Protonenleitung in imidazolhaltigen Materialien als Modellsysteme für wasserfreie Brennstoffzellenmembranen

Es wird ein neues Konzept für ein protonenleitendes Polymer vorgestellt, das ohne eine zweite, flüssige Phase auskommt. Es beruht darauf, basische Gruppen (Imidazol) über flexible Spacer kovalent an ein Polymerrückgrat zu binden und durch Dotierung mit einer geringen Menge Säure Ladungsträger (Protonen) in dieses System einzubringen.Um die für die Leitfähigkeit und ihren Mechanismus verantwortlichen Größen zu identifizieren, wurde ein Satz von niedermolekularen Modellverbindungen definierter Struktur und hoher Reinheit synthetisiert und im reinen Zustand sowie nach Dotierung mit geringen Mengen Säure umfassend charakterisiert. Untersucht wurden die thermischen Eigenschaften, die Leitfähigkeit, die Diffusion der jeweiligen Modellverbindung sowie ggf. der zugesetzten Säure, das Protonierungsgleichgewicht und die dielektrischen Eigenschaften. Insbesondere wurden durch den Vergleich von Leitfähigkeits- und Diffusionsdaten unter Anwendung der Nernst-Einstein-Beziehung Rückschlüsse auf den Leitmechanismus gezogen.Es wurden Leitfähigkeiten von bis zu 6.5E-3 S/cm bei 120°C erreicht. Der Anteil der Strukturdiffusion (vergleichbar mit dem Grotthus-Mechanismus in Wasser) an der protonischen Leitfähigkeit betrug bis zu über 90%. Als entscheidende Faktoren für die Leitfähigkeit wurden die Glastemperatur und, mit geringerer Priorität, der Imidazolgehalt des Materials identifiziert. Die Temperaturabhängigkeit aller untersuchten Transportgrößen ließ sich durch die Vogel-Tamman-Fulcher-Gleichung exzellent beschreiben.Die vorgestellten Daten bilden die Grundlage für den Entwurf eines entsprechenden Polymers.

Wasserfreie, polymere Protonenleiter für Brennstoffzellen durch Immobilisierung von Imidazol

Es werden neuartige, polymere Protonenleiter vorgestellt die nach dem 'Konzept des polymergebunden Protonensolvens' realisiert wurden. Sie zeigen protonische Leitfähigkeit als intrinsische Eigenschaft, sodass keine zweite, flüssige Phase zur Protonenleitung nötig ist. Verwirklicht wurde das Konzept anhand von kammartigen Siloxanoligomeren und -polymeren, wobei Imidazol als Protonensolvens durch flexible Spacer kovalent an das Rückgrat gebunden ist. Durch Pfropfung mit imidazoltragenden Spacereinheiten wurden ferner Kieselgelnanopartikel oberflächenmodifiziert. Um die Auswirkungen der Immobilisierung von Imidazol auf die Leitfähigkeit zu untersuchen, wurden neben unterschiedlichen Molekulargewichten, die Verbindungen auch jeweils mit verschiedenen Spacerlängen synthetisiert. Die Materialien wurden umfassend charakterisiert und auf ihr thermisches Verhalten, Stabilität, Leitfähigkeit, Diffusion und dielektrisches Verhalten sowie auch nach Dotierung mit Säure untersucht. Thermisch stabil sind die Materialien bis ca. 200°C. Die Leitfähigkeiten betragen bis zu 1,5E-3 S/cm bei 160°C, welche aufgrund der Immobilisierung des Imidazols ausschließlich auf Strukturdiffusion zurückzuführen sind. Die Strukturdiffusion ist vergleichbar mit dem Grotthus-Mechanismus in Wasser und wird durch die lokale Mobilität der Imidazolmoleküle, d.h. durch die Glasübergangstemperatur des Systems bestimmt. Entsprechend wird das für Glasbildner typische Vogel-Tamman-Fulcher-Verhalten für alle untersuchten Transportprozesse gefunden. Die mit abnehmender Glasübergangstemperatur abnehmende mechanische Stabilität der Materialien kann, wie gezeigt ist, durch Compoundierung mit Kieselgelnanopartikeln entscheidend verbessert werden, was eine kostengünstige und aussichtsreiche Möglichkeit zur Herstellung von Membranen für Brennstoffzellen darstellt.

