Two Cases of Late Shone Syndrome With Pulmonary Hypertension: Heart-Lung Transplant or Valve Surgery?

Two cases of Shone syndrome with severe mitral and aortic valve problems and pulmonary hypertension were referred for heart-lung transplantation. Severely elevated pulmonary vascular resistance (PVR) was confirmed as was severe periprosthetic mitral and aortic regurgitation. Based on the severity of the valve lesions in both patients, surgery was decided upon and undertaken. Both experienced early pulmonary hypertensive crises, one more than the other, that gradually subsided, followed by excellent recovery and reversal of pulmonary hypertension and PVR. These cases illustrate Braunwald's concept that pulmonary hypertension secondary to left-sided valve disease is reversible.

Physiological And Biochemical Aspects Of The Valve Snap And Valve Closure Responses In The Giant Scallop Placopecten-Magellanicus .1. Physiology

1. Catabolic processes of the phasic and catch parts of the adductor muscle ofPlacopecten magellanicus have been studied in relation to valve snap and valve closure responses. It is concluded that the snap response is powered by both parts of the adductor muscle and the valve closure response is powered exclusively by the catch part. 2. Both parts of the adductor muscle show a high glycolytic potential, reflected by high levels of glycolytic enzymes (Table 1) and high glycogen levels (Table 2). Lactate dehydrogenase could not be detected. In contrast, octopine dehydrogenase shows high activities in both parts of the adductor muscle. It is therefore concluded that a main anaerobic pathway in both tissues is the breakdown of glycogen to octopine. In the catch part, however, a considerable amount of the pyruvate formed from glycogen may also be converted into alanine (see below). The glycolytic flux in the catch part is much higher during the snap response than during valve closure. 3. The absence of phosphoenolpyruvate carboxykinase in the adductor muscle ofP. magellanicus and the observed changes in aspartate, alanine and succinate demonstrate that the energy metabolism in the catch part during valve closure shows great similarities to that which occurs only in the initial stage of anaerobiosis in the catch adductor muscle of the sea musselMytilus edulis L. 4. Arginine kinase activity and arginine phosphate content of the phasic part are much higher than those of the catch part (Tables 1 and 3). This may explain why in the phasic part during the snap response most ATP equivalents are derived from arginine phosphate, and in the catch part during both valve responses most are derived from glycolysis (Table 6). Despite the limited contribution of glycolysis in the phasic part during the snap response, the glycolytic flux increases by a factor of at least 75. 5. Evidence is obtained that octopine is neither transported from one part of the adductor muscle to the other, nor from the adductor muscle to other tissues.

Physiological And Biochemical Aspects Of The Valve Snap And Valve Closure Responses In The Giant Scallop Placopecten-Magellanicus .2. Biochemistry

1. Catabolic processes of the phasic and catch parts of the adductor muscle ofPlacopecten magellanicus have been studied in relation to valve snap and valve closure responses. It is concluded that the snap response is powered by both parts of the adductor muscle and the valve closure response is powered exclusively by the catch part. 2. Both parts of the adductor muscle show a high glycolytic potential, reflected by high levels of glycolytic enzymes (Table 1) and high glycogen levels (Table 2). Lactate dehydrogenase could not be detected. In contrast, octopine dehydrogenase shows high activities in both parts of the adductor muscle. It is therefore concluded that a main anaerobic pathway in both tissues is the breakdown of glycogen to octopine. In the catch part, however, a considerable amount of the pyruvate formed from glycogen may also be converted into alanine (see below). The glycolytic flux in the catch part is much higher during the snap response than during valve closure. 3. The absence of phosphoenolpyruvate carboxykinase in the adductor muscle ofP. magellanicus and the observed changes in aspartate, alanine and succinate demonstrate that the energy metabolism in the catch part during valve closure shows great similarities to that which occurs only in the initial stage of anaerobiosis in the catch adductor muscle of the sea musselMytilus edulis L. 4. Arginine kinase activity and arginine phosphate content of the phasic part are much higher than those of the catch part (Tables 1 and 3). This may explain why in the phasic part during the snap response most ATP equivalents are derived from arginine phosphate, and in the catch part during both valve responses most are derived from glycolysis (Table 6). Despite the limited contribution of glycolysis in the phasic part during the snap response, the glycolytic flux increases by a factor of at least 75. 5. Evidence is obtained that octopine is neither transported from one part of the adductor muscle to the other, nor from the adductor muscle to other tissues.

Evolution of the Diatoms: VIII. Re-Examination of the SSU-Rrna Gene Using Multiple Outgroups and a Cladistic Analysis of Valve Features.

The resolution of the SSU rRNA gene for phylogenetic analysis in the diatoms has been evaluated by Theriot et al. who claimed that the SSU rRNA gene could not be used to resolve the monophyly of the three diatoms classes described by Medlin and Kaczmarska. Although they used both only bolidomonads and heterokonts as outgroups, they did not explore outgroups further away than the heterokonts. In this study, the use of the multiple outgroups inside and outside the heterokonts with the rRNA gene for recovering the three monophyletic clades at the class level is evaluated. Trees with multiple outgroups ranging from only bolidophytes to Bacteria and Archea were analyzed with Bayesian and Maximum Likelihood analyses and two data sets were recovered with the classes being monophyletic. Other data sets were analyzed with non-weighted and weighted maximum parsimony. The latter reduced the number of clades and lengthened branch lengths between the clades. One data set using a weighted analysis recovered the three classes as monophyletic. Taking only bolidophytes as the only outgroup never produced monophyletic clades. Multiple outgroups including many heterokonts and certain members of the crown group radiation recovered monophyletic clades. The three classes can be defined by clear morphological differences primarily based on auxospore ontogeny and envelope structure, the presence or absence of a structure (tube process or sternum) associated with the annulus and the location of the cribrum in those genera with loculate areolae. A cladistic analysis of some of these features is presented and recovers the three classes.

Analysis of the Steady Flow Characteristics Through a Poppet Valve

This paper describes the flow characteristics in the near throat region of a poppet valve under steady flow conditions. An experimental and theoretical procedure was undertaken to determine the total pressure at the assumed throat region of the valve, and also at a downstream location. Experiments of this type can be used to accurately determine the flow performance of a particular induction system. The static pressure recovery was calculated from the near throat region of the valve to the downstream location and was shown to be dependant on valve lift. Total pressure profiles suggest that for this particular induction system, the majority of pressure loss occurs downstream of the valve for lift/diameter ratios up to 0.1, and upstream of the valve for lift/diameter ratios greater than 0.1. Negligible pressure recovery was shown to exist from the cylindrical periphery of the valve head to the downstream location for all valve lifts, indicating that the flow had probably separated completely from the trailing edge of the valve seating face. The calculated discharge coefficients, based on the geometric throat static pressure measurements on the seating face, were in general less than those determined using the downstream static pressure, by as much as 12% in some instances towards the valves lower mass flow rate range.