Application of prospective ECG-triggered dual-source CT coronary angiography for infants and children with coronary artery aneurysms due to Kawasaki disease

OBJECTIVES

The aim of this study was to prospectively evaluate the initial application and value of prospective electrocardiogram (ECG)-triggered dual-source CT coronary angiography (DSCTCA) in the diagnosis of infants and children with coronary artery aneurysms due to Kawasaki disease.

METHODS

19 children [12 males; mean age 13.47 months, range 3 months to 5 years; mean heart rate 112 beats per minute (bpm), range 83-141 bpm] underwent prospective ECG-triggered DSCTCA with free breathing. Subjective image quality was assessed on a five-point scale (1, excellent; 5, non-diagnostic) by two blinded observers. The location, number and size of each aneurysm were observed and compared with those of transthoracic echocardiography (TTE) performed within 1 week. Interobserver agreement concerning the subjective image quality was evaluated with Cohen's κ-test. Bland-Altman analysis was used to evaluate the agreement on measurements (diameter and length of aneurysms) between DSCTCA and TTE. The average effective dose required for DSCTCA was calculated for all children.

RESULTS

All interobserver agreement for subjective image quality assessment was excellent (κ=0.87). The mean ± standard deviation (SD) aneurysm diameter with DSCTCA was 0.76 ± 0.36 cm and with TTE was 0.76 ± 0.39 cm. The mean ± SD aneurysm length with DSCTCA was 2.06 ± 1.35 cm and with TTE was 2.00 ± 1.22 cm. The Bland-Altman plot for agreement between DSCTCA and TTE measurements showed good agreement. The mean effective dose was 0.36 ± 0.06 mSv.

CONCLUSION

As an alternative diagnostic modality, prospective ECG-triggered DSCTCA with excellent image quality and low radiation exposure has been proved useful for diagnosing infants and children with coronary artery aneurysms due to Kawasaki disease.

ADVANCES IN KNOWLEDGE

Prospective ECG-triggered DSCTCA for infants and children allows rapid, accurate assessment of coronary aneurysms due to Kawasaki diseases, compared with TTE.

Influence of oxytetracycline on carprofen pharmacodynamics and pharmacokinetics in calves

A tissue cage model of inflammation in calves was used to determine the pharmacokinetic and pharmacodynamic properties of individual carprofen enantiomers, following the administration of the racemate. RS(±) carprofen was administered subcutaneously both alone and in combination with intramuscularly administered oxytetracycline in a four-period crossover study. Oxytetracycline did not influence the pharmacokinetics of R(-) and S(+) carprofen enantiomers, except for a lower maximum concentration (Cmax ) of S(+) carprofen in serum after co-administration with oxytetracycline. S(+) enantiomer means for area under the serum concentration-time curve (AUC0-96 h were 136.9 and 128.3 μg·h/mL and means for the terminal half-life (T(1/2) k10 ) were = 12.9 and 17.3 h for carprofen alone and in combination with oxytetracycline, respectively. S(+) carprofen AUC0-96 h in both carprofen treatments and T(1/2) k10 for carprofen alone were lower (P < 0.05) than R(-) carprofen values, indicating a small degree of enantioselectivity in the disposition of the enantiomers. Carprofen inhibition of serum thromboxane B2 ex vivo was small and significant only at a few sampling times, whereas in vivo exudate prostaglandin (PG)E2 synthesis inhibition was greater and achieved overall significance between 36 and 72 h (P < 0.05). Inhibition of PGE2 correlated with mean time to achieve maximum concentrations in exudate of 54 and 42 h for both carprofen treatments for R(-) and S(+) enantiomers, respectively. Carprofen reduction of zymosan-induced intradermal swelling was not statistically significant. These data provide a basis for the rational use of carprofen with oxytetracycline in calves and indicate that no alteration to carprofen dosage is required when the drugs are co-administered.

