0), for which mortality decreased from 14.8% (60/406) at small programs to 8.4%(157/1858) at very large programs (P = .02). The same was true for the subgroup of patients who underwent Norwood procedures (36.5%[23/63] vs 16.9%[81/479], P < .0001). After risk adjustment, all groups performed similarly for low-difficulty operations.

find more Conversely, for difficult procedures, small programs performed significantly worse. For Norwood procedures, very large programs outperformed all other groups.

Conclusion: There was an inverse association between pediatric cardiac surgical volume and mortality that became increasingly important as case complexity increased. Although volume was not associated with mortality for low-complexity cases, lower-volume programs underperformed larger programs as case complexity increased.”
“Neurons are highly polarized cells comprising somatodendritic and axonal domains. For proper neuronal BAY 73-4506 order function, such as neurotransmission and synaptic plasticity, membrane proteins must be transported to precise positions. alpha-Amino-3-hydroxy-5-methyl-4-isoxazole propionic acid-type glutamate receptors (AMPA receptors) are membrane proteins localized in the somatodendritic domain. AMPA receptors mediate excitatory synaptic transmission: thus, regulation of the intracellular trafficking of AMPA receptors has a critical role in synaptic plasticity. An understanding

of the molecular mechanisms that regulate AMPA receptor trafficking is essential for gaining further insight into neuronal function. Despite its importance, however, how neurons selectively transport AMPA receptors to the somatodendritic domain is largely unknown. In this Update Article, we discuss recent progress in studies of the mechanisms underlying the somatodendritic targeting of AMPA receptors in neurons. (C) 2009 Elsevier Ireland Ltd and the

Japan Neuroscience Society. All rights Amrubicin reserved.”
“Objective: Off-pump valve replacement using self-expandable stents is an emerging technique for pulmonary valve disease. However, significant limitations are the lack of easily available valve substitute to be inserted within the stent and, in the setting of repaired tetralogy of Fallot, the existence of huge pulmonary trunk. We report the first experimental results of a transventricular approach using a decellularized porcine xenograft mounted in a self-expandable stent.

Methods: Pulmonary valve replacement was realized in 15 lambs by direct access of the infundibulum through a left thoracotomy, combined with pulmonary artery banding. Animals were followed by transthoracic echocardiography and, after control hemodynamic study, were electively killed either at day 7, month 1, or month 4 after implantation.

Results: Implantation succeeded in all lambs. Two animals died after implantation (1 pneumothorax and 1 endocarditis).