291. Segmental analysis of aortic basal ring dimensions in normal and dilated tricuspid aortic rootsMatija Jelenc, Blaž Jelenc, Sara Habjan, Christian Giebels, Peter Fries, Hector I. Michelena, Thomas Foley, Hans Joachim Schäfers, 2024, original scientific article Abstract: Objectives: In patients with aortic root aneurysm, the aortic basal ring is frequently dilated. It has been speculated that the muscular part of the basal ring dilates most. The purpose of this study was to analyse the segmental dilatation of the basal ring, comparing normal and dilated roots in patients with tricuspid aortic valves. Methods: Retrospective analysis of computed tomography studies in patients with normal and dilated aortic roots was performed. Lengths of segments of the basal ring corresponding to each of the 3 sinuses, and to the muscular and fibrous parts were measured. Fractions of these segments relative to the total basal ring perimeter were calculated. Results: We analysed 152 normal and 126 dilated aortic roots and 86 propensity-matched pairs. Basal ring dilatation was present in all segments of dilated aortic roots with subtle differences between the segments corresponding to the 3 sinuses. The muscular part of the basal ring dilated proportionately to its fibrous part, with no difference in fractions of measured muscular part in normal and dilated roots [42.2% (interquartile range 4.3%) vs 42.1% (interquartile range 6.3%)]. CONCLUSIONS: Basal ring dilatation was present in all segments corresponding to the 3 sinuses in dilated aortic roots. Both muscular and fibrous parts dilated equally, supporting the need to stabilize the entire basal ring when performing aortic valve repair surgery.
Keywords: aortic root dilatation, aortic valve anatomy, computed tomography angiography, tricuspid aortic valve, propensity score matching, aortic valve annulus
Published in DiRROS: 26.11.2025; Views: 148; Downloads: 63
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292. Comparison of pulmonary and aortic root and cusp dimensions in normal adults using computed tomography : potential implications for Ross procedure planningMatija Jelenc, Blaž Jelenc, Sara Habjan, Karen B. Abeln, Peter Fries, Hector I. Michelena, Hans Joachim Schäfers, 2024, original scientific article Abstract: Objectives: The Ross procedure is currently receiving renewed interest. Its function and durability depend on preservation of pulmonary valve anatomy; limited data exist on normal pulmonary valve geometry. The objective was to compare aortic and pulmonary root and cusp dimensions in adults with normal tricuspid aortic and pulmonary valves. Methods: We reviewed 507 coronary computed tomography studies, selecting those with adequate visibility of both pulmonary and aortic roots for further analysis. Diastolic aortic and pulmonary root and cusp dimensions were measured. Root dimensions at different phases of the cardiac cycle were measured in 3 patients. Results: We analysed studies of 50 patients with the mean age of 54 years [standard deviation (SD): 16]. In end-diastole, pulmonary root had a smaller sinutubular to basal ring ratio than the aortic root [0.82 (SD: 0.09) vs 1.14 (SD: 0.12), P<0.001]. Aortic and pulmonary cusps had similar dimensions; however, pulmonary cusp effective height was lower [5.9 mm (SD: 1.6) vs 8.4 mm (SD: 1.2), P<0.001]. Pulmonary basal ring perimeter was largest at end-diastole and smallest at end-systole, with the relative difference of 23.5% (SD: 2.7). Conclusions: The pulmonary root has a similar cusp size compared to the aortic root, but a different shape, resulting in a lower pulmonary cusp effective height. The perimeter of the pulmonary basal ring changes during the cardiac cycle. These findings suggest that stabilizing the autograft to normal aortic, rather than pulmonary, root dimensions should result in normal autograft cusp configuration. Computed tomography angiography could become a tool for personalized planning of the Ross procedure.