Bioequivalence in dogs of a meloxicam formulation administered as a transmucosal oral mist with an orally administered pioneer suspension product

A mucosal mist formulation of meloxicam, administered as a spray into the mouth (test article), was compared for bioequivalence to a pioneer meloxicam suspension for oral administration (reference article). Pharmacokinetic profiles and average bioequivalence were investigated in 20 dogs. The study design comprised a two-period, two-sequence, two-treatment cross-over design, with maximum concentration (C(max)) and area under plasma concentration-time curve to last sampling time (AUC(last)) used as pivotal bioequivalence variables. Bioequivalence of the products was confirmed, based on relative ratios of geometric mean concentrations (and 90% confidence intervals within the range 0.80-1.25) for C(max) of 101.9 (97.99-106.0) and for AUC(last) of 97.24 (94.44-100.1). The initial absorption of meloxicam was more rapid for the test article, despite virtually identical C(max) values for the two products. Mean elimination half-lives were 29.6 h (test article) and 30.0 h (reference article). The meloxicam plasma concentration-time profiles were considered in relation to published data on the inhibition of the cyclooxygenase-1 (COX-1) and COX-2 isoenzymes by meloxicam.

Pathogenic role of mast cells in the development of diabetic nephropathy: a study of patients at different stages of the disease

AIMS/HYPOTHESIS

Increased renal mast cells have been detected in diabetic nephropathy. However, only a few patients have been examined. Evidence of the involvement of mast cells in diabetic nephropathy is still scarce, and no observation of mast cells during the development of diabetic nephropathy has yet been reported in humans. Here, we examined changes in renal mast cells in patients at different stages of diabetic nephropathy and related these to the development of the disease.

METHODS

Eighty patients at different clinical stages of diabetic nephropathy and 16 normal kidney donors were recruited. Immunohistochemical staining for tryptase, chymase, TGF-β1, renin and TNF-α was done on renal sections from patients and control participants. Changes in mast cell number, degranulation, subtype and phenotype were examined. Correlation between mast cells and patients' clinical and pathological indices was analysed.

RESULTS

With progression of diabetic nephropathy, the number and degranulation level of mast cells increased. Increase in mast cell number and degranulation level correlated significantly with tubular interstitial injury. Almost all renal mast cells in patients with diabetic nephropathy were found to produce chymase, renin, TGF-β1 and TNF-α. The level of TNF-α in mast cells increased with progression of diabetic nephropathy.

CONCLUSIONS/INTERPRETATION

This study suggests that mast cells are involved in development of diabetic nephropathy. Through release of bioactive substances, such as tryptase, chymase, TGF-β1, renin and TNF-α, into the tubular interstitium by degranulation, mast cells could promote renal inflammation and fibrosis, and thus contribute to diabetic nephropathy.

Reproductive performance and survival of Chinese Holstein dairy cows in central China

Fertility and longevity, major factors affecting the economic performance of dairy herds, are influenced by management and genetics. This study determined the reproductive performance and survival of Chinese Holstein cows in a large, modern dairy farm in central China using two complementary datasets. In Dataset 1, fertility and culling records were obtained from 1430 cows calving in 2008; in Dataset 2, all calving episodes during 2005 and 2006 were recorded (n = 1540) and the subsequent survival and reasons for death or culling of all female calves born during this period were monitored. In Dataset 1, the mean ages at first breeding and first calving for heifers were 18.7 ± 2.6 and 29.3 ± 3.6 months, respectively. Cows (lactations 1–10) were first inseminated at 110 ± 49 days after calving (mean ± s.d.), conceived at 185 ± 103 days and required 2.3 ± 1.6 services per conception with a first service conception rate of 34%. Reproduction performance was lower in the first lactation, with the best fertility in autumn-calving cows. In Dataset 2, 601 live-born heifers were monitored from birth until first calving. Of these, 521 (87%) were inseminated at least once and 502 (84%) calved once, but only 68% of the starting population calved successfully for a second time. The main reasons for culling in both datasets were poor fertility, disease and lameness. Improved management strategies to avoid calving cows in the spring and so offset the adverse effects of summer heat stress together with increased emphasis on selection for good fertility and conformation traits would increase future profitability.

