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Sample records for cardioverter defibrillator explantation

  1. Making post-mortem implantable cardioverter defibrillator explantation safe

    DEFF Research Database (Denmark)

    Räder, Sune B E W; Zeijlemaker, Volkert; Pehrson, Steen;

    2009-01-01

    that the resting voltage over the operating person would not exceed 50 V. CONCLUSION: The use of intact medical gloves made of latex, neoprene, or plastic eliminates the potential electrical risk during explantation of an ICD. Two gloves on each hand offer sufficient protection. We will recommend the use......AIMS: The aim of this study is to investigate whether protection with rubber or plastic gloves during post-mortem explantation of an implantable cardioverter defibrillator (ICD) offers enough protection for the explanting operator during a worst-case scenario (i.e. ICD shock). METHODS AND RESULTS......: We investigated the insulating properties of rubber and plastic gloves (double layer) within the first 60 min exposure (mimicking the maximum time of an explantation procedure) to saline (simulating the effects of body fluids on the gloves). For latex gloves, we measured an increase in voltage up...

  2. Implantable Cardioverter Defibrillator

    Science.gov (United States)

    ... NHLBI on Twitter. What Is an Implantable Cardioverter Defibrillator? An implantable cardioverter defibrillator (ICD) is a small ... pacemakers and defibrillators. Comparison of an Implantable Cardioverter Defibrillator and a Pacemaker The image compares an ICD ...

  3. Implantable cardioverter defibrillator - discharge

    Science.gov (United States)

    ... medlineplus.gov/ency/patientinstructions/000108.htm Implantable cardioverter defibrillator - discharge To use the sharing features on this ... chest wall. A device called an implantable cardioverter-defibrillator (ICD) was inserted under your skin and muscle. ...

  4. Implantable cardioverter-defibrillator

    Science.gov (United States)

    ... medlineplus.gov/ency/article/007370.htm Implantable cardioverter-defibrillator To use the sharing features on this page, please enable JavaScript. An implantable cardioverter-defibrillator (ICD) is a device that detects any life- ...

  5. Cardioverter-Defibrillator: A Treatment for Arrhythmia

    Science.gov (United States)

    MENU Return to Web version Arrhythmia | Cardioverter-Defibrillator: A Treatment for Arrhythmia What is an implantable cardioverter-defibrillator? An implantable cardioverter-defibrillator (often called an ICD) is a device that keeps ...

  6. How Will Having an Implantable Cardioverter Defibrillator Affect My Lifestyle?

    Science.gov (United States)

    ... NHLBI on Twitter. How Will an Implantable Cardioverter Defibrillator Affect My Lifestyle? The low-energy electrical pulses ... short time. Devices That Can Disrupt Implantable Cardioverter Defibrillator Functions Once you have an ICD, you have ...

  7. [The implantable cardioverter-defibrillator: sometimes necessary

    NARCIS (Netherlands)

    Smeets, J.L.R.M.

    2004-01-01

    The implantable cardioverter-defibrillator (ICD) is used in patients who are at risk for ventricular fibrillation after having suffered from a myocardial infarction. Initially, patient selection was limited to survivors of impending sudden death with coronary artery disease. Later, ICD implantation

  8. An entirely subcutaneous implantable cardioverter-defibrillator

    NARCIS (Netherlands)

    G.H. Bardy (Gust); W.M. Smith (Warren); A.M. Hood (Margaret); I.G. Crozier (Ian); I.C. Melton (Iain Craig); L.J.L.M. Jordaens (Luc); D.A.M.J. Theuns (Dominic); E. Park (Robert); D.J. Wright (David Justin); D.T. Connelly (Derek); S.P. Fynn (Simon Patrick); F.D. Murgatroyd (Francis); J. Sperzel (Johannes); J. Neuzner (Jörg); S.G. Spitzer (Stefan); A.V. Ardashev (Andrey); A. Oduro (Amo); L. Boersma (Lucas); A.H. Maass (Alexander); I.C. van Gelder (Isabelle); A.A.M. Wilde (Arthur); P.F.H.M. van Pascal; R.E. Knops (Reinoud); C.S. Barr (Craig); P. Lupo (Pierpaolo); R. Cappato (Riccardo); A.A. Grace (Andrew)

    2010-01-01

    textabstractBACKGROUND: Implantable cardioverter-defibrillators (ICDs) prevent sudden death from cardiac causes in selected patients but require the use of transvenous lead systems. To eliminate the need for venous access, we designed and tested an entirely subcutaneous ICD system. METHODS: First, w

  9. Concerns about the implantable cardioverter defibrillator

    DEFF Research Database (Denmark)

    Pedersen, Susanne S.; van Domburg, Ron T; Theuns, Dominic A M J;

    2005-01-01

    Patients with an implantable cardioverter defibrillator (ICD) are at increased risk of anxiety disorders. In turn, anxiety has been identified as a precipitant of ventricular arrhythmias. Anxiety may in part be attributed to concerns about the ICD firing, but the relationship between ICD concerns...

  10. Living with an implantable cardioverter defibrillator

    DEFF Research Database (Denmark)

    Pedersen, Susanne S; Knudsen, Charlotte; Dilling, Karen;

    2016-01-01

    AIMS: The clinical management and care of patients with an implantable cardioverter defibrillator (ICD) has shifted from face-to-face in-clinic visits to remote monitoring. Reduced interactions between patients and healthcare professionals may impede patients' transition to adapting post......-implant. We examined patients' needs and preferences for information provision and care options and overall satisfaction with treatment. METHODS AND RESULTS: Patients implanted with a first-time ICD or defibrillator with cardiac resynchronization therapy (n = 389) within the last 2 years at Odense University...

  11. The automatic implantable cardioverter-defibrillator.

    Science.gov (United States)

    Mirowski, M; Reid, P R; Mower, M M; Watkins, L; Platia, E V; Griffith, L S; Juanteguy, J M

    1984-05-01

    The automatic implantable cardioverter-defibrillator is an electronic device designed to monitor the heart continuously, to identify malignant ventricular tachyarrhythmias, and then to deliver effective countershock to restore normal rhythm. There are two defibrillating electrodes which are also used for waveform analysis; one is located in the superior vena cava, the other is placed over the cardiac apex. A third bipolar right ventricular electrode serves for rate counting and R-wave synchronization. When ventricular fibrillation occurs, a 25 joule pulse is delivered; when ventricular tachycardia faster than a preset rate is detected, the discharge is R-wave synchronized. The device can recycle three times if required. Special batteries can deliver over 100 shocks or provide a 3-year monitoring life. Implantation of the device is made either through a thoracotomy or by a subxiphoid approach. Thus far, the device has been implanted in 160 patients with a follow-up of 42 months. Acceleration of ventricular tachycardia to a faster rhythm or to ventricular fibrillation occurred only rarely and is dealt with most successfully through recycling. Actuarial analysis of the initial 52 patients has indicated 22.9% one-year total mortality, a 52% decrease from the 48% mortality that would be expected in the same group of patients without the device; the mortality attributed to arrhythmias was only 8.5%. In conclusion, the automatic cardioverter-defibrillator can reliably identify and correct potentially lethal ventricular tachyarrhythmias, leading to a substantial increase in survival in properly selected high-risk patients. PMID:6204311

  12. Gender differences in anxiety and concerns about the cardioverter defibrillator

    DEFF Research Database (Denmark)

    Spindler, Helle; Johansen, Jens B; Andersen, Kirsten Krogh;

    2009-01-01

    Little is known about gender differences in the response to implantable cardioverter defibrillator (ICD) therapy. We compared female and male ICD patients on anxiety, depression, health-related quality of life (HRQL), ICD concerns, and ICD acceptance.......Little is known about gender differences in the response to implantable cardioverter defibrillator (ICD) therapy. We compared female and male ICD patients on anxiety, depression, health-related quality of life (HRQL), ICD concerns, and ICD acceptance....

  13. Implantable cardioverter defibrillator specific rehabilitation improves health cost outcomes

    DEFF Research Database (Denmark)

    Berg, Selina Kikkenborg; Zwisler, Ann-Dorthe; Koch, Mette Bjerrum;

    2015-01-01

    ) were randomized (1:1) to comprehensive cardiac rehabilitation or usual care. Outcomes were measured by implantable cardioverter defibrillator therapy history from patient records and national register follow-up on mortality, hospital admissions and costs. RESULTS: No significant differences were found...... was -6,789 USD/-5,593 Euro in favour of rehabilitation. CONCLUSION: No long-term health outcome benefits were found for the rehabilitation programme. However, the rehabilitation programme resulted in a reduction in total attributable direct costs.......OBJECTIVE: The Copenhagen Outpatient ProgrammE - implantable cardioverter defibrillator (COPE-ICD) trial included patients with implantable cardioverter defibrillators in a randomized controlled trial of rehabilitation. After 6-12 months significant differences were found in favour...

  14. Pacemakers and implantable cardioverter defibrillators - general and anesthetic considerations

    Directory of Open Access Journals (Sweden)

    Amy G. Rapsang

    2014-06-01

    Full Text Available A pacemaking system consists of an impulse generator and lead or leads to carry the electrical impulse to the patient's heart. Pacemaker and implantable cardioverter defibrillator codes were made to describe the type of pacemaker or implantable cardioverter defibrillator implanted. Indications for pacing and implantable cardioverter defibrillator implantation were given by the American College of Cardiologists. Certain pacemakers have magnet-operated reed switches incorporated; however, magnet application can have serious adverse effects; hence, devices should be considered programmable unless known otherwise. When a device patient undergoes any procedure (with or without anesthesia, special precautions have to be observed including a focused history/physical examination, interrogation of pacemaker before and after the procedure, emergency drugs/temporary pacing and defibrillation, reprogramming of pacemaker and disabling certain pacemaker functions if required, monitoring of electrolyte and metabolic disturbance and avoiding certain drugs and equipments that can interfere with pacemaker function. If unanticipated device interactions are found, consider discontinuation of the procedure until the source of interference can be eliminated or managed and all corrective measures should be taken to ensure proper pacemaker function should be done. Post procedure, the cardiac rate and rhythm should be monitored continuously and emergency drugs and equipments should be kept ready and consultation with a cardiologist or a pacemaker-implantable cardioverter defibrillator service may be necessary.

  15. Cost effectiveness of the implantable cardioverter defibrillator: a preliminary analysis

    OpenAIRE

    O'Brien, Bernie J; Buxton, Martin J; Rushby, Julia A

    1992-01-01

    Background—An implantable cardioverter defibrillator (ICD) may be effective in reducing the risk of sudden cardiac death. The high cost of ICD treatment, however, compared with alternatives raises the question of whether this new technology is an efficient use of scarce health care resources.

  16. Phantom shocks in patients with implantable cardioverter defibrillator

    DEFF Research Database (Denmark)

    Berg, Selina Kikkenborg; Moons, Philip; Zwisler, Ann-Dorthe;

    2013-01-01

    The aim of this trial was to assess a combined rehabilitation intervention including an exercise training component and a psycho-educational component in patients treated with implantable cardioverter defibrillator (ICD). The hypothesis was that the intervention would reduce the occurrence of...

  17. Intra-operative defibrillation testing and clinical shock efficacy in patients with implantable cardioverter-defibrillators

    DEFF Research Database (Denmark)

    Bänsch, Dietmar; Bonnemeier, Hendrik; Brandt, Johan;

    2015-01-01

    AIMS: This trial was designed to test the hypothesis that shock efficacy during follow-up is not impaired in patients implanted without defibrillation (DF) testing during first implantable cardioverter-defibrillator (ICD) implantation. METHODS AND RESULTS: Between February 2011 and July 2013, 1077...... within 30 days in 94 patients (17.6%) tested compared with 89 events in 74 patients (13.9%) not tested (P = 0.095). CONCLUSION: Defibrillation efficacy during follow-up is not inferior in patients with a 40 J ICD implanted without DF testing. Defibrillation testing during first time ICD implantation...

  18. Impact of carvedilol and metoprolol on inappropriate implantable cardioverter-defibrillator therapy

    DEFF Research Database (Denmark)

    Ruwald, Martin H; Abu-Zeitone, Abeer; Jons, Christian;

    2013-01-01

    The goal of this study was to evaluate the effects of carvedilol and metoprolol on the endpoint of inappropriate implantable cardioverter-defibrillator therapy in the MADIT-CRT (Multicenter Automatic Defibrillator Implantation With Cardiac Resynchronization Therapy) study.......The goal of this study was to evaluate the effects of carvedilol and metoprolol on the endpoint of inappropriate implantable cardioverter-defibrillator therapy in the MADIT-CRT (Multicenter Automatic Defibrillator Implantation With Cardiac Resynchronization Therapy) study....

  19. Behavioral interventions in patients with an implantable cardioverter defibrillator

    DEFF Research Database (Denmark)

    Habibović, Mirela; Burg, Matthew M; Pedersen, Susanne S.

    2013-01-01

    The implantable cardioverter defibrillator (ICD) is the first-line treatment for primary and secondary prevention of sudden cardiac death. A subgroup of patients experience psychological distress postimplant, and no clear evidence base exists regarding how best to address patients' needs. The aim...... of this critical review is to provide an overview of behavioral interventions in ICD patients to date, and to delineate directions for future research using lessons learned from the ongoing RISTA and WEBCARE trials....

  20. Implantable cardioverter-defibrillators in congenital heart disease

    OpenAIRE

    Chubb, H; Rosenthal, E

    2016-01-01

    Implantable cardioverter-defibrillators (ICD) have an important role in reducing sudden cardiac death in patients with congenital heart disease (CHD); however, the benefit of ICDs needs to be weighed up against both short-term and long-term adverse effects, which are difficult to evaluate in the heterogeneous CHD population. A tailored approach, taking into account risk stratification and patient-specific factors, is needed to select the most appropriate strategy. This review discusses primar...

  1. The occupational routine of patients implanted with cardioverter-defibrillator

    Directory of Open Access Journals (Sweden)

    Juliana Mannini

    2015-03-01

    Full Text Available Implantable cardioverter-defibrillators (ICD have become a reference as to the standard of care for patients with potentially lethal ventricular arrhythmias. The ICD treats the symptoms of the disease with no impact on its cause; however, the electrical discharge originating from the operating mechanism of this device has been the source of many studies addressing the quality of life of this population. The specific literature points to limitations of patients implanted with cardioverter-defibrillators regarding activities such as working and driving, but little has been discussed whether other areas of occupational performance are also limited. The purpose of this prospective exploratory research, which uses a case study design of quantitative nature, is to know the routine of patients implanted with cardioverter-defibrillator. Fifteen subjects with ICD participated in the study; they were outpatients in the arrhythmia sector of the ‘Clementino Fraga Filho’ University Hospital - HUCFF. The instruments for data collection included an initial interview, SF36 inventory, Role Checklist, and an open question. The results showed interference in the routine occupational performance and occupational roles evaluated, as well as in the fields of mental health and vitality, with greater focus on influences arising from the pathology than the mechanism of the device.

  2. Implantable cardioverter-defibrillator oversensing due to electric shock

    Directory of Open Access Journals (Sweden)

    Jurčević Ružica

    2010-01-01

    Full Text Available Introduction. We described the first case of oversensing due to electric shock in Serbia, in a 54-year-old man who had implantable cardioverter-defibrillator (ICD. Case Outline. In July 2002, the patient had acute anteroseptal myocardial infarction and ventricular fibrillation (VF which was terminated with six defibrillation shocks of 360 J. Coronary angiography revealed 30% stenosis of circumflex artery, the left anterior descending coronary artery was recanalized and the right coronary artery was without stenosis. Left ventricular ejection fraction was 20%. In December 2003, an electrophysiology study was performed and ventricular tachycardia (VT was induced and terminated with 200 J defibrillation shock. Single chamber ICD Medtronic Gem III VR was implanted in January 2004 and defibrillation threshold was 12 J. The patient was followed up during three years every three months and there were no VT/VF episodes and VT/VF therapies. In December 2007, the patient experienced electric shock through the fork while he was making barbecue on the electric grill. ICD recognized this event in VF zone (oversensing and delivered defibrillation shock of 18 J. The electrogram of the episode showed ventricular sensing - intrinsic sinus rhythm with electric shock potentials which were misidentified as VF. After charge time of 3.16 seconds, ICD delivered defibrillation shock and sinus rhythm was still present. Conclusion. Oversensing of ICD has different aetiology and the most common cause is supraventricular tachyarrhythmia.

  3. Patient perceptions of implantable cardioverter-defibrillator deactivation discussions: A qualitative study

    Directory of Open Access Journals (Sweden)

    Jane MacIver

    2016-04-01

    Full Text Available Background: There is a class I recommendation for implantable cardioverter-defibrillator deactivation discussions to occur between physicians and heart failure patients. Few studies have reported the patient’s perspective on the timing of implantable cardioverter-defibrillator deactivation discussions. Aim: To determine patient awareness, preferences and timing of implantable cardioverter-defibrillator deactivation discussions. Design: Grounded theory was used to collect and analyze interview data from 25 heart failure patients with an implantable cardioverter-defibrillator. Setting and participants: Patients with an implantable cardioverter-defibrillator, from the Heart Function Clinic at University Health Network (Toronto, Canada. Results: The sample (n = 25 was predominately male (76% with an average age of 62 years. Patients identified three stages where they felt implantable cardioverter-defibrillator deactivation should be discussed: (1 prior to implantation, (2 with any significant deterioration but while they were of sound mind to engage in and communicate their preferences and (3 at end of life, where patients wished further review of their previously established preferences and decisions about implantable cardioverter-defibrillator deactivation. Most patients (n = 17, 68% said they would consider deactivation, six (24% were undecided and two (8% were adamant they would never turn it off. Conclusion: The patient preferences identified in this study support the need to include information on implantable cardioverter-defibrillator deactivation at implant, with change in clinical status and within broader discussions about end-of-life treatment preferences. Using this process to help patients determine and communicate their implantable cardioverter-defibrillator deactivation preferences may reduce the number of patients experiencing distressing implantable cardioverter-defibrillator shocks at end of life.

  4. Pre-implantation implantable cardioverter defibrillator concerns and Type D personality increase the risk of mortality in patients with an implantable cardioverter defibrillator

    DEFF Research Database (Denmark)

    Pedersen, Susanne S.; van den Broek, Krista C; Erdman, Ruud A M;

    2010-01-01

    Little is known about the influence of psychological factors on prognosis in implantable cardioverter defibrillator (ICD) patients. We examined the influence of the distressed personality (Type D) and pre-implantation device concerns on short-term mortality in ICD patients.......Little is known about the influence of psychological factors on prognosis in implantable cardioverter defibrillator (ICD) patients. We examined the influence of the distressed personality (Type D) and pre-implantation device concerns on short-term mortality in ICD patients....

  5. Prevention of sudden cardiac death by the implantable cardioverter defibrilator

    Directory of Open Access Journals (Sweden)

    Kovačević Dragan V.

    2011-01-01

    Full Text Available Introduction. Sudden cardiac death or, as it is also called, a modern man’s killer occurs a few hours after the beginning of the disease. Sudden death is the one that happens within an hour from the onset of the subjective discomforts regardless of the existence of any previous disease. According to modern statistics, 450.000 people die suddenly in the USA and 150,000 in Germany. Causes of sudden death. The most frequent causes of sudden death are cardiologic or, in other words, a heart rhythm disorder such as ventricular tachycardia, ventricular fibrillation and bradycardiac rhythm disorder. All these reasons can be efficiently prevented by the implantation of the cardioverter defibrillators. Implantable cardioverter defibrillator. In comparison with the already known medications, the defibrillator seems to be the most efficient in prevention of sudden cardiac death. This fact has been confirmed by large multicentre studies. The implantation itself is a routine procedure. It lasts about an hour and it often passes without any complications. The patient leaves the hospital a few days after the procedure. About 150 of these procedures are performed per year at the Institute of Cardiovascular Diseases Vojvodina. The Social Insurance Fund bears medical costs and the patient only pays the participation fee, which is symbolical if compared to the value and use of the device. Owing to this fact, this device is available to every patient thus making the efficient sudden cardiac death prevention possible.

  6. Experience With the Wearable Cardioverter-Defibrillator in Patients at High Risk for Sudden Cardiac Death

    Science.gov (United States)

    Günther, Michael; Quick, Silvio; Pfluecke, Christian; Rottstädt, Fabian; Szymkiewicz, Steven J.; Ringquist, Steven; Strasser, Ruth H.; Speiser, Uwe

    2016-01-01

    Background: This study evaluated the wearable cardioverter-defibrillator (WCD) for use and effectiveness in preventing sudden death caused by ventricular tachyarrhythmia or fibrillation. Methods: From April 2010 through October 2013, 6043 German WCD patients (median age, 57 years; male, 78.5%) were recruited from 404 German centers. Deidentified German patient data were used for a retrospective, nonrandomized analysis. Results: Ninety-four patients (1.6%) were treated by the WCD in response to ventricular tachyarrhythmia/fibrillation. The incidence rate was 8.4 (95% confidence interval, 6.8–10.2) per 100 patient-years. Patients with implantable cardioverter-defibrillator explantation had an incidence rate of 19.3 (95% confidence interval, 12.2–29.0) per 100 patient-years. In contrast, an incidence rate of 8.2 (95% confidence interval, 6.4–10.3) was observed in the remaining cardiac diagnosis groups, including dilated cardiomyopathy, myocarditis, and ischemic and nonischemic cardiomyopathies. Among 120 shocked patients, 112 (93%) survived 24 hours after treatment, whereas asystole was observed in 2 patients (0.03%) with 1 resulting death. ConclusionS: This large cohort represents the first nationwide evaluation of WCD use in patients outside the US healthcare system and confirms the overall value of the WCD in German treatment pathways. PMID:27458236

  7. Automatic implantable cardioverter/defibrillator discharges and acute myocardial injury

    Energy Technology Data Exchange (ETDEWEB)

    Avitall, B.; Port, S.; Gal, R.; McKinnie, J.; Tchou, P.; Jazayeri, M.; Troup, P.; Akhtar, M. (Univ. of Wisconsin-Milwaukee Clinical Campus (USA))

    1990-05-01

    Multiple defibrillations by the automatic implantable cardioverter/defibrillator (AICD) have been reported to result in localized epicardial damage. No data exist, however, regarding whether this damage can be detected in the clinical setting or whether it interferes with the detection of true myocardial infarction. Forty-nine patients who received defibrillations by patch electrodes were studied prospectively. We attempted to document the presence of myocardial injury with the following three commonly used modalities for the detection of myocardial infarction: serial electrocardiographic changes, serial creatine phosphokinase (CPK) and CPK-MB release, and technetium 99m pyrophosphate scanning. Fifteen patients received defibrillations by AICD patches at the time of AICD generator replacement. Nine patients received defibrillations at the time of new AICD lead placement. The average total energy delivered was 85 +/- 29 J. None of these patients had detectable myocardial injury. Ten patients had defibrillations by the AICD patches at the time of bypass operation. One patient in this group developed acute myocardial infarction in the inferior wall after posterior descending coronary bypass operation, as detected by electrocardiogram, 99mTc pyrophosphate scanning, and CPK-MB analysis. Fifteen patients were evaluated for spontaneous AICD discharges. Thirteen had a maximum of five consecutive shocks, and cumulative energy delivered was not greater than 330 J. None of these patients had detectable injury. Two patients had CPK-MB release of 15.3% and 7.5%, respectively. One of these patients had a positive 99mTc pyrophosphate scan. These two patients received 12 and 17 rapid and consecutive AICD discharges, respectively, with cumulative delivered energy of 360 and 510 J, respectively.

  8. [Implantable cardioverter-defibrillator at the end of life].

    Science.gov (United States)

    Pfeiffer, D; Hagendorff, A; Kühne, C; Reinhardt, S; Klein, N

    2015-06-01

    Brady- and tachyarrhythmias at the end of life are common observations. Implantable cardioverter-defibrillators answer with antibrady and antitachycardia pacing, which will not be associated with any complaints of the dying patient. In contrast, defibrillation and cardioversion shocks are extremely painful. Therefore shocks should be inactivated at the end of life. Family doctors, internists, emergency physicians and paramedics are unable to inactivate shocks. Deactivation of shocks at the end of life is not comparable to euthanasia or assisted suicide, but allow the patient to die at the end of an uncurable endstage disease. Deactivation of shocks should be discussed with the patient before initial implantation of the devices. The precise moment of the inactivation at the end of life should be discussed with patients and relatives. There is no common recommendation for the time schedule of this decision; therefore it should be based on the individual situation of the patient. Emergency health care physicians need magnets and sufficient information to inactivate defibrillators. The wishes of the patient have priority in the decision process and should be written in the patient's advance directive, which must be available in the final situation. However the physician must not necessarily follow every wish of the patient. As long as the laws in the European Union are not uniform, German recommendations are needed. PMID:26001358

  9. Somatosensory amplification mediates sex differences in psychological distress among cardioverter-defibrillator patients

    DEFF Research Database (Denmark)

    Versteeg, Henneke; Baumert, Jens; Kolb, Christof;

    2010-01-01

    The present study examined whether female patients with an implantable cardioverter defibrillator (ICD) report more psychological distress than male patients, and whether somatosensory amplification mediates this relationship. Design: Consecutive ICD patients (N = 241; 33% women) participating in...

  10. Prognostic importance of distressed (Type D) personality and shocks in patients with an implantable cardioverter defibrillator

    DEFF Research Database (Denmark)

    Denollet, Johan; Tekle, Fetene B; Pedersen, Susanne S.;

    2013-01-01

    Clinical trials have shown the benefit of implantable cardioverter defibrillator (ICD) treatment. In this study, we examined the importance of chronic psychological distress and device shocks among ICD patients seen in clinical practice....

  11. Monitoring device acceptance in implantable cardioverter defibrillator patients using the Florida Patient Acceptance Survey

    DEFF Research Database (Denmark)

    Versteeg, Henneke; Starrenburg, Annemieke; Denollet, Johan;

    2012-01-01

    Patient device acceptance might be essential in identifying patients at risk for adverse patient-reported outcomes following implantation of an implantable cardioverter defibrillator (ICD). We examined the validity and reliability of the Florida Patient Acceptance Scale (FPAS) and identified...

  12. Anxiety and risk of ventricular arrhythmias or mortality in patients with an implantable cardioverter defibrillator

    DEFF Research Database (Denmark)

    Habibović, Mirela; Pedersen, Susanne S.; van den Broek, Krista C;

    2013-01-01

    A subgroup of patients with an implantable cardioverter defibrillator (ICD) experiences anxiety after device implantation. The purpose of the present study was to evaluate whether anxiety is predictive of ventricular arrhythmias and all-cause mortality 1 year post ICD implantation.......A subgroup of patients with an implantable cardioverter defibrillator (ICD) experiences anxiety after device implantation. The purpose of the present study was to evaluate whether anxiety is predictive of ventricular arrhythmias and all-cause mortality 1 year post ICD implantation....

  13. Economic evaluations of implantable cardioverter defibrillators: a systematic review.

    Science.gov (United States)

    García-Pérez, Lidia; Pinilla-Domínguez, Pilar; García-Quintana, Antonio; Caballero-Dorta, Eduardo; García-García, F Javier; Linertová, Renata; Imaz-Iglesia, Iñaki

    2015-11-01

    The aim of this paper was to review the cost-effectiveness studies of implantable cardioverter defibrillators (ICD) for primary or secondary prevention of sudden cardiac death (SCD). A systematic review of the literature published in English or Spanish was performed by electronically searching MEDLINE and MEDLINE in process, EMBASE, NHS-EED, and EconLit. Some keywords were implantable cardioverter defibrillator, heart failure, heart arrest, myocardial infarction, arrhythmias, syncope, sudden death. Selection criteria were the following: (1) full economic evaluations published after 1995, model-based studies or alongside clinical trials (2) that explored the cost-effectiveness of ICD with or without associated treatment compared with placebo or best medical treatment, (3) in adult patients for primary or secondary prevention of SCD because of ventricular arrhythmias. Studies that fulfilled these criteria were reviewed and data were extracted by two reviewers. The methodological quality of the studies was assessed and a narrative synthesis was prepared. In total, 24 studies were included: seven studies on secondary prevention and 18 studies on primary prevention. Seven studies were performed in Europe. For secondary prevention, the results showed that the ICD is considered cost-effective in patients with more risk. For primary prevention, the cost-effectiveness of ICD has been widely studied, but uncertainty about its cost-effectiveness remains. The cost-effectiveness ratios vary between studies depending on the patient characteristics, methodology, perspective, and national settings. Among the European studies, the conclusions are varied, where the ICD is considered cost-effective or not dependent on the study. PMID:25323413

  14. Assessment of a remote monitoring system for implantable cardioverter defibrillators.

    Science.gov (United States)

    Masella, Cristina; Zanaboni, Paolo; Di Stasi, Francesca; Gilardi, Serena; Ponzi, Patrizia; Valsecchi, Sergio

    2008-01-01

    We conducted a multicentre study in five Italian hospitals to assess the feasibility of a remote monitoring service for the follow-up of implanted cardiac devices. The system was designed to monitor device performance as well as physiological aspects of the patient's condition. Sixty-seven patients (mean age 64 years) affected by chronic heart failure and with a biventricular implantable cardioverter defibrillator for cardiac re-synchronization therapy (CRT-D) were enrolled for a three-month observation period. A total of 267 device recordings were transmitted through the ordinary telephone network, with a success rate of 99%. The telemonitoring service was more efficient than conventional face-to-face follow-up in terms of the time savings: both for physicians (4.7 minutes versus 15 minutes for remote and conventional monitoring) and for patients (6.6 minutes versus 116.3 minutes). In addition, a total of 23 clinical events occurred during the study, but only two cases required a clinic visit, thus reducing inappropriate hospital admissions. Finally, the service was well accepted by all the users. PMID:18776073

  15. E-Health to Manage Distress in Patients With an Implantable Cardioverter-Defibrillator

    DEFF Research Database (Denmark)

    Habibović, Mirela; Denollet, Johan; Cuijpers, Pim;

    2014-01-01

    UNLABELLED: The Web-based distress management program for patients with an implantable cardioverter-defibrillator (ICD; WEBCARE) was developed to mitigate distress and enhance health-related quality of life in ICD patients. This study investigated the treatment effectiveness at 3-month follow-up ...

  16. Gender disparities in anxiety and quality of life in patients with an implantable cardioverter-defibrillator

    DEFF Research Database (Denmark)

    Habibović, Mirela; van den Broek, Krista C; Theuns, Dominic A M J;

    2011-01-01

    A paucity of studies in implantable cardioverter-defibrillator (ICD) patients has examined gender disparities in patient-reported outcomes, such as anxiety and quality of life (QoL). We investigated (i) gender disparities in anxiety and QoL and (ii) the magnitude of the effect of gender vs. New...

  17. Emotional distress in partners of patients with an implantable cardioverter defibrillator

    DEFF Research Database (Denmark)

    Van Den Broek, Krista C; Habibović, Mirela; Pedersen, Susanne S.

    2010-01-01

    Both patients with an implantable cardioverter defibrillator (ICD) and their partners face challenges when adapting to the ICD. Distress is a burden on its own for partners but may also affect well being and health of patients. This review provides a systematic overview of the literature on psych...

  18. Shock as a determinant of poor patient-centered outcomes in implantable cardioverter defibrillator patients

    DEFF Research Database (Denmark)

    Pedersen, Susanne S.; Van Den Broek, Krista C; Van Den Berg, Martha;

    2010-01-01

    The medical benefits of the implantable cardioverter defibrillator (ICD) are well established, but ICD shocks are known to influence patient-centered outcomes. In this viewpoint, we examine the strength of the evidence as found in primary and secondary prevention trials that used quality of life ...

  19. Undertreatment of anxiety and depression in patients with an implantable cardioverter-defibrillator

    DEFF Research Database (Denmark)

    Hoogwegt, Madelein T; Kupper, Nina; Theuns, Dominic A M J;

    2012-01-01

    Twenty-five to 33% of patients with an implantable cardioverter-defibrillator (ICD) experience anxiety and depression, but it is not known whether their symptoms are adequately treated. We investigated (a) whether patients with clinically relevant symptoms of distress received appropriate treatment...

  20. Psychological vulnerability, ventricular tachyarrhythmias and mortality in implantable cardioverter defibrillator patients

    DEFF Research Database (Denmark)

    Pedersen, Susanne S.; Brouwers, Corline; Versteeg, Henneke

    2012-01-01

    Implantable cardioverter defibrillator (ICD) therapy is the first-line treatment for the prevention of sudden cardiac death. Despite the demonstrated survival benefits of the ICD, predicting which patients will die from a ventricular tachyarrhythmia remains a major challenge. So far, psychological...

  1. Non-pharmacological treatment of heart failure: Implantable cardioverter defibrillator (ICD) and cardiac resynchronisation therapy

    NARCIS (Netherlands)

    Van Gelder, I.C.; Smit, M.D.; Nieuwland, W; Van Veldhuisen, D.J.

    2006-01-01

    The non-pharmacological therapy of heart failure, in particular an implantable cardioverter defibrillator (ICD) and cardiac resynchronisation therapy or biventricular stimulation, improves symptoms and survival in patients with heart failure. - An ICD is indicated in many patients with heart failure

  2. SUDDEN CARDIAC DEATH AND THE USE OF IMPLANTABLE CARDIOVERTER-DEFIBRILLATORS IN PEDIATRIC-PATIENTS

    NARCIS (Netherlands)

    SILKA, MJ; KRON, J; DUNNIGAN, A; DICK, M; BINKBOELKENS, M; ERICKSON, CC; JEDEIKIN, R; WETZEL, GT; VANHARE, GF; CAMPBELL, R; WALSH, E; SAUL, JP; SCHAFFER, MS; KARPAWICH, P; VOGEL, RL; BENSON, DW; DEAL, B; SCAGLIOTTI, D; STERBA, R; HORDOF, AJ; KRONGRAD, E; KANTER, RJ; EPSTEIN, M; COHEN, M; BEDER, S; HAMILTON, R; FOURNIER, A; HUBBARD, J; CHRISTIANSEN, JL; JENNINGS, J; VILLAFANE, J; PORTER, CBJ; CASE, C; GILLETTE, PC; BELAND, M; KUGLER, JD; OCONNOR, BK; ALLENDER, H; HERNDON, SP; SMITH, RT; BURTON, D; KURER, CC; BYRUM, C; GUAM, WE; FRIEDMAN, R; PERRY, JC; SCOTT, W; MEHTA, AV; PICKHOFF, AS; FISH, F; YEAGER, S; KAWABORI, [No Value; TRIPPLE, M; ROSENFELD, LE

    1993-01-01

    Background. During the past decade. the implantable cardioverter-defibrillator (ICD) has emerged as the primary therapeutic option for survivors of sudden cardiac death (SCD). Investigation of the clinical efficacy of these devices has primarily assessed outcome in adults with coronary artery diseas

  3. Psychosocial impact of implantable cardioverter defibrillators (ICD) in young adults with Tetralogy of Fallot.

    NARCIS (Netherlands)

    Opic, P.; Utens, E.M.; Moons, P.; Theuns, D.A.; Dijk, A.P.J. van; Hoendermis, E.S.; Vliegen, H.W.; Groot, N.M. de; Witsenburg, M.; Schalij, M.; Roos-Hesselink, J.W.

    2012-01-01

    OBJECTIVE: To investigate the psychosocial impact of having an implantable cardioverter defibrillator (ICD) in adults with Tetralogy of Fallot (ToF). METHODS: Included were 26 ToF-patients with an ICD (age 44 +/- 12 years), and two control groups consisting of 28 ToF-patients without an ICD (age 40

  4. Psychosocial impact of implantable cardioverter defibrillators (ICD) in young adults with Tetralogy of Fallot

    NARCIS (Netherlands)

    Opic, Petra; Utens, Elisabeth M. W. J.; Moons, Philip; Theuns, Dominic A. M. J.; van Dijk, Arie P. J.; Hoendermis, Elke S.; Vliegen, Hubert W.; de Groot, Natasja M. S.; Witsenburg, Maarten; Schalij, Martin; Roos-Hesselink, Jolien W.

    2012-01-01

    To investigate the psychosocial impact of having an implantable cardioverter defibrillator (ICD) in adults with Tetralogy of Fallot (ToF). Included were 26 ToF-patients with an ICD (age 44 +/- A 12 years), and two control groups consisting of 28 ToF-patients without an ICD (age 40 +/- A 10 years) an

  5. Psychosocial impact of implantable cardioverter defibrillators (ICD) in young adults with Tetralogy of Fallot

    NARCIS (Netherlands)

    P. Opic (Petra); E.M.W.J. Utens (Elisabeth); P. Moons (Philip); D.A.M.J. Theuns (Dominic); A.P.J. van Dijk (Arie); E.S. Hoendermis (Elke); H.W. Vliegen (Hubert); N. de Groot (Natasja); M. Witsenburg (Maarten); M.J. Schalij (Martin Jan); J.W. Roos-Hesselink (Jolien)

    2012-01-01

    textabstractObjective To investigate the psychosocial impact of having an implantable cardioverter defibrillator (ICD) in adults with Tetralogy of Fallot (ToF). Methods Included were 26 ToF-patients with an ICD (age 44 ± 12 years), and two control groups consisting of 28 ToF-patients without an ICD

  6. Increased anxiety in partners of patients with a cardioverter-defibrillator

    DEFF Research Database (Denmark)

    Pedersen, Susanne S.; VAN DEN Berg, Martha; Erdman, Ruud A M;

    2009-01-01

    The partner of the implantable cardioverter-defibrillator (ICD) patient serves as an important source of support for the patient, which may be hampered if the partner experiences increased distress. We examined (1) potential differences in anxiety and depressive symptoms in ICD patients compared...

  7. Experiences of patients with implantable cardioverter defibrillator in Turkey: A qualitative study

    Directory of Open Access Journals (Sweden)

    Özgür Aslan

    2012-01-01

    Full Text Available Background. There has been an increase in the number of patients with implantable cardioverter defibrillator (ICD. It isimportant to understand ICD patients’ experiences with it.Aim. The aim of this study was to describe experiences of patients with implantable cardioverter defibrillator (ICD.Methodology. A qualitative approach was used. Focus group interviews were used to obtain data from 19 patients whowere implanted cardioverter defibrillator at two centers in Izmir, Turkey. The patients were assigned into four groups. Thedata was analyzed using qualitative content analysis.Results. The analysis revealed six main themes: activities of daily living, social life, familial relationships, emotionalchanges, implantable cardioverter defibrillator shocks and experiences with receiving information and counselling fromhealth care providers.Conclusions. It can be concluded that patients with ICD experience physical and psychological problems and are not offeredthe education they need. To reduce the fears of the patients and their families and to prepare them for possible life stylechanges, comprehensive training programs that start in the pre-implantation period and continue into the post-implantationperiod should be organized.

  8. Relation of statin therapy to psychological functioning in patients with an implantable cardioverter defibrillator

    DEFF Research Database (Denmark)

    Hoogwegt, Madelein T; Theuns, Dominic A M J; Kupper, Nina;

    2013-01-01

    patients, in general, and patients with an implantable cardioverter defibrillator (ICD), in particular. We investigated the association between statin therapy and symptoms of anxiety and depression and patients' health status during the 12 months after implantation, reckoning with statin type and dosage...

  9. Ventricular Tachyarrhythmias and Mortality in Patients With an Implantable Cardioverter Defibrillator

    DEFF Research Database (Denmark)

    Mastenbroek, Mirjam H; Versteeg, Henneke; Jordaens, Luc;

    2014-01-01

    Objective We examined whether depression is independently associated with implantable cardioverter defibrillator (ICD) therapy for ventricular tachyarrhythmias and mortality. Methods A cohort of 430 consecutive patients with a first-time ICD (79% men; mean [standard deviation] age = 57.8 [12...

  10. Dual-chamber implantable cardioverter-defibrillator. Is it useful in patient with permanent atrial fibrillation?

    Science.gov (United States)

    Porres-Aracama, José M; Cerezuela, José Luis; García-Urra, Francisco; Luque-Lezcano, Oscar; Herrero, Vicente

    2016-08-01

    In patients with permanent atrial fibrillation (AF) and implantable cardioverter-defibrillator (ICD) implant indication, a single-chamber device is the choice because AF does not provide interesting information for the treatment. It is very unusual to find patients with permanent AF that coexist with atrial tachycardia with various degree of Atrioventricular block. PMID:27525075

  11. Spinal cord stimulation for refractory angina in patients implanted with cardioverter defibrillators: five case reports

    DEFF Research Database (Denmark)

    Enggaard, Thomas P; Andersen, Claus; Scherer, Christian

    2010-01-01

    Patients implanted with a cardioverter defibrillator (ICD) who are suffering from refractory angina pectoris could benefit from spinal cord stimulation (SCS) due to the well-documented pain relieving effect. However, the combined treatment remains controversial. The aim of the study is to report...... tolerable level of stimulation was carried out to exclude inference with the ICD. The following treatment with SCS has in all cases been successful, with significant pain relief and improved quality of life. There were no incidences of inappropriate defibrillator shocks. Spinal cord stimulation...... successful long-term treatment with SCS in five patients implanted with cardioverter defibrillators. The combined treatments with ICD and thoracic epidural electrical stimulation were used in five patients with refractory angina pectoris. During the procedure of the implantation, testing with the maximal...

  12. The effect of intermittent atrial tachyarrhythmia on heart failure or death in cardiac resynchronization therapy with defibrillator versus implantable cardioverter-defibrillator patients

    DEFF Research Database (Denmark)

    Ruwald, Anne-Christine; Pietrasik, Grzegorz; Goldenberg, Ilan;

    2014-01-01

    OBJECTIVES: This study aimed to investigate the effect of both history of intermittent atrial tachyarrhythmias (IAT) and in-trial IAT on the risk of heart failure (HF) or death comparing cardiac resynchronization therapy with defibrillator (CRT-D) to implantable cardioverter-defibrillator (ICD) t...

  13. Clinical effects and implications of cardiac rehabilitation for implantable cardioverter defibrillator patients

    DEFF Research Database (Denmark)

    Berg, Selina Kikkenborg; Moons, Philip; Christensen, Anne Vingaard;

    2015-01-01

    BACKGROUND:: The Copenhagen Outpatient ProgrammE-Implantable Cardioverter Defibrillator trial was a randomized clinical trial that compared a complex rehabilitation intervention including exercise training and psychoeducational interventions with usual care. A significant difference between...... rehabilitation and usual care was found in physical capacity and general and mental health. However, the clinical effect sizes of these findings were not investigated, and the findings from the quantitative and qualitative analyses were not triangulated to address the issue of whether the qualitative results......-time implantable cardioverter defibrillator implantation were randomized (1:1) to comprehensive cardiac rehabilitation (12 weeks of exercise training and 1 year of psychoeducational follow-up) versus treatment as usual. Two primary outcomes, perceived health (Short Form-36) and peak oxygen uptake, were used. Cohen...

  14. Initial Experiences of Implantable Cardioverter-Defibrillator Treatment in Patients with Ventricular Tachyarrhythmias

    OpenAIRE

    CHINUSHI, Masaomi; Aizawa, Yoshifusa; Abe, Akira; Shiba, Masami; Washizuka, Takashi; Tamura, Makoto; Igarashi, Yutaka; Kusano, Yoriko; Niwano, Shinichi; Shibata, Akira; Watanabe, Hiroshi; Eguchi, Shoji

    1996-01-01

    Implantable cardioverter-defibrillators (ICD) were implanted in 11 patients with drug refractory ventricular tachyarrhythmias. Both ventricular fibrillation (VF) and sustained ventricular tachycardia (VT) were documented in 4 of the 11 patients, and VF or VT was observed in the other 4 and 3 patients, respectively. The mean left ventricular ejection fraction of the 11 patients was 40±22%; underlying heart diseases were observed in 9 patients, old myocardial infarction in 4 patients, and dilat...

  15. Spiritual well-being may buffer psychological distress in patients with implantable cardioverter defibrillators (ICD)

    OpenAIRE

    Salmoirago-Blotcher, Elena; Crawford, Sybil; Tran, Chau; Goldberg, Robert; Rosenthal, Lawrence; Ockene, Ira

    2012-01-01

    Psychological distress is common in patients with implantable cardioverter defibrillators (ICDs) and has been associated with a worse prognosis. The authors examined whether spiritual wellbeing is associated with reduced psychological distress in patients with ICDs. The Functional Assessment of Chronic Illness Therapy-Spiritual Wellbeing (FACIT-SWB) questionnare and the Hospital Anxiety and Depression Scale (HADS) were used to measure spiritual wellbeing and overall psychological distress. Mu...

  16. Driving restrictions after implantable cardioverter defibrillator implantation: an evidence-based approach

    OpenAIRE

    Thijssen, Joep; Borleffs, C. Jan Willem; van Rees, Johannes B.; de Bie, Mihály K; van der Velde, Enno T.; Van Erven, Lieselot; Bax, Jeroen J; Cannegieter, Suzanne C.; Schalij, Martin J

    2011-01-01

    Aims Little evidence is available regarding restrictions from driving following implantable cardioverter defibrillator (ICD) implantation or following first appropriate or inappropriate shock. The purpose of the current analysis was to provide evidence for driving restrictions based on real-world incidences of shocks (appropriate and inappropriate). Methods and results A total of 2786 primary and secondary prevention ICD patients were included. The occurrence of shocks was noted during a medi...

  17. The dilemma of implantable cardioverter-defibrillator therapy in the geriatric population

    Institute of Scientific and Technical Information of China (English)

    Diana Revenco; James P Morgan; Lana Tsao

    2011-01-01

    Current guidelines for implantable cardioverter-defibrillator(ICD)therapy in heart failure patients were established by multiple device trials;however,very few geriatric patients(patients≥65 years old)were included in these studies.This article explores the controversies of ICD implantation in the geriatric population,management of delivered ICD therapy in this age group,and the end of life care in patients with ICD.

  18. Radiotherapy in patients with pacemakers and implantable cardioverter defibrillators

    DEFF Research Database (Denmark)

    Zaremba, Tomas; Jakobsen, Annette Ross; Søgaard, Mette;

    2016-01-01

    defibrillators malfunctioning at low radiation doses. Besides scant knowledge about optimal safety measures, only little is known about the exact prevalence of patients with devices undergoing RT. In this review, we provide a short overview of the principles of RT and present the current evidence on the...

  19. The Medtronic Sprint Fidelis Lead Advisory Notification has no adverse impact on patient reported outcomes in Danish implantable cardioverter defibrillator patients

    DEFF Research Database (Denmark)

    Pedersen, Susanne Møller; Versteeg, Henneke; Nielsen, Jens C.;

    The Medtronic Sprint Fidelis Lead Advisory Notification has no adverse impact on patient reported outcomes in Danish implantable cardioverter defibrillator patients.......The Medtronic Sprint Fidelis Lead Advisory Notification has no adverse impact on patient reported outcomes in Danish implantable cardioverter defibrillator patients....

  20. The Medtronic Sprint Fidelis Lead Advisory Notification Has No Adverse Impact on Patient Reported Outcomes in Danish Implantable Cardioverter Defibrillator Patients

    DEFF Research Database (Denmark)

    Pedersen, Susanne Møller; Versteeg, Henneke; Nielsen, Jens C.;

    The Medtronic Sprint Fidelis Lead Advisory Notification Has No Adverse Impact on Patient Reported Outcomes in Danish Implantable Cardioverter Defibrillator Patients.......The Medtronic Sprint Fidelis Lead Advisory Notification Has No Adverse Impact on Patient Reported Outcomes in Danish Implantable Cardioverter Defibrillator Patients....

  1. Beam Profile Disturbances from Implantable Pacemakers or Implantable Cardioverter-Defibrillator Interactions

    Energy Technology Data Exchange (ETDEWEB)

    Gossman, Michael S., E-mail: mgossman@tsrcc.com [Tri-State Regional Cancer Center, Medical Physics Section, Ashland, KY (United States); Comprehensive Heart and Vascular Associates, Heart and Vascular Center, Ashland, KY (United States); Medtronic, Inc., External Research Program, Mounds View, MN (United States); Nagra, Bipinpreet; Graves-Calhoun, Alison; Wilkinson, Jeffrey [Tri-State Regional Cancer Center, Medical Physics Section, Ashland, KY (United States); Comprehensive Heart and Vascular Associates, Heart and Vascular Center, Ashland, KY (United States); Medtronic, Inc., External Research Program, Mounds View, MN (United States)

    2011-01-01

    The medical community is advocating for progressive improvement in the design of implantable cardioverter-defibrillators and implantable pacemakers to accommodate elevations in dose limitation criteria. With advancement already made for magnetic resonance imaging compatibility in some, a greater need is present to inform the radiation oncologist and medical physicist regarding treatment planning beam profile changes when such devices are in the field of a therapeutic radiation beam. Treatment plan modeling was conducted to simulate effects induced by Medtronic, Inc.-manufactured devices on therapeutic radiation beams. As a continuation of grant-supported research, we show that radial and transverse open beam profiles of a medical accelerator were altered when compared with profiles resulting when implantable pacemakers and cardioverter-defibrillators are placed directly in the beam. Results are markedly different between the 2 devices in the axial plane and the sagittal planes. Vast differences are also presented for the therapeutic beams at 6-MV and 18-MV x-ray energies. Maximum changes in percentage depth dose are observed for the implantable cardioverter-defibrillator as 9.3% at 6 MV and 10.1% at 18 MV, with worst distance to agreement of isodose lines at 2.3 cm and 1.3 cm, respectively. For the implantable pacemaker, the maximum changes in percentage depth dose were observed as 10.7% at 6 MV and 6.9% at 18 MV, with worst distance to agreement of isodose lines at 2.5 cm and 1.9 cm, respectively. No differences were discernible for the defibrillation leads and the pacing lead.

  2. Use of the Wearable Cardioverter Defibrillator in High-Risk Populations.

    Science.gov (United States)

    Lamichhane, Madhab; Safadi, Abdul; Surapaneni, Phani; Salehi, Negar; Thakur, Ranjan K

    2016-08-01

    The United States Food and Drug Administration has approved the wearable cardioverter defibrillator (WCD) for use in patients who are at high risk for sudden cardiac arrest (SCA) and who do not yet have an established indication for an implantation cardioverter defibrillator (ICD) or have contraindications for device implantation for various reasons. The WCD is typically used for primary prevention in (1) high-risk patients with reduced left ventricular ejection fraction (LVEF) ≤35 % after recent acute myocardial infarction (MI) during the 40-day ICD waiting period, (2) before and after coronary artery bypass graft or percutaneous coronary intervention during the 90-day ICD waiting period, (3) after recently diagnosed nonischemic dilated cardiomyopathy (NICM) during the 3- to 9-month medical therapy optimization period, or (4) for those with inherited proarrhythmic conditions such as long QT syndrome or hypertrophic cardiomyopathy. Unlike the automatic external defibrillator, the WCD does not require assistance from bystanders for therapy and conscious patients can delay or avert therapy with the use of response buttons. The WCD exhibits a small risk of inappropriate shock, mostly due to supraventricular tachycardia and/or electrical noise. Multiple non-randomized observational studies have shown high efficacy in detection and appropriate shock therapy for sustained ventricular tachyarrhythmias. This paper discusses the use of the WCD for prevention of SCA in patients with various cardiac substrates. PMID:27319008

  3. Intensity of primary emotions in patients after implantation of an implantable cardioverter defibrillator

    DEFF Research Database (Denmark)

    Stoier, Louise; Pedersen, Preben Ulrich; Berg, Selina Kikkenborg

    2013-01-01

    the support needed for coping. Living with an Implantable Cardi- overter Defibrillator can lead to anxiety and depression. Focus on the intensity of the primary emotions might be a potential to prevent development of these psychological states. Objectives: The aim of this paper are 1) to describe......-test. Results: One hundred and ninety-six patients were invited to fill in the questionnaire. It was completed by 182, a response rate of 93 %. Patients with a newly implanted Implantable Cardioverter Defibrillator experienced an increased intensity of joy, sadness, disgust, anticipation, anger, fear...... and surprise. No difference was found regarding the intensity of the primary emotions when the group of patients was divided according to occupation or age. A significant increase in the negative emotions sadness, disgust, anger and surprise was observed in women and in patients who receive the Implantable...

  4. Successful use of wearable cardioverter defibrillator in a patient with dextrocardia and persistent left superior vena cava.

    Science.gov (United States)

    Wan, Chingping; Oren, Jess W; Szymkiewicz, Steven J

    2013-09-01

    Congenital disorders, such as dextrocardia and persistent left superior vena cava, are rare. However, their presence is often associated with other cardiac anomalies, and may lead to lethal ventricular tachyarrhythmias, which result in sudden cardiac death. Treating patients with these disorders can present a challenge to clinicians, as it may cause technical difficulties during interventional procedures, and more often, altered defibrillation techniques in a setting of prehospital sudden cardiac arrest. This report describes the first case of successful defibrillation therapy delivered by the wearable cardioverter defibrillator to a patient with dextrocardia and persistent left superior vena cava during a ventricular tachycardia arrest.

  5. Shock and patient preimplantation type D personality are associated with poor health status in patients with implantable cardioverter-defibrillator

    DEFF Research Database (Denmark)

    Pedersen, Susanne S.; Tekle, Fetene B; Hoogwegt, Madelein T;

    2012-01-01

    Implantable cardioverter-defibrillator (ICD) shock is a critical event to patients associated with well-being after implantation, although other factors may play an equally important role. We compared the association of shock and the patient's preimplantation personality with health status, using...

  6. Patient-reported outcomes in Danish implantable cardioverter defibrillator patients with a Sprint Fidelis lead advisory notification

    DEFF Research Database (Denmark)

    Pedersen, Susanne S; Versteeg, Henneke; Nielsen, Jens Cosedis;

    2011-01-01

    Few studies have investigated the association between implantable cardioverter defibrillators (ICDs) and lead advisory notifications and patient-reported outcomes (PROs). We examined (i) whether the mode used to inform patients about a device advisory is associated with PROs, and (ii) whether pat...

  7. Postoperative infection with the automatic implantable cardioverter defibrillator: clinical presentation and use of the gallium scan in diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Kelly, P.A.; Wallace, S.; Tucker, B.; Hurvitz, R.J.; Ilvento, J.; Mirabel, G.S.; Cannom, D.S.

    1988-08-01

    This report describes three patients with infection involving an automatic implantable cardioverter defibrillator. All three patients presented with fever, fluid in the pulse generator pocket, leukocytosis and an elevated erythrocyte sedimentation rate. A gallium scan, together with aspiration and culture of the fluid from the pocket, confirmed the diagnosis in each case.

  8. Monitoring treatment expectations in patients with an implantable cardioverter-defibrillator using the EXPECT-ICD scale

    DEFF Research Database (Denmark)

    Habibovic, Mirela; Pedersen, Susanne S.; van den Broek, Krista C;

    2014-01-01

    AIMS: Patient treatment expectations may affect cardiac outcomes; however, till date, no validated instruments have been developed to monitor treatment expectations in patients with an implantable cardioverter-defibrillator (ICD). This study evaluates the predictive value of the newly developed 10...

  9. Influence of diabetes mellitus on inappropriate and appropriate implantable cardioverter-defibrillator therapy and mortality in the Multicenter Automatic Defibrillator Implantation Trial-Reduce Inappropriate Therapy (MADIT-RIT) Trial

    DEFF Research Database (Denmark)

    Ruwald, Martin H.; Zareba, Wojciech; Jons, Christian;

    2013-01-01

    The relationship between diabetes mellitus and risk of inappropriate or appropriate therapy in patients receiving an implantable cardioverter-defibrillator (ICD) and resynchronization therapy has not been investigated thoroughly. The effect of innovative ICD programming on therapy delivery in the...

  10. Type D personality is associated with increased anxiety and depressive symptoms in patients with an implantable cardioverter defibrillator and their partners

    DEFF Research Database (Denmark)

    Pedersen, Susanne S.; van Domburg, Ron T; Theuns, Dominic A M J;

    2014-01-01

    We investigated the prevalence of anxiety and depressive symptoms in patients with an implantable cardioverter defibrillator (ICD) and their partners, and the role of personality factors and social support as determinants of distress.......We investigated the prevalence of anxiety and depressive symptoms in patients with an implantable cardioverter defibrillator (ICD) and their partners, and the role of personality factors and social support as determinants of distress....

  11. Silicone Breast Implant and Automatic Implantable Cardioverter Defibrillator: Can They Coexist? A Case Report

    Science.gov (United States)

    Arik, Zaretski

    2016-01-01

    Summary: We present a case of a silicone breast implant rupture after insertion of an automatic implantable cardioverter defibrillator (AICD). A 51-year-old woman presented to our plastic surgery clinic to exchange her silicone breast implants. The patient underwent cosmetic mastopexy and breast augmentation in 2008. Because of recurrent myocardial infarctions and chronic heart failure, she underwent an insertion of an AICD in 2014 in which the left breast implant was hit. In this report, we discuss the first case of an AICD insertion, disrupting a breast implant. This case report illustrates the rare but real possibility of breast implant rupture after even minor surgical manipulation of the breast area. PMID:27622117

  12. Gender disparities in psychological distress and quality of life among patients with an implantable cardioverter defibrillator

    DEFF Research Database (Denmark)

    Brouwers, Corline; van den Broek, Krista C; Denollet, Johan;

    2011-01-01

    A subset of patients with an implantable cardioverter defibrillator (ICD) reports psychological distress and poor quality of life (QoL). Gender is one of the factors that has been proposed to explain individual differences in these outcomes. In this viewpoint, we (1) review the evidence for gender...... disparities in psychological distress and QoL in ICD patients by means of a systematic review, and (2) provide recommendations for future research and clinical implications. A systematic search of the literature identified 18 studies with a sample size ≥ 100 that examined gender disparities in anxiety....../depression and QoL in ICD patients (mean prevalence of women = 21%; mean age = 62 years). Our review shows that there is insufficient evidence to conclude that gender per se is a major autonomous predictor for disparities in psychological distress and QoL in ICD patients. Women had a higher prevalence of anxiety...

  13. Patients' perspective on deactivation of the implantable cardioverter-defibrillator near the end of life

    DEFF Research Database (Denmark)

    Pedersen, Susanne S.; Chaitsing, Rismy; Szili-Torok, Tamas;

    2013-01-01

    for information; and the prevalence and correlates of a favorable attitude toward deactivation. Three cohorts of ICD patients (n = 440) extracted from our institutional database were asked to complete a survey that included a vignette about deactivation near the end of life. Of the 440 patients approached, 294......Recent guidelines have emphasized the importance of discussing the issue of deactivation near the end of life with patients with an implantable cardioverter-defibrillator (ICD). Few studies have examined the patient perspective and patients' wishes. We examined patients' knowledge and wishes...... (67%) completed the survey. Most patients (68%) were aware that it is possible to turn the ICD off, and 95% believed it is important to inform patients about the possibility. Of the patients completing the survey, 84% indicated a choice for or against deactivation. Psychological morbidity...

  14. Relation between emotional distress and heart rate variability in patients with an implantable cardioverter-defibrillator

    DEFF Research Database (Denmark)

    Hoogwegt, Madelein T; Pedersen, Susanne S.; Theuns, Dominic A M J;

    2014-01-01

    We investigated the relationship between Type D personality, depression, and anxiety, and heart rate variability (HRV) in 64 patients with an implantable cardioverter-defibrillator (ICD). HRV was obtained via 24-h Holter monitoring, and 24-h, 30-min daytime rest and 30-min nighttime sleep HRV were...... for depression (lower RMSSD: p = .10; lower pNN50: p = .09). During daytime rest, similar results were found for anxiety and depression. During sleep, only noteworthy adjusted associations were found for depression (lower root mean square of successive differences in NN intervals [RMSSD]: p = .06; lower pNN50: p...... = .043). A Benjamini-Hochberg correction for multiple testing led to reduction of the number of significant relationships, but there was still support for lower autonomic control patients with Type D personality and depression. Future research with larger sample sizes is warranted....

  15. Attitudes towards implantable cardioverter-defibrillator therapy: a national survey in Danish health-care professionals

    DEFF Research Database (Denmark)

    Johansen, Jens B; Mortensen, Peter T; Videbæk, Regitze;

    2011-01-01

    Aims The aim of this study was to examine health-care professionals attitudes towards implantable cardioverter-defibrillator (ICD) therapy and issues discussed with patients. Methods and results Survey of 209 health-care professionals providing specialized treatment and care of ICD patients at the......-physicians. Physicians were less likely to believe that their personal attitude towards ICD treatment has no influence on how they deal professionally with patients (27.8 vs. 43.6%; P = 0.04). Physicians and non-physicians were equally positive towards ICD therapy as primary prophylaxis in ischaemic cardiomyopathy (87...... discussing ICD treatment with candidate patients. At the same time, physicians are more aware that their attitude towards ICD treatment may influence how they deal professionally with patients compared with non-physicians....

  16. Comprehensive cardiac rehabilitation improves outcome for patients with implantable cardioverter defibrillator

    DEFF Research Database (Denmark)

    Berg, Selina Kikkenborg; Pedersen, Preben Ulrich; Zwisler, Ann-Dorthe;

    2015-01-01

    Aims:The aim of this randomised clinical trial was to assess a comprehensive cardiac rehabilitation intervention including exercise training and psycho-education vs 'treatment as usual' in patients treated with an implantable cardioverter defibrillator (ICD).Methods:In this study 196 patients...... with first time ICD implantation (mean age 57.2 (standard deviation (SD)=13.2); 79% men) were randomised (1:1) to comprehensive cardiac rehabilitation vs 'treatment as usual'. Altogether 144 participants completed the 12 month follow-up. The intervention consisted of twelve weeks of exercise training and one...... rehabilitation significantly increased VO2 uptake after exercise training to 23.0 (95% confidence interval (CI) 20.9-22.7) vs 20.8 (95% CI 18.9-22.7) ml/min/kg in the control group (p=0.004 (multiplicity p=0.015)). Comprehensive cardiac rehabilitation significantly increased general health; at three months (mean...

  17. Genome-wide association of implantable cardioverter-defibrillator activation with life-threatening arrhythmias.

    Directory of Open Access Journals (Sweden)

    Sarah S Murray

    Full Text Available OBJECTIVES: To identify genetic factors that would be predictive of individuals who require an implantable cardioverter-defibrillator (ICD, we conducted a genome-wide association study among individuals with an ICD who experienced a life-threatening arrhythmia (LTA; cases vs. those who did not over at least a 3-year period (controls. BACKGROUND: Most individuals that receive implantable cardioverter-defibrillators never experience a life-threatening arrhythmia. Genetic factors may help identify who is most at risk. METHODS: Patients with an ICD and extended follow-up were recruited from 34 clinical sites with the goal of oversampling those who had experienced LTA, with a cumulative 607 cases and 297 controls included in the analysis. A total of 1,006 Caucasian patients were enrolled during a time period of 13 months. Arrhythmia status of 904 patients could be confirmed and their genomic data were included in the analysis. In this cohort, there were 704 males, 200 females, and the average age was 73.3 years. We genotyped DNA samples using the Illumina Human660 W Genotyping BeadChip and tested for association between genotype at common variants and the phenotype of having an LTA. RESULTS AND CONCLUSIONS: We did not find any associations reaching genome-wide significance, with the strongest association at chromosome 13, rs11856574 at P = 5×10⁻⁶. Loci previously implicated in phenotypes such as QT interval (measure of the time between the start of the Q wave and the end of the T wave as measured by electrocardiogram were not found to be significantly associated with having an LTA. Although powered to detect such associations, we did not find common genetic variants of large effect associated with having a LTA in those of European descent. This indicates that common gene variants cannot be used at this time to guide ICD risk-stratification. TRIAL REGISTRATION: ClinicalTrials.gov NCT00664807.

  18. Surgical techniques for implanting implantable cardioverter defibrillators in children and infants.

    Science.gov (United States)

    Suzuki, Shoji; Motohashi, Shinya; Matsumoto, Masahiko

    2014-10-01

    Implantable cardioverter defibrillators (ICDs) are now being used in children. ICDs can be used to prevent sudden cardiac death caused by not only congenital heart defects, but also various non-structural diseases, such as long QT syndrome. However, a standard implantation technique for children, especially infants, has not yet been established. As the surgical implantation in infants is not amenable to transvenous lead placement, it was necessary to choose from epicardial, subcutaneous and pericardial ICD systems. However, many of these systems are associated with high rates of late complications. Lead fracture, insulation breakage, migration, buckling or crinkling of the patch lead and constrictive pericarditis have been reported as the most common lead-related complications. An increase in the defibrillation threshold is another issue that must be considered when using an ICD in a child or infant. Further studies on the outcomes, psychosomatic impact and other specific complications in the pediatric population need to be considered. The clinical use of ICDs in infants is still limited. Therefore, it is important to have many surgical options available so that the treatment can be custom-tailored to suit individual patients. PMID:24154922

  19. General anaesthesia for insertion of an automated implantable cardioverter defibrillator in a child with Brugada and autism

    Directory of Open Access Journals (Sweden)

    Shwetal Goraksha

    2010-01-01

    Full Text Available A 14-year-old autistic boy presented with acute gastroenteritis and hypotension. The electrocardiogram showed a ventricular fibrillation rhythm - he went into cardiorespiratory arrest and was immediately resuscitated. On investigation, the electrocardiogram showed a partial right bundle branch block with a "coved" pattern of ST elevation in leads v 1 -v 3 . A provisional diagnosis of Brugada syndrome was made, for which an automated implantable cardioverter defibrillator (AICD implantation was advised. Although the automated implantable cardioverter defibrillator implantation is usually performed under sedation, because this was an autistic child, he needed general anaesthesia. We performed the procedure uneventfully under general anaesthesia and he was discharged after a short hospital stay.

  20. Cost Effectiveness of Implantable Cardioverter Defibrillator Therapy versus Drug Therapy for Patients at High Risk of Sudden Cardiac Death

    OpenAIRE

    Spath, Marian A.; Bernie J. O'Brien

    2002-01-01

    The implantable cardioverter defibrillator (ICD) is a therapy for patients at risk of sudden cardiac death due to ventricular tachycardia (VT) or ventricular fibrillation (VF). But the apparent high cost of ICD therapy relative to antiarrhythmic drugs such as amiodarone has raised questions about the cost effectiveness of ICD therapy versus drug therapy. To inform this debate we reviewed the literature on ICD cost effectiveness. An electronic and manual search was conducted for articles publi...

  1. Clinical Course After Cardioverter-Defibrillator Implantation: Chagasic Versus Ischemic Patients

    Science.gov (United States)

    Pereira, Francisca Tatiana Moreira; Rocha, Eduardo Arrais; Monteiro, Marcelo de Paula Martins; Lima, Neiberg de Alcantara; Rodrigues Sobrinho, Carlos Roberto Martins; Pires Neto, Roberto da Justa

    2016-01-01

    Background: The outcome of Chagas disease patients after receiving implantable cardioverter defibrillator (ICD) is still controversial. Objective: To compare clinical outcomes after ICD implantation in patients with chronic Chagas cardiomyopathy (CCC) and ischemic heart disease (IHD). Methods: Prospective study of a population of 153 patients receiving ICD (65 with CCC and 88 with IHD). The devices were implanted between 2003 and 2011. Survival rates and event-free survival were compared. Results: The groups were similar regarding sex, functional class and ejection fraction. Ischemic patients were, on average, 10 years older than CCC patients (p < 0.05). Patients with CCC had lower schooling and monthly income than IHD patients (p < 0.05). The number of appropriate therapies was 2.07 higher in CCC patients, who had a greater incidence of appropriate shock (p < 0.05). Annual mortality rate and electrical storm incidence were similar in both groups. There was no sudden death in CCC patients, and only one in IHD patients. Neither survival time (p = 0.720) nor event-free survival (p = 0.143) significantly differed between the groups. Conclusion: CCC doubles the risk of receiving appropriate therapies as compared to IHD, showing the greater complexity of arrhythmias in Chagas patients. PMID:27411097

  2. Remote monitoring of implantable cardioverter-defibrillators. Problems and implications using a telemonitoring system.

    Science.gov (United States)

    Siebermair, J; Clauss, S; Martens, E; Schuessler, F; Oversohl, N; Haserueck, N; Estner, H L; Kääb, S; Wakili, R

    2015-04-01

    The rising number of implantable devices has led to an increase in device-related workload, e.g., regular interrogation follow-up visits. Telemonitoring systems for implantable cardioverter-defibrillators (ICDs) seem to be a promising tool for reducing workload and costs, and they have the potential of optimizing patient care. However, issues such as practical functionality of ICD telemonitoring in daily routine may affect its broad implementation. The objective of this study was to evaluate potential problems during the implementation of a telemonitoring system, Medtronic CareLink™ (CL™) with respect to the installation and data transmission process. A total of 159 patients with ICDs who were equipped with the CL™ system were evaluated and followed up for 16 months regarding the success rate of the first data transmission via the telemonitoring system. In this cohort, a high rate of nontransmission of 23.9 % was observed after the 16-month follow-up. A detailed interview of these patients (no transmission) revealed that the main reasons for failed transmissions were due to the patients' loss of interest in the concept (approximately 50 %) as well as technical problems (approximately 25 %) with setting up the system. These results indicate that telemonitoring systems bear potential problems and that the evaluation of patient motivation and technical support options seems to play an important role in establishing the functionality of these systems. PMID:24848864

  3. Radiotherapy in patients with pacemakers and implantable cardioverter defibrillators: a literature review.

    Science.gov (United States)

    Zaremba, Tomas; Jakobsen, Annette Ross; Søgaard, Mette; Thøgersen, Anna Margrethe; Riahi, Sam

    2016-04-01

    An increasing number of patients with implantable cardiac rhythm devices undergo radiotherapy (RT) for cancer and are thereby exposed to the risk of device failure. Current safety recommendations seem to have limitations by not accounting for the risk of pacemakers and implantable cardioverter defibrillators malfunctioning at low radiation doses. Besides scant knowledge about optimal safety measures, only little is known about the exact prevalence of patients with devices undergoing RT. In this review, we provide a short overview of the principles of RT and present the current evidence on the predictors and mechanisms of device malfunctions during RT. We also summarize practical recommendations from recent publications and from the industry. Strongly associated with beam energy of photon RT, device malfunctions occur at ∼3% of RT courses, posing a substantial issue in clinical practice. Malfunctions described in the literature typically consist of transient software disturbances and only seldom manifest as a permanent damage of the device. Through close cooperation between cardiologists and oncologists, a tailored individualized approach might be necessary in this patient group in waiting time for updated international guidelines in the field. PMID:26041870

  4. Arrhythmia Management in the Elderly-Implanted Cardioverter Defibrillators and Prevention of Sudden Death.

    Science.gov (United States)

    Manian, Usha; Gula, Lorne J

    2016-09-01

    We present an overview of arrhythmia management in elderly patients as it pertains to implantable cardioverter defibrillator (ICD) therapy and prevention of sudden death. Treatment of arrhythmia in elderly patients is fraught with challenges pertaining to goals of care and patient frailty. With an ever increasing amount of technology available, realistic expectations of therapy need to balance quality and quantity of life. The ICD is an important treatment option for selected patients at risk of ventricular arrhythmia and sudden cardiac death. However, the incidence of sudden death as a percentage of all-cause mortality decreases with age. Studies have reported that 20% of elderly patients might die within 1 year of an episode of life-threatening ventricular arrhythmia, but most because of nonarrhythmic causes. This illustrates the 'sudden cardiac death paradox,' with a great proportion of death in elderly patients, even those at risk for ventricular arrhythmias, attributable to medical conditions that cannot be addressed by an ICD. We discuss current practices in ICD therapy in elderly patients, existing evidence from registries and clinical trials, approaches to risk stratification, and important ethical considerations. Although the decision on whether ICD insertion is appropriate in the elderly population remains an area of uncertainty from an evidence-based and ethical perspective, we offer insight on potential clinical and research strategies for this growing population. PMID:27568872

  5. Sleep, Psychosocial Functioning, and Device-Specific Adjustment in Patients with Implantable Cardioverter Defibrillators (ICDs).

