Single ventricle refers to congenital heart defects where there is only one functional ventricle supporting both the pulmonary and systemic circulations. There are various classifications, and the goal of treatment is to balance blood flow between the lungs and body. Initial medical management uses prostaglandins and aims for balanced pulmonary flow. Later stages involve surgical procedures like shunts, banding of arteries, and ultimately the Fontan procedure to separate circulation to the lungs and body without overloading the single ventricle. Complications can include arrhythmias, heart failure, and protein-losing enteropathy. Long term outcomes are improved with careful patient selection and multi-stage management to optimize hemodynamics at each stage.
preop TEE assessment of atrial septal defect is very important for making decision for device closure, properly assessed adequate rims of ASD will reduce risk of device embolization to almost nil.
A lecture on the echocardiographic evaluation of hypertrophic cardiomyopathy. Starts with an overview of the topic then a systematic approach to diagnosis and then a differential diagnosis followed by take-home messages and conclusion.
Single ventricle presentation for pediatricianLaxmi Ghimire
As the number of children who survive single ventricle physiology, it is very important for the pediatrician to understand about them to give them the best care.
preop TEE assessment of atrial septal defect is very important for making decision for device closure, properly assessed adequate rims of ASD will reduce risk of device embolization to almost nil.
A lecture on the echocardiographic evaluation of hypertrophic cardiomyopathy. Starts with an overview of the topic then a systematic approach to diagnosis and then a differential diagnosis followed by take-home messages and conclusion.
Single ventricle presentation for pediatricianLaxmi Ghimire
As the number of children who survive single ventricle physiology, it is very important for the pediatrician to understand about them to give them the best care.
comprehensive presentation on 2D echo use in ICu set up. helpful in finding causes of shock and also in monitoring of fluid status in critically ill patients.
a clinical syndrome that results from inadequate tissue perfusion.
Hypovolemic shock - Blood or fluid loss, both leading to a decreased circulating blood volume, diastolic filling pressure, and volume.
Cardiogenic shock - due to cardiac pump failure related to loss of myocardial contractility/functional myocardium or structural/mechanical failure of the cardiac anatomy and characterized by elevations of diastolic filling pressures and volumes
Extra-cardiac/obstructive shock - due to obstruction to flow in the cardiovascular circuit and characterized by either impairment of diastolic filling or excessive afterload
Distributive shock - caused by loss of vasomotor control resulting in arteriolar/venular dilatation leading to a decrease in preload, with decreased, normal, or elevated cardiac output, depending on the presence of myocardial depression.
A presentation by Ulf Thilén at the 2017 meeting of the Scandinavian Society of Anaestesiology and Intensive Care Medicine.
All available content from SSAI2017: https://scanfoam.org/ssai2017/
Delivered in collaboration between scanFOAM, SSAI & SFAI.
Seminar of U.V. Spectroscopy by SAMIR PANDASAMIR PANDA
Spectroscopy is a branch of science dealing the study of interaction of electromagnetic radiation with matter.
Ultraviolet-visible spectroscopy refers to absorption spectroscopy or reflect spectroscopy in the UV-VIS spectral region.
Ultraviolet-visible spectroscopy is an analytical method that can measure the amount of light received by the analyte.
A brief information about the SCOP protein database used in bioinformatics.
The Structural Classification of Proteins (SCOP) database is a comprehensive and authoritative resource for the structural and evolutionary relationships of proteins. It provides a detailed and curated classification of protein structures, grouping them into families, superfamilies, and folds based on their structural and sequence similarities.