Trepanation and curettage treatment for acute implant periapical lesions

Six dental implants in six patients with periapical lesions were inserted and underwent trepanation and thorough curettage. During surgery, the lesion area was irrigated with copious natural saline and chlorhexidine and the bone defects were treated with tetracycline paste. The six implants were stable and asymptomatic postoperatively. The implants were loaded after 3 months. Radiologically, the radiolucency in the apical part disappeared gradually. These prostheses have functioned satisfactorily with no further complication during the follow-up period. For cases in which small lesions initially appear soon after implant placement, trepanation and curettage of the periapical lesion without resection of the apical part of the implant or bone substitute material and/or autogenous bone grafting is an effective management option. A rapid and exact diagnosis is important for treating implant periapical lesions.

Inactivation of a single copy of Crebbp selectively alters pre-mRNA processing in mouse hematopoietic stem cells

Global expression analysis of fetal liver hematopoietic stem cells (FL HSCs) revealed the presence of unspliced pre-mRNA for a number of genes in normal FL HSCs. In a subset of these genes, Crebbp+/− FL HSCs had less unprocessed pre-mRNA without a corresponding reduction in total mRNA levels. Among the genes thus identified were the key regulators of HSC function Itga4, Msi2 and Tcf4. A similar but much weaker effect was apparent in Ep300+/− FL HSCs, indicating that, in this context as in others, the two paralogs are not interchangeable. As a group, the down-regulated intronic probe sets could discriminate adult HSCs from more mature cell types, suggesting that the underlying mechanism is regulated with differentiation stage and is active in both fetal and adult hematopoiesis. Consistent with increased myelopoiesis in Crebbp hemizygous mice, targeted reduction of CREBBP abundance by shRNA in the multipotent EML cell line triggered spontaneous myeloid differentiation in the absence of the normally required inductive signals. In addition, differences in protein levels between phenotypically distinct EML subpopulations were better predicted by taking into account not only the total mRNA signal but also the amount of unspliced message present. CREBBP thus appears to selectively influence the timing and degree of pre-mRNA processing of genes essential for HSC regulation and thereby has the potential to alter subsequent cell fate decisions in HSCs.

Effects of n-6 polyunsaturated fatty acids on prostaglandin production in ovine fetal chorion cells in vitro in late gestation ewes

OBJECTIVE

To use an in vitro model of the ovine placenta to determine effects of n-6 polyunsaturated fatty acid (PUFA) supplementation on prostaglandin (PG) production. PGs are key regulators of fetal maturation and parturition.

STUDY DESIGN

Fetal allantochorion tissue (FC) was collected in late pregnancy (day 135). FC cells were isolated and cultured with 0-100 μM of linoleic acid (LA), γ-linolenic acid (GLA) or arachidonic acid (AA) in serum free medium and challenged with control medium, lipopolysaccharide (LPS, 0.1 μg/ml), dexamethasone (DEX, 5 μM) or a combination of LPS (0.1 μg/ml) with DEX (5 μM). Spent medium was harvested at 2 h and 24 h post challenge for measuring PGs.

MAIN OUTCOME MEASURES

To assess the effects of treatment on placental 1- and 2-series PGE production.

RESULTS

LA supplementation inhibited both PGE(1) and PGE(2) production. GLA predominantly stimulated PGE(1) generation, although it also increased PGE(2) production. AA supplementation predominantly increased PGE(2) production, but also stimulated PGE(1). DEX treatment with or without LPS inhibited PG production. Supplementation with n-6 PUFAs attenuated or neutralised the stimulatory effect of LPS challenge on FC cells for both PGE(1) and PGE(2) production.

