IntroductIon It has been shown that formation of denser and poorly lysable fibrin clots is observed in elderly patients with peripheral artery disease (PAD).objectIves The aim of the study was to test the hypothesis that premature PAD is associated with more prothrombotic fibrin clot phenotype.PAtIents And methods Ex-vivo plasma fibrin clot permeability, turbidity, and susceptibility to lysis were evaluated in 31 premature PAD patients (median ankle brachial index [ABI], 0.75; interquartile range, 0.5-0.8) aged 55 or less and 32 PAD patients (ABI, 0.66; 0.56-0.76) aged over 55 years. Subjects without PAD matched for age and sex (n = 40) served as controls.results Premature PAD patients were characterized by 32% lower clot permeability (K s ) (P <0.001), 7% longer clot lysis time (t 50% ) (P = 0.004), and 31% higher maximum D-dimer levels released from fibrin clots (D-D max ) (P <0.001) compared with controls. These differences remained significant after adjustment for risk factors and medications. None of the fibrin clot parameters differed between premature and older PAD patients. There were correlations between fibrin clot parameters and CRP in premature PAD patients and with ABI in older PAD patients. In a multiple regression model, premature PAD and ABI were independent predictors of K s , and premature PAD and plasma fibrinogen of the maximum absorbance of a fibrin gel.conclusIons Plasma fibrin clots show similarly abnormal prothrombotic phenotype in premature and older PAD patients. However, different factors influence fibrin clot parameters in these patient groups. Premature PAD was an independent predictor of clot permeability and maximum absorbance of a fibrin gel. Key wordsankle brachial index, D-dimer, fibrin clot, peripheral artery disease orIGInAl ArtIcle

We conducted a cross-sectional observation study that included 500 asymptomatic subjects to investigate the relationship between bone metabolism and coronary artery calcification (CAC) in hypertensive conditions. Osteoprotegerin (OPG) and osteopontin (OPN) levels and their associations with hypertension were analyzed to predict CAC in 316 subjects. Multislice computed tomography was used to quantify CAC. Multivariate analysis of variance was used to test the non-interactive effects of hypertension, CAC severity and biomarker levels, and the logistic regression model was applied to predict the risk of CAC. OPG and OPN concentrations were significantly higher in the hypertensive than the normotensive subjects, at 3.0 (2.3-4.0) pmol l À1 and 51 (21-136) ng ml À1 vs. 2.4 (2.0-3.0) pmol l À1 and 41 (13-63) ng ml À1 , respectively. The OPG level, but not OPN level, increased with age (r¼0.29; P¼0.0001). Zero or minimal CAC (o10 Agatston units (AU)) was observed in 63% of the subjects, mild (11-100 AU) in 17%, moderate (101-400 AU) in 12% and severe (401-1000 AU)-to-extensive (41000 AU) in 8%. In hypertensive subjects, only glomerular filtration rate (GFR) (b¼À0.67) and gender (b¼0.52) were significant predictors for CAC (R¼0.68). In normotensive patients, GFR (b¼À0.81), gender (b¼0.48) and log-transformed OPG levels (b¼0.15) were significant predictors for CAC. OPG levels were associated with an increased risk of CAC in normotensive subjects only (odds ratio: 3.37; 95% confidence interval (1.63-6.57); P¼0.0002). OPG predicted a premature state of vascular calcification in asymptomatic normotensive individuals, and renal function significantly contributed to this process in both hypertensive and normotensive subjects.

Liver status in adult patients after the Fontan procedure 181 and kidney or liver dysfunction. These complica tions influence the patient's life expectancy and quality of life. 6,7 The characteristic hemodynamic derangement in Fontan circulation causing liver abnormalities and pathology is commonly identified as Fontan associated liver disease (FALD). 2,8 This can lead to nodular hyperplasia, cirrhosis, and hepatocel lular carcinoma associated with ascites, variceal bleeding, and encephalopathy. Moreover, it is re lated with higher late morbidity and mortality in this particular population. 8-10 Recent studies have shown that elevated ve nous pressure (3 to 4 fold in comparison with INTRODUCTION The Fontan procedure was first described over 40 years ago and still remains the standard surgical treatment for patients with a functional single ventricular heart, affecting 35 per 100 000 newborns. 1-3 It is considered one of the most complex congenital heart diseases. Dur ing the procedure, a systemic venous return is di rectly connected with pulmonary circulation, with out a subpulmonary pump. 1,4,5 As a result, the cir culatory system is hemodynamically less efficient. Although the Fontan procedure is associated with low mortality, once patients reach adulthood, they can develop various cardiac and extracar diac complications, including plastic bronchitis

No abstract

Pieces of 1H18N9T acid-proof steel foil were subjected to thermoprogrammed oxidation up to 823K, 873K, 1023K and 1113K in air flow. The phases in the oxide layers were determined by Raman spectroscopy. The chemical compositions of the surface microlayers of oxidized foils were investigated by energy dispersive X-ray spectrometry and the chemical compositions of their surface nanolayers were determined by X-ray photoelectron spectrometry. The affinity to oxygen of the foil components was found to be a main factor determining chemical composition and phase structure of the oxides.