Multi-source connectivity as the driver of solar wind variability in the heli...Sérgio Sacani
The ambient solar wind that flls the heliosphere originates from multiple
sources in the solar corona and is highly structured. It is often described
as high-speed, relatively homogeneous, plasma streams from coronal
holes and slow-speed, highly variable, streams whose source regions are
under debate. A key goal of ESA/NASA’s Solar Orbiter mission is to identify
solar wind sources and understand what drives the complexity seen in the
heliosphere. By combining magnetic feld modelling and spectroscopic
techniques with high-resolution observations and measurements, we show
that the solar wind variability detected in situ by Solar Orbiter in March
2022 is driven by spatio-temporal changes in the magnetic connectivity to
multiple sources in the solar atmosphere. The magnetic feld footpoints
connected to the spacecraft moved from the boundaries of a coronal hole
to one active region (12961) and then across to another region (12957). This
is refected in the in situ measurements, which show the transition from fast
to highly Alfvénic then to slow solar wind that is disrupted by the arrival of
a coronal mass ejection. Our results describe solar wind variability at 0.5 au
but are applicable to near-Earth observatories.
(May 29th, 2024) Advancements in Intravital Microscopy- Insights for Preclini...Scintica Instrumentation
Intravital microscopy (IVM) is a powerful tool utilized to study cellular behavior over time and space in vivo. Much of our understanding of cell biology has been accomplished using various in vitro and ex vivo methods; however, these studies do not necessarily reflect the natural dynamics of biological processes. Unlike traditional cell culture or fixed tissue imaging, IVM allows for the ultra-fast high-resolution imaging of cellular processes over time and space and were studied in its natural environment. Real-time visualization of biological processes in the context of an intact organism helps maintain physiological relevance and provide insights into the progression of disease, response to treatments or developmental processes.
In this webinar we give an overview of advanced applications of the IVM system in preclinical research. IVIM technology is a provider of all-in-one intravital microscopy systems and solutions optimized for in vivo imaging of live animal models at sub-micron resolution. The system’s unique features and user-friendly software enables researchers to probe fast dynamic biological processes such as immune cell tracking, cell-cell interaction as well as vascularization and tumor metastasis with exceptional detail. This webinar will also give an overview of IVM being utilized in drug development, offering a view into the intricate interaction between drugs/nanoparticles and tissues in vivo and allows for the evaluation of therapeutic intervention in a variety of tissues and organs. This interdisciplinary collaboration continues to drive the advancements of novel therapeutic strategies.
Comparing Evolved Extractive Text Summary Scores of Bidirectional Encoder Rep...University of Maribor
Slides from:
11th International Conference on Electrical, Electronics and Computer Engineering (IcETRAN), Niš, 3-6 June 2024
Track: Artificial Intelligence
https://www.etran.rs/2024/en/home-english/
Slide 1: Title Slide
Extrachromosomal Inheritance
Slide 2: Introduction to Extrachromosomal Inheritance
Definition: Extrachromosomal inheritance refers to the transmission of genetic material that is not found within the nucleus.
Key Components: Involves genes located in mitochondria, chloroplasts, and plasmids.
Slide 3: Mitochondrial Inheritance
Mitochondria: Organelles responsible for energy production.
Mitochondrial DNA (mtDNA): Circular DNA molecule found in mitochondria.
Inheritance Pattern: Maternally inherited, meaning it is passed from mothers to all their offspring.
Diseases: Examples include Leber’s hereditary optic neuropathy (LHON) and mitochondrial myopathy.
Slide 4: Chloroplast Inheritance
Chloroplasts: Organelles responsible for photosynthesis in plants.
Chloroplast DNA (cpDNA): Circular DNA molecule found in chloroplasts.
Inheritance Pattern: Often maternally inherited in most plants, but can vary in some species.
Examples: Variegation in plants, where leaf color patterns are determined by chloroplast DNA.
Slide 5: Plasmid Inheritance
Plasmids: Small, circular DNA molecules found in bacteria and some eukaryotes.
Features: Can carry antibiotic resistance genes and can be transferred between cells through processes like conjugation.
Significance: Important in biotechnology for gene cloning and genetic engineering.
Slide 6: Mechanisms of Extrachromosomal Inheritance
Non-Mendelian Patterns: Do not follow Mendel’s laws of inheritance.