CONCLUSION

These data show that supplementation with n-6 PUFAs alters placental PG production, but their precise effects depend on their position in the biosynthetic pathway for PG synthesis. This study supports the possibility that GLA containing oils, widely promoted as dietary supplements, might reduce the risk of pre-term labour by inhibiting the responsiveness of PGE(2) production to LPS challenge in the placenta.

Tangeretin and its metabolite 4'-hydroxytetramethoxyflavone attenuate EGF-stimulated cell cycle progression in hepatocytes; role of inhibition at the level of mTOR/p70S6K

BACKGROUND AND PURPOSE

The mechanisms by which the dietary compound tangeretin has anticancer effects may include acting as a prodrug, forming an antiproliferative product in cancer cells. Here we show that tangeretin also inhibits cell cycle progression in hepatocytes and investigate the role of its primary metabolite 4'-hydroxy-5,6,7,8-tetramethoxyflavone (4'-OH-TMF) in this effect.

EXPERIMENTAL APPROACH

We used epidermal growth factor (EGF)-stimulated rat hepatocytes, with [(3)H]-thymidine incorporation into DNA as an index of progression to S-phase of the cell cycle, and Western blots for phospho-proteins involved in the cell signalling cascade.

KEY RESULTS

Incubation of tangeretin with microsomes expressing CYP1A, or with hepatocytes, generated a primary product we identified as 4'-OH-TMF. Low micromolar concentrations of tangeretin or 4'-OH-TMF gave a concentration-dependent inhibition of EGF-stimulated progression to S-phase while having little effect on cell viability. To determine whether time for conversion of tangeretin to an active metabolite would enhance the inhibitory effect we used long pre-incubations; this reduced the inhibitory effect, in parallel with a reduction in the concentration of tangeretin. The EGF-stimulation of hepatocyte cell cycle progression requires signalling through Akt/mTOR/p70S6K kinase cascades. The tangeretin metabolite 4'-OH-TMF selectively inhibited S6K phosphorylation in the absence of significant inhibition of upstream Akt activity, suggesting an effect at the level of mTOR.

CONCLUSIONS AND IMPLICATIONS

Tangeretin and 4'-OH-TMF both inhibit cell cycle progression in primary hepatocytes. The inhibition of p70S6K phosphorylation by 4'-OH-TMF raises the possibility that inhibition of the mTOR pathway may contribute to the anticancer influence of a flavonoid-rich diet.

Characterization of 236 novel alleles at the HLA-A, -B, -C, -DRB1, -DQB1 and -DPB1 loci from China Marrow Donor Program

Two hundred and thirty-six novel human leukocyte antigen (HLA) alleles are described from volunteer donors of the China Marrow Donor Program: 71 HLA-A alleles, 79 HLA-B alleles, 43 HLA-C, 16 HLA-DRB1 alleles, 26 HLA-DQB1 and 1 HLA-DPB1. Two hundred and thirteen (90.3%) of the 236 novel alleles are single nucleotide substitution variants when compared with their most homologous allele. Seventy-eight of these single nucleotide variants are silent substitutions. The remaining novel alleles differ from their most similar allele by two to four nucleotide substitutions. Some of the novel alleles encode amino acid changes at positions not previously reported to be polymorphic, such as codons 57, 62, 67, 41 and 52 in HLA-A alleles; codons 133, 156, 201 and 215 in HLA-B alleles; codons 74, 208 and 225 in HLA-C; codons 25, 32 and 72 in HLA-DRB1; codons 20, 39 and 77 in HLA-DQB1.