Keywords: computed tomography angiography, pulmonary valve anatomy, ross procedure, aortic valve anatomy, cardiac cycle
Published in DiRROS: 26.11.2025; Views: 129; Downloads: 75
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293. Evaluating the effect of bile acid levels on maternal and perinatal outcomes in intrahepatic cholestasis of pregnancy : a retrospective studyPetra Gregorc, Ivan Verdenik, Polona Pečlin, 2025, original scientific article Abstract: first_pagesettingsOrder Article Reprints Open AccessArticle Evaluating the Effect of Bile Acid Levels on Maternal and Perinatal Outcomes in Intrahepatic Cholestasis of Pregnancy: A Retrospective Study by Petra Gregorc 1,Ivan Verdenik 1ORCID andPolona Pečlin 1,2,*ORCID 1 Division of Obstetrics and Gynaecology, Department of Perinatology, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia 2 Department of Gynaecology and Obstetrics, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia * Author to whom correspondence should be addressed. Diagnostics 2025, 15(17), 2185; https://doi.org/10.3390/diagnostics15172185 (registering DOI) Submission received: 14 July 2025 / Revised: 21 August 2025 / Accepted: 22 August 2025 / Published: 28 August 2025 (This article belongs to the Special Issue Diagnosis and Prognosis of Gynecological and Obstetric Diseases) Downloadkeyboard_arrow_down Browse Figures Versions Notes Abstract Background: Intrahepatic cholestasis of pregnancy (ICP) is the most common reversible liver disorder linked to pregnancy, characterised by pruritus and elevated serum bile acids (BAs). Condition severity correlates with increased maternal and neonatal complications, and recent evidence highlights a significantly elevated risk of adverse perinatal outcomes, including stillbirth, when BA > 100 µmol/L. Methods: This retrospective study, conducted at a tertiary perinatology centre between 2019 and 2023, was performed in two phases. In the first phase, baseline group characteristics and pregnancy outcomes were compared between ICP and non-ICP (control) groups. In the second phase, outcomes were analysed across three ICP severity subgroups: mild (BA < 40 µmol/L), moderate (BA 40–99 µmol/L), and severe (BA ≥ 100 µmol/L). Results: A total of 210 patients diagnosed with ICP and 24,177 controls were included in the analysis. After multivariable regression, the results indicated that patients with severe ICP (BA ≥ 100 µmol/L) experienced significantly worse perinatal outcomes compared to those with mild or moderate disease: spontaneous preterm birth occurred in 26.7% of cases (p = 0.002), iatrogenic preterm birth in 36.7% (p < 0.001), meconium-stained amniotic fluid in 43.3% (p = 0.001), and neonatal intensive care unit (NICU) admission in 23.3% (p = 0.006). This subgroup also had the lowest mean birth weight (2830 g, p < 0.001). Notably, no stillbirths were recorded in any of the subgroups. Compared to controls, no major differences in maternal characteristics were noted, except in pregnancies conceived via in vitro fertilisation (IVF, p = 0.012) and those complicated by gestational diabetes (p = 0.040), both showing elevated risk for ICP development. Conclusions: This study confirms an association between ICP and increased perinatal complications, with severity of disease correlating with poorer outcomes. The findings highlight the need for standardised BA testing and improved strategies for perinatal management.