Cytoplasmic Segregation: During cell division, organelles like mitochondria and chloroplasts are randomly distributed to daughter cells.
Heteroplasmy: Presence of more than one type of organellar genome within a cell, leading to variation in expression.
Slide 7: Examples of Extrachromosomal Inheritance
Four O’clock Plant (Mirabilis jalapa): Shows variegated leaves due to different cpDNA in leaf cells.
Petite Mutants in Yeast: Result from mutations in mitochondrial DNA affecting respiration.
Slide 8: Importance of Extrachromosomal Inheritance
Evolution: Provides insight into the evolution of eukaryotic cells.
Medicine: Understanding mitochondrial inheritance helps in diagnosing and treating mitochondrial diseases.
Agriculture: Chloroplast inheritance can be used in plant breeding and genetic modification.
Slide 9: Recent Research and Advances
Gene Editing: Techniques like CRISPR-Cas9 are being used to edit mitochondrial and chloroplast DNA.
Therapies: Development of mitochondrial replacement therapy (MRT) for preventing mitochondrial diseases.
Slide 10: Conclusion
Summary: Extrachromosomal inheritance involves the transmission of genetic material outside the nucleus and plays a crucial role in genetics, medicine, and biotechnology.
Future Directions: Continued research and technological advancements hold promise for new treatments and applications.
Slide 11: Questions and Discussion
Invite Audience: Open the floor for any questions or further discussion on the topic.
Introduction:
RNA interference (RNAi) or Post-Transcriptional Gene Silencing (PTGS) is an important biological process for modulating eukaryotic gene expression.
It is highly conserved process of posttranscriptional gene silencing by which double stranded RNA (dsRNA) causes sequence-specific degradation of mRNA sequences.
dsRNA-induced gene silencing (RNAi) is reported in a wide range of eukaryotes ranging from worms, insects, mammals and plants.
This process mediates resistance to both endogenous parasitic and exogenous pathogenic nucleic acids, and regulates the expression of protein-coding genes.
What are small ncRNAs?
micro RNA (miRNA)
short interfering RNA (siRNA)
Properties of small non-coding RNA:
Involved in silencing mRNA transcripts.
Called “small” because they are usually only about 21-24 nucleotides long.
Synthesized by first cutting up longer precursor sequences (like the 61nt one that Lee discovered).
Silence an mRNA by base pairing with some sequence on the mRNA.
Discovery of siRNA?
The first small RNA:
In 1993 Rosalind Lee (Victor Ambros lab) was studying a non- coding gene in C. elegans, lin-4, that was involved in silencing of another gene, lin-14, at the appropriate time in the
development of the worm C. elegans.
Two small transcripts of lin-4 (22nt and 61nt) were found to be complementary to a sequence in the 3' UTR of lin-14.
Because lin-4 encoded no protein, she deduced that it must be these transcripts that are causing the silencing by RNA-RNA interactions.
Types of RNAi ( non coding RNA)
MiRNA
Length (23-25 nt)
Trans acting
Binds with target MRNA in mismatch
Translation inhibition
Si RNA
Length 21 nt.
Cis acting
Bind with target Mrna in perfect complementary sequence
Piwi-RNA
Length ; 25 to 36 nt.
Expressed in Germ Cells
Regulates trnasposomes activity
MECHANISM OF RNAI:
First the double-stranded RNA teams up with a protein complex named Dicer, which cuts the long RNA into short pieces.
Then another protein complex called RISC (RNA-induced silencing complex) discards one of the two RNA strands.
The RISC-docked, single-stranded RNA then pairs with the homologous mRNA and destroys it.
THE RISC COMPLEX:
RISC is large(>500kD) RNA multi- protein Binding complex which triggers MRNA degradation in response to MRNA
Unwinding of double stranded Si RNA by ATP independent Helicase
Active component of RISC is Ago proteins( ENDONUCLEASE) which cleave target MRNA.