Frugivores, seed dispersal and tree regeneration along a human disturbance gradient in East African tropical rainforests

Samenausbreitung und Regeneration von Bäumen sind wichtig für den langfristigen Bestand von Baum- und Frugivorengemeinschaften in tropischen Regenwäldern. Zunehmende Rohdung und Degradation gefährden den Ablauf dieser mutualistischen Prozesse in diesem Ökosystem. Um den Einfluss von kleinräumiger menschlicher Störung auf die Frugivorengemeinschaft und die zentralen Ökosystemprozesse Samenausbreitung und Regeneration zu erforschen, habe ich 1) die Frugivorengemeinschaft und die Samenausbreitungsrate von Celtis durandii (Ulmaceae) und 2) den Zusammenhang zwischen Baumarten mit fleischigen Früchten, Frugivoren und der Etablierung von Keimlingen dieser Baumarten in unterschiedlich stark gestörten Flächen dreier ostafrikanischer tropischer Regenwälder untersucht. Insgesamt konnte ich 40 frugivore Vogel- und Primatenarten in den drei untersuchten Waldgebieten nachweisen. Auf gering gestörten Flächen wurden mehr Frugivore als auf stark gestörten Flächen aufgenommen. Auch die Beobachtungen an C. durandii ergaben mehr frugivore Besucher in Bäumen auf gering gestörten als auf stark gestörten Flächen. Dies führte zu einer marginal signifikant höheren Samenausbreitungsrate auf den gering gestörten Flächen. Diese Ergebnisse waren auf regionaler Ebene in allen drei untersuchten Wäldern konsistent. Dies zeigt, dass kleinräumige Störung einen umfassenderen negativen Einfluss auf Frugivore und ihre Funktion als Samenausbreiter hat als zuvor angenommen. Bei der Vegetationserfassung nahm ich 131 verschiedene Baumarten mit fleischigen Früchten in den drei Regenwäldern auf. Kleinräumige menschliche Störung erhöhte den Artenreichtum dieser Baumarten marginal signifikant, hatte jedoch keinen direkten Einfluss auf die Frugivorendichte und den Artenreichtum von Keimlingen dieser Baumarten. Der Artenreichtum von Baumarten mit fleischigen Früchten zeigte einen marginal signifikant positiven Einfluss auf die Frugivorendichte, allerdings nicht auf die Keimlinge. Allerdings führte die Dichte der Frugivoren zu signifikant erhöhtem Artenreichtum der Keimlinge. Folglich scheint kleinräumige Störung die Keimlingsetablierung indirekt durch erhöhten Baumartenreichtum und erhöhte Frugivorendichte zu beeinflussen. Die Frugivorendichte hatte einen größeren Einfluss auf die Waldregeneration als kleinräumige Störung und Baumartenreichtum. Demnach scheint kleinräumige menschliche Störung sowohl positive als auch negative Effekte auf Samenausbreitung und Regeneration zu haben. Somit sind weitere Studien notwendig, die den Einfluss von kleinräumiger menschlicher Störung auf Mutualismen tropischer Regenwälder aufklären.

Die Reproduktion von Dinosauriern, speziell der Sauropoden, und deren Bedeutung für ihren Gigantismus

