996 resultados para late potential


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While most healthy elderly are able to manage their everyday activities, studies showed that there are both stable and declining abilities during healthy aging. For example, there is evidence that semantic memory processes which involve controlled retrieval mechanism decrease, whereas the automatic functioning of the semantic network remains intact. In contrast, patients with Alzheimer’s disease (AD) suffer from episodic and semantic memory impairments aggravating their daily functioning. In AD, severe episodic as well as semantic memory deficits are observable. While the hallmark symptom of episodic memory decline in AD is well investigated, the underlying mechanisms of semantic memory deterioration remain unclear. By disentangling the semantic memory impairments in AD, the present thesis aimed to improve early diagnosis and to find a biomarker for dementia. To this end, a study on healthy aging and a study with dementia patients were conducted investigating automatic and controlled semantic word retrieval. Besides the inclusion of AD patients, a group of participants diagnosed with semantic dementia (SD) – showing isolated semantic memory loss – was assessed. Automatic and controlled semantic word retrieval was measured with standard neuropsychological tests and by means of event-related potentials (ERP) recorded during the performance of a semantic priming (SP) paradigm. Special focus was directed to the N400 or N400-LPC (late positive component) complex, an ERP that is sensitive to the semantic word retrieval. In both studies, data driven topographical analyses were applied. Furthermore, in the patient study, the combination of the individual baseline cerebral blood flow (CBF) with the N400 topography of each participant was employed in order to relate altered functional electrophysiology to the pathophysiology of dementia. Results of the aging study revealed that the automatic semantic word retrieval remains stable during healthy aging, the N400-LPC complex showed a comparable topography in contrast to the young participants. Both patient groups showed automatic SP to some extent, but strikingly the ERP topographies were altered compared to healthy controls. Most importantly, the N400 was identified as a putative marker for dementia. In particular, the degree of the topographical N400 similarity was demonstrated to separate healthy elderly from demented patients. Furthermore, the marker was significantly related to baseline CBF reduction in brain areas relevant for semantic word retrieval. Summing up, the first major finding of the present thesis was that all groups showed semantic priming, but that the N400 topography differed significantly between healthy and demented elderly. The second major contribution was the identification of the N400 similarity as a putative marker for dementia. To conclude, the present thesis added evidence of preserved automatic processing during healthy aging. Moreover, a possible marker which might contribute to an improved diagnosis and lead consequently to a more effective treatment of dementia was presented and has to be further developed.

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OBJECTIVES This study sought to describe the frequency and clinical impact of acute scaffold disruption and late strut discontinuity of the second-generation Absorb bioresorbable polymeric vascular scaffolds (Absorb BVS, Abbott Vascular, Santa Clara, California) in the ABSORB (A Clinical Evaluation of the Bioabsorbable Everolimus Eluting Coronary Stent System in the Treatment of Patients With De Novo Native Coronary Artery Lesions) cohort B study by optical coherence tomography (OCT) post-procedure and at 6, 12, 24, and 36 months. BACKGROUND Fully bioresorbable scaffolds are a novel approach to treatment for coronary narrowing that provides transient vessel support with drug delivery capability without the long-term limitations of metallic drug-eluting stents. However, a potential drawback of the bioresorbable scaffold is the potential for disruption of the strut network when overexpanded. Conversely, the structural discontinuity of the polymeric struts at a late stage is a biologically programmed fate of the scaffold during the course of bioresorption. METHODS The ABSORB cohort B trial is a multicenter single-arm trial assessing the safety and performance of the Absorb BVS in the treatment of 101 patients with de novo native coronary artery lesions. The current analysis included 51 patients with 143 OCT pullbacks who underwent OCT at baseline and follow-up. The presence of acute disruption or late discontinuities was diagnosed by the presence on OCT of stacked, overhung struts or isolated intraluminal struts disconnected from the expected circularity of the device. RESULTS Of 51 patients with OCT imaging post-procedure, acute scaffold disruption was observed in 2 patients (3.9%), which could be related to overexpansion of the scaffold at the time of implantation. One patient had a target lesion revascularization that was presumably related to the disruption. Of 49 patients without acute disruption, late discontinuities were observed in 21 patients. There were no major adverse cardiac events associated with this finding except for 1 patient who had a non-ischemia-driven target lesion revascularization. CONCLUSIONS Acute scaffold disruption is a rare iatrogenic phenomenon that has been anecdotally associated with anginal symptoms, whereas late strut discontinuity is observed in approximately 40% of patients and could be viewed as a serendipitous OCT finding of a normal bioresorption process without clinical implications. (ABSORB Clinical Investigation, Cohort B [ABSORB B]; NCT00856856).

