONS: The outcomes of MD group were not significantly different from non-MD group. Particularly, in low-risk recipient, the MD group showed excellent early and long-term outcomes. These results suggest the usability of selected MD hearts without increasing adverse events.

A Case Report of Large Tailgut Cyst Located from the Perirenal to the Perivesical Spaces.

Tailgut cysts are known to originate from the remnants of the embryonic hindgut. They occur exclusively in the retrorectal and presacral spaces. There have been limited reports of tailgut cysts occurring in the left perirenal space. The present case features a huge tailgut cyst extending from the right perirenal to the perivesical space. We believe that this case report will help to further elucidate the characteristics of perirenal and perivesical tailgut cysts.

Synthetic TGF-ß Signaling Agonist-Treated Dendritic Cells Induce Tolerogenicity and Antirheumatic Effects.

The newly synthesized compound TGF-ß signaling agonist (T74) is a small molecule associated with the TGF-ß receptor signaling pathway. Tolerogenic dendritic cells (tDCs) have been used to examine immunosuppressive and anti-inflammatory effects in multiple autoimmune disease models. The aim of this study was to investigate whether treatment of DCs with T74 has an antirheumatic effect in a mouse model of collagen-induced arthritis (CIA). Bone marrow-derived cells were obtained from DBA/1J mice and differentiated into DCs. T74-treated DCs (T74-DCs) were generated by treating bone marrow-derived DCs with LPS, type II collagen, and T74. T74-DCs expressed lower levels of surface molecules and inflammatory cytokines associated with antigen presentation and T cell stimulation. The ability of T74-DCs to differentiate effector T cells was lower than that of T74-untreated DCs (NT-DCs), but T74-DCs increased the regulatory T (Treg) cell differentiation in vitro. DBA/1J mice received two subcutaneous (s.c.) injections of type II collagen to establish CIA. Mice then received two s.c. injections of T74-DCs or NT-DCs. Joint inflammation was ameliorated in the paws of T74-DC-treated mice. Additionally, Treg populations in T74-DC-treated mice were higher than in NT-DC-treated or PBS-treated CIA mice. Taken together, these results demonstrate that T74 induces tolerance in DCs, and that T74-mediated DCs exert antirheumatic effects via induction of Tregs.

A Case of Heart Transplantation for Fulminant Myocarditis After ChAdOx1 nCoV-19 Vaccination.

Vaccines have become the mainstay of management against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (coronavirus disease 2019; COVID-19) in the absence of effective antiviral therapy. Various adverse effects of COVID-19 vaccination have been reported, including cardiovascular complications such as myocarditis or pericarditis. Herein, we describe clinical records of a 63-year woman with fulminant myocarditis following ChAdOx1 nCoV-19 vaccination that was salvaged by heart transplantation. She complained chest pain, nausea, vomiting, and fever after the second vaccination. After the heart transplantation, the patient died due to necrotizing pneumonia on the 54th day of onset. Fulminant myocarditis is very rare after ChAdOx1 nCoV-19 vaccination but can be fatal.

Enpp2 Expression by Dendritic Cells Is a Key Regulator in Migration.

Enpp2 is an enzyme that catalyzes the conversion of lysophosphatidylcholine (LPC) to lysophosphatidic acid (LPA), which exhibits a wide variety of biological functions. Here, we examined the biological effects of Enpp2 on dendritic cells (DCs), which are specialized antigen-presenting cells (APCs) characterized by their ability to migrate into secondary lymphoid organs and activate naïve T-cells. DCs were generated from bone marrow progenitors obtained from C57BL/6 mice. Enpp2 levels in DCs were regulated using small interfering (si)RNA or recombinant Enpp2. Expression of Enpp2 in LPS-stimulated mature (m)DCs was high, however, knocking down Enpp2 inhibited mDC function. In addition, the migratory capacity of mDCs increased after treatment with rmEnpp2; this phenomenon was mediated via the RhoA-mediated signaling pathway. Enpp2-treated mDCs showed a markedly increased capacity to migrate to lymph nodes in vivo. These findings strongly suggest that Enpp2 is necessary for mDC migration capacity, thereby increasing our understanding of DC biology. We postulate that regulating Enpp2 improves DC migration to lymph nodes, thus improving the effectiveness of cancer vaccines based on DC.

TGF-ß/IL-7 Chimeric Switch Receptor-Expressing CAR-T Cells Inhibit Recurrence of CD19-Positive B Cell Lymphoma.

