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Chen J, Chiu F, Chang S, Cheng H, Huang P, Wu C, Wang Y, Hwang J, Tsai C. Pattern of Endothelialization in Left Atrial Appendage Occluder by Optic Coherence Tomography: A Pilot Study. J Am Heart Assoc 2024; 13:e030080. [PMID: 38156658 PMCID: PMC10863799 DOI: 10.1161/jaha.123.030080] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 10/03/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Implantation of the left atrial appendage occluder (LAAO) has been proven to prevent stroke effectively in patients with atrial fibrillation who cannot tolerate anticoagulants. Incomplete endothelization of LAAO may cause device-related thrombus, and currently no good image modality exists to clearly see LAAO endothelialization. We aimed to use coronary optic coherence tomography (OCT) to visualize LAAO endothelialization. METHODS AND RESULTS We enrolled 14 patients (72.8±9.4 years old) undergoing pulmonary vein isolation with a preexisting LAAO implanted more than 1 year ago (5 Watchman and 9 Amulet). After pulmonary vein isolation, we did OCT via steerable sheath and coronary guiding catheter to adjust OCT probe location and injected contrast medium to visualize the LAAO surface. In vitro testing was also performed to see the bare occluder. In vitro OCT showed the surface of the bare device as an interrupted granule pattern, which included the Watchman surface polytetrafluoroethylene membrane string, Amulet disc metal strut, and inner polytetrafluoroethylene membrane string. In the implanted Watchman, OCT showed endothelialization as a smooth surface layer with noninterrupted coarser granules. In the implanted Amulet, OCT showed endothelialization as thin (early) or thick (late) endothelialization layer covering struts with OCT shadows. Among patients with Watchman, 2 showed no, 2 early, and 1 complete endothelialization. Among patients with Amulet, 2 showed no, 3 early, and 4 late endothelialization. CONCLUSIONS We demonstrated the feasibility of OCT to visualize LAAO endothelization with high resolution. Further studies are needed to determine antithrombotic regimens if incomplete endothelization is detected. A new OCT catheter may be designed specifically for LAAO.
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Affiliation(s)
- Jien‐Jiun Chen
- Division of Cardiology, Department of Internal MedicineNational Taiwan University College of Medicine and Hospital Yun‐Ling BranchDou‐Liu CityTaiwan
| | - Fu‐Chun Chiu
- Division of Cardiology, Department of Internal MedicineNational Taiwan University College of Medicine and Hospital Yun‐Ling BranchDou‐Liu CityTaiwan
| | - Sheng‐Nan Chang
- Division of Cardiology, Department of Internal MedicineNational Taiwan University College of Medicine and Hospital Yun‐Ling BranchDou‐Liu CityTaiwan
| | - Hsiao‐Liang Cheng
- Department of AnesthesiaNational Taiwan University HospitalTaipeiTaiwan
| | - Pang‐Shuo Huang
- Division of Cardiology, Department of Internal MedicineNational Taiwan University College of Medicine and Hospital Yun‐Ling BranchDou‐Liu CityTaiwan
| | - Cho‐Kai Wu
- Division of Cardiology, Department of Internal MedicineNational Taiwan University College of Medicine and HospitalTaipeiTaiwan
| | - Yi‐Chih Wang
- Division of Cardiology, Department of Internal MedicineNational Taiwan University College of Medicine and HospitalTaipeiTaiwan
| | - Juey‐Jen Hwang
- Division of Cardiology, Department of Internal MedicineNational Taiwan University College of Medicine and HospitalTaipeiTaiwan
| | - Chia‐Ti Tsai
- Division of Cardiology, Department of Internal MedicineNational Taiwan University College of Medicine and HospitalTaipeiTaiwan
- Graduate Institute of Clinical MedicineNational Taiwan University College of Medicine, Cardiovascular Center, National Taiwan University HospitalTaipeiTaiwan
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Kole GE, Hasirci V, Yucel D. Development of a Tri-Layered Vascular Construct and In Vitro Evaluation of Endothelization. Macromol Biosci 2023:e2300369. [PMID: 38134246 DOI: 10.1002/mabi.202300369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 12/18/2023] [Indexed: 12/24/2023]
Abstract
Advances in the development of vascular substitutes for small-sized arteries are ongoing because the present grafts do not entirely meet the requirements of native equivalents and are suboptimal in clinical performance. This study aims to develop a tri-layered vascular construct mimicking natural tissue using polyester blends and to investigate its endothelization through in vitro studies as a potential small-caliber vascular graft. The innermost layer is obtained by dip coating as a tubular porous film with a lumen diameter of 3 mm and a pore size of ≤8 µm. Circumferentially aligned electrospun fiber (diameter 100-800 nm) with a deviation angle of 15° are deposited over the porous film forming the intermediate layer. The random electrospun fibers (diameter 100-1100 nm) deviating at different angles are wrapped as the outermost layer. The mechanical properties of the tri-layered vascular construct are determined to be 44.80 ± 14.80 MPa for Young's modulus and 4.25 ± 0.75 MPa for ultimate tensile strength. MTS and cell behavior studies show that the isolated human umbilical cord vein endothelial cells proliferate and line the lumen of the vascular substitute. The vascular construct developed, with its biomimetic architecture, mechanical features, size, and endothelization, can be tested with in vivo studies.
