Presence Of Crypts Research Articles

C76 FINDING OF MYOCARDIAL CRYPTS IN SUDDEN CARDIAC ARREST PATIENTS: TWO CASE REPORT

Abstract Left ventricular myocardial crypts are definined as deep blood–filled invaginations trasversing > 50% of the myocardial wall and are located predominantly at the mid–basal segment of inferoseptal wall or at the apical segment. To date the incidence of crypts is 9.1% of patients undergoing cardiac CT and are not associated with intermediate–term major adverse cardiovascular events. However several studies have suggested that the presence of crypts is a marker of myocardial disease that should warrant clinical follow–up prior to the potential development of left ventricular hypertrophy and occurrence of serious cardiovascular events, such as heart failure or death. A lot of publications demonstrate that ventricular crypts could be a pre–phenotypic marker of hypertrophic cardiomyopathy (HCM). HCM is a genetic ereditary cardiomyopathy which is associated with fatal ventricular arrhytmias. We present the case of two patients who had a sudden cardiac arrest resuscitated with cardiac defibrillation. These are two males, 59 and 53 years old respectively, without cardiovascular risk factor and with familiarity for HCM. The first patient had a sudden cardiac arrest during exercise and was resuscitated with early cardiac defibrillation. The second patient had ventricular fibrillation after otolaryngology surgery treated with single defibrillator shock. Coronary arteries were free from atherosclerotic lesions at the angiografy study and no other reversible causes of cardiac arrest were identified. CMR showed normal biventricular funtion and ruled out signs of myocardial oedema or fibrosis. The only morphological finding was the detection of single left ventricular myocardial crypt at the CMR study in both patients: in one patient the crypt was located at the inferior wall while in the other at the level of the septum in the mid–apical segment. Ultimately both patients underwent genetic testing for cardiomyopathy. These findings may be a pre–phenotypic markers of HCM in patients who don’t present a clear expression of the pathology but may be a correlation with sudden cardiac arrest. The rarity of their finding in patient who have had sudden cardiac arrest can be explained by the small survival rate in patients with sudden cardiac arrest. Future studies and the increasingly simple access to advanced imaging methods like CMR and CT will allow us to clarify the role of these myocardial anomalies in the risk of developing fatal arrhythmic events.

Geophysical Investigation at the Santa Chiara Church in Nardò (Southern Italy)

The church of Santa Chiara with its adjacent convent, whose foundations date back to the 13th century, is a monastic complex in the city of Nardò in the province of Lecce. The current church was built ex novo between the 17th and 18th centuries under the direction of Bishop Orazio Fortunato. Currently, there is no information about the presence of crypts or burials in the church and in the adjacent area. For this reason, a campaign of geophysical investigations was undertaken using electromagnetic, electrical resistivity and ground-penetrating radar methods. Geophysical investigations were carried out both inside and in the courtyard of the church. The results showed the presence of a series of anomalies, whose interpretation suggests important structures of probable archaeological interest.