Chimeric antigen receptor (CAR)-T cells are effective in the treatment of hematologic malignancies but have shown limited efficacy against solid tumors. Here, we demonstrated an approach to inhibit recurrence of B cell lymphoma by co-expressing both a human anti-CD19-specific single-chain variable fragment (scFv) CAR (CD19 CAR) and a TGF-ß/IL-7 chimeric switch receptor (tTRII-I7R) in T cells (CD19 CAR-tTRII-I7R-T cells). The tTRII-I7R was designed to convert immunosuppressive TGF-ß signaling into immune-activating IL-7 signaling. The effect of TGF-ß on CD19 CAR-tTRII-I7R-T cells was assessed by western blotting. Target-specific killing by CD19 CAR-tTRII-I7R-T cells was evaluated by Eu-TDA assay. Daudi tumor-bearing NSG (NOD/SCID/IL2Rγ-/-) mice were treated with CD19 CAR-tTRII-I7R-T cells to analyze the in vivo anti-tumor effect. In vitro, CD19 CAR-tTRII-I7R-T cells had a lower level of phosphorylated SMAD2 and a higher level of target-specific cytotoxicity than controls in the presence of rhTGF-ß1. In the animal model, the overall survival and recurrence-free survival of mice that received CD19 CAR-tTRII-I7R-T cells were significantly longer than in control mice. These findings strongly suggest that CD19 CAR-tTRII-I7R-T cell therapy provides a new strategy for long-lasting, TGF-ß-resistant anti-tumor effects against B cell lymphoma, which may lead ultimately to increased clinical efficacy.

Heart transplantation in a patient with complex heart lung disease: a case report.

Heart disease is often accompanied by lung disease as they share the same risk factors. Heart or lung transplantation is regarded as a definitive treatment for the end-stage disease of each, while the expected median survival for lung transplantation is far shorter than heart transplantation. We present a case of refractory heart failure along with severe obstructive and restrictive lung disease that showed dramatic improvement in pulmonary function after single heart transplantation.

Imaging features of primary peritoneal serous carcinoma: A case report.

Primary peritoneal serous carcinoma (PPSC) is an epithelial tumor that arises from the peritoneum. On histopathologic analysis, it resembles a malignant ovarian surface epithelial stromal tumor. A 62-year-old woman visited the emergency room with low abdominal pain. Peritoneal carcinomatosis from ovarian cancer was initially suspected and underwent radical hysterectomy, both salpingo-oophorectomy and omentectomy. Both ovaries and uterus were intact, and ultimate diagnosis was PPSC. PPSC is a rare disease that is difficult to diagnose prior to surgery. We suspected peritoneal carcinomatosis due to the rarity of primary tumor originating from the peritoneum and overlooked PPSC, but when the primary site is not clear, we advise to consider the possibility of PPSC. Median survival time is 11-17 months with poor prognosis, and thus early diagnosis, treatment is important, and further imaging studies are warranted.

Invisible Silver Nanomesh Skin Electrode via Mechanical Press Welding.

Silver nanowire (AgNW) has been studied as an important material for next-generation wearable devices due to its high flexibility, high electrical conductivity and high optical transmittance. However, the inherently high surface roughness of AgNWs and low adhesion to the substrate still need to be resolved for various device applications. In this study, an embedded two-dimensional (2D) Ag nanomesh was fabricated by mechanical press welding of AgNW networks with a three-dimensional (3D) fabric shape into a nanomesh shape, and by embedding the Ag nanomesh in a flexible substrate. The effect of the embedded AgNWs on the physical and electrical properties of a flexible transparent electrode was investigated. By forming embedded nanomesh-type AgNWs from AgNW networks, improvements in physical and electrical properties, such as a 43% decrease in haziness, 63% decrease in sheet resistance, and 26% increase in flexibility, as well as improved adhesion to the substrate and low surface roughness, were observed.

Efficient metallic nanowire welding using the Eddy current method.

In this study, metallic nanowires (M-NWs) such as silver nanowires (AgNWs) and copper nanowires (CuNWs) were welded only at junctions resistively by a novel method using an indirect Eddy current through an inductive power transfer. By applying an inductive power of 45 kHz alternating current power indirectly for 6 s to the M-NW network deposited on polymer substrates, a decrease of sheet resistance up to ∼67.9% for AgNWs and ∼49.9% for CuNWs could be obtained without changing the optical transmittance. For AgNWs, after the welding a decrease of surface roughness could also be observed from 44.5 nm to 26.3 nm, which is similar to the height of a single layer AgNW (22.2 nm) for a bilayer junction. For AgNWs coated on a transparent flexible substrate, after the cyclic bending of 10 000 times, no change of resistance (ΔR/R0) of the AgNWs after the welding was observed and the welded AgNWs were not easily peeled off from the substrate. It is believed that this novel welding method can be applied not only to all kinds of M-NWs on various flexible low-temperature polymer substrates, but also to large areas at a short time and at low cost.

Fabrication of high-performance graphene nanoplatelet-based transparent electrodes via self-interlayer-exfoliation control.