Es wurde ein Teil der life-history, die Reproduktion, von Dinosauriern, speziell der Sauropoden, den größten bekannten jemals auf der Erde existierenden Landtieren, untersucht, um unter anderem den Zusammenhang zwischen Gigantismus und Reproduktion zu erforschen. Hierzu wurde eine mögliche life-history für Sauropoden, auf Grundlage des heutigen Forschungsstands in der Biologie und der Paläontologie, anhand einer Literaturrecherche erstellt. Des Weiteren wurde ein Modell zur Reproduktion bei ausgestorbenen oviparen Amnioten, basierend auf bestehenden Zusammenhängen zwischen Körpergröße und verschiedenen masse-spezifischen Reproduktionsmerkmalen (Eigewicht, Gelegegewicht, jähr. Gelegegewicht) bei rezenten oviparen Amnioten, erarbeitet. Mit Hilfe dieses Modells und Informationen aus Fossilfunden wurde der Frage nachgegangen, wie diese Reproduktionsmerkmale bei Dinosauriern wahrscheinlich ausgesehen haben. Weiterhin erfolgte die Überprüfung der Hypothese, dass Dinosaurier, insbesondere Sauropoden, eine höhere Reproduktionskapazität hatten als gleich große landlebende Säugetiere, was ersteren im Vergleich zu letzteren ermöglicht haben soll so viel größer zu werden (Janis und Carrano 1992). rnDie Untersuchungen der Zusammenhänge zwischen Körpergewicht und den masse-spezifischen Reproduktionsmerkmalen ergaben, dass das Körpergewicht immer stark mit den untersuchten Reproduktionsmerkmalen korreliert war. Große Vögel und große Reptilien unterscheiden sich in ihrem relativen Eigewicht (Eigewicht/Körpergewicht). Vögel haben relativ größere Eier. Betrachtet man das relative Gelegegewicht oder das relative jährliche Gelegegewicht so wird der Unterschied kleiner bzw. ist zwischen manchen Reptilien- und Vogelgruppen nicht mehr vorhanden. Dinosaurier hatten relative Eigewichte, die zwischen denen von Reptilien und Vögel liegen. Basale Dinosaurier, wie Prosauropoden, waren in ihrer Reproduktion eher reptilien-ähnlich, während vogel-ähnliche Theropoden eine Reproduktion hatten, die sich besser durch ein Vogelmodel beschreiben lässt. Die Reproduktion anderer Dinosaurier, wie Sauropoden und Hadrosaurier, lässt sich nicht eindeutig durch eines der beiden Modelle beschreiben und/oder die Modelle variierten in Abhängigkeit des betrachteten Merkmals. Trotzdem war es möglich für alle untersuchten Dinosaurier eine Abschätzung zur Gelegegröße und der Anzahl der jährlich gelegten Eier zu machen. Diese Schätzungen ergaben, dass die vermutete hohe Reproduktionskapazität von mehreren hundert Eiern pro Jahr nur für extrem große Sauropoden (70 t) haltbar ist. rnMit Ausnahme der Nagetiere fand ich die Unterschiede in der Reproduktionskapazität von Vögeln und Säugetieren, die Janis und Carrano (1992) postulierten, sogar auf der Ebene von Ordnungen. Dinosauriergelege waren größer als die Würfe von gleichgroßen (extrapolierten) Säugetieren während die Gelegegröße von gleichgroßen (extrapolierten) Vögeln ähnlich der von Sauropoden war. Da das Aussterberisiko häufig mit niedriger Reproduktionskapazität korreliert ist, impliziert dies ein geringeres Aussterberisiko großer Dinosaurier im Vergleich zu großen Säugetieren. Populationen sehr großer Dinosaurier, wie der Sauropoden, konnten vermutlich daher, über evolutionäre Zeiträume betrachtet, sehr viel länger existieren als Populationen großer Säugetiere.rn