Dextran sulphate sodium increases splenic Gr1(+)CD11b(+) cells which accelerate recovery from colitis following intravenous transplantation

While Gr1(+)CD11b(+) cells are known to regulate immune responses and accumulate in most cancer tissues, the function of Gr1(+)CD11b(+) cells in inflammation is poorly understood. We investigated the role of Gr1(+)CD11b(+) cells in a dextran sulphate sodium (DSS)-treated mouse model of ulcerative colitis (UC). C57BL/6 mice were treated with 2% DSS in drinking water for 5 days. Disease progression and recovery were assessed by body weight, disease activity index score (DAI) score and colon length. Splenic Gr1(+)CD11b(+) cell number was greatly increased during the recovery phase of DSS-induced colitis. DSS-derived splenic Gr1(+)CD11b(+) cells were administered intravenously to recipient (C57BL/6) mice during the early phase of DSS treatment. The transplanted splenic DSS-induced Gr1(+)CD11b(+) cells improved DSS-induced colitis and promoted efficient colonic mucosal healing. We found that the CD11b(+) single positive cells increased in the course of DSS-induced colitis in lamina propria. The transplantation of splenic Gr1(+)CD11b(+) cells induced feedback suppression of myeloid-lineage cell development. Namely, the transplantation of splenic Gr1(+)CD11b(+) cells greatly suppressed the migration of CD11b(+) single positive cells to the lamina propria. Further, transplantation of Gr-1(+)CD11b(+) cells greatly suppressed the increase of the same population, especially during the late phase of DSS colitis both in spleen and bone marrow.

Abstract P6-04-10: Genetic Discrimination of Aggressive from Indolent DCIS

Background: Treatment options for DCIS vary from surgical excision with or without radiation and/or chemopreventive therapy, or mastectomy. Intuitively, more aggressive treatment options should lead to improved survival rates, however, studies have shown no difference in breast cancer mortality between women treated with wide excision only versus those with excision plus radiation and treatments can be costly, lengthy and associated with side effects. To avoid over-treating women with indolent disease, while intensively treating women with aggressive disease, new molecular tools must be developed to supplement pathological information to classify DCIS lesions and predict clinical outcome.

Methods: Formalin-fixed paraffin-embedded (FFPE) pure DCIS biopsy specimens were collected from the pathology archives of the Anne Arundel Medical Center. Samples included those with poor prognosis characterized by either recurrence of DCIS or progression to invasive cancer (n=7) and those good prognosis, having ≥5-year disease-free survival (n=10). RNA was isolated after laser-microdissection of pure tumor cells and hybridized to Breast Cancer DSA™ microarrays (Almac Diagnostics). S-way ANOVA was used to account for batch effects and then Support Vector Machine (SVM) was used to identify candidate genes effective at discriminating good from poor prognosis DCIS. Pathway analysis was performed using MetaCore (GeneGeo).

Results: 328 genes were found to be differentially expressed between good and poor prognosis specimens (P&lt;0.01). Preliminary analysis with SVM found that a 70-gene candidate signature from these 328 genes wasoptimal under the tested conditions for discriminating favorable from poor prognosis DCIS. This candidate signature included genes such as MEF2C, PTK2 and ZBTB2. Pathway analysis revealed that genes involved in cytoskeleton modeling, apoptosis and survival, DNA damage repair and cell adhesion are expressed at lower levels in poor prognosis DCIS while those involved in cell cycle, immune response and cell proliferation are expressed at higher levels.

Conclusions: While studies have attempted to identify molecular profiles associated with aggressive DCIS by comparing DCIS co-occurring with invasive disease to pure DCIS, to our knowledge, this is the first study that identified a candidate molecular signature of prognosis in pure DCIS. Although many of the 70 genes found to differ between favorable and poor prognosis DCIS have not been previously associated with breast cancer or have unknown function, MEF2C and PTK2 have been implicated in invasion and migration, while ZBTB2 is a master regulator of p53 and stimulates cellular proliferation. These data demonstrate aggressive DCIS do differ from indolent DCIS at the genetic level and that these differences may be useful in developing molecular tools to classify DCIS lesions and guide appropriate treatment.

Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P6-04-10.

Detection of coronary artery anomalies by dual-source CT coronary angiography

AIM

To retrospectively evaluate the clinical value of dual-source computed tomography (DSCT) coronary angiography in the diagnosis of coronary artery anomalies.