    Science.gov (United States)

    McCrae, Christina S; Roth, Alicia J; Ford, Jessica; Crew, Earl C; Conti, Jamie B; Berry, Richard B; Sears, Samuel F

    2016-01-01

    Rates of sleep disorders and associated adjustment were examined in patients with implantable cardioverter defibrillators (ICDs; n = 42; Mage = 61.57, SD = 12.60). One night of ambulatory polysomnography, 14 days of sleep diaries, and questionnaires (mood, sleepiness, fatigue, device acceptance) were administered. Controlling for ischemia, MANCOVA examined adjustment by sleep diagnosis. Apnea was most common (28.6%), followed by Insomnia (16.7%) and Comorbid Insomnia/Apnea (11.9%). Patients with insomnia reported poorer mood, greater sleepiness, and lower device acceptance than good sleepers; they also demonstrated poorer mood and less ICD device acceptance than patients with sleep apnea. Patients with comorbid insomnia/apnea also exhibited poorer mood and less ICD device acceptance than good sleepers; however, comorbid patients did not significantly differ from insomnia or apnea patients on any measure. Those with disordered sleep (regardless of type) reported greater fatigue than good sleepers. Assessment (and treatment) of difficulties with sleep, mood, fatigue, and device acceptance may be important for the comprehensive clinical management of ICD patients. Further research appears warranted. PMID:25174823

  6. A trial design for evaluation of empiric programming of implantable cardioverter defibrillators to improve patient management

    Directory of Open Access Journals (Sweden)

    Morgan John M

    2004-11-01

    Full Text Available Abstract The delivery of implantable cardioverter defibrillator (ICD therapy is sophisticated and requires the programming of over 100 settings. Physicians tailor these settings with the intention of optimizing ICD therapeutic efficacy, but the usefulness of this approach has not been studied and is unknown. Empiric programming of settings such as anti-tachycardia pacing (ATP has been demonstrated to be effective, but an empiric approach to programming all VT/VF detection and therapy settings has not been studied. A single standardized empiric programming regimen was developed based on key strategies with the intention of restricting shock delivery to circumstances when it is the only effective and appropriate therapy. The EMPIRIC trial is a worldwide, multi-center, prospective, one-to-one randomized comparison of empiric to physician tailored programming for VT/VF detection and therapy in a broad group of about 900 dual chamber ICD patients. The trial will provide a better understanding of how particular programming strategies impact the quantity of shocks delivered and facilitate optimization of complex ICD programming.

  7. Arrhythmia detection in single- and dual-chamber implantable cardioverter defibrillators: the more leads, the better?

    Science.gov (United States)

    Francia, Pietro; Balla, Cristina; Uccellini, Arianna; Cappato, Riccardo

    2009-09-01

    The implantable cardioverter defibrillator (ICD) offers life-saving therapies for primary and secondary prevention of sudden cardiac death in high-risk patients. However, ICD detection algorithms consistently misclassify a substantial proportion of supraventricular rhythms, thus carrying the risk for inappropriate therapies. Although single-chamber ICD (Sc-ICD) discrimination tools have been reported to provide high specificity in rejecting sinus tachycardia and atrial fibrillation with a relatively low ventricular rate, accurate recognition of atrial fibrillation with faster ventricular rates, atrial tachycardias, atrial flutter, and some reentrant tachycardias is still an issue. Dual-chamber ICDs (Dc-ICDs) are supposed to overcome specificity issues by enhancing detection algorithms with information derived from the atrial and ventricular timing relationship. The initial promise of Dc-ICDs was to improve detection specificity without compromising sensitivity, and to translate this advantage over Sc-ICDs in a more selective use of aggressive therapies. Despite this solid background, superiority of Dc- over Sc-ICDs has never been convincingly demonstrated. The present review focuses on the efficacy of contemporary ICD arrhythmia discrimination tools and appraises the so far reported evidence supporting the superiority of Dc-ICDs in preventing inappropriate therapies.

  8. Cost-Effectiveness of Adding Cardiac Resynchronization Therapy to an Implantable Cardioverter-Defibrillator Among Patients With Mild Heart Failure

    DEFF Research Database (Denmark)

    Woo, Christopher Y; Strandberg, Erika J; Schmiegelow, Michelle D;

    2015-01-01

    . INTERVENTION: CRT-D or ICD alone. OUTCOME MEASURES: Life-years, quality-adjusted life-years (QALYs), costs, and incremental cost-effectiveness ratios (ICERs). RESULTS OF BASE-CASE ANALYSIS: Use of CRT-D increased life expectancy (9.8 years versus 8.8 years), QALYs (8.6 years versus 7.6 years), and costs ($286......, shorter CRT-D battery life, and older age also made the cost-effectiveness of CRT-D less favorable. LIMITATIONS: The estimated mortality reduction for CRT-D was largely based on a single trial. Data on patients with NYHA class I symptoms were limited. The cost-effectiveness of CRT-D in patients with NYHA......BACKGROUND: Cardiac resynchronization therapy (CRT) reduces mortality and heart failure hospitalizations in patients with mild heart failure. OBJECTIVE: To estimate the cost-effectiveness of adding CRT to an implantable cardioverter-defibrillator (CRT-D) compared with implantable cardioverter...

  9. Cognitive behavioral therapy (CBT in a Patient with Implantable Cardioverter Defibrillator (ICD and Posttraumatic stress disorder(PTSD.

    Directory of Open Access Journals (Sweden)

    Sahar Ansari

    2014-09-01

    Full Text Available The implantable cardioverter defibrillator (ICD has currently become the standard treatment for preventing sudden cardiac death. There are some psychological consequences in patients with ICD such as posttraumatic stress disorder (PTSD after the shocks induced by ICD. This report aimed to present the case of a 54-year-old man with ICD who had developed PTSD; his PTSD was treated, using cognitive-behavioral psychotherapy consisting of relaxation, mindfulness and problem solving techniques. In patients with ICD who are experiencing PTSD using cognitive behavioral interventions may be helpful to reduce their psychological sufferings.

  10. Cognitive behavioral therapy (CBT) in a Patient with Implantable Cardioverter Defibrillator (ICD) and Posttraumatic stress disorder(PTSD).

    Science.gov (United States)

    Ansari, Sahar; Arbabi, Mohammad

    2014-07-01

    The implantable cardioverter defibrillator (ICD) has currently become the standard treatment for preventing sudden cardiac death. There are some psychological consequences in patients with ICD such as posttraumatic stress disorder (PTSD) after the shocks induced by ICD. This report aimed to present the case of a 54-year-old man with ICD who had developed PTSD; his PTSD was treated, using cognitive-behavioral psychotherapy consisting of relaxation, mindfulness and problem solving techniques. In patients with ICD who are experiencing PTSD using cognitive behavioral interventions may be helpful to reduce their psychological sufferings.

  11. Longitudinal changes in intracardiac repolarization lability in patients with implantable cardioverter-defibrillator

    Directory of Open Access Journals (Sweden)

    Abhilash eGuduru

    2013-08-01

    Full Text Available Background─While it is known that elevated baseline intracardiac repolarization lability is associated with the risk of fast ventricular tachycardia (FVT /ventricular fibrillation (VF, the effect of its longitudinal changes on the risk of FVT/VF is unknown. Methods and Results─Near-field (NF right ventricular (RV intracardiac electrograms (EGMs were recorded every 3-6 months at rest in 248 patients with structural heart disease (mean age 61.2±13.3; 185[75%] male; 162[65.3%] ischemic cardiomyopathy and implanted cardioverter-defibrillator (ICD or cardiac resynchronization therapy defibrillator (CRT-D [201 (81% primary prevention]. Intracardiac beat-to-beat QT variability index (QTVINF was measured on NF RV EGM. During the first study phase (median 18 months, participants made on average 2.4 visits. Then remote follow-up was continued for an additional median period of 3 years. Average QTVINF did not change during the first year after ICD implantation (-0.342±0.603 at baseline vs. -0.262±0.552 at 6 months vs. -0.334±0.603 at 12 months; however, it decreased thereafter (-0.510±0.603 at 18 months; P=0.042. Adjusted population-averaged GEE model showed that the odds of developing FVT/VF increased by 75% for each 1 unit increase in QTVINF. (OR 1.75 [95%CI 1.05-2.92]; P=0.031. However, individual patient–specific QTVINF trends (increasing, decreasing, flat varied from patient to patient. For a given patient, the odds of developing FVT/VF were not associated with increasing or decreasing QTVINF over time (OR 1.27; [95%CI 0.05–30.10]; P = 0.881.Conclusion─While on average the odds of FVT/VF increased with an increase in QTVINF, patient-specific longitudinal trends in QTVINF did not affect the odds of FVT/VF.

  12. No Electromagnetic Interference Occurred in a Patient with a HeartMate II Left Ventricular Assist System and a Subcutaneous Implantable Cardioverter-Defibrillator

    OpenAIRE

    Raman, Ajay Sundara; Shabari, Farshad Raissi; Kar, Biswajit; Loyalka, Pranav; Hariharan, Ramesh

    2016-01-01

    The use of subcutaneous implantable cardioverter-defibrillators is a novel option for preventing arrhythmia-mediated cardiac death in patients who are at risk of endovascular-device infection or in whom venous access is difficult. However, the potential for electromagnetic interference between subcutaneous defibrillators and left ventricular assist devices is largely unknown. We report the case of a 24-year-old man in whom we observed no electromagnetic interference between a subcutaneous imp...

  13. Long-Term Performance of the Riata/ST Implantable Cardioverter-Defibrillator Lead.

    Science.gov (United States)

    Ströker, Erwin; de Asmundis, Carlo; Vanduynhoven, Philippe; De Vadder, Katrien; De Vusser, Philip; Mullens, Wilfried; Chierchia, Gian-Battista; Brugada, Pedro; Czapla, Jens; La Meir, Mark; Wellens, Francis; Van Herendael, Hugo; Rivero-Ayerza, Maximo

    2016-03-01

    Riata and Riata ST implantable cardioverter-defibrillator leads are prone to structural and electrical failure (EF). Our objective was to evaluate Riata/ST lead performance over a long-term follow-up. Of 184 patients having undergone Riata/ST and Riata ST Optim lead implantation from September 2003 to June 2008, 154 patients were evaluated for EF and radiographic conductor externalization (CE). Survival analysis for EF was performed for Riata/ST leads, both for failure-free lead survival and cumulative hazard. Subanalysis on 7Fr leads was performed to evaluate EF and CE rates both for different Riata ST lead management (monitoring vs proactive) and between Riata ST and Riata ST Optim leads. During a mean follow-up of 7 years, Riata/ST lead EF rate was 13% overall. Similar failure-free survival rate was noted for 7Fr as for 8Fr leads (log-rank, p = 0.63). Of all failed leads, 64% failed only after 5 years of follow-up. Compared with the absolute failure rate of 1.84% per device year, cumulative hazard analysis for leads surviving past 5 years revealed an estimated failure rate of 7% per year. No clinical or procedural predictors for EF were found. The subanalysis on 7Fr leads showed an excellent outcome both for a proactive lead management approach as for Optim leads. In conclusion, long-term survival of the Riata/ST lead is impaired with an accelerating EF risk over time. An initial exponential trend was followed by a linear lead failure pattern for leads surviving past 5 years, corresponding to an estimated 7% annual EF rate. These findings may have repercussions on the lead management strategy in patients currently surviving with a Riata/ST lead to prevent significant clinical events like inappropriate shocks or failed device interventions. PMID:26762730

  14. Comorbidity burden is associated with poor psychological well-being and physical health status in patients with an implantable cardioverter-defibrillator

    DEFF Research Database (Denmark)

    Hoogwegt, Madelein T; Kupper, Nina; Jordaens, Luc;

    2013-01-01

    Comorbidity burden has been linked to survival in patients with an implantable cardioverter-defibrillator (ICD), but no study has examined the influence on psychological well-being and health status. We examined the relationship between comorbidity burden and anxiety, depression, and health status...

  15. Long-term follow-up of prophylactic implantable cardioverter-defibrillator- only therapy: Comparison of ischemic and nonischemic heart disease

    NARCIS (Netherlands)

    T. Smith (Tim); D.A.M.J. Theuns (Dominic); K. Caliskan (Kadir); L.J.L.M. Jordaens (Luc)

    2011-01-01

    textabstractBackground: The benefits of primary prophylactic implantable cardioverter-defibrillators (ICDs) are actually debated, as some drawbacks become more apparent and as the natural history of cardiac disease seems to improve. Therefore, contemporary follow-up data of non-trial populations tre

  16. The distressed (Type D) personality in both patients and partners enhances the risk of emotional distress in patients with an implantable cardioverter defibrillator

    DEFF Research Database (Denmark)

    van den Broek, Krista C; Versteeg, Henneke; Erdman, Ruud A M;

    2011-01-01

    A subgroup of patients with an implantable cardioverter defibrillator (ICD) experiences emotional distress. This may be related to partner factors. We examined the impact of the personality of the partner (i.e., the distressed (Type D) personality) in combination with that of the patient on anxiety...

  17. Temporal Influence of Heart Failure Hospitalizations Prior to Implantable Cardioverter Defibrillator or Cardiac Resynchronization Therapy With Defibrillator on Subsequent Outcome in Mild Heart Failure Patients (from MADIT-CRT)

    DEFF Research Database (Denmark)

    Lee, Andy Y; Moss, Arthur J; Ruwald, Martin H;

    2015-01-01

    effects on subsequent outcomes and benefit from cardiac resynchronization therapy with a defibrillator (CRT-D). Multivariate Cox models were used to determine the temporal influence of previous HF hospitalization on the end point of HF or death within all left bundle branch block implantable cardioverter-defibrillator...... (ICD) and CRT-D patients enrolled in the Multicenter Automatic Defibrillator Implantation Trial-Cardiac Resynchronization Therapy (MADIT-CRT) trial (n = 1,250) and to evaluate the clinical benefit of CRT-D implantation, comparing CRT-D patients with ICD patients within each previous HF hospitalization...

  18. Implantable Cardioverter-Defibrillators at End of Battery Life: Opportunities for Risk (Re)-Stratification in ICD Recipients.

    Science.gov (United States)

    Merchant, Faisal M; Quest, Tammie; Leon, Angel R; El-Chami, Mikhael F

    2016-02-01

    Although implantable cardioverter-defibrillators (ICDs) are frequently viewed as a lifelong commitment in that patients are routinely scheduled for generator exchange (GE) at end of battery life, several considerations should prompt a reevaluation of risks and benefits before GE. Compared with initial ICD implant, patients receiving replacement devices are older, and have more comorbidities and shorter life expectancy, all of which may limit the benefit of ICD therapy following GE. Additionally, GE is associated with significant complications, including infection, which may increase the risk of mortality. In this paper, we review recent data regarding opportunities for risk stratification before GE, with a particular focus on those with improved left ventricular function and those who have not experienced ICD therapies during the first battery life. We also provide a broader perspective on ICD therapy, focusing on how decisions regarding GE may affect goals of care at the end of life. PMID:26821633

  19. Embodied Revelation: A Classic Grounded Theory of Heart Failure Patient Decision Making Surrounding Primary Prevention Implantable Cardioverter Defibrillator Therapy

    Directory of Open Access Journals (Sweden)

    Vera Barton-Caro Ph.D.,

    2015-12-01

    Full Text Available The purpose of this classic grounded theory study was to explain the complex decision making process of heart failure (HF patients considering primary prevention implantable cardioverter defibrillator (ICD therapy. Sudden cardiac death (SCD is the leading cause of death for people with HF as well as the primary cause of death in the United States (US. ICDs represent the standard of care as the only effective therapy for primary prevention of SCD. However, a significant proportion of qualifying HF patients declines this invasive, yet life-saving device. The grounded theory is of Embodied revelation. The threat of SCD for ICD candidates consists of four stages: living in conscious denial, heightening of awareness, sanctioning ICD therapy, and living in new assurance. The first stage ends abruptly with the critical juncture of grasping the threat of SCD. This grounded theory has implications for research, nursing and medical practice, as well as bioethical considerations.

  20. Programming implantable cardioverter-defibrillators in primary prevention: higher or later.

    Science.gov (United States)

    Clementy, Nicolas; Pierre, Bertrand; Simeon, Edouard; Lallemand, Bénédicte; Fauchier, Laurent; Babuty, Dominique

    2014-05-01

    Defibrillator shocks, appropriate or not, are associated with significant morbidity, as they decrease quality of life, can be involved in depression and anxiety, and are known to be proarrhythmic. Most recent data have even shown an association between shocks and overall mortality. As opposed to other defibrillator-related complications, the rate of inappropriate and unnecessary shocks can (and should) be decreased with adequate programming. This review focuses on the different programming strategies and tips available to reduce the rate of shocks in primary prevention patients with left ventricular dysfunction implanted with a defibrillator, as well as some of the manufacturers' device specificities.

  1. 12. Physicians’ knowledge and attitudes in Saudi Arabia regarding implantable cardioverter-defibrillators and cardiac resynchronization therapy

    Directory of Open Access Journals (Sweden)

    A. Aljasser

    2016-07-01

    Full Text Available Information is limited regarding the knowledge and attitudes of physicians in Saudi Arabia involved in the referral of patients for implantable cardioverter-defibrillator (ICD and cardiac resynchronization and defibrillation therapy (CRT-D devices implantation. As such knowledge is the key to provide the patient with an important treatment, we aimed for its assessment. We conducted personal interviews with physicians involved in treating patients with heart failure. We included all hospitals in Riyadh region that has no cardiac electrophysiology service. Every participant was met in person and received an oral questionnaire that aims to assess basic knowledge about ICD and CRT.63 physicians were met from 13 hospitals (14 consultants and 49 specialist. 41% of participants use ⩽35% as the LVEF criterion for ICD referral in patients with cardiomyopathy. 30% of participants use ⩽35% as the LVEF criterion for CRT referral. 24% of participants were not aware about CRT as a therapy for patients with heart failure. 50% of the consultants use ⩽35% for ICD and CRT referral. 70% of the participants think that ICD may improve heart failure symptoms. 45% of participants who were about CRT do not think that CRT-D may prevent sudden death due to arrhythmia.There is a lack of knowledge with current clinical guidelines regarding ICD and CRT implantation. This finding highlights the need to improve the dissemination of guidelines to practitioners involved in managing patients with heart failure in an effort to improve ICD and CRT utilization.

  2. Beta-blocker therapy is not associated with symptoms of depression and anxiety in patients receiving an implantable cardioverter-defibrillator

    DEFF Research Database (Denmark)

    Hoogwegt, Madelein T; Kupper, Nina; Theuns, Dominic A M J;

    2012-01-01

    Beta-blockers are frequently prescribed to implantable cardioverter-defibrillator (ICD) patients. Beta-blocker therapy has been proposed to induce emotional distress such as depression and anxiety, but a paucity of studies has examined the relationship between beta-blockers and distress. We...... investigated the association between beta-blocker therapy, including type and dosage, and symptoms of anxiety and depression in a consecutive cohort of patients receiving an ICD....

  3. Results of ENHANCED Implantable Cardioverter Defibrillator Programming to Reduce Therapies and Improve Quality of Life (from the ENHANCED-ICD Study)

    DEFF Research Database (Denmark)

    Mastenbroek, Mirjam H.; Pedersen, Susanne S.; van der Tweel, Ingeborg;

    2016-01-01

    -reported outcomes. The "ENHANCED Implantable Cardioverter Defibrillator programming to reduce therapies and improve quality of life" study (ENHANCED-ICD study) was a prospective, safety-monitoring study enrolling 60 primary and secondary prevention patients at the University Medical Center Utrecht. Patients...... during follow-up. In conclusion, the ENHANCED-ICD study demonstrates that programming a NID 60/80 for VT/VF detection is safe for ICD patients and does not negatively impact their quality of life....

  4. 可嵌入心电震发生器的电击系统方案%A Shocking System Solution for Implantable Cardioverter Defibrillators

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    @@ 可嵌入心电震发生器(Implantable Cardioverter Defibrillators-ICD)已通用几年了.ICD在连接到心脏的两个电极之间施加高压脉冲,它随时检测心脏纤维性颤动.此脉冲可高达800V,在几毫秒期间电流达几十安培.

  5. Late Development of a Bronchocutaneous Fistula due to an Epicardial Cardioverter-Defibrillator Lead

    Directory of Open Access Journals (Sweden)

    Vasileios Patris

    2015-10-01

    Full Text Available Cutaneous complications caused by a pacemaker or defibrillator are widely documented, but the development of a bronchocutaneous fistula has never been described before. We report the case of a 79-year-old man who was admitted to our hospital because of a seemingly superficial cutaneous infection, externalized defibrillator leads, and hemoptysis. Bronchoscopical investigation proved the existence of the fistula, which connected the epicardium, the left main bronchus, and the aforementioned site of skin infection. The patient refused an operation for the complete removal of the epicardial defibrillator and was treated conservatively. This case demonstrated that the long-term presence of foreign bodies in the epicardium may cause serious complications

  6. A meta-analysis of mortality in end-stage renal disease patients receiving implantable cardioverter defibrillators (ICDs.

    Directory of Open Access Journals (Sweden)

    Tien-Hsing Chen

    Full Text Available Data on the effectiveness of implantable implantable cardioverter defibrillators (ICDs with respect to reducing mortality in patients with chronic kidney disease (CKD and end-stage renal disease (ESRD are lacking. The purpose of this meta-analysis was to compare the mortality of patients with ESRD who have received and not received an ICD. A search was conducted on January 31, 2013 of Medline, Cochrane, EMBASE, and Google Scholar. Studies were selected for inclusion based on the following criteria. 1 Randomized controlled trial. 2 ESRD patients with heart failure. 3 Device therapy (ICD, CRT-defibrillator [CRT-D] used to treat heart failure. 4 Primary outcome is survival analysis. 5 Retrospective study if survival analysis was performed. The primary outcome was overall survival (OS, and the secondary outcome was 2-year survival. Odds ratios (ORs with 95% confidence intervals (CI were calculated, and a χ2-based test of homogeneity was performed. Three studies were included in the analysis. The combined OR for OS was 2.245 (95% CI 1.871 to 2.685, P<0.001, indicating that patients with an ICD had a significantly higher OS than those without an ICD. The combined OR for 2-year survival was 2.312 (95% CI 1.921 to 2.784, P<0.001, indicating that patients with an ICD had a significantly higher 2-year survival rate than those without an ICD. The use of ICD in patients with ESRD is associated with an increase in the OS and the 2-year survival rate.

  7. Pacemakers and Implantable Defibrillators

    Science.gov (United States)

    ... need a cardiac pacemaker or an implantable cardioverter defibrillator (ICD). They are devices that are implanted in ... can act as both a pacemaker and a defibrillator. Many ICDs also record the heart's electrical patterns ...

  8. Prophylactic use of implantable cardioverter-defibrillators in the elderly population

    Institute of Scientific and Technical Information of China (English)

    Yuchuan LIU; Hue-Teh Shih

    2005-01-01

    @@ Introduction Sudden cardiac death (SCD) accounts for approximately 300,000 deaths each year in the United States. Ventricular fibrillation, as the initial event, had been reported in 65%-85% of these patients.1 An implantable cardioverterdefibrillator (ICD) is the single most effective life saving device to date. The advances in medicine and technology have led to wide spread utilization of defibrillators in developed countries.

  9. A pilot study of a mindfulness based stress reduction program in adolescents with implantable cardioverter defibrillators or pacemakers.

    Science.gov (United States)

    Freedenberg, Vicki A; Thomas, Sue A; Friedmann, Erika

    2015-04-01

    Adolescents with implantable cardioverter defibrillators (ICDs) or pacemakers (PMs) face unique challenges that can cause psychosocial distress. Psychosocial interventions are effective for adults with cardiac devices and could potentially impact adolescents' adjustment to these devices. Mindfulness Based Stress Reduction (MBSR) is a structured psycho-educational program that includes meditation, yoga, and group support and has been studied extensively among adults. This study examined the feasibility of the MBSR program for adolescents with ICDs/PMs, a population previously unexamined in the research literature. The participants completed measures of anxiety and depression (Hospital Anxiety and Depression Scale) and coping (Responses to Stress Questionnaire) at baseline and after the six-session MBSR intervention. Mean age of the cohort (n = 10) was 15 ± 3 years, 6 were male, 6 had a PM, and 4 had an ICD. Feasibility was demonstrated by successful recruitment of 10 participants, 100 % participation and completion. Anxiety decreased significantly following the intervention, with a large effect size, t[9] = 3.67, p MBSR interventions in adolescents with high-risk cardiac diagnoses.

  10. Characteristics associated with low treatment satisfaction in patients with implanted cardioverter defibrillators: results from the LICAD study.

    Science.gov (United States)

    Ladwig, Karl-Heinz; Deisenhofer, Isabelle; Simon, Heidi; Schmitt, Claus; Baumert, Jens J

    2005-06-01

    The evaluation of low treatment satisfaction (LTS) with an implanted cardioverter defibrillator (ICD) remains a neglected area of clinical research. However, a trustful attitude toward an ICD is crucial. Within the scope of ICD health technology assessment, we searched for predictors of LTS. Of 195 ICD patients enrolled (mean 59.8 years, standard deviation 12.6), 163 (83.6%) were men and 26 (16.4%) were women. We measured anxiety, helplessness, and depression with standardized instruments and LTS with 11 dichotomous items concerning a mistrustful attitude, a negative body image, and low appraisal. A total of 47 (24.1%) patients were considered as LTS patients. Multivariate logistic regression was used for assessment of LTS. Adjusted for age and survey, LTS was significantly more prevalent in depressed, anxious, and phobic patients. Multivariate logistic regression including medical and psychological covariates revealed the experience of > or =5 shocks with an odds ratio (OR) of 10.17 (95% CI 3.57-29.00, P effect on LTS. Age, educational status, and depression were not significant. LTS patients required more support for living with the ICD (P < or = 0.001). Thus, LTS serves as surrogate measure for deteriorated psychic health. Clinicians should be advised to identify LTS patients and to consider psychotherapeutic counseling for them. PMID:15955182

  11. A pilot study of a mindfulness based stress reduction program in adolescents with implantable cardioverter defibrillators or pacemakers.

    Science.gov (United States)

    Freedenberg, Vicki A; Thomas, Sue A; Friedmann, Erika

    2015-04-01

    Adolescents with implantable cardioverter defibrillators (ICDs) or pacemakers (PMs) face unique challenges that can cause psychosocial distress. Psychosocial interventions are effective for adults with cardiac devices and could potentially impact adolescents' adjustment to these devices. Mindfulness Based Stress Reduction (MBSR) is a structured psycho-educational program that includes meditation, yoga, and group support and has been studied extensively among adults. This study examined the feasibility of the MBSR program for adolescents with ICDs/PMs, a population previously unexamined in the research literature. The participants completed measures of anxiety and depression (Hospital Anxiety and Depression Scale) and coping (Responses to Stress Questionnaire) at baseline and after the six-session MBSR intervention. Mean age of the cohort (n = 10) was 15 ± 3 years, 6 were male, 6 had a PM, and 4 had an ICD. Feasibility was demonstrated by successful recruitment of 10 participants, 100 % participation and completion. Anxiety decreased significantly following the intervention, with a large effect size, t[9] = 3.67, p depression (r = -.88, p = .001). Post-intervention, the group independently formed their own Facebook group and requested to continue meeting monthly. Although generalizability is limited due to the small sample size, this successful pilot study paves the way for larger studies to examine the efficacy of MBSR interventions in adolescents with high-risk cardiac diagnoses. PMID:25519914

  12. Investigation of Pt, Ti, TiN, and nano-porous carbon electrodes for implantable cardioverter-defibrillator applications

    Energy Technology Data Exchange (ETDEWEB)

    Norlin, A.; Pan, J.; Leygraf, C

    2004-09-15

    The electrochemical behavior and stability of Pt, Ti, TiN, and nano-porous carbon for implantable cardioverter-defibrillator (ICD) electrode application were investigated in a phosphate buffered saline solution. The electrochemical interfacial properties were examined by electrochemical impedance spectroscopy, and the potential and current response during ICD shock pulses were recorded by a digital oscilloscope. Changes in surface composition and structure were investigated using X-ray photoelectron spectroscopy and environmental scanning electron microscopy. When exposed to anodic 700 V shock pulses with duration of 10 ms, only Pt was stable, nano-porous carbon electrode was slightly attacked, whereas Ti and TiN electrodes suffered severe degradation. Upon cathodic shock pulsing, all the materials were stable, but Ti and TiN electrodes with a smooth surface showed evidence of hydrogen adsorption. Porous and rough electrodes produced less gas evolution compared to a smooth surfaces, due to a higher amount of charge transferred through non-Faradaic processes. The reason for this could be higher interfacial capacity due to the large surface area.

  13. Predictors of appropriate therapy in patients with implantable cardioverter-defibrillator for primary prevention of sudden cardiac death

    Directory of Open Access Journals (Sweden)

    Dennis W. Zhu

    2010-02-01

    Full Text Available The purpose of this study was to evaluate predictors of appropriate therapy in patients with implantable cardioverter-defibrillators (ICD for primary prevention of sudden cardiac death. A retrospective cohort of 321 patients with systolic heart failure undergoing ICD placement for primary prevention of sudden cardiac death was queried with a mean follow-up period of 2.6 years. Appropriate ICD therapy was defined as therapy delivered for termination of a ventricular tachyarrhythmia. Appropriate ICD therapy was delivered in 142 (44% of the patients. In a multivariate model, body mass index ≥28.8 kg/m2 , chronic kidney disease, left ventricular ejection fraction ≤20% and metabolic syndrome were found to be independent predictors of appropriate ICD therapy. Appropriate ICD therapy was associated with higher cardiovascular mortality. These findings show the importance of identification of risk factors, especially metabolic syndrome, in patients following ICD implantation as aggressive treatment of these co-morbidities may decrease appropriate ICD therapy and cardiovascular mortality.

  14. Desfibrilador cardioversor automático implantável: experiência inicial Implantable cardioverter defibrillator: initial experience

    Directory of Open Access Journals (Sweden)

    Victor BAUER JÚNIOR

    1999-04-01

    Full Text Available Este estudo tem por objetivo demonstrar o protocolo de implante, técnica utilizada, avaliação dos parâmetros iniciais do implante de desfibrilador cardioversor automático implantável (DCAI e seguimento precoce dos 15 pacientes operados em nosso Serviço. O implante transvenoso nessa série de pacientes obteve sucesso em 14 casos. O limiar de desfibrilação teve média de 8,05 ± 4,60 Joules, onda R 16,00 ± 4,32 mV, "slew rate" 1,25 ± 0,29 V/s, limiar de comando de 0,65 ± 0,80 Volts e resistência de 620,00 ± 102,77 Ohms. O tempo médio de implante foi de 164,17 ± 71,15 minutos. Não ocorreu morte operatória, nem episódios de rejeição ou infecção. A média de seguimento foi de 18,79 ± 13,81 meses sendo que 9 pacientes receberam choques apropriados com reversão das arritmias. Choques inapropriados ocorreram em uma paciente devido à perda do limiar de sensibilidade do cardioversor. Observamos a facilidade técnica do implante utilizando o modelo Phylax 06 na região infraclavicular esquerda com eletrodo único, sendo o DCAI capaz de reconhecer e realizar a terapia de cardioversão ou desfibrilação com sucesso, sugerindo ser um método importante e eficaz para o tratamento dos pacientes que desenvolvem arritmias com alto risco de mortalidade em ambulatório.The implantable cardioverter-defibrillator (ICD is gaining increasing significance in therapy of life-threatening ventricular arrhythmias. Mirowski started to develop experimental automatic implantable defibrillators in the seventies. In 1980, the first human implant of an automatic implantable defibrillator was done by the team of Mirowski in Baltimore, USA. The purpose of this report is to examine 15 implantation at our Institution. Adequate defibrillation thresholds with were obrtained mean 8.0 Joules, slew rate 1.25 V/s and impedance of 620 Ohms. All implants were performed with non-thoracotomy lead, two abdominal implantations and three left pectoral implantations

  15. Pacemakers and implantable cardioverter defibrillators, unknown to chest radiography: Review, complications and systematic reading

    Energy Technology Data Exchange (ETDEWEB)

    Alandete Germán, Salvador Pascual, E-mail: salaiger@gmail.com; Isarria Vidal, Santiago, E-mail: isarria@comv.es; Domingo Montañana, María Luisa, E-mail: domingo.luimon@gmail.com; De la vía Oraá, Esperanza, E-mail: esviao82@gmail.com; Vilar Samper, José, E-mail: vilarsamper@gmail.com

    2015-03-15

    Highlights: •Radiologists have an important function in the evaluation of these devices. •We revise their radiological appearances and possible complications. •The knowledge in normal aspects and complications is important for radiologist. •To ensure an accurate reading of the chest x-ray, we present a systematic approach. -- Abstract: Chest X-ray is the imaging technique of choice for an initial study of pacemakers and implantable cardio-defibrillators (ICD). Radiologists have an important role in the evaluation of its initial placement and in the assessment during its follow-up. For this reason, it is necessary to know not only the different existing devices and its components but also the reasons of malfunction or possible complications. The purpose of this article is to do a systematic review of the different types of pacemakers and ICD. We review their usual radiological appearances, the possible complications which might take place and its causes of malfunctioning.

  16. Pacemakers and implantable cardioverter defibrillators, unknown to chest radiography: Review, complications and systematic reading

    International Nuclear Information System (INIS)

    Highlights: •Radiologists have an important function in the evaluation of these devices. •We revise their radiological appearances and possible complications. •The knowledge in normal aspects and complications is important for radiologist. •To ensure an accurate reading of the chest x-ray, we present a systematic approach. -- Abstract: Chest X-ray is the imaging technique of choice for an initial study of pacemakers and implantable cardio-defibrillators (ICD). Radiologists have an important role in the evaluation of its initial placement and in the assessment during its follow-up. For this reason, it is necessary to know not only the different existing devices and its components but also the reasons of malfunction or possible complications. The purpose of this article is to do a systematic review of the different types of pacemakers and ICD. We review their usual radiological appearances, the possible complications which might take place and its causes of malfunctioning

  17. Wrong detection of ventricular fibrillation in an implantable cardioverter defibrillator caused by the movement near the MRI scanner bore.

    Science.gov (United States)

    Mattei, Eugenio; Censi, Federica; Triventi, Michele; Mancini, Matteo; Napolitano, Antonio; Genovese, Elisabetta; Cannata, Vittorio; Falsaperla, Rosaria; Calcagnini, Giovanni

    2015-01-01

    The static magnetic field generated by MRI systems is highly non-homogenous and rapidly decreases when moving away from the bore of the scanner. Consequently, the movement around the MRI scanner is equivalent to an exposure to a time-varying magnetic field at very low frequency (few Hz). For patients with an implanted cardiac stimulators, such as an implantable cardioverter/defibrillator (ICD), the movements inside the MRI environment may thus induce voltages on the loop formed by the leads of the device, with the potential to affect the behavior of the stimulator. In particular, the ICD's detection algorithms may be affected by the induced voltage and may cause inappropriate sensing, arrhythmia detections, and eventually inappropriate ICD therapy.We performed in-vitro measurements on a saline-filled humanshaped phantom (male, 170 cm height), equipped with an MRconditional ICD able to transmit in real-time the detected cardiac activity (electrograms). A biventricular implant was reproduced and the ICD was programmed in standard operating conditions, but with the shock delivery disabled. The electrograms recorded in the atrial, left and right ventricle channels were monitored during rotational movements along the vertical axis, in close proximity of the bore. The phantom was also equipped with an accelerometer and a magnetic field probe to measure the angular velocity and the magnetic field variation during the experiment. Pacing inhibition, inappropriate detection of tachyarrhythmias and of ventricular fibrillation were observed. Pacing inhibition began at an angular velocity of about 7 rad/s, (dB/dt of about 2 T/s). Inappropriate detection of ventricular fibrillation occurred at about 8 rad/s (dB/dt of about 3 T/s). These findings highlight the need for a specific risk assessment of workers with MR-conditional ICDs, which takes into account also effects that are generally not considered relevant for patients, such as the movement around the scanner bore. PMID

  18. Cognitive-Behavioral Treatment of Posttraumatic Stress in Patients With Implantable Cardioverter Defibrillators: Results From a Randomized Controlled Trial.

    Science.gov (United States)

    Ford, Jessica; Rosman, Lindsey; Wuensch, Karl; Irvine, Jane; Sears, Samuel F

    2016-08-01

    Approximately 20% of patients with implantable cardioverter defibrillators (ICDs) suffer from posttraumatic stress disorder (PTSD) due to a history of cardiac arrest, device implantation, and ICD shock. There has been very little examination of treatment of PTSD symptoms in these patients. This study evaluated the effect of a specific cognitive-behavioral therapy (CBT) intervention for ICD patients with high levels of PTSD symptoms: a manualized program consisting of 8 telephone sessions with a trained counselor, a patient education book, and a stress management procedure on compact disc. Participants were 193 ICD patients, who were randomized to CBT or usual cardiac care (UCC) who completed self-report surveys at the time of recruitment and 6 and 12 months after initial measurement. Previous publication on the primary research evaluation questions reported that the CBT condition resulted in greater improvement on PTSD and depression symptoms than the UCC for the general population of ICD patients, but did not evaluate the effect on those with elevated symptoms of PTSD. The authors conducted secondary analyses of the effect of treatment on high and low PTSD symptom groups based on a cutoff for the Impact of Event Scale-Revised (Weiss & Marmar, 1997). Participants in the CBT group who had high symptoms experienced significantly greater symptom reduction from baseline to 12 months (d = 2.44, p = .021) than the UCC group (d = 1.12). Participants with low symptoms had small reductions regardless of group assignment (d = 0.16, p = .031). ICD-focused CBT was sufficient to produce a large, statistically significant reduction in PTSD symptoms in ICD patients with indications for treatment.

  19. Efficacy of cognitive behavioral therapy in reducing psychiatric symptoms in patients with implantable cardioverter defibrillator: an integrative review

    Directory of Open Access Journals (Sweden)

    A.C.C.O. Maia

    2014-04-01

    Full Text Available This article is a systematic review of the available literature on the benefits that cognitive behavioral therapy (CBT offers patients with implanted cardioverter defibrillators (ICDs and confirms its effectiveness. After receiving the device, some patients fear that it will malfunction, or they remain in a constant state of tension due to sudden electrical discharges and develop symptoms of anxiety and depression. A search with the key words “anxiety”, “depression”, “implantable cardioverter”, “cognitive behavioral therapy” and “psychotherapy” was carried out. The search was conducted in early January 2013. Sources for the search were ISI Web of Knowledge, PubMed, and PsycINFO. A total of 224 articles were retrieved: 155 from PubMed, 69 from ISI Web of Knowledge. Of these, 16 were written in a foreign language and 47 were duplicates, leaving 161 references for analysis of the abstracts. A total of 19 articles were eliminated after analysis of the abstracts, 13 were eliminated after full-text reading, and 11 articles were selected for the review. The collection of articles for literature review covered studies conducted over a period of 13 years (1998-2011, and, according to methodological design, there were 1 cross-sectional study, 1 prospective observational study, 2 clinical trials, 4 case-control studies, and 3 case studies. The criterion used for selection of the 11 articles was the effectiveness of the intervention of CBT to decrease anxiety and depression in patients with ICD, expressed as a ratio. The research indicated that CBT has been effective in the treatment of ICD patients with depressive and anxiety symptoms. Research also showed that young women represented a risk group, for which further study is needed. Because the number of references on this theme was small, further studies should be carried out.

  20. Cognitive-Behavioral Treatment of Posttraumatic Stress in Patients With Implantable Cardioverter Defibrillators: Results From a Randomized Controlled Trial.

    Science.gov (United States)

    Ford, Jessica; Rosman, Lindsey; Wuensch, Karl; Irvine, Jane; Sears, Samuel F

    2016-08-01

    Approximately 20% of patients with implantable cardioverter defibrillators (ICDs) suffer from posttraumatic stress disorder (PTSD) due to a history of cardiac arrest, device implantation, and ICD shock. There has been very little examination of treatment of PTSD symptoms in these patients. This study evaluated the effect of a specific cognitive-behavioral therapy (CBT) intervention for ICD patients with high levels of PTSD symptoms: a manualized program consisting of 8 telephone sessions with a trained counselor, a patient education book, and a stress management procedure on compact disc. Participants were 193 ICD patients, who were randomized to CBT or usual cardiac care (UCC) who completed self-report surveys at the time of recruitment and 6 and 12 months after initial measurement. Previous publication on the primary research evaluation questions reported that the CBT condition resulted in greater improvement on PTSD and depression symptoms than the UCC for the general population of ICD patients, but did not evaluate the effect on those with elevated symptoms of PTSD. The authors conducted secondary analyses of the effect of treatment on high and low PTSD symptom groups based on a cutoff for the Impact of Event Scale-Revised (Weiss & Marmar, 1997). Participants in the CBT group who had high symptoms experienced significantly greater symptom reduction from baseline to 12 months (d = 2.44, p = .021) than the UCC group (d = 1.12). Participants with low symptoms had small reductions regardless of group assignment (d = 0.16, p = .031). ICD-focused CBT was sufficient to produce a large, statistically significant reduction in PTSD symptoms in ICD patients with indications for treatment. PMID:27415850

  1. Implantable cardioverter defibrillator therapy in pediatric and congenital heart disease patients: a single tertiary center experience in Korea

    Directory of Open Access Journals (Sweden)

    Bo Kyung Jin

    2013-03-01

    Full Text Available Purpose: The use of implantable cardioverter defibrillators (ICDs to prevent sudden cardiac death is increasing in children and adolescents. This study investigated the use of ICDs in children with congenital heart disease. Methods: This retrospective study was conducted on the clinical characteristics and effectiveness of ICD implantation at the department of pediatrics of a single tertiary center between 2007 and 2011. Results: Fifteen patients underwent ICD implantation. Their mean age at the time of implantation was 14.5±5.4 years (range, 2 to 22 years. The follow-up duration was 28.9±20.4 months. The cause of ICD implantation was cardiac arrest in 7, sustained ventricular tachycardia in 6, and syncope in 2 patients. The underlying disorders were as follows: ionic channelopathy in 6 patients (long QT type 3 in 4, catecholaminergic polymorphic ventricular tachycardia [CPVT] in 1, and J wave syndrome in 1, cardiomyopathy in 5 patients, and postoperative congenital heart disease in 4 patients. ICD coils were implanted in the pericardial space in 2 children (ages 2 and 6 years. Five patients received appropriate ICD shock therapy, and 2 patients received inappropriate shocks due to supraventricular tachycardia.During follow-up, 2 patients required lead dysfunction-related revision. One patient with CPVT suffered from an ICD storm that was resolved using sympathetic denervation surgery. Conclusion: The overall ICD outcome was acceptable in most pediatric patients. Early diagnosis and timely ICD implantation are recommended for preventing sudden death in high-risk children and patients with congenital heart disease.

  2. Management of radiation oncology patients with implanted cardiac pacemakers or implant able cardioverter defibrilators; Tratamiento de pacientes en radioterapia con marcapasos o desfibriladores automaticos implantables

    Energy Technology Data Exchange (ETDEWEB)

    Martin Martin, G.

    2012-07-01

    The increase in life expectancy along with the technological development in the last decades has resulted in an increase in the number of patients requiring pacemaker implants or implantable cardioverter defibrillators worldwide. An increase in the number of patients with implanted cardiac devices in radiotherapy is also expected due to the risk factors in common between heart disease and cancer. In 1994 the American Association of Physicists in Medicine (AAPM) released a report about the management of radiation oncology patients with implanted cardiac pacemakers. The addition of new technologies, both in radiotherapy units and in the manufacturing process of heart devices, has shown the need for an updated protocol for the management of these patients. In this work, the most important articles published after the report of the AAPM have been compiled, in order to analyze the effects not previously studied such as dose rate, scattered radiation, electromagnetic interference or random failures produced by neutrons and protons. Additionally, the latest recommendations given by the manufacturers have been analyzed and, finally, some indications are given as an updated guide for the management of radiation oncology patients with pacemakers or cardioverter defibrillators implanted. (Author)

  3. Methodological limitations of psychosocial interventions in patients with an implantable cardioverter-defibrillator (ICD A systematic review

    Directory of Open Access Journals (Sweden)

    Ockene Ira S

    2009-12-01

    Full Text Available Abstract Background Despite the potentially life-saving benefits of the implantable cardioverter-defibrillator (ICD, a significant group of patients experiences emotional distress after ICD implantation. Different psychosocial interventions have been employed to improve this condition, but previous reviews have suggested that methodological issues may limit the validity of such interventions. Aim: To review the methodology of previously published studies of psychosocial interventions in ICD patients, according to CONSORT statement guidelines for non-pharmacological interventions, and provide recommendations for future research. Methods We electronically searched the PubMed, PsycInfo and Cochrane databases. To be included, studies needed to be published in a peer-reviewed journal between 1980 and 2008, to involve a human population aged 18+ years and to have an experimental design. Results Twelve studies met the eligibility criteria. Samples were generally small. Interventions were very heterogeneous; most studies used cognitive behavioural therapy (CBT and exercise programs either as unique interventions or as part of a multi-component program. Overall, studies showed a favourable effect on anxiety (6/9 and depression (4/8. CBT appeared to be the most effective intervention. There was no effect on the number of shocks and arrhythmic events, probably because studies were not powered to detect such an effect. Physical functioning improved in the three studies evaluating this outcome. Lack of information about the indication for ICD implantation (primary vs. secondary prevention, limited or no information regarding use of anti-arrhythmic (9/12 and psychotropic (10/12 treatment, lack of assessments of providers' treatment fidelity (12/12 and patients' adherence to the intervention (11/12 were the most common methodological limitations. Conclusions Overall, this review supports preliminary evidence of a positive effect of psychosocial interventions

  4. Nurse- and peer-led self-management programme for patients with an implantable cardioverter defibrillator; a feasibility study

    Directory of Open Access Journals (Sweden)

    van Eijk Jacques

    2007-09-01

    Full Text Available Abstract Background The prevalence of cardiovascular disease is increasing. Improved treatment options increase survival after an acute myocardial infarction or sudden cardiac arrest, although patients often have difficulty adjusting and regaining control in daily life. In particular, patients who received an implantable cardioverter defibrillator (ICD experience physical and psychological problems. Interventions to enhance perceived control and acceptance of the device are therefore necessary. This paper describes a small-scale study to explore the feasibility and the possible benefits of a structured nurse- and peer-led self-management programme ('Chronic Disease Self-Management Program' – CDSMP among ICD patients. Methods Ten male ICD patients (mean age = 65.5 years participated in a group programme, consisting of six sessions, led by a team consisting of a nurse specialist and a patient with cardiovascular disease. Programme feasibility was evaluated among patients and leaders by measuring performance of the intervention according to protocol, attendance and adherence of the participating ICD patients, and patients' and leaders' opinions about the programme. In addition, before and directly after attending the intervention, programme benefits (e.g. perceived control, symptoms of anxiety and depression, and quality of life were assessed. Results The programme was conducted largely according to protocol. Eight patients attended at least four sessions, and adherence ranged from good to very good. On average, the patients reported to have benefited very much from the programme, which they gave an overall report mark of 8.4. The leaders considered the programme feasible as well. Furthermore, improvements were identified for general self-efficacy expectancies, symptoms of anxiety, physical functioning, social functioning, role limitations due to physical problems, and pain. Conclusion This study suggests that a self-management programme led by a

  5. Physical Activity in Primary Versus Secondary Prevention Indication Implantable Cardioverter Defibrillator Recipients 6–12 Months After Implantation – A Cross-Sectional Study With Register Follow Up

    DEFF Research Database (Denmark)

    Berg, Selina Kikkenborg; Thygesen, Lau Caspar; Svendsen, Jesper Hastrup;

    2015-01-01

    OBJECTIVES: To describe physical activity status among patients with implantable cardioverter defibrillators (ICDs) according to the indication for ICD implant compared with international guidelines and compared with a matched healthy reference population to detect potential for improved physical...... outcomes; to describe patients' beliefs regarding participation in physical exercise by ICD indication; to describe factors predicting low physical activity; and to describe physical activity as a predictor of mortality. DESIGN: National survey with register follow-up. Comparisons were made to a matched...... healthy reference population, and patients were followed in registers for 15 months. SETTING: Patients are identified from national registers and questionnaires are distributed by postal mail. PARTICIPANTS: All diagnostic profiles and indications were included as were both single-chamber ICD...

  6. Implantable cardioverter-defibrillator therapy in a 34-year-old patient with eating disorders and after the third sudden cardiac arrest.

    Science.gov (United States)

    Piotrowicz, Ewa; Orzechowski, Piotr; Bilinska, Maria; Przybylski, Andrzej; Szumowski, Lukasz; Piotrowicz, Ryszard

    2015-03-01

    Eating disorders (ED) such as anorexia nervosa and bulimia are psychiatric diseases associated with the highest mortality rate of any other psychiatric disorders. More recently, long-term outcome studies with follow-up of over 20 years report a mortality of between 15% and 18% (Casiero and Frishman, Cardiol Rev 14(5), 227, 2006). The sudden death secondary to arrhythmias is often the cause of death in these patients (Casiero and Frishman, Cardiol Rev 14(5), 227, 2006). A case of life-threatening ventricular arrhythmia (VA) in a patient with ED is presented. Clinical records (cardiologic, psychiatric), electrocardiograms, echocardiogram, coronary angiogram, cardiac magnetic resonance, and endocrine diagnostics were performed. Finally a cardioverter-defibrillator (ICD) was implanted in the patient after her third cardiac arrest. An optimal approach to antiarrhythmic therapy in such patients is a real challenge for a cardiologist.

  7. Gender differences in appropriate shocks and mortality among patients with primary prophylactic implantable cardioverter-defibrillators: Systematic review and meta-analysis

    CERN Document Server

    Conen, David; Röver, Christian; Bergau, Leonard; Muñoz, Pascal; Wijers, Sofieke; Sticherling, Christian; Zabel, Markus; Friede, Tim

    2016-01-01

    BACKGROUND: Some but not all prior studies have shown that women receiving a primary prophylactic implantable cardioverter defibrillator (ICD) have a lower risk of death and appropriate shocks than men. PURPOSE: To evaluate the effect of gender on the risk of appropriate shock, all-cause mortality and inappropriate shock in contemporary studies of patients receiving a primary prophylactic ICD. DATA SOURCE: PubMed, LIVIVO, Cochrane CENTRAL between 2010 and 2016. STUDY SELECTION: Studies providing at least 1 gender-specific risk estimate for the outcomes of interest. DATA EXTRACTION: Abstracts were screened independently for potentially eligible studies for inclusion. Thereby each abstract was reviewed by at least two authors. DATA SYNTHESIS: Out of 680 abstracts retained by our search strategy, 20 studies including 46'657 patients had gender-specific information on at least one of the relevant endpoints. Mean age across the individual studies varied between 58 and 69 years. The proportion of women enrolled ran...

  8. Primary Prevention of Sudden Cardiac Death in Adults with Transposition of the Great Arteries: A Review of Implantable Cardioverter-Defibrillator Placement.

    Science.gov (United States)

    Sodhi, Sandeep S; Cedars, Ari M

    2015-08-01

    Transposition of the great arteries encompasses a set of structural congenital cardiac lesions that has in common ventriculoarterial discordance. Primarily because of advances in medical and surgical care, an increasing number of children born with this anomaly are surviving into adulthood. Depending upon the subtype of lesion or the particular corrective surgery that the patient might have undergone, this group of adult congenital heart disease patients constitutes a relatively new population with unique medical sequelae. Among the more common and difficult to manage are cardiac arrhythmias and other sequelae that can lead to sudden cardiac death. To date, the question of whether implantable cardioverter-defibrillators should be placed in this cohort as a preventive measure to abort sudden death has largely gone unanswered. Therefore, we review the available literature surrounding this issue. PMID:26413012

  9. Implante de cardio-desfibrilador em gestantes com cardiomiopatia hipertrófica Implantable cardioverter-defibrillator in pregnant women with hypertrophic cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Leonardo Jorge Cordeiro de Paula

    2010-09-01

    Full Text Available Descrevemos os casos de duas gestantes portadoras de cardiomiopatia hipertrófica com alto risco de morte súbita arrítmica, que foram submetidas a implante de cardioversor-desfibrilador automático (CDI no intercurso da gestação. O momento para a realização do procedimento e os cuidados necessários para o implante do CDI durante a gestação são discutidos e foram os principais objetivos deste relato.We describe the successful implantation of a cardioverter-defibrillator (ICD in two pregnant women with hypertrophic cardiomyopathy at high risk. The indication of ICD and the necessary care for ICD implantation during pregnancy are discussed and were the main objectives of this case report.

  10. Results of ENHANCED Implantable Cardioverter Defibrillator Programming to Reduce Therapies and Improve Quality of Life (from the ENHANCED-ICD Study).

    Science.gov (United States)

    Mastenbroek, Mirjam H; Pedersen, Susanne S; van der Tweel, Ingeborg; Doevendans, Pieter A; Meine, Mathias

    2016-02-15

    Novel implantable cardioverter defibrillator (ICD) discrimination algorithms and programming strategies have significantly reduced the incidence of inappropriate shocks, but there are still gains to be made with respect to reducing appropriate but unnecessary antitachycardia pacing (ATP) and shocks. We examined whether programming a number of intervals to detect (NID) of 60/80 for ventricular tachyarrhythmia (VT)/ventricular fibrillation (VF) detection was safe and the impact of this strategy on (1) adverse events related to ICD shocks and syncopal events; (2) ATPs/shocks; and (3) patient-reported outcomes. The "ENHANCED Implantable Cardioverter Defibrillator programming to reduce therapies and improve quality of life" study (ENHANCED-ICD study) was a prospective, safety-monitoring study enrolling 60 primary and secondary prevention patients at the University Medical Center Utrecht. Patients implanted with any type of ICD with SmartShock technology and aged 18 to 80 years were eligible to participate. In all patients, a prolonged NID 60/80 was programmed. The cycle length for VT/fast VT/VF was 360/330/240 ms, respectively. Programming a NID 60/80 proved safe for ICD patients. Because of the new programming strategy, unnecessary ICD therapy was prevented in 10% of ENHANCED-ICD patients during a median follow-up period of 1.3 years. With respect to patient-reported outcomes, levels of distress were highest and perceived health status lowest at the time of implantation, which both gradually improved during follow-up. In conclusion, the ENHANCED-ICD study demonstrates that programming a NID 60/80 for VT/VF detection is safe for ICD patients and does not negatively impact their quality of life.

  11. 埋藏式心脏转复除颤器植入术中除颤阈值测试的管理%Management of defibrillation threshold test in the implantation of implantable cardioverter defibrillator

    Institute of Scientific and Technical Information of China (English)

    周燕; 王玉如; 翟大玲; 徐金凤; 胡玉芳; 陈桂花; 何英; 殷雪梅

    2013-01-01

    目的 探讨埋藏式心脏转复除颤器(ICD)植入术中除颤阈值(DFT)测试过程中的监护与管理要点,降低测试过程中的并发症发生率.方法 回顾性分析50例植入ICD患者术中DFT测试与管理的过程,观察在规范化监护和管理下并发症的发生率.结果 50例患者植入手术过程顺利.1例患者在测试中首次除颤未成功,第2次予最大能量除颤成功;1例在行DFT测试后出现持续低血压和低血氧状态,通过及时应用升压药和增大给氧流量后恢复;1例患者诱发室颤未成功,放弃DFT测试,给予经验性能量设置.术后所有患者生命体征平稳,无手术相关重大并发症发生.结论 ICD除颤阈值测试的过程中,有出现持续低血压、低血氧和除颤阈值偏高等情况的可能,全面、有效的监护管理能显著降低DFT测试中的风险.%Objective To explore the guardianship and management points of defibrillation threshold test(DFT) in the implantation of implantable cardioverter defibrillator (ICD). Methods Test and management procedures of DFT in 50 patients with ICD implantation were analyzed retrospectively. Incidence rate of complications was observed under the standardized guardianship and management. Results All the patients had successful operations. One patient failed in the first defibrillation, and then had successful defibrillation with a maximum energy in second time. One patient had persistent hypotension and hypoxemia after DFT, which were corrected after application of pressor agent and increasing of oxygen flow. One patient received empirical energy setting instead of DFT because of ventricular fibrillation. After the operation, all the patients'vital signs were stable, and no one had severe operation- related complications. Conclusion Persistent hypotension, hypoxemia and high defibrillation threshold may occur in process of DFT, and comprehensive and effective management and guardianship can significantly reduce the

  12. Analysis of implantable cardioverter-defibrillator lead failures%植入型心律转复除颤器导线故障分析

    Institute of Scientific and Technical Information of China (English)

    陈太波; 程康安; 程中伟; 范静波; 姜秀春; 方全

    2011-01-01

    目的 总结分析我院植入型心律转复除颤器( ICD)起搏除颤导线故障病例特点。方法 对2005年10月至2009年12月62例在我院新植入ICD导线患者进行随访分析,所有导线植入均以锁骨下静脉作为入路。随访中出现以下1项或多项异常考虑导线故障:(1)起搏阻抗永久性或间歇性>2000 Ω或<250 Ω;(2)除颤高压阻抗>200 Ω;(3)心内电图证实除颤导线感知非生理性高频噪声导致误放电。结果 中位数随访时间28(10 ~46)个月,4例患者(6.5%)诊断ICD导线故障,导线寿命18~38个月;临床均以ICD误放电至医院就诊,同时程控发现ICD导线起搏阻抗异常。其中l例患者放电前闻及ICD导线阻抗报警,4例患者均重新植入新的起搏感知导线。结论 ICD导线故障是一个值得重视的临床问题。ICD导线阻抗报警功能可能有助于早期发现导线故障。如程控发现仅仅除颤导线起搏阻抗异常,植入新的起搏感知导线可以作为首选的故障处理方法。%Objective The aim of the present study was to analyze the characteristics of patients with defibrillation lead failures after implantable cardioverter-defibrillator( ICD)implantation. Methods From Oct. 2005 to Dec 2009 we implanted a new defibrillation lead for 62 consecutive cases, among which all leads were implanted by puncture of the subclavian vein. A lead failure was diagnosed if one or more of the following criteria were met: ( 1 ) permanent or temporary pacing impedance increased to more than 2000 ohms or decreased to less than 200 to 250 ohms; ( 2 ) permanent or temporary high voltage impedance increased to more than 200ohms ; (3) inappropriate shock due to oversensing non-physiologic high frequence noises was documented by intracardiac electrogram. Results During the median follow-up of 28 months ( between 10 and 46 months after implantation) 4 (6. 5% )defibrillation leads failed and the leads survival time ranged

  13. 起搏器和植入性心律转复除颤器的召回和安全警示%Recalls and Safety Alerts Involving Pacemakers and Implantable Cardioverter-Defibrillator Generators

    Institute of Scientific and Technical Information of China (English)

    William H.Maisel; Maisel O. Sweeney; William G.Stevenson; Kristin E.Ellison; Laurence M. Epstein

    2002-01-01

    @@ 背景:起搏器和植入性心律转复除颤器(implantable cardioverter-defibrillator,ICD)常常发生出乎预料的故障,需由美国食品与药物管理局(FDA)召回(recall).尽管起搏器和ICD植入日益增多,但对它们的召回和安全警示(报告)知之甚少.

  14. Development of a hybrid battery system for an implantable biomedical device, especially a defibrillator/cardioverter (ICD)

    Science.gov (United States)

    Drews, Jürgen; Wolf, R.; Fehrmann, G.; Staub, R.

    An implantable defibrillator battery has to provide pulse power capabilities as well as high energy density. Low self-discharge rates are mandatory and a way to check the remaining available capacity is necessary. These requirements are accomplished by a system consisting of a lithium/manganese dioxide 6 V battery, plus a lithium/iodine-cell. The use of a high rate 6 V double-cell design in combination with a high energy density cell reduces the total volume required by the power source within an implantable defibrillator. The design features and performance data of the hybrid system are described.

  15. Development of a hybrid battery system for an implantable biomedical device, especially a defibrillator/cardioverter (ICD)

    Energy Technology Data Exchange (ETDEWEB)

    Drews, J.; Wolf, R.; Fehrmann, G.; Staub, R. [Litronik GmbH und Co., Pirna (Germany)

    1999-07-01

    An implantable defibrillator battery has to provide pulse power capabilities as well as high energy density. Low self-discharge rates are mandatory and a way to check the remaining available capacity is necessary. These requirements are accomplished by a system consisting of a lithium/manganese dioxide 6 V battery, plus a lithium/iodine-cell. The use of a high rate 6 V double-cell design in combination with a high energy density cell reduces the total volume required by the power source within an implantable defibrillator. The design features and performance data of the hybrid system are described. (orig.)

  16. Elderly Benefit from Using Implantable Defibrillators

    Science.gov (United States)

    ... org Learn More Elderly benefit from using implantable defibrillators June 17, 2013 Categories: Heart News Study Highlights: Older people may benefit from implantable cardioverter defibrillators (ICDs) as much as younger people. Overall health, ...

  17. Unusual Cause of Inappropriate Implantable Cardioverter Defibrillators’ Shock: Tremor

    Directory of Open Access Journals (Sweden)

    Mustafa Oylumlu

    2013-08-01

    Full Text Available Implantable cardioverter defibrillators are widely used for primary and secondary prevention from sudden death. These devices terminate attacks of ventricular tachycardia and ventricular fibrillation by applying direct current shock, if it necessary. Despite these benefical effects, inappropriate shocks are important side effects of implantable cardioverter defibrillators. Inappropriate implantable cardioverter defibrillator shocks impair life quality by causing pain and psychological side-effects, and even induce new arrhytmias. In this paper we present a case of inappropriate implantable cardioverter defibrillator shock due to tremor.

  18. Appropriate evaluation and treatment of heart failure patients after implantable cardioverter-defibrillator discharge: time to go beyond the initial shock.

    Science.gov (United States)

    Mishkin, Joseph D; Saxonhouse, Sherry J; Woo, Gregory W; Burkart, Thomas A; Miles, William M; Conti, Jamie B; Schofield, Richard S; Sears, Samuel F; Aranda, Juan M

    2009-11-24

    Multiple clinical trials support the use of implantable cardioverter-defibrillators (ICDs) for prevention of sudden cardiac death in patients with heart failure (HF). Unfortunately, several complicating issues have arisen from the universal use of ICDs in HF patients. An estimated 20% to 35% of HF patients who receive an ICD for primary prevention will experience an appropriate shock within 1 to 3 years of implant, and one-third of patients will experience an inappropriate shock. An ICD shock is associated with a 2- to 5-fold increase in mortality, with the most common cause being progressive HF. The median time from initial ICD shock to death ranges from 168 to 294 days depending on HF etiology and the appropriateness of the ICD therapy. Despite this prognosis, current guidelines do not provide a clear stepwise approach to managing these high-risk patients. An ICD shock increases HF event risk and should trigger a thorough evaluation to determine the etiology of the shock and guide subsequent therapeutic interventions. Several combinations of pharmacologic and device-based interventions such as adding amiodarone to baseline beta-blocker therapy, adjusting ICD sensitivity, and employing antitachycardia pacing may reduce future appropriate and inappropriate shocks. Aggressive HF surveillance and management is required after an ICD shock, as the risk of sudden cardiac death is transformed to an increased HF event risk. PMID:19926003

  19. The mismatch between patient life expectancy and the service life of implantable devices in current cardioverter-defibrillator therapy: a call for larger device batteries.

    Science.gov (United States)

    Neuzner, Jörg

    2015-06-01

    In 2005, Bob Hauser published a paper in the Journal of the American College of Cardiology entitled "The growing mismatch between patient longevity and the service life of Implantable Cardioverter-Defibrillators". Now, nearly a decade later, I would like to perform a second look on the problem of a mismatching between ICD device service life and the survival of ICD recipients. Since 2005, the demographics of the ICD population has changed significantly. Primary prevention has become the dominant indication in defibrillator therapy and device implantation is indicated more and more in earlier stages of cardiac diseases. In former larger scale ICD trials, the patient average 5-year survival probability was in a range of 68-71%; in newer CRT-D trials in a range of 72-88%. Due to a progressively widened ICD indication and implantation preferentially performed in patients with better life expectancy, the problem of inadequate device service life is of growing importance. The early days of defibrillator therapy started with a generator volume of 145 ccm and a device service life service life were similar challenges for the technicians. Today, we have reached a formerly unexpected extent of device miniaturization. However, technologic improvements were often preferentially translated in further device miniaturization and not in prolonging device service life. In his analysis, Bob Hauser reported a prolonged device service life of 2.3 years in ICD models with a larger battery capacity of 0.54 up to 0.69 Ah. Between 2008 and 2014, several studies had been published on the problem of ICD longevity in clinical scenarios. These analyses included "older" and currently used single chamber, dual chamber and CRT devices. The reported average 5-year device service life ranged from 0 to 75%. Assuming today technology, larger battery capacities will only result in minimal increase in device volume. Selected ICD patients may further benefit from device miniaturization-but the vast

  20. Electrical Storm after Implantation of Implantable Cardioverter Defibrillator and Its treatment%植入型心律转复除颤器植入术后电风暴发生及其治疗进展

    Institute of Scientific and Technical Information of China (English)

    茅魁; 蔡鑫

    2013-01-01

    近年来,植入型心律转复除颤器治疗恶性心律失常的疗效明确,但术后电风暴诱发因素的治疗进展和预后愈来愈受到临床重视,现就近年的研究进展进行综述.%In recent years, the efficacy of implantable cardioverter defibrillator has been proved definite in treatment of nausea arrhythmia, and the treatment of postoperative electrical storm and its prognosis have been attached more and more importance to. This paper reviews its recent research progress.

  1. Combined etiology of anaphylactic cardiogenic shock: Amiodarone, epinephrine, cardioverter defibrillator, left ventricular assist devices and the Kounis syndrome

    Directory of Open Access Journals (Sweden)

    Nicholas G Kounis

    2015-01-01

    Full Text Available Anaphylactic shock is a life-threatening condition which needs detailed and mediculous clinical assessment and thoughtful treatment. Several causes can join forces in order to degranulate mast cells. Amiodarone which is an iodine-containing highly lipophilic benzofuran can induce allergic reactions and anaphylactic shock in sensitized patients. Epinephrine is a life saving drug, but in sulfite allergic patients it should be given with caution due its metabisulfite preservative. Metals covering cardiac defibrillators and pacemakers can act as antigens attached to serum proteins and induce allergic reactions. In anaphylactic shock, myocardial involvement due to vasospasm-induced coronary blood flow reduction manifesting as Kounis syndrome should be always considered. Clinically, combined treatment targeting the primary cause of anaphylaxis together with protection of cardiac tissue seems to be of paramount importance.

  2. Is metal artefact reduction mandatory in cardiac PET/CT imaging in the presence of pacemaker and implantable cardioverter defibrillator leads?