МОРФОЛОГИЧЕСКОЕ СОСТОЯНИЕ ОРГАНОВ ПИЩЕВАРИТЕЛЬНОГО КАНАЛА У ЛЕБЕДЯ-ШИПУНА

The paper presents data on the histological structure of the gastrointestinal tract of the Mute swan (Cygnus olor). When studying the architectonics of the stomach of a swan, it was found that the wall of its glandular and muscular sections consists of 3 membranes – mucous, muscular and serous. At the same time, the mucous membrane of the glandular stomach is thick-walled, with a high density of excretory ducts of complex gastric glands per conventional unit of area. It has been established that the muscular plate of the mucous membrane of the wall of the glandular stomach is fragmented and its individual myocytes penetrate between the complex glands, which contributes to a more effective excretion of the secretion of the glands. The mucous membrane also contains a muscular layer, which, in our opinion, is associated with an abundance of secreted hydrochloric acid. This can also explain the presence in this section of the stomach of a well-developed submucosa and a thick-walled muscular membrane. The muscular layer of the mucous membrane and the submucosa are also extended to the muscular section of the stomach in swans. At the same time, the cuticle of the muscular part of the stomach is relatively thin, with superficial striation. In the small intestine, the presence of crypts on the entire surface and a denser arrangement of villi were found. This feature indicates an increased absorption surface of the small intestine and is considered as compensation for its anatomical size. The liver of the swans did not differ significantly in morphology from other representatives of the class Aves. However, in the swans, the boundaries of classical hepatic lobules were not detected in the liver, and two nuclei were often visualized in hepatocytes. Thus, the noted structural features of the digestive canal of the Mute swan are physiologically justified and are associated with the trophic specialization of the represented bird species.

THE PLACE OF CARDIAC COMPUTED TOMOGRAPHY IN PREOPERATIVE PLANNING OF EXTENDED SEPTAL MYECTOMY IN PATIENTS WITH OBSTRUCTIVE FORM OF HYPERTROPHIC CARDIOMYOMATHY.

Hypertrophic cardiomyopathy (HCM) is the most common genetic cardiomyopathy. Extended septalmyectomy (ESM) is one of the priority methods of treatment of drug-refractory obstructive HCM. In recent years,hospital mortality during surgical correction of obstructive HCM in expert centers does not exceed 1-2 %. However,typical threatening complications of septal myectomy, such as iatrogenic ventricular septal defect (VSD) and rupture of the anterior or posterior walls of the left ventricle (LV), remain a topical issue in surgery of HCM. to show the role of preoperative CT-planning to predict and reduce possible technical problems associated with ESM, including iatrogenic VSD. This study includes 217 symptomatic patients with obstructive HCM, who from April 2016to October 2019 as one of the steps of preoperative planning underwent cardiac CT prior to ESM. Cardiac CT was performed to delineate the left ventricular myocardium, assess the distribution of hypertrophy and the presence ofcrypts. Special attention was also paid to the anatomy of the mitral valve (MV) and subvalvular apparatus. Coronaryartery patency was assessed by CAD-RADS, a standardized method for reporting the results of coronary CT angiography to determine tactics for further management of the patient. In the study group, the average age of patients was (49 ± 15) years, 48 % - men. All patientshad a symptomatic, drug-refractory obstructive form of HCM. The mean maximum wall thickness of the interventricular septum (IVS) was (20 ± 5) mm (range 16-33). The average LV mass was (118 ± 23) g/m2. 195 patients (89.9 %)had systolic anterior motion ( SAM) of the MV. MV and subvalvular apparatus anomalies were detected in 62 patients(28.6 %). A zone of scarring and regression of IVS after alcohol septal ablation (ASA) was detected in 7 patients(0.3 %) with residual LV outflow gradient. Coronary arteries atherosclerosis was detected in 32 patients (14.7 %). Preoperative CT-planning of septal myectomy allows to obtain information on morphology of the LV,IVS, MV and subvalvular apparatus, and gives the surgeon the advantage to form a more accurate plan for the location and volume of septal resection, and avoid complications when correcting obstructive HCM. No iatrogenic VSDwas detected in any of the patient in the study group.

First conclusions about results of GPR investigations in the Church of the Assumption of the Blessed Virgin Mary in Kłodzko, Poland

Abstract. The article presents results of a ground penetrating radar (GPR) investigation carried out in the Church of the Assumption of the Blessed Virgin Mary in Kłodzko, Poland, dating from the 14th to 16th centuries. Due to the 20th century wars, the current state of knowledge about the history of the church is still poor. Under the floor of the Catholic temple, unknown structures might exist. To verify the presence of underground structures such as crypts and tombs, a GPR survey was carried out in chapels and aisles with 500 and 800 MHz GPR shielded antennas. Numerous anomalies were detected. It was concluded that those under the chapels were caused by the presence of crypts beneath the floor.