MATERIALS AND METHODS

A large cohort of 3625 consecutive patients, who underwent DSCT coronary angiography in our institute, was reviewed for coronary artery anomalies. All images were evaluated by two experienced readers using axial source images, multi-planar reformations (MPR), maximum intensity projections (MIP) and volume rendering (VR). Coronary artery anomalies were found in 36 patients (male 20, female 16, mean age 48 years, range 15-76 years). Of the 36 patients, 19 patients also underwent conventional coronary angiography (CCA).

RESULTS

The incidence of coronary artery anomalies was 0.99% (36/3625). Six different types of coronary artery anomalies were diagnosed by DSCT coronary angiography: (1) 11 anomalies of the right coronary artery; (2) five anomalies of the left coronary artery; (3) 10 anomalies of the left circumflex artery; (4) two single coronary artery; (5) one anomalous pulmonary origin of the coronary artery; (6) seven coronary artery fistula. Evaluation of the CCA resulted in a precise diagnosis in 53% (10/19) patients.

CONCLUSION

DSCT coronary angiography is a good diagnostic tool to examine coronary artery anomalies.

The effects of a high-fat, high-cholesterol diet on markers of uterine contractility during parturition in the rat

Increasing levels of obesity within women of reproductive age is a major concern in the UK. Approximately, 13% of women aged <30 and 22% of 31- to 40-year-old women are obese. Obesity increases complications during pregnancy and the risk of caesarean section due to prolonged labour and poor uterine activity. The aim was to investigate whether a high-fat, high-cholesterol (HFHC) diet decreases markers of uterine contractility during parturition in the rat. Female Wistar rats were fed control (CON, n=10) or HFHC (n=10) diets for 6 weeks. Animals were mated and, once pregnant, maintained on their diet throughout gestation. On gestational day 19, rats were monitored continuously and killed at the onset of parturition. Body and fat depot weights were recorded. Myometrial tissue was analysed for cholesterol (CHOL), triglycerides (TAG), and expression of the contractile associated proteins gap junction protein alpha 1 (GJA1; also known as connexin-43, CX-43), prostaglandin-endoperoxide synthase 2 (PTGS2; also known as cyclo-oxygenase-2, COX-2) and caveolin-1 (CAV1) and maternal plasma for prostaglandin F(2)(α) (PGF(2)(α)) and progesterone. HFHC fed rats gained greater weight than CON (P<0.003) with significant increases in peri-renal fat (P<0.01). The HFHC diet increased plasma CHOL, TAG and progesterone, but decreased PGF(2)(α) versus CON (P<0.01, P<0.01, P=0.05 and P<0.02 respectively). Total CHOL and TAG levels of uterine tissue were similar. However, HFHC fed rats showed significant increases in PTGS2 (P<0.037), but decreases in GJA1 and CAV1 (P=0.059). In conclusion, a HFHC diet significantly increases body weight and alters lipid profiles that correlate with decreases in key markers of uterine contractility. Further work is required to ascertain whether these changes have adverse effects on uterine activity.

Polyunsaturated fatty acids modulate prostaglandin synthesis by ovine amnion cells in vitro