    Energy Technology Data Exchange (ETDEWEB)

    Ghafarian, Pardis [Shahid Beheshti University, Department of Radiation Medicine, Tehran (Iran, Islamic Republic of); Geneva University Hospital, Division of Nuclear Medicine, Geneva 4 (Switzerland); Tehran University of Medical Sciences, Research Center for Science and Technology in Medicine, Tehran (Iran, Islamic Republic of); Aghamiri, S.M.R. [Shahid Beheshti University, Department of Radiation Medicine, Tehran (Iran, Islamic Republic of); Ay, Mohammad R. [Tehran University of Medical Sciences, Research Center for Science and Technology in Medicine, Tehran (Iran, Islamic Republic of); Tehran University of Medical Sciences, Department of Medical Physics and Biomedical Engineering, Tehran (Iran, Islamic Republic of); Tehran University of Medical Sciences, Research Institute for Nuclear Medicine, Tehran (Iran, Islamic Republic of); Rahmim, Arman [Johns Hopkins University, Department of Radiology, Baltimore, MD (United States); Schindler, Thomas H. [Geneva University, Cardiovascular Center, Nuclear Cardiology, Geneva (Switzerland); Ratib, Osman [Geneva University Hospital, Division of Nuclear Medicine, Geneva 4 (Switzerland); Zaidi, Habib [Geneva University Hospital, Division of Nuclear Medicine, Geneva 4 (Switzerland); Geneva University, Geneva Neuroscience Center, Geneva (Switzerland)

    2011-02-15

    Cardiac PET/CT imaging is often performed in patients with pacemakers and implantable cardioverter defibrillator (ICD) leads. However, metallic implants usually produce artefacts on CT images which might propagate to CT-based attenuation-corrected (CTAC) PET images. The impact of metal artefact reduction (MAR) for CTAC of cardiac PET/CT images in the presence of pacemaker, ICD and ECG leads was investigated using both qualitative and quantitative analysis in phantom and clinical studies. The study included 14 patients with various leads undergoing perfusion and viability examinations using dedicated cardiac PET/CT protocols. The PET data were corrected for attenuation using both artefactual CT images and CT images corrected using the MAR algorithm. The severity and magnitude of metallic artefacts arising from these leads were assessed on both linear attenuation coefficient maps ({mu}-maps) and attenuation-corrected PET images. CT and PET emission data were obtained using an anthropomorphic thorax phantom and a dedicated heart phantom made in-house incorporating pacemaker and ICD leads attached at the right ventricle of the heart. Volume of interest-based analysis and regression plots were performed for regions related to the lead locations. Bull's eye view analysis was also performed on PET images corrected for attenuation with and without the MAR algorithm. In clinical studies, the visual assessment of PET images by experienced physicians and quantitative analysis did not reveal erroneous interpretation of the tracer distribution or significant differences when PET images were corrected for attenuation with and without MAR. In phantom studies, the mean differences between tracer uptake obtained without and with MAR were 10.16{+-}2.1% and 6.86{+-}2.1% in the segments of the heart in the vicinity of metallic ICD or pacemaker leads, and were 4.43{+-}0.5% and 2.98{+-}0.5% in segments far from the leads. Although the MAR algorithm was able to effectively improve

  3. Prediction of Appropriate Shocks Using 24-Hour Holter Variables and T-Wave Alternans After First Implantable Cardioverter-Defibrillator Implantation in Patients With Ischemic or Nonischemic Cardiomyopathy.

    Science.gov (United States)

    Seegers, Joachim; Bergau, Leonard; Expósito, Pascal Muñoz; Bauer, Axel; Fischer, Thomas H; Lüthje, Lars; Hasenfuß, Gerd; Friede, Tim; Zabel, Markus

    2016-07-01

    In patients treated with implantable cardioverter defibrillator (ICD), prediction of both overall survival and occurrence of shocks is important if improved patient selection is desired. We prospectively studied the predictive value of biomarkers and indexes of cardiac and renal function and spectral microvolt T-wave alternans testing and 24-hour Holter variables in a population who underwent first ICD implantation. Consecutive patients in sinus rhythm with ischemic or dilated cardiomyopathy scheduled for primary or secondary prophylactic ICD implantation were enrolled. Exercise microvolt T-wave alternans and 24-hour Holter for number of ventricular premature contractions (VPCs), deceleration capacity, heart rate variability, and heart rate turbulence were done. Death of any cause and first appropriate ICD shock were defined as end points. Over 33 ± 15 months of follow-up, 36 of 253 patients (14%) received appropriate shocks and 39 of 253 patients (15%) died. Only 3 of 253 patients (1%) died after receiving at least 1 appropriate shock. In univariate analyses, New York Heart Association class, ejection fraction, N-terminal pro brain-type natriuretic peptide (NT-proBNP), renal function, ICD indication, deceleration capacity, heart rate variability, and heart rate turbulence were predictive of all-cause mortality and VPC number and deceleration capacity predicted first appropriate shock. NT-proBNP (≥1,600 pg/ml) was identified as the only independent predictor of all-cause mortality (hazard ratio 3.0, confidence interval 1.3 to 7.3, p = 0.014). In contrast, VPC number predicted appropriate shocks (hazard ratio 2.3, confidence interval 1.0 to 5.5, p = 0.047) as the only independent risk marker. In conclusion, NT-proBNP is a strong independent predictor of mortality in a typical prospective cohort of newly implanted patients with ICD, among many electrocardiographic and clinical variables studied. Number of VPCs was identified as a predictor of appropriate shocks

  4. Is metal artefact reduction mandatory in cardiac PET/CT imaging in the presence of pacemaker and implantable cardioverter defibrillator leads?

    International Nuclear Information System (INIS)

    Cardiac PET/CT imaging is often performed in patients with pacemakers and implantable cardioverter defibrillator (ICD) leads. However, metallic implants usually produce artefacts on CT images which might propagate to CT-based attenuation-corrected (CTAC) PET images. The impact of metal artefact reduction (MAR) for CTAC of cardiac PET/CT images in the presence of pacemaker, ICD and ECG leads was investigated using both qualitative and quantitative analysis in phantom and clinical studies. The study included 14 patients with various leads undergoing perfusion and viability examinations using dedicated cardiac PET/CT protocols. The PET data were corrected for attenuation using both artefactual CT images and CT images corrected using the MAR algorithm. The severity and magnitude of metallic artefacts arising from these leads were assessed on both linear attenuation coefficient maps (μ-maps) and attenuation-corrected PET images. CT and PET emission data were obtained using an anthropomorphic thorax phantom and a dedicated heart phantom made in-house incorporating pacemaker and ICD leads attached at the right ventricle of the heart. Volume of interest-based analysis and regression plots were performed for regions related to the lead locations. Bull's eye view analysis was also performed on PET images corrected for attenuation with and without the MAR algorithm. In clinical studies, the visual assessment of PET images by experienced physicians and quantitative analysis did not reveal erroneous interpretation of the tracer distribution or significant differences when PET images were corrected for attenuation with and without MAR. In phantom studies, the mean differences between tracer uptake obtained without and with MAR were 10.16±2.1% and 6.86±2.1% in the segments of the heart in the vicinity of metallic ICD or pacemaker leads, and were 4.43±0.5% and 2.98±0.5% in segments far from the leads. Although the MAR algorithm was able to effectively improve the quality of

  5. Estimating dose to implantable cardioverter-defibrillator outside the treatment fields using a skin QED diode, optically stimulated luminescent dosimeters, and LiF thermoluminescent dosimeters

    Energy Technology Data Exchange (ETDEWEB)

    Chan, Maria F., E-mail: chanm@mskcc.org [Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Song, Yulin; Dauer, Lawrence T.; Li Jingdong; Huang, David; Burman, Chandra [Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY (United States)

    2012-10-01

    The purpose of this work was to determine the relative sensitivity of skin QED diodes, optically stimulated luminescent dosimeters (OSLDs) (microStar Trade-Mark-Sign DOT, Landauer), and LiF thermoluminescent dosimeters (TLDs) as a function of distance from a photon beam field edge when applied to measure dose at out-of-field points. These detectors have been used to estimate radiation dose to patients' implantable cardioverter-defibrillators (ICDs) located outside the treatment field. The ICDs have a thin outer case made of 0.4- to 0.6-mm-thick titanium ({approx}2.4-mm tissue equivalent). A 5-mm bolus, being the equivalent depth of the devices under the patient's skin, was placed over the ICDs. Response per unit absorbed dose-to-water was measured for each of the dosimeters with and without bolus on the beam central axis (CAX) and at a distance up to 20 cm from the CAX. Doses were measured with an ionization chamber at various depths for 6- and 15-MV x-rays on a Varian Clinac-iX linear accelerator. Relative sensitivity of the detectors was determined as the ratio of the sensitivity at each off-axis distance to that at the CAX. The detector sensitivity as a function of the distance from the field edge changed by {+-} 3% (1-11%) for LiF TLD-700, decreased by 10% (5-21%) for OSLD, and increased by 16% (11-19%) for the skin QED diode (Sun Nuclear Corp.) at the equivalent depth of 5 mm for 6- or 15-MV photon energies. Our results showed that the use of bolus with proper thickness (i.e., {approx}d{sub max} of the photon energy) on the top of the ICD would reduce the scattered dose to a lower level. Dosimeters should be calibrated out-of-field and preferably with bolus equal in thickness to the depth of interest. This can be readily performed in clinic.

  6. 置入型心律转复除颤器52例术中除颤阈值的测定及术后随访%Safety and efficacy of intraoperative defibrillation threshold measured by defibrillation safety margin n 52 patients with implantable cardioverter defibrillator

    Institute of Scientific and Technical Information of China (English)

    张宇; 袁宽道; 汤宝鹏; 马依彤; 张燕一; 王疆; 李晋新; 张疆华; 许国军

    2010-01-01

    Objective To observe the safety and efficacy of implantable cardioverter defibrillator (ICD) intraoperative defibrillation threshold (DFT) measured by defibrillation safety margin (DSM).Methods Fifty-two patients underwent ICD implantation were enrolled in this study (25 single chamber ICD, 23 double chamber ICD, 4 three chamber ICD). DFT was measured by DSM method. All patients were followuped regularly. Results DFT was ( 13.27 ± 2. 95 ) J and DSM was ( 17. 40 ± 2. 89 ) J in this patient cohort. There were no serious intraoperative complications. Malignant ventricular arrhythmia occurred in 38 patients post ICD, 469 episodes of nonsustained ventricular tachycardia (VT) were spontaneously terminated, 265 episodes were sustained VT and 245 (92. 5% ) episodes were successfully terminated by 1 antitachycardia pace treatment (ATP), 13(4. 89% ) episodes successfully terminated by 2 ATP, and ATP failed to terminate VT in 7 (2. 64% ) episodes and VTs were terminated by low energy cardioversion. All 141 episodes of ventricular fibrillation (VF) were successfully identified, and 14 episodes spontaneously terminated before discharging, 127 VF episodes (91.34%) were terminated by 1 energy shock,defibrillation energy was ( 12. 84 ±3. 18)J, 11 ( 12.2% ) VF episodes were terminated by 2 energy shocks,defibrillation energy was ( 16. 36 ± 2. 34)J. Conclusion It is safe and feasible to use defibrillation threshold measured by DSM for patients receiving ICD implantation.%目的 探讨置入型心律转复除颤器(ICD)置入术中除颤阈值(DFT)的测定方法并观察术后随访结果.方法 52例置入ICD患者,其中单腔ICD 25例(48.08%),双腔ICD 23例(44.23%),三腔ICD 4例(7.69%).置入术中用测定除颤安全范围(DSM)方法进行DFT测定,并对患者进行定期随访.结果 52例ICD置入术中,测得DFT为(13.27±2.95)J,DSM为(17.40±2.89)J,手术中无严重并发症发生.52例中,38例出现恶性室性心律失常,其中469次为非持续性(可自行终

  7. Rationale and design of a prospective study of the efficacy of a remote monitoring system used in implantable cardioverter defibrillator follow-up: the Lumos-T Reduces Routine Office Device Follow-Up Study (TRUST) study.

    Science.gov (United States)

    Varma, Niraj

    2007-12-01

    Increased implantable cardioverter defibrillator (ICD) implant volumes (and product advisories/recalls) pose management challenges. Most device interrogations at 3- to 6-month routine follow-up visits are "nonactionable," that is, require no clinically significant reprogramming, lead revision, or initiation or up-titration of antiarrhythmic medications. Conversely, implanted devices collect important diagnostic data (eg, atrial fibrillation onset, system integrity) that remain concealed between device interrogations. Remote monitoring may resolve some of these challenges, but has not been studied in a large-scale clinical trial. Home Monitoring (HM) uses automatic (without patient intervention) data and electrogram transmissions with rapid (automatically occur between periodic checks for compromised system integrity (battery, lead parameters, high-voltage circuitry) or arrhythmia occurrence (eg, atrial fibrillation, ventricular arrhythmia). All study patients will have a final office visit 15 months after implant. The results of TRUST may confirm the role of remote monitoring as an intensive surveillance mechanism for device management. PMID:18035071

  8. Rationale, design, and baseline characteristics of the DANish randomized, controlled, multicenter study to assess the efficacy of Implantable cardioverter defibrillators in patients with non-ischemic Systolic Heart failure on mortality (DANISH)

    DEFF Research Database (Denmark)

    Thune, Jens Jakob; Pehrson, Steen; Nielsen, Jens Cosedis;

    2016-01-01

    BACKGROUND: The effect of an implantable cardioverter defibrillator (ICD) in patients with symptomatic systolic heart failure (HF) caused by coronary artery disease is well documented. However, the effect of primary prophylactic ICDs in patients with systolic HF not due to coronary artery disease...... by coronary artery disease have been randomized to receive an ICD or not, in addition to contemporary standard therapy. The primary outcome of the trial is time to all-cause death. Follow-up will continue until June 2016 with a median follow-up period of 5 years. Baseline characteristics show that enrolled...... (range, 21-84 years) at baseline, and 28% were women. CONCLUSION: DANISH will provide pertinent information about the effect on all-cause mortality of a primary prophylactic ICD in patients with symptomatic systolic HF not caused by coronary artery disease on contemporary standard therapy including CRT....

  9. Nursing Experience on Electrical Storm of Implantable Cardioverter Defibrillator%植入型心脏转复除颤器患者发生电风暴的护理体会

    Institute of Scientific and Technical Information of China (English)

    丁恒

    2010-01-01

    心脏性猝死(sudden cardiac death,SCD)通常是致命性室性心律失常的最终结局.预防室性心律失常所致心源性猝死惟一有效的方法是植入植入型心脏转复除颤器(implantable cardioverter defibrillator,ICD)以减少心脏性猝死的发生[1].ICD已经从对室性心动过速(简称室速)、心室颤动(简称室颤)进行二级预防,扩展到对低射血分数的一级预防.

  10. Behandling med implanterbar defibrillator

    DEFF Research Database (Denmark)

    Roseva-Nielsen, Natasha G; Svendsen, Jesper Hastrup

    2003-01-01

    About 20 years ago the first patient received an implantable cardioverter defibrillator (ICD), and since then the number of implants have increased dramatically. The ICD can terminate ventricular fibrillation and ventricular tachycardia. Studies of secondary prophylaxis show that ICD treatment can...

  11. Nursing care of patients receiving implantable cardioverter defibrillator implantation//%心脏转复除颤器植入术患者的护理

    Institute of Scientific and Technical Information of China (English)

    李燕林; 丁莉; 陈琴

    2011-01-01

    Objective To summarize the main nursing measures of implantable cardioverter defibrillator (ICD) implantation and to highlight the maneuvers of commonly seen complications. Methods Seven cases were successfully resuscitated after sudden cardiac death. They received ICD implantation. Before the procedure, patients were closely monitored with ECG and observed; after the procedure, patients had ECG and blood pressure monitoring, and the changes in heart rates and rhythm were closely observed.Nurses instructed patients to have good rest, gave diet guidance, helped them handle pain, and kept close eyes on vital signs and delivered health education. Nurses also handled complications and accidents timely. Results The 7 patients had a hospital stay of 1430 d. All patients were symptomatic in New York Heart Association Functional Class Ⅱ or Ⅲ at discharge. Patients were followed up 2-52 months. One cases died from lung infection and pump failure. The other six patients experienced 4 times of ICD shock delivery, 3 ventricular tachycardia, 1 supraventricular tachycardia. The quick-beating heart turned into sinus rhythm after shock delivery. One case developed hallucinations of electric shock; one case had effusion of the pouch. Both the above cases received symptomatic treatment. Conclusion The complications of ICD implantation be reduced by strengthening observation of vital signs of patients, giving scrupulous fundamental nursing and psychological nursing, and taking preventive precautions, which also lengthens the service life of the ICD system.%目的 总结植入型心脏转复除颤器(1CD)植入术的护理要点和常见并发症的处理方法.方法 对收治的心源性猝死抢救成功的7例患者行ICD植入术,术前加强心电监护及病情观察;术后持续心电、血压监测,尤其注意观察心率、心律的变化,做好休息与饮食、疼痛及生命体征护理和健康教育,及时处理常见并发症和意外.结果 7例患者住院14

  12. Subcutaneous Implantable Cardioverter-Defibrillator

    Science.gov (United States)

    ... LIBRARY Hello, Guest! My alerts Sign In Join Facebook Twitter Home About this Journal Editorial Board General Statistics Circulation Cover Doodle → Blip the Doodle Go Red For Women's Issue Information for Advertisers Author Reprints Commercial Reprints Customer Service and Ordering ...

  13. Adding the implantable cardioverter-defibrillator to cardiac resynchronization therapy is associated with improved long-term survival in ischaemic, but not in non-ischaemic cardiomyopathy

    DEFF Research Database (Denmark)

    Witt, Christoffer Tobias; Kronborg, Mads Brix; Nohr, Ellen Aagaard;

    2015-01-01

    Hospital, Denmark from 2000 to 2010 were included. Baseline characteristics were retrieved from patient files and survival data were obtained from the Danish Civil Registration System. The primary outcome was all-cause mortality. The effect of ICD backup was estimated using Cox proportional hazards model...... to ischaemic cardiomyopathy (ICM) or non-ischaemic cardiomyopathy (NICM) treated with a CRT device with or without defibrillator backup. METHODS AND RESULTS: In this observational study, consecutive patients with an ejection fraction ≤35% and QRS width ≥120 ms receiving a CRT device at Aarhus University...

  14. Psychological intervention following implantation of an implantable defibrillator

    DEFF Research Database (Denmark)

    Pedersen, Susanne S.; van den Broek, Krista C; Sears, Samuel F

    2007-01-01

    The medical benefits of the implantable cardioverter defibrillator (ICD) are unequivocal, but a subgroup of patients experiences emotional difficulties following implantation. For this subgroup, some form of psychological intervention may be warranted. This review provides an overview of current...

  15. Differential effects of defibrillation on systemic and cardiac sympathetic activity

    OpenAIRE

    Bode, F; U. Wiegand; Raasch, W; Richardt, G.; Potratz, J

    1998-01-01

    Objective—To assess the effect of defibrillation shocks on cardiac and circulating catecholamines.
Design—Prospective examination of myocardial catecholamine balance during dc shock by simultaneous determination of arterial and coronary sinus plasma concentrations. Internal countershocks (10-34 J) were applied in 30 patients after initiation of ventricular fibrillation for a routine implantable cardioverter defibrillator test. Another 10 patients were externally cardioverted (50-360 J) for at...

  16. Clinical observation and nursing of implantable cardioverter-defibrillator patients with oral anticoagulants in the peroperative period%ICD围术期未停口服抗凝药的临床观察和护理

    Institute of Scientific and Technical Information of China (English)

    孙丽; 冯婕; 陆敬平; 徐冬梅

    2012-01-01

    目的 探讨植入型心律转复除颤器(ICD)围术期未停口服抗凝药的临床观察和护理.方法 回顾ICD植入术35例患者,其中围术期未停抗凝药15例,总结护理要点和并发症的处理方法.结果 35例行ICD植入术患者均痊愈出院,随访患者无不良反应和并发症.结论 术前全面评估患者围术期是否停用或替代抗凝剂,同时做好患者教育及凝血监测工作,术后严密观察术区情况,发现异常及时处理.%Objective To explore the clinical manifestations and nursing of implantable car-dioverter- defibrillator (ICD) patients with oral anticoagulants in the peroperative period. Methods The clinical data of 35 ICD patients were reviewed. Among them, 15 patients continued the oral anticoagulants. The nursing highlights and the ways to deal with complications have been summarized. Results All patients were discharged from hospital with good recovery. Follow-up showed that there were no adverse reactions and complications. Conclusion Comprehensive assessment should be done to identify whether patients has discontinued oral anticoagulants or other substitutes in the perioperative period before surgery. Meanwhile, health education and coagulation should be properly managed. The progression of disease should be closely observed after surgery in case of e-mergencies.

  17. T-wave oversensing and inappropriate shocks in implantable cardioverter def ibrillators

    Institute of Scientific and Technical Information of China (English)

    GAO Lei; LU Cai-yi; WANG Shi-wen; XUE Qiao; YAN Wei; ZHOU Sheng-hua; CHEN Rui; LIU Peng; ZHAI Jin-yue

    2010-01-01

    @@ The implantable cardioverter defibrillator (ICD) represents today the treatment and prophylaxis of choice for patients at risk for sustained ventricular tachyarrhythmias.1"6 Accurate sensing of ventricular tachyarrhythmias is a critical aspect of the function of ICD.

  18. Painless Implanted Cardioverter Defibrillator Therapy: Have We Taken It Seriously?%植入式心脏复律除颤器的无痛性治疗:我们重视了吗?

    Institute of Scientific and Technical Information of China (English)

    宿燕岗

    2011-01-01

    Shocking therapy of implanted cardioverter defibrillator (ICD) has been criticized for its causing myocardium damage and inducing electrical storm. Instead the anti-tachycardia pacing (ATP) function has been introduced as the main pain-free therapy of ICD, which could terminate about 3/4 ventricular tachycardia ( VT) events, without raising the risk of syncope or accelerated VT. The main concerns of ATP include differential identification of supraventricular tachycardia, re-confirmation of charging, settings of fast VT zone, strategies for optimization, and ATP while or before charging etc. , and the parameters should be adjusted individually during follow up. More concern should be paid to pain-free ICD therapy in clinical practice.%电击治疗可导致包括心肌损伤及诱发植入式心脏复律除颤器电风暴等弊端.植入式心脏复律除颤器的无痛性治疗主要是指其抗心动过速起搏功能.抗心动过速起搏能成功终止约3/4的室性心动过速事件,不增加晕厥或加速室性心动过速.无痛性治疗的主要策略包括室上性心动过速的鉴别程序、充电时的再确认、设定快速室性心动过速区、抗心动过速起搏策略优化、充电中和充电前抗心动过速起搏等.这些参数设置应个体化并在随访中进行调整.应重视植入式心脏复律除颤器无痛性治疗在临床上的应用.

  19. AUTOMATIC IMPLANTABLE CARDIOVERTER DEFIBRILLATOR - COST-EFFECTIVENESS

    NARCIS (Netherlands)

    HAUER, RNW; WEVER, EFD; CRIJNS, HJGM

    1993-01-01

    Unexpected out-of-hospital cardiac arrest is in most cases due to ventricular fibrillation or rapid ventricular tachycardia. The usual therapeutic strategy in survivors starts with drug treatment, in case of failure followed by nonpharmacological therapy, which may include catheter ablation, ablativ

  20. 除颤电极导线故障判断与植入起搏感知电极的处理效果%Efficacy Analysis of Pace/Sense Lead Implantation in Management of Cardioverter-Defibrillator Lead Malfunction

    Institute of Scientific and Technical Information of China (English)

    于海波; 王冬梅; 梁延春; 许国卿; 刘荣; 王祖禄; 韩雅玲

    2015-01-01

    目的:评价植入起搏感知电极处理埋藏式心律转复除颤器( implantable cardioverter defibrillator, ICD)电极导线功能故障的效果。方法回顾性分析4例植入ICD患者发生除颤电极导线功能故障的原因及处理方法。结果4例均因右心室除颤电极导线功能故障出现ICD误感知及误电击,高压阻抗均在正常范围,其中3例有术侧不适当用力情况。分析故障原因,3例为起搏感知电极断裂,1例为除颤电极早期磨损。4例均经腋静脉入路重新植入一根起搏感知电极,其中电池耗竭1例术中更换ICD。随访观察7~70个月,均未再出现ICD误感知及误电击事件,导线参数变化均在正常范围。结论术侧过度用力可能是除颤电极导线功能故障发生的主要原因,在除颤功能正常的情况下,植入起搏感知电极可解决该故障。%Objective To evaluate the efficacy and safety of pace/sense lead implantation in management of implant-able cardioverter defibrillator ( ICD) lead failure. Methods 4 patients were implanted with pace/sense lead to manage defib-rillation lead malfunction. Cause of the lead failure was analyzed, and the efficacy and safety of pace/sense lead replacement were evaluated. Results 4 patients with defibrillation lead malfunction in the right ventricle underwent inappropriate detec-tion and shocks. Among them, the high voltage impedance of defibrillation leads of all the patients were in the normal range. 3 cases experienced inappropriate force on the operation side. The cause of lead malfunction might be fraction of pace/sense lead in 3 patients and early abrasion of pace/sense in 1 patient. An additional pace/sense lead was implanted through trans-axillary venous for 4 patients, and the patients were then followed up for 7-70 months and no more inappropriate sense and shocks recurred, and all the changes of lead parameters were within the normal range. Conclusion A possible main cause for lead malfunction

  1. [The clinical practice guidelines of the Sociedad Española de Cardiología on the automatic implantable defibrillator].

    Science.gov (United States)

    Pérez-Villacastín, J; Carmona Salinas, J R; Hernández Madrid, A; Marín Huerta, E; Merino Llorens, J L; Ormaetxe Merodio, J; Moya i Mitjans, A

    1999-12-01

    Since the first implantation in man in 1980 implantable cardioverter defibrillator technology has greatly improved and the number of devices implanted has increased considerably every year. Non thoracotomy lead systems and biphasic shocks are now the approach of choice, offering an almost 100% success rate. This document reviews the recommendations for qualification of personnel and for the centres implanting and carrying out follow-ups on defibrillators. The current indications for the implantation of implantable cardioverter defibrillator are also addressed.

  2. Custo-efetividade de cardiodesfibriladores implantáveis no Brasil nos setores público e privado Cost-effectiveness of implantable cardioverter defibrillators in Brazil in the public and private sectors

    Directory of Open Access Journals (Sweden)

    Rodrigo Antonini Ribeiro

    2010-10-01

    Full Text Available FUNDAMENTO: Vários ensaios clínicos randomizados demonstraram a efetividade do cardiodesfibrilador implantável (CDI na redução de morte de pacientes com insuficiência cardíaca congestiva (ICC. Estudos de países desenvolvidos já avaliaram a custo-efetividade do CDI, porém as informações não são transferíveis para o Brasil. OBJETIVO: Avaliar a custo-efetividade do CDI em pacientes com ICC sob duas perspectivas: pública e saúde suplementar. MÉTODOS: Um modelo de Markov foi criado para analisar a relação de custo-efetividade incremental (RCEI do CDI, comparado à terapia convencional, em pacientes com ICC. Efetividade foi medida em anos de vida ajustados para qualidade (QALY. Na literatura, buscaram-se dados de efetividade e complicações. Custos foram extraídos das tabelas do SUS e de valores praticados pelos convênios, assim como médias de internações hospitalares. Análises de sensibilidade univariadas foram feitas em todas as variáveis do modelo. RESULTADOS: A RCEI foi de R$ 68.318/QALY no cenário público e R$ 90.942/QALY no privado. Esses valores são superiores aos sugeridos como pontos de corte pela Organização Mundial da Saúde, de três vezes o PIB per capita (R$ 40.545 no Brasil. Variáveis mais influentes na análise de sensibilidade foram: custo do CDI, intervalo de troca do gerador e efetividade do CDI. Em simulação de cenário semelhante ao MADIT-I, as relações foram de R$ 23.739/QALY no cenário público e R$ 33.592/QALY no privado. CONCLUSÃO: Para a população em geral com ICC, a relação de RCEI do CDI, tanto na perspectiva pública como na privada, é elevada. Resultados mais favoráveis ocorrem em pacientes com alto risco de morte súbita.BACKGROUND: Many randomized clinical trials have demonstrated the effectiveness of the implantable cardioverter-defibrillator (ICDs in death reduction of chronic heart failure (CHF patients. Some developed countries studies have evaluated its cost

  3. Implantable cardioverter defibrillator and application in cardiac rehabilitation%植入式自动心律转复除颤器及其在心脏康复中的应用

    Institute of Scientific and Technical Information of China (English)

    李之明; 张彩举; 于钦军

    2004-01-01

    植入式自动心律转复除颤器(implantable cardioverter defibrillator,ICD)作为一种治疗严重心律失常的设备,具有高效、安全、实用的特点,能显著降低室性心律失常患者猝死的风险和死亡率,在国际上受到广泛关注。

  4. Risk of chronic anxiety in implantable defibrillator patients

    DEFF Research Database (Denmark)

    Pedersen, Susanne S.; den Broek, Krista C van; Theuns, Dominic A M J;

    2011-01-01

    Little is known about the prevalence of chronic anxiety in patients with an implantable cardioverter defibrillator (ICD). In a multi-center, prospective study, we examined 1) the prevalence of chronic anxiety (i.e., patients anxious at implantation and 12 months), and 2) predictors of chronic...... anxiety....

  5. Defibrillator Implantation in Patients with Nonischemic Systolic Heart Failure

    DEFF Research Database (Denmark)

    Køber, Lars; Thune, Jens J; Nielsen, Jens C;

    2016-01-01

    Background The benefit of an implantable cardioverter-defibrillator (ICD) in patients with symptomatic systolic heart failure caused by coronary artery disease has been well documented. However, the evidence for a benefit of prophylactic ICDs in patients with systolic heart failure that is not due...

  6. Prophylactic implantable defibrillator in patients with arrhythmogenic right ventricular cardiomyopathy/dysplasia and no prior ventricular fibrillation or sustained ventricular tachycardia.

    LENUS (Irish Health Repository)

    Corrado, Domenico

    2010-09-21

    The role of implantable cardioverter-defibrillator (ICD) in patients with arrhythmogenic right ventricular cardiomyopathy\\/dysplasia and no prior ventricular fibrillation (VF) or sustained ventricular tachycardia is an unsolved issue.

  7. A patch in the pectoral position lowers defibrillation threshold.

    Science.gov (United States)

    Karasik, P; Solomon, A; Verdino, R; Moore, H; Rodak, D; Hannan, R; Fletcher, R

    1997-06-01

    Implantable pacemaker cardioverter defibrillators are now available with biphasic waveforms, which have been shown to markedly improve defibrillation thresholds (DFTs). However, in a number of patients the DFT remains high. Also, DFT may increase after implantation, especially if antiarrhythmic drugs are added. We report on the use of a subcutaneous patch in the pectoral position in 15 patients receiving a transvenous defibrillator as a method of easily reducing the DFT. A 660-mm2 patch electrode was placed beneath the generator in a pocket created on the pectoral fascia. The energy required for defibrillation was lowered by 56% on average, and the system impedance was lowered by a mean of 25%. This maneuver allowed all patients to undergo a successful implant with adequate safety margin.

  8. Prevención primaria y secundaria de muerte súbita en un hospital de la Seguridad Social de Costa Rica: reporte del registro de pacientes con desfibrilador automático implantable, 2007-2011 Primary and secondary prevention of sudden cardiac death in a hospital of the social security system in Costa Rica: report from the registry of patients with implantable cardioverter-defibrillators, 2007-2011

    Directory of Open Access Journals (Sweden)

    Hugo Arguedas-Jiménez

    2013-03-01

    Full Text Available Justificación y objetivo: diversos estudios han demostrado la eficacia de los desfibriladores automáticos implantables en la prevención de la muerte súbita cardiaca. La aplicación de dicha evidencia debe ser evaluada mediante registros. El objetivo de este estudio fue describir las principales características epidemiológicas y clínicas y las complicaciones de los pacientes a quienes se les implanta un desfibrilador automático implantable en un hospital de tercer nivel en Costa Rica. Métodos: estudio observacional de cohorte, retrospectivo, que incluyó la totalidad de pacientes a quienes se les implantó un desfibrilador automático implantable en el hospital “Dr. Rafael Ángel Calderón Guardia” entre 2007 y 2011. Resultados: se incluyó 23 pacientes. La edad media fue de 55 ± 18 años. La cardiopatía isquémica fue la etiología más frecuente (10 pacientes. Veinte pacientes estaban en clase funcional I o II; la fracción de eyección media fue 0,38 ± 0,17. En los 18 pacientes el desfibrilador automático se implantó por prevención secundaria. Cinco pacientes presentaron una complicación temprana, todos ellos con dispositivos bicamerales: 2 hematomas menores, una disección del seno coronario, un desplazamiento del electrodo atrial derecho y un ictus cardioembólico. Hubo un total de 101 terapias (en 8 pacientes, de las cuales 94 fueron apropiadas (en 5 pacientes y 7 inapropiadas (en 3 pacientes; dos de estos últimos habían tenido episodios previos de fibrilación atrial. Conclusión: este registro muestra que la mayoría de los implantes de desfibriladores automáticos se realizan por prevención secundaria, con una alta tasa de terapias adecuadas y una baja tasa de terapias inadecuadas y de complicaciones; además, permite evaluar las indicaciones y las complicaciones asociadas con esta terapia.Aim: Several studies have demonstrated the efficacy of implantable cardioverter-defibrillators in the prevention of sudden

  9. Towards Low Energy Atrial Defibrillation

    Directory of Open Access Journals (Sweden)

    Philip Walsh

    2015-09-01

    Full Text Available A wireless powered implantable atrial defibrillator consisting of a battery driven hand-held radio frequency (RF power transmitter (ex vivo and a passive (battery free implantable power receiver (in vivo that enables measurement of the intracardiac impedance (ICI during internal atrial defibrillation is reported. The architecture is designed to operate in two modes: Cardiac sense mode (power-up, measure the impedance of the cardiac substrate and communicate data to the ex vivo power transmitter and cardiac shock mode (delivery of a synchronised very low tilt rectilinear electrical shock waveform. An initial prototype was implemented and tested. In low-power (sense mode, >5 W was delivered across a 2.5 cm air-skin gap to facilitate measurement of the impedance of the cardiac substrate. In high-power (shock mode, >180 W (delivered as a 12 ms monophasic very-low-tilt-rectilinear (M-VLTR or as a 12 ms biphasic very-low-tilt-rectilinear (B-VLTR chronosymmetric (6ms/6ms amplitude asymmetric (negative phase at 50% magnitude shock was reliably and repeatedly delivered across the same interface; with >47% DC-to-DC (direct current to direct current power transfer efficiency at a switching frequency of 185 kHz achieved. In an initial trial of the RF architecture developed, 30 patients with AF were randomised to therapy with an RF generated M-VLTR or B-VLTR shock using a step-up voltage protocol (50–300 V. Mean energy for successful cardioversion was 8.51 J ± 3.16 J. Subsequent analysis revealed that all patients who cardioverted exhibited a significant decrease in ICI between the first and third shocks (5.00 Ω (SD(σ = 1.62 Ω, p < 0.01 while spectral analysis across frequency also revealed a significant variation in the impedance-amplitude-spectrum-area (IAMSA within the same patient group (|∆(IAMSAS1-IAMSAS3[1 Hz − 20 kHz] = 20.82 Ω-Hz (SD(σ = 10.77 Ω-Hz, p < 0.01; both trends being absent in all patients that failed to cardiovert

  10. Modulatory effects of cognitive behavior therapy on depression and anxiety in patients with implantable cardioverter defibrillator%认知行为疗法对心律转复除颤器植入患者抑郁焦虑症状的调节作用

    Institute of Scientific and Technical Information of China (English)

    祁述善; 方臻飞; 刘启明; 周胜华

    2005-01-01

    BACKGROUND: 60% of the patients receiving implantable cardioverter defibrillator(ICD) believe their quality of life has been improved. However,about 30% to 50% of the patients suffer from postoperative depression and anxiety; especially those patients receive electroconvulsive therapy (ECT).OBJECTIVE: To probe into the modulatory effects of cognitive behavior therapy(CBT) on depression and anxiety in patients with ICD.DESIGN: A retrospective case analysis based on ICD patients SETTING: Room of Cardiac Catheterization, Department of Cardiology, Xiangya Second Hospital PARTICIPANTS: The study was conducted in the Room of Cardiac Catheterization of the Department of Cardiology, Xiangya Second Hospital,Central South University from October 2000 to August 2001. Inclusive criteria: ICD patients that had ineffective medicine therapy for paroxysmal ventricular tachycardia and/or ventricular fibrillation complicated with cardiac syncope. Exclusive criteria: incoorperative patients or patients who unable to receive periodical follow up. A total of 6 patients were involved including 4 male and 2 female patients aged from 45 to 71 years old with an average age of (57.3 ± 2.4) years old. All of the patients received Micro Jewell Ⅱ 7223 ICD made by Medtronic Company. Diagnoses of basic disease:2 cases of coronary heart disease, 2 cases of right ventricular myocardial disease, 1 case of paroxysmal ventricular tachycardia due to unknown reason,and 1 case of Brugada syndrome.METHODS: "Morita therapy" technique was used. Patients were asked to transfer their spirit energies into feasible objectives of their real life, which would be helpful to the rapid improvement of their symptoms. symptom checklist-90(SCL-90) scale was used to evaluate the psychological symptoms before and after the therapy.MAIN OUTCOME MEASURES: Comparison of the scores gained in SCL-90 between before and after CBT.RESULTS: There were significant differences in the items of somatization,compulsion, sensitive

  11. Renal infarction due to atrial fibrillation after implantation of implantable cardioverter-defibrillator:a case report and review of literature%心房颤动患者植入植入式心脏复律除颤器术后肾梗死1例及文献复习

    Institute of Scientific and Technical Information of China (English)

    黄樱硕; 孙颖; 邢云利; 王翠英; 黄蔚; 李清清; 吴永全; 马清

    2014-01-01

    1例合并阵发性心房颤动(AF)的老年女性因室性心动过速(VT)而植入植入式心脏复律除颤器(ICD),围术期为避免出血风险,未予抗凝治疗,术后7d出现发热、腹痛,完善检查后诊断为肾梗死,立即开始规律抗凝治疗。目前针对AF患者植入心脏节律装置(CRD)围术期不同抗凝策略的安全性及有效性仍有争议。AF患者合并肾梗死相对少见,且该患者临床表现不典型,增加了早期诊断的难度。该病例带给我们的启示是:(1)对于卒中高危的AF患者,在植入CRD的围术期,抗凝治疗是必要的,但是采用何种抗凝策略尚有争议;(2)对于卒中高危的AF患者,在无抗凝的情况下,出现急腹症等表现时,应考虑腹腔脏器急性栓塞梗死的可能性。%We reported an elderly female (76 years old) accompanied with paroxysmal atrial fibrillation (AF) who underwent the implantation of implantable cardioverter-defibrillator (ICD) due to ventricular tachycardia (VT) in our department. No peri-operative anticoagulation was given to her in consideration of risk for hemorrhage. The patient was found to have fever and abdominal pain at the 7th day after surgery, and then right renal infarction was confirmed after diagnosis. Then the patient was given standard anticoagulant therapy. In present, it is a controversial issue on the efficacy and safety of anticoagulation strategy during perioperation of implantation of cardiac rhythm device (CRD). Renal infarction due to AF is relatively rare and the atypical clinical manifestations make early diagnosis for this patient more difficult. The revelation of this case includes:for patients with AF and high risk of stroke, anticoagulation therapy is necessary, but the strategy of anticoagulation remains controversial;for patients with AF and moderate risk of stroke, acute embolic infarction of abdominal organs should be taken into account when acute abdominal

  12. Phantom shocks in patients with implantable cardioverter defibrillator

    DEFF Research Database (Denmark)

    Berg, Selina Kikkenborg; Moons, Philip; Zwisler, Ann-Dorthe;

    2013-01-01

    of phantom shocks.METHODS AND RESULTS: The design was secondary explorative analyses of data from a randomized controlled trial. One hundred and ninety-six patients with first-time ICD implantation (79% male, mean age 58 years) were randomized (1 : 1) to either combined rehabilitation or a control group...

  13. Sexual Health for Patients with an Implantable Cardioverter Defibrillator

    Science.gov (United States)

    ... LIBRARY Hello, Guest! My alerts Sign In Join Facebook Twitter Home About this Journal Editorial Board General Statistics Circulation Cover Doodle → Blip the Doodle Go Red For Women's Issue Information for Advertisers Author Reprints Commercial Reprints Customer Service and Ordering ...

  14. How to Respond to an Implantable Cardioverter-Defibrillator Recall

    Science.gov (United States)

    ... LIBRARY Hello, Guest! My alerts Sign In Join Facebook Twitter Home About this Journal Editorial Board General Statistics Circulation Cover Doodle → Blip the Doodle Go Red For Women's Issue Information for Advertisers Author Reprints Commercial Reprints Customer Service and Ordering ...

  15. Updated care guidelines for patients with automatic implantable cardioverter defibrillators.

    Science.gov (United States)

    Moser, S A; Crawford, D; Thomas, A

    1993-04-01

    Since its clinical introduction, AICD therapy has gained significant acceptance. Some physicians consider it the "gold standard" in treating malignant tachyarrhythmias associated with sudden cardiac death. As the technology and therapy application have grown, nursing responsibilities have evolved as well. And, with the forthcoming combinations of technology such as AICDs with antitachycardia pacing and bradycardia pacing, the sophistication of the therapy is expected to increase. However, the most critical role for nurses in AICD patient care remains education. Increased utilization has made AICD implants more common, but many patients still lack the initial information and acceptance needed for therapeutic success. Health-care professionals who continue to update and share their understanding of this life-saving technology make invaluable contributions to the care of these patients who have received a second chance at life.

  16. Prevention of sudden cardiac death by the implantable cardioverter defibrilator

    OpenAIRE

    Kovačević Dragan V.; Stojišić-Milosavljević Anastazija; Topalov Vasilije; Mihajlović Bogoljub; Sakač Dejan; Kozlovački Živa

    2011-01-01

    Introduction. Sudden cardiac death or, as it is also called, a modern man’s killer occurs a few hours after the beginning of the disease. Sudden death is the one that happens within an hour from the onset of the subjective discomforts regardless of the existence of any previous disease. According to modern statistics, 450.000 people die suddenly in the USA and 150,000 in Germany. Causes of sudden death. The most frequent causes of sudden death are cardiologic or, in other words, a heart...

  17. Venous thromboembolism in patients with implantable cardioverter-defibrillators

    DEFF Research Database (Denmark)

    Pedersen, Susanne Bendesgaard; Hjortshøj, Søren Pihlkjær; Bøtker, Hans Erik;

    2016-01-01

    , overall and according to gender, age, Charlson Comorbidity Index score (no, moderate, or severe comorbidity), prior pacemaker or cardiac resynchronization therapy (CRT-D) implantation, and ICD type (single-chamber, dual-chamber, or CRT-D). We computed the risk of VTE within 3 months and 5 years...

  18. Implantable Cardiac Defibrillator Lead Failure and Management.

    Science.gov (United States)

    Swerdlow, Charles D; Kalahasty, Gautham; Ellenbogen, Kenneth A

    2016-03-22

    The implantable-cardioverter defibrillator (ICD) lead is the most vulnerable component of the ICD system. Despite advanced engineering design, sophisticated manufacturing techniques, and extensive bench, pre-clinical, and clinical testing, lead failure (LF) remains the Achilles' heel of the ICD system. ICD LF has a broad range of adverse outcomes, ranging from intermittent inappropriate pacing to proarrhythmia leading to patient mortality. ICD LF is often considered in the context of design or construction defects, but is more appropriately considered in the context of the finite service life of a mechanical component placed in chemically stressful environment and subjected to continuous mechanical stresses. This clinical review summarizes LF mechanisms, assessment, and differential diagnosis of LF, including lead diagnostics, recent prominent lead recalls, and management of LF and functioning, but recalled leads. Despite recent advances in lead technology, physicians will likely continue to need to understand how to manage patients with transvenous ICD leads.

  19. Implantable Cardiac Defibrillator Lead Failure and Management.

    Science.gov (United States)

    Swerdlow, Charles D; Kalahasty, Gautham; Ellenbogen, Kenneth A

    2016-03-22

    The implantable-cardioverter defibrillator (ICD) lead is the most vulnerable component of the ICD system. Despite advanced engineering design, sophisticated manufacturing techniques, and extensive bench, pre-clinical, and clinical testing, lead failure (LF) remains the Achilles' heel of the ICD system. ICD LF has a broad range of adverse outcomes, ranging from intermittent inappropriate pacing to proarrhythmia leading to patient mortality. ICD LF is often considered in the context of design or construction defects, but is more appropriately considered in the context of the finite service life of a mechanical component placed in chemically stressful environment and subjected to continuous mechanical stresses. This clinical review summarizes LF mechanisms, assessment, and differential diagnosis of LF, including lead diagnostics, recent prominent lead recalls, and management of LF and functioning, but recalled leads. Despite recent advances in lead technology, physicians will likely continue to need to understand how to manage patients with transvenous ICD leads. PMID:26988958

  20. Cause analysis of imappropriate detection or treatment episodes of im-plantable cardioverter defibrillator%埋藏式心脏转复除颤器不适当识别或治疗事件原因分析及处理

    Institute of Scientific and Technical Information of China (English)

    何冉; 韩战营; 张杰; 卢文杰; 宋红星; 陈晓杰; 邱春光; 刘怀霖

    2014-01-01

    Aim:To analyze the causes of imappropriate detection or treatment of implantable cardioverter defibrillator (ICD).Methods:Since 2008 to 2013,42 patients were implanted ICD,clinic materials of 9 patients who subjected imap-propriate detection or treatment were reviewed .Results:Nine(26.5%) patients happened in 41 imappropriate detection or treatment episodes,the average follow-up time was (18.5 ±11.7) months.Twelve imappropriate detections in 4 patients and 29 imappropriate discharges in 7 patients occurred(2 patient was double counted ).Among the total,there are 14 imap-propriate discharge events in 4 patients for sustain VT/FVT with stable hemodynamics ,11 imappropriate discharges and 2 imappropriate detections in one patient for T wave oversensing ,3 imappropriate discharges in one patient for P/R wave double count ,1 imappropriate discharge for electromagnetic interference ,1 imappropriate detection for electromagnetic inter-ference and 1 imappropriate detection for sinus tachycardia .Conclusion:After ICD was implanted ,the incidence of imap-propriate detection or treatment episode is higher , it is necessary to strengthen programing follow-up for prompt abnormal discovery ,therapeutic change and sufficient ATP treatment without pain under a safe condition ,it will profit to reduce imap-propriate discharge and improve the quality of life .%目的:分析埋藏式心脏转复除颤器( ICD)不适当识别或治疗事件的原因。方法:回顾2008年至2013年42例ICD植入患者发生不适当识别或治疗的临床资料。结果:34例随访(18.5±11.7)个月,9例(26.5%)共发生41次不适当识别或治疗事件(其中单腔ICD 2台,双腔ICD 1台,CRT-D 6台)。4例发生不适当识别12次,7例发生不适当治疗29次,其中2例不适当识别或治疗共存。1例发生3次血流动力学稳定的室性心动过速( VT )事件,经抗心动过速起搏(ATP)失败后给予电击治疗6次;3例发生

  1. Impacto da parada cardíaca induzida nas funções cognitivas após o implante de cardiodesfibrilador Impacto de la parada cardíaca inducida en las funciones cognitivas después del implante de desfibrilador cardiaco Impact of induced cardiac arrest on cognitive function after implantation of a cardioverter-defibrillator

    Directory of Open Access Journals (Sweden)

    Mauro Prado da Silva

    2009-02-01

    1980 y se considera el tratamiento estándar para individuos bajo el riesgo de desarrollar arritmias ventriculares fatales. Con el interés de garantizar el funcionamiento adecuado del desfibrilador cardiaco, la energía necesaria para el término de la taquicardia ventricular o de la fibrilación ventricular, debe ser determinada durante el implante, siendo este procedimiento llamado test del límite de desfibrilación. Para la realización del test es necesario que se haga la inducción de la fibrilación ventricular, para que el aparato pueda identificar el ritmo cardíaco y tratarlo. El objetivo de este estudio fue verificar la incidencia de disfunción cognitiva 24 horas después del implante del desfibrilador cardiaco. MÉTODO: Se seleccionó una muestra consecutiva de 30 pacientes con indicación de colocación de desfibrilador cardiaco implantable (DCI y 30 pacientes con indicación de implante de marca-paso (MP. Los pacientes fueron evaluados en los siguientes momentos: 24 horas antes de la colocación del DCI o MP con ficha de evaluación preanestésica, Mini-Examen del Estado Mental (MEEM y Confusion Assessment Method (CAM. Durante el implante del DCI o MP fueron medidas las variables: número de paradas cardíacas y tiempo total de parada cardíaca. Veinte y cuatro horas después de la colocación del DCI o MP, se evaluaron las variables: MEEM y CAM. RESULTADOS: El test de Fisher mostró que no había diferencia de la frecuencia de puntuaciones alteradas del MEEM y del CAM entre los grupos antes y después de los implantes. El tiempo promedio de PCR 7,06, con máximos y mínimos de 15,1 y 4,7 segundos. CONCLUSIONES: La inducción de parada cardíaca durante el test del límite de desfibrilación, no conllevó a la disfunción cognitiva veinte y cuatro horas después del implante del desfibrilador cardiaco.BACKGROUND AND OBJECTIVES: Implantable cardioverter-defibrillators (ICD were introduced in clinical practice in 1980 and they are considered the standard

  2. The NO Regular Defibrillation testing In Cardioverter Defibrillator Implantation (NORDIC ICD) trial

    DEFF Research Database (Denmark)

    Bänsch, Dietmar; Bonnemeier, Hendrik; Brandt, Johan;

    2015-01-01

    was standardized across all participating centres. After inducing a fast ventricular tachycardia (VT) with a heart rate ≥240 b.p.m. or ventricular fibrillation (VF) with a low-energy T-wave shock, DF was attempted with an initial 15 J shock. If the shock reversed the VT or VF, DF testing was considered successful...

  3. Cost-effectiveness of implantable defibrillator as first-choice therapy versus electrophysiologically guided, tiered strategy in postinfarct sudden death survivors - A randomized study

    NARCIS (Netherlands)

    Hauer, RNW; Schrijvers, G; vanCapelle, FJL; Tijssen, JGP; Crijns, HJGM; Algra, A; Ramanna, H; Bakker, PFA; deMedina, EOR; Wever, Eric F. D.

    1996-01-01

    Background Rising costs of health care, partly as a result of costly therapeutic innovations, are of concern to both the medical profession and healthcare authorities. The implantable cardioverter-defibrillator or (ICD) is still not remunerated by Dutch healthcare insurers. The aim of this study was

  4. Subcutaneous chronic implantable defibrillation systems in humans.

    Science.gov (United States)

    Cappato, Riccardo; Smith, Warren M; Hood, Margaret A; Crozier, Ian G; Jordaens, Luc; Spitzer, Stefan G; Ardashev, Andrey V; Boersma, Lucas; Lupo, Pierpaolo; Grace, Andrew A; Bardy, Gust H

    2012-09-01

    The recent introduction of subcutaneous implantable cardioverter defibrillator (S-ICD) has raised attention about the potential of this technology for clinical use in daily clinical practice. We review the methods and results of the four studies conducted in humans for approval of this innovative technology for daily practice. Two studies using a temporary S-ICD system (acute human studies) were conducted to search for an appropriate lead configuration and energy requirements. For this purpose, 4 S-ICD configurations were tested in 78 patients at the time of transvenous (TV)-ICD implantation. The optimal configuration was tested in 49 more patients to comparatively assess the subcutaneous defibrillation threshold (S-DFT) versus the standard TV-ICD. Long-term implants were evaluated in 55 patients using an implanted system (chronic human study). The acute humans studies led to an optimal S-ICD configuration comprising a parasternal electrode and left anterolateral thoracic pulse generator. Both configurations successfully terminated 98% of induced ventricular fibrillation (VF), but significantly higher energy levels were required with S-ICD than with TV-ICD systems (36.6 ± 19.8 J vs. 11.1 ± 8.5 J). In the chronic study, all 137 VF episodes induced at time of implant were detected with a 98% conversion rate. Two pocket infections and four lead revisions were required during 10 ± 1 months of follow-up. During this period, survival was 98%, and 12 spontaneous ventricular tachyarrhythmias were detected and treated by the device. These data show that the S-ICD systems here consistently detected and converted VF induced at time of implant as well as sustained ventricular tachyarrhythmias occurring during follow-up (248). PMID:22426601

  5. Public Access Defibrillation

    DEFF Research Database (Denmark)

    Agerskov, Marianne; Nielsen, Anne Møller; Hansen, Carolina Malta;

    2015-01-01

    BACKGROUND: In Copenhagen, a volunteer-based Automated External Defibrillator (AED) network provides a unique opportunity to assess AED use. We aimed to determine the proportion of Out-of-Hospital Cardiac Arrest (OHCA) where an AED was applied before arrival of the ambulance, and the proportion o...

  6. Interference from a hand held radiofrequency remote control causing discharge of an implantable defibrillator.

    Science.gov (United States)

    Man, K C; Davidson, T; Langberg, J J; Morady, F; Kalbfleisch, S J

    1993-08-01

    A 46-year-old man with a history of sustained monomorphic ventricular tachycardia underwent an implantation of a third generation multiprogrammable implantable cardioverter defibrillator. One year post implant, while manipulating a remote control to a radiofrequency modulated toy car, the patient experienced a defibrillator discharge not preceded by an arrhythmia prodrome. Subsequent interrogation of the defibrillator revealed that a 34-joule shock had been delivered and had been preceded by RR intervals ranging from 141-406 msec, consistent with sensing lead noise. The remote control utilizes a 12-volt battery and has a carrier frequency of 75.95 MHz and a modulating frequency of 50 Hz. Evaluation of the remote control and defibrillator interaction revealed that the remote control was able to trigger tachyarrhythmia sensing and reproduce the clinical episode. Interference was present only when the remote control was within 8 cm of the pulse generator and at specific angles relative to the device and only when the antenna length was > 45 cm. Interference was eliminated when a ground wire was attached to the antenna and when an aluminium shield was placed between the pulse generator and the remote control. This case report suggests that patients with third generation multiprogrammable defibrillators should be cautioned against close contact with potential sources of electromagnetic interference, such as remote control units.

  7. Wearable defibrillator use in heart failure (WIF: results of a prospective registry

    Directory of Open Access Journals (Sweden)

    Kao Andrew C

    2012-12-01

    Full Text Available Abstract Background Heart failure (HF patients have a high risk of death, and implantable cardioverter defibrillators (ICDs are effective in preventing sudden cardiac death (SCD. However, a certain percentage of patients may not be immediate candidates for ICDs, particularly those having a short duration of risk or an uncertain amount of risk. This includes the newly diagnosed patients, as well as those on the cardiac transplant list or NYHA class IV heart failure patients who do not already have an ICD. In these patients, a wearable cardioverter defibrillator (WCD may be used until long term risk of SCD is defined. The purpose of this study was to determine the incidence of SCD in this population, and the efficacy of early defibrillation by a WCD. Methods Ten enrolling centers identified 89 eligible HF patients who were either listed for cardiac transplantation, diagnosed with dilated cardiomyopathy, or receiving inotropic medications. Data collected included medical history, device records, and outcomes (including 90 day mortality. Results Out of 89 patients, final data on 82 patients has been collected. Patients wore the device for 75±58 days. Mean age was 56.8±13.2, and 72% were male. Most patients (98.8% were diagnosed with dilated cardiomyopathy with a low ejection fraction ( Conclusions In conclusion, the WCD monitored HF patients until further assessment of risk. The leading reasons for end of WCD use were improvement in left ventricular ejection fraction (LVEF or ICD implantation if there was no significant improvement in LVEF.

  8. Defibrillation thresholds are lower with smaller storage capacitors.

    Science.gov (United States)

    Leonelli, F M; Kroll, M W; Brewer, J E

    1995-09-01

    Present implantable cardioverter defibrillators use a wide range of capacitance values for the storage capacitor. However, the optimal capacitance value is unknown. We hypothesized that a smaller capacitor, by delivering its charge in a time closer to the heart chronaxie, should lower the defibrillation threshold (DFT). We compared the energy required to defibrillate 10 open-chest dogs, after 15 seconds of ventricular fibrillation, with a monophasic, time-truncated waveform delivered from either a 85-microF or a 140-microF capacitor. Shocks were delivered through a pair of 14-cm2 epicardial patch electrodes: The two capacitors were randomly tested twice with each dog using a modified 3-reversal method for each DFT determination. The average stored and delivered DFT energies for the 85-microF capacitor were 6.0 +/- 1.7 joules and 5.2 +/- 1.5 joules, respectively, compared to 6.7 +/- 1.7 joules and 6.0 +/- 1.5 joules for the 140-microF capacitor (P = 0.01 and P = 0.004, respectively). The mean leading edge voltages were higher, the pulse duration shorter, and the mean impedance lower for the 85-microF capacitor. The impedance was inversely related to the pulse duration and the voltage decay suggesting that, at least in part, the mechanism of improved defibrillation could be accounted for by the waveform electrical characteristics. There was an equal number of episodes of postshock bradyarrhythmias and tachyarrhythmias following discharges from each capacitor. Moreover, there was no relationship between the likelihood of these arrhythmias and either the initial voltage or the delivered current nor there was a higher number of episodes of postshock hypotension following the smaller capacitor discharges.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7491309

  9. Pacemaker, implanted cardiac defibrillator and irradiation: Management proposal in 2010 depending on the type of cardiac stimulator and prognosis and location of cancer; Pacemaker, defibrillateur et radiotherapie: propositions de conduite a tenir en 2010 en fonction du type de stimulateur cardiaque, du pronostic et du site du cancer

    Energy Technology Data Exchange (ETDEWEB)

    Lambert, P. [Service d' anesthesie reanimation, hopital Nord, centre hospitalier universitaire de Saint-etienne, 42055 Saint-etienne cedex 2 (France); Da Costa, A. [Service de cardiologie, hopital Nord, centre hospitalier universitaire de Saint-etienne, 42055 Saint-etienne cedex 2 (France); Marcy, P.Y. [Departement de radiologie, centre Antoine-Lacassagne, 33, avenue de Valombrose, 06189 Nice cedex 2 (France); Universite Nice Sophia-Antipolis, 33, avenue de Valombrose, 06189 Nice cedex 2 (France); Kreps, S. [Service de radiotherapie Corad, centre regional universitaire de cancerologie Henry-S.-Kaplan, hopital Bretonneau-2, CHU de Tours, boulevard Tonnelle, 37000 Tours (France); Angellier, G.; Marcie, S.; Bondiau, P.Y. [Universite Nice Sophia-Antipolis, 33, avenue de Valombrose, 06189 Nice cedex 2 (France); Departement de radiotherapie oncologie, centre CyberKnife, centre Antoine-Lacassagne, 33, avenue de Valombrose, 06189 Nice cedex 2 (France); Briand-Amoros, C. [Service de radiotherapie, hopital europeen Georges-Pompidou, 20, rue Leblanc, 75015 Paris (France); Thariat, J. [Universite Nice Sophia-Antipolis, 33, avenue de Valombrose, 06189 Nice cedex 2 (France); Departement de radiotherapie oncologie, centre CyberKnife, centre Antoine-Lacassagne, 33, avenue de Valombrose, 06189 Nice cedex 2 (France); IBDC CNRS UMR 6543, centre Antoine-Lacassagne, universite Sophia-Antipolis, 33, avenue de Valombrose, 06189 Nice cedex 2 (France)

    2011-06-15

    Ionizing radiation may interfere with electric components of pacemakers or implantable cardioverter defibrillators. The type, severity and extent of radiation damage to pacemakers, have previously been shown to depend on the total dose and dose rate. Over 300,000 new cancer cases are treated yearly in France, among which 60% are irradiated in the course of their disease. One among 400 of these patients has an implanted pacemaker or defibrillator. The incidence of pacemaker and implanted cardioverter defibrillator increases in an ageing population. The oncologic prognosis must be weighted against the cardiologic prognosis in a multidisciplinary and transversal setting. Innovative irradiation techniques and technological sophistications of pacemakers and implantable cardioverter-defibrillators (with the introduction of more radiosensitive complementary metal-oxide-semiconductors since 1970) have potentially changed the tolerance profiles. This review of the literature studied the geometric, dosimetric and radiobiological characteristics of the radiation beams for high energy photons, stereotactic irradiation, proton-therapy. Standardized protocols and radiotherapy optimization (particle, treatment fields, energy) are advisable in order to improve patient management during radiotherapy and prolonged monitoring is necessary following radiation therapy. The dose received at the pacemaker/heart should be calculated. The threshold for the cumulated dose to the pacemaker/implantable cardioverter-defibrillator (2 to 5 Gy depending on the brand), the necessity to remove/displace the device based on the dose-volume histogram on dosimetry, as well as the use of lead shielding and magnet are discussed. (authors)

  10. Single-coil and dual-coil defibrillator leads and association with clinical outcomes in a complete Danish nationwide ICD cohort

    DEFF Research Database (Denmark)

    Larsen, Jacob M; Hjortshøj, Søren P; Nielsen, Jens C;

    2016-01-01

    BACKGROUND: The best choice of defibrillator lead in patients with routine implantable cardioverter-defibrillator (ICD) is not settled. Traditionally, most physicians prefer dual-coil leads but the use of single-coil leads is increasing. OBJECTIVE: The purpose of this study was to compare clinical...... outcomes in patients with single- and dual-coil leads. METHODS: All 4769 Danish patients 18 years or older with first-time ICD implants from 2007 to 2011 were included from the Danish Pacemaker and ICD Register. Defibrillator leads were 38.9% single-coil leads and 61.1% dual-coil leads. The primary end...... point was all-cause mortality. Secondary end points were lowest successful energy at implant defibrillation testing, first shock failure in spontaneous arrhythmias, structural lead failure, and lead extraction outcomes. RESULTS: Single-coil leads were associated with lower all-cause mortality...

  11. Effects of drugs on defibrillation threshold%药物对除颤阈值的影响

    Institute of Scientific and Technical Information of China (English)

    黄震华

    2009-01-01

    Implantable cardioverter-defibrillator possesses vital value for preventing sudden cardiac death. For patients with already implantable cardioverter-defibrillator, some cardiovascular drugs especially the anti-arrhythmic ones are still inevitably needed. Some evidences showed that sotalol, and β-adrenergic receptor antagonists may decrease defibrillation threshold, and amiodarone, lidocaine, mexiletine, moracizine, verapamil may increase defibrillation threshold.%埋藏式心脏复律除颤器对于预防心源性猝死具有重要价值.对于已安装埋藏式心脏复律除颤器的病人,不可避免地仍需使用一些心血管药物,特别是抗心律失常药物.一些证据表明,索他洛尔、肾上腺素β受体阻滞药可降低除颤阈值,而胺碘酮、利多卡因、美西律、莫雷西嗪、维拉帕米等可提高除颤阈值.

  12. Optimizing defibrillation waveforms for ICDs.

    Science.gov (United States)

    Kroll, Mark W; Swerdlow, Charles D

    2007-04-01

    While no simple electrical descriptor provides a good measure of defibrillation efficacy, the waveform parameters that most directly influence defibrillation are voltage and duration. Voltage is a critical parameter for defibrillation because its spatial derivative defines the electrical field that interacts with the heart. Similarly, waveform duration is a critical parameter because the shock interacts with the heart for the duration of the waveform. Shock energy is the most often cited metric of shock strength and an ICD's capacity to defibrillate, but it is not a direct measure of shock effectiveness. Despite the physiological complexities of defibrillation, a simple approach in which the heart is modeled as passive resistor-capacitor (RC) network has proved useful for predicting efficient defibrillation waveforms. The model makes two assumptions: (1) The goal of both a monophasic shock and the first phase of a biphasic shock is to maximize the voltage change in the membrane at the end of the shock for a given stored energy. (2) The goal of the second phase of a biphasic shock is to discharge the membrane back to the zero potential, removing the charge deposited by the first phase. This model predicts that the optimal waveform rises in an exponential upward curve, but such an ascending waveform is difficult to generate efficiently. ICDs use electronically efficient capacitive-discharge waveforms, which require truncation for effective defibrillation. Even with optimal truncation, capacitive-discharge waveforms require more voltage and energy to achieve the same membrane voltage than do square waves and ascending waveforms. In ICDs, the value of the shock output capacitance is a key intermediary in establishing the relationship between stored energy-the key determinant of ICD size-and waveform voltage as a function of time, the key determinant of defibrillation efficacy. The RC model predicts that, for capacitive-discharge waveforms, stored energy is minimized

  13. Electrostriction Effects During Defibrillation

    CERN Document Server

    Fritz, Michelle M; Roth, Bradley J

    2011-01-01

    Background-The electric field applied to the heart during defibrillation causes mechanical forces (electrostriction), and as a result the heart deforms. This paper analyses the physical origin of the deformation, and how significant it is. Methods-We represent the heart as an anisotropic cylinder. This simple geometry allows us to obtain analytical solutions for the potential, current density, charge, stress, and strain. Results-Charge induced on the heart surface in the presence of the electric field results in forces that deform the heart. In addition, the anisotropy of cardiac tissue creates a charge density throughout the tissue volume, leading to body forces. These two forces cause the tissue to deform in a complicated manner, with the anisotropy suppressing radial displacements in favor of tangential ones. Quantitatively, the deformation of the tissue is small, although it may be significant when using some imaging techniques that require the measurement of small displacements. Conclusions-The anisotrop...

  14. 21 CFR 870.5325 - Defibrillator tester.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Defibrillator tester. 870.5325 Section 870.5325...) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Therapeutic Devices § 870.5325 Defibrillator tester. (a) Identification. A defibrillator tester is a device that is connected to the output of...

  15. Frequent Home Monitoring of ICD Is Effective to Prevent Inappropriate Defibrillator Shock Delivery

    Directory of Open Access Journals (Sweden)

    Paolo Bifulco

    2014-01-01

    Full Text Available Recently, in the context of telemedicine, telemonitoring services are gaining attention. They are offered, for example, to patients with implantable cardioverter defibrillators (ICDs. A major problem associated with ICD therapy is the occurrence of inappropriate shocks which impair patients’ quality of life and may also be arrhythmogenic. The telemonitoring can provide a valid support to intensify followup visits, in order to improve the prevention of inappropriate defibrillator shock, thus enhancing patient safety. Inappropriate shock generally depends on atrial fibrillation, supraventricular tachycardia, and abnormal sensing (such as those caused by electromagnetic interferences. As a practical example, an unusual case of an ICD patient who risked an inappropriate shock while taking a shower is reported. Continuous remote telemonitoring was able to timely warn cardiologist via GSM-SMS, who were able to detect improper sensing examining the intracardiac electrogram via Web. Patient was promptly contacted and warned to not further come in contact with the hydraulic system and any electrical appliance to prevent an inappropriate defibrillator shock. This demonstrates the effectiveness and usefulness of continuous remote telemonitoring in supporting ICD patients.

  16. AED (Automated External Defibrillator) Programs: Questions and Answers

    Science.gov (United States)

    ... live. What is an AED ? The automated external defibrillator ( AED ) is a computerized medical device. An AED ... AED or another defibrillation device (semiautomatic or manual defibrillator). The AHA also supports placing AEDs in targeted ...

  17. Clinical and psychological impact of prophylactic implantable cardioverter-defibrillators in a community heart failure population.

    LENUS (Irish Health Repository)

    Arnous, S

    2012-02-01

    AIMS: ICD implantation for primary prevention of sudden cardiac death in patients with left ventricular systolic dysfunction (ejection fraction <\\/= 35%) has increased since the publication of the SCD-HEFT and MADIT-II data. The aim of this study is to examine the effectiveness and safety of prophylactic ICD use in a community heart failure population and to assess the impact on patient\\'s quality of life. METHODS AND RESULTS: Seventy-one ICDs were inserted between the years 2002 and 2006. The mean follow-up from time of insertion was 24 +\\/- 11 months. Eighteen patients (25%) had potentially life-saving therapy. Seven (10%) patients received inappropriate shocks. Complications were encountered in five patients (7%). CONCLUSION: In a community heart failure population, prophylactic ICD implantation is associated with a high incidence of life-saving therapy, a low complication rate and a high level of tolerability. These data indicate translation of clinical trial benefits to the general heart failure population.

  18. Trajectories of Patient-Reported Health Status in Patients With an Implantable Cardioverter Defibrillator

    DEFF Research Database (Denmark)

    Mastenbroek, Mirjam H; Denollet, Johan; Versteeg, Henneke;

    2015-01-01

    failure, ICD shock, psychotropic medication, negative affectivity, and type D personality were identified as independent determinants of poorer physical health status. For mental health status, 6 trajectories were identified. Younger age, low educational level, symptomatic heart failure, renal failure......, no use of ACE inhibitors, psychotropic medication, negative affectivity, and type D personality were identified as independent determinants of poorer mental health status. In conclusion, the population with an ICD seems to be heterogeneous in terms of patient-reported physical and mental health status....... Patients with an ICD who present with poor health status and a distressed personality profile should be timely identified and monitored as they may benefit from cardiac rehabilitation in combination with behavioral intervention....

  19. Long-term mortality risk in patients with an implantable cardioverter-defibrillator

    DEFF Research Database (Denmark)

    Hoogwegt, Madelein T; Theuns, Dominic A M J; Pedersen, Susanne S.;

    2014-01-01

    .9)). The impact of heart rate and QRS duration on time to all-cause mortality was separately assessed with Cox proportional hazard regression analysis, adjusting for clinical factors and symptoms of depression and anxiety. RESULTS: Mean (SD) heart rate was 68.0 ± 13.3 bpm and mean QRS duration was 130.9 ± 36.9 ms....... Heart rate of ≥80 bpm was associated with increased risk of mortality (HR=1.86; 95% CI=1.15-3.00; p=.011) in unadjusted analysis. In adjusted analyses, this relationship remained significant both with depression (HR=1.86, 95% CI=1.12-3.09; p=.017) and anxiety (HR=1.82, 95% CI=1.10-3.03; p=.021...

  20. Coping with Trauma and Stressful Events As a Patient with an Implantable Cardioverter-Defibrillator

    Science.gov (United States)

    ... LIBRARY Hello, Guest! My alerts Sign In Join Facebook Twitter Home About this Journal Editorial Board General Statistics Circulation Cover Doodle → Blip the Doodle Go Red For Women's Issue Information for Advertisers Author Reprints Commercial Reprints Customer Service and Ordering ...

  1. Poor perceived social support in implantable cardioverter defibrillator (ICD) patients and their partners

    DEFF Research Database (Denmark)

    Pedersen, Susanne S.; Spinder, Helle; Erdman, Ruud A M;

    2009-01-01

    Social support is a known buffer of psychological distress and has also been shown to influence adverse medical outcomes.......Social support is a known buffer of psychological distress and has also been shown to influence adverse medical outcomes....

  2. Effects of an alert system on implantable cardioverter defibrillator-related anxiety

    DEFF Research Database (Denmark)

    Duru, Firat; Dorian, Paul; Favale, Stefano;

    2010-01-01

    failing to receive needed therapy for the same reason. New devices include programmable vibrating patient notifiers (PN), which, by warning patients of a possible device dysfunction, might lower device-related anxiety. PAtient NOtifier feature for Reduction of Anxiety: a Multicentre ICD study (PANORAMIC......) is a multicentre, randomized, clinical trial designed to examine the effects of the awareness of an active vibrating alert system on device-related anxiety....