Trimethylsilyl versus Bis(trimethylsilyl) Substitution in Tris(cyclopentadienyl) Complexes of La, Ce, and Pr: Comparison of Structure, Magnetic Properties, and Reactivity

To evaluate the effect of cyclopentadienyl ligand substitution in complexes of new +2 ions of the lanthanides, comparisons in reactivity and spectroscopic and magnetic properties have been made between [K(crypt)][Cp′3Ln], 1-Ln (Cp′ = C5H4SiMe3; crypt = 2.2.2-cryptand; Ln = La, Ce, Pr, and Nd), and [K(crypt)][Cp′′3Ln], 2-Ln [Cp′′ = C5H3(SiMe3)2]. The 2-Ln complexes (Ce, Pr, and Nd) were synthesized by reduction of Cp′′3Ln with potassium graphite in the presence of crypt and crystallographically characterized. The structures and UV–visible spectra of 2-Ln are similar to those of 1-Ln, as expected, but greater thermal stability for 2-Ln, expected from comparisons of 2-U and 1-U, was not observed. The magnetic susceptibilities of 2-Ce and 2-Pr were investigated because those of 1-Ce and 1-Pr did not match simple coupling models for 4fn5d1 electron configurations. The magnetic data of the 2-Ln complexes are similar to those of 1-Ln, which suggests that Ce2+ and Pr2+ complexes with 4fn5d1 electron configuration...

Screening of Corynebacterium diphtheriae, Corynebacterium ulcerans and Corynebacterium pseudotuberculosis in throat swab specimens of children with upper respiratory tract infections

Although a significant decrease has been reported in the incidence of diphteria in many regions of the world following the routine diphtheria immunization programs, the emergence of new cases indicated that toxigenic strains are still circulating in the community. Diphtheria vaccine does not provide protection against asymptomatic carriage and colonization of non-toxigenic Corynebacterium diphtheriae. It is a known fact that invasive infections may arise from non-toxigenic C.diphtheriae strains that the non-toxigenic strains can become toxigenic strains leading to diphteria. It is also known that there is a risk of diphteria outbreaks due to decreased antitoxin level and inadequate adult immunization programs. In our country, there is no routine surveillance of toxigenic and non-toxigenic C.diphtheriae. In the present study we aimed to investigate the presence of C.diphtheriae, Corynebacterium ulcerans and Corynebacterium pseudotuberculosis in children presenting with the symptoms of upper respiratory tract infections that might be confused with those moderate diphteria, in order to highlight the requirement of microbiological surveillance and to create awareness about these microorganisms among public health experts, microbiologists and clinicians. Throat swab specimens were obtained from children who were admitted to the pediatric outpatient clinics, in Dr. Sami Ulus Obstectrics, Children Health and Diseases Educational and Research Hospital, with upper respiratory tract infections between 1 February 2016-22 March 2016. The specimens were inoculated in 5% sheep blood agar plates. The plates that were incubated in appropriate conditions, were evaluated for Group A beta hemolytic streptococcocci. Subsequently, culture plates were sent to the Public Health Institution of Turkey, National Respiratory Pathologens Reference Laboratories for the investigation of the presence of C.diphtheriae, C.ulcerans and C.pseudotuberculosis. The growth in each plate were collected with a sterile swab and inoculated in tryptic soy broth. Following 2 hours of incubation at 37oC, subcultures were inoculated in cystine-tellurite-blood agar (CTBA) and 5% sheep-blood agar plates; after an overnight incubation tellurite-reducing colonies were inoculated in Tinsdale agar plates. The suspected colonies with positive cystinase activity were identified by conventional methods and also with Coryne API (Biomerieux, France) systems. Toxicity tests (ELEK, PCR) were performed to investigate whether the C.diphtheriae strains were producing toxins. A total of 500 patients were involved in the study. Of these 260 (52%) were girls and 240 (48%) were boys with a mean age of 76 (range, 21-213) months. All patients except one were fully vaccinated with boosters. Most common presenting symptoms of the patients were fever (19.8%), sore throat (52.6%), cough (49.2%), tonsillar hyperemia (97.6%), presence of crypt (24.6%), and membrane over tonsils (1%). Group A beta-hemolytic streptococcocci were detected in the throat swab cultures of 66 (%13.2) patients. Genotypically toxin negative C.diphtheriae biovar gravis was identified in the throat swab cultures of 3 patients (2 girls and 1 boy). The tonsils were hyperemic and hypertrophic in all the patients with C.diphtheriae biovar gravis. C.ulcerans and C.pseudotuberculosis were detected in none of the patients. It is considered that similar regular cross-sectional studies or routine screening programs are expected to raise awareness about this forgotten microorganism both epidemiologically and microbiologically.