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In the Bolivian Amazon several paleochannel generations are preserved. Their wide spectrum of morphologies clearly provides crucial information on the type and magnitude of geomorphic and hydrological changes within the drainage network of the Andean foreland. Therefore, in this study we mapped geomorphological characteristics of paleochannels, and applied radiocarbon and optically stimulated luminescence dating. Seven paleochannel generations are identified. Significant changes in sinuosity, channel widths and river pattern are observed for the successive paleochannel generations. Our results clearly reflect at least three different geomorphic and hydrological periods in the evolution of the fluvial system since the late Pleistocene. Changes in discharge and sediment load may be controlled by combinations of two interrelated mechanisms: (i) spatial changes and re-organizations of the drainage network in the upper catchment, and/or (ii) climate changes with their associated local to catchment-scale modifications in vegetation cover, and changes in discharge, inundation frequencies and magnitudes, which have likely affected the evolution of the fluvial system in the Llanos de Moxos. In summary, our study has revealed the enormous potential which geomorphic mapping and analysis combined with luminescence based chronologies hold for the reconstruction of the late Pleistocene to recent fluvial system in a large portion of Amazonia.

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The cardiac late Na (+) current is generated by a small fraction of voltage-dependent Na (+) channels that undergo a conformational change to a burst-gating mode, with repeated openings and closures during the action potential (AP) plateau. Its magnitude can be augmented by inactivation-defective mutations, myocardial ischemia, or prolonged exposure to chemical compounds leading to drug-induced (di)-long QT syndrome, and results in an increased susceptibility to cardiac arrhythmias. Using CytoPatch™ 2 automated patch-clamp equipment, we performed whole-cell recordings in HEK293 cells stably expressing human Nav1.5, and measured the late Na (+) component as average current over the last 100 ms of 300 ms depolarizing pulses to -10 mV from a holding potential of -100 mV, with a repetition frequency of 0.33 Hz. Averaged values in different steady-state experimental conditions were further corrected by the subtraction of current average during the application of tetrodotoxin (TTX) 30 μM. We show that ranolazine at 10 and 30 μM in 3 min applications reduced the late Na (+) current to 75.0 ± 2.7% (mean ± SEM, n = 17) and 58.4 ± 3.5% ( n = 18) of initial levels, respectively, while a 5 min application of veratridine 1 μM resulted in a reversible current increase to 269.1 ± 16.1% ( n = 28) of initial values. Using fluctuation analysis, we observed that ranolazine 30 μM decreased mean open probability p from 0.6 to 0.38 without modifying the number of active channels n, while veratridine 1 μM increased n 2.5-fold without changing p. In human iPSC-derived cardiomyocytes, veratridine 1 μM reversibly increased APD90 2.12 ± 0.41-fold (mean ± SEM, n = 6). This effect is attributable to inactivation removal in Nav1.5 channels, since significant inhibitory effects on hERG current were detected at higher concentrations in hERG-expressing HEK293 cells, with a 28.9 ± 6.0% inhibition (mean ± SD, n = 10) with 50 μM veratridine.