  3. The gulf implantable cardioverter-defibrillator registry: Rationale, methodology, and implementation

    Directory of Open Access Journals (Sweden)

    Alawi A Alsheikh-Ali

    2015-01-01

    Conclusions: Gulf ICD is the first prospective, observational, multi-center, and multinational study of the characteristics and, the outcomes of patients receiving ICDs in the Arab Gulf region. The study will provide valuable insights into the utilization of and outcomes related to ICD therapy in the Gulf region.

  4. My Child Needs or Has an Implantable Cardioverter-Defibrillator: What Should I Do?

    Science.gov (United States)

    ... it is important to provide open, honest, and age-appropriate information to provide the tools for adaptation. You can ... 502 Boston, MA 02118 email: circ@circulationjournal.org Information for: Advertisers Subscribers Subscriber ... National Center 7272 Greenville Ave. Dallas, TX 75231 Customer Service 1-800-AHA-USA-1 1-800- ...

  5. Low disease prevalence and inappropriate implantable cardioverter defibrillator shock rate in Brugada syndrome

    DEFF Research Database (Denmark)

    Holst, Anders Gaarsdal; Jensen, Henrik Kjærulf; Eschen, Ole;

    2012-01-01

    Brugada syndrome (BrS) is an inherited channelopathy that predisposes to malignant ventricular arrhythmias and thereby syncope and sudden cardiac death. Prior studies characterizing BrS patients have used highly selected referral populations from tertiary centres and prevalence estimates have bee...

  6. Use of Automated External Defibrillators

    Energy Technology Data Exchange (ETDEWEB)

    Gregory K Christensen

    2009-02-01

    In an effort to improve survival from cardiac arrest, the American Heart Association (AHA) has promoted the Chain of Survival concept, describing a sequence of prehospital steps that result in improved survival after sudden cardiac arrest. These interventions include immediate deployment of emergency medical services, prompt cardiopulmonary resuscitation, early defibrillation when indicated, and early initiation of advanced medical care. Early defibrillation has emerged as the most important intervention with survival decreasing by 10% with each minute of delay in defibrillation. Ventricular Fibrillation (VF) is a condition in which there is uncoordinated contraction of the heart cardiac muscle of the ventricles in the heart, making them tremble rather than contract properly. VF is a medical emergency and if the arrhythmia continues for more than a few seconds, blood circulation will cease, and death can occur in a matter of minutes. During VF, contractions of the heart are not synchronized, blood flow ceases, organs begin to fail from oxygen deprivation and within 10 minutes, death will occur. When VF occurs, the victim must be defibrillated in order to establish the heart’s normal rhythm. On average, the wait for an ambulance in populated areas of the United States is about 11 minutes. In view of these facts, the EFCOG Electrical Safety Task Group initiated this review to evaluate the potential value of deployment and use of automated external defibrillators (AEDs) for treatment of SCA victims. This evaluation indicates the long term survival benefit to victims of SCA is high if treated with CPR plus defibrillation within the first 3-5 minutes after collapse. According to the American Heart Association (AHA), survival rates as high as 74% are possible if treatment and defibrillation is performed in the first 3 minutes. In contrast survival rates are only 5% where no AED programs have been established to provide prompt CPR and defibrillation. ["CPR statistics

  7. Mexiletine as an adjunctive therapy to amiodarone reduces the frequency of ventricular tachyarrhythmia events in patients with an implantable defibrillator.

    Science.gov (United States)

    Gao, Dongsheng; Van Herendael, Hugo; Alshengeiti, Lamia; Dorian, Paul; Mangat, Iqwal; Korley, Victoria; Ahmad, Kamran; Golovchiner, Gregory; Aves, Theresa; Pinter, Arnold

    2013-08-01

    The most effective pharmacological management of frequent ventricular tachyarrhythmia events in patients with an implantable defibrillator who failed or did not tolerate amiodarone is unknown. The aim of this retrospective cohort study was to assess the efficacy and tolerability of mexiletine in such patients. The patients served as self-controls. The number of treated ventricular tachyarrhythmia episodes (primary outcome); mortality, shocks from the defibrillator, and electrical storm events (secondary outcomes) during mexiletine therapy was compared with a matched duration of observation just before initiating mexiletine in 29 patients who were treated with a median dose of 300 mg/d of mexiletine and were followed for a median of 12 months. None of the patients had to stop mexiletine due to side effect. There was a significant reduction in the incidence of ventricular tachycardia/fibrillation episodes (median 2 vs. 12 events, P = 0.001) and shocks (median 0 vs. 2 events, P = 0.003) in the first 3 months of treatment, but long-term efficacy was only observed among patients who continued amiodarone therapy. In conclusion, mexiletine, when added to amiodarone in case of amiodarone inefficacy, reduces ventricular tachycardia/fibrillation events and appropriate therapies in patients with an implantable cardioverter defibrillator. A randomized trial should validate the efficacy and safety of mexiletine as an adjunctive therapy to amiodarone. PMID:23609328

  8. A second defibrillator chest patch electrode will increase implantation rates for nonthoracotomy defibrillators.

    Science.gov (United States)

    Solomon, A J; Swartz, J F; Rodak, D J; Moore, H J; Hannan, R L; Tracy, C M; Fletcher, R D

    1996-09-01

    Nonthoracotomy defibrillator systems can be implanted with a lower morbidity and mortality, compared to epicardial systems. However, implantation may be unsuccessful in up to 15% of patients, using a monophasic waveform. It was the purpose of this study to prospectively examine the efficacy of a second chest patch electrode in a nonthoracotomy defibrillator system. Fourteen patients (mean age 62 +/- 11 years, ejection fraction = 0.29 +/- 0.12) with elevated defibrillation thresholds, defined as > or = 24 J, were studied. The initial lead system consisted of a right ventricular electrode (cathode), a left innominate vein, and subscapular chest patch electrode (anodes). If the initial defibrillation threshold was > or = 24 J, a second chest patch electrode was added. This was placed subcutaneously in the anterior chest (8 cases), or submuscularly in the subscapular space (6 cases). This resulted in a decrease in the system impedance at the defibrillation threshold, from 72.3 +/- 13.3 omega to 52.2 +/- 8.6 omega. Additionally, the defibrillation threshold decreased from > or = 24 J, with a single patch, to 16.6 +/- 2.8 J with two patches. These changes were associated with successful implantation of a nonthoracotomy defibrillator system in all cases. In conclusion, the addition of a second chest patch electrode (using a subscapular approach) will result in lower defibrillation thresholds in patients with high defibrillation thresholds, and will subsequently increase implantation rates for nonthoracotomy defibrillators.

  9. 植入除颤器患者的双腔起搏或心室后备起搏双腔和VVI植入型除颤器(DAVID)试验%Dual-Chamber Pacing or Ventricular Backup Pacing in Patients With an Implantable Defibrillator The Dual Chamber and VVI Implantable Defibrillator (DAVID) Trial

    Institute of Scientific and Technical Information of China (English)

    The DAVID Trial Investigators

    2003-01-01

    @@ 背景:有后备心室起搏的植入型心律转复除颤器(implant-able cardioverter defibrillator,ICD)可使有危及生命的室性心律失常患者的生存率提高.最新的植入型ICD绝大多数具有双腔起搏治疗功能.在该人群,死亡率的最常见原因是充血性心力衰竭.

  10. Electrical Heart Defibrillation with Ion Channel Blockers

    Science.gov (United States)

    Feeney, Erin; Clark, Courtney; Puwal, Steffan

    Heart disease is the leading cause of mortality in the United States. Rotary electrical waves within heart muscle underlie electrical disorders of the heart termed fibrillation; their propagation and breakup leads to a complex distribution of electrical activation of the tissue (and of the ensuing mechanical contraction that comes from electrical activation). Successful heart defibrillation has, thus far, been limited to delivering large electrical shocks to activate the entire heart and reset its electrical activity. In theory, defibrillation of a system this nonlinear should be possible with small electrical perturbations (stimulations). A successful algorithm for such a low-energy defibrillator continues to elude researchers. We propose to examine in silica whether low-energy electrical stimulations can be combined with antiarrhythmic, ion channel-blocking drugs to achieve a higher rate of defibrillation and whether the antiarrhythmic drugs should be delivered before or after electrical stimulation has commenced. Progress toward a more successful, low-energy defibrillator will greatly minimize the adverse effects noted in defibrillation and will assist in the development of pediatric defibrillators.

  11. Implantable defibrillator lead extraction with optimized standard extraction techniques

    Institute of Scientific and Technical Information of China (English)

    Xian-Ming Chu; Xue-Bin Li; Ping Zhang; Yi An; Jiang-Bo Duan; Long Wang; Ding Li; Bing Li; Ji-Hong Guo

    2013-01-01

    Background Implantable cardioverter-defibrillator (ICD) leads might not be extracted especially in developing countries because of the high cost and lack of specialized tools. We aimed to evaluate transvenous extraction of ICD leads using optimized standard techniques. Methods We prospectively analyzed clinical characteristics, optimized extraction techniques and the feasibility of extraction for 40 patients (33 males; mean age 47.9 ± 16.1 years) with 42 ICD leads. Results Complete procedural success rate was 95.2% (40/42), and the clinical success rate was 97.6% (41/42). One ICD lead required cardiothoracic surgery. Minor complications occurred in three cases (7.5%), and no major complications or death occurred. Locking stylets were used to extract most leads (34, 81.0%) and almost half of the leads (20, 47.6%) required mechanical dilatation to free fibrotic adhesions; these leads had been implanted for a longer period of time than the others (43.7 ± 18.2 vs. 18.4 ± 13.4 months, P < 0.05). Three-quarters of the leads (30, 71.4%) were extracted with locking stylets plus manual traction (12, 28.6%), or mechanical dilatation with counter-traction (18, 42.8%) by the superior vena cava approach and one-quarter of the leads (11, per lead. Linear regression analysis showed that the extraction time was significantly correlated with implant duration (r = 0.70, P < 0.001). optimized procedure for transvenous extraction of ICD leads provides a practical and low-cost method for standard procedures.

  12. Explant cultures of human colon

    DEFF Research Database (Denmark)

    Autrup, Herman; Barrett, L.A.; Jackson, F.E.;

    1978-01-01

    Human colonic epithelium has been cultured as explants in a chemically defined medium for periods of 1 to 20 days. The viability of the explants was shown by the preservation of the ultrastructural features of the colonic epithelial cells and by active incorporation of radioactive precursors...... into cellular DNA and protein. A progressive decrease in the number of goblet cells, decrease in the depth of the crypts, and a change from a columnar to a cuboidal epithelium were observed. After 20 days in culture the colonic mucosa consisted of a single layer of cuboidal epithelial cells and a few glands....... The ability to maintain colonic mucosa in culture was subject to both intra- and interindividual variation. Cultured human colonic mucosa also activated a chemical procarcinogen, benzo[a]pyrene, into metabolites which bound to cellular DNA. A 100-fold interindividual variation in this binding was observed....

  13. Defibrillation lead placement using a transthoracic transatrial approach in a case without transvenous access due to lack of the right superior vena cava.

    Science.gov (United States)

    Otsuka, Yosuke; Okamura, Hideo; Sato, Syunsuke; Nakajima, Ikutaro; Ishibashi, Kohei; Miyamoto, Kouji; Noda, Takashi; Aiba, Takeshi; Kamakura, Shiro; Kobayashi, Junjiro; Yasuda, Satoshi; Ogawa, Hisao; Kusano, Kengo

    2015-06-01

    A 65-year-old woman with a history of syncope was diagnosed with hypertrophic cardiomyopathy. She had previously undergone mastectomy of the left breast owing to breast cancer. Holter electrocardiogram (ECG) and monitor ECG revealed sick sinus syndrome (Type II) and non-sustained ventricular tachycardia. Sustained ventricular tachycardia and ventricular fibrillation were induced in an electrophysiological study. Although the patient was eligible for treatment with a dual chamber implantable cardioverter defibrillator (ICD), venography revealed lack of the right superior vena cava (R-SVC). Lead placement from the left subclavian vein would have increased the risk of lymphedema owing to the patient׳s mastectomy history. Consequently, the defibrillation lead was placed in the right ventricle by direct puncture of the right auricle through the tricuspid valve. The atrial lead was sutured to the atrial wall, and the postoperative course was unremarkable. Defibrillation lead placement using a transthoracic transatrial approach can be an alternative method in cases where a transvenous approach for lead placement is not feasible.

  14. Insulation Failure of the Linox Defibrillator Lead: A Case Report and Retrospective Review of a Single Center Experience.

    Science.gov (United States)

    Howe, Andrew J; McKeag, Nicholas A; Wilson, Carol M; Ashfield, Kyle P; Roberts, Michael J

    2015-06-01

    Implantable cardioverter defibrillator (ICD) lead insulation failure and conductor externalization have been increasingly reported. The 7.8F silicon-insulated Linox SD and Linox S ICD leads (Biotronik, Berlin, Germany) were released in 2006 and 2007, respectively, with an estimated 85,000 implantations worldwide. A 39-year-old female suffered an out-of-hospital ventricular fibrillation (VF) arrest with successful resuscitation. An ICD was implanted utilizing a single coil active fixation Linox(Smart) S lead (Biotronik, Berlin, Germany). A device-triggered alert approximately 3 years after implantation confirmed nonphysiological high rate sensing leading to VF detection. A chest X-ray showed an abnormality of the ICD lead and fluoroscopic screening confirmed conductor externalization proximal to the defibrillator coil. In view of the combined electrical and fluoroscopic abnormalities, urgent lead extraction and replacement were performed. A review of Linox (Biotronik) and Vigila (Sorin Group, Milan, Italy) lead implantations within our center (n = 98) identified 3 additional patients presenting with premature lead failure, 2 associated with nonphysiological sensed events and one associated with a significant decrease in lead impedance. All leads were subsequently removed and replaced. This case provides a striking example of insulation failure affecting the Linox ICD lead and, we believe, is the first to demonstrate conductor externalization manifesting both electrical and fluoroscopic abnormalities. PMID:25711237

  15. Infarct size and recurrence of ventricular arrhythmias after defibrillator implantation

    Energy Technology Data Exchange (ETDEWEB)

    Sutter, J. de; Tavernier, R.; Kazmierckzak, J.; Buyzere, M. de; Clement, D.L. [Department of Cardiology, University Hospital Gent, Gent (Belgium); Wiele, C. van de; Dierckx, R.A. [Department of Nuclear Medicine, University Hospital Gent (Belgium); Jordaens, L. [Thoraxcenter, University Hospital Rotterdam-Dijkzigt (Netherlands)

    2000-07-01

    Infarct size as determined by perfusion imaging is an independent predictor of mortality after implantable cardioverter defibrillator (ICD) implantation in patients with coronary artery disease (CAD) and life-threatening ventricular arrhythmias (VA). However, its value as a predictor of VA recurrence and hospitalisation after ICD implantation is unknown. Therefore, the objective of this study was to evaluate whether infarct size as determined by perfusion imaging can help to identify patients who are at high risk for recurrence of VA and hospitalisation after ICD implantation. We studied 56 patients with CAD and life-threatening VA. Before ICD implantation, all patients underwent a uniform study protocol including a thallium-201 stress-redistribution perfusion study. A defect score as a measurement of infarct size was calculated using a 17-segment 5-point scoring system. Study endpoints during follow-up were documented episodes of appropriate anti-tachycardia pacing and/or shocks for VA and cardiac hospitalisation for electrical storm (defined as three or more appropriate ICD interventions within 24 h), heart failure or angina. After a mean follow-up of 470{+-}308 days, 22 patients (39%) had recurrences of VA. In univariate analysis, predictors for recurrence were: (a) ventricular tachycardia (VT) as the initial presenting arrhythmia (86% vs 59% for patients without ICD therapy, P=0.04), (b) treatment with {beta}-blockers (36% vs 68%, P=0.03) and (c) a defect score (DS) {>=}20 (64% vs 32%, P=0.03). In multivariate analysis, VT as the presenting arrhythmia ({chi}2=5.51, P=0.02) and a DS {>=}20 ({chi}2=4.22, P=0.04) remained independent predictors. Cardiac hospitalisation was more frequent in patients with a DS {>=}20 (44% vs 13% for patients with DS <20, P=0.015) and this was particularly due to more frequent hospitalisations for electrical storm (24% vs 3% for patients with DS<20, P=0.037). The extent of scarring determined by perfusion imaging can separate

  16. The association between biventricular pacing and cardiac resynchronization therapy-defibrillator efficacy when compared with implantable cardioverter defibrillator on outcomes and reverse remodelling

    DEFF Research Database (Denmark)

    Ruwald, Anne-Christine; Kutyifa, Valentina; Ruwald, Martin H;

    2015-01-01

    : Using Kaplan-Meier plots, we estimated the threshold of BIV pacing percentage needed for CRT-D to be superior to ICD on the end-point of heart failure (HF) or death in 1219 left bundle branch block (LBBB) patients in the MADIT-CRT trial. Patients were censored at the time of crossover. In multivariable...

  17. 75 FR 70015 - External Defibrillators; Public Workshop

    Science.gov (United States)

    2010-11-16

    ... cardiac arrest can cause death. External defibrillators are important, life-saving devices. However, over... life-saving devices designed to restore normal heart rhythms following sudden cardiac arrest. Each year, nearly 300,000 Americans collapse from sudden cardiac arrest. In sudden cardiac arrest, the...

  18. Defibrillator-Induced Tricuspid Abscess Presenting as Diabetic Ketoacidosis and Wound Ulceration.

    Science.gov (United States)

    Khan, Rafay; Arshed, Sabrina; Ahmed, Amar; Sen, Shuvendu; Yousif, Abdalla

    2016-01-01

    Right-sided endocarditis is predominantly seen in patients with a history of intravenous drug abuse. However, it is well shown in the literature to be associated with patients containing foreign bodies such as pacemakers, central venous lines, and in those with congenital heart disease. In patients with pacemaker leads and in those with automatic implantable cardioverter defibrillators (AICDs), it is important to suspect foreign body infection when there are signs and indications of bacteremia. When these leads become infected, they can spread the infection to the tricuspid valve resulting in vegetations. The proper management is removal of the infected lead and foreign body along with a prolonged course of antibiotics. However, it is unusual and a relatively rare entity to see foreign body infection resulting from a wound ulcer resulting in not only endocarditis but also abscess formation on the tricuspid valve. Here we report a case of a 60-year-old male with recent AICD placement presenting as diabetic ketoacidosis due to tricuspid abscess formation as a result of a foot ulcer. PMID:26668682

  19. Attrition and Adherence in a Web-Based Distress Management Program for Implantable Cardioverter Defibrillator Patients (WEBCARE): Randomized Controlled Trial

    DEFF Research Database (Denmark)

    Habibovic, M.; Cuijpers, P.; Alings, M.;

    2014-01-01

    . Conclusions: Current findings underline the importance of focusing on adherence and dropout, as this remains a significant problem in behavioral Web-based trials. Examining possibilities to address barriers indicated by patients might enhance treatment engagement and improve patient outcomes....

  20. Incidence of ineffective safety margin testing (J) and efficacy of routine subcutaneous array insertion during implantable cardioverter defibrillator implantation.

    Science.gov (United States)

    Ohlow, Marc-Alexander; Roos, Marcus; Lauer, Bernward; Geller, J Christoph

    2016-01-01

    The purpose of this study was to assess (1) the incidence of safety margin testing J (SMT) and (2) the efficacy/safety of routinely adding a subcutaneous array (SQA) (Medtronic 6996SQ) for these patients. Patients with SMT smaller than a 10-J safety margin from maximum output were considered to have very high readings and underwent SQA insertion. These patients were compared with the rest of the patients who had acceptable SMT (≥10 J). A total of 616 patients underwent ICD implantation during the analysis period. Of those, 16 (2.6%) had SMT J. By univariate analysis, younger age, and non-ischemic cardiomyopathy, were all significant predictors of SMT J (p J; p J occur in about 2.6% of patients undergoing ICD implantation. SQA insertion corrects this problem without procedural/mid-term complications.

  1. Relation of symptomatic heart failure and psychological status to persistent depression in patients with implantable cardioverter-defibrillator

    DEFF Research Database (Denmark)

    Pedersen, Susanne S.; Hoogwegt, Madelein T; Jordaens, Luc;

    2011-01-01

    months after implantation. Information on ICD therapies was obtained by device interrogation. At 3 months after implantation, 52 (14%) of the 386 patients had persistent depression (HADS cutoff ≥8 before and 3 months after implantation). Heart failure (odds ratio [OR] 2.29; 95% confidence interval [CI] 1...

  2. Small bowel capsule endoscopy in patients with cardiac pacemakers and implantable cardioverter defibrillators: Outcome analysis using telemetry review

    OpenAIRE

    2012-01-01

    AIM: To determine if there were any interactions between cardiac devices and small bowel capsules secondary to electromagnetic interference (EMI) in patients who have undergone small bowel capsule endoscopy (SBCE).

  3. Risk of pacemaker or implantable cardioverter defibrillator after radiotherapy for early-stage breast cancer in Denmark, 1982-2005

    DEFF Research Database (Denmark)

    Rehammar, Jens Christian; Johansen, Jens Brock; Jensen, Maj-Britt;

    2016-01-01

    (RT). MATERIAL AND METHODS: All women treated for early-stage BC in Denmark from 1982 to 2005 were identified from the Danish Breast Cancer Cooperative Group. By record linkage to the Danish Pacemaker and ICD Registry information was retrieved on CIED implants subsequent to RT. Standardized incidence...

  4. Reliability systems for implantable cardiac defibrillator batteries

    Energy Technology Data Exchange (ETDEWEB)

    Takeuchi, E.S. [Wilson Greatbatch Ltd., Clarence, NY (United States)

    1995-03-01

    The reliability of the power sources used in implantable cardiac defibrillators is critical due to the life-saving nature of the device. Achieving a high reliability power source depends on several systems functioning together. Appropriate cell design is the first step in assuring a reliable product. Qualification of critical components and of the cells using those components is done prior to their designation as implantable grade. Product consistency is assured by control of manufacturing practices and verified by sampling plans using both accelerated and real-time testing. Results to date show that lithium/silver vanadium oxide cells used for implantable cardiac defibrillators have a calculated maximum random failure rate of 0.005% per test month. (orig.)

  5. Reliability systems for implantable cardiac defibrillator batteries

    Science.gov (United States)

    Takeuchi, Esther S.

    The reliability of the power sources used in implantable cardiac defibrillators is critical due to the life-saving nature of the device. Achieving a high reliability power source depends on several systems functioning together. Appropriate cell design is the first step in assuring a reliable product. Qualification of critical components and of the cells using those components is done prior to their designation as implantable grade. Product consistency is assured by control of manufacturing practices and verified by sampling plans using both accelerated and real-time testing. Results to date show that lithium/silver vanadium oxide cells used for implantable cardiac defibrillators have a calculated maximum random failure rate of 0.005% per test month.

  6. Legal aspects in implantable defibrillator extraction.

    Science.gov (United States)

    D'Ovidio, C; Costantini, S; Vellante, P; Carnevale, A

    2013-10-01

    At the Institute of Legal Medicine in Chieti, a case of iatrogenic superior vena cava perforation was observed during laser extraction of an infected biventricular implantable cardiac defibrillator. The presentation of this particular case represented a starting point for studying the occurrence of similar complications in literature, since their knowledge and understanding should induce resolution of any organisation problems, aid in increasing physicians' training and impose the availability of cardiac surgeons during such operations.

  7. 采用植入式除颤器预防非缺血性心肌病患者发生死亡随机对照试验汇总分析%Implantable Defibrillators for the Prevention of Mortality in Patients With Nonischemic Cardiomyopathy A Meta-analysis of Randomized Controlled Trials

    Institute of Scientific and Technical Information of China (English)

    Akshay S. Desai; James C. Fang; William H. Maisel; 顾佳

    2005-01-01

    @@ 背景:植入式心脏复律除颤器(implantable cardioverter defibrillator,ICD)能有效预防(包括一级预防和二级预防)心脏射血分数(ejection fraction)下降的陈旧性心肌梗死患者发生心源性猝死.但是,目前仍缺乏证据肯定该疗法能提高非缺血性心肌病(nonischemic cardiomyopathy,NICM)患者的生存率.

  8. Nationwide Fluoroscopic Screening of Recalled Riata Defibrillator Leads in Denmark

    DEFF Research Database (Denmark)

    Larsen, Jacob Mosgaard; Riahi, Sam; Nielsen, Jens C.;

    2013-01-01

    The natural history of insulation defects with inside-out conductor externalization in recalled St Jude Medical Riata defibrillator leads is not well understood.......The natural history of insulation defects with inside-out conductor externalization in recalled St Jude Medical Riata defibrillator leads is not well understood....

  9. A study to improve communication between clinicians and patients with advanced heart failure: methods and challenges behind the working to improve discussions about defibrillator management trial.

    Science.gov (United States)

    Goldstein, Nathan E; Kalman, Jill; Kutner, Jean S; Fromme, Erik K; Hutchinson, Mathew D; Lipman, Hannah I; Matlock, Daniel D; Swetz, Keith M; Lampert, Rachel; Herasme, Omarys; Morrison, R Sean

    2014-12-01

    We report the challenges of the Working to Improve Discussions About Defibrillator Management trial, our novel, multicenter trial aimed at improving communication between cardiology clinicians and their patients with advanced heart failure (HF) who have implantable cardioverter defibrillators (ICDs). The study objectives are (1) to increase ICD deactivation conversations, (2) to increase the number of ICDs deactivated, and (3) to improve psychological outcomes in bereaved caregivers. The unit of randomization is the hospital, the intervention is aimed at HF clinicians, and the patient and caregiver are the units of analysis. Three hospitals were randomized to usual care and three to intervention. The intervention consists of an interactive educational session, clinician reminders, and individualized feedback. We enroll patients with advanced HF and their caregivers, and then we regularly survey them to evaluate whether the intervention has improved communication between them and their HF providers. We encountered three implementation barriers. First, there were institutional review board concerns at two sites because of the palliative nature of the study. Second, we had difficulty in creating entry criteria that accurately identified an HF population at high risk of dying. Third, we had to adapt our entry criteria to the changing landscape of ventricular assist devices and cardiac transplant eligibility. Here we present our novel solutions to the difficulties we encountered. Our work has the ability to enhance conduct of future studies focusing on improving care for patients with advanced illness.

  10. Oxygen dynamics in choanosomal sponge explants

    NARCIS (Netherlands)

    Hoffmann, F.; Larsen, O.; Rapp, H.T.; Osinga, R.

    2005-01-01

    Oxygen microprofiles were measured over the boundary layer and into the tissue of 10-day-old cultivated tissue fragments (explants of 2-4 cm 3) from the choanosome of the cold-water sponge Geodia barretti with oxygen-sensitive Clark-type microelectrodes. At this time of cultivation, the surface tiss

  11. Primärprävention des plötzlichen Herztodes mit implantierbaren Cardioverter-Defibrillatoren - Vernünftig oder MADIT?

    Directory of Open Access Journals (Sweden)

    Steinwender C

    2004-01-01

    Full Text Available Mehrere in jüngerer Zeit publizierte Studien belegen die Überlegenheit des implantierbaren Cardioverter-Defibrillators gegenüber einer medikamentösen Therapie in der Primärprävention des plötzlichen Herztodes. Die Kollektive dieser Untersuchungen bestanden aus den bekannten Hochrisikopatienten im Postinfarktstadium mit höher- bis höchstgradig eingeschränkter Linksventrikelfunktion. MADIT II war die erste Studie, die auf eine aufwendige rhythmologische Risikostratifizierung verzichtete und dennoch in sämtlichen Subgruppen einen therapeutischen Benefit durch die Defibrillatortherapie nachwies. Die sich hierdurch ergebende Evidenz fand rasch Eingang in die Richtlinien der großen kardiologischen Gesellschaften. Ungelöst bleiben vorerst zwei große Probleme: 1. die Frage der Finanzierung einer Umsetzung dieser Richtlinien; 2. die weitere Strategie zur effektiven Primärprävention des plötzlichen Herztodes, da durch oben genannte Studien nur ein kleiner Prozentsatz der möglichen künftigen Opfer abgedeckt wird. Als Lösungsansatz bietet sich eine kostengünstige, auf die Erfordernisse der Primärprävention abgestimmte Defibrillator-Technologie an, die gemeinsam mit einer Vereinfachung der Implantationsprozedur die Kosteneffektivität zugunsten der Prophylaxe beeinflussen kann. Weiters müssen zusätzlich große Anstrengungen zur Identifizierung von zukünftigen Opfern des plötzlichen Herztodes vor ihrer ersten Arrhythmie-Episode unternommen werden.

  12. [ILCOR recommendation on signage of automated external defibrillators (AEDs)].

    Science.gov (United States)

    Truhlár, A

    2010-05-01

    Early defibrillation is a determinant of survival in both out-of-hospital and in-hospital cardiac arrests from ventricular fibrillation and pulseless ventricular tachycardia. The review summarizes importance of early defibrillation with automated external defibrillators (AED) and presents the International Liaison Committee on Resuscitation (ILCOR) recommendation for universal AED sign. The aim of the recommendation is to unify the AED signs worldwide and to spread the knowledge of this. The public in general, but healthcare professionals particularly, should be able to recognize AED location and use the device immediately in case of cardiac arrest.

  13. Genoplivning med automatisk ekstern defibrillator på hospital

    DEFF Research Database (Denmark)

    Løfgren, Bo; Wahlgreen, Claus; Hoffmann, Anne Mette;

    2009-01-01

    Early defibrillation is a determinant of survival in cardiac arrest. We report a Danish case of successful in-hospital resuscitation using an automated external defibrillator (AED). This case illustrates important aspects of implementation of in-hospital use of an AED, i.e. location of the AED......, education of the staff, systematic registration and data collection and technical aspects of AED use. If in-hospital AED implementation is carefully executed, its use may provide a safe and effective way of obtaining early defibrillation. Udgivelsesdato: 2009-Jan-26...

  14. Impact of implantable defibrillators and resynchronization therapy on outcome in patients with left ventricular dysfunction--a meta-analysis

    DEFF Research Database (Denmark)

    Abdulla, Jawdat; Haarbo, Jens; Køber, Lars;

    2006-01-01

    BACKGROUND: The clinical benefits of cardiac resynchronization therapy (CRT) and primary prophylactic implantable cardioverter defibrillator (ICD) in patients with left ventricular systolic dysfunction (LVSD) are debated. OBJECTIVE: To evaluate by a meta-analysis the effect of CRT and prophylactic...... ICD therapy in patients with LVSD. METHODS: Eligible trials evaluating the effect of CRT vs. no-CRT, ICD vs. no-ICD and adding ICD to CRT vs. no-ICD were selected and meta-analyzed. The outcomes were: all cause mortality, cardiac mortality, hospitalization for heart failure and change in exercise...... tolerance and New York Heart Association class. RESULTS: Implantation of CRT reduced all cause mortality odds ratio (OR) = 0.73 (0.60-0.89) p = 0.002 and hospitalization for heart failure OR = 0.60 (0.45, 0.80) p = 0.001, increased peak oxygen consumption by 1.77 (0.32-3.22) ml/kg/min p = 0.017 and improved...

  15. Many People with Implantable Defibrillators Can Participate in Vigorous Sports

    Science.gov (United States)

    ... people with implantable defibrillators can participate in vigorous sports May 20, 2013 Categories: Heart News Study Highlights : ... may safely participate in a number of vigorous sports. The study challenges some current science recommendations advising ...

  16. Patient ECG recording control for an automatic implantable defibrillator

    Science.gov (United States)

    Fountain, Glen H. (Inventor); Lee, Jr., David G. (Inventor); Kitchin, David A. (Inventor)

    1986-01-01

    An implantable automatic defibrillator includes sensors which are placed on or near the patient's heart to detect electrical signals indicative of the physiology of the heart. The signals are digitally converted and stored into a FIFO region of a RAM by operation of a direct memory access (DMA) controller. The DMA controller operates transparently with respect to the microprocessor which is part of the defibrillator. The implantable defibrillator includes a telemetry communications circuit for sending data outbound from the defibrillator to an external device (either a patient controller or a physician's console or other) and a receiver for sensing at least an externally generated patient ECG recording command signal. The patient recording command signal is generated by the hand held patient controller. Upon detection of the patient ECG recording command, DMA copies the contents of the FIFO into a specific region of the RAM.

  17. 基于有限元方法的心脏除颤仿真研究%Simulation Study of Heart Defibrillation Based on Finite Element Method

    Institute of Scientific and Technical Information of China (English)

    杨圣均; 郑懿; 邬小玫; 魏大名; 方祖祥

    2011-01-01

    临床动物电击除颤实验无法精确测量放电电场在心脏上的实际分布情况,且存在诸多不便利和不安全因素.鉴于此,提出了一种基于心脏建模及有限元求解的心脏除颤电场分布仿真研究方法,心脏模型包含了完整的心房心室解剖结构和左右心腔,考虑了心肌细胞和血液的电阻率,然后采用有限元方法进行分析,并使用Abaqus集成环境进行求解,求解结果与文献报道的参考标准进行对比.仿真结果在除颤电压阈值和能量阈值方面与目前的植入式心脏复律除颤器( ICD)的临床应用效果具有相当的吻合度,能量阈值相对误差仅为10%,验证了所提出方法的可行性.%Clinical animal defibrillation experiments can not measure the electrical field distribution of heart precisely, also with inconvenience and unsafety. Thereby, a method for studying heart defibrillation electric field distribution based on heart modeling and finite element solution was proposed in this paper. The heart model covers integrated anatomy of atria and ventricles, with taking resistivity of cardiac muscle cells and blood into account. And then, finite element method and Abaqus Integrated Environment was adopted. Lastly, the result was put into contrast with the benchmark. In defibrillation voltage and energy threshold, the simulation result coincided with the clinical effect of Implantable Cardioverter Defibrillator (ICD) very well, with the relative error of energy threshold limited to 10% , which verified the feasibility of the proposed method.

  18. The assessment of stress reactions of patients with implanted defibrillators

    Directory of Open Access Journals (Sweden)

    Daria Schneider-Matyka

    2016-02-01

    Full Text Available Background. Although they save life, implantable defibrillators have psychological side effects and increase the number of patients who experience anxiety, depressive symptoms and, in extreme cases, post-traumatic stress disorder (PT SD. Escalation of PT SD symptoms depends on patients’ ability to cope with stress. Objectives . The aim of this study was to assess the reactions of patients after defibrillator implantation, and their ways to cope with stress, as well as to analyze the relationship between the ways of coping with stress and PT SD symptoms. Material and methods. The study was conducted using the Mini-Cope, the Impact of Event Scale-Revised (IES-R, and the author’s questionnaire. It involved 111 patients with implanted defibrillators at the mean age of 60 years, including 88 (79.3% men. The majority of the patients had secondary education – 38 (34.2% and were married – 85 (76.6%. 51 (45.9% were one year after defibrillator implantation. Results. It was demonstrated that 49 (44.1% of the surveyed experienced intracardiac discharges, out of whom 8 (17.1% went through an ‘electrical storm’. This group obtained higher PT SD scores in all three IES-R domains comparing to those without implanted defibrillators. The most common strategy to cope with stress was acceptance of the situation and searching for emotional support. Conclusions . 1. Intracardiac discharges are the vital problem of patients after defibrillator implantation. 2. Searching for emotional support and acceptance of the situation are the most common strategies to cope with stress. 3. There is a relationship between PT SD symptoms occurring in patients after implantation of a defibrillator and their strategies to cope with stress.

  19. Stabilization of gene expression and cell morphology after explant recycling during fin explant culture in goldfish

    Energy Technology Data Exchange (ETDEWEB)

    Chenais, Nathalie; Lareyre, Jean-Jacques; Le Bail, Pierre-Yves; Labbe, Catherine, E-mail: catherine.labbe@rennes.inra.fr

    2015-07-01

    The development of fin primary cell cultures for in vitro cellular and physiological studies is hampered by slow cell outgrowth, low proliferation rate, poor viability, and sparse cell characterization. Here, we investigated whether the recycling of fresh explants after a first conventional culture could improve physiological stability and sustainability of the culture. The recycled explants were able to give a supplementary cell culture showing faster outgrowth, cleaner cell layers and higher net cell production. The cells exhibited a highly stabilized profile for marker gene expression including a low cytokeratin 49 (epithelial marker) and a high collagen 1a1 (mesenchymal marker) expression. Added to the cell spindle-shaped morphology, motility behavior, and actin organization, this suggests that the cells bore stable mesenchymal characteristics. This contrast with the time-evolving expression pattern observed in the control fresh explants during the first 2 weeks of culture: a sharp decrease in cytokeratin 49 expression was concomitant with a gradual increase in col1a1. We surmise that such loss of epithelial features for the benefit of mesenchymal ones was triggered by an epithelial to mesenchymal transition (EMT) process or by way of a progressive population replacement process. Overall, our findings provide a comprehensive characterization of this new primary culture model bearing mesenchymal features and whose stability over culture time makes those cells good candidates for cell reprogramming prior to nuclear transfer, in a context of fish genome preservation. - Highlights: • Recycled fin explants outgrow cells bearing stable mesenchymal traits. • Cell production and quality is enhanced in the recycled explant culture system. • Fresh fin primary culture is highly variable and loose epithelial traits over time.

  20. Stabilization of gene expression and cell morphology after explant recycling during fin explant culture in goldfish

    International Nuclear Information System (INIS)

    The development of fin primary cell cultures for in vitro cellular and physiological studies is hampered by slow cell outgrowth, low proliferation rate, poor viability, and sparse cell characterization. Here, we investigated whether the recycling of fresh explants after a first conventional culture could improve physiological stability and sustainability of the culture. The recycled explants were able to give a supplementary cell culture showing faster outgrowth, cleaner cell layers and higher net cell production. The cells exhibited a highly stabilized profile for marker gene expression including a low cytokeratin 49 (epithelial marker) and a high collagen 1a1 (mesenchymal marker) expression. Added to the cell spindle-shaped morphology, motility behavior, and actin organization, this suggests that the cells bore stable mesenchymal characteristics. This contrast with the time-evolving expression pattern observed in the control fresh explants during the first 2 weeks of culture: a sharp decrease in cytokeratin 49 expression was concomitant with a gradual increase in col1a1. We surmise that such loss of epithelial features for the benefit of mesenchymal ones was triggered by an epithelial to mesenchymal transition (EMT) process or by way of a progressive population replacement process. Overall, our findings provide a comprehensive characterization of this new primary culture model bearing mesenchymal features and whose stability over culture time makes those cells good candidates for cell reprogramming prior to nuclear transfer, in a context of fish genome preservation. - Highlights: • Recycled fin explants outgrow cells bearing stable mesenchymal traits. • Cell production and quality is enhanced in the recycled explant culture system. • Fresh fin primary culture is highly variable and loose epithelial traits over time

  1. Use a defibrillator, save a life

    CERN Multimedia

    Joannah Caborn Wengler

    2012-01-01

    With the work for Long Shutdown 1 looming on the horizon, the CERN Fire Brigade is anticipating a heavy workload: more people working at CERN means more call-outs. So the more trained first-aiders around to help out before the paramedics arrive, the better. Would you know what to do in a medical emergency?   It could happen at any time: two colleagues are having a coffee at work, when one suddenly clutches his or her chest and falls to the floor unconscious. What would you do? Run to find a first-aider? Call the ambulance and wait, finishing your coffee? Neither response is entirely correct. On Monday 11 June in Building 40 the CMS safety group, in collaboration with the Fire Brigade and the Medical Service, demonstrated the recommended, potentially life-saving response to cardiac arrest (see the video), including the correct use of a defibrillator, ten of which were recently installed in key CERN locations (the Bulletin reported).     “In countries where...

  2. A new approach to optimization-based defibrillation.

    Science.gov (United States)

    Muzdeka, S; Barbieri, E

    2001-01-01

    The purpose of this paper is to develop a new model for optimal cardiac defibrillation, based on simultaneous minimization of energy consumption and defibrillation time requirements. In order to generate optimal defibrillation waveforms that will accomplish the objective stated above, one parameter rho has been introduced as a part of the performance measure to weigh the relative importance of time and energy. All the results of this theoretical study have been obtained for the proposed model, under the assumption that cardiac tissue can be represented by a simple parallel resistor-capacitor circuit. It is well known from modern control theory that the selection of a numerical value of the weight factor is the matter of subjective judgment of a designer. However, it has been shown that defining a cost function can help in selecting a value for rho. Some results of the mathematical development of the algorithm and computer simulations will be included in the paper. PMID:11347410

  3. Praehospital-hjertestopbehandling med semiautomatisk defibrillator--Heartstart 2000

    DEFF Research Database (Denmark)

    Fonsmark, L; Sandøe, E; Kastrup, J;

    1989-01-01

    In order to test the efficacy of a semiautomatic defibrillator (Heartstart 2000) in connection with cardiac arrest outside hospital, the apparatus was installed in two of the ambulances belonging to the Copenhagen Fire Service. The ambulance district involved was also equipped with an ambulance...... staffed by a doctor. A total of 48 patients with cardiac arrest were found and 16 of these had ventricular fibrillation. Six of the 16 patients have since been discharged from hospital (37.5%). The defibrillator had a high diagnostic certainty with a sensitivity of 96.5% and a specificity of 100%. No...... practical problems of note occurred in connection with employment of the defibrillator. The ambulance staffs underwent six hours of training and this appeared to be adequate. It is concluded that Heartstart 2000 functions well and effectively in connection with revival of patients with cardiac arrest...

  4. Breast calcifications following electrical defibrillation: An unusual mammographic appearance.

    Science.gov (United States)

    Westphal, Steven M; Jani, Manish; Badve, Sunil

    2010-01-01

    We present a case of a 57-year-old woman with a past medical history of end-stage renal disease and a recent history of electrical defibrillation who arrived for her annual mammogram with no breast-related complaints. The mammogram showed interval development of unusual clusters of heterogeneous calcifications. The patient underwent stereotactic core-needle biopsy for definitive diagnosis. The pathologic evaluation revealed fibrosis, abnormal adipocytes, and calcifications with no evidence of malignancy. The constellation of findings was consistent with fat necrosis and fibrosis related to tissue damage sustained during the recent defibrillation. PMID:27307857

  5. Stabilization of gene expression and cell morphology after explant recycling during fin explant culture in goldfish.

    Science.gov (United States)

    Chenais, Nathalie; Lareyre, Jean-Jacques; Le Bail, Pierre-Yves; Labbe, Catherine

    2015-07-01

    The development of fin primary cell cultures for in vitro cellular and physiological studies is hampered by slow cell outgrowth, low proliferation rate, poor viability, and sparse cell characterization. Here, we investigated whether the recycling of fresh explants after a first conventional culture could improve physiological stability and sustainability of the culture. The recycled explants were able to give a supplementary cell culture showing faster outgrowth, cleaner cell layers and higher net cell production. The cells exhibited a highly stabilized profile for marker gene expression including a low cytokeratin 49 (epithelial marker) and a high collagen 1a1 (mesenchymal marker) expression. Added to the cell spindle-shaped morphology, motility behavior, and actin organization, this suggests that the cells bore stable mesenchymal characteristics. This contrast with the time-evolving expression pattern observed in the control fresh explants during the first 2 weeks of culture: a sharp decrease in cytokeratin 49 expression was concomitant with a gradual increase in col1a1. We surmise that such loss of epithelial features for the benefit of mesenchymal ones was triggered by an epithelial to mesenchymal transition (EMT) process or by way of a progressive population replacement process. Overall, our findings provide a comprehensive characterization of this new primary culture model bearing mesenchymal features and whose stability over culture time makes those cells good candidates for cell reprogramming prior to nuclear transfer, in a context of fish genome preservation.

  6. 心脏除颤器的质量控制%Quality Control of Cardiac Defibrillator/Defibrillation Monitor

    Institute of Scientific and Technical Information of China (English)

    崔亮; 崔骊; 苏燕平

    2012-01-01

    目的:通过对心脏除颤器/除颤监护仪进行质量控制检测,分析检测中发现的问题,提出解决方案,以确保该设备的安全使用.方法:采用除颤器检定仪检测,并分析失准设备的检测数据.结果:通过分析心脏除颤器/除颤监护仪的失准原因,及时维修,解决了检测中出现的问题,保障了除颤器/除颤监护仪的临床使用安全.结论:对除颤器/除颤监护仪进行质量控制非常必要,可以预防因设备失准而引起的医疗事故.%Objective: Through quality control testing to the cardiac defibrillator/defibrilLation monitor, we can analyze the problems of testing and propose solutions to ensure the use of safety in the clinical. Methods: Through the detector to detect the defibrillator, so we can analyze the data of misalignment equipment. Results: Trough analyzing and solving the problems in the testing, ensure the safety of the defibrillator. Conclusion: It is very necessary to test the cardiac defibrillator/defibrillation monitor that can prevent the medical accident, which caused by misalignment of medical equipment.

  7. Hvor er den automatiske eksterne defibrillator? Udvikling og uddannelse

    DEFF Research Database (Denmark)

    Løfgren, Bo; Grove, Erik; Krarup, Niels Henrik

    2009-01-01

    The International Liaison Committee on Resuscitation has presented a universal sign to indicate the presence of automated external defibrillators (AED). To disseminate the knowledge of this important signage, a review in a Danish context is presented. It is essential that the public in general...

  8. Advantage of four-electrode over two-electrode defibrillators.

    Science.gov (United States)

    Bragard, J; Šimić, A; Laroze, D; Elorza, J

    2015-12-01

    Defibrillation is the standard clinical treatment used to stop ventricular fibrillation. An electrical device delivers a controlled amount of electrical energy via a pair of electrodes in order to reestablish a normal heart rate. We propose a technique that is a combination of biphasic shocks applied with a four-electrode system rather than the standard two-electrode system. We use a numerical model of a one-dimensional ring of cardiac tissue in order to test and evaluate the benefit of this technique. We compare three different shock protocols, namely a monophasic and two types of biphasic shocks. The results obtained by using a four-electrode system are compared quantitatively with those obtained with the standard two-electrode system. We find that a huge reduction in defibrillation threshold is achieved with the four-electrode system. For the most efficient protocol (asymmetric biphasic), we obtain a reduction in excess of 80% in the energy required for a defibrillation success rate of 90%. The mechanisms of successful defibrillation are also analyzed. This reveals that the advantage of asymmetric biphasic shocks with four electrodes lies in the duration of the cathodal and anodal phase of the shock. PMID:26764786

  9. Advantage of four-electrode over two-electrode defibrillators

    Science.gov (United States)

    Bragard, J.; Šimić, A.; Laroze, D.; Elorza, J.

    2015-12-01

    Defibrillation is the standard clinical treatment used to stop ventricular fibrillation. An electrical device delivers a controlled amount of electrical energy via a pair of electrodes in order to reestablish a normal heart rate. We propose a technique that is a combination of biphasic shocks applied with a four-electrode system rather than the standard two-electrode system. We use a numerical model of a one-dimensional ring of cardiac tissue in order to test and evaluate the benefit of this technique. We compare three different shock protocols, namely a monophasic and two types of biphasic shocks. The results obtained by using a four-electrode system are compared quantitatively with those obtained with the standard two-electrode system. We find that a huge reduction in defibrillation threshold is achieved with the four-electrode system. For the most efficient protocol (asymmetric biphasic), we obtain a reduction in excess of 80% in the energy required for a defibrillation success rate of 90%. The mechanisms of successful defibrillation are also analyzed. This reveals that the advantage of asymmetric biphasic shocks with four electrodes lies in the duration of the cathodal and anodal phase of the shock.

  10. 21 CFR 870.5310 - Automated external defibrillator.

    Science.gov (United States)

    2010-04-01

    ... device with a rhythm recognition detection system that delivers into a 50 ohm test load an electrical shock of a maximum of 360 joules of energy used for defibrillating (restoring normal heart rhythm) the atria or ventricles of the heart. An AED analyzes the patient's electrocardiogram, interprets...

  11. Contemporary strategies for risk stratification and prevention of sudden death with the implantable defibrillator in hypertrophic cardiomyopathy.

    Science.gov (United States)

    Maron, Barry J; Maron, Martin S

    2016-05-01

    Hypertrophic cardiomyopathy (HCM) is regarded as the most common nontraumatic cause of sudden death (SD) in young people (including trained athletes). Introduction of implantable cardioverter-defibrillators (ICD) to HCM 15 years ago represented a new paradigm for clinical practice and probably the most significant advance in management of this disease. ICDs offer protection against SD by terminating potentially lethal ventricular tachyarrhythmias (11%/year secondary and 4%/year primary prevention), although implant decisions are weighed against the possibility of device-related complications (5%/year). ICDs have altered the natural history of HCM, creating the opportunity for extended or normal longevity for many patients. However, assessing SD risk and targeting appropriate candidates for prophylactic device therapy can be compounded by unpredictability of the underlying arrhythmogenic substrate, evident by delays ≥10 years between implant and first ICD intervention. Multiple or a single strong risk marker within the clinical profile of an individual HCM patient can justify consideration for a primary-prevention ICD when combined with physician judgment and shared decision making. The role of the mathematical SD risk score proposed by the European Society of Cardiology to identify patients who benefit from ICD therapy is incompletely resolved. Contemporary treatment interventions and advanced risk stratification using ≥1 conventional markers have served the HCM patient population well, with reduced disease-related mortality rates across all age groups to <1%/year, due largely to the penetration of ICDs into HCM practice. Prevention of SD has now become an integral, albeit challenging, component of HCM management, contributing importantly to its emergence as a contemporary treatable cardiac disease. PMID:26749314

  12. Incidence and causes of inappropriate detection and therapy by implantable defibrillators of cardioversion in patients with ventricular tachyarrhythmia

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Background Implantable cardioverter defibrillator (ICD) is the only effective therapy in patients with life threatening ventricular arrhythmias. Inappropriate detection and therapy by ICDs are the most common causes of side effects that affect the quality of life in ICD recipients. This study evaluated the incidence and causes of inappropriate detection and therapy by ICDs in patients in our hospital.Methods From January 2000 to December 2005, fifty patients who received ICD implantation for ventricular arrhythmias for prevention of sudden cardiac death were evaluated in this study. Each ICD was programmed using clinical arrhythmic and cardiac data of the patient before discharge. Patients were followed up by standard schedule after implantation and all data retrieved from each device were collected and saved for further analysis. Results No arrhythmic event was detected in 12/50 (24%) patients during the period of follow-up. Among the remaining patients, 11 (22%) experienced inappropriate detections and therapies during follow-up in this study. ICD detected 383 ventricular tachyarrhythmia (VT) and 108 ventricular fibrillation (VF) episodes and delivered 678 therapies. In VT group, ICD delivered 413 antitachycardiac pacings (ATPs) and 118 shocks, among which 78 ATPs and 9 shocks were initiated by 55/383 (14.3%) inappropriate detections. In VF group ICD delivered 147 shocks, among which 56 shocks were initiated by 28/108 (26.9%) inappropriate detections. Overall, more than 50% of these episodes were caused by atrial fibrillation (AF) with rapid ventricular response, followed by electromagnetic or myopotential interference. In addition, most inappropriate therapies occurred within one year after ICD implantation.Conclusions About one fifth of patients experienced ICD inappropriate detection and therapy after implantation. The main cause was AF with rapid ventricular response, followed by electromagnetic or myopotential interference.

  13. Estudo clínico de um sistema cardioversor-desfibrilador implantável que apresenta limiares de desfibrilação baixos usando eletrodos de estrutura fractal Clinical studies of an implantable cardioversor - defibrillators system providing low defibrillation thresholds as well as high signal amplitudes due to fractal coated electrodes

    Directory of Open Access Journals (Sweden)

    Fernando A. LUCCHESE

    1999-01-01

    Full Text Available Em função do contínuo desenvolvimento tecnológico, a geração atual de cardioversores-desfibriladores implantáveis (CDI garante um alto grau de segurança e eficiência na detecção e reversão de taquiarritmias ventriculares. O presente trabalho sumariza os resultados clínicos obtidos com 1058 CDI de câmara única (Phylax 6, Phylax XM, Biotronik utilizando eletrodo único e tecnologia de carcaça ativa, SPS e Kainox RV (com uma mola intracavitária de choque, SL-ICD e Kainox SL (com duas molas intracavitárias de choque, Biotronik. Na quase totalidade dos pacientes, com exceção de 3 (> 99%, foram obtidos limiares de desfibrilação com baixa energia usando apenas um eletrodo transvenoso. Isto tem permitido substituir o teste de limiar de desfibrilação usual por um teste simples durante o implante, afim de minimizar os riscos associados com repetidas induções de fibrilação e conseqüente extensão do período de anestesia.Due to continuously improved technologies, the present generation of implantable cardioverter-defibrillators (ICD guarantees a high degree of safety and efficacy for detecting and terminating ventricular tachyarrhythmias. This paper summarizes the clinical results obtained with 1058 single-chamber ICD (Phylax 6, Phylax XM, Biotronik employing single-lead and active housing technology (SPS and Kainox RV (single coil, SL-ICD and Kainox SL (double coil, Biotronik. In all but 3 patients (> 99%, reliable low-energy defibrillation was achieved using transvenous leads only. This has led to the trend to replace DFT testing by a short function test during implantation in order to minimize the risks associated with repeated induction of fibrillation and extended anesthesia.

  14. An ovine tracheal explant culture model for allergic airway inflammation

    Directory of Open Access Journals (Sweden)

    Abeynaike Latasha

    2010-08-01

    Full Text Available Abstract Background The airway epithelium is thought to play an important role in the pathogenesis of asthmatic disease. However, much of our understanding of airway epithelial cell function in asthma has been derived from in vitro studies that may not accurately reflect the interactive cellular and molecular pathways active between different tissue constituents in vivo. Methods Using a sheep model of allergic asthma, tracheal explants from normal sheep and allergic sheep exposed to house dust mite (HDM allergen were established to investigate airway mucosal responses ex vivo. Explants were cultured for up to 48 h and tissues were stained to identify apoptotic cells, goblet cells, mast cells and eosinophils. The release of cytokines (IL-1α, IL-6 and TNF-α by cultured tracheal explants, was assessed by ELISA. Results The general morphology and epithelial structure of the tracheal explants was well maintained in culture although evidence of advanced apoptosis within the mucosal layer was noted after culture for 48 h. The number of alcian blue/PAS positive mucus-secreting cells within the epithelial layer was reduced in all cultured explants compared with pre-cultured (0 h explants, but the loss of staining was most evident in allergic tissues. Mast cell and eosinophil numbers were elevated in the allergic tracheal tissues compared to naïve controls, and in the allergic tissues there was a significant decline in mast cells after 24 h culture in the presence or absence of HDM allergen. IL-6 was released by allergic tracheal explants in culture but was undetected in cultured control explants. Conclusions Sheep tracheal explants maintain characteristics of the airway mucosa that may not be replicated when studying isolated cell populations in vitro. There were key differences identified in explants from allergic compared to control airways and in their responses in culture for 24 h. Importantly, this study establishes the potential for the

  15. The friction of explanted hip prostheses.

    Science.gov (United States)

    Hall, R M; Unsworth, A; Wroblewski, B M; Siney, P; Powell, N J

    1997-01-01

    Charnley prostheses, retrieved at revision surgery, were studied to assess the effects of friction on the total hip replacement procedure. Frictional resistance was measured using the Durham hip function simulator under both dry and lubricated conditions. The friction factor values (f) for the explanted prostheses were found to have a non-Gaussian distribution with medians of 0.13 [inter-quartile range (IQR) 0.10-0.16] and 0.06 (IQR 0.005-0.08) for dry and lubricated (n = 0.01 Pa s) regimes, respectively. New Charnley prostheses had values of f equal to 0.11 +/- 0.025 and 0.04 +/- 0.01 under the same conditions, and showed no large deviation from a Gaussian distribution. There was found to be a statistically significant difference in the medians of the friction factors for new and retrieved prostheses in the lubricated regime. Ingression of cement into the worn region of the cup was found to increase the friction factor significantly under dry conditions. There was no evidence of an increase in the friction factor or torque for those joints that had a loose socket with respect to those that were fixed at revision. A decrease in the frictional torque against number of cycles undergone by the joint in vivo may indicate that a fatigue-type process may have a role in the loosening of the socket. However, this relationship was found not to be significant for friction measured under lubricated conditions and it seems unlikely that the frictional torque generated in this type of prosthesis will contribute significantly to the long-term loosening of the socket.

  16. Non-linear dynamical signal characterization for prediction of defibrillation success through machine learning

    OpenAIRE

    Shandilya Sharad; Ward Kevin; Kurz Michael; Najarian Kayvan

    2012-01-01

    Abstract Background Ventricular Fibrillation (VF) is a common presenting dysrhythmia in the setting of cardiac arrest whose main treatment is defibrillation through direct current countershock to achieve return of spontaneous circulation. However, often defibrillation is unsuccessful and may even lead to the transition of VF to more nefarious rhythms such as asystole or pulseless electrical activity. Multiple methods have been proposed for predicting defibrillation success based on examinatio...

  17. The Cause and Mechanism of Cardiac Electrical Instability. Defibrillation Mechanism

    Directory of Open Access Journals (Sweden)

    Rustam G. Habchabov

    2012-06-01

    Full Text Available The reason for the ominous arrhythmias pathway, causing sudden somatic death from cardiovascular diseases is still not clear, cardiological examinations of this phenomenon are conducted throughout the world. Laceration of connective insulating tissue membrane of heart pathway with ectopic nodes oxidation may cause ominous arrhythmias; nobody has considered this cause as a cardiac electrical instability before. Defibrillator electric discharges cannot penetrate into myocardium due to the connective insulating tissue membrane, nobody has considered nervous system, transmitting electricity.

  18. Basal genoplivning af voksne og automatisk ekstern defibrillering

    DEFF Research Database (Denmark)

    Berlac, P.A.; Lippert, F.K.; Torp-Pedersen, Christian Tobias

    2008-01-01

    The new ERC guidelines on resuscitation emphasize the importance of quality CPR. BLS should be started as early as possible. Lay rescuers should not check for a pulse, they should call for help and start chest compressions immediately. Compression depth should be 4-5 cm at a rate of 100 compressi...... ventilations followed by a compression-ventilation ratio of 15:2. Automatic External Defibrillation should be used as early as possible Udgivelsesdato: 2008/11/17...

  19. Breast calcifications following electrical defibrillation: An unusual mammographic appearance

    OpenAIRE

    Westphal, Steven M.; Jani, Manish; BADVE, SUNIL

    2015-01-01

    We present a case of a 57-year-old woman with a past medical history of end-stage renal disease and a recent history of electrical defibrillation who arrived for her annual mammogram with no breast-related complaints. The mammogram showed interval development of unusual clusters of heterogeneous calcifications. The patient underwent stereotactic core-needle biopsy for definitive diagnosis. The pathologic evaluation revealed fibrosis, abnormal adipocytes, and calcifications with no evidence of...

  20. Estimation of current density distribution under electrodes for external defibrillation

    Directory of Open Access Journals (Sweden)

    Papazov Sava P

    2002-12-01

    Full Text Available Abstract Background Transthoracic defibrillation is the most common life-saving technique for the restoration of the heart rhythm of cardiac arrest victims. The procedure requires adequate application of large electrodes on the patient chest, to ensure low-resistance electrical contact. The current density distribution under the electrodes is non-uniform, leading to muscle contraction and pain, or risks of burning. The recent introduction of automatic external defibrillators and even wearable defibrillators, presents new demanding requirements for the structure of electrodes. Method and Results Using the pseudo-elliptic differential equation of Laplace type with appropriate boundary conditions and applying finite element method modeling, electrodes of various shapes and structure were studied. The non-uniformity of the current density distribution was shown to be moderately improved by adding a low resistivity layer between the metal and tissue and by a ring around the electrode perimeter. The inclusion of openings in long-term wearable electrodes additionally disturbs the current density profile. However, a number of small-size perforations may result in acceptable current density distribution. Conclusion The current density distribution non-uniformity of circular electrodes is about 30% less than that of square-shaped electrodes. The use of an interface layer of intermediate resistivity, comparable to that of the underlying tissues, and a high-resistivity perimeter ring, can further improve the distribution. The inclusion of skin aeration openings disturbs the current paths, but an appropriate selection of number and size provides a reasonable compromise.

  1. Percutaneous Extraction of Transvenous Permanent Pacemaker/Defibrillator Leads

    Directory of Open Access Journals (Sweden)

    Stylianos Paraskevaidis

    2014-01-01

    Full Text Available Background. Widespread use of cardiovascular implantable electronic devices has inevitably increased the need for lead revision/replacement. We report our experience in percutaneous extraction of transvenous permanent pacemaker/defibrillator leads. Methods. Thirty-six patients admitted to our centre from September 2005 through October 2012 for percutaneous lead extraction were included. Lead removal was attempted using Spectranetics traction-type system (Spectranetics Corp., Colorado, CO, USA and VascoExtor countertraction-type system (Vascomed GmbH, Weil am Rhein, Germany. Results. Lead extraction was attempted in 59 leads from 36 patients (27 men, mean ± SD age 61±5 years, with permanent pacemaker (n=25, defibrillator (n=8, or cardiac resynchronisation therapy (n=3 with a mean ± SD implant duration of 50±23 months. The indications for lead removal included pocket infection (n=23, endocarditis (n=2, and ventricular (n=10 and atrial lead dysfunction (n=1. Traction device was used for 33 leads and countertraction device for 26 leads. Mean ± SD fluoroscopy time was 4±2 minutes/lead for leads implanted 48 months (n=21, P=0.03. Complete procedural success rate was 91.7% and clinical procedural success rate was 100%, while lead procedural success rate was 95%. Conclusions. In conclusion, percutaneous extraction of transvenous permanent pacemaker/defibrillator leads using dedicated removal tools is both feasible and safe.

  2. A comparison of the health status and psychological distress of partners of patients with a left ventricular assist device versus an implantable cardioverter defibrillator

    DEFF Research Database (Denmark)

    Brouwers, Corline; Caliskan, Kadir; de Jonge, Nicolaas;

    2014-01-01

    therefore an important aspect in the care of LVAD and ICD patients. METHODS: Multi-center prospective observational study with 6 months follow-up of 33 LVAD partners (27% men; mean age = 54 ± 10 years) and 414 ICD partners (22% men; mean age = 60 ± 12 years). RESULTS: LVAD partners reported better physical...

  3. Effect of Fish Oil on Ventricular Tachyarrhythmia and Death in Patients With Implantable Cardioverter Defibrillators: The Study on Omega-3 Fatty Acids and Ventricular Arrhythmia (SOFA) Randomized Trial

    NARCIS (Netherlands)

    Brouwer, I.A.; Zock, P.L.; Camm, A.J.; Bocker, D.; Hauer, R.N.W.; Wever, E.F.D.; Dullemeijer, C.; Ronden, J.E.; Katan, M.B.; Lubinski, A.; Buschler, H.; Schouten, E.G.

    2006-01-01

    Context Very-long-chain n-3 polyunsaturated fatty acids (omega-3 PUFAs) from fish are thought to reduce risk of sudden death, possibly by reducing susceptibility to cardiac arrhythmia. Objective To study the effect of supplemental fish oil vs placebo on ventricular tachyarrhythmia or death. Design,

  4. The CopenHeartSF trial—comprehensive sexual rehabilitation programme for male patients with implantable cardioverter defibrillator or ischaemic heart disease and impaired sexual function

    DEFF Research Database (Denmark)

    Johansen, Pernille Palm; Zwisler, Ann-Dorthe; Svendsen, Jesper Hastrup;

    2013-01-01

    Sexuality is an important part of people's physical and mental health. Patients with heart disease often suffer from sexual dysfunction. Sexual dysfunction has a negative impact on quality of life and well-being in persons with heart disease, and sexual dysfunction is associated with anxiety...

  5. Potential demographic and baselines variables for risk stratification of high-risk post-myocardial infarction patients in the era of implantable cardioverter-defibrillator - a prognostic indicator

    DEFF Research Database (Denmark)

    Yap, Yee Guan; Duong, Trinh; Bland, Martin;

    2008-01-01

    BACKGROUND: Risk stratification after myocardial infarction (MI) remains expensive and disappointing. We designed a prognostic indicator using demographic information to select patients at risk of dying after MI. METHOD AND RESULTS: We combined individual patient data from the placebo arms of EMIAT...... containing only significant variables. The prognostic index was the sum of the individual contribution from the risk factors. 2707 patients were pooled (age: 66 (23-92) years, 78.8% M) with 480 deaths at 2-years (44% arrhythmic and 35.6% non-arrhythmic cardiac deaths). Variables predicting mortality were age...

  6. Location of cardiac arrest in a city center: strategic placement of automated external defibrillators in public locations

    DEFF Research Database (Denmark)

    Folke, Fredrik; Lippert, Freddy; Nielsen, Søren Loumann;

    2009-01-01

    BACKGROUND: Public-access defibrillation with automated external defibrillators (AEDs) is being implemented in many countries worldwide with considerable financial implications. The potential benefit and economic consequences of focused or unfocused AED deployment are unknown. METHODS AND RESULTS...

  7. Citrus tissue culture employing vegetative explants.

    Science.gov (United States)

    Chaturvedi, H C; Singh, S K; Sharma, A K; Agnihotri, S

    2001-11-01

    Citrus being a number one fruit of the world due to its high nutritional value, huge production of fruits and fruit products, the citrus industry may be considered a major fruit industry. Though citrus orchard area in India is comparable to USA, the produce is far less, while its export is nil. Biotechnology has played an outstanding role in boosting the citrus industry, e.g., in Spain, which is now the biggest exporter of citrus fruit with the application of micrografting. Amongst the fruit trees, perhaps the maximum tissue culture research has been done in citrus during the past four decades, however, the results of practical value are meagre. The shortfalls in citrus tissue culture research and some advancements made in this direction along with bright prospects are highlighted, restricting the review to vegetative explants only. Whilst utilization of nucellar embryogenesis is limited to rootstocks, the other aspects, like, regeneration and proliferation of shoot meristems measuring 200 microm in length--a global breakthrough--of two commercially important scion species, Citrus aurantifolia and C. sinensis and an important rootstock, C. limonia, improvement of micrografting technique, cloning of the same two scion species as well as some Indian rootstock species, employing nodal stem segments of mature trees, of immense practical value have been elaborated. A rare phenomenon of shift in the morphogenetic pattern of differentiation from shoot bud differentiation to embryoid formation occurred during the long-term culture of stem callus of C. grandis. Stem callus-regenerated plants of C. aurantifolia, C. sinensis and C. grandis showed variation in their ploidy levels and a somaclonal variant of C. sinensis, which produced seedless fruits was isolated. Tailoring of rooting in microshoots to a tap root-like system by changing the inorganic salt composition of the rooting medium, resulting in 100% transplant success, and germplasm preservation through normal growth

  8. Transthoracic electrical impedance during external defibrillation: comparison of measured and modelled waveforms.

    Science.gov (United States)

    Al Hatib, F; Trendafilova, E; Daskalov, I

    2000-02-01

    The transthoracic electrical impedance is an important defibrillation parameter, affecting the defibrillating current amplitude and energy, and therefore the defibrillation efficiency. A close relationship between transthoracic impedance and defibrillation success rate was observed. Pre-shock measurements (using low amplitude high frequency current) of the impedance were considered a solution for selection of adequate shock voltages or for current-based defibrillation dosage. A recent approach, called 'impedance-compensating defibrillation' was implemented, where the pulse duration was controlled with respect to the impedance measured during the initial phase of the shock. These considerations raised our interest in reassessment of the transthoracic impedance characteristics and the corresponding measurement methods. The purpose of this work is to study the variations of the transthoracic impedance by a continuous measurement technique during the defibrillation shock and comparing the data with results obtained by modelling. Voltage and current impulse waveforms were acquired during cardioversion of patients with atrial fibrillation or flutter. The same type of defibrillation pulse was taken from dogs after induction of fibrillation. The electrodes were located in the anterior position, for both the patients and animals.

  9. Explant exenisation for tissue culture in marine macroalgae

    Science.gov (United States)

    Liu, Xuewu; Kloareg, Bernard

    1992-09-01

    Unialgal explants from Laminaria digitata, and from a variety of red algae, were obtained by hand removing the visible epiphytes, and stirring the tissue in the presence of glass beads. Two antibiotic mixtures were found to be efficient in removing the contaminating fungi and bacteria from the algae. The procedure proved suitable as a primary step in the tissue culture of the investigated species.

  10. Thidiazuron-induced high-frequency plant regeneration from leaf explants of Paulownia tomentosa mature trees

    OpenAIRE

    CORREDOIRA, E.; Ballester, A.; Viéitez Martín, Ana María

    2008-01-01

    Attempts were made to study the effect of thidiazuron (TDZ) on adventitious shoot induction and plant development in Paulownia tomentosa explants derived from mature trees. Media with different concentrations of TDZ in combination with an auxin were used to induce adventitious shoot-buds in two explant types: basal leaf halves with the petiole attached (leaf explant) and intact petioles. Optimal shoot regeneration was obtained in leaf explants cultured on induction medium containing TDZ (22.7...

  11. Morphologic differences observed by scanning electron microscopy according to the reason for pseudophakic IOL explantation

    DEFF Research Database (Denmark)

    Fernandez-Buenaga, Roberto; Alio, Jorge L.; Ramirez, Jose M.;

    2015-01-01

    Purpose To compare variations in surface morphology, as studied by scanning electron microscopy (SEM), of explanted intraocular lenses (IOLs) concerning the cause leading to the explantation surgery. Methods In this prospective multicenter study, explanted IOLs were analyzed by SEM and energy-dis...