Solution Synthesis, Structure, and CO2 Reduction Reactivity of a Scandium(II) Complex, {Sc[N(SiMe3 )2 ]3 }.

The first crystallographically characterizable complex of Sc2+ , [Sc(NR2 )3 ]- (R=SiMe3 ), has been obtained by LnA3 /M reactions (Ln=rare earth metal; A=anionic ligand; M=alkali metal) involving reduction of Sc(NR2 )3 with K in the presence of 2.2.2-cryptand (crypt) and 18-crown-6 (18-c-6) and with Cs in the presence of crypt. Dark maroon [K(crypt)]+ , [K(18-c-6)]+ , and [Cs(crypt)]+ salts of the [Sc(NR2 )3 ]- anion are formed, respectively. The formation of this oxidation state of Sc is also indicated by the eight-line EPR spectra arising from the I=7/2 45 Sc nucleus. The Sc(NR2 )3 reduction differs from Ln(NR2 )3 reactions (Ln=Y and lanthanides) in that it occurs under N2 without formation of isolable reduced dinitrogen species. [K(18-c-6)][Sc(NR2 )3 ] reacts with CO2 to produce an oxalate complex, {K2 (18-c-6)3 }{[(R2 N)3 Sc]2 (μ-C2 O4 -κ1 O:κ1 O'')}, and a CO2- radical anion complex, [(R2 N)3 Sc(μ-OCO-κ1 O:κ1 O')K(18-c-6)]n .

Solution Synthesis, Structure, and CO2 Reduction Reactivity of a Scandium(II) Complex, {Sc[N(SiMe3)2]3}−

AbstractThe first crystallographically characterizable complex of Sc2+, [Sc(NR2)3]− (R=SiMe3), has been obtained by LnA3/M reactions (Ln=rare earth metal; A=anionic ligand; M=alkali metal) involving reduction of Sc(NR2)3 with K in the presence of 2.2.2‐cryptand (crypt) and 18‐crown‐6 (18‐c‐6) and with Cs in the presence of crypt. Dark maroon [K(crypt)]+, [K(18‐c‐6)]+, and [Cs(crypt)]+ salts of the [Sc(NR2)3]− anion are formed, respectively. The formation of this oxidation state of Sc is also indicated by the eight‐line EPR spectra arising from the I=7/2 45Sc nucleus. The Sc(NR2)3 reduction differs from Ln(NR2)3 reactions (Ln=Y and lanthanides) in that it occurs under N2 without formation of isolable reduced dinitrogen species. [K(18‐c‐6)][Sc(NR2)3] reacts with CO2 to produce an oxalate complex, {K2(18‐c‐6)3}{[(R2N)3Sc]2(μ‐C2O4‐κ1O:κ1O′′)}, and a CO2− radical anion complex, [(R2N)3Sc(μ‐OCO‐κ1O:κ1O′)K(18‐c‐6)]n.