DICER: endonuclease (RNase Family III)
Argonaute: Central Component of the RNA-Induced Silencing Complex (RISC)
One strand of the dsRNA produced by Dicer is retained in the RISC complex in association with Argonaute
ARGONAUTE PROTEIN :
1.PAZ(PIWI/Argonaute/ Zwille)- Recognition of target MRNA
2.PIWI (p-element induced wimpy Testis)- breaks Phosphodiester bond of mRNA.)RNAse H activity.
MiRNA:
The Double-stranded RNAs are naturally produced in eukaryotic cells during development, and they have a key role in regulating gene expression .
THE IMPORTANCE OF MARTIAN ATMOSPHERE SAMPLE RETURN.Sérgio Sacani
The return of a sample of near-surface atmosphere from Mars would facilitate answers to several first-order science questions surrounding the formation and evolution of the planet. One of the important aspects of terrestrial planet formation in general is the role that primary atmospheres played in influencing the chemistry and structure of the planets and their antecedents. Studies of the martian atmosphere can be used to investigate the role of a primary atmosphere in its history. Atmosphere samples would also inform our understanding of the near-surface chemistry of the planet, and ultimately the prospects for life. High-precision isotopic analyses of constituent gases are needed to address these questions, requiring that the analyses are made on returned samples rather than in situ.
This pdf is about the Schizophrenia.
For more details visit on YouTube; @SELF-EXPLANATORY;
https://www.youtube.com/channel/UCAiarMZDNhe1A3Rnpr_WkzA/videos
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2. Single Ventricle: congenital cardiac malformations that
lack two completely well developed ventricles, and in
which functionally there is only a single ventricular
chamber that supports both pulmonary and systemic
circulations
3. Classifications of Single ventricle:
Hearts with common inlet atrioventricular connection [Double-
inlet RV/ Double-inlet LV]
Hearts with absence of one atrioventricular connection [Tricuspid
atresia / Mitral atresia]
Hearts with common atrioventricular valve and only one well-
developed ventricle [unbalanced common atrioventricular canal
defect]
Hearts with only one fully developed ventricle
Hypoplastic left heart syndrome
Double-outlet right ventricle and a ventricular septal defect
remote from semilunar valves
Other rare forms of univentricular hearts
6. Medical management: (temporary palliation)
Prostaglandin E1
Restoraration of normal acid base status
Maintain End organ perfusion & function
Aim of surgical intervention: to improve the natural
history by balancing blood flow between the pulmonary and
systemic circulations and ultimately separating these two
circulations.
7. In patients with Pulmonary
outflow obstruction:
pulmonary atresia/stenosis
Consistently SaO2 <75~80%
Systemic to pulmonary
arterial shunt: modified B-T
shunt: graft from subclavian
A to PA
To improve SaO2
8. In patients with excessive pulmonary blood flow:
SaO2> 85% strongly suggest excessive pulmonary blood flow
Volume overload to the single ventricle: cause CHF
Pressure overload to the pulmonary arteriole tree: cause
pulmonary vascular disease
Tx: PA banding!
Exclude obstruction of systemic outflow!
SaO2 80~85%
9. In patients with excessive pulmonary blood flow with
systemic obstruction-
DKS procedure (Norwood + BT shunt)
10. One of the following conditions:
Mean PA pressure up to 20mmHg
2 PVR≦ ＜ 4 Wood units but reactive to vasodilators
Surgically repairable PA hypoplasia or discrete stenosis
present
McGoon ratio is 2.0 and repairable
LVED volume is 2SD above the mean[compared with
normal structural heart]
Target SpO2: 78~85%
11. Bidirectional cavopulmonary shunt as a staging
Maneuver, usually combined with repair of associated lesion
leading to poor outcome of Fontan’s operation,
including pulmonary arterial stenosis, atrioventricular
valve regurgitation, and systemic outflow tract
obstruction.