  12. Absorção de macronutrientes por explantes de bananeira in vitro Macronutrient absorption by banana explants in vitro

    Directory of Open Access Journals (Sweden)

    Josefa Diva Nogueira Diniz

    1999-07-01

    Full Text Available Com o objetivo de estudar a absorção de macronutrientes (N, P, K, Ca, Mg e S em explantes de bananeira cv. Prata Anã, foram utilizados explantes de plantas estabelecidas in vitro, inoculados em meio básico de Murashige & Skoog (1962 contendo sacarose (30 g/L, e BAP (3,5 mg/L com sete tratamentos, representados pelos períodos de 0, 10, 20, 30, 40, 50 e 60 dias de cultivo e três repetições. As quantidades de macronutrientes totais absorvidas pelos explantes seguiram a ordem: K > N > Ca > ou = P > Mg @ S. O P foi o nutriente absorvido mais rapidamente pelos explantes, com 75% extraído do meio de cultivo nos primeiros 30 dias, cessando sua absorção aos 50 dias, restando ainda 9% no meio de cultivo. A absorção do S cessou também aos 50 dias, quando 66% deste nutriente ainda permanecia no meio de cultivo. Este resultado sugere haver uma relação, quanto à absorção, entre esses dois nutrientes. As maiores taxas de absorção de todos os nutrientes foram verificadas nos primeiros 20 dias. O rizoma, o pseudocaule e as folhas, se diferenciaram quanto à concentração e extração ou acúmulo de nutrientes.The absorption of the nutrients (N, P, K, Ca, Mg and S by banana (Musa sp. cv. Prata Anã explants on the basic medium of Murashige & Skoog (1962 supplemented with sucrose (30 g/L and BAP (3.5 mg/L were evaluated at 0, 10, 20, 30, 40, 50 and 60 days after inoculation. The seven treatments were arranged on a completely randomized design with three replicates. The sequence of nutrient absorption by the explants was K > N > Ca > or = P > Mg @ S. The P was the nutrient with the fastest absorption rate and at the 30th day the explants had already absorbed 75% of the P from the medium. The P absorption stopped by the 50th day. The S absorption stopped at the 50th day with 66% of it remaining in the medium. The results suggested a close relationship between these two nutrients. The highest rates of nutrient absorption were observed during the

  13. The Effect of Compressor-Administered Defibrillation on Peri-shock Pauses in a Simulated Cardiac Arrest Scenario

    Directory of Open Access Journals (Sweden)

    Joshua Glick

    2014-03-01

    Full Text Available Introduction: Coordination of the tasks of performing chest compressions and defibrillation can lead to communication challenges that may prolong time spent off the chest. The purpose of this study was to determine whether defibrillation provided by the provider performing chest compressions led to a decrease in peri-shock pauses as compared to defibrillation administered by a second provider, in a simulated cardiac arrest scenario. Methods: This was a randomized, controlled study measuring pauses in chest compressions for defibrillation in a simulated cardiac arrest model. We approached hospital providers with current CPR certification for participation between July, 2011 and October, 2011. Volunteers were randomized to control (facilitator-administered defibrillation or experimental (compressor-administered defibrillation groups. All participants completed one minute of chest compressions on a mannequin in a shockable rhythm prior to administration of defibrillation. We measured and compared pauses for defibrillation in both groups. Results: Out of 200 total participants, we analyzed data from 197 defibrillations. Compressor-initiated defibrillation resulted in a significantly lower pre-shock hands-off time (0.57 s; 95% CI: 0.47-0.67 compared to facilitator-initiated defibrillation (1.49 s; 95% CI: 1.35-1.64. Furthermore, compressor-initiated defibrillation resulted in a significantly lower peri-shock hands-off time (2.77 s; 95% CI: 2.58-2.95 compared to facilitator-initiated defibrillation (4.25 s; 95% CI: 4.08-4.43. Conclusion: Assigning the responsibility for shock delivery to the provider performing compressions encourages continuous compressions throughout the charging period and decreases total time spent off the chest. However, as this was a simulation-based study, clinical implementation is necessary to further evaluate these potential benefits. [West J Emerg Med. 2014;15(2:246–250.

  14. Laboratory analyses of two explanted hydrophobic acrylic intraocular lenses

    Directory of Open Access Journals (Sweden)

    Yunhai Dai

    2014-01-01

    Full Text Available Two three-piece hydrophobic acrylic intraocular lenses (IOLs were explanted from two patients at 7 and 9 years, respectively, after implantation, because of poor fundus visualisation and/or a clinically significant decrease in visual acuity related to their opacified IOLs. In addition to light microscopy, scanning electron microscopy and energy dispersive X-ray spectroscopy, confocal laser scanning microscopy was used for the first time to observe the explanted IOLs. The clinical aspect seemed to correspond to the phenomenon of surface light scattering, while laboratory analyses showed dense glistenings in the central layer of the IOL optic, which had no change next to the surface. Further studies on these phenomena are needed.

  15. Bovine explant model of degeneration of the intervertebral disc

    OpenAIRE

    Sivan Sarit; Menage Janis; Roberts Sally; Urban Jill PG

    2008-01-01

    Abstract Background Many new treatments for degeneration of the intervertebral disc are being developed which can be delivered through a needle. These require testing in model systems before being used in human patients. Unfortunately, because of differences in anatomy, there are no ideal animal models of disc degeneration. Bovine explant model systems have many advantages but it is not possible to inject any significant volume into an intact disc. Therefore we have attempted to mimic disc de...

  16. Diverse response of tomato fruit explants to high temperature

    Directory of Open Access Journals (Sweden)

    Zofia Starck

    2014-02-01

    Full Text Available Tomato explants (fruit with a pedicel and a piece of peduncle, with fruit growth stimulated by treating the flowers with NOA + GA3 (NG-series were used as a model system for studying the effect of high temperature on C-sucrose uptake, its distribution and Ca retranslocation. Two cultivars with contrasting responses to high temperature were compared. In sensitive cv. Roma heat stress during 22h (40oC for 10h and 30oC for 12h, drastically depressed the uptake of 14C-sucrose coinciding with diminished fruit 14C-supply. It also decreased the specific activity of soluble acid invertase and the calcium content. All these strong negative responses to high temperature were markedly reduced in the NG-treated series involving remobilization of Ca to the fruits and a higher stability of the invertase activity. This indicates the indirect role of flower treatment with NG in addaptation to heat stress. In tolerant cv. Robin even higher temperatures (42oC for 10h and 34oC for 12h were not stressful. They did not affect the 14C-sucrose uptake and stimulated 14C-supply to the fruit. Increased specific activity of acid invertase and a higher calcium content were also recorded but only in the control explants. In contrast to cv. Roma elevated temperature was slightly stressful for cv. Robin explants of NG-series. The differences in response of both cultivar explants to elevated temperature, based on unequal fruit supply with 14C-sucrose, seem to be causaly connected with two factors: the invertase activity being more or less sensitive to the heat stress, the ability to translocate Ca to the heated fruits.

  17. Shoot Regeneration from Leaf Explants of Withania somnifera (L. Dunal

    Directory of Open Access Journals (Sweden)

    Aruna Girish JOSHI

    2010-03-01

    Full Text Available Regeneration from leaf explants of Withania somnifera (L. for mass propagation was studied on Murashige and Skoog�s medium supplemented with Kinetin (Kn and 6-benzylaminopurine (BAP alone or in combination. Shoot buds were induced from the midrib on the abaxial side in presence of Kn and BAP (4 �M. These shoot buds developed into shoots on the same medium. Rooting of these shoots was achieved in 0.5 �M of IBA.

  18. Foldable Lens Explantation and Exchange:The Reason and Solution

    Institute of Scientific and Technical Information of China (English)

    Danying Zheng; Zhenpin Zhang; Wenhui Yang; Weirong Chen

    2001-01-01

    Objective: To report the explantation and exchange of Hydrophilic Acrylic foldable intraocular lens (IOL) on 14 patients who had visual disturbances caused by the change of transparence on optic. Methods: Sixteen Hydrophilic Acrylic foldable intraocular lenses from 14 patients who presented with decreased visual acuity from 6 months to 1 year after normal phacoemulsification and IOL implantation associated with extensive transparent change on optic of the lens. The lenses were explanted with the bisection technique. All the eyes were reinserted with Acrysof foldable lenses. Results: Sixteen lenses were removed successfully and exchanged with the new lens in the capsule. The posterior capsular rupture and vitreous loss were found in the first two cases. One of them had the zonulysis due to the radial tear of the anterior capsule during the enlargement of the capsular opening. The anterior vitrectomy was performed with IOL fixed on the ciliary sulcus. The visual acuity of all the patients improved obviously without posterior complication. Conclusion: Foldable lens explantation with the bisection technique and exchange had a successful outcome with improvement of ocular condition. Eye science 2001; 17:54 ~56.

  19. Molecular weight characterization of virgin and explanted polyester arterial prostheses.

    Science.gov (United States)

    Maarek, J M; Guidoin, R; Aubin, M; Prud'homme, R E

    1984-10-01

    The macromolecular properties of 17 virgin commercial arterial prostheses and a series of explanted prostheses, both manufactured from poly(ethylene terephthalate) (PET) yarns, have been studied by gel permeation chromatography (GPC) and by differential scanning calorimetry (DSC). Only small differences were found between the average molecular weights and the degree of crystallinity of the unused reference grafts. A broadening of the DSC curves was observed for the prostheses containing texturized yarns compared with those made solely from flat, untexturized yarns. This broadening may be due to greater heterogeneity of the crystal sizes caused by the texturizing process and to the use of two or more different yarns with dissimilar thermal histories in the same prosthesis. Average molecular weights of the explant series were significantly lower than those of the corresponding reference grafts but almost time independent. The polydispersity index and the degree of crystallinity of the explants remained constant as a function of time. These results are discussed in regard to others available in the literature. PMID:6242474

  20. Development of standard test methods for evaluating defibrillation recovery characteristics of disposable ECG electrodes.

    Science.gov (United States)

    Schoenberg, A A; Booth, H E; Lyon, P C

    1979-01-01

    A clinically relevant test for the measurement of defibrillation overload recovery of prefilled disposable ECG electrodes was developed and is proposed for use in an ECG electrode standard under development by AAMI. Defibrillation overload voltages and currents, as well as electrode polarization recovery voltages, were first measured in animal tests on 12 types of electrodes to allow correlation with various bench tests using a capacitor discharge at 10, 200, or 1000 V. Current overloads absorbed by the electrodes under worst conditions in animal tests were in the range of 2 percent of the defibrillation current flowing through the chest. These overloads were absorbed by most Ag-AgCl electrodes without excessive polarization. However, stainless steel, brass, and tin electrodes tended to polarize to levels that would saturate many ECG monitors. A standard bench test using a 200-V 10-muF capacitor was recommended for inclusion in the AAMI standard to determine whether electrodes are acceptable for use during defibrillation.

  1. Use of automated external defibrillators in a Brazilian airline. A 1-year experience

    Directory of Open Access Journals (Sweden)

    Alves Paulo Magalhães

    2001-01-01

    Full Text Available After the incorporation of automated external defibrilators by other airlines and the support of the Brazilian Society of cardiology, Varig Airlines Began the onboard defibrilation program with the initial purpose of equiping wide-body aircrafts frequently used in international flights and that airplanes use in the Rio - São Paulo route. With all fight attendants trained, the automated. External defibrilation devides were incorporated to 34 airplanes of a total pleet of 80 aircrats. The devices were intalled in the bagage compartments secured with velero straps and 2 pairs of electrods, one or which pre-conected to the device to minimize application time. Later, a portable monitor was addres to the ressocitation kit in the long flights. The expansion of the knowledge of the basic life support fundamentors and the correted implantation of the survival chain and of the automated external defibrilators will increase the extense of recovery of cardiorespiratory arrest victins in aircrafts.

  2. Implantable Defibrillators Improve Survival in Patients With Mildly Symptomatic Heart Failure Receiving Cardiac Resynchronization Therapy

    DEFF Research Database (Denmark)

    Gold, Michael R; Daubert, Jean-Claude; Abraham, William T;

    2013-01-01

    Cardiac resynchronization therapy (CRT) decreases mortality, improves functional status, and induces reverse left ventricular remodeling in selected populations with heart failure. These benefits have been noted with both CRT-pacemakers as well as those devices with defibrillator backup (CRT...

  3. A bioreaction-diffusion model for growth of marine sponge explants in bioreactors.

    Science.gov (United States)

    Garcia Camacho, F; Chileh, T; Cerón García, M C; Sánchez Mirón, A; Belarbi, E H; Chisti, Y; Molina Grima, E

    2006-12-01

    Marine sponges are sources of high-value bioactives. Engineering aspects of in vitro culture of sponges from cuttings (explants) are poorly understood. This work develops a diffusion-controlled growth model for sponge explants. The model assumes that the explant growth is controlled by diffusive transport of at least some nutrients from the surrounding medium into the explant that generally has a poorly developed aquiferous system for internal irrigation during early stages of growth. Growth is assumed to obey Monod-type kinetics. The model is shown to satisfactorily explain the measured growth behavior of the marine sponge Crambe crambe in two different growth media. In addition, the model is generally consistent with published data for growth of explants of the sponges Disidea avara and Hemimycale columella. The model predicted that nutrient concentration profiles for nutrients, such as dissolved oxygen within the explant, are consistent with data published by independent researchers. In view of the proposed model's ability to explain available data for growth of several species of sponge explants, diffusive transport does play a controlling role in explant growth at least until a fully developed aquiferous system has become established. According to the model and experimental observations, the instantaneous growth rate depends on the size of the explant and all those factors that influence the diffusion of critical nutrients within the explant. Growth follows a hyperbolic profile that is consistent with the Monod kinetics.

  4. PATTERN OF PLANT REGENERATION FROM SHOOT TIP EXPLANTS OF PIGEONPEA (CAJANUS CAJAN L MILLLSP) VAR LRG-41

    OpenAIRE

    T. Raghavendra; P. Sudhakar

    2014-01-01

    An efficient direct shoot bud differentiation and multiple shoot induction from shoot tip explants of pigeon pea (Cajanus cajan L.) has been achieved. The frequency of shoot bud regeneration was influenced by the type of explants, genotype and concentrations of cytokinin. Explants viz. shoot tip isolated from 10 day old seedlings showed better explants response Explants were cultured on Murashige and skoog (MS) medium augmented with different concentrations of BAP and NAA. Among the various c...

  5. The influence of season collection of explants on micropropagation of peach rootstock GF-677

    Directory of Open Access Journals (Sweden)

    Elektra Spahiu

    2013-02-01

    Full Text Available The influence of season on the rate of multiplication on in vitro culture of peach rootstock GF- 677 was investigated on Murashige and Skoog (MS media, supplemented with GA3 0.1 mg/L and IAA 0.1mg/l. Benzyladenine (BAP at concentrations 1mg/l was used in the multiplication stage and 1mg/l IBA in the stage of rooting. Shoot-tip and nodal segment explants were collected from 5 years old rootstock GF-677 (Prunus persica x Prunus amygdalus in February 24th (from dormant shoots that have been sprouted in climatic room, March 22th, April 20th, May 18th and September 15th during the 2009 growing season and have been sterilized by sodium hypochlorite (NaOCl 10% for 20 min. The data on the effect of the season collection of the explants on number of shoots per explants, the mean shoot length and the percentage of rooted shoots were recorded six weeks after culture. In vitro performance of explants indicated a positive correlation between shoot proliferation and season collection The highest number of shoots per explants (3,5 was obtained on explants collected in March 22th (3,5, which was on a par with explants collected in February 24th (from shoots that have been sprouted in climatic room. Moreover, the highest shoot length was observed on explants collected on February and March (1,53cm and 1,505cm respectively. The percentage of rooted shoots from explants sampled on February was not markedly greater than those sampled on March. The number of shoots per explants, the shoot length and the percentage of rooted shoots on explants sampled in April, May and September were significantly lower than those sampled in February and March. The amount of chlorophyll a + b of the shoots coming from explants collected in March was markedly greater than those collected in February, April, May and September.

  6. Histology of Somatic Embryogenesis in Cultured Leaf Explants of Pistachio (Pistacia veraL)

    OpenAIRE

    ONAY, Ahmet

    2000-01-01

    The histology of somatic embryo initiation and development in pistachio ( Pistacia were L.) embryogenic masses (EMS) derived from leaf explants was examined using light microscopy. Explants with somatic embryos at different developmental stages were fixed for histological examination, cut into 10 µm thick sections, stained with hematoxylin-eosin and observed microscopically. The histological examination showed that the two types of cell clusters induced originated from explants and were mo...

  7. Chlorophyll Fluorescence as a Tool to Assess the Regeneration Potential of African Violet Leaf Explants

    Directory of Open Access Journals (Sweden)

    Norbert KEUTGEN

    2016-06-01

    Full Text Available Micropropagation of many ornamentals has enabled their efficient commercialisation and many problems have been solved by the elaboration of adequate culture protocols. Nevertheless, a non-destructive technique for monitoring the developmental progress of explants would be desirable. The present study focussed on the applicability of chlorophyll fluorescence in leaf explants of African violet (a Saintpaulia ionantha × confusa – hybrid explanted onto Murashige and Skoog basic medium. The explants that survived on the medium without additional phytohormones had the capacity to develop further into two different kinds of explants: light green explants, characterized by a non-regular size growth and stiffer appearance, and dark green explants capable of organogenesis. Compared to the source leaves of African violet plants, explants were characterized by reduced chlorophyll (Chl and carotenoid (Car contents as well as a tendency towards a higher Car/Chl ratio. The Chl a/b ratio decreased significantly in the light green explants. A reduction of maximum quantum efficiency of photosystem II (Fv/Fm accompanied by a high percentage (> 50% of thermal energy dissipation as a consequence of an elevated light intensity (800 µmol m-2 s-1 quanta indicated photoinhibition in the light green explants, whereas in the dark green explants the largest percentage (> 50% of the light energy was dissipated into the fraction of photon energy trapped by ‘closed’ photosystem II reaction centres. These results suggest that the capacity of organogenesis of leaf explants of African violet can be monitored using chlorophyll fluorescence, because it is related to modifications of the photosynthetic system.

  8. Effect of peripheral nerve on the neurite growth from retinal explants in culture

    Institute of Scientific and Technical Information of China (English)

    LiuLi; SoKwokfai

    1990-01-01

    The effect of peripheral nerve (PN) on neurite outgrowth from retinal explants of adult hamsters was examined.Cultures of retinal explants,and co-cultures of retinal explants and PN were performed using chick retinal basement memebrane (BM) as substrate.The presence of PN increases the number and length of neurite outgrowth.In addition,a high proportion of neurites situated close to PN tend to grow towards it.Since there was no contact between retinal explants and PN,we suggest that PN might secete diffusible substances to attract the neurites to grow towards it.

  9. Proliferation of Female Inflorescences explants of Date Palm

    International Nuclear Information System (INIS)

    This study was conducted to determine the effect of Abscisic acid (ABA) and Ancymidol on proliferation of female inflorescences explants of date palm. In the first experiment two lengths of spath at (5-7 cm) or at (7-10 cm) were cultured on nutrient media which consists of half macro and full micro salts of MS medium supplemented with gradual decreasing in concentration of Abscisic acid (ABA) and Ancymidol from 4.5, 3.0, 1.5 to 0.5 mg-1. In the second experiment two phases of nutrient medium (solid and liquid) and two source of carbon were investigated. Gradual decreasing of ABA concentrations from 4.5 mg-1 to 1.5 mg-1 in culture medium, stimulated the production of direct somatic embryos and accelerated callus initiation, but at last decrement (0.5 mg-1) of Ancymidol concentration few embryos were produced. Callus initiation from inflorescences explants gave high production and well development of somatic embryos when cultured on liquid medium supplemented with 40 g-1 sucrose. All direct or indirect somatic embryos obtained in these experiments were converted successfully to healthy normal plantlets which could be transferred to acclimatization stage.

  10. Bovine explant model of degeneration of the intervertebral disc

    Directory of Open Access Journals (Sweden)

    Sivan Sarit

    2008-02-01

    Full Text Available Abstract Background Many new treatments for degeneration of the intervertebral disc are being developed which can be delivered through a needle. These require testing in model systems before being used in human patients. Unfortunately, because of differences in anatomy, there are no ideal animal models of disc degeneration. Bovine explant model systems have many advantages but it is not possible to inject any significant volume into an intact disc. Therefore we have attempted to mimic disc degeneration in an explant bovine model via enzymatic digestion. Methods Bovine coccygeal discs were incubated with different concentrations of the proteolytic enzymes, trypsin and papain, and maintained in culture for up to 3 weeks. A radio-opaque solution was injected to visualise cavities generated. Degenerative features were monitored histologically and biochemically (water and glycosaminoglycan content, via dimethylmethylene blue. Results and Conclusion The central region of both papain and trypsin treated discs was macro- and microscopically fragmented, with severe loss of metachromasia. The integrity of the surrounding tissue was mostly in tact with cells in the outer annulus appearing viable. Biochemical analysis demonstrated greatly reduced glycosaminoglycan content in these compared to untreated discs. We have shown that bovine coccygeal discs, treated with proteolytic enzymes can provide a useful in vitro model system for developing and testing potential new treatments of disc degeneration, such as injectable implants or biological therapies.

  11. Microscopic and spectroscopic investigation of an explanted opacified intraocular lens

    Energy Technology Data Exchange (ETDEWEB)

    Simon, V., E-mail: viosimon@phys.ubbcluj.ro [Babeş-Bolyai University, Faculty of Physics and Interdisciplinary Research Institute on Bio-Nano-Sciences, 400084 Cluj-Napoca (Romania); Radu, T.; Vulpoi, A. [Babeş-Bolyai University, Faculty of Physics and Interdisciplinary Research Institute on Bio-Nano-Sciences, 400084 Cluj-Napoca (Romania); Rosca, C. [Optilens Clinic of Ophthalmology, 400604 Cluj-Napoca (Romania); Eniu, D. [Iuliu Haţieganu University of Medicine and Pharmacy, Department of Molecular Sciences, 400349 Cluj-Napoca (Romania)

    2015-01-15

    Highlights: • Changes on intraocular lens (IOL) surface after implantation. • Partial opacification of IOL central area. • Elemental composition on IOL surface prior to and after implantation. • First XPS depth profiling examination of the opacifying deposits. • Cell-mediated hydroxyapatite structuring. - Abstract: The investigated polymethylmethacrylate intraocular lens explanted an year after implantation presented a fine granularity consisting of ring-like grains of about 15 μm in diameter. In order to evidence the changes occurred on intraocular lens relative to morphology, elemental composition and atomic environments, microscopic and spectroscopic analyses were carried out using scanning electron microscopy (SEM), Fourier transform infrared (FTIR), energy-dispersive X-ray (EDS), and X-ray photoelectron (XPS) spectroscopies. The results revealed that the grains contain hydroxyapatite mineral phase. A protein layer covers the lens both in opacified and transparent zones. The amide II band is like in basal epithelial cells. The shape and size of the grains, and the XPS depth profiling results indicate the possibility of a cell-mediated process involving lens epithelial cells which fagocitated apoptotic epithelial cells, and in which the debris derived from cell necrosis were calcified. To the best of our knowledge, this is the first investigation on explanted intraocular lenses using XPS depth profiling in order to examine the inside of the opacifying deposits.

  12. Microscopic and spectroscopic investigation of an explanted opacified intraocular lens

    Science.gov (United States)

    Simon, V.; Radu, T.; Vulpoi, A.; Rosca, C.; Eniu, D.

    2015-01-01

    The investigated polymethylmethacrylate intraocular lens explanted an year after implantation presented a fine granularity consisting of ring-like grains of about 15 μm in diameter. In order to evidence the changes occurred on intraocular lens relative to morphology, elemental composition and atomic environments, microscopic and spectroscopic analyses were carried out using scanning electron microscopy (SEM), Fourier transform infrared (FTIR), energy-dispersive X-ray (EDS), and X-ray photoelectron (XPS) spectroscopies. The results revealed that the grains contain hydroxyapatite mineral phase. A protein layer covers the lens both in opacified and transparent zones. The amide II band is like in basal epithelial cells. The shape and size of the grains, and the XPS depth profiling results indicate the possibility of a cell-mediated process involving lens epithelial cells which fagocitated apoptotic epithelial cells, and in which the debris derived from cell necrosis were calcified. To the best of our knowledge, this is the first investigation on explanted intraocular lenses using XPS depth profiling in order to examine the inside of the opacifying deposits.

  13. Long-term culture of sponge explants: conditions enhancing survival and growth, and assessment of bioactivity.

    Science.gov (United States)

    de Caralt, Sònia; Agell, Gemma; Uriz, María-J

    2003-07-01

    Sponges are an important source of secondary metabolites with pharmaceutical interest. This is the main reason for the increasing interest of sponge culture recent years. The optimal culture system depends on the species to be cultured: while some species easily produce sponge aggregates after dissociation (primmorphs), others show a great capacity to regenerate after fragmentation (explants). Corticium candelabrum is a Mediterranean bacteriosponge that can undergo asexual reproduction. We have taken advantage of this capability and cultured C. candelabrum explants under several experimental conditions. To find the best conditions for obtaining functional explants, we assayed a range of conditions, including seasons of collection, culture temperature, filtered versus filtered-sterile seawater, addition of antibiotics and proportion of ectosome. We monitored the changes in shape and ultrastructure during the formation of explants. After 24 h, TEM images showed the aquiferous system disarranged, in particular at the sponge periphery. From 2 to 4 weeks later, the aquiferous system regenerated, and fragments became functional sponges (explants). Explants were cultured under two regimes: in vitro and in a closed aquarium system. Antibiotics were only added to the in vitro culture to assess their effect on the symbiotic bacteria, which remained healthy despite the presence of antibiotics. Two food regimens (marine bacteria and green algae) were assayed for their ability to satisfy the metabolic requirements of explants. We monitored explant survival and growth. Explants showed a high long-term survival rate (close to 100%). Growth rates were higher in the closed aquarium system, without antibiotic addition, and fed with algae. Explants cultures were hardly contaminated because manipulation was reduced to a minimum and we used sterilized seawater. C. candelabrum produces bioactive molecules, which may play a defensive role in the sponge and may have pharmaceutical

  14. Management of radiation therapy patients with cardiac defibrillator or pacemaker.

    Science.gov (United States)

    Salerno, Francesca; Gomellini, Sara; Caruso, Cristina; Barbara, Raffaele; Musio, Daniela; Coppi, Tamara; Cardinale, Mario; Tombolini, Vincenzo; de Paula, Ugo

    2016-06-01

    The increasing growth of population with cardiac implantable electronic devices (CIEDs) such as Pacemaker (PM) and Implantable Cardiac Defibrillators (ICD), requires particular attention in management of patients needing radiation treatment. This paper updates and summarizes some recommendations from different international guidelines. Ionizing radiation and/or electromagnetic interferences could cause device failure. Current approaches to treatment in patients who have these devices vary among radiation oncology centres. We refer to the German Society of Radiation Oncology and Cardiology guidelines (ed. 2015); to the Society of Cardiology Australia and New Zealand Statement (ed. 2015); to the guidelines in force in the Netherlands (ed. 2012) and to the Italian Association of Radiation Oncology recommendations (ed. 2013) as reported in the guidelines for the treatment of breast cancer in patients with CIED. Although there is not a clear cut-off point, risk of device failure increases with increasing doses. Cumulative dose and pacing dependency have been combined to categorize patients into low-, medium- and high-risk groups. Measures to secure patient safety are described for each category. The use of energy ≤6MV is preferable and it's strongly recommended not to exceed a total dose of 2 Gy to the PM and 1 Gy for ICD. Given the dangers of device malfunction, radiation oncology departments should adopt all the measures designed to minimize the risk to patients. For this reason, a close collaboration between cardiologist, radiotherapist and physicist is necessary.

  15. Organogênese direta de explantes cotiledonares e regeneração de plantas de mogango Direct organogenesis of cotyledon explants and plant regeneration of squash

    Directory of Open Access Journals (Sweden)

    André Luís Lopes da Silva

    2006-06-01

    Full Text Available Os objetivos foram induzir a organogênese direta de explantes cotiledonares de mogango e estudar a regeneração de plântulas completas a partir das brotações adventícias. Foram utilizados cotilédones como explantes, originados das plântulas de mogango com 20 dias após a semeadura. O meio basal utilizado foi o MS (MURASHIGE & SKOOG, 1962 suplementado com 30g L-1 de sacarose e 7g L-1 de agar. Foram testadas as concentrações de 6-benzilaminopurina (BAP de 0; 0,5; 1,0 e 2,0mg L-1. Explantes de ápices caulinares e segmentos nodais de brotações adventícias foram então cultivados em meio MS suplementado com 30g L-1 de sacarose e 7g L-1 de agar. Maiores concentrações de BAP no meio MS promoveram um aumento da percentagem de explantes cotiledonares com brotações adventícias e uma redução da percentagem de enraizamento. Explantes de segmentos nodais e ápices caulinares oriundos de brotações adventícias cresceram e enraizaram em meio MS sem reguladores de crescimento. Altas percentagens de enraizamento dependem do tamanho dos explantes utilizados.The objectives were to induce direct organogenesis of squash cotyledons and to study the regeneration of complete plantlets from adventitious shoot. Cotyledon explants of 20-day seedlings were cultured in MS (MURASHIGE & SKOOG, 1962 medium supplemented with 30g L-1 of sucrose and 7g L-1 of agar. The 6-benzilaminopurina (BAP concentrations of 0, 0.5, 1.0 and 2.0mg L-1 were tested. Apical and nodal explants from adventitious shoots were transferred to MS medium supplemented with 30g L-1 of sucrose and 7g L-1 of agar. Increasing BAP concentrations in the MS medium enhance the percentage of adventitious shoot and reduce the percentage of root organogenesis of squash cotyledon explants. Apical and nodal explants from adventitious shoot regenerated plantlets with roots in MS medium without growth regulators. High percentage of plantlet rooting depends upon the size of the explants.

  16. Development of Automated External Defibrillator%体外自动除颤器的研制

    Institute of Scientific and Technical Information of China (English)

    惠杰; 朱宗成; 谷云飞; 邬小玫; 方祖祥; 蒋文平

    2013-01-01

    Automatic external defibrillator (AED) is independently designed and developed and evaluated ventricular tachycardia ( VT/VF ) recognition sensitivity, specificity and defibrillation effect through animal experiment. The result shows that this device has advantages of convenient carrying, fast operation and accuracy, and has higher recognition sensitivity, specificity and defibrillation effect.%  自主设计和研制体外自动除颤器(AED),并通过动物实验评价该AED对室速/室颤(VT/VF)识别的敏感性、特异性以及除颤效果。实验结果表明该设备具有较高的识别敏感性、特异性和除颤效果,且便于携带、操作快捷和工作精确的优点。

  17. Cardiomyopathy and the use of implanted cardio-defibrillators in children.

    Science.gov (United States)

    Kaminer, S J; Pickoff, A S; Dunnigan, A; Sterba, R; Wolff, G S

    1990-05-01

    Children and adults with cardiomyopathy and ventricular dysrhythmias have a uniformly poor prognosis, despite medical therapy. The use of automatic implantable cardio-defibrillators in adult patients with medically resistant ventricular dysrhythmias has resulted in a positive impact on survival. Because of its size and former lack of programmability, the device has been used rarely in children. Four patients with cardiomyopathy, in whom refractory ventricular dysrhythmias were managed with automatic implantable cardio-defibrillators, are presented. Two of these children are the youngest and smallest known in whom the device has been used; one of them received the first programmable model. The use of the automatic implantable cardio-defibrillator may enhance survival in selected young patients. PMID:1693196

  18. In vitro morphogenic events in culture of Lotus corniculatus L. seedling root explants

    Directory of Open Access Journals (Sweden)

    Jan J. Rybczyński

    2011-04-01

    Full Text Available The experiments were carried out on Lotus corniculatus (L. seedling root explants of the cultivar varieties Skrzeszowicka, Caroll A10 and strain 175. Callus formation and shoot regeneration were the major explant response depended mainly on of the studied genotype and used plant growth regulators (PGRs. Primary cortex of proximal and distal end of explant was the most active tissue for callus proliferation. For shoot primordia differentiation deeper zones of cortex took a part. The process of meristematic centre initiation was not uniform and various level of shoot differentiation events were observed not earlier than 3 weeks of culture. Usually, the shoot primordia regeneration began on proximal rather than distal end of the explant. BAP rather than urea derivatives stimulated shoot proliferation in extended cultures. Increasing of BAP and TDZ concentrations brought about the explant polarity and expansion of the meristematic zones. The explant position in root did not have significant influence on the number of regenerated shoots. The cultures only had better bud formation by TDZ when compared to BAP. BAP stimulated bud formation and development of the shoots from them. Short term of TDZ treatment of explants stimulated meristem formation which developed into buds and shoots. CPPU stimulated callus proliferation and bud formation when explants pretreatment was prolonged from 12 to 36 hrs.

  19. Plant Regeneration of Sweet Potato via Somatic Embryogenesis from Different Explants

    Institute of Scientific and Technical Information of China (English)

    Ling ZHANG; Hongxuan XU; Baifu QIN; Zhihua LIA0; Min CHEN; Chunxian YANG; Yufan FU; Qitang ZHANG

    2012-01-01

    [Objective] This study aimed to regenerate plants of sweet potato (Ipomoea batatas) cultivar Xushu22 via somatic embryogenesis, using leaf and shoot apex as explants. [Method] The leaf and shoot apex of Xushu 22 were separately cultured on MSB medium and MSD medium. The induced embryogenic calluses were then cultured on MS medium. The regeneration frequency of leaf and shoot apex ex- plants were respectively calculated. [Result] The average frequency of leaf explants developing somatic callus was 95.69% compared to 30.56% in case of shoot apex explants. There were different types of morphogenic structures in the process of so- matic embryo development. Leaf explants gave a high regeneration frequency to 60.61%, while the regeneration frequency of shoot apices was 22%. In addition, no morphological variations were observed in the regeneration plants. [Conclusion] Leaf explant was better than shoot apices in plant regeneration of Xushu22 via somatic embryogenesis.

  20. Use and benefits of public access defibrillation in a nation-wide network

    DEFF Research Database (Denmark)

    Nielsen, Anne Møller; Folke, Fredrik; Lippert, Freddy Knudsen;

    2013-01-01

    BACKGROUND: Automated External Defibrillators (AEDs) are known to increase survival after out-of-hospital cardiac arrest (OHCA). The aim of this study was to examine the use and benefit of public-access defibrillation (PAD) in a nation-wide network. We primarily sought to assess survival at 1 month...... to an OHCA victim prior to the arrival of Emergency Medical Services (EMS) in 48 instances. Ten percent of bystanders were off-duty healthcare professionals. Shockable arrests (N=31, 70%) were significantly more likely to be witnessed (94% vs. 54%) to occur at sports facilities (74% vs. 31%), in relation...

  1. Glucosamine increases hyaluronic acid production in human osteoarthritic synovium explants

    Directory of Open Access Journals (Sweden)

    Uitterlinden EJ

    2008-09-01

    Full Text Available Abstract Background Glucosamine (GlcN used by patients with osteoarthritis was demonstrated to reduce pain, but the working mechanism is still not clear. Viscosupplementation with hyaluronic acid (HA is also described to reduce pain in osteoarthritis. The synthesis of HA requires GlcN as one of its main building blocks. We therefore hypothesized that addition of GlcN might increase HA production by synovium tissue. Methods Human osteoarthritic synovium explants were obtained at total knee surgery and pre-cultured for 1 day. The experimental conditions consisted of a 2 days continuation of the culture with addition of N-Acetyl-glucosamine (GlcN-Ac; 5 mM, glucosamine-hydrochloride (GlcN-HCl; 0.5 and 5 mM, glucose (Gluc; 0.5 and 5 mM. Hereafter HA production was measured in culture medium supernatant using an enzyme-linked binding protein assay. Real time RT-PCR was performed for hyaluronic acid synthase (HAS 1, 2 and 3 on RNA isolated from the explants. Results 0.5 mM and 5 mM GlcN-HCl significantly increased HA production compared to control (approximately 2 – 4-fold, whereas GlcN-Ac had no significant effect. Addition of 5 mM Gluc also increased HA production (approximately 2-fold, but 0.5 mM Gluc did not. Gene expression of the HA forming enzymes HAS 1, 2 and 3 was not altered by the addition of GlcN or Gluc. Conclusion Our data suggest that exogenous GlcN can increase HA production by synovium tissue and is more effective at lower concentrations than Gluc. This might indicate that GlcN exerts its potential analgesic properties through stimulation of synovial HA production.

  2. Quality control of cardiac defibrillator/defibrillation monitor%心脏除颤器/除颤监护仪的质量控制

    Institute of Scientific and Technical Information of China (English)

    崔亮; 崔骊; 黄韬

    2011-01-01

    目的:确保除颤器临床使用的安全性.方法:采用除颤器检定仪检测;结果:分析并解决了检测中出现的问题,保障了除颤器的安全使用.结论:对除颤器进行质量控制,可以预防因医疗设备失准而引起的医疗事故.%Objective: To ensure the safety of defibrillator that is usually used in clinical practice. Methods: The detector was used for examination of the defibriilator. Results: The problems in the testing were analyzed and solved to ensure the safety of the defibrillator. Conclusion: The medical accident that caused by misalignment of medical equipment can be prevented through the quality control.

  3. Pseudodefects in SPET myocardium imaging after placement of a defibrillator patch electrode; Pseudodefekte bei der Myokard-SPECT durch implantierte Defibrillator-Patches: Phantommessungen mit SPECT und PET

    Energy Technology Data Exchange (ETDEWEB)

    Buchert, R. [Universitaetskrankenhaus Eppendorf, Hamburg (Germany). Abt. fuer Nuklearmedizin der Radiologischen Klinik; Rickers, C. [Universitaetskrankenhaus Eppendorf, Hamburg (Germany). Abt. Kardiologie der Klinik fuer Innere Medizin; Fuchs, C. [Universitaetskrankenhaus Eppendorf, Hamburg (Germany). Abt. fuer Nuklearmedizin der Radiologischen Klinik; Nienaber, C.A. [Universitaetskrankenhaus Eppendorf, Hamburg (Germany). Abt. Kardiologie der Klinik fuer Innere Medizin; Luebeck, M. [Universitaetskrankenhaus Eppendorf, Hamburg (Germany). Abt. fuer Nuklearmedizin der Radiologischen Klinik

    1996-12-01

    Aim and Methods: In order to estimate the effect of an epicardial or subcutan defibrillator patch electrode on the imaging of myocardium with SPET and PET we performed measurements with a body phantom and two different patch electrodes. Results: We found that in {sup 201}Tl-SPET with epicardial placing one electrode causes significant pseudodefects, which might lead to the impression of an infarction (`pseudoinfarction`), particularly in the case of reduced myocardial wall thickness. Measurements with {sup 99m}Tc show the same pseudodefects. In case of subcutaneous placing the electrodes are much less likely to cause relevant absorption effects. With PET even epicardially placed both patch electrodes do not produce pseudodefects. Therefore the risk of false-positive findings is very small with PET. Conclusion: In order to avoid false positive findings in cardiovascular nuclear medicine caused by defibrillator patch electrodes, patients with patch electrodes should be referred to PET, if available. (orig.) [Deutsch] Ziel und Methoden: Um den Effekt eines epikardial oder subkutan implantierten Defibrillator-Patches bei der nuklearmedizinischen Herzdiagnostik mittels SPECT und PET abzuschaetzen, wurden Messungen an einem Koerperphantom mit zwei verschiedenen Patchelektroden durchgefuehrt. Ergebnisse: Es zeigte sich, dass bei der {sup 201}Tl-SPECT bei epikardialer Plazierung eine der beiden Elektroden Pseudodefekte verursacht, die insbesondere im Falle duennwandiger Herzen die Beurteilung erschweren oder sogar zu falsch-positiven Befunden (`Pseudoinfarkte`) fuehren koennen. Bei Messungen mit {sup 99m}Tc findet man dieselben Pseudodefekte in nahezu gleicher Auspraegung. Im Falle subkutaner Plazierung sind beide Elektroden sowohl bei der {sup 201}Tl-SPECT als auch bei der {sup 99m}Tc-SPECT unkritisch. Bei der PET stellen die untersuchten Patchelektroden selbst bei epikardialer Plazierung keine erkennbare Stoerung dar, so dass hier die Gefahr eines falsch

  4. Effect of vasoactive intestinal peptide on pulmonary surfactants phospholipid synthesis in lung explants

    Institute of Scientific and Technical Information of China (English)

    Lian LI; Zi-qiang LUO; Fu-wen ZHOU; Dan-dan FENG; Cha-xiang GUAN; Chang-qing ZHANG; Xiu-hong SUN

    2004-01-01

    AIM: To investigate the effect of vasoactive intestinal peptide (VIP) on pulmonary surfactants (PS) phospholipid synthesis in cultured lung explants. METHODS: Lung explants were cultured with serum-free medium, [methyl-3H]choline incorporation, total phospholipid, phosphatidylcholine, activity of choline-phosphate cytidylyltransferase (CCT) and CCTα mRNA level in lung explants were determined. RESULTS: (1) VIP (10-10-10-7 mol/L) for 16 h promoted [methyl-3H]choline incorporation in dose dependence and VIP (10-8 mol/L) for 2 h-16 h promoted [methylz3H]choline incorporation in time dependence. (2) VIP (10-8 mol/L) enhanced the contents of total phospholipidsand phosphatidylcholine in lung explants. (3) VIP (10-10-10-7 mol/L) elevated microsomal CCT activity of lung explants in dose dependence. (4) VIP (10-8 mol/L) increased expression of CCTα mRNA in lung explants and alveolar type Ⅱ cells (ATII). (5) [D-P-Cl-Phe(6)-Leu(17)]-VIP (10-6 mol/L), a VIP receptors antagonist, abolished the increase of [3H]choline incorporation, microsomal CCT activity and CCTα mRNA level induced by VIP (10-8 mol/L) in lung explants. CONCLUSION: VIP could enhance synthesis of phosphatidylcholine, the major component of pulmonary surfactants by enhancing microsomal CCT activity and CCTα mRNA level via VIP receptormediated pathway.

  5. The metabolic dynamics of cartilage explants over a long-term culture period

    Directory of Open Access Journals (Sweden)

    E.K Moo

    2011-01-01

    Full Text Available INTRODUCTION: Although previous studies have been performed on cartilage explant cultures, the generalized dynamics of cartilage metabolism after extraction from the host are still poorly understood due to differences in the experimental setups across studies, which in turn prevent building a complete picture. METHODS: In this study, we investigated the response of cartilage to the trauma sustained during extraction and determined the time needed for the cartilage to stabilize. Explants were extracted aseptically from bovine metacarpal-phalangeal joints and cultured for up to 17 days. RESULTS: The cell viability, cell number, proteoglycan content, and collagen content of the harvested explants were analyzed at 0, 2, 10, and 17 days after explantation. A high percentage of the cartilage explants were found to be viable. The cell density initially increased significantly but stabilized after two days. The proteoglycan content decreased gradually over time, but it did not decrease to a significant level due to leakage through the distorted peripheral collagen network and into the bathing medium. The collagen content remained stable for most of the culture period until it dropped abruptly on day 17. CONCLUSION: Overall, the tested cartilage explants were sustainable over long-term culture. They were most stable from day 2 to day 10. The degradation of the collagen on day 17 did not reach diseased levels, but it indicated the potential of the cultures to develop into degenerated cartilage. These findings have implications for the application of cartilage explants in pathophysiological fields.

  6. Culturing Schwann Cells from Neonatal Rats by Improved Enzyme Digestion Combined with Explants-culture Method.

    Science.gov (United States)

    Liu, Di; Liang, Xiao-Chun; Zhang, Hong

    2016-08-01

    Objective To develop an improved method for culturing Schwann cells(SCs) by using both enzyme digestion and explants-culture approaches and compared with traditional explants-culture method and general hemi-explants-culture method. Methods Bilaterally sciatic nerves and brachial plexus nerves were dissected from 3 to 5-day-old neonatal SD rats and explants-culture method,general hemi-explants-culture method,and improved enzyme digestion combined with explants-culture method were adopted to culture SCs,respectively. SCs were digested and passaged after 7 days in culture and counted under the microscope. The purity of SCs was identified by S-100 immunofluorescence staining. Results The SCs of improved method group grew fastest and the total number of cells obtained was(1.85±0.13)×10(6);the SCs of the hemi-explants-culture method group grew slower than the improved method group and the total number of cells obtained was (1.10±0.10)×10(6);the SCs of the explants-culture method group grew slowest and the total number of cells obtained was (0.77±0.03)×10(6).The total number of cells obtained showed significant difference among the three groups(Pculture method group,and (74.50±4.23)% in the explants-culture method group(Pculture method can obtain sufficient amount of high-purity SCs in a short time and thus may be applied in further research on peripheral nerve regeneration.

  7. Out-of-hospital cardiac arrest and placement of automated external defibrillators in the community

    DEFF Research Database (Denmark)

    Folke, Fredrik

    2010-01-01

    INDLEDNING Chancen for at overleve et hjertestop udenfor hospital er i de første minutter efter kollaps afhængig af hjælpen fra nærmeste tilstedeværende. Dette har faciliteret strategier for placering af automatiske eksterne defibrillatorer (AED) i det offentlige rum og muliggjort hurtig defibril...

  8. Automated external defibrillator rescues among children with diagnosed and treated long QT syndrome.

    NARCIS (Netherlands)

    Pundi, K.N.; Bos, J.M.; Cannon, B.C.; Ackerman, M.J.

    2015-01-01

    BACKGROUND: Long QT syndrome (LQTS) is a potentially lethal yet highly treatable cardiac channelopathy. A comprehensive LQTS-directed treatment program often includes an automated external defibrillator (AED). OBJECTIVE: The purpose of this study was to determine the incidence of AED rescues among c

  9. 78 FR 17890 - Effective Date of Requirement for Premarket Approval for Automated External Defibrillator System.

    Science.gov (United States)

    2013-03-25

    ... 8, 2004 (69 FR 10615). B. Device Subject to This Proposal--Automated External Defibrillator (Sec... order (74 FR 16214, April 9, 2009) requiring manufacturers to submit information about a number of...-month period has expired (see 68 FR 61342, October 28, 2003). If a PMA is not filed for such...

  10. Data management in automated external defibrillators: a call for a standardised solution

    DEFF Research Database (Denmark)

    Nielsen, Anne Møller; Rasmussen, L S

    2011-01-01

    The ECG data stored in automated external defibrillators (AEDs) may be valuable for establishing a final diagnosis and deciding further diagnostics and treatment. Different data management systems are used and this may create significant problems for data storage and access for physicians treating...

  11. Reproducible simulation of respiratory motion in porcine lung explants

    International Nuclear Information System (INIS)

    Purpose: To develop a model for exactly reproducible respiration motion simulations of animal lung explants inside an MR-compatible chest phantom. Materials and Methods: The materials included a piston pump and a flexible silicone reconstruction of a porcine diaphragm and were used in combination with an established MR-compatible chest phantom for porcine heart-lung preparations. The rhythmic inflation and deflation of the diaphragm at the bottom of the artificial thorax with water (1-1.5 L) induced lung tissue displacement resembling diaphragmatic breathing. This system was tested on five porcine heart-lung preparations using 1.5T MRI with transverse and coronal 3D-GRE (TR/TE=3.63/1.58, 256 x 256 matrix, 350 mm FOV, 4 mm slices) and half Fourier T2-FSE (TR/TE=545/29, 256 x 192, 350 mm, 6 mm) as well as multiple row detector CT (16 x 1 mm collimation, pitch 1.5, FOV 400 mm, 120 mAs) acquired at five fixed inspiration levels. Dynamic CT scans and coronal MRI with dynamic 2D-GRE and 2D-SS-GRE sequences (image frequencies of 10/sec and 3/sec, respectively) were acquired during continuous 'breathing' (7/minute). The position of the piston pump was visually correlated with the respiratory motion visible through the transparent wall of the phantom and with dynamic displays of CT and MR images. An elastic body splines analysis of the respiratory motion was performed using CT data. Results: Visual evaluation of MRI and CT showed three-dimensional movement of the lung tissue throughout the respiration cycle. Local tissue displacement inside the lung explants was documented with motion maps calculated from CT. The maximum displacement at the top of the diaphragm (mean 26.26 [SD 1.9] mm on CT and 27.16 [SD 1.5] mm on MRI, respectively [p=0.25; Wilcoxon test]) was in the range of tidal breathing in human patients. Conclusion: The chest phantom with a diaphragmatic pump is a promising platform for multi-modality imaging studies of the effects of respiratory lung motion. (orig.)

  12. Primary human bronchial epithelial cells grown from explants.

    Science.gov (United States)

    Yaghi, Asma; Zaman, Aisha; Dolovich, Myrna

    2010-01-01

    Human bronchial epithelial cells are needed for cell models of disease and to investigate the effect of excipients and pharmacologic agents on the function and structure of human epithelial cells. Here we describe in detail the method of growing bronchial epithelial cells from bronchial airway tissue that is harvested by the surgeon at the times of lung surgery (e.g. lung cancer or lung volume reduction surgery). With ethics approval and informed consent, the surgeon takes what is needed for pathology and provides us with a bronchial portion that is remote from the diseased areas. The tissue is then used as a source of explants that can be used for growing primary bronchial epithelial cells in culture. Bronchial segments about 0.5-1cm long and open and minced into 2-3mm(3) pieces of tissue. The pieces are used as a source of primary cells. After coating 100mm culture plates for 1-2 hr with a combination of collagen (30 microg/ml), fibronectin (10 microg/ml), and BSA (10 microg/ml), the plates are scratched in 4-5 areas and tissue pieces are placed in the scratched areas, then culture medium (DMEM/Ham F-12 with additives) suitable for epithelial cell growth is added and plates are placed in an incubator at 37 degrees C in 5% CO(2) humidified air. The culture medium is changed every 3-4 days. The epithelial cells grow from the pieces forming about 1.5 cm diameter rings in 3-4 weeks. Explants can be re-used up to 6 times by moving them into new pre-coated plates. Cells are lifted using trypsin/EDTA, pooled, counted, and re-plated in T75 Cell Bind flasks to increase their numbers. T75 flasks seeded with 2-3 million cells grow to 80% confluence in 4 weeks. Expanded primary human epithelial cells can be cultured and allowed to differentiate on air-liquid interface. Methods described here provide an abundant source of human bronchial epithelial cells from freshly isolated tissues and allow for studying these cells as models of disease and for pharmacology and toxicology

  13. Life Cycle of Heterodera zeae Koshy, Swarup, and Sethi on Zea mays L. Axenic Root Explants

    OpenAIRE

    Lauritis, J. A.; Rebois, R. V.; Graney, L. S.

    1983-01-01

    Monoxenic cultures of Heterodera zeae, the corn cyst nematode (CCN), were established on root explants of corn Zea mays L., cv. Kenworthy. The life cycle of H. zeae was determined from light anti scanning electron microscopic observations of the root explants grown in the dark at 29.5 ± .5 C under gnotobiotic conditions. The life cycle, from the time the explants were inoculated with second-stage larvae (L2) to the first appearance of newly hatched second-generation L2, required 22 days. The ...

  14. Prevention of sudden death in hypertrophic cardiomyopathy (HCM):implanted defibrillators in HCM%肥厚型心肌病猝死预防:肥厚型心肌病患者除颤器置入

    Institute of Scientific and Technical Information of China (English)

    Barry J Maron; Paolo Spirito

    2009-01-01

    Hypertrophic cardiomyopathy (HCM) is the most common cause of sudden cardiac death in young people. The implantable cardioverter-defibrillator (ICD), has recently proved to be a safe and effective therapeutic intervention in patients with HCM, both for the primary and secondary prevention of sudden death. Based on recent substantial experience, the ICD intervenes appropriately to termiante ventricular tachycardia/fibrillation (VT/VF), at a rate of 5.5%/year. ICD discharge rate is 4%/year in those patients implanted prophylactically due to one or more major risk markers, but often with considerable delays of up to 10 years before the device is required to intervene appropriately to terminate potentially letal ventricular tachyarrhythmias. Primary prevention of VT/VF occurs with similar frequency in high-risk patients having either 1,2 or ≥ 3 noninvasive risk markers, and about one-third of patients with appropriate device interventions had been implanted for only one risk factor. The ICD has proved reliable in HCM despite the extreme and complex phenotypes often present with massive degrees of left vcntricular hypertrophy, microvascular ischemia, diastolic dysfunction, or dynamic left ventricular outflow tract obstruction. Failure to convert life-threatening ventrieular tachyarrhythmias to normal rhythm is extraordinarily rare. In conclusion, in high-risk HCM patients, ICDs perform in a highly effective fashion,frequently preventing sudden death by aborting primary life-threatening ventricular tachyarrhythmias. A single marker of high risk can be sufficient evidence to justify the recommendation for a prophylactic ICD in selected patients with HCM.

  15. Direct organogenesis of seaside heliotrope (Heliotropium crassavicum) using stem explants.

    Science.gov (United States)

    Satyavani, K; Dheepak, V; Gurudeeban, S; Ramanathan, T

    2013-10-15

    Heliotropium crassavicum L. is a sand binder salt marsh herb with enormous traditional value and widely found in South Asia America and Europe. In the direct method of regeneration from stem explants, we observed the maximum number of shoot regeneration after four weeks culture of MS elongation medium with 2.0 mg L(-1) of 2, 4-D (17.27 +/- 0.51). It was clear that MS medium with 2.0 mg mL(-1) 2, 4-D alone suitable for shoot multiplication as well as shoot elongation then compared to other combination of auxin and cytokinin. In vitro shoots were excised from shoot clumps and transferred to rooting medium containing 2, 4-dichlorophenoxy acetic acid (0.5-3.0 mg L(-1)). The maximum number of root regeneration (6.4 +/- 0.416) and root length (6.08 +/- 0.07) were observed in MS rooting medium fortified with 2.5 mg L(-1) of 2, 4-D after 2 weeks of culture. 85% of in vitro raised plantlets with well-developed shoots and roots were transferred to ex vivo conditions into polythene bag containing sterile compost with ratio (v/v/v) of organic fertilizer: sand: peat (1:2:2; 3:1:0 or 2:2:1). Sixty five percent of acclimated plants were transferred to the pots under full sun where they grew well without any detectable phenotypic variations. PMID:24506027

  16. Proteomic Profile of Brucella abortus-Infected Bovine Chorioallantoic Membrane Explants

    Science.gov (United States)

    Mol, Juliana P. S.; Pires, Simone F.; Chapeaurouge, Alexander D.; Perales, Jonas; Santos, Renato L.; Andrade, Hélida M.; Lage, Andrey P.

    2016-01-01

    Brucella abortus is the etiological agent of bovine brucellosis, a zoonotic disease that causes significant economic losses worldwide. The differential proteomic profile of bovine chorioallantoic membrane (CAM) explants at early stages of infection with B. abortus (0.5, 2, 4, and 8 h) was determined. Analysis of CAM explants at 0.5 and 4 h showed the highest differences between uninfected and infected CAM explants, and therefore were used for the Differential Gel Electrophoresis (DIGE). A total of 103 spots were present in only one experimental group and were selected for identification by mass spectrometry (MALDI/ToF-ToF). Proteins only identified in extracts of CAM explants infected with B. abortus were related to recognition of PAMPs by TLR, production of reactive oxygen species, intracellular trafficking, and inflammation. PMID:27104343

  17. Molecular Profiling of Multiplexed Gene Markers to Assess Viability of Ex Vivo Human Colon Explant Cultures

    OpenAIRE

    Drew, Janice E.; Andrew J Farquharson; Vase, Hollie; Carey, Frank A.; Steele, Robert J C; Ross, Ruth A; Bunton, David C.

    2015-01-01

    Abstract Human colon tissue explant culture provides a physiologically relevant model system to study human gut biology. However, the small (20–30 mg) and complex tissue samples used present challenges for monitoring tissue stability, viability, and provision of sufficient tissue for analyses. Combining molecular profiling with explant culture has potential to overcome such limitations, permitting interrogation of complex gene regulation required to maintain gut mucosa in culture, monitor res...

  18. Explant culture of rat colon: A model system for studying metabolism of chemical carcinogens

    DEFF Research Database (Denmark)

    Autrup, Herman; Stoner, G.D.; Jackson, F.;

    1978-01-01

    An explant culture system has been developed for the long-term maintenance of colonic tissue from the rat. Explants of 1 cm2 in size were placed in tissue-culture dishes to which was added 2 ml of CMRL-1066 medium supplemented with glucose, hydrocortisone, beta-retinyl acetate, and either 2.5% bo......,12-dimethylbenz[alpha]anthracene, aflatoxin B1, dimethylnitrosamine, 1,2-dimethylhydrazine, and methylazoxymethanol acetate into chemical species that bind to cellular DNA and protein....

  19. Integration of Attributes from Non-Linear Characterization of Cardiovascular Time-Series for Prediction of Defibrillation Outcomes.

    Directory of Open Access Journals (Sweden)

    Sharad Shandilya

    Full Text Available The timing of defibrillation is mostly at arbitrary intervals during cardio-pulmonary resuscitation (CPR, rather than during intervals when the out-of-hospital cardiac arrest (OOH-CA patient is physiologically primed for successful countershock. Interruptions to CPR may negatively impact defibrillation success. Multiple defibrillations can be associated with decreased post-resuscitation myocardial function. We hypothesize that a more complete picture of the cardiovascular system can be gained through non-linear dynamics and integration of multiple physiologic measures from biomedical signals.Retrospective analysis of 153 anonymized OOH-CA patients who received at least one defibrillation for ventricular fibrillation (VF was undertaken. A machine learning model, termed Multiple Domain Integrative (MDI model, was developed to predict defibrillation success. We explore the rationale for non-linear dynamics and statistically validate heuristics involved in feature extraction for model development. Performance of MDI is then compared to the amplitude spectrum area (AMSA technique.358 defibrillations were evaluated (218 unsuccessful and 140 successful. Non-linear properties (Lyapunov exponent > 0 of the ECG signals indicate a chaotic nature and validate the use of novel non-linear dynamic methods for feature extraction. Classification using MDI yielded ROC-AUC of 83.2% and accuracy of 78.8%, for the model built with ECG data only. Utilizing 10-fold cross-validation, at 80% specificity level, MDI (74% sensitivity outperformed AMSA (53.6% sensitivity. At 90% specificity level, MDI had 68.4% sensitivity while AMSA had 43.3% sensitivity. Integrating available end-tidal carbon dioxide features into MDI, for the available 48 defibrillations, boosted ROC-AUC to 93.8% and accuracy to 83.3% at 80% sensitivity.At clinically relevant sensitivity thresholds, the MDI provides improved performance as compared to AMSA, yielding fewer unsuccessful defibrillations

  20. Effects of laser irradiation on immature olfactory neuroepithelial explants from the rat

    Energy Technology Data Exchange (ETDEWEB)

    Mester, A.F.; Snow, J.B. Jr.

    1988-07-01

    The photobiological effect of low-output laser irradiation on the maturation and regeneration of immature olfactory bipolar receptor cells of the rat was studied. The maturation and regeneration of the receptor cells of rat fetuses were quantified in neuroepithelial explants with morphometric analysis. The number of explants with outgrowth and the number and length of neuritic outgrowths were determined on a regular basis for 12 days. Explants in the experimental group were irradiated with a helium-neon laser using different incident energy densities (IED). Explants in the fluorescent light control group were exposed to fluorescent light for the same periods of time as those in the experimental group were exposed to laser irradiation. Explants in another control group were not exposed to laser or fluorescent light irradiation. The IED of 0.5 J/cm2 laser irradiation has been found to increase significantly the number of explants with outgrowth and the number and length of the outgrowths. Other laser IEDs or fluorescent light irradiation did not influence maturation or regeneration.

  1. del Nido versus St. Thomas Cardioplegia Solutions: A Single-Center Retrospective Analysis of Post Cross-Clamp Defibrillation Rates.

    Science.gov (United States)

    Buel, Shane T; Striker, Carrie Whittaker; O'Brien, James E

    2016-06-01

    There are many cardioplegia solutions currently in use for pediatric cardiopulmonary bypass (CPB). The most common being del Nido solution. Another common cardioplegia solution used for pediatric CPB is St. Thomas. In October 2014, Children's Mercy Kansas City changed from the use of modified St. Thomas to del Nido. This study compared rates of post cross-clamp fibrillation requiring defibrillation between del Nido solution and modified St. Thomas solution stratified by weight at Children's Mercy Kansas City. This retrospective study consisted of 394 patients who underwent cardiac surgery requiring cardioplegia between January 1, 2014 and July 31, 2015. The outcome measured was defibrillation upon cross-clamp removal. Statistical significance was determined using Fishers exact test with a two-sided significance level of .05. Incidence of defibrillation post cross-clamp removal was 4.4% in the del Nido group and 26.8% in the St. Thomas group (p 60-kg category had an incidence of defibrillation of 16.7% in the del Nido group and 63% in the St. Thomas group (p < .0623). This study demonstrates a 6-fold decrease in the overall rate of defibrillation post cross-clamp removal between St. Thomas and del Nido cardioplegia solutions. Analyses of weight stratifications demonstrate a decrease in the rate of defibrillation post cross-clamp removal in all categories within the del Nido group. PMID:27578896

  2. Pine somatic embryogenesis using zygotic embryos as explants.

    Science.gov (United States)

    Pullman, Gerald S; Bucalo, Kylie

    2011-01-01

    Somatic embryogenesis (SE) has the potential to be the lowest-cost method to rapidly produce large numbers of high-value somatic seedlings with desired characteristics for plantation forestry. At least 24 of the 115-120 known Pinus species can undergo SE. Initiation for most species works best with immature megagametophytes as starting material, although a few pines can initiate SE cultures from isolated mature seed embryos. Successful initiation depends heavily on explant type, embryo developmental stage, and medium salt base. Most first reports of initiation used 2,4-D and BAP or a combination of cytokinins. More recent reports have optimized initiation for many Pinus spp., but still use mostly the combinations of auxin and cytokinins. Initiation can be stimulated with medium supplements including abscisic acid (ABA), brassinosteroids, ethylene inhibitors, gibberellin inhibitors, organic acids, putrescine, specific sugar types (maltose, galactose, D-chiro-inositol, and D-xylose), triacontanol, vitamins (B12, biotin, vitamin E, and folic acid), or manipulation of environmental factors including pH, water potential, cone cold storage, gelling agent concentration, and liquid medium. Embryo development and maturation usually occur best on medium containing ABA along with water potential reduction (with sugars and polyethylene glycol) or water availability reduction (with raised gelling agent increasing gel-strength). Activated carbon and maltose may also improve embryo maturation. The main issues holding SE technology back are related to the high cost of producing a somatic seedling, incurred from low initiation percentages for recalcitrant species, culture loss, and decline after initiation and poor embryo maturation resulting in no or poor germination. Although vast progress has been made in pine SE technology over the past 24 years, fundamental studies on seed and embryo physiology, biochemistry, and gene expression are still needed to help improve the technology

  3. Combining multiple ECG features does not improve prediction of defibrillation outcome compared to single features in a large population of out-of-hospital cardiac arrests

    OpenAIRE

    He, Mi; Gong, Yushun; Li, Yongqin; Mauri, Tommaso; Fumagalli, Francesca; Bozzola, Marcella; Cesana, Giancarlo; Latini, Roberto; Pesenti, Antonio; Ristagno, Giuseppe

    2015-01-01

    Introduction Quantitative electrocardiographic (ECG) waveform analysis provides a noninvasive reflection of the metabolic milieu of the myocardium during resuscitation and is a potentially useful tool to optimize the defibrillation strategy. However, whether combining multiple ECG features can improve the capability of defibrillation outcome prediction in comparison to single feature analysis is still uncertain. Methods A total of 3828 defibrillations from 1617 patients who experienced out-of...

  4. Effect of Hormones on Direct Shoot Regeneration in Hypocotyl Explants of Tomato

    Directory of Open Access Journals (Sweden)

    Rizwan RASHID

    2010-03-01

    Full Text Available This study was conducted for developing a high frequency regeneration system in two genotypes of tomato (Lycopersicon esculentum Mill., �Punjab Upma� and �IPA-3� for direct shoot regeneration from hypocotyl explants. The explants were excised from in vitro tomato seedlings and cultured on MS medium supplemented with different concentrations and combinations of hormones. Direct regeneration was significantly influenced by the genotype hormones combination and concentrations. The MS medium supplemented with (Kinetin 0.5 mg/l and (BAP 0.5 mg/l was found optimum for inducing direct shoot regeneration and number of shoots per explant from hypocotyl explants on this medium. Shoot regeneration per cent in �Punjab Upma� and �IPA-3� per cent was recorded to be highest i.e (86.02 and (82.57 respectively. Besides this, average number shoots per explant was also highest i.e (3.16 in case of �Punjab Upma� and (2.93 in case of �IPA-3�. A significant decline was observed in percent shoot regeneration and average number of shoots per explant with increase in the hormonal concentration. Shoots were obtained and transferred to the elongation medium (MS + BAP 0.3 mg/l. Hundred per cent rooting was induced in separated shoots upon culturing on MS and � MS basal media. Hardening on moist cotton showed maximum plantlet survival rate in case of both genotypes. After hardening, plants were transferred to soil. Thus, a tissue culture base line was established in tomato for obtaining direct regeneration using hypocotyl as explants.

  5. Staphylococcus aureus induces hypoxia and cellular damage in porcine dermal explants.

    Science.gov (United States)

    Lone, Abdul G; Atci, Erhan; Renslow, Ryan; Beyenal, Haluk; Noh, Susan; Fransson, Boel; Abu-Lail, Nehal; Park, Jeong-Jin; Gang, David R; Call, Douglas R

    2015-06-01

    We developed a porcine dermal explant model to determine the extent to which Staphylococcus aureus biofilm communities deplete oxygen, change pH, and produce damage in underlying tissue. Microelectrode measurements demonstrated that dissolved oxygen (DO) in biofilm-free dermal tissue was 4.45 ± 1.17 mg/liter, while DO levels for biofilm-infected tissue declined sharply from the surface, with no measurable oxygen detectable in the underlying dermal tissue. Magnetic resonance imaging demonstrated that biofilm-free dermal tissue had a significantly lower relative effective diffusion coefficient (0.26 ± 0.09 to 0.30 ± 0.12) than biofilm-infected dermal tissue (0.40 ± 0.12 to 0.48 ± 0.12; P < 0.0001). Thus, the difference in DO level was attributable to biofilm-induced oxygen demand rather than changes in oxygen diffusivity. Microelectrode measures showed that pH within biofilm-infected explants was more alkaline than in biofilm-free explants (8.0 ± 0.17 versus 7.5 ± 0.15, respectively; P < 0.002). Cellular and nuclear details were lost in the infected explants, consistent with cell death. Quantitative label-free shotgun proteomics demonstrated that both proapoptotic programmed cell death protein 5 and antiapoptotic macrophage migration inhibitory factor accumulated in the infected-explant spent medium, compared with uninfected-explant spent media (1,351-fold and 58-fold, respectively), consistent with the cooccurrence of apoptosis and necrosis in the explants. Biofilm-origin proteins reflected an extracellular matrix-adapted lifestyle of S. aureus. S. aureus biofilms deplete oxygen, increase pH, and induce cell death, all factors that contribute to impede wound healing.

  6. Staphylococcus aureus Induces Hypoxia and Cellular Damage in Porcine Dermal Explants

    Science.gov (United States)

    Lone, Abdul G.; Atci, Erhan; Renslow, Ryan; Beyenal, Haluk; Noh, Susan; Fransson, Boel; Abu-Lail, Nehal; Park, Jeong-Jin; Gang, David R.

    2015-01-01

    We developed a porcine dermal explant model to determine the extent to which Staphylococcus aureus biofilm communities deplete oxygen, change pH, and produce damage in underlying tissue. Microelectrode measurements demonstrated that dissolved oxygen (DO) in biofilm-free dermal tissue was 4.45 ± 1.17 mg/liter, while DO levels for biofilm-infected tissue declined sharply from the surface, with no measurable oxygen detectable in the underlying dermal tissue. Magnetic resonance imaging demonstrated that biofilm-free dermal tissue had a significantly lower relative effective diffusion coefficient (0.26 ± 0.09 to 0.30 ± 0.12) than biofilm-infected dermal tissue (0.40 ± 0.12 to 0.48 ± 0.12; P diffusivity. Microelectrode measures showed that pH within biofilm-infected explants was more alkaline than in biofilm-free explants (8.0 ± 0.17 versus 7.5 ± 0.15, respectively; P < 0.002). Cellular and nuclear details were lost in the infected explants, consistent with cell death. Quantitative label-free shotgun proteomics demonstrated that both proapoptotic programmed cell death protein 5 and antiapoptotic macrophage migration inhibitory factor accumulated in the infected-explant spent medium, compared with uninfected-explant spent media (1,351-fold and 58-fold, respectively), consistent with the cooccurrence of apoptosis and necrosis in the explants. Biofilm-origin proteins reflected an extracellular matrix-adapted lifestyle of S. aureus. S. aureus biofilms deplete oxygen, increase pH, and induce cell death, all factors that contribute to impede wound healing. PMID:25847960

  7. Cost of a Recall of a Single-Center Experience Managing the Riata Defibrillator Lead

    OpenAIRE

    Hussain, Sarah; Moorman, Liza; Moorman, J. Randall; DiMarco, John P.; Malhotra, Rohit; Darby, Andrew; Bilchick, Kenneth; Mangrum, J. Michael; Ferguson, John D.; Mason, Pamela K.

    2014-01-01

    Riata and Riata ST defibrillator leads (St. Jude Medical, Sylmar, California) were recalled in 2011 due to increased risk of insulation failure leading to externalized cables. Fluoroscopic screening can identify insulation failure, although the relation between mechanical failure and electrical failure is unclear. At the time of the recall, the University of Virginia developed a screening program, including fluoroscopic evaluation, education sessions, device interrogation, and remote monitori...

  8. Study on the Switching Time-Variation of Simultaneously Controlled IGBT: Case of Defibrillators Design

    OpenAIRE

    Mudrov T.; Kostov J.

    2009-01-01

    Samples of integrated gain bipolar transistors (IGBT) of the same type but produced under different technologies were tested about the switching time-variation. This is of high importance when several IGBT are connected in series to commutate high voltage defibrillation shocks. Very often, a short voltage overload of one of the IGBT in group leads to electrical breakdown of all transistors, due to nonsynchronised driving of the gate-emitter circuits. The goal of the study was to check whether...