Three‐Dimensional Architecture of the Ovine Oviductal Mucosa

The objective of this work was to establish for the first time a complete three-dimensional model of the ovine oviductal mucosa. The oviducts of 15 cyclic ewes were examined combining the direct examination of the mucosa, by scanning electron microscopy (SEM) and histology, with the SEM observation of resin moulds of the oviductal lumen. Around the ostium abdominale, all longitudinal primary folds and wide secondary are seen to form cul-de-sacs, with their opening pointing in the ovarian direction were observed. At the connection of the ampulla to the isthmus, there is a sharp change in the morphology, from a high folded structure to a smoother one. In the utero-tubal junction, the primary folds broaden and become more voluminous, the lumen has a slit-like appearance, and secondary folds form cul-de-sacs with their opening oriented towards the uterus. The areas between the folds throughout the lumen of the oviduct show a high degree of complexity. The presence of crypts was observed in all the regions studied, branched in the ampulla and spiniform in the isthmus. Marked variations were observed in the oviductal epithelium depending on the oviductal segment and the basal or apical areas of the folds. The variations found regarding the phase of the oestrous cycle were similar to those described in studies of other species. The anatomy of the oviductal mucosa provides a complex system that seems to be designed to regulate the movement of fluids and the passage of cells within the oviductal canal.

Deep Basal Inferoseptal Crypts Occur More Commonly in Patients with Hypertrophic Cardiomyopathy Due to Disease-causing Myofilament Mutations

To determine the relationship between deep basal inferoseptal crypts and disease-causing gene mutations in hypertrophic cardiomyopathy (HCM). Institutional research and ethics board approval was obtained for this retrospective study, and the requirement to obtain informed consent was waived. Two readers, who were blinded to genetic status, independently assessed cardiac magnetic resonance (MR) images obtained in 300 consecutive unrelated genetically tested patients with HCM. Readers documented the morphologic phenotype, the presence of deep basal inferoseptal crypts, and the imaging plane in which crypts were first convincingly visualized. The Student t test, the Fisher exact test, and multivariate logistic regression were used for comparisons and to evaluate the relationship between these crypts and the detection of disease-causing mutations. The frequency of deep basal inferoseptal crypts was significantly higher in patients with disease-causing mutations than in those without disease-causing mutations (36% and 4%, respectively; P < .001). The presence of crypts was a stronger predictor of disease-causing mutations than was reverse septal curvature (P = .025). Patients with these crypts had a higher likelihood of having disease-causing mutations than non-disease-causing mutations (P < .001). Thirty-one of the 34 patients with both deep basal inferoseptal crypts and reverse septal curvature (91%) had disease-causing mutations (sensitivity, 26%; specificity, 98%). The presence of deep basal inferoseptal crypts (odds ratio: 6.64; 95% confidence interval: 2.631, 16.755; P < .001) and reverse septal curvature (odds ratio: 4.8; 95% confidence interval: 2.552, 9.083; P < .001) were predictive of disease-causing mutations. Both observers required additional imaging planes to identify approximately half of all crypts. Deep basal inferoseptal crypts occur more commonly in patients with HCM with disease-causing mutations than in those with genotype-negative HCM.

Probe-Based Confocal Laser Microscopy Identifies Criteria Predictive of Active Celiac Sprue

Celiac sprue is an underdiagnosed chronic intestinal inflammatory disease. Probe-based confocal laser microscopy (CLM) is a novel endoscopic technique for in vivo inspection of the intestinal mucosa that has not been evaluated in celiac sprue yet. To develop CLM criteria most predictive of celiac pathology in a prospective pilot study. Twenty-one patients (male n = 5, f = 16, mean age 52 years) with established or suspected celiac sprue, seven of whom had confirmed active disease (Marsh III) and 14 duodenal normal mucosa. CLM images from 91 duodenal sites were assessed. CLM recordings were obtained next to Argon beamer labeled areas. Biopsies were taken from the same spots for precise histological matching. After establishing histology-correlated criteria on one sample per patient, the remaining CLM recordings from the same patients were randomized and blindly evaluated. Villous atrophy and irregular appearing villi were most predictive of celiac pathology. Although the presence of crypts was diagnostic for celiac pathology, it was only recognized in 26.7% of celiac pathology sites. Using these criteria in the blinded assessment, the overall endoscopist's prediction of celiac sprue was accurate in 89.8% of all biopsy sites in 85.7% of all patients. Preliminary interobserver agreement testing villous atrophy, irregular villi, and crypts was poor (kappa 0.05 to 0.26). Probe-based CLM criteria developed in this pilot trial appear promising for the detection of active celiac sprue. Preliminary interobserver variability was high, indicating a learning curve effect. Our criteria need validation in an independent patient population.