To reduce the volume load on single ventricle & maintain
a viable Spo2.
So to preserve ventricular function for the subsequent
Fontan
12. COMMENTSCOMMENTS
End to side connection between the cranial end of SVC & right
pulmonary artery
Ligation of of azygous
If b/l SVC, both should be connected to respected Pas
The cavopulmonary shunt increases effective pulmonary
blood flow without volume-loading the ventricle.
Systemic venous collateralization may worsen hypoxemia by
reducing the effective pulmonary blood flow
There are concerns about the growth of the pulmonary
arteries .
Pulmonary arteriovenous fistulae may be a universal
consequence of the bidirectional cavopulmonary shunt
13. Contd.Contd.
promotes regression of left ventricular mass in younger
children.
Improvement in the degree of atrioventricular valve
regurgitation.
18. Graham and Johns pointed out that theGraham and Johns pointed out that the
following issues or criteria were not includedfollowing issues or criteria were not included
Diastolic dysfunction,
Ventricular hypertrophy,
Systemic outflow tract obstruction,
Right ventricular type of single ventricle,
Extensive systemic aortopulmonary collaterals.
19. NECESSARY CRITERIANECESSARY CRITERIA
1. Undistorted pulmonary artery anatomy;
2. Low pulmonary vascular resistance;
3. Low ventricular end diastolic pressure;
4. Absence of obstruction to systemic outflow;
and
5. Preservation of systemic atrioventricular valve
function.
20. METHODMETHOD
The lateral tunnel technique involves placement of a
baffle along the lateral aspect of the right atrium,
which conveys IVC blood to SVC orifice.
4 mm fenestration is made in the medial aspect of
baffle to prevent the systemic venous pressure risisng
to intolerable limit.
Large ASD is created to prevent any restriction of flow
between atria.
Allows to preserve systemic cardiac output at the
expense of some reduction in arterial saturation.
Lower operative mortality &p/o pleural effusion.
21. Post operative managementPost operative management
Minimize PVR
Monitor systemic & pulmonary pressure & indicators of good cardiac
output as strength of pulse, urine output, BP, CRT.
Systemic venous hypertension lead to reflex arterial constriction lead
to increased afterload may impair cardiac output- milrinone,
nitroprusside
Arrhythmias- atrial pacing lowers atrial filling pressure & augments
cardiac output
Pleural effusion & ascites- complete drainage
22. Early mortality: 7.7%
Late mortality:
Survival 93% at 5years, 91% at 10 years
Most common causes of death
Thromboembolism: intra-cardiac thrombus, lack of
Aspirin / Warfarin
Heart failure: morphological RV, high RA pressure,
protein-losing enteropathy
Sudden death: cardiac arrhythmias [within fist 5 years
after Fontan surgery]
24. Atrial arrhythmia
Major risk factor for morbidity and functional
decline after the Fontan procedure
Incidence: 10~40%
Most common: Sinus node dysfunction!! [sinus
node injury while REDO or disturbance of its
blood supply]
Cause: RA dilation, RA incision
Tx: anti-coagulant if refractory
26. Ventricular dysfunction/heart dailure: 8.3%
Preload reduced to 50~70% of normal for BSA
Ventricle: from volume overload and overstretched
to severely undeloaded
→”Disuse hypofunction”: remodelling, reduced
compliance, poor ventricular filling, continuous
declining cardiac output
Tx: heart transplantation! [Late take down or
fenestration before heart transplantation]
27. Right atriomegaly and hepatic dysfunction
Dilatation of the coronary sinus
Pulmonary arteriovenous malformations
Myocardial dysfunction and failure
Ventricular outflow obstruction
Obstruction of pulmonary veins
Recanalization of ligated main pulmonary trunk
Systemic venous collateralisation
Bronchitis
Pancreatitis
WPW syndrome