Surface patterning with colloidal monolayers

This thesis focuses on the controlled assembly of monodisperse polymer colloids into ordered two-dimensional arrangements. These assemblies, commonly referred to as colloidal monolayers, are subsequently used as masks for the generation of arrays of complex metal nanostructures on solid substrates.rnThe motivation of the research presented here is twofold. First, monolayer crystallization methods were developed to simplify the assembly of colloids and to produce more complex arrangements of colloids in a precise way. Second, various approaches to colloidal lithography are designed with the aim to include novel features or functions to arrays of metal nanostructures.rnThe air/water interface was exploited for the crystallization of colloidal monolayer architectures as it combines a two-dimensional confinement with a high lateral mobility of the colloids that is beneficial for the creation of high long range order. A direct assembly of colloids is presented that provides a cheap, fast and conceptually simple methodology for the preparation of ordered colloidal monolayers. The produced two-dimensional crystals can be transformed into non-close-packed architectures by a plasma-induced size reduction step, thus providing valuable masks for more sophisticated lithographic processes. Finally, the controlled co-assembly of binary colloidal crystals with defined stoichiometries on a Langmuir trough is introduced and characterized with respect to accessible configurations and size ratios. rnSeveral approaches to lithography are presented that aim at introducing different features to colloidal lithography. First, using metal-complex containing latex particles, the synthesis of which is described as well, symmetric arrays of metal nanoparticles can be created by controlled combustion of the organic material of the colloids. The process does not feature an inherent limit in nanoparticle size and is able to produce complex materials as will be demonstrated for FePt alloy particles. Precise control over both size and spacing of the particle array is presented. rnSecond, two lithographic processes are introduced to create sophisticated nanoparticle dimer units consisting of two crescent shaped nanostructures in close proximity; essentially by using a single colloid as mask to generate two structures simultaneously. Strong coupling processes of the parental plasmon resonances of the two objects are observed that are accompanied by high near-field enhancements. A plasmon hybridization model is elaborated to explain all polarization dependent shifts of the resonance positions. Last, a technique to produce laterally patterned, ultra-flat substrates without surface topographies by embedding gold nanoparticles in a silicon dioxide matrix is applied to construct robust and re-usable sensing architectures and to introduce an approach for the nanoscale patterning of solid supported lipid bilayer membranes. rn

Algoritmi di regolarizzazione con variazione totale nella ricostruzione di immagini di tomosintesi

La tomografia computerizzata (CT) è una metodica di diagnostica per immagini che consiste in una particolare applicazione dei raggi X. Essa, grazie ad una valutazione statistico-matematica (computerizzata) dell'assorbimento di tali raggi da parte delle strutture corporee esaminate, consente di ottenere immagini di sezioni assiali del corpo umano. Nonostante le dosi di radiazioni somministrate durante un esame siano contenute, questa tecnica rimane sconsigliata per pazienti sensibili, perciò nasce il tentativo della tomosintesi: ottenere lo stesso risultato della CT diminuendo le dosi somministrate. Infatti un esame di tomosintesi richiede poche proiezioni distribuite su un range angolare di appena 40°. Se da una parte la possibilità di una ingente diminuzione di dosi e tempi di somministrazione costituisce un grosso vantaggio dal punto di vista medico-diagnostico, dal punto di vista matematico esso comporta un nuovo problema di ricostruzione di immagini: infatti non è banale ottenere risultati validi come per la CT con un numero basso di proiezioni,cosa che va a infierire sulla mal posizione del problema di ricostruzione. Un possibile approccio al problema della ricostruzione di immagini è considerarlo un problema inverso mal posto e studiare tecniche di regolarizzazione opportune. In questa tesi viene discussa la regolarizzazione tramite variazione totale: verranno presentati tre algoritmi che implementano questa tecnica in modi differenti. Tali algoritmi verranno mostrati dal punto di vista matematico, dimostrandone ben posizione e convergenza, e valutati dal punto di vista qualitativo, attraverso alcune immagini ricostruite. Lo scopo è quindi stabilire se ci sia un metodo più vantaggioso e se si possano ottenere buoni risultati in tempi brevi, condizione necessaria per una applicazione diffusa della tomosintesi a livello diagnostico. Per la ricostruzione si è fatto riferimento a problemi-test cui è stato aggiunto del rumore, così da conoscere l'immagine originale e poter vedere quanto la ricostruzione sia ad essa fedele. Il lavoro principale dunque è stata la sperimentazione degli algoritmi su problemi test e la valutazione dei risultati, in particolare per gli algoritmi SGP e di Vogel, che in letteratura sono proposti per problemi di image deblurring.