  9. Plant regeneration from cotyledonary explants of Eucalyptus camaldulensis Regeneração de plantas de Eucalyptus camaldulensis a partir das explantes cotiledonares

    Directory of Open Access Journals (Sweden)

    Roberson Dibax

    2005-08-01

    Full Text Available Breeding methods based on genetic transformation techniques need to be implemented for Eucalyptus camaldulensis to shorten the long breeding cycles and avoid manipulation of adult trees; that requires the development of plant regeneration protocols enabling development of plants from transformed tissues. The present work aimed to optimise the regeneration process already established for the species. Cotyledonary leaves of E. camaldulensis were cultured in MS medium supplemented with naphthaleneacetic acid (NAA and 6-benzylaminopurine (BAP combinations. The most efficient treatment for bud indirect regeneration (2.7 µmol L-1 NAA and 4.44 µmol L-1 BAP was used for further experiments. When explants were kept in the dark during the first 30 days, the percentage of explants forming calluses increased and explant necrosis was reduced in comparison with light-cultured explants. Mineral medium modifications were compared and half-strength MS mineral medium turned out to be as efficient as full-strength medium, producing 54% and 47% of explants with buds, respectively. For shoot elongation, MS medium with half-strength nitrate and ammonium salts, and 0.2% activated charcoal yielded rooted shoots 1 to 8 cm high after one month. The procedure is an efficient protocol for E. camadulensis plant regeneration, reducing the stages necessary for the obtention of complete plants.A implementação, para espécies florestais, de técnicas de melhoramento baseadas em métodos de transformação genética, permitirá reduzir os longos ciclos de melhoramento e evitar a manipulação de árvores adultas. Isto implica dispor de um protocolo de regeneração que permita o desenvolvimento de plantas a partir de tecidos transformados. Este trabalho teve como objetivo otimizar este protocolo de regeneração para Eucalyptus camaldulensis. Folhas cotiledonares foram cultivadas em meio de cultura MS suplementado com combinações de ácido naftalenoacético (ANA e 6

  10. Organogênese de explante foliar de clones de Eucalyptus grandis x E. urophylla Organogenesis of the leaf explant of Eucalyptus grandis x E. urophylla clones

    Directory of Open Access Journals (Sweden)

    Elisa Cristina Soares de Carvalho Alves

    2004-05-01

    Full Text Available O objetivo deste trabalho foi avaliar os efeitos dos reguladores de crescimento TDZ [1-fenil-3-(1,2,3-tia-diazol-5-iluréia], BAP (6-benzilaminopurina e ANA (ácido naftalenoacético no desempenho da propagação in vitro por organogênese de explante foliar de três clones híbridos de Eucalyptus grandis x Eucalyptus urophylla. Houve resposta diferenciada dos clones quanto a intensidade, textura e coloração dos calos, em razão dos tratamentos com os reguladores de crescimento. Os melhores resultados de calejamento dos três genótipos foram observados nos tratamentos com a combinação dos reguladores de crescimento TDZ (0,5 mg L-1 e ANA (0,1 mg L-1, obtendo-se 100% de calejamento no explante foliar. Os piores resultados de calejamento foram observados nos tratamentos com a combinação dos reguladores de crescimento BAP (0,1 mg L-1 e ANA (0,1 mg L-1. Em relação à regeneração, a melhor resposta foi obtida com 1,0 mg L-1 BAP em que 8% dos calos formados a partir de explantes foliares regeneraram gemas, com número médio destas formadas por calo igual a 4,2.The aim of this work was to evaluate the effects of growth regulators TDZ [1-phenil-3-(1,2,3-thiadiazol-5-yl urea], BAP (6-benzilaminopurine e NAA (Naphthalene acetic acid on the in vitro propagation by organogenesis from foliar explants of Eucalyptus grandis x E. urophylla. Depending on the clone used, there were singular responses to growth regulators treatment regarding callusing intensity, texture and color. The best results of the three genotypes used were observed with the TDZ (0.5 mg L-1 and NAA (0.1 mg L-1 treatment, where 100% of the foliar explants presented callus. The worst results were observed with the BAP (0.1 mg L-1 and NAA (0.1 mg L-1 treatment. Subsequently, considering the regeneration process, the best response was achieved with 1.0 mg L-1 BAP, in which 8% of the calli regenerated buds, with an average of 4.2 buds per explant.

  11. Non-linear dynamical signal characterization for prediction of defibrillation success through machine learning

    Directory of Open Access Journals (Sweden)

    Shandilya Sharad

    2012-10-01

    Full Text Available Abstract Background Ventricular Fibrillation (VF is a common presenting dysrhythmia in the setting of cardiac arrest whose main treatment is defibrillation through direct current countershock to achieve return of spontaneous circulation. However, often defibrillation is unsuccessful and may even lead to the transition of VF to more nefarious rhythms such as asystole or pulseless electrical activity. Multiple methods have been proposed for predicting defibrillation success based on examination of the VF waveform. To date, however, no analytical technique has been widely accepted. We developed a unique approach of computational VF waveform analysis, with and without addition of the signal of end-tidal carbon dioxide (PetCO2, using advanced machine learning algorithms. We compare these results with those obtained using the Amplitude Spectral Area (AMSA technique. Methods A total of 90 pre-countershock ECG signals were analyzed form an accessible preshosptial cardiac arrest database. A unified predictive model, based on signal processing and machine learning, was developed with time-series and dual-tree complex wavelet transform features. Upon selection of correlated variables, a parametrically optimized support vector machine (SVM model was trained for predicting outcomes on the test sets. Training and testing was performed with nested 10-fold cross validation and 6–10 features for each test fold. Results The integrative model performs real-time, short-term (7.8 second analysis of the Electrocardiogram (ECG. For a total of 90 signals, 34 successful and 56 unsuccessful defibrillations were classified with an average Accuracy and Receiver Operator Characteristic (ROC Area Under the Curve (AUC of 82.2% and 85%, respectively. Incorporation of the end-tidal carbon dioxide signal boosted Accuracy and ROC AUC to 83.3% and 93.8%, respectively, for a smaller dataset containing 48 signals. VF analysis using AMSA resulted in accuracy and ROC AUC of 64

  12. 78 FR 43533 - Medicare and Medicaid Programs: Hospital Outpatient Prospective Payment and Ambulatory Surgical...

    Science.gov (United States)

    2013-07-19

    ..., Ninth Revision, Clinical Modification ICD Implantable cardioverter defibrillator ICU Intensive care unit...: Cardiac Rehabilitation Measure: Patient Referral From an Outpatient Setting D. Quality Measures...

  13. Heart pacemaker

    Science.gov (United States)

    ... Elsevier Saunders; 2015:chap 36. Read More Arrhythmias Atrial fibrillation or flutter Cardiac ablation procedures Heart failure - overview Implantable cardioverter-defibrillator Sick sinus syndrome Wolff- ...

  14. Association of psychiatric history and type D personality with symptoms of anxiety, depression, and health status prior to ICD implantation

    DEFF Research Database (Denmark)

    Starrenburg, Annemieke H; Kraaier, Karin; Pedersen, Susanne S.;

    2013-01-01

    Personality factors and psychiatric history may help explain individual differences in risk of psychological morbidity and poor health outcomes in patients with an implantable cardioverter defibrillator (ICD)....

  15. Embryoid Body-Explant Outgrowth Cultivation from Induced Pluripotent Stem Cells in an Automated Closed Platform

    Science.gov (United States)

    Tone, Hiroshi; Yoshioka, Saeko; Akiyama, Hirokazu; Nishimura, Akira; Ichimura, Masaki; Nakatani, Masaru; Kiyono, Tohru

    2016-01-01

    Automation of cell culture would facilitate stable cell expansion with consistent quality. In the present study, feasibility of an automated closed-cell culture system “P 4C S” for an embryoid body- (EB-) explant outgrowth culture was investigated as a model case for explant culture. After placing the induced pluripotent stem cell- (iPSC-) derived EBs into the system, the EBs successfully adhered to the culture surface and the cell outgrowth was clearly observed surrounding the adherent EBs. After confirming the outgrowth, we carried out subculture manipulation, in which the detached cells were simply dispersed by shaking the culture flask, leading to uniform cell distribution. This enabled continuous stable cell expansion, resulting in a cell yield of 3.1 × 107. There was no evidence of bacterial contamination throughout the cell culture experiments. We herewith developed the automated cultivation platform for EB-explant outgrowth cells. PMID:27648449

  16. Embryoid Body-Explant Outgrowth Cultivation from Induced Pluripotent Stem Cells in an Automated Closed Platform

    Science.gov (United States)

    Tone, Hiroshi; Yoshioka, Saeko; Akiyama, Hirokazu; Nishimura, Akira; Ichimura, Masaki; Nakatani, Masaru; Kiyono, Tohru

    2016-01-01

    Automation of cell culture would facilitate stable cell expansion with consistent quality. In the present study, feasibility of an automated closed-cell culture system “P 4C S” for an embryoid body- (EB-) explant outgrowth culture was investigated as a model case for explant culture. After placing the induced pluripotent stem cell- (iPSC-) derived EBs into the system, the EBs successfully adhered to the culture surface and the cell outgrowth was clearly observed surrounding the adherent EBs. After confirming the outgrowth, we carried out subculture manipulation, in which the detached cells were simply dispersed by shaking the culture flask, leading to uniform cell distribution. This enabled continuous stable cell expansion, resulting in a cell yield of 3.1 × 107. There was no evidence of bacterial contamination throughout the cell culture experiments. We herewith developed the automated cultivation platform for EB-explant outgrowth cells.

  17. Incidência de choques e qualidade de vida em jovens com cardioversor-desfibrilador implantável Incidence of shock and quality of life in young patients with implantable cardioverter-defibrillator

    Directory of Open Access Journals (Sweden)

    Roberto Costa

    2007-03-01

    Full Text Available OBJETIVOS: Avaliar a incidência e a causa de choques de CDI em crianças e adolescentes e sua repercussão na qualidade de vida (QV. MÉTODOS: De março/1997 a fevereiro/2006, 29 pacientes (15,7±5,4 anos foram submetidos a implante de CDI. Parada cardiorrespiratória recuperada (41,5%, taquicardia ventricular sustentada (27,6% e profilaxia primária de morte súbita cardíaca (30,9% motivaram os implantes. O número de terapias foi avaliado por entrevista e pela telemetria dos CDI. A QV foi avaliada pela aplicação do questionário SF-36 e comparada à de indivíduos saudáveis. Empregou-se o método de Kaplan-Meier para análise da sobrevida livre de choques. RESULTADOS: Após 2,6±1,8 anos de seguimento, 8 (27,6% pacientes receberam 141 choques apropriados em razão de TV polimórfica (6 ou FV (2, e 11 (37,9% sofreram 152 choques inapropriados em razão de taquiarritmias supraventriculares (8 ou oversensing (3. A expectativa de sobrevida livre de choques apropriados foi de 74,2%±9,0 após um ano, e de 66,7%±10,7 após três anos. Observou-se diminuição da QV nos aspectos físicos (61,7±28,7, na vitalidade (64,7±19,1, na saúde mental (65,9±22,7 e nos aspectos emocionais (66,7±38,5. Medo e preocupações relacionados ao CDI foram referidos por todos os pacientes. CONCLUSÃO: A despeito da grande eficácia dessa terapêutica, a incidência elevada de choques interferiu na QV e na adaptação ao dispositivo.OBJECTIVES: To analyze the incidence and causes of ICD therapies in children and young adults and verify their impact on the quality of life (QoL. METHODS: From March/1977 to February/2006, 29 patients (15.7±5.4 years old were submitted to ICD implants. Aborted cardiac arrest (41.5%, sustained ventricular tachycardia (27.6% and primary prophylaxis of sudden cardiac death (30.9% indicated device therapy. The number of therapies was evaluated by interviewing patients and by ICD diagnostic data. The SF-36 questionnaire was used to measure the QoL and the results were compared to healthy population. The expectative of freedom from ICD therapies were estimated by the Kaplan-Meier method. RESULTS: After 2.6±1.8 years follow-up, 8 (27.6% patients received 141 appropriate ICD shocks due to ventricular tachycardia (6 or ventricular fibrillation (2, and 11 (37.9% patients received 152 inappropriate ICD shocks due to supraventricular tachyarrhythmias (8 or oversensing (3. Expectative of freedom from appropriate shocks was 74.2±9.0% and 66.7±10.7% after one and three years, respectively. Compared to healthy population, QoL decreased in physical function (61.7±28.7, vitality (64.7±19.1, mental health (65.9±22.7 and role-emotional domains (66.7±38.5. All patients referred fear and concern related to ICD use. CONCLUSION: Despite the efficacy of ICD therapies, the high incidence of appropriate and inappropriate shocks interfered in patients’ QoL and adaptation to the device.

  18. Polymorphisms associated with ventricular tachyarrhythmias: rationale, design, and endpoints of the 'diagnostic data influence on disease management and relation of genomics to ventricular tachyarrhythmias in implantable cardioverter/defibrillator patients (DISCOVERY)' study

    DEFF Research Database (Denmark)

    Garcia, Javier; Wieneke, Heinrich; Spencker, Sebastian;

    2010-01-01

    (SNPs) are DNA sequence variations occurring when a single nucleotide in the genome differs among members of a species. A novel concept has emerged being that these common genetic variations might modify the susceptibility of a certain population to specific diseases. Thus, genetic factors may also...... modulate the risk for arrhythmias and sudden cardiac death, and identification of common variants could help to better identify patients at risk. The DISCOVERY study is an interventional, longitudinal, prospective, multi-centre diagnostic study that will enrol 1287 patients in approximately 80 European...... centres. In the genetic part of the DISCOVERY study, candidate gene polymorphisms involved in coding of the G-protein subunits will be correlated with the occurrence of ventricular arrhythmias in patients receiving an ICD for primary prevention. Furthermore, in order to search for additional sequence...

  19. Analysis of Clinical Application of Electric Defibrillation%电除颤的临床应用分析

    Institute of Scientific and Technical Information of China (English)

    李黎

    2015-01-01

    Objective To analyse the clinical application of electric defibril ation. Methods Our hospital admissions for patients with cardiac ar est in 78 cases as the research object, conform to the requirements of electric defibril ation indications, according to ventricular fibril ation cardiac arrest - time (T) divided into study group and control group, 40 cases in the study group, T 2min defibril ator. Comparative analysis of two groups of the successful rate of CPR and defibril ation ef iciency. Results The ef ective rate of the study group the successful rate of CPR and defibril ation were significantly higher than those in the control group ( 2min除颤。对比分析两组复苏成功率与除颤有效率。结果研究组复苏成功率与除颤有效率皆明显高于对照组(<0.05)。结论确保心脏骤停患者符合电除颤适应症且排除禁忌症情况下,尽早予以电除颤可提高复苏成功率与除颤有效率,值得借鉴。

  20. Effects of Ureaplasma diversum on bovine oviductal explants: quantitative measurement using a calmodulin assay.

    Science.gov (United States)

    Smits, B; Rosendal, S; Ruhnke, H L; Plante, C; O'Brien, P J; Miller, R B

    1994-01-01

    Calmodulin (CAM) acts as an intracellular regulator of calcium, an important mediator of many cell processes. We used the CAM assay and electron microscopy to investigate the effects of Ureaplasma diversum on bovine oviductal explants obtained aseptically from slaughtered cows. A stock suspension of U. diversum (treated specimens) and sterile broth (controls) was added to replicates of cultured explants and incubated at 38 degrees C in an atmosphere of 5.5% CO2 for 48 hours. Explants were examined for ciliary activity, extracellular CAM loss, and for histological and ultrastructural changes. Explants and their culture media were examined for changes in CAM concentration. All experiments were replicated three times. In addition, U. diversum, medium and broth were assayed for CAM content. The concentrations of CAM in explants and media changed significantly (p diversum when compared to controls. The controls and infected specimens did not differ histologically or ultrastructurally, but U. diversum was seen to be closely associated with infected explant tissue. In view of this close affinity it is assumed the loss of CAM from the oviductal cells was causally related, but this was not proven. The failure to show cell membrane injury on light and electron microscopic examination was probably related to the short duration of the experiment and may only point out the sensitivity of the CAM assay in detecting early cell membrane injury. Compromise in characteristics of the medium to support both, the viability of oviductal cells and U. diversum limited the experimental time to 48 hours.(ABSTRACT TRUNCATED AT 250 WORDS) Images Fig. 1. Fig. 2. Fig. 3. Fig. 4. Fig. 5. Fig. 6. PMID:8004536

  1. Complications after cardiac implantable electronic device implantations

    DEFF Research Database (Denmark)

    Kirkfeldt, Rikke Esberg; Johansen, Jens Brock; Nohr, Ellen Aagaard;

    2013-01-01

    Complications after cardiac implantable electronic device (CIED) treatment, including permanent pacemakers (PMs), cardiac resynchronization therapy devices with defibrillators (CRT-Ds) or without (CRT-Ps), and implantable cardioverter defibrillators (ICDs), are associated with increased patient...

  2. In Vitro Propagation of Desmodium gangeticum (L. DC. from Cotyledonary Nodal Explants

    Directory of Open Access Journals (Sweden)

    U R Vishwakarma

    2009-01-01

    Full Text Available An in vitro procedure for rapid multiplication of medicinally important plant Desmodium gangeticum (L. DC. (Fabaceae, has been developed using cotyledonary nodal explant. An average of 9.2 shoots per explant were obtained by culturing cotyledonary nodal explaint on Murashige and Skoog′s medium containing 8.8 μM BAP and 21.2 μM NAA, in combination, within 28 days. These shoots were rooted on half strength MS medium supplemented with IAA 17.1 μM. Rooted plantlets were hardened using 1:1:1 mixture of soil, river sand and vermiculite under green house conditions.

  3. In Vitro Propagation of Desmodium gangeticum (L.) DC. from Cotyledonary Nodal Explants

    OpenAIRE

    U R Vishwakarma; Gurav, A M; Sharma, P.C

    2009-01-01

    An in vitro procedure for rapid multiplication of medicinally important plant Desmodium gangeticum (L.) DC. (Fabaceae), has been developed using cotyledonary nodal explant. An average of 9.2 shoots per explant were obtained by culturing cotyledonary nodal explaint on Murashige and Skoog′s medium containing 8.8 μM BAP and 21.2 μM NAA, in combination, within 28 days. These shoots were rooted on half strength MS medium supplemented with IAA 17.1 μM. Rooted plantlets were hardened using 1:1:1 mix...

  4. Efficient Regeneration of �Caralis� Alstroemeria Cultivar from Rhizome Explants

    OpenAIRE

    Amir Ghaffar SHAHRIARI; Bagheri, Abdolreza; Sharifi, Ahmad; Nasrin MOSHTAGHI

    2012-01-01

    In this paper, the effects of a number of growth regulators as well as supplements to the Murashige and Skoog (MS) basal medium were evaluated on the regeneration of Alstroemeria rhizome explants. In the first experiment the effects of three cytokinins (BA, TDZ and 2IP each at 0.5, 1 and 2 mg/l) in combination with NAA (0.2 mg/l), followed by another PGR combination of 2IP (at 0.5, 1 and 2 mg/l) with NAA (0 and 0.2 mg/l), on regeneration of rhizome-derived explants, was investigated. Through ...

  5. Defibrillation efficacy of a newly developed automated external defibrillator in a swine ventricular tachycardia/fibrillation model%自主研发体外自动除颤器的实验研究

    Institute of Scientific and Technical Information of China (English)

    惠杰; 蒋文平; 谷云飞; 邬小玫; 朱宗成; 宋建平; 杨向军; 刘志华; 蒋廷波; 方祖祥

    2009-01-01

    Objective The aim of this study was to evaluate the recognition and defibrillation efficiency of a newly developed automated extemal defibrillator (AED). Method Ventricular tachycardia (VT) /ventricular fibrillation (VF) was induced by alternating current (50 Hz) through an electrode placed on apex of right ventricle in 23 anesthetized swine and recorded, recognized and defibrillated by a newly developed AED. Results A total of 96 VF was induced and 145 defibrillations were recorded. We analyzed available 167 electrocardiosignal with a total length of 103 740 seconds. The accuracy, sensitivity and the specificity of the AED on VT/VF recognition are 99.5%, 98.2% and 99.6%, respectively. The success rate of defibrillation was 33.4% which increased in proportion to defibrillation energy. The defibrillation threshold of energy is 29.10-116.91 (78.75±35.64 ) J, the defibrillation threshold of electric quantity is (0.11±0.04)C and the defibrillation threshold of voltage is (1216.67±260.87) V. Conclusions This newly developed AED has high sensitivity and the specificity on recognizing VT/VF. The lower success rate of defibrillation of this AED is associated with the low defibrillation energy during defibrillation which needs to be improved on further development.%目的 评价自主设计和研制体外自动除颤器(AED)对室性心动过速(室速)/心室颤动(室颤)识别的敏感性、特异性以及除颤效果.方法 应用交流电刺激实验动物诱发室速/室颤,记录并分析AED对窜速/室颤的识别以及除颤放电的整个过程,评价其诊断识别和除颤性能.结果 诱颤96次,除颤145次,记录心电数据167段次,共计103 740 S.室速/室颤的识别准确性为99.5%,敏感性为98.2%,特异性为99.6%.除颤成功率和除颤能量呈正相关,成功除颤的能量阈值为(78.75±35.64)J,电量阈值为(0.11±0.04)C,电压阈值为(1216.67±260.87)V.结论 自主研制的AED具有较高的识别敏感性和特异性,其识别和

  6. Discussion on Quality Control of Defibrillator Monitor%除颤监护器质量控制探讨

    Institute of Scientific and Technical Information of China (English)

    朱悦; 尹钢; 廖云粤

    2016-01-01

    In reference to Calibration Specification for Defibrillator Monitor, this paper adopted the Fluke Impluse7000DP Defibrillator Analyzers to conduct quality control to test five parameters of cardiac de-fibrillator monitors in our hospital, including appearance and function, delivered energy, charging time, delay time under synchronizer, and heart rate value. Timely maintenance was carried out on defibrillators with certain problems to ensure the safe use of defibrillators in clinical practice. Meanwhile a compar-ative analysis was conducted on the results of quality control. The research explored a quality control program that was appropriate for defibrillator quality control in the context of clinical experience in the hospital.%本文参照国家对除颤监护器的校准规范,采用Fluke Impluse7000DP除颤器分析仪,对本院的全部除颤监护器进行了外观功能、释放能量准确性、充电时间、同步延时时间、心率示值这5个项目的质控检测,对存在问题的除颤器及时进行维修,保证了除颤器的临床使用安全。同时对质控检测结果进行了比较分析,并结合临床的使用体验,探索适合我院除颤监护器质量控制方案。

  7. Effect of clinorotation on in vitro cultured explants of Mentha piperita L.

    Science.gov (United States)

    Paolicchi, Fabio; Mensuali-Sodi, Anna; Tognoni, Franco

    2002-02-14

    An in vitro culture system was used to study the influence of gravity on axillary shoot formation and adventitious root regeneration in Mentha piperita L. The direction of the gravity vector was altered by displacing stem node explants in different orientations. Also, microgravity conditions were simulated by rotating the explants on a horizontal clinostat so that the main axis of nodes was either parallel (Cpa) or perpendicular to the clinostat axis (Ccp and Ccf, centripetally and centrifugally oriented, respectively). Mint nodes were cultured on solidified Linsmaier and Skoog's medium [Physiol. Plant. 18 (1965) 100] adding a filter-sterilized aqueous solution of 2 mg/l benzyladenine (BA) in half of the cultures. The proliferation of axillary shoots as well as adventitious root formation were not affected by altering upright explant orientation. On the contrary clinorotation was able to modify plantlet development. In absence of BA, leaf width was hindered by Cpa treatment and penultimate internode length was enhanced by Ccp. Furthermore, a negative effect of Cpa treatment was observed in root length parameter, while Ccp increased the root number both in absence and in presence of BA. An effect strictly connected to clinorotation in presence of BA was the occurrence of hyperhydricity. Moreover, explants under clinorotation treatments switched their gravitropic response modifying shoot curvature.

  8. Fumonisin B₁ (FB₁) Induces Lamellar Separation and Alters Sphingolipid Metabolism of In Vitro Cultured Hoof Explants.

    Science.gov (United States)

    Reisinger, Nicole; Dohnal, Ilse; Nagl, Veronika; Schaumberger, Simone; Schatzmayr, Gerd; Mayer, Elisabeth

    2016-03-24

    One of the most important hoof diseases is laminitis. Yet, the pathology of laminitis is not fully understood. Different bacterial toxins, e.g. endotoxins or exotoxins, seem to play an important role. Additionally, ingestion of mycotoxins, toxic secondary metabolites of fungi, might contribute to the onset of laminitis. In this respect, fumonsins are of special interest since horses are regarded as species most susceptible to this group of mycotoxins. The aim of our study was to investigate the influence of fumonisin B₁ (FB₁) on primary isolated epidermal and dermal hoof cells, as well as on the lamellar tissue integrity and sphingolipid metabolism of hoof explants in vitro. There was no effect of FB₁ at any concentration on dermal or epidermal cells. However, FB₁ significantly reduced the separation force of explants after 24 h of incubation. The Sa/So ratio was significantly increased in supernatants of explants incubated with FB₁ (2.5-10 µg/mL) after 24 h. Observed effects on Sa/So ratio were linked to significantly increased sphinganine concentrations. Our study showed that FB₁ impairs the sphingolipid metabolism of explants and reduces lamellar integrity at non-cytotoxic concentrations. FB₁ might, therefore, affect hoof health. Further in vitro and in vivo studies are necessary to elucidate the effects of FB₁ on the equine hoof in more detail.

  9. CALLUS INDUCTION AND PLANT REGENERATION IN PUNICA GRANATUM L. ?NANA' FROM LEAF EXPLANTS

    Directory of Open Access Journals (Sweden)

    Alireza Bonyanpour

    2013-09-01

    Full Text Available ABSTRACT In this investigation, leaf explants of a local cultivar of dwarf pomegranate were placed on Murashige and Skoog (1962 (MS medium supplemented with various concentrations of 6-benzyl adenin (BA and naphthalene acetic acid (NAA for callus induction. After 40 days, maximum callus induction was observed on a media containing 1 mg L-1 BA and 0.2 to 0.4 mg L-1 NAA. However, the highest callus growth was obtained on a medium containing 1 mg L-1 BA and 1 mg L-1 NAA. The highest number of shoots (7 shoots per explants was obtained by transferring the calli to the media containing 5 mg L-1 BA with 0.1 mg L-1 NAA. Maximum shoot proliferation was observed when shoots were cultured on woody plant medium (WPM supplemented with 5 mg L-1 kinetin (Kin. In this treatment, after 4 subcultures, 36 shoots were produced from one original explant. Among treatments used in rooting experiments, shoots cultured on WPM medium containing 0.2 mg L-1 indol butyric acid (IBA had the maximum root percentage (100% and good root growth (2.06 cm mean length and 2 roots in each explants. Rooted plantlets were cultured in a soil mixture containing vermiculite (60%, perlite (30% and coco peat (10% v/v. After 2 months, 80% of plants survived and transferred to the greenhouse.

  10. Re-use of explanted DDD pacemakers as VDD- clinical utility and cost effectiveness.

    Science.gov (United States)

    Namboodiri, K K N; Sharma, Y P; Bali, H K; Grover, A

    2004-01-01

    Re-use of DDD pulse generators explanted from patients died of unrelated causes is associated with an additional cost of two transvenous leads if implanted as DDD itself, and high rate of infection according to some studies. We studied the clinical and economical aspects of reutilization of explanted DDD pacemakers programmed to VDD mode. Out of 28 patients who received VDD pacemaker during the period, October 2000- September 2001 in the Department of Cardiology, PGIMER, Chandigarh, 5 poor patients were implanted with explanted DDD pulse generators programmed to VDD mode. Each implantation was planned and carried out according to a standard protocol. The age ranged from 45 to 75 (mean-61) years. The indications for pacing were complete heart block (4) and second degree AV block (1). The clinical profile, costs and complications, if any were noted and followed up at regular intervals. The results were compared with patients who received new DDD pulse generators during this period. The additional cost for the atrial lead was not required in these patients. None of these patients had any local site infection. Compared to the two-lead system, the single lead system provided more rapid implantation and minimized complications associated with placement of an atrial lead. The explanted DDD pacemaker can be safely reused as VDD mode with same efficacy in selected patient population. This is associated with lower cost and complications compared to reimplantation as DDD itself.

  11. Production of immunoglobulins in gingival tissue explant cultures from juvenile periodontitis patients

    Energy Technology Data Exchange (ETDEWEB)

    Hall, E.R.; Falkler, W.A. Jr.; Suzuki, J.B. (Univ. of Maryland Dental School, Baltimore (USA))

    1990-10-01

    B lymphocytes and plasma cells are histologically observed in granulomatous periodontal tissues of juvenile periodontitis (JP) patients. Local immune processes may participate in protective or immunopathologic roles in the pathogenesis of this disease. An in vitro explant culture system was utilized to demonstrate the production of immunoglobulins by diseased JP tissues. Immunodiffusion studies using goat anti-human gamma, alpha, or mu chain serum revealed IgG to be the major immunoglobulin present in 92% of the day 1 supernatant fluids (SF) of the 47 JP gingival tissue explant cultures. IgA was present in 15% of the SF; however, no IgM was detected. Staph Protein A isolated 14C-labeled IgG from the SF, when allowed to react with goat anti-human gamma chain serum, formed lines of precipitation. Positive autoradiographs confirmed the biosynthesis of IgG by the explant cultures. The in vitro gingival tissue explant culture system described provides a useful model for the study of localized immunoglobulins produced by diseased tissues of JP patients.

  12. Fumonisin B₁ (FB₁) Induces Lamellar Separation and Alters Sphingolipid Metabolism of In Vitro Cultured Hoof Explants.

    Science.gov (United States)

    Reisinger, Nicole; Dohnal, Ilse; Nagl, Veronika; Schaumberger, Simone; Schatzmayr, Gerd; Mayer, Elisabeth

    2016-04-01

    One of the most important hoof diseases is laminitis. Yet, the pathology of laminitis is not fully understood. Different bacterial toxins, e.g. endotoxins or exotoxins, seem to play an important role. Additionally, ingestion of mycotoxins, toxic secondary metabolites of fungi, might contribute to the onset of laminitis. In this respect, fumonsins are of special interest since horses are regarded as species most susceptible to this group of mycotoxins. The aim of our study was to investigate the influence of fumonisin B₁ (FB₁) on primary isolated epidermal and dermal hoof cells, as well as on the lamellar tissue integrity and sphingolipid metabolism of hoof explants in vitro. There was no effect of FB₁ at any concentration on dermal or epidermal cells. However, FB₁ significantly reduced the separation force of explants after 24 h of incubation. The Sa/So ratio was significantly increased in supernatants of explants incubated with FB₁ (2.5-10 µg/mL) after 24 h. Observed effects on Sa/So ratio were linked to significantly increased sphinganine concentrations. Our study showed that FB₁ impairs the sphingolipid metabolism of explants and reduces lamellar integrity at non-cytotoxic concentrations. FB₁ might, therefore, affect hoof health. Further in vitro and in vivo studies are necessary to elucidate the effects of FB₁ on the equine hoof in more detail. PMID:27023602

  13. Effects of electromagnetic fields on proteoglycan metabolism of bovine articular cartilage explants

    NARCIS (Netherlands)

    De Mattei, M; Pasello, M; Pellati, A; Stabellini, G; Massari, L; Gemmati, D; Caruso, A

    2003-01-01

    Electromagnetic field (EMF) exposure has been proposed for the treatment of osteoarthritis. In this study, we investigated the effects of EMF (75 Hz, 2,3 mT) on proteoglycan (PG) metabolism of bovine articular cartilage explants cultured in vitro, both under basal conditions and in the presence of i

  14. Staphylococcus aureus induces hypoxia and cellular damage in porcine dermal explants

    Science.gov (United States)

    Methicillin-resistant Staphylococcus aureus (MRSA) can infect wounds and produce difficult-to- treat biofilms. To determine the extent that MRSA biofilms can deplete oxygen, change pH and damage host tissue, we developed a porcine dermal explant model on which we cultured GFP-labeled MRSA biofilms. ...

  15. Effect of explant type on the rooting and acclimatization of Dianthus serotinus Waldst. & Kit.

    Directory of Open Access Journals (Sweden)

    Marković Marija

    2014-01-01

    Full Text Available The effect of the concentration of MS salts and explant type on D. serotinus rooting and acclimatization was investigated in order to optimize a protocol for the micropropagation of this species. The obtained results showed that explant type as well as the concentration of MS salts had a significant effect on rooting, and the highest rooting rate (85-86,7% was achieved when culturing single-node cuttings and terminal buds on a half-strength MS medium supplemented with 0,5 mgL-1 NAA. Nevertheless, mean number of roots per explant was higher on the MS media (15,3-18,6 than on the half-strength MS media (11,8-13,4. The best acclimatization rate was obtained in a 4:1 mixture of peat and sand (83,3-86,7%. The explant type from which in vitro plantlets developed had no effect on the acclimatization rate. [Projekat Ministarstva nauke Republike Srbije, br. 43007

  16. Effect of Pre-culture Irradiation and Explant Types on Efficiency of Brassica napus Genetic Transformation

    International Nuclear Information System (INIS)

    The irradiated seeds of canola cv. Drakkar ( Brassica napus l. ) were germinated under aspect conditions, cotyledonary petioles and hypocotyl of 6 days old seedlings were used for Agrobacterium-mediated transformation. Agrobacterium tumefaciens has construct with the selectable marker gene (NPT II) and the desirable gene (HPPD). Direct and indirect shoot organogenesis were obtained from the both explants. Cotyledonary petioles was higher responded than hypocotyl with respective 26% and 14% of the explants producing NPT II-positive shoots after the selection on 50mg/l kanamycin. Calli might develop on and not in the agar medium were un transformation. This explains the higher number of escapes detected in hypocotyl explants than in experiments with cotyledons. The frequency of transformation plants as a function of indirect organogenesis was more than direct shoot regeneration from explants. The pre- irradiation with 75 Gy of gamma rays enhanced the genetic transformation frequencies by about 10 % as compared to that of the un-irradiated material. The obtained shoots were rooted and regenerated mature plants

  17. Effect of explants, hormonal combination and genotype on micropropagation of pepper

    Directory of Open Access Journals (Sweden)

    Z. Moheb Mohamadi

    2014-07-01

    Full Text Available Pepper (Capsicum annuum is generally propagated from seeds. In Iran, imported hybrid seeds are used for this purpose. Germination of the greenhouse pepper seeds and stabilization of their seedlings takes a long time. But, tissue culture technique could rapidly propagate this plant with a homogeneous genetic structure in a large scale. An attempt was made in this study to evaluate the effects of different genotypes, explants and growth regulators on callus production and regeneration and introduce the appropriate protocol for micropropagation of commercial varieties of pepper in Iran. Analysis of variance indicated that effect of different genotypes, interaction of various explants and combination of hormones and interaction between genotypes, explants and hormones were significant on the evaluated traits at 1% level. Based on the results, for micropropagation of pepper with leaves and cotyledons, combination of 1 mg/l IAA and 5 mg/l BAP was selected. It seems that using leaf explants for micropropagation of pepper in large scale in greenhouses would be suitable.

  18. Characterisation of coral explants: a model organism for cnidarian-dinoflagellate studies

    Science.gov (United States)

    Gardner, S. G.; Nielsen, D. A.; Petrou, K.; Larkum, A. W. D.; Ralph, P. J.

    2015-03-01

    Coral cell cultures made from reef-building scleractinian corals have the potential to aid in the pursuit of understanding of the cnidarian-dinoflagellate symbiosis. Various methods have previously been described for the production of cell cultures in vitro with a range of success and longevity. In this study, viable tissue spheroids containing host tissue and symbionts (coral explants) were grown from the tissues of Fungia granulosa. The cultured explants remained viable for over 2 months and showed morphological similarities in tissue structure and internal microenvironment to reef-building scleractinian corals. The photophysiology of the explants (1 week old) closely matched that of the parent coral F. granulosa. This study provides the first empirical basis for supporting the use of coral explants as laboratory models for studying coral symbioses. In particular, it highlights how these small, self-sustaining, skeleton-free models can be useful for a number of molecular, genetic and physiological analyses necessary for investigating host-symbiont interactions at the microscale.

  19. A RIFAMPICINA NA DESCONTAMINAÇÃO BACTERIANA DE EXPLANTES DE MAMOEIRO PROVENIENTES DO CAMPO

    Directory of Open Access Journals (Sweden)

    GIOVANNI RODRIGUES VIANNA

    1997-01-01

    Full Text Available Observou-se alta contaminação bacteriana nos explantes de mamoeiro introduzidos in vitro, a partir de plantas matrizes desenvolvidas no campo, independentemente da época do ano em que se realizaram as coletas. O uso de desinfestantes superficiais, como álcool e hipoclorito de sódio, garantiram níveis aceitáveis de controle apenas para fungos, não para bactérias. A rifampicina, por tratamento de imersão ou introdução em meio de cultura, controlou satisfatoriamente as contaminações de caráter endofítico, obtendo-se 70% de explantes sadios, sem sinais de fitotoxicidade.High contamination by bacteria was observed in papaya tissue cuttings introduced in vitro from plants grown in the field, independent of the period of the year that samples were collected. The use of alcohol and sodium hypoclorite did not guarantee good bacteria control. Rifampicin, added as an immersion solution treatment or in the culture media, controlled the internal contamination of explants, without damaging the cuttings. Up to 70% of healthy tissue explants were obtained by the use of rifampicin.

  20. TED-Time and life saving External Defibrillator for home-use.

    Science.gov (United States)

    Weiss, Teddy A; Rosenheck, Shimon; Gorni, Shraga; Katz, Ioni; Mendelbaum, Mendel; Gilon, Dan

    2014-06-01

    Sudden Cardiac Death--SCD --is a major unmet health problem that needs urgent and prompt solution. AICDs are very expensive, risky and indicated for a small group of patients, at the highest risk. AEDs--Automatic External Defibrillators--are designed for public places and although safe, cannot enter the home-market due to their cost and need for constant, high-cost maintenance. We developed TED, a low-cost AED that derives its energy off the mains, designed for home-use, to save SCD victims' lives. PMID:24721586

  1. Is there an Optimal Shape of the Defibrillation Shock: Constant Current vs. Pulsed Biphasic Waveforms

    OpenAIRE

    Ivan Dotsinsky; Tsvetan Mudrov; Vessela Krasteva; Jecho Kostov

    2013-01-01

    Three waveforms for transthoracic defibrillation are assessed and compared: the Pulsed Biphasic Waveform (PBW), the Rectilinear Biphasic Waveform (RBW), and the "lossless" constant current (LLCC) pulses. Two indices are introduced: 1) kf = W/W0 - the ratio between the delivered energy W and the energy W0 of a rectangular pulse with the same duration and electric charge; 2) ηC = W/WC0 - the level of utilizing the initially loaded capacitor energy WC0. The envisioned comparative study shows tha...

  2. Ventricular Arrhythmias in Apparently Normal Hearts: Who Needs an Implantable Cardiac Defibrillator?

    Science.gov (United States)

    Tan, Alex Y; Ellenbogen, Kenneth

    2016-09-01

    Idiopathic ventricular tachycardia is often considered a benign form of ventricular arrhythmia in patients without apparent structural heart disease. However, a subset of patients may develop malignant ventricular arrhythmias and present with syncope and sudden cardiac arrest. Survivors of cardiac arrest are candidates for implantable cardiac defibrillators (ICDs). The indications for ICDs in patients with less than a full-blown cardiac arrest presentation but with electrocardiographically high-risk ectopy features remain uncertain. This article addresses some of the uncertainties and pitfalls in ICD risk stratification in this patient group and explores potential mechanisms for malignant conversion of benign premature ventricular complexes to sustained arrhythmia.

  3. Ventricular Arrhythmias in Apparently Normal Hearts: Who Needs an Implantable Cardiac Defibrillator?

    Science.gov (United States)

    Tan, Alex Y; Ellenbogen, Kenneth

    2016-09-01

    Idiopathic ventricular tachycardia is often considered a benign form of ventricular arrhythmia in patients without apparent structural heart disease. However, a subset of patients may develop malignant ventricular arrhythmias and present with syncope and sudden cardiac arrest. Survivors of cardiac arrest are candidates for implantable cardiac defibrillators (ICDs). The indications for ICDs in patients with less than a full-blown cardiac arrest presentation but with electrocardiographically high-risk ectopy features remain uncertain. This article addresses some of the uncertainties and pitfalls in ICD risk stratification in this patient group and explores potential mechanisms for malignant conversion of benign premature ventricular complexes to sustained arrhythmia. PMID:27521094

  4. Study on the Switching Time-Variation of Simultaneously Controlled IGBT: Case of Defibrillators Design

    Directory of Open Access Journals (Sweden)

    Mudrov T.

    2009-12-01

    Full Text Available Samples of integrated gain bipolar transistors (IGBT of the same type but produced under different technologies were tested about the switching time-variation. This is of high importance when several IGBT are connected in series to commutate high voltage defibrillation shocks. Very often, a short voltage overload of one of the IGBT in group leads to electrical breakdown of all transistors, due to nonsynchronised driving of the gate-emitter circuits. The goal of the study was to check whether compensation of the delays introduced throughout the IGBT control circuits might be efficient despite the own dispersion of the transistor parameters.

  5. 经胸双相波除颤的进展

    Institute of Scientific and Technical Information of China (English)

    RogerDWhiteMD

    2005-01-01

    In 1996 the United States Food and Drug Administration approved the first biphasic waveform for external defibrillation after the safety and efficacy of biphasic waveforms had been well-established for defibrillation with internal cardioverter-defibrillators (ICDs). The first approved waveform was incorporated in an automated external defibrillator (AED) marketed as the ForeRunner ((Philips Medical Systems,

  6. Milk Thistle Extract and Silymarin Inhibit Lipopolysaccharide Induced Lamellar Separation of Hoof Explants in Vitro

    Directory of Open Access Journals (Sweden)

    Nicole Reisinger

    2014-10-01

    Full Text Available The pathogenesis of laminitis is not completely identified and the role of endotoxins (lipopolysaccharides, LPS in this process remains unclear. Phytogenic substances, like milk thistle (MT and silymarin, are known for their anti-inflammatory and antioxidant properties and might therefore have the potential to counteract endotoxin induced effects on the hoof lamellar tissue. The aim of our study was to investigate the influence of endotoxins on lamellar tissue integrity and to test if MT and silymarin are capable of inhibiting LPS-induced effects in an in vitro/ex vivo model. In preliminary tests, LPS neutralization efficiency of these phytogenics was determined in an in vitro neutralization assay. Furthermore, tissue explants gained from hooves of slaughter horses were tested for lamellar separation after incubation with different concentrations of LPS. By combined incubation of explants with LPS and either Polymyxin B (PMB; positive control, MT or silymarin, the influence of these substances on LPS-induced effects was assessed. In the in vitro neutralization assay, MT and silymarin reduced LPS concentrations by 64% and 75%, respectively, in comparison PMB reduced 98% of the LPS concentration. In hoof explants, LPS led to a concentration dependent separation. Accordantly, separation force was significantly decreased by 10 µg/mL LPS. PMB, MT and silymarin could significantly improve tissue integrity of explants incubated with 10 µg/mL LPS. This study showed that LPS had a negative influence on the structure of hoof explants in vitro. MT and silymarin reduced endotoxin activity and inhibited LPS-induced effects on the lamellar tissue. Hence, MT and silymarin might be used to support the prevention of laminitis and should be further evaluated for this application.

  7. Improved explant method to isolate umbilical cord-derived mesenchymal stem cells and their immunosuppressive properties.

    Science.gov (United States)

    Mori, Yuka; Ohshimo, Jun; Shimazu, Takahisa; He, Haiping; Takahashi, Atsuko; Yamamoto, Yuki; Tsunoda, Hajime; Tojo, Arinobu; Nagamura-Inoue, Tokiko

    2015-04-01

    The umbilical cord (UC) has become one of the major sources of mesenchymal stem cells (MSCs). The common explant method of isolating UC-derived MSCs (UC-MSCs) involves mincing the UCs into small fragments, which are then attached to a culture dish bottom from which the MSCs migrate. However, the fragments frequently float up from the bottom of the dish, thereby reducing the cell recovery rate. To overcome this problem, we demonstrate an improved explant method for UC-MSC isolation, which involves the use of a stainless steel mesh (Cellamigo(®); Tsubakimoto Chain Co.), to protect the tissue from floating after the minced fragments are aligned at regular intervals in culture dishes. The culture medium was refreshed every 3 days and the adherent cells and tissue fragments were harvested using trypsin. The number of UC-MSCs isolated from 1 g of UC using the explant method with Cellamigo was 2.9 ± 1.4 × 10(6)/g, which was significantly higher than that obtained without Cellamigo (0.66 ± 0.53 × 10(6)/g) (n = 6, p < 0.01) when cells reached 80-90% confluence. In addition, the processing and incubation time required to reach 80-90% confluence was reduced in the improved explant method compared with the conventional method. The UC-MSCs isolated using the improved method were positive for CD105, CD73, CD90, and HLA class I expression and negative for CD45 and HLA class II expression. The isolated UC-MSCs efficiently inhibited the responder T cells induced by allogeneic dendritic cells in a mixed lymphocyte reaction. Conclusively, we demonstrated that the use of Cellamigo improves the explant method for isolating UC-MSCs. PMID:25220032

  8. Efficient Regeneration of �Caralis� Alstroemeria Cultivar from Rhizome Explants

    Directory of Open Access Journals (Sweden)

    Amir Ghaffar SHAHRIARI

    2012-05-01

    Full Text Available In this paper, the effects of a number of growth regulators as well as supplements to the Murashige and Skoog (MS basal medium were evaluated on the regeneration of Alstroemeria rhizome explants. In the first experiment the effects of three cytokinins (BA, TDZ and 2IP each at 0.5, 1 and 2 mg/l in combination with NAA (0.2 mg/l, followed by another PGR combination of 2IP (at 0.5, 1 and 2 mg/l with NAA (0 and 0.2 mg/l, on regeneration of rhizome-derived explants, was investigated. Through the second experiment, the effects of a number of supplements, including glucose (30 g/l as the alternative for sucrose, casein hydrolysate (1 g/l, asparagine and glutamine, (each at 30 mg/l added to MS medium, containing 1 mg/l BA and 0.2 mg/l NAA, was examined on rhizome explants� regeneration. Among the tested cytokinins, BA induced better regeneration of rhizome explants, resulting in a higher number of shoots compared to the other cytokinins. A medium supplemented with 1 mg/l BA and 0.2 mg/l NAA proved to be the most effective, with an average of 4.16 regenerated shoots per explant. In the second PGR combination, addition of NAA at 0.2 mg/l improved regeneration, compared to NAA-free treatments. In the second experiment, glucose substitution for sucrose improved regeneration with an average of 5.10 regenerated shoots per explant, compared to 4.16 shoots in sucrose-containing medium; whereas glutamine and asparagine (with 2.66 shoots and casein hydrolysate (with 3.80 shoots showed a negative influence on rhizome explants� regeneration.

  9. Influencing micropropagation in Clitoria ternatea L. through the manipulation of TDZ levels and use of different explant types.

    Science.gov (United States)

    Mukhtar, Seemab; Ahmad, Naseem; Khan, Md Imran; Anis, Mohammad; Aref, Ibrahim M

    2012-10-01

    A comparative performance of two explants types (CN and Nodal) for their efficiency to induce multiple shoot regeneration in Clitoria ternatea has been carried out. Thidiazuron (TDZ) in different concentrations (0.05-2.5 μM) was used as a supplement to the Murashige and Skoog's (MS) basal media. Explant type apart, two factors viz. concentration and exposure duration to TDZ played an important role in affecting multiple shoot regeneration. Cotyledonary node explants produced the best results at 0.1 μM TDZ, while in nodal explants the highest rate of shoot formation was achieved on MS medium supplemented with 1.0 μM TDZ. In both the explants, shoot multiplication increased when the regenerated shoots were subcultured on hormone free MS medium after 4 weeks of exposure to TDZ. Among the two, cotyledonary node explants produced considerably higher number of shoots at a comparatively lower concentration of TDZ than nodal explants. The regenerated shoots rooted best on MS medium containing 1.0 μM indole-3-butyric acid (IBA) and were successfully established in pots containing garden soil with 88 % survival rate. All the regenerated plants showed normal morphology and growth characteristics. PMID:24082502

  10. Prospective Nationwide Fluoroscopic and Electrical Longitudinal Follow-up of Recalled Riata Defibrillator Leads in Denmark

    DEFF Research Database (Denmark)

    Larsen, Jacob M.; Nielsen, Jens C; Johansen, Jens B;

    2014-01-01

    BACKGROUND Recalled St. Jude Medical Riata defibrillator leads are prone to insulation failures with externalized conductors (ECs). Longitudinal studies are needed to guide lead management. OBJECTIVE The purpose of this study was to describe the dynamic nature of EC and the association with elect......BACKGROUND Recalled St. Jude Medical Riata defibrillator leads are prone to insulation failures with externalized conductors (ECs). Longitudinal studies are needed to guide lead management. OBJECTIVE The purpose of this study was to describe the dynamic nature of EC and the association...... with electrical abnormalities and lead extraction outcomes. METHODS A nationwide cohort established in 2012 of 295 patients with recalled Riata leads with dwell time 5.1 +/- 1.1 years, 34 ECs, and 19 electrical abnormalities were followed until death, lead discontinuation with fluoroscopy, or a new 2013 screening......-up in 27 patients with baseline EC showed an increase in EC length of 4 +/- 1 mm (P Electrical follow-up in 276 patients with normal baseline electrical function demonstrated 20 incident electrical abnormalities after 1.0 +/- 0.3 years, with an incidence rate of 7.1 per 100...

  11. Is there an Optimal Shape of the Defibrillation Shock: Constant Current vs. Pulsed Biphasic Waveforms

    Directory of Open Access Journals (Sweden)

    Ivan Dotsinsky

    2013-04-01

    Full Text Available Three waveforms for transthoracic defibrillation are assessed and compared: the Pulsed Biphasic Waveform (PBW, the Rectilinear Biphasic Waveform (RBW, and the "lossless" constant current (LLCC pulses. Two indices are introduced: 1 kf = W/W0 - the ratio between the delivered energy W and the energy W0 of a rectangular pulse with the same duration and electric charge; 2 ηC = W/WC0 - the level of utilizing the initially loaded capacitor energy WC0. The envisioned comparative study shows that ηC index is favorable for both PBW and LLCC, while kf of both RBW and LLCC demonstrates advantage over the PBW in the range of small inter-electrode thoracic impedances below 80 Ω. Some design considerations are also discussed. The attractive LLCC concept needs large and heavy inductive coil to support the constant current amplitude, besides it is capable to induce strong electromagnetic influences due to the complex current control. The RBW technology controls the delivery of current through a series of internal resistors which are, however, a source of high heat losses. The PBW implements controlled duty cycle of high-frequency chopped pulses to adapt the energy delivery in respect of the patient impedance measured at the beginning of the shock. PBW technology makes use of small capacitors which allows the construction of light weight and small-size portable devices for transthoracic defibrillation.

  12. The prognosis of implantable defibrillator patients treated with cardiac resynchronization therapy: Comorbidity burden as predictor of mortality

    NARCIS (Netherlands)

    D.A.M.J. Theuns (Dominic); B. Schaer (Beat); O.I.I. Soliman (Osama Ibrahim Ibrahim); D. Altmann (David); C. Sticherling (Christian); M.L. Geleijnse (Marcel); S. Osswald (Stefan); L.J.L.M. Jordaens (Luc)

    2011-01-01

    textabstractAimsComorbidity, such as myocardial infarction, diabetes, and renal failure, plays a pivotal role in the prognosis of a patient with arrhythmias. However, data on the prognostic impact of comorbiditiy in heart failure patients with cardiac resynchronization therapy and defibrillation (CR

  13. Worldwide experience with a totally subcutaneous implantable defibrillator: Early results from the EFFORTLESS S-ICD registry

    NARCIS (Netherlands)

    P.D. Lambiase (Pier); C.S. Barr (Craig); D.A.M.J. Theuns (Dominic); R.E. Knops (Reinoud); P. Neuzil (Petr); J.B. Johansen (Jens); A.M. Hood (Margaret); S.S. Pedersen (Susanne); S. Kääb (Stefan); F.D. Murgatroyd (Francis); H.L. Reeve (Helen); N. Carter (Nathan); L. Boersma (Lucas)

    2014-01-01

    textabstractAims The totally subcutaneous implantable-defibrillator (S-ICD) is a new alternative to the conventional transvenous ICD system to minimize intravascular lead complications. There are limited data describing the long-term performance of the S-ICD. This paper presents the first large inte

  14. Subclavian Vein Stenosis/Occlusion Following Transvenous Cardiac Pacemaker and Defibrillator Implantation: Incidence, Pathophysiology and Current Management

    Directory of Open Access Journals (Sweden)

    Brian O'Leary

    2015-08-01

    Full Text Available Subclavian vein stenosis is a common, but usually asymptomatic, complication following cardiac device placement. In addition to reviewing the literature on incidence, pathogenesis and management options for this important clinical problem, we describe two cases of symptomatic subclavian vein occlusion following pacemaker/defibrillator placement and successful treatment with venoplasty and stenting.

  15. Automated external defibrillators inaccessible to more than half of nearby cardiac arrests in public locations during evening, nighttime, and weekends

    DEFF Research Database (Denmark)

    Hansen, Carolina Malta; Wissenberg, Mads; Weeke, Peter;

    2013-01-01

    BACKGROUND: Despite wide dissemination, use of automated external defibrillators (AEDs) in community settings is limited. We assessed how AED accessibility affected coverage of cardiac arrests in public locations. METHODS AND RESULTS: We identified cardiac arrests in public locations (1994-2011) ...

  16. Survival and health care costs until hospital discharge of patients treated with onsite, dispatched or without automated external defibrillator

    NARCIS (Netherlands)

    J. Berdowski; M.J. Kuiper; M.G.W. Dijkgraaf; J.G.P. Tijssen; R.W. Koster

    2010-01-01

    Background: This study aimed to determine whether automated external defibrillator (AED) use during resuscitation is associated with lower in-hospital health care costs. Methods: For this observational prospective study, we included all treated out-of-hospital cardiac arrests of suspected cardiac ca

  17. Automated external defibrillators, life vest defibrillator, or both%体外自动除颤器、救生衣除颤器的使用或两者同时使用?

    Institute of Scientific and Technical Information of China (English)

    C.RichardConti; 杨渊; 丁荣晶

    2012-01-01

    As most understand,survival of cardiac arrest victims falls significantly if cardioversion is not performed promptly.The standard of practice for out-of-hospital defibrilhtion is the implantable cardiac defibrillator; however, much has been written and discussed about the use of automated external defibrillators.Not as much has been written about life vest wearable defibrillators.How to use these devices will be reviewed in this article.%医院外除颤临床上推荐使用埋藏式心律转复除颤器(Implantable cardiac defibrillator,ICD),关于体外自动除颤器(automated external defibrillators,AED)的使用和讨论也比较多,救生衣除颤器的报道则较少.Winkle[1]在近期综述指出,美国每年有数十万的院外患者死于心脏骤停.众所周知,心脏骤停患者如果未及时得到心脏电复律,生存的机会非常低.电生理学家在给患者置入ICD后,常通过诱发心室颤动并立即除颤来检测ICD功能.这强调了早期除颤是提高生存率的关键.一般来说,除非ICD不能正常工作,置入ICD的患者不需要心肺复苏.

  18. Callus induction and plant regeneration from different explant types of Miscanthus x ogiformis Honda 'Giganteus'

    DEFF Research Database (Denmark)

    Holme, Inger Bæksted; Petersen, Karen Koefoed

    1996-01-01

    Different explants of Miscanthus x ogiformis Honda 'Giganteus' were tested in order to develop an efficient tissue culture system. Shoot apices, leaf and root sections from in vitro-propagated plants, and leaf and immature inflorescence sections from 6-month-old greenhouse-grown plants were used....... The explants were cultured on urashige and Skoog medium supplemented with 4.5, 13.6, 22.6 or 31.7 μM 2,4-dichlorophenoxyacetic acid. Three types of callus were formed but only one was embryogenic and regenerated plants. Callus induction and formation of embryogenic callus depended on the type and developmental......-propagated shoots and older leaves of greenhouse-grown plants. Immature inflorescences smaller than 2.5 cm produced a higher percentage of embryogenic callus than larger more mature inflorescences. Embryogenic callus derived from immature inflorescences had the highest regeneration capacity. Differences in 2...

  19. The Slice Culture Method for Following Development of Tooth Germs In Explant Culture

    OpenAIRE

    Alfaqeeh, Sarah A; Tucker, Abigail S.

    2013-01-01

    Explant culture allows manipulation of developing organs at specific time points and is therefore an important method for the developmental biologist. For many organs it is difficult to access developing tissue to allow monitoring during ex vivo culture. The slice culture method allows access to tissue so that morphogenetic movements can be followed and specific cell populations can be targeted for manipulation or lineage tracing.

  20. Comparative effects of plant growth regulators on leaf and stem explants of Labisia pumila var. alata

    OpenAIRE

    Ling, Anna Pick Kiong; Tan, Kinn Poay; Hussein, Sobri

    2013-01-01

    Objective: Labisia pumila var. alata, commonly known as ‘Kacip Fatimah’ or ‘Selusuh Fatimah’ in Southeast Asia, is traditionally used by members of the Malay community because of its post-partum medicinal properties. Its various pharmaceutical applications cause an excessive harvesting and lead to serious shortage in natural habitat. Thus, this in vitro propagation study investigated the effects of different plant growth regulators (PGRs) on in vitro leaf and stem explants of L. pumila. Metho...

  1. Prolonged viability of human organotypic skin explant in culture method (hOSEC)*

    OpenAIRE

    Frade, Marco Andrey Cipriani; de Andrade, Thiago Antônio Moretti; Aguiar, Andréia Fernanda Carvalho Leone; Guedes, Flávia Araújo; Leite, Marcel Nani; Passos, Williane Rodrigues; Coelho, Eduardo Barbosa; Das, Pranab Kummar

    2015-01-01

    BACKGROUND: Currently, the cosmetic industry is overwhelmed in keeping up with the safety assessment of the increasing number of new products entering the market. To meet such demand, research centers have explored alternative methods to animal testing and also the large number of volunteers necessary for preclinical and clinical tests. OBJECTIVES: This work describes the human skin ex-vivo model (hOSEC: Human Organotypic Skin Explant Culture) as an alternative to test the effectiveness of co...

  2. Staphylococcus aureus Induces Hypoxia and Cellular Damage in Porcine Dermal Explants

    OpenAIRE

    Lone, Abdul G.; Atci, Erhan; Renslow, Ryan; Beyenal, Haluk; Noh, Susan; Fransson, Boel; Abu-Lail, Nehal; Park, Jeong-Jin; Gang, David R.; Douglas R. Call

    2015-01-01

    We developed a porcine dermal explant model to determine the extent to which Staphylococcus aureus biofilm communities deplete oxygen, change pH, and produce damage in underlying tissue. Microelectrode measurements demonstrated that dissolved oxygen (DO) in biofilm-free dermal tissue was 4.45 ± 1.17 mg/liter, while DO levels for biofilm-infected tissue declined sharply from the surface, with no measurable oxygen detectable in the underlying dermal tissue. Magnetic resonance imaging demonstrat...

  3. Ni2+ treatment causes cement gland formation in ectoderm explants of Xenopus laevis embryo

    Institute of Scientific and Technical Information of China (English)

    HUANGYONG; XIAOYANDING

    1999-01-01

    We found T-type calcium channel blocker Ni2+ can efficiently induce the formation of cement gland in Xenopus laevis animal cap explants.Nother T-typer specific calcium channel blocker Amiloride can also induce the formation of cement gland,while L-type specific calcium channel blocker Nifedipine as no inductive effect.These results may offer us an new approach to study the differentiation of cement gland through the change of intracelluar calcium concentration.

  4. Further assessment of neuropathology in retinal explants and neuroprotection by human neural progenitor cells

    Science.gov (United States)

    Mohlin, Camilla; Liljekvist-Soltic, Ingela; Johansson, Kjell

    2011-10-01

    Explanted rat retinas show progressive photoreceptor degeneration that appears to be caspase-12-dependent. Decrease in photoreceptor density eventually affects the inner retina, particularly in the bipolar cell population. Explantation and the induced photoreceptor degeneration are accompanied by activation of Müller and microglia cells. The goal of this study was to determine whether the presence of a feeder layer of human neural progenitor cells (hNPCs) could suppress the degenerative and reactive changes in the explants. Immunohistochemical analyses showed considerable sprouting of rod photoreceptor axon terminals into the inner retina and reduced densities of cone and rod bipolar cells. Both sprouting and bipolar cell degenerations were significantly lower in retinas cultured with feeder layer cells compared to cultured controls. A tendency toward reduced microglia activation in the retinal layers was also noted in the presence of feeder layer cells. These results indicate that hNPCs or factors produced by them can limit the loss of photoreceptors and secondary injuries in the inner retina. The latter may be a consequence of disrupted synaptic arrangement.

  5. In vitro regeneration from petiole explants of non-toxic Jatropha curcas

    KAUST Repository

    Kumar, Nitish

    2011-01-01

    Jatropha curcas, a multipurpose shrub has acquired significant economic potential as biodiesel plant. The seeds or pressed cake is toxic due to the presence of toxic substances and is not useful as food/fodder despite having the best protein composition. A simple, efficient, and reproducible method for plant regeneration through direct organogenesis from petiole explants of non-toxic J. curcas was developed using Murashige and Skoog (MS) medium supplemented with different concentrations of thidiazuron (TDZ). The best induction of shoot buds (57.61%), and number of shoot buds (4.98) per explant were obtained when in vitro petiole explants were placed horizontally on MS medium supplemented with 2.27 mu M TDZ. The Induced shoot buds were transferred to MS medium containing 10 mu M kinetin (Kn), 4.5 mu M 6-benzyl aminopurine (BA), and 5.5 mu M alpha-naphthaleneacetic acid (NAA) for shoot proliferation and subsequent elongation was achieved on MS medium supplemented with 2.25 mu M BA and 8.5 mu M IAA. The elongated shoots could be rooted on half-strength MS medium with 15 mu M IBA, 11.4 mu M IAA and 5.5 mu M NAA with more than 90% survival rate. (C) 2010 Elsevier B.V. All rights reserved.

  6. Characterization of Myelomonocytoid Progenitor Cells with Mesenchymal Differentiation Potential Obtained by Outgrowth from Pancreas Explants

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    Marc-Estienne Roehrich

    2012-01-01

    Full Text Available Progenitor cells can be obtained by outgrowth from tissue explants during primary ex vivo tissue culture. We have isolated and characterized cells outgrown from neonatal mouse pancreatic explants. A relatively uniform population of cells showing a distinctive morphology emerged over time in culture. This population expressed monocyte/macrophage and hematopoietic markers (CD11b+ and CD45+, and some stromal-related markers (CD44+ and CD29+, but not mesenchymal stem cell (MSC-defining markers (CD90− and CD105− nor endothelial (CD31− or stem cell-associated markers (CD133− and stem cell antigen-1; Sca-1−. Cells could be maintained in culture as a plastic-adherent monolayer in culture medium (MesenCult MSC for more than 1 year. Cells spontaneously formed sphere clusters “pancreatospheres” which, however, were nonclonal. When cultured in appropriate media, cells differentiated into multiple mesenchymal lineages (fat, cartilage, and bone. Positive dithizone staining suggested that a subset of cells differentiated into insulin-producing cells. However, further studies are needed to characterize the endocrine potential of these cells. These findings indicate that a myelomonocytoid population from pancreatic explant outgrowths has mesenchymal differentiation potential. These results are in line with recent data onmonocyte-derivedmesenchymal progenitors (MOMPs.

  7. Heparin exerts anti-apoptotic effects on uterine explants by targeting the endocannabinoid system.

    Science.gov (United States)

    Salazar, Ana Inés; Vercelli, Claudia; Schiariti, Victoria; Davio, Carlos; Correa, Fernando; Franchi, Ana María

    2016-09-01

    Miscarriage caused by Gram-negative bacteria infecting the female genital tract is one of the most common complications of human pregnancy. Intraperitoneal administration of LPS to 7-days pregnant mice induces embryo resorption after 24 h. Here, we show that LPS induced apoptosis on uterine explants from 7-days pregnant mice and that CB1 receptor was involved in this effect. On the other hand, heparin has been widely used for the prevention of pregnancy loss in women with frequent miscarriage with or without thrombophilia. Besides its anticoagulant properties, heparin exerts anti-inflammatory, immunomodulatory and anti-apoptotic effects. Here, we sought to investigate whether the administration of heparin prevented LPS-induced apoptosis in uterine explants from 7-days pregnant mice. We found that heparin enhanced cell survival in LPS-treated uterine explants and that this effect was mediated by increasing uterine FAAH activity. Taken together, our results point towards a novel mechanism involved in the protective effects of heparin. PMID:27364950

  8. Rapid and simple method for in vivo ex utero development of mouse embryo explants.

    Science.gov (United States)

    Gonçalves, André B; Thorsteinsdóttir, Sólveig; Deries, Marianne

    2016-01-01

    The in utero development of mammals drastically reduces the accessibility of the mammalian embryo and therefore limits the range of experimental manipulation that can be done to study functions of genes or signaling pathways during embryo development. Over the past decades, tissue and organ-like culture methods have been developed with the intention of reproducing in vivo situations. Developing accessible and simple techniques to study and manipulate embryos is an everlasting challenge. Herein, we describe a reliable and quick technique to culture mid-gestation explanted mouse embryos on top of a floating membrane filter in a defined medium. Viability of the cultured tissues was assessed by apoptosis and proliferation analysis showing that cell proliferation is normal and there is only a slight increase in apoptosis after 12h of culture compared to embryos developing in utero. Moreover, differentiation and morphogenesis proceed normally as assessed by 3D imaging of the transformation of the myotome into deep back muscles. Not only does muscle cell differentiation occur as expected, but so do extracellular matrix organization and the characteristic splitting of the myotome into the three epaxial muscle groups. Our culture method allows for the culture and manipulation of mammalian embryo explants in a very efficient way, and it permits the manipulation of in vivo developmental events in a controlled environment. Explants grown under these ex utero conditions simulate real developmental events that occur in utero.

  9. Differential antiepileptic effects of the organic calcium antagonists verapamil and flunarizine in neurons of organotypic neocortical explants from newborn rats

    NARCIS (Netherlands)

    Bingmann, D; Speckmann, E J; Baker, R E; Ruijter, J; de Jong, B. M.

    1988-01-01

    Effects of the organic calcium antagonists verapamil and flunarizine on pentylenetetrazol induced paroxysmal depolarizations were tested in organotypic neocortical explants taken from neonatal rats. In these in vitro experiments the papaverin derivative verapamil depressed, and finally abolished, ep

  10. The effect of pinacidil on postshock activation and ventricular defibrillation threshold in canine hearts

    Institute of Scientific and Technical Information of China (English)

    Qi JIN; Ning ZHANG; Jian ZHOU; Chang-jian LIN; Yang PANG; Gang GU; Wei-feng SHEN; Li-qun WU

    2012-01-01

    Aim: To determine the postshock activation patterns with both successful and failed shocks in a canine model of ventricular fibrillation,and whether piniacidil,an early after-depolarization (EAD) inhibitor,altered the defibrillation threshold (DFT) and postshock activation patterns.Methods: In 6 beagles,a basket catheter with 64 unipolar electrodes was placed in the LV for global endocardial mapping,a monophasic action potential catheter was inserted into the LV apex,and a catheter with the negative electrode in the right ventricle and the positive electrode in the superior vena cava was inserted for defibrillation.The DFT,90% action potential duration (APD90) and activation recovery interval (ARI) were evaluated before and after pinacidil administration (loading dosage 0.5 mg/kg and maintenance dosage 0.5 mg·kg-1-h-1,iv).Electrical heterogeneities were defined with the dispersion of ARI.After successful and failed shocks with nearDFT strength,the earliest postshock activation patterns (focal or nonfocal endocardial activation),interval and location were detected.Results: Pinacidil significantly decreased APD90 (from 178±16 ms to 168±18 ms) and ARI from (152±10 ms to 143±10 ms) at pacing cycle length of 300 ms.The drug significantly increased VF activation rate (from 10.0±1.9 Hz to 10.8±2.0 Hz).The drug did not affect the dispersion of ARI,neither it changed DFT (baseline: 480±110 V; pinacidil: 425±55 V,P>O.05).The earliest postshock activation arose locally on the LV apical endocardium before and after the drug treatment.Pinacidil significantly prolonged the postshock cycle length of cycles 2 to 5 for the successful episodes but not for the failed episodes.Conclusion: Pinacidil increases the postshock cycle length suggesting that EAD may play a role in postshock activation,while it fails to alter DFT suggesting that EAD produced by shock does not determine a defibrillation success or failure.

  11. Chest Compressions Cause Recurrence of Ventricular Fibrillation After the First Successful Conversion by Defibrillation in Out-of-Hospital Cardiac Arrest

    NARCIS (Netherlands)

    J. Berdowski; J.G.P. Tijssen; R.W. Koster

    2010-01-01

    Background-Unlike Resuscitation Guidelines (GL) 2000, GL2005 advise resuming cardiopulmonary resuscitation (CPR) immediately after defibrillation. We hypothesized that immediate CPR resumption promotes earlier recurrence of ventricular fibrillation (VF). Methods and Results-This study used data of a

  12. Selection of valine-resistance in callus culture of Arabidopsis thaliana (L.) Heynh. derived from leaf explants

    OpenAIRE

    Małgorzata D. Gaj; Grzegorz Czaja; Małgorzata Nawrot

    2014-01-01

    The selection of valine-resistant mutants was carried out in leaf explant cultures of three Arabidopsis thaliana (L.) Heynh. ecotypes: C-24, RLD and Columbia. The valine concentration used for in vitro selection, lethal for seed-growing plants, has not affected callus formation and growth. However, strong inhibition of shoot regeneration ability of calli growing under selection pressure was noticed. In total, 1043 explants were cultured on valine medium and 18 shoots were regenerated with an ...

