We describe a very rare case of outflow cannula obstruction with fungal infectious thrombus formation. Discussion includes the etiology, diagnosis, and management of fungal infection complications related with long-term mechanical circulatory support. Left ventricular assist devices (LVADs) are increasingly used as bridge to transplant and permanent long-term therapy in the population with end-stage heart failure. Even though better clinical outcomes have been achieved with the newer-generation continuous-flow devices, infection complications are still a major risk for patients with continuous-flow LVAD implantation in long-term follow-up [Ann Thorac Surg 90:1270-1277, 2010]. Device-related infections can be categorized as driveline infections, pump-pocket infections, and LVAD-associated endocarditis [Expert Rev Med Devices 8: 627-634, 2011]. The microbiological profile is very heterogeneous; the most common pathogens are Staphylococcus, Pseudomonas, Streptococcus species, and Candida. Severe fungal infection may lead to dysfunction of the LVAD due to obstructive mass formation within the device. Due to the only anecdotal reports in the current literature, we present a very rare case of outflow fungal infectious thrombus formation leading to outflow cannula obstruction in patient with LVAD.

The present experiments were performed to evaluate if increased heart tissue concentration of fatty acids, specifically myristic, palmitic and palmitoleic acids that are believed to promote physiological heart growth, can attenuate the progression of unloading-induced cardiac atrophy in rats with healthy and failing hearts. Heterotopic abdominal heart transplantation (HTx) was used as a model for heart unloading. Cardiac atrophy was assessed from the ratio of the native- to-transplanted heart weight (HW). The degree of cardiac atrophy after HTx was determined on days 7, 14, 21 and 28 after HTx in recipients of either healthy or failing hearts. HTx of healthy hearts resulted in 23±3, 46±3, 48±4 and 46±4 % HW loss at the four time-points. HTx of the failing heart resulted in even greater HW losses, of 46±4, 58±3, 66±2 and 68±4 %, respectively (P<0.05). Activation of “fetal gene cardiac program” (e.g. beta myosin heavy chain gene expression) and “genes reflecting cardiac remodeling” (e.g. atrial natriuretic peptide gene expression) after HTx was greater in failing than in healthy hearts (P<0.05 each time). Exposure to isocaloric high sugar diet caused significant increases in fatty acid concentrations in healthy and in failing hearts. However, these increases were not associated with any change in the course of cardiac atrophy, similarly in healthy and post-HTx failing hearts. We conclude that increasing heart tissue concentrations of the fatty acids allegedly involved in heart growth does not attenuate the unloading-induced cardiac atrophy.

Six Mg co-doped Lu 3 Al 5 O 12 :Ce scintillating films were prepared by a liquid phase epitaxy method, having Mg concentration of 0−3000 ppm. The following luminescence and scintillation characteristics and their dependence on Mg concentration were studied: photoluminescence emission and excitation spectra, radioluminescence spectra, photoluminescence and scintillation decay curves, light yield, energy resolution, and afterglow. Light yield increases with Mg concentration until 700 ppm and becomes 15−20% higher than in the Mg-free sample. Further increase of Mg concentration leads to light yield decrease. Scintillation decay is getting faster with an increasing Mg concentration and the afterglow is significantly reduced. The results are compared to ceramics and crystals of very similar compositions.

Ventricular septal defect (VSD) is a severe complication of myocardial infarction (MI) with a high mortality rate. We report a case of a large post-MI VSD treated with percutaneous venoarterial extracorporeal membrane oxygenation (VA-ECMO) to restore hemodynamic stability and to avoid surgery in the acute setting. VSD closure with endoventricular patch and implantation of biventricular assist device (BiVAD) was arranged sixteen days after MI. Because of no signs of myocardial recovery, implantation of durable left ventricular assist device (LVAD) as a bridge to transplant was provided, leaving right ventricular assist device (RVAD) to right ventricle recovery. RVAD was explanted 18 days after durable LVAD placement and the patient was discharged home two months after MI. The use of durable LVAD is a unique solution that can be applied in selected patients with MI-VSD and heart failure.

Low-frequency Raman spectra of Na-DNA fibers and films show that a mode near 25 cm-l softens with increasing water content.1,2Lattice dynamics calculations predict a 23-cm-l mode (at the 0 = + point of the Brillouin zone where it is Raman active) with a n eigenvector displacement pattern similar to that of the calculated soft mode for the A-to-B transition (i.e., the square of the inner products of the two eigenvectors is 0.232). Thus, the observed softening might be due to the 25-cm-' band sharing spring constants with a soft mode, a n interpretation used in support of the soft mode theory of the t r a n s i t i~n .~,~ In this communication, we compare the low-frequency Raman spectra of Na-DNA films, which undergo a n A-to-B transition, with those of Li-DNA films, which do not. We have also obtained the Brillouin spectra of these samples; they should provide an indirect, but sensitive, probe of mode softening. A soft optic branch would interact with the acoustic modes because it must go to zero frequency a few degrees from the zone center (in order to drive the change in pitch between the A-and the B-form). It would be desirable to follow softening of the lowest-lying optic mode directly, and while we believe that we have found this mode, the conditions required for its observation make a direct study of softening very d i f f i c~l t .~ Wet-spun films were made with 1% Na-DNA (1 g NaC1/100 g dry DNA) and 4.5% Li-DNA (4.5 g LiC1/100 g dry DNA) prepared from high-molecularweight calf thymus DNA (from Worthington) using the methods described by Rupprecht and F~r s l i n d .~We also used fibers made from a phenol-extracted calf thymus DNA (from P.L. Biochemicals), as described elsewhere! Samples were mounted over saturated salt solutions, chosen to maintain the desired humidity, and equilibrated for at least a week. Their conformations were determined by standard fiber diffraction methods. Na-DNA films were disordered at the lowest ( < 59% relative humidities (r.h.), A-form up to about 88% r.h., and went into the B-form between 92 and 95% r.h. Li-DNA films gave highly crystalline B patterns at 66 and 75% r.h. and the fiber B pattern beyond 80% r.h. (some of these samples may have been C-form at 33% r.h.1.Raman spectra were obtained with a Spex 1402 double grating monochromator, using the 4765 A line of a n argon-ion laser. The laser was focused to a 100 pm spot, with the incident power kept below 20 mW. We have also monitored the conformation using the Raman spectrum in the 800-cm-l region,? obtaining results that agree with the x-ray fiber patterns in every case. Thus, there is no significant drying of the samples in the laser beam. The spectra shown in Fig. 1 were obtained in backscattering, with the films tilted