Complementary mass spectrometric techniques for the characterization of the organic fraction in atmospheric aerosols

Aerosol particles are strongly related to climate, air quality, visibility and human health issues. They contribute the largest uncertainty in the assessment of the Earth´s radiative budget, directly by scattering or absorbing solar radiation or indirectly by nucleating cloud droplets. The influence of aerosol particles on cloud related climatic effects essentially depends upon their number concentration, size and chemical composition. A major part of submicron aerosol consists of secondary organic aerosol (SOA) that is formed in the atmosphere by the oxidation of volatile organic compounds. SOA can comprise a highly diverse spectrum of compounds that undergo continuous chemical transformations in the atmosphere.rnThe aim of this work was to obtain insights into the complexity of ambient SOA by the application of advanced mass spectrometric techniques. Therefore, an atmospheric pressure chemical ionization ion trap mass spectrometer (APCI-IT-MS) was applied in the field, facilitating the measurement of ions of the intact molecular organic species. Furthermore, the high measurement frequency provided insights into SOA composition and chemical transformation processes on a high temporal resolution. Within different comprehensive field campaigns, online measurements of particular biogenic organic acids were achieved by combining an online aerosol concentrator with the APCI-IT-MS. A holistic picture of the ambient organic aerosol was obtained through the co-located application of other complementary MS techniques, such as aerosol mass spectrometry (AMS) or filter sampling for the analysis by liquid chromatography / ultrahigh resolution mass spectrometry (LC/UHRMS).rnIn particular, during a summertime field study at the pristine boreal forest station in Hyytiälä, Finland, the partitioning of organic acids between gas and particle phase was quantified, based on the online APCI-IT-MS and AMS measurements. It was found that low volatile compounds reside to a large extent in the gas phase. This observation can be interpreted as a consequence of large aerosol equilibration timescales, which build up due to the continuous production of low volatile compounds in the gas phase and/or a semi-solid phase state of the ambient aerosol. Furthermore, in-situ structural informations of particular compounds were achieved by using the MS/MS mode of the ion trap. The comparison to MS/MS spectra from laboratory generated SOA of specific monoterpene precursors indicated that laboratory SOA barely depicts the complexity of ambient SOA. Moreover, it was shown that the mass spectra of the laboratory SOA more closely resemble the ambient gas phase composition, indicating that the oxidation state of the ambient organic compounds in the particle phase is underestimated by the comparison to laboratory ozonolysis. These observations suggest that the micro-scale processes, such as the chemistry of aerosol aging or the gas-to-particle partitioning, need to be better understood in order to predict SOA concentrations more reliably.rnDuring a field study at the Mt. Kleiner Feldberg, Germany, a slightly different aerosol concentrator / APCI-IT-MS setup made the online analysis of new particle formation possible. During a particular nucleation event, the online mass spectra indicated that organic compounds of approximately 300 Da are main constituents of the bulk aerosol during ambient new particle formation. Co-located filter analysis by LC/UHRMS analysis supported these findings and furthermore allowed to determine the molecular formulas of the involved organic compounds. The unambiguous identification of several oxidized C 15 compounds indicated that oxidation products of sesquiterpenes can be important compounds for the initial formation and subsequent growth of atmospheric nanoparticles.rnThe LC/UHRMS analysis furthermore revealed that considerable amounts of organosulfates and nitrooxy organosulfates were detected on the filter samples. Indeed, it was found that several nitrooxy organosulfate related APCI-IT-MS mass traces were simultaneously enhanced. Concurrent particle phase ion chromatography and AMS measurements indicated a strong bias between inorganic sulfate and total sulfate concentrations, supporting the assumption that substantial amounts of sulfate was bonded to organic molecules.rnFinally, the comprehensive chemical analysis of the aerosol composition was compared to the hygroscopicity parameter kappa, which was derived from cloud condensation nuclei (CCN) measurements. Simultaneously, organic aerosol aging was observed by the evolution of a ratio between a second and a first generation biogenic oxidation product. It was found that this aging proxy positively correlates with increasing hygroscopicity. Moreover, it was observed that the bonding of sulfate to organic molecules leads to a significant reduction of kappa, compared to an internal mixture of the same mass fractions of purely inorganic sulfate and organic molecules. Concluding, it has been shown within this thesis that the application of modern mass spectrometric techniques allows for detailed insights into chemical and physico-chemical processes of atmospheric aerosols.rn

Coronary collateral growth by external counterpulsation: a randomised controlled trial

The efficacy of external counterpulsation (ECP) on coronary collateral growth has not been investigated in a randomised controlled study. Objective To test the hypothesis that ECP augments collateral function during a 1 min coronary balloon occlusion.

