| 1. |
- Brunkwall, J., et al.
(författare)
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Endovascular Repair of Acute Uncomplicated Aortic Type B Dissection Promotes Aortic Remodelling: 1 Year Results of the ADSORB Trial
- 2014
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Ingår i: European Journal of Vascular and Endovascular Surgery. - : Elsevier BV. - 1532-2165 .- 1078-5884. ; 48:3, s. 285-291
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Uncomplicated acute type B aortic dissection (AD) treated conservatively has a 10% 30-day mortality and up to 25% need intervention within 4 years. In complicated AD, stent grafts have been encouraging. The aim of the present prospective randomised trial was to compare best medical treatment (BMT) with BMT and Gore TAG stent graft in patients with uncomplicated AD. The primary endpoint was a combination of incomplete/no false lumen thrombosis, aortic dilatation, or aortic rupture at 1 year. Methods: The AD history had to be less than 14 days, and exclusion criteria were rupture, impending rupture, malperfusion. Of the 61 patients randomised, 80% were DeBakey type IIIB. Results: Thirty-one patients were randomised to the BMT group and 30 to the BMT+TAG group. Mean age was 63 years for both groups. The left subclavian artery was completely covered in 47% and in part in 17% of the cases. During the first 30 days, no deaths occurred in either group, but there were three crossovers from the BMT to the BMT TAG group, all due to progression of disease within 1 week. There were two withdrawals from the BMT+TAG group. At the 1-year follow up there had been another two failures in the BMT group: one malperfusion and one aneurysm formation (p = .056 for all). One death occurred in the BMT TAG group. For the overall endpoint BMT+TAG was significantly different from BMT only (p < .001). Incomplete false lumen thrombosis, was found in 13 (43%) of the TAG+BMT group and 30 (97%) of the BMT group (p < .001). The false lumen reduced in size in the BMT+TAG group (p < .001) whereas in the BMT group it increased. The true lumen increased in the BMT TAG (p < .001) whereas in the BMT group it remained unchanged. The overall transverse diameter was the same at the beginning and after 1 year in the BMT group (42.1 mm), but in the BMT+TAG it decreased (38.8 mm; p = .062). Conclusions: Uncomplicated AD can be safely treated with the Gore TAG device. Remodelling with thrombosis of the false lumen and reduction of its diameter is induced by the stent graft, but long term results are needed. (C) 2014 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.
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| 2. |
- Rütting, Tobias, 1977, et al.
(författare)
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Ten years of elevated atmospheric carbon dioxide alters
- 2010
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Ingår i: Global Change Biology. - 1354-1013. ; 16:9, s. 2530-2542
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Tidskriftsartikel (refereegranskat)abstract
- The increasing concentration of atmospheric carbon dioxide (CO2) is expected to lead to enhanced competition between plants and microorganisms for the available nitrogen (N) in soil. Here, we present novel results from a 15N tracing study conducted with a sheep-grazed pasture soil that had been under 10 years of CO2 enrichment. Our study aimed to investigate changes in process-specific gross N transformations in a soil previously exposed to an elevated atmospheric CO2 (eCO2) concentration and to examine indicators for the occurrence of progressive nitrogen limitation (PNL). Our results show that the mineralization–immobilization turnover (MIT) was enhanced under eCO2, which was driven by the mineralization of recalcitrant organic N. The retention of N in the grassland was enhanced by increased dissimilatory NO3− reduction to NH4+ (DNRA) and decreased NH4+ oxidation. Our results indicate that heterotrophic processes become more important under eCO2. We conclude that higher MIT of recalcitrant organic N and enhanced N retention are mechanisms that may alleviate PNL in grazed temperate grassland.
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