Keywords: intrahepatic cholestasis of pregnancy, peak bile acid, adverse perinatal outcomes, stillbirth
Published in DiRROS: 26.11.2025; Views: 126; Downloads: 43
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294. Circulating miRNAs correlate with clinical evaluation of activity in ANCA-associated glomerulonephritisMatic Bošnjak, Željka Večerić-Haler, Živa Pipan Tkalec, Emanuela Boštjančič, Nika Kojc, 2025, original scientific article Abstract: Introduction: Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis is an autoimmune necrotizing small vessel vasculitis, frequently resulting in severe renal manifestations such as rapidly progressive glomerulonephritis (AAV-GN). Monitoring disease activity and determining ongoing renal involvement remain significant clinical challenges due to the limitations associated with traditional biomarkers. This study focused on the potential of circulating microRNA (miRNA) as supplementary noninvasive biomarkers for disease activity in AAV-GN. Methods: This prospective follow-up study involved serum samples from 60 patients with biopsy-proven AAV-GN, collected at renal biopsy and at 3-, 6-, 12-, and 24-month intervals post-biopsy. Nine miRNAs (miR-21-3p, miR-30b/d/e-5p, miR-142-5p, miR-150-5p, miR-181a-5p, miR-181b-5p, and let-7a-5p) were selected based on the differential expressions in renal tissue and corresponding serum samples identified in the previous research phases. Expression analysis was performed using quantitative real-time polymerase chain reaction and correlated with disease activity based on the Birmingham Vasculitis Activity Score and other clinical parameters. Results: A significant correlation was identified between disease activity and the expression levels of the miR-30 family members and let-7a. Specifically, these miRNAs demonstrated consistent correlation patterns across follow-up samples independent of the time elapsed post-biopsy, with down-regulation correlating with the presence of active disease. Notably, the miRNA expression profile in partial remission appeared analogous to that of complete remission, suggesting that many patients categorized as having partial remission may, in fact, be considered in true clinical remission. Conclusion: This study supports serum miRNA profiling as an adjunct noninvasive biomarker for assessing disease activity in AAV-GN. Such an approach could provide complementary information alongside traditional biomarkers and refine the future management of AAV-GN. However, it is important to acknowledge that our actual study cohort was small due to challenging technical aspects of miRNA expression analysis in the serum. Therefore, further research with larger cohorts is required to validate these results and assess their clinical applicability.
Keywords: ANCA, vasculitis, glomerulonephritis, microRNA, biomarker, BVAS, epigenetics, follow-up
Published in DiRROS: 26.11.2025; Views: 113; Downloads: 55
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299. Heterogenous mitochondrial ultrastructure and metabolism of human glioblastoma cells : differences between stem-like and differentiated cancer cells in response to chemotherapyUrban Bogataj, Metka Novak, Simona Katrin Galun, Klementina Fon Tacer, Miloš Vittori, Cornelis J. F. van Noorden, Barbara Breznik, 2025, original scientific article Abstract: Background[:] Glioblastoma stem-like cells (GSCs) contribute to the resistance of glioblastoma (GBM) tumors to standard therapies. The background of the resistance of GSCs to the chemotherapeutic agent temozolomide is not yet fully understood in the context of cellular metabolism and the role of mitochondria. The aim of this study was to perform a detailed ultrastructural characterization of the mitochondria of GSCs prior and post temozolomide exposure and to compare it to differentiated GBM cells. Materials and methods[:] Patient-derived and established GBM cell lines were used for the study. The ultrastructure of the mitochondria of the examined cell lines was assessed by transmission electron microscopy. The microscopic analysis was complemented and compared by an analysis of cell metabolism using Seahorse extracellular flux analysis. Results[:] We found that the metabolic profile of GSCs is quiescent and aerobic. Their elongated mitochondria with highly organized cristae are indicating increased biogenesis and mitochondrial fusion and corresponds to a more oxidative phosphorylation (OXPHOS)-dependent metabolism. The metabolism of GSCs is dependent on OXPHOS and there are no changes in defective mitochondria fraction after the treatment with temozolomide. In contrast, differentiated GBM cells with fragmented mitochondria, which have less organized cristae, are more energetic and glycolytic. Temozolomide treatment induced ultrastructural mitochondrial damage in differentiated GBM cells. Conclusions[:] We demonstrated differences in mitochondrial ultrastructure and cellular metabolism between GSCs and differentiated GBM cells in response to temozolomide, suggesting that mitochondria play an important role in the resistance of GSCs to temozolomide. This study provides a basis for further studies addressing GSC chemotherapy resistance in the context of mitochondrial structure and function.
Keywords: glioblastoma, mitochondria, metabolism, chemotherapy, stem cells
Published in DiRROS: 26.11.2025; Views: 97; Downloads: 50
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