  13. Response of cotyledon explants of Capsicum annuum L. cv. kujawianka to chosen plant growth regulators in in vitro culture

    Directory of Open Access Journals (Sweden)

    Alicja Fraś

    2014-02-01

    Full Text Available Shoot buds originated directly on cotyledon explants of Capsicum annuum L. cv. Kujawianka, when Linsmaier and Skoog medium was enriched with BAP (2 mg/l. Kinetin (2 mg/l or kinetin with IAA (1 mg/l + 1 mg/l induced indirect shoot buds regeneration from callus. Rooting was obtained with explants cultivated on a medium containing NAA (0,5 mg/l. Occurrence of the early stages of differentiation was proved at the histological level.

  14. Effect of Macrophage Migration Inhibitory Factor (MIF) in Human Placental Explants Infected with Toxoplasma gondii Depends on Gestational Age

    OpenAIRE

    de Oliveira Gomes, Angelica; de Oliveira Silva, Deise Aparecida; Silva, Neide Maria; de Freitas Barbosa, Bellisa; Franco, Priscila Silva; Angeloni, Mariana Bodini; Fermino, Marise Lopes; Roque-Barreira, Maria Cristina; Bechi, Nicoletta; Paulesu, Luana Ricci; dos Santos, Maria Célia; Mineo, José Roberto; Ferro, Eloisa Amália Vieira

    2011-01-01

    Because macrophage migration inhibitory factor (MIF) is a key cytokine in pregnancy and has a role in inflammatory response and pathogen defense, the objective of the present study was to investigate the effects of MIF in first- and third-trimester human placental explants infected with Toxoplasma gondii. Explants were treated with recombinant MIF, IL-12, interferon-γ, transforming growth factor-β1, or IL-10, followed by infection with T. gondii RH strain tachyzoites. Supernatants of cultured...

  15. IN VITRO REGENERATION FROM SHOOT TIP AND NODAL EXPLANTS OF SIMAROUBA GLAUCA DC, A PROMISING BIODIESEL TREE

    Directory of Open Access Journals (Sweden)

    Shastri P. Shukla

    2013-03-01

    Full Text Available An efficient regeneration protocol was developed from shoot tip and nodal explants of Simarouba glauca DC, a promising biodiesel plant. Nodal explants appeared to have better regeneration capacity than shoot tip explants (40% in the tested media. The highest regeneration frequency (90% and shoot number (7.00 ± 1.00 shoots per explants were obtained in nodal explants in Murashige and Skoog’s (MS medium supplemented with 6-benzylaminopurine (BAP 4.43 μM and α-naphthalene acetic acid (NAA 5.36 μM.Induced shoot buds were multiplied and elongated on the MS medium supplemented with BAP (4.44 μM, NAA (5.36 μM and TDZ (Thidiazuron 2.27 μM with 9.66±0.33 (mean length 5.35±0.32 cm and 9.00±0.57 (mean length 4.51±0.15cm shoots using nodal segments and shoot tip explants, respectively. Halfstrength woody plant medium (WPM containing 2.46μM indole-3-butyric acid (IBA produced the maximum number of roots (6.00±1.15. The rooted plantlets were hardened on MS basal liquid medium and subsequently in polycups containing sterile soil and vermiculite (1:1 and successfully established in pots.

  16. PATTERN OF PLANT REGENERATION FROM SHOOT TIP EXPLANTS OF PIGEONPEA (CAJANUS CAJAN L MILLLSP VAR LRG-41

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    T. Raghavendra

    2014-02-01

    Full Text Available An efficient direct shoot bud differentiation and multiple shoot induction from shoot tip explants of pigeon pea (Cajanus cajan L. has been achieved. The frequency of shoot bud regeneration was influenced by the type of explants, genotype and concentrations of cytokinin. Explants viz. shoot tip isolated from 10 day old seedlings showed better explants response Explants were cultured on Murashige and skoog (MS medium augmented with different concentrations of BAP and NAA. Among the various concentrations tested, 2.0mg/l BAP (Benzyl amino purine and 0.1 mg/l Napthalene acetic acid (NAA were found to be the best for maximum shoot bud differentiation. Percentage, as well as the number of shoots per explant showing differentiation of shoot buds was higher on MS media supplement with BAP and optimal BAP concentration for shoot regeneration was 2mg/l. The elongated shoots were successfully rooted on MS medium containing different concentrations of auxins. Among them indole buteric acid (IBA at 1.0mg/l induced maximum frequency of rooting. Regenerated plants were successfully established in soil where 91% of them have been developed into morphologically normal and fertile plants. This method can thus be advantageously applied in the production of transgenic pigeon pea plants.

  17. PATTERN OF PLANT REGENERATION FROM SHOOT TIP EXPLANTS OF PIGEONPEA (CAJANUS CAJAN L MILLLSP VAR LRG-41

    Directory of Open Access Journals (Sweden)

    T. Raghavendra

    2014-03-01

    Full Text Available An efficient direct shoot bud differentiation and multiple shoot induction from shoot tip explants of pigeon pea (Cajanus cajan L. has been achieved. The frequency of shoot bud regeneration was influenced by the type of explants, genotype and concentrations of cytokinin. Explants viz. shoot tip isolated from 10 day old seedlings showed better explants response Explants were cultured on Murashige and skoog (MS medium augmented with different concentrations of BAP and NAA. Among the various concentrations tested, 2.0mg/l BAP (Benzyl amino purine and 0.1 mg/l Napthalene acetic acid (NAA were found to be the best for maximum shoot bud differentiation. Percentage, as well as the number of shoots per explant showing differentiation of shoot buds was higher on MS media supplement with BAP and optimal BAP concentration for shoot regeneration was 2mg/l. The elongated shoots were successfully rooted on MS medium containing different concentrations of auxins. Among them indole buteric acid (IBA at 1.0mg/l induced maximum frequency of rooting. Regenerated plants were successfully established in soil where 91% of them have been developed into morphologically normal and fertile plants. This method can thus be advantageously applied in the production of transgenic pigeon pea plants.

  18. In vitro clonal propagation of Achyranthes aspera L. and Achyranthes bidentata Blume using nodal explants

    Institute of Scientific and Technical Information of China (English)

    Wesely Edward Gnanaraj; Johnson MarimuthuAntonisamy; Mohanamathi RB

    2012-01-01

    Objective: To develop the reproducible in vitro propagation protocols for the medicinally important plants viz., Achyranthes aspera (A. aspera) L. and Achyranthes bidentata (A. bidentata) Blume using nodal segments as explants. Methods: Young shoots of A. aspera and A. bidentata were harvested and washed with running tap water and treated with 0.1% bavistin and rinsed twice with distilled water. Then the explants were surface sterilized with 0.1% (w/v) HgCl2 solutions for 1 min. After rinsing with sterile distilled water for 3-4 times, nodal segments were cut into smaller segments (1 cm) and used as the explants. The explants were placed horizontally as well as vertically on solid basal Murashige and Skoog (MS) medium supplemented with 3% sucrose, 0.6% (w/v) agar (Hi-Media, Mumbai) and different concentration and combination of 6-benzyl amino purine (BAP), kinetin (Kin), naphthalene acetic acid (NAA) and indole acetic acid (IAA) for direct regeneration.Results:Adventitious proliferation was obtained from A. aspera and A. bidentata nodal segments inoculated on MS basal medium with 3% sucrose and augmented with BAP and Kin with varied frequency. MS medium augmented with 3.0 mg/L of BAP showed the highest percentage (93.60±0.71) of shootlets formation for A. aspera and (94.70±0.53) percentages for A. bidentata. Maximum number of shoots/explants (10.60±0.36) for A. aspera and (9.50±0.56) for A. bidentata was observed in MS medium fortified with 5.0 mg/L of BAP. For A. aspera, maximum mean length (5.50±0.34) of shootlets was obtained in MS medium augmented with 3.0 mg/L of Kin and for A. bidentata (5.40±0.61) was observed in the very same concentration. The highest percentage, maximum number of rootlets/shootlet and mean length of rootlets were observed in 1/2 MS medium supplemented with 1.0 mg/L of IBA. Seventy percentages of plants were successfully established in polycups. Sixty eight percentages of plants were well established in the green house condition

  19. In Vitro Shoot Regeneration of NAA-Pulse Treated Plumular Leaf Explants of Cowpea

    Directory of Open Access Journals (Sweden)

    Muhammad AASIM

    2010-06-01

    Full Text Available Cowpea (Vigna unguiculata L. is an economically important grain legume crop and is an important source of dietary protein in many of the developing countries. The present study reports the effect of pulse treatment duration, concentration of NAA and presence of NAA in the culture medium on shoot regeneration from plumular leaf explant of Turkish cowpea cv. �Akkiz� and �Karagoz�. Pulse treatment of mature embryos with 20 mg l-1 NAA for 1 and 3 weeks followed by culturing of plumular leaf explant on MS medium containing 0.25, 0.50 and 1.0 BAP with 1.0, 2.0 and 4.0 mg l-1 NAA promoted somatic embryogenesis in both cultivars. Longer duration of pulse treatment was deleterious resulting in browning and consequently death of the embryos on explants. Pulse treatment with 20 mg l-1 NAA for one week was less deleterious and developed two plantlets after the explants were transferred to MS0 medium after 6 weeks through somatic embryogenesis in cv. �Akkiz�. Pulse treatment with 10 mg l-1 NAA for 1 week showed 33.33-50.00 % and 25.00-50.00% shoot regeneration frequency in cv. �Akkiz� and �Karagoz� respectively on MS medium containing 0.25-1.00 mg l-1 BAP. Maximum number of 2.50 shoots each per explant were recorded in cv. �Akkiz� and �Karagoz� on MS medium containing 1.00 and 0.50 mg l-1 BAP respectively. Contrarily, maximum shoot length of 8.98 cm of cv. �Akkiz� and 9.42 cm of cv. �Karagoz� was recorded on MS medium containing 0.50 mg l-1 BAP and 1.00 mg l-1 BAP respectively. Regenerated shoots were rooted on MS medium containing 0.5 mg l-1 IBA and and acclimatized in growth room at room temprature where they produced viable seeds.

  20. Cardiac Resynchronization Therapy Defibrillator Treatment in a Child with Heart Failure and Ventricular Arrhythmia.

    Science.gov (United States)

    Kim, Hak Ju; Cho, Sungkyu; Kim, Woong-Han

    2016-08-01

    Cardiac resynchronization therapy (CRT) is a new treatment for refractory heart failure. However, most patients with heart failure treated with CRT are adults, middle-aged or older with idiopathic or ischemic dilated cardiomyopathy. We treated a 12-year-old boy, who was transferred after cardiac arrest, with dilated cardiomyopathy, left bundle-branch block, and ventricular tachycardia. We performed cardiac resynchronization therapy with a defibrillator (CRT-D). After CRT-D, left ventricular ejection fraction improved from 22% to 44% assessed by echocardiogram 1 year postoperatively. On electrocardiogram, QRS duration was shortened from 206 to 144 ms. The patient's clinical symptoms also improved. For pediatric patients with refractory heart failure and ventricular arrhythmia, CRT-D could be indicated as an effective therapeutic option. PMID:27525239

  1. Sealing and explant types on the mangaba micropropagation Tipo de vedação e explantes na micropropagação de mangabeira

    Directory of Open Access Journals (Sweden)

    Aline de Jesus Sá

    2012-08-01

    Full Text Available In micropropagation, especially for mangaba tree botanical variety of Northeastern Brazil, limiting aspects such as ethylene accumulation in the cultivation flask and loss of vigor in subcultures have been observed. This study was aimed at assessing the technical and scientific knowledge of the in vitro propagation of botanical mangaba tree variety and at improving the micropropagation protocol, establishing the in vitro cultivation time, the best type of flask sealing and explant at different micropropagation stages. For the establishment phase and for the first and second subcultures, the MS medium with 3% sucrose and 0.6% agar, supplemented with 1 mg L-1 IAA and 1 mg L-1 BA was used. Evaluations were performed at 30, 50 and 65 days of in vitro cultivation. The best types of flask sealing for the establishment phase were the PVC film and Para-film® and for the first subculture the Para-film® seal. In the second subculture the PVC film and Para-film® seals promoted the best growth. The median and basal nodal segments presented the best performance in the first subculture. No significant effect of explant type was observed in the second subculture. The ideal subculture interval in the establishment phase and the first and second subcultures is 50 days.Na micropropagação, especialmente para mangaba, variedade botânica da árvore do Nordeste do Brasil, aspectos limitantes, como acúmulo de etileno no recipiente de cultivo e perda de vigor em subculturas têm sido observados. Neste estudo, objetivou-se avaliar o conhecimento técnico e científico da propagação in vitro de mangabeira, variedade botânica do Nordeste do Brasil, e melhorar o protocolo de micropropagação, o melhor tipo de vedação frasco e explante em diferentes etapas. Para a fase de estabelecimento e para as subculturas primeiro e segundo, foi utlizado o meio MS com 3% de sacarose e agar 0,6%, suplementado com 1 mg L-1 de AIA e 1 mg L-1 de BAP. As avaliações foram

  2. Response of root explants to in vitro cultivation of marketable garlic cultivars Resposta dos explantes radiculares ao cultivo in vitro de cultivares comerciais de alho

    Directory of Open Access Journals (Sweden)

    Danielle C Scotton

    2013-03-01

    Full Text Available Garlic cultivars are sexually sterile under standard growth conditions, with direct implications for commercial production costs as well as breeding programs. Garlic is propagated commercially via bulblets, which facilitates disease transmission and virus load accumulation over vegetative generations. Tissue culture produces virus-free clones that are more productive, while keeping the desired traits of the cultivar. Consequently, this technique allows studies of garlic genetics as well as guarantees genetic conservation of varieties. We aimed at analyzing the in vitro regeneration of eight marketable cultivars of garlic using root segments as explants. For each genotype, bulblet-derived explants were isolated and introduced into MS medium supplemented with 2,4-D and 2-iP. Calli were transferred to MS medium supplemented with 8.8 mM BAP and 0.1 mM NAA (regeneration medium A, or with 4.6 mM kinetin alone (regeneration medium B. The calli were then evaluated for regeneration frequency after sixty days of in vitro cultivation. The noble cultivar 'Jonas' presented the highest rates of plant regeneration among the cultivars tested. The medium A, which contained auxin and cytokinin, induced the highest regeneration rates of all cultivars. The process described herein is simple, reproducible and can potentially be used as a tool in molecular breeding strategies for other marketable cultivars and genotypes of garlic.Cultivares de alho são sexualmente estéreis sob condições padrão de cultivo, com implicações diretas nos custos de produção comercial, bem como em programas de melhoramento. O alho é comercialmente propagado por meio de bulbilhos, o que facilita a transmissão de doenças e leva ao acúmulo de cargas virais ao longo das gerações. A cultura de tecidos produz clones livres de vírus que são mais produtivos, mantendo as características desejadas da cultivar. Consequentemente, esta técnica permite estudar a genética do alho, bem

  3. Spontaneous defibrillation after cessation of resuscitation in out-of-hospital cardiac arrest: a case of Lazarus phenomenon.

    Science.gov (United States)

    Kämäräinen, Antti; Virkkunen, Ilkka; Holopainen, Leevi; Erkkilä, Elja-Pekka; Yli-Hankala, Arvi; Tenhunen, Jyrki

    2007-12-01

    This report describes a case of out-of-hospital cardiac arrest with spontaneous defibrillation and subsequent return of circulation after cessation of resuscitative efforts. A 47-year-old man was found in cardiac arrest and resuscitation was initiated. As no response was achieved, the efforts were withdrawn and final registered cardiac rhythm was ventricular fibrillation. Fifteen minutes later the patient was found to be normotensive and breathing spontaneously. The patient made a poor neurological recovery and died 3 months after the arrest. The authors are unable to give an explanation to the event, but suspect the effect of adrenaline combined with mild hypothermia to have contributed to the self-defibrillation of the myocardium. PMID:17629389

  4. Effects of thidiazuron and paclobutrazol on regeneration potential of tulip flower stalk explants in vitro and subsequent shoot multiplication

    Directory of Open Access Journals (Sweden)

    Małgorzata Podwyszyńska

    2011-04-01

    Full Text Available The effects of TDZ and paclobutrazol on the primary regeneration on tulip flower stalk explants of six cultivars and subsequent shoot multiplication were examined. Explants, flower stalk slices, were excised from cooled and subsequently forced bulbs. The explants were incubated for two months in darkness on medium containing NAA and cytokinins, 2iP and BAP, as control, or TDZ (0.5-4 mg l-1 and paclobutrazol (0.05-0.4 mg l-1. Then, the regenerating explants were subcultured on medium with TDZ and NAA applied at low concentrations. Different regeneration capabilities were found depending on cultivar and growth regulators. The percentage of explants forming leaf-like structures ranged, on the control medium, from 80% in 'Blue Parrot' and 'Prominence' to below 30% in 'Apeldoorn' and 'Mirjoran'. TDZ, applied at optimum for each cultivar concentration, greatly increased the regeneration potential up to 70-100%. Paclobutrazol, added to the TDZ-containing medium, significantly enhanced the response of explants, resulting in high numbers of leaf-like structures formed per explant (13.7-22.8. The structures developed gradually into characteristic forms: the growing up cotyledonary leaf, the probable root primordium formed at its base, the growing downwards stolon and the shoot meristem developed finely on its tip. It is suggested that such primary regeneration may have a nature of somatic embryogenesis. Then, the adventitious shoots developed and formed clusters, which were divided into 2-3 smaller ones every two months. The growth regulators, used at initial stage, markedly influenced subsequent shoot multiplication. Thus, the most intensive shoot formation was noted with TDZ at concentrations of 0.5-2 mg l-1 and paclobutrazol of 0.05-0.1 mg l-1.

  5. 62. Gap in the application of implantable defibrillator and cardiac resynchronization therapy guidelines in heart failure patients

    OpenAIRE

    A. Hersi; A. Al Hammad; T. Al Doheyan; D. Al Munif; J. Alaskar; A. Haifa

    2016-01-01

    Literature review revealed no studies were done regarding the application of implantable defibrillator and cardiac resynchronization therapy guidelines in Saudi Arabia. Therefore, our aim was to identify the gap in the application of the guidelines for acute on chronic systolic heart failure patients in Saudi Arabia. Design and setting: We used data from the heart function assessment registry trial in Saudi Arabia (HEARTS) to explore the rate of device implantation. In consecutive cohort a...

  6. Using a Combined Platform of Swarm Intelligence Algorithms and GIS to Provide Land Suitability Maps for Locating Cardiac Rehabilitation Defibrillators

    OpenAIRE

    KAFFASH-CHARANDABI, Neda; SADEGHI-NIARAKI, Abolghasem; Park, Dong-Kyun

    2015-01-01

    Background: Cardiac arrest is a condition in which the heart is completely stopped and is not pumping any blood. Although most cardiac arrest cases are reported from homes or hospitals, about 20% occur in public areas. Therefore, these areas need to be investigated in terms of cardiac arrest incidence so that places of high incidence can be identi-fied and cardiac rehabilitation defibrillators installed there.Methods: In order to investigate a study area in Petersburg, Pennsylvania State, and...

  7. Assessment of the Efficacy of Pulsed Biphasic Defibrillation Shocks for Treatment of Out-of-hospital Cardiac Arrest

    Directory of Open Access Journals (Sweden)

    Jean-Philippe Didon

    2008-10-01

    Full Text Available This study evaluates the efficacy of a Pulsed Biphasic Waveform (PBW for treatment of out-of-hospital cardiac arrest (OHCA patients in ventricular fibrillation (VF. Large database (2001-2006, collected with automated external defibrillators (AED, (FRED®, Schiller Medical SAS, France, is processed.In Study1 we compared the defibrillation efficacy of two energy stacks (90-130-180 J vs. (130-130-180 J in 248 OHCA VF patients. The analysis of the first shock PBW efficacy proves that energies as low as 90 J are able to terminate VF in a large proportion of OHCA patients (77% at 5 s and 69% at 30 s. Although the results show a trend towards the benefit of higher energy PBW with 130 J (86% at 5 s, 73% at 30 s, the difference in shock efficacy does not reach statistical significance. Both PBW energy stacks (90-130-180 J and (130-130-180 J achieve equal success rates of defibrillation. Analysis of the post-shock rhythm after the first shock is also provided.For Study2 of 21 patients with PBW shocks (130-130-180 J, we assessed some attending OHCA circumstances: call-to-shock delay (median 16min, range 11-41 min, phone advices of CPR (67%. About 50% of the patients were admitted alive to hospital, and 19% were discharged from hospital. After the first shock, patients admitted to hospital are more often presenting organized rhythm (OR (27% to 55% than patients not admitted (0% to 10%, with significant difference at 15 s and 30 s. Post-shock VFs appear significantly rare until 15s for patients admitted to hospital (0% to 9% than for patients not admitted to hospital (40% to 50%. Return of OR (ROOR and efficacy to defibrillate VF at 5 s and 15 s with first shock are important markers to predict patient admission to hospital.

  8. T cells fail to develop in the human skin-cell explants system; an inconvenient truth

    Directory of Open Access Journals (Sweden)

    Vanderlocht Joris

    2011-02-01

    Full Text Available Abstract Background Haplo-identical hematopoietic stem cell (HSC transplantation is very successful in eradicating haematological tumours, but the long post-transplant T-lymphopenic phase is responsible for high morbidity and mortality rates. Clark et al. have described a skin-explant system capable of producing host-tolerant donor-HSC derived T-cells. Because this T-cell production platform has the potential to replenish the T-cell levels following transplantation, we set out to validate the skin-explant system. Results Following the published procedures, while using the same commercial components, it was impossible to reproduce the skin-explant conditions required for HSC differentiation towards mature T-cells. The keratinocyte maturation procedure resulted in fragile cells with minimum expression of delta-like ligand (DLL. In most experiments the generated cells failed to adhere to carriers or were quickly outcompeted by fibroblasts. Consequently it was not possible to reproduce cell-culture conditions required for HSC differentiation into functional T-cells. Using cell-lines over-expressing DLL, we showed that the antibodies used by Clark et al. were unable to detect native DLL, but instead stained 7AAD+ cells. Therefore, it is unlikely that the observed T-lineage commitment from HSC is mediated by DLL expressed on keratinocytes. In addition, we did confirm expression of the Notch-ligand Jagged-1 by keratinocytes. Conclusions Currently, and unfortunately, it remains difficult to explain the development or growth of T-cells described by Clark et al., but for the fate of patients suffering from lymphopenia it is essential to both reproduce and understand how these co-cultures really "work". Fortunately, alternative procedures to speed-up T-cell reconstitution are being established and validated and may become available for patients in the near future.

  9. Retrospective Analysis of Lung Transplant Recipients Found to Have Unexpected Lung Cancer in Explanted Lungs.

    Science.gov (United States)

    Nakajima, Takahiro; Cypel, Marcelo; de Perrot, Marc; Pierre, Andrew; Waddell, Tom; Singer, Lianne; Roberts, Heidi; Keshavjee, Shaf; Yasufuku, Kazuhiro

    2015-01-01

    Unexpected lung cancer is sometimes found in explanted lungs. The objective of this study was to review these patients and their outcomes to better understand and optimize management protocols for lung transplant candidates with pulmonary nodules. Retrospective analysis of pretransplant imaging and clinicopathologic characteristics of patients who were found to have lung cancer in their explanted lungs was performed. From January 2003 to December 2012, 13 of 853 lung transplant recipients were found to have unexpected lung cancer in their explanted lung (1.52%). Of them, 9 cases were for interstitial lung disease (2.8%; 9/321 recipients) and 4 cases were for chronic obstructive pulmonary disease (1.57%; 4/255 recipients). The median period between computed tomographic scan and lung transplantation was 2.40 months (range: 0.5-19.2). On computed tomographic scan, only 3 cases were shown to possibly have a neoplasm by the radiologist. The staging of these lung cancers was as follows: 3 cases of IA, 1 case of IB, 5 cases of IIA, 1 case of IIIA, and 3 cases of IV. Of 13 cases, 9 died owing to cancer progression. On the contrary, only 1 stage I case with small cell lung cancer showed cancer recurrence. The median survival time was 339 days, and the 3-year survival rate was 11.0%. In conclusion, most of the patients with unexpected lung cancer showed poor prognosis except for the early-stage disease. The establishment of proper protocol for management of such nodules is important to improve the management of candidates who are found to have pulmonary nodules on imaging. PMID:26074103

  10. Plant regeneration from single-nodal-stem explants of legume tree Prosopis alba Griseb.

    Science.gov (United States)

    Castillo de Meier, G; Bovo, O A

    2000-08-01

    Seeds of Prosopis alba were scarified with abrasive paper and placed to germinate on MS (Murashige and Skoog 1962) nutrient medium. After 7 days of culture, the basal part of cotyledons was removed and pieces of 4 mm" from distal parts were cultured on Murashige and Skoog (1962) mineral salts and vitamins (MS) (3% sucrose) supplemented with growth regulators. Callus proliferation took place in the majority of the media tested. A low percentage of calluses with green buds that developed on MS basal medium containing 0.1 mg.L-1 2,4-D alone or supplemented with BAP at 0.1 mg.L-1 was observed. Neither cotyledonary segments in any medium assayed regenerated the whole plants. Bud elongation (near 70%) was achieved when single-nodal-stem segments cut from 20 days old seedlings were cultured on MS salts supplemented with 3 mg.L-1 NAA or 3 mg.L-1 IBA combined with 0.05 mg.L-1 KIN after 60 days in culture. Multiple shoots per bud were also observed. Single-nodal-stem segments from five-year-old plants were also cultured on the same media used for seedling explants. Maximal frequency of explants with bud elongation (near 70%) was found on MS with 0.1 mg.L-1 NAA plus 1 mg.L-1 BAP after 60 days of culture. Single-nodal-stem explants cut from adult trees (more than 20 years) were also employed, but the number of bud elongation was lesser. For rooting, the elongated shoots were transferred to a semisolid or liquid MS culture medium employing a paper bridge, supplemented with 0.5 mg.L-1 IBA or 0.1 mg.L-1 NAA.

  11. Glucocorticoids affect 24 h clock genes expression in human adipose tissue explant cultures.

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    Purificación Gómez-Abellán

    Full Text Available AIMS: to examine firstly whether CLOCK exhibits a circadian expression in human visceral (V and subcutaneous (S adipose tissue (AT in vitro as compared with BMAL1 and PER2, and secondly to investigate the possible effect of the glucocorticoid analogue dexamethasone (DEX on positive and negative clock genes expression. SUBJECTS AND METHODS: VAT and SAT biopsies were obtained from morbid obese women (body mass index ≥ 40 kg/m(2 (n = 6. In order to investigate rhythmic expression pattern of clock genes and the effect of DEX on CLOCK, PER2 and BMAL1 expression, control AT (without DEX and AT explants treated with DEX (2 hours were cultured during 24 h and gene expression was analyzed at the following times: 10:00 h, 14:00 h, 18:00 h, 22:00 h, 02:00 h and 06:00 h, using qRT-PCR. RESULTS: CLOCK, BMAL1 and PER2 expression exhibited circadian patterns in both VAT and SAT explants that were adjusted to a typical 24 h sinusoidal curve. PER2 expression (negative element was in antiphase with respect to CLOCK and in phase with BMAL1 expression (both positive elements in the SAT (situation not present in VAT. A marked effect of DEX exposure on both positive and negative clock genes expression patterns was observed. Indeed, DEX treatment modified the rhythmicity pattern towards altered patterns with a period lower than 24 hours in all genes and in both tissues. CONCLUSIONS: 24 h patterns in CLOCK and BMAL1 (positive clock elements and PER2 (negative element mRNA levels were observed in human adipose explants. These patterns were altered by dexamethasone exposure.

  12. Agrobacterium-mediated transformation of oat (Avena sativa L.) cultivars via immature embryo and leaf explants.

    Science.gov (United States)

    Gasparis, Sebastian; Bregier, Cezary; Orczyk, Waclaw; Nadolska-Orczyk, Anna

    2008-11-01

    This paper reports on the successful Agrobacterium-mediated transformation of oat, and on some factors influencing this process. In the first step of the experiments, three cultivars, two types of explant, and three combinations of strain/vectors, which were successfully used for transformation of other cereals were tested. Transgenic plants were obtained from the immature embryos of cvs. Bajka, Slawko and Akt and from leaf base explants of cv. Bajka after transformation with A. thumefaciens strain LBA4404(pTOK233). The highest transformation rate (12.3%) was obtained for immature embryos of cv. Bajka. About 79% of the selected plants proved to be transgenic; however, only 14.3% of the T(0) plants and 27.5% of the T(1) showed GUS expression. Cell competence of both types of explant differed in terms of their transformation ability and transgene expression. The next step of the study was to test the suitability for oat transformation of the pGreen binary vector combined with different selection cassettes: nptII or bar under the nos or 35S promoter. Transgenic plants were selected in combinations transformed with nos::nptII, 35S::nptII and nos::bar. The highest transformation efficiency (5.3%) was obtained for cv. Akt transformed with nos::nptII. A detailed analysis of the T(0) plants selected from a given callus line and their progeny revealed that they were the mixture of transgenic, chimeric-transgenic and non-transgenic individuals. Southern blot analysis of T(0) and T(1) showed simple integration pattern with the low copy number of the introduced transgenes.

  13. Rapid in vitro multiplication of the ethnomedicinal shrub, Acacia caesia (L.) Willd. (Mimosaceae) from leaf explants

    Institute of Scientific and Technical Information of China (English)

    Thambiraj J; Paulsamy S

    2012-01-01

    Objective: To develop an efficient protocol for in vitro multiplication of the ethnomedicinal shrub Acacia caesia (A. caesia) L. Willd., Methods: Leaf explants were inoculated on MS medium supplemented with TDZ and NAA for callus induction. Subculturing experiments were conducted by using leaf derived calli for shoot proliferation on MS medium fortified with various growth regulators like IBA, TDZ, BAP and GA3. The regenerated shoots were rooted in half strength MS medium supplemented with various concentrations of IBA, IAA and Kn. After roots were developed, the plantlets were transplanted to pots filled with garden soil, sand and vermicompost and kept in growth chamber with 70%-80%humidity under16h photoperiod. After acclimatization, the plantlets were transferred to the garden and survival percentage was calculated. Data were statistically analyzed and means were compared using Duncan’s Multiple Range Test (P<0.05). Results: An in vitro multiplication protocol was developed for the locally demanded medicinal plant species, A. caesia by using leaf explant. The study revealed that the callus formation was effective in MS medium containing TDZ and NAA at 1.5 and 0.3 mg/L respectively. Shoot induction was most successful in MS medium supplemented with combination of the auxin, IBA and cytokinin, TDZ at 2.0 and 0.5 mg/L respectively. A single leaf explant was capable of producing 12 shoots/callus after 30 days of culture. The other supplementation in MS medium with IBA and Kn at 2.0 and 0.4 mg/L respectively produced higher rooting frequency, roots/shoot and root length. The survivability rate of leaf callus derived plantlets was significantly higher (84%) in the hardening medium composed by garden soil, sand and vermicompost (1:1:1) by volume. Conclusions: A significant progress has been made in the in vitro regeneration system of this medicinally important plant species, A.caesia.

  14. Agrobacterium-mediated transformation of finger millet (Eleusine coracana (L.) Gaertn.) using shoot apex explants.

    Science.gov (United States)

    Ceasar, S Antony; Ignacimuthu, S

    2011-09-01

    A new Agrobacterium-mediated transformation system was developed for finger millet using shoot apex explants. The Agrobacterium strain LBA4404 harboring binary vector pCAMBIA1301, which contained hygromycin phosphotransferase (hptII) as selectable marker gene and β-glucuronidase (GUS) as reporter gene, was used for optimization of transformation conditions. Two finger millet genotypes, GPU 45 and CO 14, were used in this study. The optimal conditions for the Agrobacterium-mediated transformation of finger millet were found to be the co-cultivation of explants obtained on the 16th day after callus induction (DACI), exposure of explants for 30 min to agrobacterial inoculum and 3 days of co-cultivation on filter paper placed on medium supplemented with 100 μM acetosyringone (AS). Addition of 100 μM L: -cysteine in the selection medium enhanced the frequency of transformation and transgenic plant recovery. Both finger millet genotypes were transformed by Agrobacterium. A frequency of 19% transient expression with 3.8% stable transformation was achieved in genotype GPU 45 using optimal conditions. Five stably transformed plants were fully characterized by Southern blot analysis. A segregation analysis was also performed in four R(1) progenies, which showed normal Mendelian pattern of transgene segregation. The inheritance of transgenes in R(1) progenies was also confirmed by Southern blot analysis. This is the first report on Agrobacterium-mediated transformation of finger millet. This study underpins the introduction of numerous agronomically important genes into the genome of finger millet in the future.

  15. Obese Patients Defibrillation Failure in 1 Cases%肥胖患者电除颤失败1例

    Institute of Scientific and Technical Information of China (English)

    赵莹; 吴浩

    2014-01-01

    利用除颤仪对某螳发生严重快速性异位性心律失常的心脏实施电击,借以消除这些心律失常。称作电除颤(也叫电复律)。在电除颤时。除颤仪释放强大的瞬时电脉冲,使全部心肌在同一时间完成除极,导致心律失常的异常兴奋灶及折返环被完全"消灭"。全部心肌在瞬问处于心电静止状态。这样窦房结就获得了重新主导心脏节律的机会。%Using the defibril ation apparatus of a serious rapidity of gladiator ectopic ar hythmias of cardiac shock, so as to eliminate these arrhythmia. Cal ed electric defibril ation (also cal ed cardioerter). When the electrical shock. Defibril ation apparatus release strong instantaneous electrical impulses, making al the myocardium in addition to the tasks at the same time, cause ar hythmia very excited and exhumation ring oven is completely"destroy". Al the myocardial instantaneous asked in ecg stationary state. The sinoatrial node have a new chance to dominate the heart rhythm.

  16. Decalogue of electric defibrillation Decálogo de la desfibrilación eléctrica

    Directory of Open Access Journals (Sweden)

    Elkín Ferdinand Cardona Duque

    2001-03-01

    Full Text Available Defibrillation is an emergency procedure and the only effective therapy for ventricular fibrillation. Electrical defibrillation delivers large amounts of current to the myocardium and thus depolarizes it, terminating ventricular fibrillation and other arrhythmias. A defibrillator is a device that administers a controlled electrical shock, allowing the operator to select a variable current at the precise moment, according to patient‘s condition. Understanding defibrillator‘s operation leads to more effective resuscitation rates and more therapeutic alternatives in patients with any cardiac electric disturbance. La desfibrilación es un procedimiento de emergencia y es la única terapia efectiva para el manejo de la fibrilación ventricular. La desfibrilación eléctrica libera corriente en gran cantidad al miocardio, despolarizándolo y terminando la fibrilación ventricular y otras arritmias. Un desfibrilador es un aparato que suministra un choque eléctrico en forma controlada, permitiendo al operador seleccionar una corriente variable en el momento oportuno, de acuerdo con la condición del paciente. El entendimiento del manejo del desfibrilador permite tasas de resucitación más efectivas y más alternativas terapéuticas en pacientes con trastornos del ritmo cardíaco.

  17. Pearls and perils of an implantable defibrillator trial using a common control: implications for the design of future studies

    Directory of Open Access Journals (Sweden)

    Hallstrom Alfred P

    2008-05-01

    Full Text Available Abstract Aims Implantable defibrillators are considered life-saving therapy in heart failure (CHF patients. Surprisingly, the recent Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT reached an opposing conclusion from that of numerous other trials about their survival benefit in patients with advanced CHF. A critical analysis of common control trial design may explain this paradoxical finding, with important implications for future studies. Methods and Results Common control trials compare several intervention groups to a single rather than separate control groups. Though potentially requiring fewer patients than trials using separate controls, variation in the common control group will influence all comparisons and creates correlations between findings. During subgroup analyses, this dependency of outcomes may increase belief in the presence of a real subgroup effect when, in fact, it should increase skepticism. For example, a high (r = 0.92, statistically unlikely (p = 0.052 correlation between comparisons was observed across the subgroups reported in SCD-HeFT. Such concordance between amiodarone and a defibrillator across subgroups was unexpected, given how much the effects of these treatments significantly differed from one another in the main study. This suggests the study's subgroup findings (specifically the absence of benefit from defibrillators in advanced CHF were not necessarily a consequence of treatment; more likely, they resulted from variation in what the treatments were compared against, the common control. Conclusion Common control trials can be more efficient than other designs, but induce dependence between treatment comparisons and require cautious interpretation.

  18. In situ fiber-optical monitoring of cytosolic calcium in tissue explant cultures

    CERN Document Server

    Ryser, Manuel; Geiser, Marianne; Frenz, Martin; Rička, Jaro

    2014-01-01

    We present a fluorescence-lifetime based method for monitoring cell and tissue activity in situ, during cell culturing and in the presence of a strong autofluorescence background. The miniature fiber-optic probes are easily incorporated in the tight space of a cell culture chamber or in an endoscope. As a first application we monitored the cytosolic calcium levels in porcine tracheal explant cultures using the Calcium Green-5N (CG5N) indicator. Despite the simplicity of the optical setup we are able to detect changes of calcium concentration as small as 2.5 nM, with a monitoring time resolution of less than 1 s.

  19. CALLUS INDUCTION AND PLANT REGENERATION IN PUNICA GRANATUM L. ?NANA' FROM LEAF EXPLANTS

    OpenAIRE

    Alireza Bonyanpour; Morteza Khosh-Khui

    2013-01-01

    ABSTRACT In this investigation, leaf explants of a local cultivar of dwarf pomegranate were placed on Murashige and Skoog (1962) (MS) medium supplemented with various concentrations of 6-benzyl adenin (BA) and naphthalene acetic acid (NAA) for callus induction. After 40 days, maximum callus induction was observed on a media containing 1 mg L-1 BA and 0.2 to 0.4 mg L-1 NAA. However, the highest callus growth was obtained on a medium containing 1 mg L-1 BA and 1 mg L-1 NAA. The highest number o...

  20. Radiation-induced outgrowth inhibition in explant cultures from surgical specimens of five human organs

    Energy Technology Data Exchange (ETDEWEB)

    Mothersill, Carmel; Cusack, Anne; Seymour, C.B.

    1988-03-01

    An explant outgrowth technique to determine the radiation response of five different human organs (bladder, oesophagus, colon, breast and thyroid) is described. In each case except thyroid, where malignancies are rare, data are presented for normal and malignant tissue. Results show that variations in response, consistent with those observed in vivo, can be measured. Tumours were in all cases highly resistant to radiation relative to their corresponding normal tissue. Possible reasons for this are discussed. The method may prove useful in the prediction of the radiobiological response for tumour and surrounding normal tissue where post-operative therapy is planned.

  1. Stable genetic transformation of Jatropha curcas via Agrobacterium tumefaciens-mediated gene transfer using leaf explants

    KAUST Repository

    Kumar, Nitish

    2010-07-01

    Jatropha curcas is an oil bearing species with multiple uses and considerable economic potential as a biofuel crop. A simple and reproducible protocol was developed for Agrobacterium tumefaciens-mediated stable genetic transformation of J. curcas using leaf explains. Agrobacterium strain LBA 4404 harbouring the binary vector pCAMBIA 1304 having sense-dehydration responsive element binding (S-DREB2A), beta-glucuronidase (gus), and hygromycin-phosphotransferase (hpt) genes were used for gene transfer. A number of parameters such as preculture of explains, wounding of leaf explants, Agrobacterium growth phase (OD), infection duration, co-cultivation period, co-cultivation medium pH, and acetosyringone, were studied to optimized transformation efficiency. The highest transformation efficiency was achieved using 4-day precultured, non-wounded leaf explants infected with Agrobacterium culture corresponding to OD(600)=0.6 for 20 min, followed by co-cultivation for 4 days in a co-cultivation medium containing 100 mu M acetosyringone, pH 5.7. Co-cultivated leaf explants were initially cultured on Murashige and Skoog (MS) medium supplemented with 2.27 mu M thidiazuron (TDZ) for regeneration of shoot buds, followed by selection on same medium with 5 mu g ml(-1) hygromycin. Selected shoot buds were transferred to MS medium containing 10 mu M kinetin (Kn), 4.5 mu M 6-benzyl aminopurine (BA), and 5.5 mu M alpha-naphthaleneacetic acid (NAA) for proliferation. The proliferated shoots were elongated on MS medium supplemented with 2.25 mu M BA and 8.5 mu M indole-3-acetic acid (IAA). The elongated shoots were rooted on half strength MS medium supplemented with 15 mu M indole-3-butyric acid (IBA), 5.7 mu M IAA, 5.5 mu M NAA, and 0.25 mg l(-1) activated charcoal. GUS histochemical analysis of the transgenic tissues further confirmed the transformation event. PCR and DNA gel blot hybridization were performed to confirm the presence of transgene. A transformation efficiency of 29% was

  2. Variation in phytate accumulation in common bean (Phaseolus vulgaris L. fruit explants

    Directory of Open Access Journals (Sweden)

    Cileide Maria Medeiros Coelho

    2008-02-01

    Full Text Available The in vitro synthesis of phytate was studied in common bean fruit explants. Different concentrations of sucrose; phosphorus (P; myo-inositol; abscisic acid (ABA; glutamine and methionine, were tested. Fixed concentrations of these compounds were tested at different periods (0, 3, 6 and 9 days. Variation in phytate coincided with different concentrations of sucrose, myo-inositol, P and ABA for the duration tested. These compounds caused an accumulation of phytate and were more effective in the presence of myo-inositol and P. The accumulation of P varied less than phytate for the different treatments tested in vitro. In conclusion, P, sucrose, ABA, and myo-inositol caused an increase in the phytate of bean seed, showing that it could be possible to alter its content by culturing bean fruit explants in vitro.O fósforo é armazenado na forma de fitato nas sementes, o qual forma complexos estáveis e insolúveis com minerais e proteínas, conferindo efeito antinutriente. A síntese de fitato foi estudada em cultivo de explantes de fruto de feijão in vitro sob diferentes concentrações de sacarose, fósforo (P, mio-inositol, ácido abscísico (ABA, glutamina e metionina. Fixada a concentração destes compostos, testou-se os diferentes tempos de cultivo (0, 3, 6 e 9 dias. A variação no acúmulo de fitato ocorreu na presença de sacarose, mio-inositol, P e ABA nas diferentes concentrações e tempos testados. O acúmulo mais efetivo de fitato ocorreu na presença de mio-inositol e P. O acúmulo de P variou menos do que fitato em todos os tratamentos. Em conclusão, P, sacarose, ABA e mio-inositol causaram aumento no fitato acumulado nas sementes, mostrando que foi possível alterar a síntese de fitato em cultivo de explantes de fruto de feijão.

  3. Biochemical investigations during in vitro adventitious shoot regeneration in leaflet explants from nodal segments of a mature Albizia procera tree

    Institute of Scientific and Technical Information of China (English)

    Ekta Rai; Sulochna Bouddha; Shamim Akhtar Ansari

    2016-01-01

    The in vitro adventitious shoot differentiation in leaflet explants of an adult tree differed from that of leaflet explants of seedlings of Albizia procera (Roxb.) Benth. reported previously elsewhere. The leaflet explants from an adult tree passed through an initial callus phase for 30 days on MS medium supplemented with 3% sucrose, 2.5 lM 2,4-D followed by a subsequent adventitious shoot differentiation phase for another 30 days on half MS medium supplemented with 0.25 lM each of BA and IBA. The regeneration rate of in vitro adventitious shoots in explants from the adult tree, i.e.1.66 shoots/callus, was lower than that from seedlings, i.e. [10 shoots/callus, which was reported elsewhere. Correspondingly, the activities of nitrate reductase and peroxidase, and endogenous phenol content remained very low during in vitro adventitious shoot differentiation in leaflet explants of an adult tree possibly due to lower availability of competent stem (juvenile) cells for the process.

  4. Organotypic Culture of Breast Tumor Explants as a Multicellular System for the Screening of Natural Compounds with Antineoplastic Potential

    Science.gov (United States)

    Carranza-Torres, Irma Edith; Guzmán-Delgado, Nancy Elena; Coronado-Martínez, Consuelo; Bañuelos-García, José Inocente; Viveros-Valdez, Ezequiel; Morán-Martínez, Javier; Carranza-Rosales, Pilar

    2015-01-01

    Breast cancer is the leading cause of death in women worldwide. The search for novel compounds with antitumor activity, with less adverse effects and higher efficacy, and the development of methods to evaluate their toxicity is an area of intense research. In this study we implemented the preparation and culture of breast tumor explants, which were obtained from precision-cut breast tumor slices. In order to validate the model we are proposing to screen antineoplastic effect of natural compounds, we selected caffeic acid, ursolic acid, and rosmarinic acid. Using the Krumdieck tissue slicer, precision-cut tissue slices were prepared from breast cancer samples; from these slices, 4 mm explants were obtained and incubated with the selected compounds. Viability was assessed by Alamar Blue assay, LDH release, and histopathological criteria. Results showed that the viability of the explants cultured in the presence of paclitaxel (positive control) decreased significantly (P < 0.05); however, tumor samples responded differently to each compound. When the explants were coincubated with paclitaxel and compounds, a synergic effect was observed. This study shows that ex vivo culture of breast cancer explants offers a suitable alternative model for evaluating natural or synthetic compounds with antitumor properties within the complex microenvironment of the tumor. PMID:26075250

  5. The effect of gamma radiation on in vitro cultured explants of yam (Dioscorea alata L.) cv. Kinampay

    International Nuclear Information System (INIS)

    Various explants of yam were irradiated with gamma rays at doses ranging from 5-50 Gy. Induction of callus was obtained in tuberous root and other vegetative explants: petiole, node, internode and shoot apex. Callus induction was observed in the irradiated and unirradiated fleshy or tuberous root explants grown in Murashige and Skoog's (MS) medium with benzyl adenine (BA) in combination with naphthalene acetic acid (NAA) ranging from 2-6 ppm. Stimulation of callus growth was obtained from tuberous root explants irradiated with 5 and 10 Gy and grown in MS medium supplemented with 2 ppm BA in combination with 6ppm NAA. Similar callus growth (as indicated by their weight) was observed at higher doses of 30 and 40 GY, provided that higher levels of 4 ppm BA and 6 ppm NAA were incorporated into the MS medium. Similarly, induction of callus was enhanced in tuberous root sections of putative mutant lines (for dwarfness and earliness) that were cultured in higher levels of BA and NAA in MS medium. Regeneration of plantlets was obtained from callus-derived shoot apex irradiated with 40 Gy and from calli-derived unirradiated nodal and tuberous root explants. (author). 40 refs.; 2 figs., 6 tabs

  6. Organotypic Culture of Breast Tumor Explants as a Multicellular System for the Screening of Natural Compounds with Antineoplastic Potential

    Directory of Open Access Journals (Sweden)

    Irma Edith Carranza-Torres

    2015-01-01

    Full Text Available Breast cancer is the leading cause of death in women worldwide. The search for novel compounds with antitumor activity, with less adverse effects and higher efficacy, and the development of methods to evaluate their toxicity is an area of ​​intense research. In this study we implemented the preparation and culture of breast tumor explants, which were obtained from precision-cut breast tumor slices. In order to validate the model we are proposing to screen antineoplastic effect of natural compounds, we selected caffeic acid, ursolic acid, and rosmarinic acid. Using the Krumdieck tissue slicer, precision-cut tissue slices were prepared from breast cancer samples; from these slices, 4 mm explants were obtained and incubated with the selected compounds. Viability was assessed by Alamar Blue assay, LDH release, and histopathological criteria. Results showed that the viability of the explants cultured in the presence of paclitaxel (positive control decreased significantly (P<0.05; however, tumor samples responded differently to each compound. When the explants were coincubated with paclitaxel and compounds, a synergic effect was observed. This study shows that ex vivo culture of breast cancer explants offers a suitable alternative model for evaluating natural or synthetic compounds with antitumor properties within the complex microenvironment of the tumor.

  7. EFEITO DE REGULADORES DE CRESCIMENTO E TIPO DE EXPLANTES NA MORFOGÊNESE in vitro DE Capsicum annuum L.

    Directory of Open Access Journals (Sweden)

    Márcio Henrique Pereira Barbosa

    1994-01-01

    Full Text Available RESUMO Explantes apicais, cotiledonares, hipocotiledonares e brotações regeneradas in vitro de Capsicum annuum cv. Agronômico 10 foram cultivados em meio (MURASHIGE & SKOOG, 1962-MS suplementado com diferentes concentrações e combinações de BAP, adenina e tidiazuron. De acordo com o tipo de explante e reguladores de crescimento, foram obtidas diferentes respostas morfogenéticas. De modo geral, meios contendo concentrações mais elevadas de BAP e tidiazuron, promoveram a indução e produção de calos nos explantes provenientes de "seedlings", enquanto que a rizogênese foi favorecida em meios com baixas concentrações de BAP. Múltiplos brotos axilares foram formados somente quando utilizou-se como explante, brotações regeneradas in vitro. Os níveis de 26,64 e 39,96 µM de BAP possiblitaram a maximização da proliferação em aproximadamente 2,08 e 2,17 novas brotações por explante, respectivamente.

  8. Slowing of electrical activity in ventricular fibrillation is not associated with increased defibrillation energies in the isolated rabbit heart

    Directory of Open Access Journals (Sweden)

    Jane eCaldwell

    2011-04-01

    Full Text Available Prolonged out-of-hospital ventricular fibrillation (VF arrests are associated with reduced ECG dominant frequency (DF and diminished defibrillation success. Partial reversal of ischaemia increases ECG DF and improves defibrillation outcome. We have investigated the metabolic components of ischaemia responsible for the decline in ECG DF and defibrillation success.Isolated Langendorff-perfused rabbit hearts were loaded with the voltage-sensitive dye RH237. Using a photodiode array, epicardial membrane potentials were recorded at 252 sites (15x15mm on the anterior surface of the left & right ventricles. Simultaneously, a global ECG was recorded. VF was induced by burst pacing, and after 60s, perfusion was either reduced to 6ml/min or the perfusate composition changed to impose hypoxia (95%N2/5%CO2, pH 6.7 (80%O2/20%CO2, or hyperkalaemia (8mM. Using Fast Fourier Transform, power spectra were created from the optical signals and the global ECG. The optical power spectra were summated to give a global power spectrum (pseudoECG. At 600s the minimum defibrillation voltage (MDV was determined by step-up protocol.During VF, the ECG and pseudoECG DF were reduced by low-flow ischaemia (9.0±1.0Hz, p<0.01, n=5 and raised [K+]o (12.2±1.3 Hz, p<0.05, n=7 compared to control (19.2±1.5 Hz, n=20, but were unaffected by acidic pHo (16.7±1.1 Hz, n=11 and hypoxia (14.0±1.2 Hz, n=10. In contrast, the MDV was raised by acidic pH (156.1±26.4V, p<0.001 and hypoxia (154.1±22.1V, p<0.01 compared to control (65.6±2.3V, but comparable changes were not observed in low-flow ischaemia (61.0±0.5V or raised [K+]o (56±3V. In summary, different metabolites are responsible for the reduction in DF and the increase in defibrillation energy during ischaemic VF.

  9. Development of standard defibrillation energy source%除颤能量标准源的研制

    Institute of Scientific and Technical Information of China (English)

    姚国红; 张亚冬; 李岩峰; 贾建革; 武文君; 邵海明

    2015-01-01

    To develop a standard defibrillation energy source which can output monophasic and biphasic de-fibrillation impulses and can display standard energy values. The storage capacitor was charged by single-end flyback transformator and discharged through the H bridge composed of insulated gate bipolar transistor (IGBT). Impulse voltage and current were collected by divider while discharging, and the energy value was calculated by STM32. The en-ergy value and waveform were displayed through the control module. The energy source could output both monophsic and biphasic waveforms, and the accuracy of displayed value was higher than ±2% or ±1 J. The standard defibrillation energy source can be used as standard device for defibrillator analyzer, and the metrological trace-ability system of defibrillation energy may come to be completed.%目的:研制一种除颤能量标准源,该标准源能释放单相波、双相波2种除颤脉冲,并且能显示释放能量标准值。方法:利用单端反激励充电方式给储能电容充电,通过脉冲宽度调制(pulse width modulation,PWM)驱动由绝缘栅双极型晶体管(insulated gate bipolar transistor,IGBT)组成的H桥控制电容放电,同时通过分压器、分流器分别采集脉冲电压和电流值,并通过STM32微处理器计算除颤脉冲能量值,最后通过显示模块显示释放的脉冲能量准确值。结果:所研制的除颤能量标准源可释放单相波和双相波2种波形除颤脉冲,并且显示的除颤脉冲能量值精度优于±2%或±1 J。结论:该除颤能量标准源可作为除颤器分析仪溯源校准的标准器具,可完善除颤器释放能量准确度的溯源体系。

  10. Histological and molecular evaluation of patient-derived colorectal cancer explants.

    Directory of Open Access Journals (Sweden)

    Joshua M Uronis

    Full Text Available Mouse models have been developed to investigate colorectal cancer etiology and evaluate new anti-cancer therapies. While genetically engineered and carcinogen-induced mouse models have provided important information with regard to the mechanisms underlying the oncogenic process, tumor xenograft models remain the standard for the evaluation of new chemotherapy and targeted drug treatments for clinical use. However, it remains unclear to what extent explanted colorectal tumor tissues retain inherent pathological features over time. In this study, we have generated a panel of 27 patient-derived colorectal cancer explants (PDCCEs by direct transplantation of human colorectal cancer tissues into NOD-SCID mice. Using this panel, we performed a comparison of histology, gene expression and mutation status between PDCCEs and the original human tissues from which they were derived. Our findings demonstrate that PDCCEs maintain key histological features, basic gene expression patterns and KRAS/BRAF mutation status through multiple passages. Altogether, these findings suggest that PDCCEs maintain similarity to the patient tumor from which they are derived and may have the potential to serve as a reliable preclinical model that can be incorporated into future strategies to optimize individual therapy for patients with colorectal cancer.

  11. Induction of Tetraploids from Petiole Explants through Colchicine Treatments in Echinacea purpurea L.

    Directory of Open Access Journals (Sweden)

    Dahanayake Nilanthi

    2009-01-01

    Full Text Available Petiole explants were obtained from in vitro grown diploid (2x=22 Echinacea purpurea plantlets. Shoots were regenerated by culturing the explants on MS basal medium containing 0.3 mg/L benzyladenine (BA, 0.01 mg/L naphthaleneacetic acid (NAA and four concentrations (30, 60, 120, and 240 mg/L of colchicine for 30 days, or 120 mg/L of colchicine for various durations (7, 14, 21, and 28 days. The regenerated shoots were induced to root on MS basal medium with 0.01 mg/L NAA, and then the root-tips of the regenerated shoots were sampled for count of chromosome number. It was found that a treatment duration of >7 days was necessary for induction of tetraploid (4x=44 shoots, and treatment with 120 mg/L colchicine for 28 days was the most efficient for induction of tetraploids, yielding 23.5% of tetraploids among all the regenerated shoots. Chimeras were observed in almost all the treatments. However, the ratio of tetraploid to diploid cells in a chimeric plant was usually low. In comparison with diploid plants, tetraploid plants in vitro had larger stomata and thicker roots with more root branches, and had prominently shorter inflorescence stalk when mature.

  12. Clonal propagation of guava (Psidium guajava L on nodal explants of mature elite cultivar

    Directory of Open Access Journals (Sweden)

    Guochen Yang

    2011-04-01

    Full Text Available Guava (Psidium guajava L. is a very valuable tropical and subtropical fruit. However, guava micro-propagation are genotypes dependent, there are several problems associated with in vitro cultures of guava including browning or blackening of culture medium due to leaching of phenolics, microbial contamination, and in vitro tissue recalcitrance. A micro-propagation system using Murashige and Skoog (MS medium with 6-benzylaminopurine (BA, kinetin and naphthaleneacetic acid (NAA was developed for guava (Psidium guajava L from mature cultivar. As part of this research various disinfection methods and plant growth regulators were tested in vitro. The most effective method involved treating explants in a 15% bleach solution for 20 mins followed by culturing them in MS medium with 250 mg/L polyvinylpyrrolidone (PVP. This method maximized the percentage of bud breakage (53.3%, while producing the minimum browning rate (18.3% for the explants. The best observed proliferation rate (71.2% occurred on the MS medium supplemented with 4.44 μM BA, 4.65 μM kinetin (KT and 0.54 μM NAA. It produced the highest mean number of shoots (2.2. Shoots were then rooted (65% when dipped in 4.9 mM Indole-3-butyric acid (IBA solution for 1 min and rooted plantlets survived (100% after acclimatization to the greenhouse.

  13. Thermal neutron irradiation field design for boron neutron capture therapy of human explanted liver.

    Science.gov (United States)

    Bortolussi, S; Altieri, S

    2007-12-01

    The selective uptake of boron by tumors compared to that by healthy tissue makes boron neutron capture therapy (BNCT) an extremely advantageous technique for the treatment of tumors that affect a whole vital organ. An example is represented by colon adenocarcinoma metastases invading the liver, often resulting in a fatal outcome, even if surgical resection of the primary tumor is successful. BNCT can be performed by irradiating the explanted organ in a suitable neutron field. In the thermal column of the Triga Mark II reactor at Pavia University, a facility was created for this purpose and used for the irradiation of explanted human livers. The neutron field distribution inside the organ was studied both experimentally and by means of the Monte Carlo N-particle transport code (MCNP). The liver was modeled as a spherical segment in MCNP and a hepatic-equivalent solution was used as an experimental phantom. In the as-built facility, the ratio between maximum and minimum flux values inside the phantom ((phi(max)/phi(min)) was 3.8; this value can be lowered to 2.3 by rotating the liver during the irradiation. In this study, the authors proposed a new facility configuration to achieve a uniform thermal neutron flux distribution in the liver. They showed that a phi(max)/phi(min) ratio of 1.4 could be obtained without the need for organ rotation. Flux distributions and dose volume histograms were reported for different graphite configurations. PMID:18196797

  14. Increased proliferation of explanted vascular smooth muscle cells: a marker presaging atherogenesis.

    Science.gov (United States)

    Absher, P M; Schneider, D J; Baldor, L C; Russell, J C; Sobel, B E

    1997-06-01

    The JCR:LA-cp homozygous cp/cp corpulent rat is genetically predisposed to develop atherosclerosis evident after 9 and 18 months of age in males and females and to manifest metabolic derangements resembling those seen in type II diabetes in humans (hyperinsulinemia, insulin resistance, hyperglycemia and hypertriglyceridemia). The present study was undertaken to determine whether vascular smooth muscle cells (SMCs) explanted from vessels destined to become atherosclerotic later in life exhibit intrinsic properties ex vivo that presage atherogenesis to provide a means for evaluating promptly intervention designed to modify it. SMCs were cultured from aortic explants of JCR:LA-cp corpulent (cp/cp) and lean control (+/+) rats of 4, 5, 6, and 9 months of age. Compared with SMCs from controls, SMCs from cp/cp rats exhibited increased proliferation, higher saturation density, increased augmentation of proliferation in response to selected mitogens and greater adherence to extracellular matrix proteins. The increased proliferative activity ex vivo anteceded by several months the development of atherosclerotic lesions in vivo. Thus, it is a promising marker in assessments of the efficacy of interventions designed to retard or prevent atherosclerosis.

  15. Utilization of Aseptic Seedling Explants for In vitro Propagation of Indian Red Wood

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    Kishore Kumar CHIRUVELLA

    2013-12-01

    Full Text Available Micropropagation has been advocated as one of the most viable biotechnological tool for ex situ conservation of rare, endangered endemic medicinal plants germplasm. Rapid clonal micropropagation protocol for large-scale multiplication of an endemic medicinal plant Soymida febrifuga (Meliaceae was established from 15-day aseptic seedling cotyledonary node and shoot tip explants. High frequency of sprouting and shoot differentiation was observed from cotyledonary node explants compared to shoot tip, on Murashige and Skoog (MS medium fortified with BA, KN, 2-iP and CM. Of the cytokinins used, BA (3.0 mgl-1 supported highest average number and maximum multiple shoot differentiation (16.6. In vitro proliferated shoots were multiplied rapidly by culturing nodal segments as microcuttings, further subcultured on the same media for elongation. Elongated shoots upon transfer to MS medium fortified with IBA showed rooting within two weeks of culture. Rooted plantlets were successfully hardened and 75% of rooted shoots successfully survived on establishment to the soil. Plants looked healthy with no visually detectable phenotypic variations. This protocol provides a successful and rapid technique that can be used for ex situ conservation minimizing the pressure on wild populations and contributes to the conservation of this endemic medicinally potent flora.

  16. Plant Regeneration from In Vitro Cultured Hypocotyl Explants of Euonymus japonicus Cu zhi

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Adventitious shoots were successfully regenerated from hypocotyl explants of in vitro cultures of Euonymus japonicus Cu zhi. Hypocotyl slices were cultured on Murashige and Skoog (MS) and B5 basal medium supplemented with varied concentration of different plant growth-regulators, e.g., α-naphthaleneacetic acid (NAA) and indole-3-butyric acid (IBA) in combination with 6-benzylaminopurine (6-BA) and kinetin. The study showed that shoots could be directly regenerated from hypocotyl explants without the intervening callus phase; MS medium was more suitable for adventitious shoots regeneration. The ability of hypocotyls segments to produce shoots varied depending upon their position on the seedlings. The highest regeneration rate was obtained with hypocotyl segments near to the cotyledon cultured on MS basal medium supplemented with 1.5 mg L-1 6-BA and 0.05 mg L-1 NAA (63.64%). The regenerated shoots were readily elongated on the same medium as used for multiplication and rooted on half-strength MS basal medium supplemented with 1.0 mg L-1 IBA and 100 mg L-1 activated carbon. After being transferred to greenhouse conditions, 96% of the plantlets were successfully acclimatized. This regeneration system is applied for genetic transformation now.

  17. In vitro direct shoot regeneration from proximal, middle and distal segment of Coleus forskohlii leaf explants.

    Science.gov (United States)

    Krishna, Gaurav; Sairam Reddy, P; Anoop Nair, N; Ramteke, P W; Bhattacharya, P S

    2010-04-01

    Coleus forskohlii is an endangered multipurpose medicinal plant that has widespread applications. In spite of this, there have been few attempts to propagate its cultivation in India. The present communication presents an in vitro rapid regeneration method using leaf explants of Coleus forskohlii through direct organogenesis. Leaf explants that were excised into three different segments i.e. proximal (P), middle (M) and distal (D) were cultured on Murashige and Skoog (MS) basal medium supplemented with cytokinins. MS Media containing 5.0 mg L(-1) BAP (6-Benzylaminopurine) promoted regeneration of multiple shoots through direct organogenesis from the leaf, which were further elongated on MS media augmented with 0.1 mg L-1 BAP and 0.1 mg L(-1) IAA (Indole-3-acetic acid), cytokinin and auxin combination. Regenerated and elongated shoots, when transferred to ose resulted in profuse rooting plants that were transferred to soil after acclimatization and maintained in a green house. The current protocol offers a direct, mass propagation method bypassing the callus phase of C. forskohlii and is suitable for conservation, large-scale commercial cultivation, and genetic transformation with agronomically desirable traits. PMID:23572969

  18. A novel coculture model of porcine central neuroretina explants and retinal pigment epithelium cells

    Science.gov (United States)

    Di Lauro, Salvatore; Rodriguez-Crespo, David; Gayoso, Manuel J.; Garcia-Gutierrez, Maria T.; Pastor, J. Carlos; Srivastava, Girish K.

    2016-01-01

    Purpose To develop and standardize a novel organ culture model using porcine central neuroretina explants and RPE cells separated by a cell culture membrane. Methods RPE cells were isolated from porcine eyes, expanded, and seeded on the bottom of cell culture inserts. Neuroretina explants were obtained from the area centralis and cultured alone (controls) on cell culture membranes or supplemented with RPE cells in the same wells but physically separated by the culture membrane. Finally, cellular and tissue specimens were processed for phase contrast, cyto-/histological, and immunochemical evaluation. Neuroretina thickness was also determined. Results Compared to the neuroretinas cultured alone, the neuroretinas cocultured with RPE cells maintained better tissue structure and cellular organization, displayed better preservation of photoreceptors containing rhodopsin, lower levels of glial fibrillary acidic protein immunoexpression, and preservation of cellular retinaldehyde binding protein both markers of reactive gliosis. Neuroretina thickness was significantly greater in the cocultures. Conclusions A coculture model of central porcine neuroretina and RPE cells was successfully developed and standardized. This model mimics a subretinal space and will be useful in studying interactions between the RPE and the neuroretina and to preclinically test potential therapies. PMID:27081295

  19. EXPRESIÓN GUS EN EXPLANTES DE Solanum phureja (Juz. et. Buk Var. Criolla Colombia , TRANSFORMADOS CON Agrobacterium tumefaciens Gus Expression in Solanum phureja Explants (Juz. et. Buk Cultivar Criolla Colombia , Transformed with Agrobacterium tumefaciens

    Directory of Open Access Journals (Sweden)

    IVÁN DARÍO BARRERO-FARFÁN

    Full Text Available La expresión transitoria y estable del gen gusA-intron en explantes internodales de papa criolla variedad Criolla Colombia cocultivados con Agrobacterium tumefaciens es reportada. Con el fin de determinar la susceptibilidad de esta variedad a la transformación mediada por A. tumefaciens, explantes internodales de Solanum phureja fueron infectados con la cepa LBA4404 de A. tumefaciens que contiene el plásmido pCAMBIA2301. Este plásmido contiene el gen ntpII que confiere resistencia a kanamicina y el gen reportero gusA-intron. La selección de los explantes potencialmente transgénicos fue realizada en medios con kanamicina. La eficiencia de transformación estable y transitoria fue calculada con base en la actividad GUS (ß-glucuronidasa, detectada por el ensayo histoquímico X-gluc. La expresión transitoria y estable del gen gusA-intron fue observada en células del explante más bien que en tejidos completos. Estos resultados demuestran que la papa criolla (S. phureja Juz. et. Buk variedad Criolla Colombia es susceptible a la infección por A. tumefaciens.The stable and transient expression of the gusA-intron reporter gene in internodal explants of "Papa Criolla" cultivar Criolla Colombia co-cultivated with Agrobacterium tumefaciens is reported. In order to determine the susceptibility of this cultivar to the A. tumefaciens-mediated transformation, internodal explants of Solanum phureja were infected by A. tumefaciens containing the vector pCAMBIA2301. This vector contains the kanamycin resistance gene ntpII and the reporter gene gusA-intron. The selection of potential transgenic explants was performed on kanamycin-containing media. The stable and transient transformation efficiency was calculated on the basis of the GUS (ß-glucuronidase activity, detected by the histochemical X-Gluc essay. Transient and stable expression of the gusA-intron gene is observed in explants cells rather than in whole tissues. Nonetheless, these results

  20. Comparative effects of plant growth regulators on leaf and stem explants of Labisia pumila var.alata

    Institute of Scientific and Technical Information of China (English)

    Anna Pick Kiong LING; Kinn Poay TAN; Sobri HUSSEIN

    2013-01-01

    Objective:Labisia pumi/a var.a/ata,commonly known as ‘Kacip Fatimah’ or ‘Selusuh Fatimah’ in Southeast Asia,is traditionally used by members of the Malay community because of its post-partum medicinal properties.Its various pharmaceutical applications cause an excessive harvesting and lead to serious shortage in natural habitat.Thus,this in vitro propagation study investigated the effects of different plant growth regulators (PGRs) on in vitro leaf and stem explants of L.pumila.Methods:The capabilities of callus,shoot,and root formation were evaluated by culturing both explants on Murashige and Skoog (MS) medium supplemented with various PGRs at the concentrations of 0,1,3,5,and 7 mg/L.Results:Medium supplemented with 3 mg/L indole-3-butyric acid (IBA) showed the optimal callogenesis from both leaf and stem explants with (72.34± 19.55)% and (70.40± 14.14)% efficacy,respectively.IBA was also found to be the most efficient PGR for root induction.A total of (50.00±7.07)% and (77.78±16.47)% of root formation were obtained from the in vitro stem and leaf explants after being cultured for (26.5±5.0) and (30.0±8.5) d in the medium supplemented with 1 and 3 mg/L of IBA,respectively.Shoot formation was only observed in stem explant,with the maximum percentage of formation ((100.00±0.00)%) that was obtained in 1 mg/L zeatin after (11.0±2.8) d of culture.Conclusions:Callus,roots,and shoots can be induced from in vitro leaf and stem explants of L.pumila through the manipulation of types and concentrations of PGRs.

  1. Analysis of Calcium Content,Hormones,and Degrading Enzymes in Tomato Pedicel Explants During Calcium-Inhibited Abscission

    Institute of Scientific and Technical Information of China (English)

    XU Tao; LI Tian-lai; QI Ming-fang

    2009-01-01

    This study was designed to analyze the changes of phytohormone concentrations,calcium fraction,and the activities of degrading enzymes during calcium-inhibited and ethyleneglycol-bis-(β-aminoethyl ether)N,N'-tetraacetic acid (EGTA)induced abscission of tomato pedicel explants.Added calcium caused an increase in the total calcium content within the abscission zone and produced a corresponding reduction (20%) in pedicel explant abscission.As expected,EGTA treatment produced the opposite effect and resulted in a decrease in the total calcium content,while accelerating abscission of pedicel explants.Hormone analysis revealed that indole-3-acetic acid (IAA) concentrations in the abscission zone first decreased and then increased before the occurrence of abscission in all treatments,with the greatest effect produced by addition of EGTA.Similarly,abscisic acid (ABA),and gibberellin (GA1+3) concentrations,and ethylene production were elevated in the abscission zone during the first 16 h before abscission when explants imbibed EGTA.With calcium treatment,the concentrations of ABA,ethylene,and GA1+3 also increased in pedicels throughout the first 16 h following exposure,but the increase was slower and less dramatic than with EGTA.Both cellulase and polygalacturonase were induced in the explants during abscission and the activities were also strengthened by treatment with EGTA.Calciumtreated explants produced lower hydrolysing enzyme activities than controls throughout abscission.Calcium played a role of mediating hormone balance and degrading enzymes activities and affected on abscission.