Diets or supplements high in n-3 and n-6 polyunsaturated fatty acids (PUFAs) have been shown to influence the timing of parturition. PUFAs are substrates for prostaglandin (PG) synthesis, and PGs play central roles in parturition. Hence, the effects of altering PUFA composition may be mediated through alterations in the type and relative quantities of PGs synthesised. Therefore, we have investigated the effects of a range of n-3 and n-6 PUFAs in vitro on PG synthesis by amnion cells of late gestation ewes. The n-6 PUFA, arachidonic acid (20:4, n-6), increased synthesis of two-series PGs. Degree of stimulation induced by the n-6 PUFAs was dependent on the position of the PUFA in the PG synthetic pathway, i.e. PG production of the two-series (principally prostaglandin E(2):PGE(2)) increased progressively with longer chain PUFAs. Effects of n-3 PUFAs on output of PGE(2) were more modest and variable. The two shorter chain n-3 PUFAs, α-linolenic acid (18:3, n-3) and stearidonic acid (18:4, n-3), induced a small but significant increase in PGE(2) output, while the longest chain n-3 PUFA docosahexaenoic acid (22:6, n-3) inhibited PGE(2) synthesis. Dihomo-γ-linolenic acid (20:3, n-6), the PUFA substrate for synthesis of one-series PGs, induced an increase in PGE(1) generation and a decrease in PGE(2) and PGE(3) outputs. Hence, we have demonstrated that PUFA supplementation of ovine amnion cells in vitro affects the type and quantity of PGs synthesised.

Temporal variations in arsenic uptake by rice plants in Bangladesh: the role of iron plaque in paddy fields irrigated with groundwater

The transfer of arsenic to rice grains is a human health issue of growing relevance in regions of southern Asia where shallow groundwater used for irrigation of paddy fields is elevated in As. In the present study, As and Fe concentrations in soil water and in the roots of rice plants, primarily the Fe plaque surrounding the roots, were monitored during the 4-month growing season at two sites irrigated with groundwater containing approximately 130microgl(-1) As and two control sites irrigated with water containing <15microgl(-1) As. At both sites irrigated with contaminated water, As concentrations in soil water increased from <10microgl(-1) to >1000microgl(-1) during the first five weeks of the growth season and then gradually declined to <10microgl(-1) during the last five weeks. At the two control sites, concentrations of As in soil water never exceeded 40microgl(-1). At both contaminated sites, the As content of roots and Fe plaque rose to 1000-1500mgkg(-1) towards the middle of the growth season. It then declined to approximately 300mgkg(-1) towards the end, a level still well above As concentration of approximately 100mgkg(-1) in roots and plaque measured throughout the growing season at the two control sites. These time series, combined with simple mass balance considerations, demonstrate that the formation of Fe plaque on the roots of rice plants by micro-aeration significantly limits the uptake of As by rice plants grown in paddy fields. Large variations in the As and Fe content of plant stems at two of the sites irrigated with contaminated water and one of the control sites were also recorded. The origin of these variations, particularly during the last month of the growth season, needs to be better understood because they are likely to influence the uptake of As in rice grains.

Analysis of flow patterns in a patient-specific aortic dissection model

Aortic dissection is the most common acute catastrophic event affecting the thoracic aorta. The majority of patients presenting with an uncomplicated type B dissection are treated medically, but 25% of these patients develop subsequent aneurysmal dilatation of the thoracic aorta. This study aimed at gaining more detailed knowledge of the flow phenomena associated with this condition. Morphological features and flow patterns in a dissected aortic segment of a presurgery type B dissection patient were analyzed based on computed tomography images acquired from the patient. Computational simulations of blood flow in the patient-specific model were performed by employing a correlation-based transitional version of Menter's hybrid k-epsilon/k-omega shear stress transport turbulence model implemented in ANSYS CFX 11. Our results show that the dissected aorta is dominated by locally highly disturbed, and possibly turbulent, flow with strong recirculation. A significant proportion (about 80%) of the aortic flow enters the false lumen, which may further increase the dilatation of the aorta. High values of wall shear stress have been found around the tear on the true lumen wall, perhaps increasing the likelihood of expanding the tear. Turbulence intensity in the tear region reaches a maximum of 70% at midsystolic deceleration phase. Incorporating the non-Newtonian behavior of blood into the same transitional flow model has yielded a slightly lower peak wall shear stress and higher maximum turbulence intensity without causing discernible changes to the distribution patterns. Comparisons between the laminar and turbulent flow simulations show a qualitatively similar distribution of wall shear stress but a significantly higher magnitude with the transitional turbulence model.