First Paramagnetic Zerovalent Transition Metal Isocyanides. Syntheses, Structural Characterizations, and Magnetic Properties of Novel Low-Valent Isocyanide Complexes of Vanadium1

The first homoleptic paramagnetic transition metal isocyanide, V(CNXyl)6 (2, Xyl = 2,6-dimethylphenyl), can be isolated in high yield by reacting bis(naphthalene)vanadium(0) (1a) or bis(1-methylnaphthalene)vanadium(0) (1b) with 6 equiv of CNXyl in tetrahydrofuran/heptane. Reduction of 2 with excess cesium graphite in THF affords excellent yields of [V(CNXyl)6]- (3) as an unsolvated Cs+ salt, the first homoleptic octahedral isocyanide metalate. Cs3 reacts with 2 equiv of 18-Crown-6 to give [Cs(18-Crown-6)2]3. Anion 3 can also be isolated as a practically insoluble [K(Crypt{2.2.2.})]+ salt by reducing 2 with potassium naphthalenide in the presence of Crypt{2.2.2.}. Complex 3 reduces [Et3NH]Cl to form paramagetic 2. Oxidation of 2 by ferricinium hexafluorophosphate in THF provides nearly quantitative yields of the 16-electron paramagnetic [V(CNXyl)6][PF6] (4[PF6]), analogous to the exceedingly unstable [V(CO)6]+. Interaction of V(CO)6 with excess CNXyl in heptane results in the efficient formation of trans-[V(CO)2(CNXyl)4] (5). Such a substitution reaction is highly unusual for V(CO)6. Oxidation of compound 5 by ferricinium hexafluorophosphate in THF affords homoleptic 4[PF6]. Complexes 2, 3, 4, and 5 were characterized by a variety of spectroscopic methods and X-ray crystallography. Spectroscopic, magnetic, and structural features of these novel electron rich vanadium isocyanides are discussed in detail. The average V−CN bond length increases in the series [V(CNXyl)6]- < V(CNXyl)6 < trans-V(CO)2(CNXyl)4 < [V(CNXyl)6]+. Well-resolved 1H and 13C NMR spectra were obtained for paramagnetic 2 and its chromium congener, [Cr(CNXyl)6]+. The importance of back-bonding in the mechanism of unpaired spin delocalization within 2 was demonstrated. Contrary to the previous prediction for dπ(M)−pπ*(L) unpaired spin delocalization in low-spin d5 octahedral complexes, negative spin appears to be induced on the CNXyl ligands of 2 by means of dπ(V)−pπ*(CNXyl) back-bonding.

Polyanionic clusters of post-transition elements : EXAFS study of their solutions

The solutions in ethylenediamine (en) of an arsenic rich potassium- arsenic alloy (KAs2.1 ) and of a potassium-germanium alloy (KGe1.e ) in the presence of crypt (2.2.2) have been studied by EXAFS spectroscopy at the As and Ge K-edges.It has been shown that the former red solution essentially contains the anionic cluster As7 3- and the second copper-red solution predominantly the Ge9 4- anion.The red solution obtained after reduction of As4 Se4 with potassium in (en) and replacement of K+ by tetraphenyl-phosphonium (PPh4 + ) cation was also studied by EXAFS at the As and Se K-edges.It has been shown that this solution contains polycyclic cage heteropolyatomic anions of relatively high nuclearity.