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The Quaternary Vakinankaratra volcanic field in the central Madagascar highlands consists of scoria cones, lava flows, tuff rings, and maars. These volcanic landforms are the result of processes triggered by intracontinental rifting and overlie Precambrian basement or Neogene volcanic rocks. Infrared-stimulated luminescence (IRSL) dating was applied to 13 samples taken from phreatomagmatic eruption deposits in the Antsirabe–Betafo region with the aim of constraining the chronology of the volcanic activity. Establishing such a chronology is important for evaluating volcanic hazards in this densely populated area. Stratigraphic correlations of eruption deposits and IRSL ages suggest at least five phreatomagmatic eruption events in Late Pleistocene times. In the Lake Andraikiba region, two such eruption layers can be clearly distinguished. The older one yields ages between 109 ± 15 and 90 ± 11 ka and is possibly related to an eruption at the Amboniloha volcanic complex to the north. The younger one gives ages between 58 ± 4 and 47 ± 7 ka and is clearly related to the phreatomagmatic eruption that formed Lake Andraikiba. IRSL ages of a similar eruption deposit directly overlying basement laterite in the vicinity of the Fizinana and Ampasamihaiky volcanic complexes yield coherent ages of 68 ± 7 and 65 ± 8 ka. These ages provide the upper age limit for the subsequently developed Iavoko, Antsifotra, and Fizinana scoria cones and their associated lava flows. Two phreatomagmatic deposits, identified near Lake Tritrivakely, yield the youngest IRSL ages in the region, with respective ages of 32 ± 3 and 19 ± 2 ka. The reported K-feldspar IRSL ages are the first recorded numerical ages of phreatomagmatic eruption deposits in Madagascar, and our results confirm the huge potential of this dating approach for reconstructing the volcanic activity of Late Pleistocene to Holocene volcanic provinces.

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BACKGROUND Bioresorbable scaffolds provide transient lumen support followed by complete resorption. OBJECTIVES This study examined whether very late scaffold thrombosis (VLScT) occurs when resorption is presumed to be nearly complete. METHODS Patients with VLScT at 3 tertiary care centers underwent thrombus aspiration followed by optical coherence tomography (OCT). Thrombus aspirates were analyzed by histopathological and spectroscopic examination. RESULTS Between March 2014 and February 2015, 4 patients presented with VLScT at 44 (case 1), 19 (cases 2 and 4), and 21 (case 3) months, respectively, after implantation of an Absorb Bioresorbable Vascular Scaffold 1.1 (Abbott Laboratories, Abbott Park, Illinois). At the time of VLScT, all patients were taking low-dose aspirin, and 2 patients were also taking prasugrel. OCT showed malapposed scaffold struts surrounded by thrombus in 7.1%, 9.0%, and 8.9% of struts in cases 1, 2, and 4, respectively. Scaffold discontinuity with struts in the lumen center was the cause of malapposition in cases 2 and 4. Uncovered scaffold struts with superimposed thrombus were the predominant findings in case 3. OCT percent area stenosis at the time of VLScT was high in case 1 (74.8%) and case 2 (70.9%) without evidence of excessive neointimal hyperplasia. Spectroscopic thrombus aspirate analysis showed persistence of intracoronary polymer fragments in case 1. CONCLUSIONS VLScT may occur at advanced stages of scaffold resorption. Potential mechanisms specific for VLScT include scaffold discontinuity and restenosis during the resorption process, which appear delayed in humans; these findings suggest an extended period of vulnerability for thrombotic events.