Cancer of the oral cavity and oropharynx

Tumours in the oral cavity and oropharynx differ in presentation and prognosis and the detection of spread of tumour from one subsite to another is essential for the T-staging. This article reviews the anatomy and describes the pattern of spread of different cancers arising in the oral cavity and oropharynx; the imaging findings on computerized tomography and magnetic resonance imaging are also described. Brief mention is made on the role of newer imaging modalities such as [(18)F]fluorodeoxyglucose-positron emission tomography/computed tomography, perfusion studies and diffusion-weighted magnetic resonance imaging.

Late Infiltration of Post-orthodontic White Spot Lesions

White spot lesion (WSL) infiltration has been recommended immediately after debonding of orthodontic brackets. It is however not clear if established inactive WSLs can also be masked through infiltrationOrthodontic treatment of a 19-year-old patient had to be terminated prematurely due to development of multiple WSLs of varying severity. Three months after debonding, the patient presented for lesion infiltration. After etching with 15% HCl gel and re-wetting of the dried surfaces it seemed that a good outcome could be expected. Lesion infiltration led to complete masking of less severe WSLs. The visual appearance of moderate and severe WSLs was improved but they were still visible after treatment.Inactive WSLs may not represent an increased caries risk, but patients are often bothered esthetically. Infiltration by repeated etching might be a viable approach even for inactive WSLs. Controlled clinical trials are needed to investigate the long-term performance of this technique.

The role of the interplay between polymer architecture and bacterial surface properties on the microbial adhesion to polyoxazoline-based ultrathin films

Surface platforms were engineered from poly(L-lysine)-graft-poly(2-methyl-2-oxazoline) (PLL-g-PMOXA) copolymers to study the mechanisms involved in the non-specific adhesion of Escherichia coli (E. coli) bacteria. Copolymers with three different grafting densities (PMOXA chains/Lysine residue of 0.09, 0.33 and 0.56) were synthesized and assembled on niobia (Nb O ) surfaces. PLL-modified and bare niobia surfaces served as controls. To evaluate the impact of fimbriae expression on the bacterial adhesion, the surfaces were exposed to genetically engineered E. coli strains either lacking, or constitutively expressing type 1 fimbriae. The bacterial adhesion was strongly influenced by the presence of bacterial fimbriae. Non-fimbriated bacteria behaved like hard, charged particles whose adhesion was dependent on surface charge and ionic strength of the media. In contrast, bacteria expressing type 1 fimbriae adhered to the substrates independent of surface charge and ionic strength, and adhesion was mediated by non-specific van der Waals and hydrophobic interactions of the proteins at the fimbrial tip. Adsorbed polymer mass, average surface density of the PMOXA chains, and thickness of the copolymer films were quantified by optical waveguide lightmode spectroscopy (OWLS) and variable-angle spectroscopic ellipsometry (VASE), whereas the lateral homogeneity was probed by time-of-flight secondary ion mass spectrometry (ToF-SIMS). Streaming current measurements provided information on the charge formation of the polymer-coated and the bare niobia surfaces. The adhesion of both bacterial strains could be efficiently inhibited by the copolymer film only with a grafting density of 0.33 characterized by the highest PMOXA chain surface density and a surface potential close to zero.

[Persistent neutropenia]

We report the case of a 72-old patient with persistent neutropenia diagnosed during investigation of sialadenitis. Further examination led to the diagnosis of immune neutropenia and systemic lupus erythematosus. Anamnesis and the clinical course made initial diagnosis of drug-induced lupus erythematosus implausible. Steroid trial was done, followed by maintenance therapy, with good control of symptoms.

