Radiofrequency Pulmonary Artery Ablation for Treatment of Residual Pulmonary Hypertension After Pulmonary Endarterectomy.

OBJECTIVE: to assess the safety and efficiency of radiofrequency pulmonary artery ablation for treatment of residual pulmonary hypertension after pulmonary endarterectomy. MATERIAL AND METHODS: Radiofrequency pulmonary artery denervation (PADN) was performed in 16 patients (10 men, mean age 39 years [26; 51]). Indication for PADN was mean pulmonary artery pressure (PAP) >25 mm Hg with absence of proximal pulmonary artery lesion according to computer tomography. PADN procedure was performed with nonfluoroscopic 3D navigation system. RESULTS: After PADN mean PAP decreased from 37.3 mm Hg [29; 38] to 24.6 mm Hg [17; 30] (p=0.01); pulmonary vascular resistance decreased from 672 dyn∙s∙c-5 [387; 566] to 386 dyn∙s∙c-5 [155; 449] (р=0.02); cardiac output increased from 3.4 l/min [3.2; 3.4] to 3.5 l/ min [3.2; 4.0] (p=0.4); 6-minute walk test distance increased from 427 meters [352; 510] to 447 meters [370; 525] (p=0.16), respectively. CONCLUSION: Initial results allow to assume that radiofrequency pulmonary artery denervation combined with optimal medical therapy may take its rightful place in the treatment of this category of patients.

A new Tl4.86Fe0.82Hf1.18(MoO4)6 ternary molybdate: crystal structure and properties.

Single crystals of Tl4.86Fe0.82Hf1.18(MoO4)6 [a = b = 10.5550 (3), c = 37.7824 (9) Å, γ = 120°] are obtained by the self-flux method in the Tl2MoO4-Fe2(MoO4)3-Hf(MoO4)2 system. On the differential scanning calorimetry curve in the temperature range 320-350 K and at T ∼ 690 K, endothermic peaks are observed. The second harmonic generation test shows an excess of the signal of the quartz standard by almost three times at room temperature. In the range 320-340 K its intensity decreases by almost three times and at T ∼ 700 K it drops to zero. In the same interval, the temperature dependences of the unit-cell parameters and volume show stepwise changes. According to the X-ray diffraction data, the crystal structure consists of nonpolar and polar domains with different local symmetries. The structure is a three-dimensional framework consisting of alternating (Hf,Fe)O6 octahedra connected by MoO4 tetrahedra. Hf and Fe atoms occupy mixed Hf/Fe positions with different probabilities: 0.77:0.23, 0.50:0.50 and 0.32:0.68. Tl cations are located inside the framework in zigzag channels extended along the a and b axes. The thallium arrangement is disordered, i.e. it involves additional positions and vacancies. The complex crystal structure has been solved using the nonstandard space group R1, taking into account the local symmetry R3c for the Mo atoms and mixed Hf/Fe positions mainly occupied by Hf atoms. The possible paths of ion transport are analyzed. The energy required to overcome the potential barrier between sites of Tl cations to migrate, which corresponds to the activation energy of conductivity, is estimated. The ion current is shown to be most probable in the ab plane.

Synthesis, structure and properties of layered Pr2MoO6-based oxymolybdates doped with Mg.

Undoped and Mg-doped Pr2MoO6 oxymolybdate polycrystals and single crystals have been prepared by solid-state reactions and flux growth. The compounds have been characterized by powder X-ray diffraction, energy-dispersive spectroscopy, inductively coupled plasma mass spectrometry, scanning transmission electron microscopy, single crystal X-ray structure analysis, differential scanning calorimetry and thermogravimetry. The (MgO)x(Pr2O3)y(MoO3)z (x + y + z = 1) solid solution series has been shown to extend to x = 0.03. The structure of the Mg-doped Pr2MoO6 single crystals can be represented as superimposed lattices of the main matrix (Pr2MoO6) and lattices in which Mo atoms are partially replaced by Mg. The incorporation of Mg atoms into the structure of Pr2MoO6 results in the disordering of the praseodymium and oxygen lattices. Both the polycrystalline and single-crystal Mg-doped samples are hygroscopic.

