Andersonwinkel6347

BACKGROUND In this report, we present technical problems and solutions used in the reconstruction of the inferior vena cava and graft venous outflow during living donor liver transplantation (LDLT) in children. MATERIAL AND METHODS In 65 grafts out of 379 liver transplantations from living donors, reconstruction of multiple hepatic venous branches and/or IVC was necessary. In 4 cases, cryopreserved deceased donor venous grafts were used for the reconstruction of the IVC and/or HV. RESULTS Follow-up ranged from 2 months to 17.8 years (median 7.2 years). In 4 children, liver re-transplantation was required for a reason not related to venous outflow (biliary complications in 3 patients, graft insufficiency caused by small-for-size syndrome). Two patients died 1 due to tumor recurrence and 1 due to multi-organ failure. Fifty-nine patients are alive with good liver function. One patient (1.5%) after deceased donor venous graft reconstruction showed symptoms of venous outflow obstruction, which was successfully treated with endovascular balloon angioplasty and stent placement. The remaining 59 transplanted patients do not show any signs of venous outflow obstruction. CONCLUSIONS In most cases, the reconstruction of multiple hepatic veins of living donor allografts can successfully be done with local venoplasty, while using cold-stored vein grafts may be helpful in selected cases of LDLT.BACKGROUND Cardiac metastases of head and neck tumors are extremely rare, and antemortem diagnosis is even rarer. In most cases, patients show symptoms or electrocardiographic abnormalities and expected survival is considerably low. CASE REPORT A 72-year-old man was admitted to our cardiology ward with suspected endocarditis 2 months after a right hemiglossectomy for a squamous cell carcinoma. He was asymptomatic and showed no electrocardiogram abnormalities. Echocardiography showed an iso-ipoechogenic round-shaped formation at the right ventricle apex that was suspected to be a metastasis owing to 2 cardiac magnetic resonance imaging examinations showing a significant increase in its volume over 14 days. The patient was evaluated by a multidisciplinary team and referred for first-line chemotherapy with carboplatin, 5-fluoruracil, and cetuximab. He died after almost 4 months of follow-up. CONCLUSIONS This case presents a very rare diagnosis as well as some unique features, including the intramyocardial localization, the absence of symptoms, and electrocardiogram abnormalities. Our report shows the relevance of imaging techniques in defining even the most unusual clinical findings, and it emphasizes the significance of early recognition of cardiac masses in order to identify the appropriate medical or surgical therapy for patients.Delayed family planning and increased parental age increase the risk for infertility and impaired offspring health. While the impact of ageing on oogenesis is well studied, this is less understood on spermatogenesis. Assessing ageing effects on the male germline presents a challenge in differentiating between the effects of ageing-associated morbidities, infertility and 'pure' ageing. However, understanding the impact of ageing on male germ cells requires the separation of age from other factors. In this review, we therefore discuss the current knowledge on healthy ageing and spermatogenesis. Male ageing has been previously associated with declining sperm parameters, disrupted hormone secretion and increased time-to-pregnancy, among others. However, recent data show that healthy ageing does not deteriorate testicular function in terms of hormone production and spermatogenic output. In addition, intrinsic, age-dependent, highly specific processes occur in ageing germ cells that are clearly distinct from somatic ageing. Changes in spermatogonial stem cell populations indicate compensation for stem cell exhaustion. Alterations in the stem cell niche and molecular ageing signatures in sperm can be observed in ageing fertile men. DNA fragmentation rates as well as changes in DNA methylation patterns and increased telomere length are hallmarks of ageing sperm. Taken together, we propose a putative link between the re-activation of quiescent Adark spermatogonia and molecular changes in aged sperm descending from these activated spermatogonia. We suggest a baseline of 'pure' age effects in male germ cells which can be used for subsequent studies in which the impact of infertility or co-morbidities will be studied.Fin whale calls are among the strongest animal vocalizations that are detectable over great distances in the oceans. We analyze fin whale songs recorded at ocean-bottom seismometers in the northeast Pacific Ocean and show that in addition to the waterborne signal, the song recordings also contain signals reflected and refracted from crustal interfaces beneath the stations. With these data, we constrain the thickness and seismic velocity of the oceanic sediment and basaltic basement and the P-wave velocity of the gabbroic lower crust beneath and around the ocean bottom seismic stations. The abundant and globally available fin whale calls may be used to complement seismic studies in situations where conventional air-gun surveys are not available.Mountain belts modulate denudation flux and hydrologic processes and are thus fundamental to nutrient cycling on Earth's surface. Almorexant ic50 We used europium anomalies in detrital zircons to track mountain-building processes over Earth's history. We show that the average thickness of active continental crust varied on billion-year time scales, with the thickest crust formed in the Archean and Phanerozoic. By contrast, the Proterozoic witnessed continuously decreasing crustal thickness, leaving the continents devoid of high mountains until the end of the eon. We link this gradually diminished orogenesis to the long-lived Nuna-Rodinia supercontinent, which altered the mantle thermal structure and weakened the continental lithosphere. This prolonged orogenic quiescence may have resulted in a persistent famine in the oceans and stalled life's evolution in Earth's middle age.High thermoelectric performance is generally achieved through either electronic structure modulations or phonon scattering enhancements, which often counteract each other. A leap in performance requires innovative strategies that simultaneously optimize electronic and phonon transports. We demonstrate high thermoelectric performance with a near room-temperature figure of merit, ZT ~ 1.5, and a maximum ZT ~ 2.6 at 573 kelvin, by optimizing atomic disorder in cadmium-doped polycrystalline silver antimony telluride (AgSbTe2). Cadmium doping in AgSbTe2 enhances cationic ordering, which simultaneously improves electronic properties by tuning disorder-induced localization of electronic states and reduces lattice thermal conductivity through spontaneous formation of nanoscale (~2 to 4 nanometers) superstructures and coupling of soft vibrations localized within ~1 nanometer around cadmium sites with local strain modulation. The strategy is applicable to most other thermoelectric materials that exhibit inherent atomic disorder.