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BACKGROUND The pathomechanisms underlying very late stent thrombosis (VLST) after implantation of drug-eluting stents (DES) are incompletely understood. Using optical coherence tomography, we investigated potential causes of this adverse event. METHODS AND RESULTS Between August 2010 and December 2014, 64 patients were investigated at the time point of VLST as part of an international optical coherence tomography registry. Optical coherence tomography pullbacks were performed after restoration of flow and analyzed at 0.4 mm. A total of 38 early- and 20 newer-generation drug-eluting stents were suitable for analysis. VLST occurred at a median of 4.7 years (interquartile range, 3.1-7.5 years). An underlying putative cause by optical coherence tomography was identified in 98% of cases. The most frequent findings were strut malapposition (34.5%), neoatherosclerosis (27.6%), uncovered struts (12.1%), and stent underexpansion (6.9%). Uncovered and malapposed struts were more frequent in thrombosed compared with nonthrombosed regions (ratio of percentages, 8.26; 95% confidence interval, 6.82-10.04; P<0.001 and 13.03; 95% confidence interval, 10.13-16.93; P<0.001, respectively). The maximal length of malapposed or uncovered struts (3.40 mm; 95% confidence interval, 2.55-4.25; versus 1.29 mm; 95% confidence interval, 0.81-1.77; P<0.001), but not the maximal or average axial malapposition distance, was greater in thrombosed compared with nonthrombosed segments. The associations of both uncovered and malapposed struts with thrombus were consistent among early- and newer-generation drug-eluting stents. CONCLUSIONS The leading associated findings in VLST patients in descending order were malapposition, neoatherosclerosis, uncovered struts, and stent underexpansion without differences between patients treated with early- and new-generation drug-eluting stents. The longitudinal extension of malapposed and uncovered stent was the most important correlate of thrombus formation in VLST.

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OBJECTIVE Due to reduction of immune-suppressive drugs, patients with rheumatic diseases can experience an increase in disease activity during pregnancy. In such cases, TNF-inhibitors may be prescribed. However, monoclonal antibodies with the Fc moiety are actively transported across the placenta, resulting in therapeutic drug levels in the newborn. As certolizumab (CZP) lacks the Fc moiety, it may bear a lower risk for the child. METHOD We report a case series of thirteen patients (5 with rheumatoid arthritis and 8 with spondyloarthritis) treated with CZP during late pregnancy to control disease activity. RESULT CZP measured in cord blood of eleven infants ranged between undetectable levels and 1μg/mL whereas the median CZP level of maternal plasma was 32.97μg/mL. Three women developed an infection during the third trimester, of whom one had a severe infection and one had an infection that resulted in a pre-term delivery. During the postpartum period, 6 patients remained on CZP while breastfeeding. CZP levels in the breast milk of two breastfeeding patients were undetectable. CONCLUSION The lack of the active transplacental transfer of CZP gives the possibility to treat inflammatory arthritis during late gestation without potential harm to the newborn. However, in pregnant women treated with TNF-inhibitors and prednisone, attention should be given to the increased susceptibility to infections, which might cause prematurity. CZP treatment can be continued while breastfeeding.

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The sediment record from Rodderberg potentially provides a climate and environmental record spanning at least the last ca 130 ka. Results from a low resolution pilot study reveal characteristic fluctuations that can be related to global climate variability as reflected in marine isotope stages and document the potential of this site for continuous and high-resolution investigations of the Middle to Late Pleistocene. Here we document the tentative lithology drilled, and show how the elemental composition can be interpreted with regard to lake level fluctuations, related redox conditions, but also to grain-size distribution and changes in lacustrine productivity. Finally, based on major lithological changes, a preliminary depth/age model is suggested that allows reassessing published luminescence ages from the same site.