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Affiliation(s)
- Gozde E Kole
- Graduate School of Health Sciences, Department of Medical Biotechnology, Acıbadem Mehmet Ali Aydınlar University (ACU), Istanbul, 34752, Turkey
- ACU Biomaterials A &R Center, Acıbadem Mehmet Ali Aydınlar University (ACU), Istanbul, 34752, Turkey
| | - Vasif Hasirci
- ACU Biomaterials A &R Center, Acıbadem Mehmet Ali Aydınlar University (ACU), Istanbul, 34752, Turkey
- Faculty of Engineering and Natural Sciences, Department of Biomedical Engineering, Acıbadem Mehmet Ali Aydınlar University (ACU), Istanbul, 34752, Turkey
- Graduate School of Natural and Applied Sciences, Department of Biomaterials, Acıbadem Mehmet Ali Aydınlar University (ACU), Istanbul, 34752, Turkey
- Middle East Technical University, BIOMATEN Center of Excellence in Biomaterials and Tissue Engineering, Ankara, 06800, Turkey
| | - Deniz Yucel
- Graduate School of Health Sciences, Department of Medical Biotechnology, Acıbadem Mehmet Ali Aydınlar University (ACU), Istanbul, 34752, Turkey
- ACU Biomaterials A &R Center, Acıbadem Mehmet Ali Aydınlar University (ACU), Istanbul, 34752, Turkey
- Graduate School of Natural and Applied Sciences, Department of Biomaterials, Acıbadem Mehmet Ali Aydınlar University (ACU), Istanbul, 34752, Turkey
- School of Medicine, Department of Histology and Embryology, Acıbadem Mehmet Ali Aydınlar University (ACU), Istanbul, 34752, Turkey
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Alkazemi H, Huang T, Mail M, Lokmic-Tomkins Z, Heath DE, O'Connor AJ. Spontaneous Orthogonal Alignment of Smooth Muscle Cells and Endothelial Cells Captures Native Blood Vessel Morphology in Tissue-Engineered Vascular Grafts. ACS Appl Mater Interfaces 2023. [PMID: 37440289 DOI: 10.1021/acsami.3c08511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 07/14/2023]
Abstract
Tissue-engineered vascular grafts (TEVGs) have emerged as a potential alternative to autologous grafts for replacing small-diameter blood vessels during bypass surgery. The axial alignment of endothelial cells (ECs) and the circumferential alignment of smooth muscle cells (SMCs) are crucial for functional native blood vessels (NBVs). However, achieving this cellular alignment in TEVGs remains a formidable challenge. In this study, TEVGs were developed using a low-cost technique that aligned ECs axially and SMCs circumferentially within hours. The TEVGs comprised an electrospun polycaprolactone (PCL) layer and a gelatin methacryloyl (GelMA) cast layer. A freezing-induced alignment technique was developed that partially aligns the electrospun fibers axially, thereby promoting rapid axial alignment of ECs. Furthermore, SMCs cultured in a GelMA layer with intermediate stiffness (5-12 kPa) surrounding a PCL tube could promote conformation of the SMCs to the curvature of the PCL tube, resulting in their spontaneous circumferential alignment. Additionally, the TEVGs demonstrated mechanical properties similar to those of NBVs, which could facilitate future translation. This approach represents a significant advance in tissue engineering, enabling the fabrication of TEVGs with appropriate mechanical properties that recapitulate key NBV cell structural features within hours using a scalable and accessible method.