Pulmonary Artery Denervation for Patients With Residual Pulmonary Hypertension After Pulmonary Endarterectomy.

BACKGROUND: Pulmonary artery denervation (PADN) procedure has not been applied to patients with residual chronic thromboembolic pulmonary hypertension (CTEPH) after pulmonary endarterectomy (PEA). OBJECTIVES: This study sought to assess the safety and efficacy of PADN using remote magnetic navigation in patients with residual CTEPH after PEA. METHODS: Fifty patients with residual CTEPH despite medical therapy at least 6 months after PEA, who had mean pulmonary artery pressure ≥25 mm Hg or pulmonary vascular resistance (PVR) > 400 dyn‧s‧cm-5 based on right heart catheterization were randomized to treatment with PADN (PADN group; n = 25) using remote magnetic navigation for ablation or medical therapy with riociguat (MED group; n = 25). In the MED group, a sham procedure with mapping but no ablation was performed. The primary endpoint was PVR at 12 months after randomization. Key secondary endpoint included 6-min walk test. RESULTS: After PADN procedure, 2 patients (1 in each group) developed groin hematoma that resolved without any consequences. At 12 months, mean PVR reduction was 258 ± 135 dyn‧s‧cm-5 in the PADN group versus 149 ± 73 dyn‧s‧cm-5 in the MED group, mean between-group difference was 109 dyn‧s‧cm-5 (95% confidence interval: 45 to 171; p = 0.001). The 6-min walk test distance was significantly increased in the PADN group as compared to distance in the MED group (470 ± 84 m vs. 399 ± 116 m, respectively; p = 0.03). CONCLUSIONS: PADN in patients with residual CTEPH resulted in substantial reduction of PVR at 12 months of follow-up, accompanied by improved 6-min walk test.

Characteristic features of polytypism in compounds with the La18W10O57-type structure.

Crystals with the La18W10O57-type structure (6H and 5H polytypes) were obtained by a self-flux method from high-temperature solutions. Some of the crystal samples were studied by single-crystal X-ray structure analysis. The diffraction patterns indicated that two phases co-exist in each sample. The hexagonal lattices have a common period of a ≈ 9.0 Šand are non-equal in length but have equally oriented superstructure periods 6c (phase I) and 5c (phase II), c ≈ 5.4 Å. The structures of phases I and II were solved in the symmetry groups P-62c and P321, respectively, based on the X-ray data for crystals I and II, with predominant content of the first and second phase. The motif of isolated WO6 prisms with W atoms on the cell edges is common to both phases. WO6 octahedra, both isolated and joined by faces, are distributed along the c axis within the unit cells. Phase I contains extra layers of isolated WO6 octahedra compared to phase II. Tungsten sites in joined octahedra are disordered and partially occupied. Disordering is more expressed in phase II, which in return contains rather more W and O per atom of La. The refined chemical compositions are La18W10O57 for I and La15W8.5O48 for II.

Changes in immunoreactivity of orexin-A-positive neurons after intravenous lipopolysaccharide injection.

BACKGROUND: Orexins are neuromediators that help regulate many different physiological processes; however, their role in regulating immune system functioning is unclear. This study sought to investigate the distribution of orexin in hypothalamic orexin-containing neurons during the first 6 hours after an intravenous injection of a lipopolysaccharide. MATERIAL/METHODS: Orexin-containing neurons were detected by immunohistochemistry (avidin-biotin) on frontal sections from the brains of intact rats and rats after injections of either saline or lipopolysaccharide. RESULTS: Analysis of immunohistochemically stained sections (levels 26-32 according to Swanson's atlas) revealed that the main pool of orexin-containing neurons was located at brain levels 28 to 30. No changes were shown in the number of orexin-containing neurons in the hypothalamus of intact animals at different times of a day. Visualization of orexin-containing neurons in the lateral hypothalamus decreased only in 6 hours after an injection of lipopolysaccharide (500 microg/kg body weight) at levels 28, 29, and 30 of the rat brain; this might have been the result of changes in the balance of orexin synthesis and utilization. CONCLUSIONS: These data suggest that orexin-containing neurons play a role in complex reactions in the brain to lipopolysaccharide application.