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A high-resolution record of foraminiferal fragmentation (a dissolution indicator) for the last 250 k.y. (isotopic Stages 1 to 7) is identified in the upper 61.9 m of Ocean Drilling Program (ODP) Hole 828A, west Vanuatu. This record is comparable in detail to the atmospheric CO2 record and the d18O stack. Phase shifts between preservation spikes and maximum ice volumes (d18O of Globigerinoides sacculifer) are analogous to those on Ontong Java Plateau. Mass spectrometer (AMS14C) dating of a sample taken at the base of dissolution cycle B1 and the position of the last glacial maximum indicates a lag in time of ~8 k.y. in the Vanuatu region for the last glacial termination. When dissolution spikes are compared with minimum ice volumes there is no phase shift for the last two glacial terminations. The difference between Vanuatu and Ontong Java Plateau may be explained by local CO2 sinks and the interplay between intermediate and deep water masses. Terrigenous input increasingly affected sediment of Hole 828A on the North d'Entrecasteaux Ridge (NDR) as it approached Espiritu Santo Island. Mud and silt suspended in mid-water flows become important after 125 ka, while turbidites bypass the New Hebrides Trench only towards the last glacial maximum (LGM). Terrigenous supply seems to affect the lysocline profile that changed from an "open ocean" to a "near continent" type, thus favoring dissolution. Fragmentation of planktonic foraminifers is a more sensitive indicator of lysocline variations than is foraminiferal susceptibility to dissolution, the foraminiferal dissolution index, the abundance of benthic foraminifers, or CaCO3 content. A modern foraminiferal lysocline for the neighboring area (between 10°S and 30°S, and 160°E and 180°E) is found at 3.1 km below sea level, compared to west Vanuatu where it is shallower. The past lysocline level was deeper than 3086 m during intervals of dissolution minima, and ranged from ~2550 to 3000 m during intervals of dissolution maxima. The high sedimentation rates (in the order of 10 to 50 cm/k.y.) found in Hole 828A offer a great potential for future high-resolution studies either in this hole or other western localities along the NDR. Areas of high sedimentation near continental regions have been discarded for paleoceanographic and/or paleoclimatic studies. Nonetheless, conditions analogous to those found in Hole 828A are expected to occur in many trench areas around the world where mid-water flows have preserved as yet undiscovered fine high-resolution sedimentary records.

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The Niveau Breistroffer black shale succession in the Vocontian Basin (SE France) is the regional equivalent of the widely distributed Late Albian Oceanic Anoxic Event 1d. The studied black shale-rich interval at the Col de Palluel section is 6.28 m thick and comprises four black shale units with up to 2.5 wt% total organic carbon (TOC) intercalated with marlstones. Calcareous nannofossil, palynomorph, planktic Foraminifera and stable isotopic data from the Niveau Breistroffer succession suggest that short-term climate changes influenced its deposition, with relatively warm and humid climate during black shale formation in comparison with relatively cool and dry climatic conditions during marlstone deposition. An increase in the terrigenous/marine ratio of palynomorphs indicates enhanced humidity and higher runoff during black shale formation. A nutrient index based on calcareous nannofossils and the abundance pattern of small (63-125 µm) hedbergellid Foraminifera show short-term changes in the productivity of the surface water. Surface-water productivity was reduced during black shale formation and increased during marlstone deposition. A calcareous nannofossil temperature index and bulk-rock oxygen isotope data indicate relative temperature changes, with warmer surface waters for black shale samples. At these times, warm-humid climate and reduced surface-water productivity were accompanied by greater abundances of 'subsurface'-dwelling calcareous nannofossils (nannoconids) and planktic Foraminifera (rotaliporids). These taxa presumably indicate more stratified surface-water conditions. We suggest that the formation of the Niveau Breistroffer black shales occurred during orbitally induced increase in monsoonal activity that led to increasing humidity during periods of black shale formation. This, in turn, caused a decrease in low-latitude deep-water formation and probably an increase in surface-water stratification. The combination of these two mechanisms caused depleted O2 concentrations in the bottom water that increased the preservation potential of organic matter

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Late Eocene to Pleistocene planktonic foraminifers from Leg 120 Holes 747A and 749B on the Kerguelen Plateau were quantitatively analyzed. Microperforate tenuitellid forms dominate the Oligocene to middle Miocene, and 17 species (including the new species Tenuitella jamesi and Tenuitellinata selleyi) are recorded. A lineage zonation of tenuitellid foraminifers is proposed as an alternative scheme for refinement of the Oligocene-Miocene biostratigraphy in high latitudes. Progressive or abrupt alterations in morphological characters within this lineage, producing different morphotypes or species, coincided with prolonged or sudden changes in paleoclimate. These microperforate planktonic foraminifers thus appear to have potential as indicators of cold-water masses and temperature fluctuations in post-Eocene oceans.