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Affiliation(s)
- Hazem Alkazemi
- Department of Biomedical Engineering, Graeme Clark Institute, University of Melbourne, Melbourne, Victoria 3010, Australia
| | - Tao Huang
- Department of Biomedical Engineering, Graeme Clark Institute, University of Melbourne, Melbourne, Victoria 3010, Australia
| | - Matthew Mail
- Department of Biomedical Engineering, Graeme Clark Institute, University of Melbourne, Melbourne, Victoria 3010, Australia
| | - Zerina Lokmic-Tomkins
- Medicine, Nursing and Health Sciences, Monash University, Monash, Victoria 3800, Australia
| | - Daniel E Heath
- Department of Biomedical Engineering, Graeme Clark Institute, University of Melbourne, Melbourne, Victoria 3010, Australia
| | - Andrea J O'Connor
- Department of Biomedical Engineering, Graeme Clark Institute, University of Melbourne, Melbourne, Victoria 3010, Australia
- Aikenhead Centre for Medical Discovery (ACMD), Fitzroy, Victoria 3065, Australia
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Cassari L, Todesco M, Zamuner A, Imran SJ, Casarin M, Sandrin D, Ródenas-Rochina J, Gomez Ribelles JL, Romanato F, Bagno A, Gerosa G, Dettin M. Covalently Grafted Peptides to Decellularized Pericardium: Modulation of Surface Density. Int J Mol Sci 2023; 24. [PMID: 36769254 DOI: 10.3390/ijms24032932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 01/19/2023] [Accepted: 01/27/2023] [Indexed: 02/05/2023] Open
Abstract
The covalent functionalization of synthetic peptides allows the modification of different biomaterials (metallic, polymeric, and ceramic), which are enriched with biologically active sequences to guide cell behavior. Recently, this strategy has also been applied to decellularized biological matrices. In this study, the covalent anchorage of a synthetic peptide (REDV) to a pericardial matrix decellularized via Schiff base is realized starting from concentrated peptide solutions (10-4 M and 10-3 M). The use of a labeled peptide demonstrated that as the concentration of the working solution increased, the surface density of the anchored peptide increased as well. These data are essential to pinpointing the concentration window in which the peptide promotes the desired cellular activity. The matrices were extensively characterized by Water Contact Angle (WCA) analysis, Differential Scanning Calorimetry (DSC) analysis, geometric feature evaluation, biomechanical tests, and preliminary in vitro bioassays.
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Lu J, Hu X, Yuan T, Cao J, Zhao Y, Xiong C, Li K, Ye X, Xu T, Zhao J. 3D-Printed Poly (P-Dioxanone) Stent for Endovascular Application: In Vitro Evaluations. Polymers (Basel) 2022; 14:polym14091755. [PMID: 35566924 PMCID: PMC9103802 DOI: 10.3390/polym14091755] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/13/2022] [Accepted: 04/19/2022] [Indexed: 02/04/2023] Open
Abstract
Rapid formation of innovative, inexpensive, personalized, and quickly reproducible artery bioresorbable stents (BRSs) is significantly important for treating dangerous and sometimes deadly cerebrovascular disorders. It is greatly challenging to give BRSs excellent mechanical properties, biocompatibility, and bioabsorbability. The current BRSs, which are mostly fabricated from poly-l-lactide (PLLA), are usually applied to coronary revascularization but may not be suitable for cerebrovascular revascularization. Here, novel 3D-printed BRSs for cerebrovascular disease enabling anti-stenosis and gradually disappearing after vessel endothelialization are designed and fabricated by combining biocompatible poly (p-dioxanone) (PPDO) and 3D printing technology for the first time. We can control the strut thickness and vessel coverage of BRSs by adjusting the printing parameters to make the size of BRSs suitable for small-diameter vascular use. We added bis-(2,6-diisopropylphenyl) carbodiimide (commercial name: stabaxol®-1) to PPDO to improve its hydrolytic stability without affecting its mechanical properties and biocompatibility. In vitro cell experiments confirmed that endothelial cells can be conveniently seeded and attached to the BRSs and subsequently demonstrated good proliferation ability. Owing to the excellent mechanical properties of the monofilaments fabricated by the PPDO, the 3D-printed BRSs with PPDO monofilaments support desirable flexibility, therefore offering a novel BRS application in the vascular disorders field.