Graphene nanoplatelets (GNP) have attracted considerable attention due to their high yield and fabrication route that is scalable to enable graphene production. However, the absence of a means of fabricating a transparent and conductive GNP film has been the biggest obstacle to the replacement of pristine graphene. Here, we report on a novel means of fabricating uniform and thin GNP-based high-performance transparent electrodes for flexible and stretchable optoelectronic devices involving the use of an adhesive polymer layer (PMMA) as a GNP layer controller and by forming a hybrid GNP/AgNW electrode embedded on PET or PDMS. Relative to the commercially available indium tin oxide (ITO) film on a PET substrate, a GNP-based electrode composed of hybrid GNP/AgNW on PET exhibits superb optical, physical, and electrical properties: a sheet resistance of 12 Ω sq-1 with 87.4% transmittance, a variable work function from 4.16 to 5.26 eV, an ultra-smooth surface, a rate of resistance increase of only 4.0% after 100 000 bending cycles, stretchability to 50% of tensile strain, and robust stability against oxidation. Moreover, the GNP-based electrode composed of hybrid Cl-doped GNP/AgNW shows outstanding performance in actual organic light-emitting diodes (OLEDs) by exhibiting an increased current efficiency of 29.5% and an increased luminous efficiency of 36.2%, relative to the commercial ITO electrode on PET.

Association of Dietary Flavonoid Intake with Prevalence of Type 2 Diabetes Mellitus and Cardiovascular Disease Risk Factors in Korean Women Aged ≥30 Years.

The purpose of this study was to investigate the association between dietary flavonoid intake and the prevalence of type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD) risk factors among Korean women aged ≥30 y. This study used data collected from the 2007-2012 Korean National Health and Nutrition Examination Survey. We excluded subjects who had energy intake <500 kcal or ≥5,000 kcal, were diagnosed with chronic disease, were taking medication, or were pregnant or lactating. The final subjects included 7,963 women, and they were divided into 2 groups, the normal fasting glucose (NFG) group (n=7,738) and the T2DM group (n=225). The intake of flavonoids was estimated on the basis of the flavonoid database. After adjustment for confounding factors, the mean intakes of fruits, anthocyanidins, and flavones were significantly lower in the T2DM group than in the NFG group. In multiple regression analysis, the dietary flavone intake was negatively associated with systolic blood pressure, triglyceride, TG/HDL-cholesterol, and homesostatic model assessment of insulin resistance. Daily intake of flavones above the 25th percentile was associated with a lower prevalence of T2DM compared with intake below the 25th percentile (OR=0.593, 95% confidence interval (CI): 0.414-0.847). These study results showed that dietary flavone intake may have some beneficial effects in reducing CVD risks and prevalence of T2DM in Korean women.

Association between dietary flavanones intake and lipid profiles according to the presence of metabolic syndrome in Korean women with type 2 diabetes mellitus.

BACKGROUND/OBJECTIVES: This study was aimed at examining the association between dietary flavanones intake and lipid profiles according to the presence of metabolic syndrome (MetS) in Korean women with type 2 diabetes mellitus (T2DM). SUBJECTS/METHODS: A cross-sectional analysis was performed among 502 female T2DM patients (non-MetS group; n = 129, MetS group; n = 373) who were recruited from the Huh's Diabetes Clinic in Seoul, Korea between 2005 and 2011. The dietary intake was assessed by a validated semi-quantitative food frequency questionnaire (FFQ) and the data was analyzed using the Computer Aided Nutritional Analysis program (CAN-Pro) version 4.0 software. The intake of flavanones was estimated on the basis of the flavonoid database. RESULTS: In the multiple linear regression analysis after adjustment for confounding factors, daily flavanones intake was negatively associated with CVD risk factors such as total cholesterol, LDL-cholesterol, and apoB and apoB/apoA1 ratio only in the MetS group but not in the non-MetS group. Multiple logistic regression analysis revealed that the odds ratio for a higher apoB/apoA1 ratio above the median (≥ 0.74) was significantly low in the 4(th) quartile compared to that in the 1(st) quartile of dietary flavanones intake [OR: 0.477, 95% CI: 0.255-0.894, P for trend = 0.0377] in the MetS group. CONCLUSIONS: Dietary flavanones intake was inversely associated with the apoB/apoA1 ratio, suggesting a potential protective effect of flavanones against CVD in T2DM women with MetS.

Nano-Welding of Ag Nanowires Using Rapid Thermal Annealing for Transparent Conductive Films.

Ag nanowire (NW) films obtained by the spraying the Ag NWs on the substrates were nano-welded by rapid thermal annealing (RTA) process and the effect of RTA process on the change of sheet resistance and optical transmittance of the Ag NW films was investigated. The increased number of Ag NW sprays on the substrate decreased the sheet resistance but also decreased the optical transmittance. By the annealing for 60 sec in a nitrogen environment to 225-250 degrees C, the sheet resistance of Ag NW film could be decreased to about 50%, even though it was accompanied by the slight decrease of optical transmittance less than 5%. The decrease of sheet resistance was related to the nano-welding of the Ag NW junctions and the slight decrease of optical transmittance was related local melting of the Ag NWs and spreading on the substrate surface. Through the nano-welding by RTA process, the Ag NW film with the sheet resistance of -20 Ω/sq. and the optical transmittance of 93% could be obtained.