Impact of stent overlap on angiographic and long-term clinical outcome in patients undergoing drug-eluting stent implantation

Objectives We compared the angiographic and long-term clinical outcomes of patients with and without overlap of drug-eluting stents (DES). Background DES overlap has been associated with delayed healing and increased inflammation in experimental studies, but its impact on clinical outcome is not well established. Methods We analyzed the angiographic and clinical outcomes of 1,012 patients treated with DES in the SIRTAX (Sirolimus-Eluting Versus Paclitaxel-Eluting Stents for Coronary Revascularization) trial according to the presence or absence of stent overlap and the number of stents per vessel: 134 (13.2%) patients with multiple DES in a vessel with overlap, 199 (19.7%) patients with multiple DES in a vessel without overlap, and 679 (67.1%) patients with 1 DES per vessel. Results Angiographic follow-up at 8 months showed an increased late loss in DES overlap patients (0.33 ± 0.61 mm) compared with the other groups (0.18 ± 0.43 mm and 0.15 ± 0.38 mm, p < 0.01). The smallest minimal lumen diameter was located at the zone of stent overlap in 17 (68%) of 25 patients with stent overlap who underwent target lesion revascularization. Major adverse cardiac events were more common in patients with DES overlap (34 events, 25.4%) than in the other groups (42 events, 21.1% and 95 events, 14.0%) at 3 years (p < 0.01). Both the risk of target lesion revascularization (20.2% vs. 16.1% vs. 9.7%, p < 0.01) and the composite of death or myocardial infarction (17.2% vs. 14.1% vs. 9.1%, p = 0.01) were increased in patients with DES overlap compared with the other groups. Conclusions DES overlap occurs in >10% of patients undergoing percutaneous coronary intervention in routine clinical practice and is associated with impaired angiographic and long-term clinical outcome, including death or myocardial infarction. (Sirolimus-Eluting Versus Paclitaxel-Eluting Stents for Coronary Revascularization; NCT00297661).

Impact of arterial injury on neointimal hyperplasia after implantation of drug-eluting stents in coronary arteries: an intravascular ultrasound study

Aims: We investigated the impact of arterial injury on neointimal hyperplasia following implantation of drug-eluting stents (DES). Methods and results: A total of 196 patients with 223 segments (sirolimus-eluting stents [SES]: 104, paclitaxel-eluting stents [PES]: 119) underwent intravascular ultrasound eight months after DES implantation. Arterial injury was defined as the balloon-to-artery ratio (BAR). Segments were categorised into two groups: high BAR defined as BAR>1.1 (120 segments), and low BAR defined as BAR ≤1.1 (103 segments). Baseline clinical characteristics were similar for both groups. Although reference vessel diameter was smaller, stent diameter, maximal balloon pressure and balloon diameter were higher in the high BAR compared with the low BAR group. Lumen (7.10±1.91 vs. 6.25±1.69, p=0.001), stent (7.31±1.95 vs. 6.41±1.80, p=0.001), and external elastic membrane (17.1±4.9 vs. 14.8±4.0, p<0.0001) areas (mm2) were higher, but neointimal hyperplasia (0.21±0.36 vs. 0.16±0.48, p=0.42) area (mm2) was similar in the high BAR compared with the low BAR group. Arterial injury as assessed by BAR was not associated with the amount of neointimal hyperplasia (R2=0.003, p=0.40). Conclusions: Arterial injury does not correlate with the amount of neointimal hyperplasia following DES implantation. Conventionally aggressive DES implantation techniques do not adversely affect long-term outcome with respect to restenosis. - See more at: http://www.pcronline.com/eurointervention/30th_issue/79/#sthash.1do4X31G.dpuf

Iatrogenic left main coronary artery dissection: incidence, classification, management, and long-term follow-up

Although rare, iatrogenic left main coronary artery (LM) dissection is a feared complication of coronary catheterization. Its incidence, optimal therapeutic management, and prognosis remain largely unknown. The aim of the present study was to estimate the incidence, characterize the population at risk, depict the initial management, and evaluate the long-term prognosis of iatrogenic LM dissection.