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Continental rise Site 905 yielded upper Miocene and Pliocene uniform hemipelagic mud (a contourite) from approximately 215 to 540 meters below seafloor. The nannofossil biostratigraphy of this interval was reexamined using closely spaced samples from core interiors. Additionally, total nannofossil abundances and dominant species and species group abundances were determined to evaluate the potential of this section for extracting sequence stratigraphic information. The data indicate that the putative hiatuses at the end of the late Pliocene (Zones NN17 and NN18) and in the early Pliocene (Zones NN13 and NN14) probably are condensed intervals, but the base of the late Miocene is almost certainly marked by an unconformity. Judging from carbonate content and sedimentation rate both, nannofossil abundance may be governed by carbonate dissolution or by siliciclastic dilution. Consequently, condensed sections cannot be identified by the abundance of pelagic component in the sediment alone, as is possible in equivalent age Gulf of Mexico sediments. Where nannofossil preservation is adequate in consecutive samples, as in the early Pliocene and latest late Miocene, total nannofossil abundance fluctuates regularly and with a periodicity of less than 105 yr, which suggests that dilution of the pelagic component occurred with a frequency probably related to astronomical forcing.

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The main objectives of this study are (1) to characterize the spatial and temporal variations in organic matter deposited in upwelling and related sediments (manifest in the palynoclast and organic-walled microplankton assemblages) and (2) to relate these variations to paleoenvironmental changes. A total of 40 samples from Holes 679D, 680B, 681B, 684B, 686B, and 687B were analyzed. Without exception, amorphogen dominates the palynoclast assemblages overwhelmingly. Influx of terrestrial particulate organic matter to the marine realm was extremely low. Levels of amorphogen swamp other palynoclast categories, and little significance can be attached to any variations observed. Microplankton dominate the palynomorph assemblages, with variable levels of subordinate foraminiferal test linings. Miospores are rare and are absent in most samples. Foraminiferal test linings are particularly abundant in the shallowest samples, which may reflect low surface-water paleotemperatures. Cysts of heterotrophic peridiniacean dinoflagellates (P-cysts) dominate the microplankton assemblages, with variable levels of cysts of autotrophic gonyaulacacean dinoflagellates (G-cysts). Samples dominated by P-cysts are derived largely from laminated, unbioturbated units deposited under the influence of strong upwelling. A lower abundance of P-cysts in some samples is restricted to unlaminated, bioturbated units deposited under oxygenated conditions. We conclude that the ratio of P-cysts to G-cysts is a useful indicator of variable upwelling strength. Detailed study of the variations in the microplankton assemblages offers one the greatest potential for palynological characteriztion and understanding of the upwelling system.

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We examine whether or not a relationship exists between the late Miocene carbon isotope shift (~7.6-6.6 Ma) and marine productivity at four sites from the Indian and Pacific Oceans (Ocean Drilling Program Sites 721, 1146, 1172, and 846). We use a multiproxy approach based on benthic foraminiferal accumulation rates, elemental ratios, and dissolution indices, and we compare these data to benthic foraminiferal d13C values measured on the same samples. Although some of these sites have been targeted previously in studies of either the late Miocene/early Pliocene "biogenic bloom" (Sites 721 and 846) or the late Miocene carbon isotope shift (Site 1172), our records are the first to establish paired proxy records of carbon isotopes and paleoproductivity allowing a direct assessment of a potential link. Our results indicate that at all sites, productivity increased sometime during the d13C shift; at three sites (721, 1146, and 846), productivity increased at the beginning of the shift. The correlation coefficients derived from linear regression between micropaleontologically derived productivity and foraminiferal d13C values are relatively high during the time interval containing the late Miocene d13C shift (and statistically significant at three of the sites). Carbon flux and isotope mass balance considerations illustrate that transfer of organic matter between the terrestrial and marine reservoirs together with enhanced oceanic upwelling best approximates observed changes in carbon isotope records and paleoproductivity. We note that long-term trend in the Site 846 paleoproductivity record can be correlated to the long-term trend in the Site 848 eolian flux reconstructions of Hovan (1995, doi:10.2973/odp.proc.sr.138.132.1995) hinting at a link between strengthened wind regime and productivity during the late Miocene.