Treinamento muscular melhora o volume corrente e a capacidade vital no pós-operatório de revascularização do miocárdioInspiratory muscle training improves tidal volume and vital capacity after CABG surgery 6. PhD in surgery at FCM Unicamp, cardiac surgeon, Campinas, SP, Brazil.This study was carried out at Hospital e Maternidade Celso Pierro, Pontifical Catholic University of Campinas (PUC Campinas), Campinas, SP, Brazil. 363Matheus GB, et al. -Inspiratory muscle training improves tidal volume and vital capacity after CABG surgery Bras Cir Cardiovasc 2012;27(3):362-9 Rev

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Levulinic acid (LA) is currently one of the most promising chemicals derived from biomass. However, its large-scale production is hampered by the challenges in biomass hydrolysis and the poor selectivity due to the formation of humins (HUs). This study addresses these challenges using the biorefinery concept of biomass fractionation. A three-step process (pretreatment, delignification, and acid-catalyzed conversion) was optimized to produce LA from SCB considering the yield (Y LA ), efficiency (E LA ), and concentration of LA (C LA ) as functions of temperature, reaction time, acid concentration, and solids loading. By means of a multi-response optimization, values of Y LA (20.9 ± 1.25 g/100g ISF-D ), E LA (37.5 ± 2.24 mol%), and C LA (25.1 ± 1.50 g/L) were obtained at 180°C, 75 min, 7.0% w/v H 2 SO 4 , and 12.0% w/v of solids loading. Six scenarios for production of LA were analyzed in terms of yields of LA, HUs, lignin, and other sugar-derived products considering one-, two-, or three-step processes. The economic analysis indicated that the three-step scenario delivers better economic figures given that other valuable biomass fractions (hemicellulosic sugars and lignin) are better used and contribute to the overall economic performance of the process. The results also demonstrate the burden of HUs in the economics of the process because it was shown that the largest production of LA is also linked to the largest formation of HUs, which does not necessarily yield the best economic results. These findings indicate the importance of added value by-products for the profitable production of LA in biorefineries.

FAK (focal adhesion kinase) has been shown to mediate the hypertrophic growth of the left ventricle. Experimental results also suggest that FAK may contribute to the structural and functional deterioration of the chronically overloaded left ventricle. In the present study, we postulated that FAK expression and phosphorylation may be altered in the volume-overloaded heart in humans. FAK expression and phosphorylation at Tyr(397) were detected by Western blotting and immunohistochemistry in samples from endomyocardial biopsies from patients with MR (mitral regurgitation; n=21) and donor subjects (n=4). Hearts from patients with MR had degenerated cardiac myocytes and areas of fibrosis. In this group, the myocardial collagen area was increased (18% in MR hearts compared with 3% in donor hearts respectively) and correlated negatively with left ventricular ejection fraction (r=-0.74; P>0.001). FAK expression and phosphorylation at Tyr(397) (a marker of the enzyme activity) were increased in samples from MR hearts compared with those from donor hearts (3.1- and 4.9-fold respectively). In myocardial samples from donor hearts, anti-FAK staining was almost exclusively restricted to cardiac myocytes; however, in myocardial samples from MR hearts, staining with the anti-FAK antibody was found to occur in myocytes and the interstitium. There was a positive correlation between collagen and the interstitial areas stained with the anti-FAK antibody (r=0.76; P>0.001). Anti-FAK and anti-vimentin staining of the interstitial areas of samples from MR hearts were extensively superimposed, indicating that most of the interstitial FAK was located in fibroblasts. In conclusion, FAK expression and phosphorylation are increased and may contribute to the underlying structural and functional abnormalities in the volume-overloaded heart in humans.

We have demonstrated that the short-term and mid-term outcomes of coronary artery surgery alone in patients with a large left ventricle are inferior to coronary artery surgery plus ventricular restoration.