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Affiliation(s)
- Junlin Lu
- Beijing Tiantan Hospital, Department of Neurosurgery, Capital Medical University, Beijing 100070, China; (J.L.); (Y.Z.)
| | - Xulin Hu
- Clinical Medical College & Affiliated Hospital of Chengdu University, Chengdu University, Chengdu 610081, China; (X.H.); (K.L.)
| | - Tianyu Yuan
- State Key Laboratory for Turbulence and Complex Systems, Department of Mechanics and Engineering Science, College of Engineering, Peking University, Beijing 100871, China;
| | - Jianfei Cao
- School of Materials and Environmental Engineering, Chengdu Technology University, Chengdu 610041, China;
| | - Yuanli Zhao
- Beijing Tiantan Hospital, Department of Neurosurgery, Capital Medical University, Beijing 100070, China; (J.L.); (Y.Z.)
- Beijing Translational Engineering Enter for 3D Printer in Clinical Neuroscience, Beijing 100070, China
| | - Chengdong Xiong
- Chengdu Institute of Organic Chemistry, Chinese Academy of Sciences, Chengdu 610041, China;
| | - Kainan Li
- Clinical Medical College & Affiliated Hospital of Chengdu University, Chengdu University, Chengdu 610081, China; (X.H.); (K.L.)
| | - Xun Ye
- Beijing Tiantan Hospital, Department of Neurosurgery, Capital Medical University, Beijing 100070, China; (J.L.); (Y.Z.)
- Beijing Translational Engineering Enter for 3D Printer in Clinical Neuroscience, Beijing 100070, China
- Correspondence: (X.Y.); (T.X.); (J.Z.)
| | - Tao Xu
- Department of Mechanical Engineering, Tsinghua University, Beijing 100084, China
- Bio-Intelligent Manufacturing and Living Matter Bioprinting Center, Research Institute of Tsinghua University in Shenzhen, Tsinghua University, Shenzhen 518057, China
- East China Institute of Digital Medical Engineering, Shangrao 334000, China
- Correspondence: (X.Y.); (T.X.); (J.Z.)
| | - Jizong Zhao
- Beijing Tiantan Hospital, Department of Neurosurgery, Capital Medical University, Beijing 100070, China; (J.L.); (Y.Z.)
- Beijing Translational Engineering Enter for 3D Printer in Clinical Neuroscience, Beijing 100070, China
- Correspondence: (X.Y.); (T.X.); (J.Z.)
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Niu Y, Galluzzi M. Hyaluronic Acid/Collagen Nanofiber Tubular Scaffolds Support Endothelial Cell Proliferation, Phenotypic Shape and Endothelialization. Nanomaterials (Basel) 2021; 11:2334. [PMID: 34578649 DOI: 10.3390/nano11092334] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 09/03/2021] [Accepted: 09/06/2021] [Indexed: 02/07/2023]
Abstract
In this study, we designed and synthetized artificial vascular scaffolds based on nanofibers of collagen functionalized with hyaluronic acid (HA) in order to direct the phenotypic shape, proliferation, and complete endothelization of mouse primary aortic endothelial cells (PAECs). Layered tubular HA/collagen nanofibers were prepared using electrospinning and crosslinking process. The obtained scaffold is composed of a thin inner layer and a thick outer layer that structurally mimic the layer the intima and media layers of the native blood vessels, respectively. Compared with the pure tubular collagen nanofibers, the surface of HA functionalized collagen nanofibers has higher anisotropic wettability and mechanical flexibility. HA/collagen nanofibers can significantly promote the elongation, proliferation and phenotypic shape expression of PAECs. In vitro co-culture of mouse PAECs and their corresponding smooth muscle cells (SMCs) showed that the luminal endothelialization governs the biophysical integrity of the newly formed extracellular matrix (e.g., collagen and elastin fibers) and structural remodeling of SMCs. Furthermore, in vitro hemocompatibility assays indicated that HA/collagen nanofibers have no detectable degree of hemolysis and coagulation, suggesting their promise as engineered vascular implants.
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Sanchis L, Farrero M, Martinez D, Castel MA, Sandoval E, Alcocer J, Regueiro A, Flores-Umanzor E, Cepas-Guillen P, Sabaté M, Sitges M, Freixa X. Anatomical Fusion of MitraClip Device With Native Mitral Apparatus: Insights From an Explanted Human Heart. JACC Cardiovasc Interv 2021; 14:1257-8. [PMID: 33992549 DOI: 10.1016/j.jcin.2021.03.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 03/09/2021] [Indexed: 11/22/2022]
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Stepanova AO, Laktionov PP, Cherepanova AV, Chernonosova VS, Shevelev GY, Zaporozhchenko IA, Karaskov AM, Laktionov PP. General Study and Gene Expression Profiling of Endotheliocytes Cultivated on Electrospun Materials. Materials (Basel) 2019; 12:E4082. [PMID: 31817735 DOI: 10.3390/ma12244082] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 11/20/2019] [Accepted: 12/03/2019] [Indexed: 12/27/2022]
Abstract
Endothelization of the luminal surface of vascular grafts is required for their long-term functioning. Here, we have cultivated human endothelial cells (HUVEC) on different 3D matrices to assess cell proliferation, gene expression and select the best substrate for endothelization. 3D matrices were produced by electrospinning from solutions of poly(D,L-lactide-co-glycolide) (PLGA), polycaprolactone (PCL), and blends of PCL with gelatin (Gl) in hexafluoroisopropanol. Structure and surface properties of 3D matrices were characterized by SEM, AFM, and sessile drop analysis. Cell adhesion, viability, and proliferation were studied by SEM, Alamar Blue staining, and 5-ethynyl-2’-deoxyuridine (EdU) assay. Gene expression profiling was done on an Illumina HiSeq 2500 platform. Obtained data indicated that 3D matrices produced from PCL with Gl and treated with glutaraldehyde provide the most suitable support for HUVEC adhesion and proliferation. Transcriptome sequencing has demonstrated a minimal difference of gene expression profile in HUVEC cultivated on the surface of these matrices as compared to tissue culture plastic, thus confirming these matrices as the best support for endothelization.
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Kolar M, Mozetič M, Stana-Kleinschek K, Fröhlich M, Turk B, Vesel A. Covalent Binding of Heparin to Functionalized PET Materials for Improved Haemocompatibility. Materials (Basel) 2015; 8:1526-1544. [PMID: 28788016 PMCID: PMC5507051 DOI: 10.3390/ma8041526] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Revised: 01/19/2015] [Accepted: 03/20/2015] [Indexed: 11/16/2022]
Abstract
The hemocompatibility of vascular grafts made from poly(ethylene terephthalate) (PET) is insufficient due to the rapid adhesion and activation of blood platelets that occur upon incubation with whole blood. PET polymer was treated with NHx radicals created by passing ammonia through gaseous plasma formed by a microwave discharge, which allowed for functionalization with amino groups. X-ray photoelectron spectroscopy characterization using derivatization with 4-chlorobenzaldehyde indicated that approximately 4% of the –NH2 groups were associated with the PET surface after treatment with the gaseous radicals. The functionalized polymers were coated with an ultra-thin layer of heparin and incubated with fresh blood. The free-hemoglobin technique, which is based on the haemolysis of erythrocytes, indicated improved hemocompatibility, which was confirmed by imaging the samples using confocal optical microscopy. A significant decrease in number of adhered platelets was observed on such samples. Proliferation of both human umbilical vein endothelial cells and human microvascular endothelial cells was enhanced on treated polymers, especially after a few hours of cell seeding. Thus, the technique represents a promising substitute for wet-chemical modification of PET materials prior to coating with heparin.
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Affiliation(s)
- Metod Kolar
- Jozef Stefan International Postgraduate School, Jamova 39, Ljubljana 1000, Slovenia.
| | - Miran Mozetič
- Plasma Laboratory, Institute Jozef Stefan, Jamova 39, Ljubljana 1000, Slovenia.
| | - Karin Stana-Kleinschek
- Faculty of Mechanical Engineering, University of Maribor, Smetanova 17, Maribor 2000, Slovenia.
| | - Mirjam Fröhlich
- Department of Biochemistry, Molecular and Structural Biology, Institute Jozef Stefan, Jamova 39, Ljubljana 1000, Slovenia.
- Educell Ltd., Prevale 9, Trzin 1236, Slovenia.
| | - Boris Turk
- Department of Biochemistry, Molecular and Structural Biology, Institute Jozef Stefan, Jamova 39, Ljubljana 1000, Slovenia.
| | - Alenka Vesel
- Plasma Laboratory, Institute Jozef Stefan, Jamova 39, Ljubljana 1000, Slovenia.
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