  2. 基于DSP的体外自动除颤仪研究%Research on Automatic External Defibrillator Based on DSP

    Institute of Scientific and Technical Information of China (English)

    景军; 丁景艳; 张玮; 洪文学

    2012-01-01

    Electrical defibrillation is the most effective way to treat the ventricular tachycardia (VT) and ventricular fibrillation (VF). An automatic external defibrillator based on DSP is introduced in this paper. The whole design consists of the signal collection module, the microprocessor controlingl module, the display module, the defibrillation module and the automatic recognition algorithm for VF and non VF, etc. This automatic external defibrillator has a-chieved goals such as ECG signal real-time acquisition, ECG wave synchronous display, data deliivering to U disk and automatic defibrillate when shockable rhythm appears, etc.%电击除颤是治疗室速(VT)和室颤(VF)的最有效的方法.本文提出了一种基于DSP的体外自动除颤仪设计方案,整个设计包括了信号采集模块、微处理器控制模块、显示模块、除颤模块及R波检测和VF与非VF自动识别算法等.本文设计的自动除颤仪实现了心电(ECG)数据实时采集、ECG波形同步显示、数据U盘导出、出现可电击复律心率时自动进行除颤等功能.

  3. Development of a pig jejunal explant culture for studying the gastrointestinal toxicity of the mycotoxin deoxynivalenol: histopathological analysis

    OpenAIRE

    Kolf-Clauw, Martine; Castellote, Jessie; Joly, Benjamin; Bourges-Abella, Nathalie; Raymond-Letron, Isabelle; Pinton, Philippe; Oswald, Isabelle P.

    2009-01-01

    The digestive tract is a target for the mycotoxin deoxynivalenol (DON), a major cereals grain contaminant of public health concern in Europe and North America. Pig, the most sensitive species to DON toxicity, can be regarded as the most relevant animal model for studying the intestinal effects of DON. A pig jejunal explants culture was developed to assess short-term effects of DON. In a first step, jejunal explants from 9-13 week-old and from 4-5 week-old pigs were cultured in vitro for up...

  4. Chitinase, beta-1,3-glucanase, osmotin, and extensin are expressed in tobacco explants during flower formation

    DEFF Research Database (Denmark)

    Neale, A D; Wahleithner, J A; Lund, Marianne;

    1990-01-01

    encodes the cell wall protein extensin, which also accumulates during pathogen attack. Another sequence family encodes the water stress-induced protein osmotin [Singh et al. (1989). Plant Physiol. 90, 1096-1101]. We found that osmotin was also induced by viral infection and wounding and, hence, could...... be considered a pathogenesis-related protein. These genes, which were highly expressed in explants during de novo flower formation but not in explants forming vegetative shoots [Meeks-Wagner et al. (1989). Plant Cell 1, 25-35], were also regulated developmentally in day-neutral and photoresponsive tobacco...

  5. In vitro Regeneration of Plantlets from Leaf and Nodal explants of Aristolochia indica L.- An Important Threatened Medicinal Plant

    Institute of Scientific and Technical Information of China (English)

    Pramod V. Pattar; M.Jayaraj

    2012-01-01

    Objective: An efficient reproducible protocol has been developed for in vitro regeneration of plantlets from leaf and nodal explants of Aristolochia indica L. Methods: Wild grown plants Aristolochia indica L. were collected and grown in the departmental garden. Leaf and nodal segments (0.5-1.0 cm) from young healthy plants were first washed thoroughly under running tap water for 15 - 20 minutes and then treated with liquid detergent [5% (v/v) Tween-20] for 5-10 minutes. Later these explants were washed with double-distilled water for 5 minutes. Subsequently, explants were immersed in 70% (v/v) ethanol for 2 - 3 minutes and washed with sterile glass double distilled water for 2-3 times. Eventually, the explants were treated with an aqueous solution of 0.1% (w/v) HgCl2 for 1 - 2 minutes and rinsed for two-to-three times in sterile ddH2O to remove all traces of HgCl2. The sterilized explants were inoculated aseptically onto solid basal Murashige and Skoog’s medium with different concentrations and combinations of BAP and NAA for in vitro regeneration of plants. Results: Both leaf and nodal explants cultured on MS medium supplemented with 0.8 mg/L BAP developed into mass of callus. These calli were subcultured for the induction of shoots and roots. Shoots were induced from both calli on MS medium supplemented with 0.8 mg/L BAP+0.5 mg/L NAA. Roots were induced from in vitro shoots on MS medium supplemented with 0.8 mg/L NAA for 4 weeks. Nodal explants were more regenerative with 95 % response compared to leaf explants with 85%. Finally, these in vitro regenerated plantlets were hardened, acclimatised and successfully transferred to the field. Conclusions: The present protocol for in vitro regeneration of Aristolochia indica L. can be used to make this plant available throughout the year for traditional healers, pharmaceutical usages, germplasm conservation, commercial cultivation, and also for the production of secondary metabolites.

  6. Towards the Automated Analysis and Database Development of Defibrillator Data from Cardiac Arrest

    Directory of Open Access Journals (Sweden)

    Trygve Eftestøl

    2014-01-01

    Full Text Available Background. During resuscitation of cardiac arrest victims a variety of information in electronic format is recorded as part of the documentation of the patient care contact and in order to be provided for case review for quality improvement. Such review requires considerable effort and resources. There is also the problem of interobserver effects. Objective. We show that it is possible to efficiently analyze resuscitation episodes automatically using a minimal set of the available information. Methods and Results. A minimal set of variables is defined which describe therapeutic events (compression sequences and defibrillations and corresponding patient response events (annotated rhythm transitions. From this a state sequence representation of the resuscitation episode is constructed and an algorithm is developed for reasoning with this representation and extract review variables automatically. As a case study, the method is applied to the data abstraction process used in the King County EMS. The automatically generated variables are compared to the original ones with accuracies ≥90% for 18 variables and ≥85% for the remaining four variables. Conclusions. It is possible to use the information present in the CPR process data recorded by the AED along with rhythm and chest compression annotations to automate the episode review.

  7. Suppression of AC railway power-line interference in ECG signals recorded by public access defibrillators

    Directory of Open Access Journals (Sweden)

    Dotsinsky Ivan

    2005-11-01

    Full Text Available Abstract Background Public access defibrillators (PADs are now available for more efficient and rapid treatment of out-of-hospital sudden cardiac arrest. PADs are used normally by untrained people on the streets and in sports centers, airports, and other public areas. Therefore, automated detection of ventricular fibrillation, or its exclusion, is of high importance. A special case exists at railway stations, where electric power-line frequency interference is significant. Many countries, especially in Europe, use 16.7 Hz AC power, which introduces high level frequency-varying interference that may compromise fibrillation detection. Method Moving signal averaging is often used for 50/60 Hz interference suppression if its effect on the ECG spectrum has little importance (no morphological analysis is performed. This approach may be also applied to the railway situation, if the interference frequency is continuously detected so as to synchronize the analog-to-digital conversion (ADC for introducing variable inter-sample intervals. A better solution consists of rated ADC, software frequency measuring, internal irregular re-sampling according to the interference frequency, and a moving average over a constant sample number, followed by regular back re-sampling. Results The proposed method leads to a total railway interference cancellation, together with suppression of inherent noise, while the peak amplitudes of some sharp complexes are reduced. This reduction has negligible effect on accurate fibrillation detection. Conclusion The method is developed in the MATLAB environment and represents a useful tool for real time railway interference suppression.

  8. Lithium-manganese dioxide cells for implantable defibrillator devices-Discharge voltage models

    Science.gov (United States)

    Root, Michael J.

    The discharge potential behavior of lithium-manganese dioxide cells designed for implantable cardiac defibrillators was characterized as a function of extent of cell depletion for tests designed to discharge the cells for times between 1 and 7 years. The discharge potential curves may be separated into two segments from 0 ≤ x ≤ ∼0.51 and ∼0.51 ≤ x ≤ 1.00, where x is the dimensionless extent of discharge referenced to the rated cell capacity. The discharge potentials conform to Tafel kinetics in each segment. This behavior allows the discharge potential curves to be predicted for an arbitrary discharge load and long term discharge performance may be predicted from short term test results. The discharge potentials may subsequently be modeled by fitting the discharge curves to empirical functions like polynomials and Padé approximants. A function based on the Nernst equation that includes a term accounting for nonideal interactions between lithium ions and the cathode host material, such as the Redlich-Kister relationship, also may be used to predict discharge behavior.

  9. Lithium-manganese dioxide cells for implantable defibrillator devices - Discharge voltage models

    Energy Technology Data Exchange (ETDEWEB)

    Root, Michael J. [Cardiac Rhythm Management Research and Development, Boston Scientific Corp., 4100 Hamline Ave. N., St. Paul, MN 55112 (United States)

    2010-08-01

    The discharge potential behavior of lithium-manganese dioxide cells designed for implantable cardiac defibrillators was characterized as a function of extent of cell depletion for tests designed to discharge the cells for times between 1 and 7 years. The discharge potential curves may be separated into two segments from 0 {<=} x {<=} {proportional_to}0.51 and {proportional_to}0.51 {<=} x {<=} 1.00, where x is the dimensionless extent of discharge referenced to the rated cell capacity. The discharge potentials conform to Tafel kinetics in each segment. This behavior allows the discharge potential curves to be predicted for an arbitrary discharge load and long term discharge performance may be predicted from short term test results. The discharge potentials may subsequently be modeled by fitting the discharge curves to empirical functions like polynomials and Pade approximants. A function based on the Nernst equation that includes a term accounting for nonideal interactions between lithium ions and the cathode host material, such as the Redlich-Kister relationship, also may be used to predict discharge behavior. (author)

  10. Life-saving automated external defibrillation in a teenager: a case report

    Directory of Open Access Journals (Sweden)

    Rey Corsino

    2007-09-01

    Full Text Available Abstract Background Adolescent sudden death during sport participation is commonly due to cardiac causes. Survival is more likely when an automated external defibrillator (AED is used soon after collapse. Case presentation We describe a case of sudden death in a 14 year old boy with two remarkable points, successful resuscitation at school using an AED and diagnosis of arrhythmogenic right ventricular cardiomyopathy (ARVC. Bystander cardiopulmonary resuscitation (CPR was immediately started by a witness and 5 minutes after the event the child was placed on an AED monitor that determined he was in a non shockable rhythm, therefore CPR was continued. Two minutes later, the AED monitor detected a shockable rhythm and recommended a shock, which was then administered. One minute after the shock, a palpable pulse was detected and the child began to breathe by himself. Four days after cardiac arrest, the boy was conversing and self-caring. Cardiac magnetic resonance imaging was suggestive of ARVC. Conclusion Ventricular fibrillation secondary to ARVC may be a devastating event and places young patients and athletes at high risk of sudden death. Immediate CPR and AED have been demonstrated to be lifesaving in such events. Therefore, we suggest that schools should have teachers skilled in CPR and accessible AEDs.

  11. Is an atrial defibrillator still an option in treating patients with atrial fibrillation?

    Directory of Open Access Journals (Sweden)

    Ziad El Khoury MD

    2013-02-01

    Full Text Available trial fibrillation (AF is a common disorder associated with significant morbidities and presents several challenges for the control of symptoms and prevention of long-term implications. Atrial defibrillators (ADs, used for rhythm control in patients with symptoms refractory to medical therapy, can detect recurrences of the arrhythmia, allow prompt patient-directed treatment, and have the potential to reduce hospitalizations and improve quality of life. The efficacy of this form of therapy is highest in patients with paroxysmal AF, and with the use of a coronary sinus shocking lead. While R-wave synchronized shocks are a prerequisite for a safe use, the procedure is well-tolerated and usually not associated with long-term psychological side effects. Limitations of ADs include acute and chronic complications related to a cardiac rhythm device implantation, the requirement in some cases for more than one shock to terminate AF, the discomfort from shocks, as well as the need for sedation to alleviate pain from the shocks. With the ever expanding role of catheter-based therapies for AF, it seems that the role of ADs in this regard is rather limited.

  12. Cardiac microstructure: implications for electrical propagation and defibrillation in the heart.

    Science.gov (United States)

    Hooks, Darren A; Tomlinson, Karl A; Marsden, Scott G; LeGrice, Ian J; Smaill, Bruce H; Pullan, Andrew J; Hunter, Peter J

    2002-08-23

    Our understanding of the electrophysiological properties of the heart is incomplete. We have investigated two issues that are fundamental to advancing that understanding. First, there has been widespread debate over the mechanisms by which an externally applied shock can influence a sufficient volume of heart tissue to terminate cardiac fibrillation. Second, it has been uncertain whether cardiac tissue should be viewed as an electrically orthotropic structure, or whether its electrical properties are, in fact, isotropic in the plane orthogonal to myofiber direction. In the present study, a computer model that incorporates a detailed three-dimensional representation of cardiac muscular architecture is used to investigate these issues. We describe a bidomain model of electrical propagation solved in a discontinuous domain that accurately represents the microstructure of a transmural block of rat left ventricle. From analysis of the model results, we conclude that (1) the laminar organization of myocytes determines unique electrical properties in three microstructurally defined directions at any point in the ventricular wall of the heart, and (2) interlaminar clefts between layers of cardiomyocytes provide a substrate for bulk activation of the ventricles during defibrillation.

  13. Indução de calos em explantes foliares de Murici-pequeno (Byrsonima intermedia A. Juss. Calli induction from leaf explants of murici-pequeno (Byrsonima intermedia A. Juss.

    Directory of Open Access Journals (Sweden)

    Raírys Cravo Nogueira

    2007-04-01

    Full Text Available O murici-pequeno (Byrsonima intermedia A. Juss. é um arbusto do cerrado cujo chá da casca do caule apresenta atividade adstringente nas diarréias e disenterias. O gênero Byrsonima apresenta taxa de germinação baixa e emergência lenta da plântula, dificultando a propagação sexuada. Objetivou-se com este trabalho obter calos friáveis em explantes foliares de murici-pequeno para estudos futuros em suspensão celular e metabolismo secundário, assim como embriogênese somática. Avaliou-se o efeito de diferentes concentrações da auxina 2,4-D e a sua interação com as citocininas TDZ e BAP na calogênese. Os resultados demonstraram que na ausência de 2,4-D não ocorre formação de calo em explantes foliares. A adição de BAP ou TDZ não influencia o processo de calogênese. Para a indução e proliferação de calo em explantes foliares de murici-pequeno, os resultados recomendam o uso de meio MS, acrescido de 1,0 mg L-1 de 2,4-D, mantendo os explantes em condição de escuro por 30 dias.Byrsonima intermedia A. Juss is a shrub of cerrado whose husk presents medicinal activities in diarrheas and dysenteries. The Byrsonima genus present low germination rate and slow plantlet emergency which makes difficult sexual propagation. The objective of this work was to obtain friable callus in leaf explants for future studies with suspension cells and secondary metabolites as well as somatic embryogenesis. The effect of different concentrations of 2,4-D and its interaction with TDZ and BAP in callus formation was evaluated. The results demonstrated that there is no formation of callus in leaf explants maintained in absence of 2,4-D. The addition of TDZ or BAP had no influence in the calogenesis process. For callus induction and proliferation, the results suggest the use of MS medium supplemented with 1.0 mg L-1 2,4-D maintaining the explants in the dark.

  14. Observations on the migratory behaviour of Schwann cells from adult peripheral nerve explant cultures.

    Science.gov (United States)

    Crang, A J; Blakemore, W F

    1987-06-01

    The migration of Schwann cells from adult sciatic nerve explant cultures has been examined by time-lapse photomicrography. Analysis of Schwann cell migratory behaviour indicates that the initial outwandering by individual Schwann cells was random. Although chance cell-cell contacts resulted in temporary immobilization of pairs of cells, stable multicellular structures did not form during this initial phase. As local cell densities increased, Schwann cells assembled networks within which Schwann cell movement continued to be observed. A second form of Schwann cell outgrowth was observed from degenerating fibres in which arrays of highly oriented Schwann cells migrated away from their basal lamina tubes onto the culture dish. These observations of Schwann cell random migration, network self-assembly and coordinated extratubal migration are considered to highlight aspects of Schwann cell behaviour, independent of axonal influences, which may have relevance to their role in peripheral nerve repair following nerve section. PMID:3612187

  15. Chemical and Structural Characterization of Several Mid-Term Explanted Breast Prostheses

    Directory of Open Access Journals (Sweden)

    Angela Amoresano

    2016-08-01

    Full Text Available The recent scandal of poly implant prostheses (PIP, which were found in some cases to be made of non-medical grade silicone (as reported by the European Scientific Committee on Emerging and Newly Identified Health Risks, had a great social impact. Thousands of patients asked for implant removal with significant costs for public health care systems. We analysed, by a multidisciplinary approach, sixteen different breast implants after explantation by using several analytical and structural techniques, such as Fourier Transform infrared spectroscopy (FT-IR, mass spectrometry equipped by ion coupled plasma (ICP-MS, gas-chromatography (GC-MS, and tensile testing. Traces of organic (fatty acid and inorganic (Fe, Cr, Pt, Na, and other metals substances were found in all samples, and, even if these values are under danger threshold levels, our study results highlight the possibility of bioaccumulation and tissue contamination, implying the need for continuous medical surveillance and monitoring of material aging.

  16. Characterisation of an accelerator-based neutron source for BNCT of explanted livers

    Energy Technology Data Exchange (ETDEWEB)

    Agosteo, S. [Politecnico di Milano (Italy). Dipartimento di Ingeneria Nucleare; Colautti, P. [INFN, Padova (Italy). Laboratori Nazionali di Legnaro; Corrado, M.G. [Universita degli Studi di Milano (Italy). Dipartimento di Fisica; d`Errico, F. [Pisa Univ. (Italy). Dipt. di Costruzioni Meccaniche e Nucleari; Matzke, M. [Physikalisch-Technische Bundesanstalt, Braunschweig (Germany); Monti, S.; Tinti, R. [ENEA-ERG-FIRE, Bologna (Italy); Silari, M. [Consiglio Nazionale delle Ricerche, Milan (Italy)

    1997-09-01

    An accelerator-based thermal neutron source for BNCT of the explanted liver was designed using the MCNP code. Neutrons are generated via (d,n) reactions by 7 MeV deuterons bombarding a beryllium target. The therapy constraints were approached by simulating an irradiation cavity placed inside a graphite reflector parallelepiped containing a heavy-water moderator in turn enclosing the beryllium target. The experimental verification was performed at the Laboratori Nazionali di Legnaro (Italy). The thermal and epithermal neutron flux was measured at various positions in the irradiation cavity by means of activation techniques employing bare and cadmium covered indium foils. Further measurements were performed with BF{sub 3} detectors. The fast neutron component of the dose equivalent and the energy spectrum above 100keV were assessed by means of a recently developed technique employing variable threshold superheated drop detectors. The prompt gamma ray dose was measured with {sup 7}LiF TLDs. (author).

  17. Differential response of normal and tumour oesophageal explant cultures to radiation

    Energy Technology Data Exchange (ETDEWEB)

    Mothersill, C.; Cusack, A.; MacDonnell, M.; Hennessy, T.P.; Seymour, C.B.

    1988-01-01

    An in vitro method is described which allows radiation dose response data to be obtained for samples of oesophageal mucosa obtained from patients undergoing resection for adeno or squamous cell carcinoma. Data are obtained using a growth endpoint from explant cultures and may be expressed in terms of absolute growth inhibition or reduced rate of growth. Radiation dose response curves suggest that cell survival is in the range expected for mammalian cells but that, as is found clinically, tumour cells are far more resistant to radiation than normal cells. The technique provides a means of assessing differential radiation response in normal and tumour tissues from the same patient, as it is unusual for both to be amenable to clonogenic assay.

  18. Immunohistochemical localization of IAA in graft union of explanted internode grafting

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    The dynamic changes of IAA in graft union of explanted internode autografting of Cucumber (Cucumis sativus Linn.) have been investigated using the immunohistochemical localization technique.It is shown that the efficiency of IAA fixation using lyophilization-gas fixation is higher than that using liquid chemical fixation.In contrast to few silver particles and no significant changes during the development of graft union cultured in hormone-free medium,more silver particles in graft union and significant changes of IAA related to graft union development have been found when graft union was cultured in medium supplemented with appropriate hormones.The fixation procedure of plant hormones and the roles of IAA in graft union are discussed.

  19. Depot-dependent effects of adipose tissue explants on co-cultured hepatocytes

    DEFF Research Database (Denmark)

    Du, Zhen-Yu; Ma, Tao; Lock, Erik-Jan;

    2011-01-01

    We have developed an in vitro hepatocyte-adipose tissue explant (ATE) co-culture model enabling examination of the effect of visceral and subcutaneous adipose tissues on primary rat hepatocytes. Initial analyses of inflammatory marker genes were performed in fractionated epididymal or inguinal...... adipose tissues. Expressions of inflammation related genes (IL-6, TNF-a, COX-2) were higher in the inguinal than the epididymal ATE. Similarly, expressions of marker genes of macrophage and monocyte (MPEG-1, CD68, F4/80, CD64) were higher in the stromal vascular fraction (SVF) isolated from inguinal ATE...... in the ATEs isolated from inguinal and epididymal adipose tissues when cultured alone, but the glycerol release was higher in the ATEs isolated from epididymal than from inguinal adipose tissue when co-cultured with hepatocytes. Compared to epididymal ATEs, the ATEs from inguinal adipose tissue elicited...

  20. Micropropagation from cultured nodal explants of rose (Rosa hybrida L. cv. ‘Perfume Delight’

    Directory of Open Access Journals (Sweden)

    Kamnoon Kanchanapoom

    2010-01-01

    Full Text Available A method for the micropropagation of rose (Rosa hybrida L. cv. ‘Perfume Delight’ was developed. First to fifth nodal explants from young healthy shoots were excised and cultured on basal medium of Murashige and Skoog (1962, MS containing several concentrations of BA and NAA. Multiple shoot formation of up to 3 shoots was obtained on MS medium supplemented with 3 mg/l BA and 0.003 mg/l NAA. Shoot readily rooted on ¼MS medium devoid of growth regulators.Rooted plantlets were hardened and established in pots at 100% survival. In vitro flowering was observed on rose plantscultured on MS medium containing 3 mg/l BA and 0.003 mg/l NAA.

  1. Identification of a benzyladenine disaccharide conjugate produced during shoot organogenesis in Petunia leaf explants

    Energy Technology Data Exchange (ETDEWEB)

    Auer, C.A. (Univ. of Connecticute, Storrs, CT (United States)); Cohen, J.D. (Beltsville Agricultural Research Ctr., MD (United States))

    1993-06-01

    Prior studies of benzyladenine (BA) metabolism in Petunia hybrida Vilm. leaf explants during shoot organogenesis revealed the presence of an abundant unidentified BA conjugate. The BA conjugate, compound C, made up to 39% of the total pool of BA conjugates in two Petunia lines and was associated with an increased shoot organogenic response when compared with a third Petunia line that did not produce any compound C. Structural analysis of compound C utilizing fast atom bombardment mass spectrometry, two methods of carbohydrate analysis, ultraviolet absorption spectra, and Fourier transform infrared spectra identified it as a new cytokinin conjugate, 6-benzylamino-9-[O-glucopyranosyl-(1[yields]3)-ribofuranosyl]-purine. Based on our prior biological studies and the similarity of this compound to related cytokinin conjugates, this disaccharide cytokinin conjugate may be part of the interconvertible pool of cytokinins active in Petunia shoot organogenesis. 17 refs., 2 figs., 2 tabs.

  2. Prolonged viability of human organotypic skin explant in culture method (hOSEC)*

    Science.gov (United States)

    Frade, Marco Andrey Cipriani; de Andrade, Thiago Antônio Moretti; Aguiar, Andréia Fernanda Carvalho Leone; Guedes, Flávia Araújo; Leite, Marcel Nani; Passos, Williane Rodrigues; Coelho, Eduardo Barbosa; Das, Pranab Kummar

    2015-01-01

    BACKGROUND: Currently, the cosmetic industry is overwhelmed in keeping up with the safety assessment of the increasing number of new products entering the market. To meet such demand, research centers have explored alternative methods to animal testing and also the large number of volunteers necessary for preclinical and clinical tests. OBJECTIVES: This work describes the human skin ex-vivo model (hOSEC: Human Organotypic Skin Explant Culture) as an alternative to test the effectiveness of cosmetics and demonstrate its viability through cutaneous keratinocytes' proliferative capacity up to 75 days in culture. METHODS: The skin explants obtained from surgeries were cultured in CO2-humid incubator. After 1, 7, 30 and 75 days in culture, skin fragments were harvested for analysis with histomorphological exam (HE staining) on all days of follow-up and immunohistochemistry for Ck5/6, Ck10 and Ki-67 only on the 75th day. RESULTS: On the 7th day, the epidermis was perfect in the dermoepidermal junction, showing the viability of the model. On the 30th day, the epidermis was thicker, with fewer layers on the stratum corneum, although the cutaneous structure was unaltered. On the 75th day, the skin became thinner but the dermoepidermal junctions were preserved and epidermal proliferation was maintained. After the 75th day on culture, the skin was similar to normal skin, expressing keratinocytes with Ck5/6 on supra-basal layers; Ck10 on differentiated layers; and viability could be assessed by the positivity of basal cells by Ki-67. CONCLUSION: The hOSEC model seems a good alternative to animal testing; it can be used as a preclinical test analogous to clinical human skin test with similar effectiveness and viability proven by immunohistological analyses. PMID:26131864

  3. Callus induction and biomass accumulation in vitro in explants from chokeberry (Aronia melanocarpa (Michx. Elliot fruit

    Directory of Open Access Journals (Sweden)

    Tatiana I. Calalb

    2014-09-01

    Full Text Available In this study, the following features were determined: biological (the optimal histogen as explant and the optimal age of donor fruit, biotechnological (type, dosage and combination of growth regulators supplements in culture medium Murashige and Skoog as well as sucrose dosage, and physical (light regime, to induce callusing and biomass accumulation in vitro from the succulent chokeberry (Aronia melanocarpa (Michx. Elliot fruit. It turned out that it was much easier to induce callus from explants composed of the epicarp and hypoderm cut from fruits at 50–60 days after flowering. The role of light regime and varied supplementation of the basic MS medium with different doses of growth regulators was established; they resulted in four pigmented carpomass: violet, cream-pink, cream-white and green. The best combinations for the proliferation of fruit callus were culture media with 0.2–2.5 mg × dm-3 2,4-D+0.5 mg × dm-3 KIN +60 g × dm-3sucrose, while for fruit biomass accumulation enriched with phenolic substances – 2.5–3.5 mg × dm-3 NAA+0.5 mg × dm-3 KIN+60 g × dm-3sucrose. The chemical study of phenolic compounds by HPLC coupled with the mass spectrometry method identified chlorogenic acid, hiperozide, quercetrin, isoquercitrin and rutozide quantitatively and qualitatively in all pigmented carpomass and fruits; an exception is p-coumaric present only qualitatively in green carpomass and absent in fruit and quercetol absent in green carpomass.

  4. Postnatal exposure history and airways: oxidant stress responses in airway explants.

    Science.gov (United States)

    Murphy, Shannon R; Schelegle, Edward S; Edwards, Patricia C; Miller, Lisa A; Hyde, Dallas M; Van Winkle, Laura S

    2012-12-01

    Postnatally, the lung continues to grow and differentiate while interacting with the environment. Exposure to ozone (O(3)) and allergens during postnatal lung development alters structural elements of conducting airways, including innervation and neurokinin abundance. These changes have been linked with development of asthma in a rhesus monkey model. We hypothesized that O(3) exposure resets the ability of the airways to respond to oxidant stress and that this is mediated by changes in the neurokinin-1 receptor (NK-1R). Infant rhesus monkeys received episodic exposure to O(3) biweekly with or without house dust mite antigen (HDMA) from 6 to 12 months of age. Age-matched monkeys were exposed to filtered air (FA). Microdissected airway explants from midlevel airways (intrapulmonary generations 5-8) for four to six animals in each of four groups (FA, O(3), HDMA, and HDMA+O(3)) were tested for NK-1R gene responses to acute oxidant stress using exposure to hydrogen peroxide (1.2 mM), a lipid ozonide (10 μM), or sham treatment for 4 hours in vitro. Airway responses were measured using real-time quantitative RT-PCR of NK-1R and IL-8 gene expression. Basal NK-1R gene expression levels were not different between the exposure groups. Treatment with ozonide or hydrogen peroxide did not change NK-1R gene expression in animals exposed to FA, HDMA, or HDMA+O(3). However, treatment in vitro with lipid ozonide significantly increased NK-1R gene expression in explants from O(3)-exposed animals. We conclude that a history of prior O(3) exposure resets the steady state of the airways to increase the NK-1R response to subsequent acute oxidant stresses. PMID:22962062

  5. Organ of Corti explants direct tonotopically graded morphology of spiral ganglion neurons in vitro.

    Science.gov (United States)

    Smith, Felicia L; Davis, Robin L

    2016-08-01

    The spiral ganglion is a compelling model system to examine how morphological form contributes to sensory function. While the ganglion is composed mainly of a single class of type I neurons that make simple one-to-one connections with inner hair cell sensory receptors, it has an elaborate overall morphological design. Specific features, such as soma size and axon outgrowth, are graded along the spiral contour of the cochlea. To begin to understand the interplay between different regulators of neuronal morphology, we cocultured neuron explants with peripheral target tissues removed from distinct cochlear locations. Interestingly, these "hair cell microisolates" were capable of both increasing and decreasing neuronal somata size, without adversely affecting survival. Moreover, axon characteristics elaborated de novo by the primary afferents in culture were systematically regulated by the sensory endorgan. Apparent peripheral nervous system (PNS)-like and central nervous system (CNS)-like axonal profiles were established in our cocultures allowing an analysis of putative PNS/CNS axon length ratios. As predicted from the in vivo organization, PNS-like axon bundles elaborated by apical cocultures were longer than their basal counterparts and this phenotype was methodically altered when neuron explants were cocultured with microisolates from disparate cochlear regions. Thus, location-dependent signals within the organ of Corti may set the "address" of neurons within the spiral ganglion, allowing them to elaborate the appropriate tonotopically associated morphological features in order to carry out their signaling function. J. Comp. Neurol. 524:2182-2207, 2016. © 2015 Wiley Periodicals, Inc. PMID:26663318

  6. A novel corneal explant model system to evaluate antiviral drugs against feline herpesvirus type 1 (FHV-1).

    Science.gov (United States)

    Pennington, Matthew R; Fort, Michael W; Ledbetter, Eric C; Van de Walle, Gerlinde R

    2016-06-01

    Feline herpesvirus type-1 (FHV-1) is the most common viral cause of ocular surface disease in cats. Many antiviral drugs are used to treat FHV-1, but require frequent topical application and most lack well-controlled in vivo studies to justify their clinical use. Therefore, better validation of current and novel treatment options are urgently needed. Here, we report on the development of a feline whole corneal explant model that supports FHV-1 replication and thus can be used as a novel model system to evaluate the efficacy of antiviral drugs. The anti-herpes nucleoside analogues cidofovir and acyclovir, which are used clinically to treat ocular herpesvirus infection in cats and have previously been evaluated in traditional two-dimensional feline cell cultures in vitro, were evaluated in this explant model. Both drugs suppressed FHV-1 replication when given every 12 h, with cidofovir showing greater efficacy. In addition, the potential efficacy of the retroviral integrase inhibitor raltegravir against FHV-1 was evaluated in cell culture as well as in the explant model. Raltegravir was not toxic to feline cells or corneas, and most significantly, inhibited FHV-1 replication at 500 µM in both systems. Importantly, this drug was effective when given only once every 24 h. Taken together, our data indicate that the feline whole corneal explant model is a useful tool for the evaluation of antiviral drugs and, furthermore, that raltegravir appears a promising novel antiviral drug to treat ocular herpesvirus infection in cats. PMID:26959283

  7. „IN VITRO” EFFECT OF SOME INDUSTRIAL BY-PRODUCTS ON LAVANDULA ANGUSTIFOLIA MILL. EXPLANT GROWTH

    Directory of Open Access Journals (Sweden)

    Corneliu Tanase

    2013-12-01

    Full Text Available After many studies, it was observed that lavender has many therapeutic effects, such as sedation, activities spasmolytic, antiviral, antibacterial. Thus, given the importance of lavender in different areas of human life, in the present study, we studied the influence of natural products bioregulatoars separated from industrial by-products on some lavender stems explants. These explants were inoculated in vitro on MS nutrient media. In these culture media were added polyphenolic extracts obtained from spruce bark and hemp shives, and evaluated their influence on lavender stems explants. The results obtained were compared with those obtained for the control variant, where MS culture medium was used as standard. It was found that the addition of aqueous extract from spruce bark of concentration of 130 mg GAE / L, in the growth of explants of Lavandula angustifolia Mill, an increase in the elongation of the main stem, number of leaves formed, the amount of photoassimilating pigments synthesized and causes the phenomenon of shoots formation. At a higher concentration of the extract (26 mgGAE/100g values are lower.

  8. Fumonisin B1 (FB1) Induces Lamellar Separation and Alters Sphingolipid Metabolism of In Vitro Cultured Hoof Explants

    Science.gov (United States)

    Reisinger, Nicole; Dohnal, Ilse; Nagl, Veronika; Schaumberger, Simone; Schatzmayr, Gerd; Mayer, Elisabeth

    2016-01-01

    One of the most important hoof diseases is laminitis. Yet, the pathology of laminitis is not fully understood. Different bacterial toxins, e.g. endotoxins or exotoxins, seem to play an important role. Additionally, ingestion of mycotoxins, toxic secondary metabolites of fungi, might contribute to the onset of laminitis. In this respect, fumonsins are of special interest since horses are regarded as species most susceptible to this group of mycotoxins. The aim of our study was to investigate the influence of fumonisin B1 (FB1) on primary isolated epidermal and dermal hoof cells, as well as on the lamellar tissue integrity and sphingolipid metabolism of hoof explants in vitro. There was no effect of FB1 at any concentration on dermal or epidermal cells. However, FB1 significantly reduced the separation force of explants after 24 h of incubation. The Sa/So ratio was significantly increased in supernatants of explants incubated with FB1 (2.5–10 µg/mL) after 24 h. Observed effects on Sa/So ratio were linked to significantly increased sphinganine concentrations. Our study showed that FB1 impairs the sphingolipid metabolism of explants and reduces lamellar integrity at non-cytotoxic concentrations. FB1 might, therefore, affect hoof health. Further in vitro and in vivo studies are necessary to elucidate the effects of FB1 on the equine hoof in more detail. PMID:27023602

  9. Improved cotyledonary node method using an alternative explant derived from mature seed for efficient Agrobacterium-mediated soybean transformation.

    Science.gov (United States)

    Paz, Margie M; Martinez, Juan Carlos; Kalvig, Andrea B; Fonger, Tina M; Wang, Kan

    2006-03-01

    The utility of transformation for soybean improvement requires an efficient system for production of stable transgenic lines. We describe here an improved cotyledonary node method using an alternative explant for Agrobacterium tumefaciens-mediated soybean transformation. We use the term "half-seed" to refer to this alternative cotyledonary explant that is derived from mature seed of soybean following an overnight imbibition and to distinguish it from cotyledonary node derived from 5-7-day-old seedlings. Transformation efficiencies using half-seed explants ranged between 1.4 and 8.7% with an overall efficiency of 3.8% based on the number of transformed events that have been confirmed in the T1 generation by phenotypic assay using the herbicide Liberty (active ingredient glufosinate) and by Southern analysis. This efficiency is 1.5-fold higher than the cotyledonary node method used in our laboratory. Significantly, the half-seed system is simple and does not require deliberate wounding of explants, which is a critical and technically demanding step in the cotyledonary node method. PMID:16249869

  10. Pulmonary arterial lesions in explanted lungs after transplantation correlate with severity of pulmonary hypertension in chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Carlsen, Jørn; Hasseriis Andersen, Kasper; Boesgaard, Søren;

    2013-01-01

    BACKGROUND: Pulmonary vascular findings are largely unreported in end-stage chronic obstructive pulmonary disease (COPD). METHODS: Pulmonary vascular lesions in explanted lungs from 70 patients with COPD/emphysema or α-1-antitrypsin deficiency were analyzed retrospectively. Patients were stratified...

  11. 心脏除颤器质量检定方法的分析研究%Analysis on cardiac defibrillators quality detection method

    Institute of Scientific and Technical Information of China (English)

    苏燕平; 姚念玲; 崔骊

    2014-01-01

    Objective:To use defibrillators calibration detection method, some problems could be find out and analyzed. Moreover, the quality safety of defibrillators calibration can be guaranteed. Methods:According to WSB 64-2003 verification regulation for cardiac defibrillators and cardiac defibrillator-Monitors, and the practical experience of effective detection methods, defibrillation analyzer verification can be used to detect the performance parameters of cardiac defibrillators. Results:In accordance with the effective test method, through regular check, not only can cardiac defibrillators risk be eliminated but also quality safety of clinical use and the life safety of patients will be safeguarded. Conclusion:The quality control can prevent medical accidents that caused by facility loses, at the same time, if we are pay attention to the daily maintenance, the defibrillator can be played a role in emergency time.%目的:按照国家计量检定规程,对临床使用中的除颤器进行质量检定,确保其在实际使用中的安全性。方法:依据国家卫生行业标准WSB64-2003“心脏除颤器和心脏除颤监护仪检定规程”,根据实际经验中有效的检定方法,使用除颤分析仪检定除颤器的各项性能参数。结果:按照有效的检定方法,通过定期检定,消除了除颤器的安全隐患,保障患者的生命安全。结论:对除颤器进行质量控制检定,可以预防因设备失准而引起的医疗事故,同时注意日常的维护和保养,确保除颤器在急救时的良好性能及临床使用的安全性。

  12. Using a Combined Platform of Swarm Intelligence Algorithms and GIS to Provide Land Suitability Maps for Locating Cardiac Rehabilitation Defibrillators

    Directory of Open Access Journals (Sweden)

    Neda KAFFASH-CHARANDABI

    2015-10-01

    Full Text Available Background: Cardiac arrest is a condition in which the heart is completely stopped and is not pumping any blood. Although most cardiac arrest cases are reported from homes or hospitals, about 20% occur in public areas. Therefore, these areas need to be investigated in terms of cardiac arrest incidence so that places of high incidence can be identi-fied and cardiac rehabilitation defibrillators installed there.Methods: In order to investigate a study area in Petersburg, Pennsylvania State, and to determine appropriate places for installing defibrillators with 5-year period data, swarm intelligence algorithms were used. Moreover, the location of the defibrillators was determined based on the following five evaluation criteria: land use, altitude of the area, econom-ic conditions, distance from hospitals and approximate areas of reported cases of cardiac arrest for public places that were created in geospatial information system (GIS.Results: The A-P HADEL algorithm results were more precise about 27.36%. The validation results indicated a wider coverage of real values and the verification results confirmed the faster and more exact optimization of the cost func-tion in the PSO method.Conclusion: The study findings emphasize the necessity of applying optimal optimization methods along with GIS and precise selection of criteria in the selection of optimal locations for installing medical facilities because the selected algorithm and criteria dramatically affect the final responses. Meanwhile, providing land suitability maps for installing facilities across hot and risky spots has the potential to save many lives.

  13. Calogênese e rizogênese em explantes de mogno (Swietenia macrophylla King cultivados in vitro.

    Directory of Open Access Journals (Sweden)

    Silvana Cruz da Rocha

    2010-08-01

    Full Text Available A exploração de árvores tropicais realizada de forma indiscriminada, buscando espécies de alto valor econômico, tem levado várias espécies, como o mogno (Swietenia macrophylla King, ao perigo de extinção. O desenvolvimento de uma metodologia de regeneração de gemas, direta ou indireta, poderia auxiliar na obtenção de um grande número de mudas e constituir uma perspectiva à propagação sexuada. Essa última é limitada pelo fato das sementes perderem rapidamente a capacidade germinativa. No presente trabalho, foram utilizados dois tipos de explantes: fragmentos foliares e de raízes de plantas cultivadas in vitro. Após desinfestação, os explantes foram colocados em meio de cultura de Murashige e Skoog (1962 contendo três quartos da concentração de sais, vitaminas do mesmo meio, 30g.L-1 de sacarose, auxina (ácido naftaleno-acético, ANA, 0,11 µM e 0,54 µM, citocinina (cinetina, CIN, 1,2 µM, 2,3 µM, 4,7 µM e 9,3 µM; 6-benziladenina, BA, 2,2 µM, 4,4 µM e 8,8 µM ou 2-isopenteniladenina, 2-iP, 2,5 µM e 7g.L-1 de ágar. As variáveis testadas foram a concentração e o tipo de regulador de crescimento e a origem dos explantes. A cada 30 dias, os explantes foram avaliados pela contagem do número de explantes formando calos ou raízes e a consistência dos calos. Foram obtidos calos a com base nos dois tipos de explantes. Nos explantes foliares, 90% deles formaram calos em meios de cultura contendo BA 4,4 µM com ANA 0,54 µM e BA 8,9 µM com ANA 0,11 ou 0,54 µM. Nos explantes de raízes, a maior percentagem de explantes com calos foi de 55%, no meio de cultura com BA 2,2 µM e ANA 0,54 µM. Raízes adventícias foram obtidas partindo de calos e do limbo dos explantes foliares, em meios de cultura com CIN e ANA. Não foi observada a formação de gemas adventícias.

  14. CALOGÊNESE E RIZOGÊNESE EM EXPLANTES DE MOGNO (Swietenia macrophylla King CULTIVADOS IN VITRO

    Directory of Open Access Journals (Sweden)

    Marguerite Quoirin

    2004-04-01

    Full Text Available A exploração de árvores tropicais realizada de forma indiscriminada, buscando espécies de alto valor econômico, tem levado várias espécies, como o mogno (Swietenia macrophylla King, ao perigo de extinção. O desenvolvimento de uma metodologia de regeneração de gemas, direta ou indireta, poderia auxiliar na obtenção de um grande número de mudas e constituir uma perspectiva à propagação sexuada. Essa última é limitada pelo fato das sementes perderem rapidamente a capacidade germinativa. No presente trabalho, foram utilizados dois tipos de explantes: fragmentos foliares e de raízes de plantas cultivadas in vitro. Após desinfestação, os explantes foram colocados em meio de cultura de Murashige e Skoog (1962 contendo três quartos da concentração de sais, vitaminas do mesmo meio, 30g.L-1 de sacarose, auxina (ácido naftaleno-acético, ANA, 0,11 M e 0,54 M, citocinina (cinetina, CIN, 1,2 M, 2,3 M, 4,7 M e 9,3 M; 6-benziladenina, BA, 2,2 M, 4,4 M e 8,8 M ou 2-isopenteniladenina, 2-iP, 2,5 M e 7g.L-1 de ágar. As variáveis testadas foram a concentração e o tipo de regulador de crescimento e a origem dos explantes. A cada 30 dias, os explantes foram avaliados pela contagem do número de explantes formando calos ou raízes e a consistência dos calos. Foram obtidos calos a com base nos dois tipos de explantes. Nos explantes foliares, 90% deles formaram calos em meios de cultura contendo BA 4,4 M com ANA 0,54 M e BA 8,9 M com ANA 0,11 ou 0,54 M. Nos explantes de raízes, a maior percentagem de explantes com calos foi de 55%, no meio de cultura com BA 2,2 M e ANA 0,54 M. Raízes adventícias foram obtidas partindo de calos e do limbo dos explantes foliares, em meios de cultura com CIN e ANA. Não foi observada a formação de gemas adventícias.

  15. Blockade of Toll-like receptor 2 prevents spontaneous cytokine release from rheumatoid arthritis ex vivo synovial explant cultures

    LENUS (Irish Health Repository)

    Nic An Ultaigh, Sinead

    2011-02-23

    Abstract Introduction The aim of this study was to examine the effect of blocking Toll-like receptor 2 (TLR2) in rheumatoid arthritis (RA) synovial cells. Methods RA synovial tissue biopsies, obtained under direct visualization at arthroscopy, were established as synovial explant cultures ex vivo or snap frozen for immunohistology. Mononuclear cell cultures were isolated from peripheral blood and synovial fluid of RA patients. Cultures were incubated with the TLR1\\/2 ligand, Pam3CSK4 (200 ng, 1 and 10 μg\\/ml), an anti-TLR2 antibody (OPN301, 1 μg\\/ml) or an immunoglobulin G (IgG) (1 μg\\/ml) matched control. The comparative effect of OPN301 and adalimumab (anti-tumour necrosis factor alpha) on spontaneous release of proinflammatory cytokines from RA synovial explants was determined using quantitative cytokine MSD multiplex assays or ELISA. OPN301 penetration into RA synovial tissue explants cultures was assessed by immunohistology. Results Pam3CSK4 significantly upregulated interleukin (IL)-6 and IL-8 in RA peripheral blood mononuclear cells (PBMCs), RA synovial fluid mononuclear cells (SFMCs) and RA synovial explant cultures (P < 0.05). OPN301 significantly decreased Pam3CSK4-induced cytokine production of tumour necrosis factor alpha (TNF-α), IL-1β, IL-6, interferon (IFN)-γ and IL-8 compared to IgG control in RA PBMCs and SFMCs cultures (all P < 0.05). OPN301 penetration of RA synovial tissue cultures was detected in the lining layer and perivascular regions. OPN301 significantly decreased spontaneous cytokine production of TNF-α, IL-1β, IFN-γ and IL-8 from RA synovial tissue explant cultures (all P < 0.05). Importantly, the inhibitory effect of OPN on spontaneous cytokine secretion was comparable to inhibition by anti-TNFα monoclonal antibody adalimumab. Conclusions These findings further support targeting TLR2 as a potential therapeutic agent for the treatment of RA.

  16. Machine Learning Techniques for the Detection of Shockable Rhythms in Automated External Defibrillators.

    Science.gov (United States)

    Figuera, Carlos; Irusta, Unai; Morgado, Eduardo; Aramendi, Elisabete; Ayala, Unai; Wik, Lars; Kramer-Johansen, Jo; Eftestøl, Trygve; Alonso-Atienza, Felipe

    2016-01-01

    Early recognition of ventricular fibrillation (VF) and electrical therapy are key for the survival of out-of-hospital cardiac arrest (OHCA) patients treated with automated external defibrillators (AED). AED algorithms for VF-detection are customarily assessed using Holter recordings from public electrocardiogram (ECG) databases, which may be different from the ECG seen during OHCA events. This study evaluates VF-detection using data from both OHCA patients and public Holter recordings. ECG-segments of 4-s and 8-s duration were analyzed. For each segment 30 features were computed and fed to state of the art machine learning (ML) algorithms. ML-algorithms with built-in feature selection capabilities were used to determine the optimal feature subsets for both databases. Patient-wise bootstrap techniques were used to evaluate algorithm performance in terms of sensitivity (Se), specificity (Sp) and balanced error rate (BER). Performance was significantly better for public data with a mean Se of 96.6%, Sp of 98.8% and BER 2.2% compared to a mean Se of 94.7%, Sp of 96.5% and BER 4.4% for OHCA data. OHCA data required two times more features than the data from public databases for an accurate detection (6 vs 3). No significant differences in performance were found for different segment lengths, the BER differences were below 0.5-points in all cases. Our results show that VF-detection is more challenging for OHCA data than for data from public databases, and that accurate VF-detection is possible with segments as short as 4-s. PMID:27441719

  17. Machine Learning Techniques for the Detection of Shockable Rhythms in Automated External Defibrillators.

    Directory of Open Access Journals (Sweden)

    Carlos Figuera

    Full Text Available Early recognition of ventricular fibrillation (VF and electrical therapy are key for the survival of out-of-hospital cardiac arrest (OHCA patients treated with automated external defibrillators (AED. AED algorithms for VF-detection are customarily assessed using Holter recordings from public electrocardiogram (ECG databases, which may be different from the ECG seen during OHCA events. This study evaluates VF-detection using data from both OHCA patients and public Holter recordings. ECG-segments of 4-s and 8-s duration were analyzed. For each segment 30 features were computed and fed to state of the art machine learning (ML algorithms. ML-algorithms with built-in feature selection capabilities were used to determine the optimal feature subsets for both databases. Patient-wise bootstrap techniques were used to evaluate algorithm performance in terms of sensitivity (Se, specificity (Sp and balanced error rate (BER. Performance was significantly better for public data with a mean Se of 96.6%, Sp of 98.8% and BER 2.2% compared to a mean Se of 94.7%, Sp of 96.5% and BER 4.4% for OHCA data. OHCA data required two times more features than the data from public databases for an accurate detection (6 vs 3. No significant differences in performance were found for different segment lengths, the BER differences were below 0.5-points in all cases. Our results show that VF-detection is more challenging for OHCA data than for data from public databases, and that accurate VF-detection is possible with segments as short as 4-s.

  18. Machine Learning Techniques for the Detection of Shockable Rhythms in Automated External Defibrillators

    Science.gov (United States)

    Irusta, Unai; Morgado, Eduardo; Aramendi, Elisabete; Ayala, Unai; Wik, Lars; Kramer-Johansen, Jo; Eftestøl, Trygve; Alonso-Atienza, Felipe

    2016-01-01

    Early recognition of ventricular fibrillation (VF) and electrical therapy are key for the survival of out-of-hospital cardiac arrest (OHCA) patients treated with automated external defibrillators (AED). AED algorithms for VF-detection are customarily assessed using Holter recordings from public electrocardiogram (ECG) databases, which may be different from the ECG seen during OHCA events. This study evaluates VF-detection using data from both OHCA patients and public Holter recordings. ECG-segments of 4-s and 8-s duration were analyzed. For each segment 30 features were computed and fed to state of the art machine learning (ML) algorithms. ML-algorithms with built-in feature selection capabilities were used to determine the optimal feature subsets for both databases. Patient-wise bootstrap techniques were used to evaluate algorithm performance in terms of sensitivity (Se), specificity (Sp) and balanced error rate (BER). Performance was significantly better for public data with a mean Se of 96.6%, Sp of 98.8% and BER 2.2% compared to a mean Se of 94.7%, Sp of 96.5% and BER 4.4% for OHCA data. OHCA data required two times more features than the data from public databases for an accurate detection (6 vs 3). No significant differences in performance were found for different segment lengths, the BER differences were below 0.5-points in all cases. Our results show that VF-detection is more challenging for OHCA data than for data from public databases, and that accurate VF-detection is possible with segments as short as 4-s. PMID:27441719

  19. P-700系列电极对猪室颤模型除颤效果的影响%The influence of defibrillation electrodes of P-700 series on the defibrillation effect at pig ventruicular fibrillation model

    Institute of Scientific and Technical Information of China (English)

    张真; 周正宇; 王禹斌; 周慧英; 王婧; 薛智谋

    2012-01-01

    Objective To evaluate the effect and safety of novel defibrillation electrode of P-700 series. Methods Cardiac catheter was used to induce and build ventricular fibrillation model on three different weight groups of Tai-hu pigs, according to the available energy in "The 2010 AHA Guidelines for CPR and ECC" , with P-500 series electrodes as control, Electrodes of P-700 and P-500 were utilized to do external defibrillate and resuscitation in vitro separately. The rate of successful defibrillation were recorded and Doppler ultrasound measurement were applied to evaluate the animals' myocardial function before and after defibrillation, Gross anatomy and pathological examination were performed after experiments. Results There was no obvious significance difference between the control groups and experimental groups on the rate of successful defibrillation(P >0. 05). Among the three groups, there was no obvious significance difference prior to and after experiment on left ventricular ejection fraction, fraction area change and left ventricular end-systolic thickness (all P > 0. 05 ). No obvious abnormal appearance was found in gross anatomy and pathological examination. Conclusion The efficacy and safety of P-700 series electrodes meet the standard.%目的 评价新型除颤电极片P-700系列除颤的有效性和安全性.方法 通过心导管对3组不同体质量的太湖猪诱导,制作太湖猪室颤模型,根据“2010美国心脏协会心肺复苏及心血管急救指南”中的除颤能量适用范围为依据,以P-500系列电极片作为对照,用P-700系列电极片和P-500系列电极片分别进行体外除颤与复苏,统计除颤成功率,进行多普勒超声检查评价除颤前后各组动物的心脏功能,实验结束后做大体解剖并作病理分析.结果 实验组和对照组的除颤成功率差异无统计学意义(P>0.05),3组动物除颤前后左室射血分数(EF)、左室舒缩面积变化率(FAC)、左心室收缩末期后壁厚

  20. ORGANOGÊNESE INDIRETA A PARTIR DE EXPLANTES FOLIARES E MULTIPLICAÇÃO IN VITRO DE BROTAÇÕES DE Eucalyptus benthamii X Eucalyptus dunnii

    Directory of Open Access Journals (Sweden)

    Yohana de Oliveira-Cauduro

    2014-01-01

    Full Text Available The aims of this research were to evaluate different culture media for indirect organogenesis and shoot multiplication of Eucalyptus benthamii x Eucalyptus dunnii . For organogenesis, leaf explants were used to test the following treatments: two culture media (MS N/2 and JADS supplemented with 0.1 μM 1-naphthaleneacetic acid (NAA and thidiazuron (TDZ (0.1 or 0.5 μ M, with or without PVP- 40 (250 mg L -1 . The percentage of oxidized explants, callus forming explants, explants with anthocyanin,buds, shoots and the shoot number per explant were evaluated. In the multiplication experiment, isolated shoots were cultivated in MS, JADS and WPM media, all supplemented with 1.11 μ M BAP. Four subcultures were carried out every 28 days. In every subculture the explant oxidation, partial or total leaf chlorosis, fresh mass and mean number of shoot per explant were evaluated. The MS N/2 medium supplemented with 0.1 μM NAA and 0.5 μM TDZ promoted the highest rate of organogenesis (8.3% and the culture media MS supplemented with 1.11 μ M BAP the multiplication rate was higher than in the other media, in the first and the second subcultures (9.28 and 9.24, respectively, without differences between the three media in the following subcultures.

  1. Temporal Trends in Coverage of Historical Cardiac Arrests Using a Volunteer-Based Network of Automated External Defibrillators Accessible to Laypersons and Emergency Dispatch Centers

    DEFF Research Database (Denmark)

    Malta Hansen, Carolina; Knudsen Lippert, Freddy; Wissenberg, Mads;

    2014-01-01

    BACKGROUND: -Although increased dissemination of Automated External Defibrillators (AEDs) has been associated with more frequent AED use, the trade-off between the number of deployed AEDs and coverage of cardiac arrests remains unclear. We investigated how volunteer-based AED dissemination affect...

  2. Design of a Defibrillator Analyzer System based on LabVIEW%基于LabVIEW的除颤监护检测仪的开发

    Institute of Scientific and Technical Information of China (English)

    赵晖

    2012-01-01

    Defibrillator is necessary apparatus for rescue and treatment. In order to assure the safety and effectiveness m clinical use of defibrillator, the defibrillator's performance must be test periodically. This paper present a defibrillator analyzer system based on Lab VIEW, to detect the parameters such as release energy and synchronization delay time, and it can output ECG signal and the sine (or square wave) signal.%除颤器是用于抢救和治疗心律失常病人的设备,为确保除颤器临床使用的安全有效,必须对其主要指标进行定期检测.本文设计了一款基于LabVIEW的除颤器检测仪,用于检测除颤器的释放能量、同步除颤延迟时间等指标,并可输出模拟心电信号和正弦波(或方波)信号.

  3. Assessment of the sensitivity of three North American fish species to disruptors of steroidogenesis using in vitro tissue explants.

    Science.gov (United States)

    Beitel, Shawn C; Doering, Jon A; Patterson, Sarah E; Hecker, Markus

    2014-07-01

    There is concern regarding exposure of aquatic organisms to chemicals that interfere with the endocrine system. One critical mechanism of endocrine disruption is impairment of steroidogenesis that can lead to altered hormone levels, altered or delayed sexual development, and ultimately reproductive failure. With the current large gap in knowledge and a high degree of uncertainty regarding the sensitivity of fishes native to northern ecosystems to endocrine disrupting chemicals (EDCs), the aim of this study was to develop an in vitro gonadal explant assay enabling the assessment of EDCs on sex-steroid production in wild fish species native to North America. Northern pike (Esox lucius), walleye (Sander vitreus), and white sucker (Catostomus commeroni) were sampled from a reference location in Lake Diefenbaker, Saskatchewan, Canada, at spawn and multiple post-spawn time points. Gonads were excised and immediately exposed for 24h to a model inducer (forskolin) or inhibitor (prochloraz) of steroidogenesis in L-15 supplemented media. Furthermore, seasonal profiles of plasma 11-ketotestosterone (11-KT) and 17-β estradiol (E2) concentrations were characterized. Enzyme-linked immunosorbent assays were used to quantify hormone concentrations in plasma and media. The seasonal profile of plasma hormones was significantly correlated with basal in vitro hormone production. Gonad tissue exposed to forskolin showed a concentration-dependent increase in E2 and a general increase in 11-KT. Gonad tissue exposed to prochloraz resulted in a decrease of concentrations of 11-KT and E2. These results illustrated that gonadal tissue is undergoing steroidogenesis in an in vitro setting that is comparable to in vivo hormone profiles, and which is responsive to chemical exposure in a concentration-dependent manner. The seasonal time point during which gonad explants were excised and exposed had an impact on the potency and magnitude of responses, resulting in a seasonal effect on sensitivity

  4. Effects of carbon ion beam irradiation on the shoot regeneration from in vitro axillary bud explants of the Impatiens hawkeri

    Science.gov (United States)

    Zhou, Libin; Zhou, Libin; Li, Wenjian; Li, Ping; Dong, Xicun; Qu, Ying; Ma, Shuang; Li, Qiang

    Accelerated ion beams is an excellent mutagen in plant breeding which can induce higher mutation frequencies and wider mutation spectrum than those of low linear energy transfer (LET) irradiations, such as X-rays (Okamura et al. 2003, Yamaguchi et al. 2003). Mutation breeding operation of two Saintpaulia ionahta cultivars using the method combining plant tissue culture technique and carbon ion beam irradiations were set out at Institute of Modern Physics from 2005 (Zhou et al. 2006). The effects of 960 MeV carbon ion beam and 8 MeV X-ray irradiations on regenerated shoots of Impatiens hawkeri from another kind of explants named in vitro axillary buds explants were studied recently. The biology endpoints in this study included relative number of roots (RNR), relative length of roots (RLR), relative height of shoots (RHS), relative number of nodes (RNN), survival fraction (SF) and morphology changes in the regenerated shoots. The experimental results showed that carbon ion beams inhibited the root and stem developments of axillary bud explants more severely than X-rays did. And the 50% lethal dose (LD50 ) is about 23.3 Gy for the carbon ion beam and 49.1 Gy for the X-rays, respectively. Relative biological effectiveness (RBE) of Impatiens hawkeri with respect to X-rays according to 50% SF was about two. Secondly, the percentage of shoots regenerated with malformed shoots including curliness, carnification, nicks in all Impatiens hawkeri axillary bud explants irradiated with carbon ion beam at 20 Gy accounted for 55.6%, while the highest number for the 40 Gy X-ray irradiation was 40%. Last, many regenerated shoots whose vascular bundle fused together were obtained only from explants irradiated with carbon ion beams. Based on the results above, it can be concluded that the effect of mutation induction by carbon ion beam irradiation on the axillary explants of Impatiens hawkeri is better than that by X-ray irradiation; and the optimal mutagenic dose varies from 20 Gy

  5. ANATOMICAL STUDIES OF IN VITRO ORGANOGENESIS INDUCED IN LEAF-DERIVED EXPLANTS OF PASSIONFRUIT ESTUDOS ANATÔMICOS DA ORGANOGÊNESE IN VITRO INDUZIDA EM EXPLANTES DE FOLHA DE MARACUJÁ

    OpenAIRE

    BEATRIZ APPEZZATO DA GLORIA; MARIA LUCIA CARNEIRO VIEIRA; MARCELO CARNIER DORNELAS

    1999-01-01

    With the aim of studying the organogenesis in vitro in Passiflora edulis Sims f. flavicarpa Deg., the passionfruit, leaf-derived explants were cultured on media containing NAA or BAP and incubated either in continuous darkness or in light. The histological events leading to de novo organ formation were evaluated. Darkness induces rhizogenesis in the presence of NAA, whereas direct shoot regeneration is stimulated by light and BAP. This latter condition is recommended for passionfruit micropro...

  6. Plant regeneration of Rhabdadenia Ragonesei (Apocynaceae by in vitro culturing of leaf explants REGENERACIÓN DE PLANTAS DE RHABDADENIA RAGONESEI (APOCYNACEAE POR CULTIVO IN VITRO DE EXPLANTES FOLIARES

    Directory of Open Access Journals (Sweden)

    Eduardo Flachsland

    2010-08-01

    Full Text Available Plants of Rhabdadenia Ragonesei Woodson (Apocynaceae were regenerated in vitro from leaves explants. The procedure employed includes: 1 Surface sterilization of leaves by immersion in 70% ethanol (10 s followed by 1,1%NaOCl (15 min and three wash with sterile distilled water. 2 Callus and buds induction by culture on Murashige and Skoog medium (MS + 3 mg/L benzyladenine (BAP. 3 Subculture of callus and buds on MS + 1 mg/L BAP, and 4 Rooting on MS + 0.5 mg/L naftalenacetic acid Se regeneraron plantas de Rhabdadenia Ragonesei Woodson (Apocynaceae mediante el cultivo in vitro de explantes foliares en condiciones ambientales controladas. El procedimiento consistió en: 1 Desinfección de las hojas por inmersión en etanol al 70% (10 s seguida de Inmersión en NaOCl al 1,1% (15 min y lavado tres veces con agua destilada estéril. 2 Inducción de callos y yemas mediante el cultivo de explantes foliares en el medio de Murashige y Skoog (MS + 3 mg/L de benciladenina (BAP. 3 Subcultivo de callos y yemas en MS + 1 mg/L de BAP y 4 Enraizamiento de los vastagos obtenidos en MS + 0,5 mg/L de ácido naftalenacético

  7. Public Claims about Automatic External Defibrillators: An Online Consumer Opinions Study

    Directory of Open Access Journals (Sweden)

    Barnett Julie

    2011-05-01

    Full Text Available Abstract Background Patients are no longer passive recipients of health care, and increasingly engage in health communications outside of the traditional patient and health care professional relationship. As a result, patient opinions and health related judgements are now being informed by a wide range of social, media, and online information sources. Government initiatives recognise self-delivery of health care as a valuable means of responding to the anticipated increased global demand for health resources. Automated External Defibrillators (AEDs, designed for the treatment of Sudden Cardiac Arrest (SCA, have recently become available for 'over the counter' purchase with no need for a prescription. This paper explores the claims and argumentation of lay persons and health care practitioners and professionals relating to these, and how these may impact on the acceptance, adoption and use of these devices within the home context. Methods We carry out a thematic content analysis of a novel form of Internet-based data: online consumer opinions of AED devices posted on Amazon.com, the world's largest online retailer. A total of #83 online consumer reviews of home AEDs are analysed. The analysis is both inductive, identifying themes that emerged from the data, exploring the parameters of public debate relating to these devices, and also driven by theory, centring around the parameters that may impact upon the acceptance, adoption and use of these devices within the home as indicated by the Technology Acceptance Model (TAM. Results Five high-level themes around which arguments for and against the adoption of home AEDs are identified and considered in the context of TAM. These include opinions relating to device usability, usefulness, cost, emotional implications of device ownership, and individual patient risk status. Emotional implications associated with AED acceptance, adoption and use emerged as a notable factor that is not currently reflected

  8. Analysis of explanted ePTFE cardiovascular grafts (modified BT shunt)

    Energy Technology Data Exchange (ETDEWEB)

    Doble, Mukesh [Department of Biotechnology, Indian Institute of Technology, Chennai 600 036 (India); Makadia, Nilesh; Pavithran, Sreeja; Kumar, R Suresh [Department of Pediatric Cardiology, Institute of Cardio-Vascular Diseases, Madras Medical Mission, Chennai, 600 037 (India)], E-mail: mukeshd@iitm.ac.in

    2008-09-01

    Structural, chemical, mechanical and surface changes were studied in expanded polytetrafluroethylene vascular grafts explanted from children undergoing planned surgical management of congenital heart disease. These grafts were implanted when recipients were aged 7 days to 8 years (median-48 weeks) and they had been in circulation for a period of 10-52 months (median-74 weeks). While no chemical changes were observed in the shunt, on average the tensile strength had decreased by 50%, total elongation by 61% and crystallinity by 3%. No salt deposits were observed on the surface of the graft. Soluble and insoluble proteins were bound to the polymer surface, which had made the surface hydrophilic. The external surface roughness had increased by 254.5 and the internal surface roughness by 2.6 times the initial value. The fine polymer structure had become fused and clumped. The fusing of strands on the polymer surface became more pronounced with longer duration of implantation. In one instance of previously documented graft stenosis, the heat capacity was found to be more than that of the unimplanted sample, indicating an increase in crystallinity. A longer period of study with a larger sample size would likely shed more light on the relation between physico-chemical changes and graft stenosis.

  9. From Single Cells to Engineered and Explanted Tissues: New Perspectives in Bacterial Infection Biology.

    Science.gov (United States)

    Bergmann, Simone; Steinert, Michael

    2015-01-01

    Cell culture techniques are essential for studying host-pathogen interactions. In addition to the broad range of single cell type-based two-dimensional cell culture models, an enormous amount of coculture systems, combining two or more different cell types, has been developed. These systems enable microscopic visualization and molecular analyses of bacterial adherence and internalization mechanisms and also provide a suitable setup for various biochemical, immunological, and pharmacological applications. The implementation of natural or synthetical scaffolds elevated the model complexity to the level of three-dimensional cell culture. Additionally, several transwell-based cell culture techniques are applied to study bacterial interaction with physiological tissue barriers. For keeping highly differentiated phenotype of eukaryotic cells in ex vivo culture conditions, different kinds of microgravity-simulating rotary-wall vessel systems are employed. Furthermore, the implementation of microfluidic pumps enables constant nutrient and gas exchange during cell cultivation and allows the investigation of long-term infection processes. The highest level of cell culture complexity is reached by engineered and explanted tissues which currently pave the way for a more comprehensive view on microbial pathogenicity mechanisms. PMID:26404465

  10. Cells that emerge from embryonic explants produce fibers of type IV collagen.

    Science.gov (United States)

    Chen, J M; Little, C D

    1985-10-01

    Double immunofluorescence staining experiments designed to examine the synthesis and deposition of collagen types I and IV in cultured explants of embryonic mouse lung revealed the presence of connective tissue-like fibers that were immunoreactive with anti-type IV collagen antibodies. This observation is contrary to the widely accepted belief that type IV collagen is found only in sheet-like arrangements beneath epithelia or as a sheath-like layer enveloping bundles of nerve or muscle cells. The extracellular matrix produced by cells that migrate from embryonic mouse lung rudiments in vitro was examined by double indirect immunofluorescence microscopy. Affinity-purified monospecific polyclonal antibodies were used to examine cells after growth on glass or native collagen substrata. The data show that embryonic mesenchymal cells can produce organized fibers of type IV collagen that are not contained within a basement membrane, and that embryonic epithelial cells deposit fibers and strands of type IV collagen beneath their basal surface when grown on glass; however, when grown on a rat tail collagen substratum the epithelial cells produce a fine meshwork. To our knowledge this work represents the first report that type IV collagen can be organized by cells into a fibrous extracellular matrix that is not a basement membrane.

  11. Examination of explanted polyurethane pacemaker leads using the scanning electron microscope.

    Science.gov (United States)

    Beyersdorf, F; Kreuzer, J; Schmidts, L; Satter, P

    1985-07-01

    Since 1978, 2,365 polyurethane (PU) insulated cardiac pacing leads were implanted transvenously at our institution. To date, there have been no insulation failures in those leads. Thirty-seven PU leads were explanted, mainly for exit block, and 28 of these were investigated using the scanning electron microscope. We found a homogeneous distribution of surface changes in all lead segments in 56% of the 28 examined. These changes were more pronounced at the ligature site; severe surface cracking was noticed in 21%, with the deepest crack being 40 micron (average range of 10-15 micron). There appeared to be no time-dependency of the surface changes as indicated by regression analysis (r = 0.32, p greater than 0.05). The ultimate severity and outcome of this degradation process in the leads reported in this study will only be known in the future after longer use. We conclude that excess stress must be avoided during the implantation procedure and that careful surveillance is necessary. PMID:2410883

  12. Epidermal DNA synthesis in organ culture explants. A study of hairless mouse ear epidermis.

    Science.gov (United States)

    Hansteen, I L; Iversen, O H; Refsum, S B

    1979-10-01

    Explants of split mouse ear were incubated in organ culture for up to 48 h, and the cell proliferation was studied by the addition of Thymidine-methyl-3-H (3HTdR) to the medium during different time periods, mainly for the first 14 h of incubation. Cultures were started at 0900, 2130 and 2300. In all cases the labelling index remained stable for 6-8 h, and then increased. The mean grain count, however, was falling and so was the epidermal DNA-specific uptake of 3HTdR. Based on the experimental results, calculations can be made of the flux of cells through S. It is concluded that the increasing LI is not due to inherent diurnal variation in cell proliferation, and is not a sign of real growth but caused instead by a complete block of the cell exit from S, probably combined with periods of an increased entrance rate into S. Other methodological factors, however, may also contribute to the increasing LI. Hence, this system is not suited for the measurement of factors that influence epidermal DNA synthesis.

  13. In Vitro Shoot Bud Differentiation from Hypocotyl Explants of Chili Peppers (Capsicum annuum L.

    Directory of Open Access Journals (Sweden)

    Owk ANIEL KUMAR

    2010-03-01

    Full Text Available Chili pepper (Capsicum annuum L. is an economically important spice crop in tropical and subtropical countries. In vitro plant regeneration was obtained from 15th day old hypocotyl explants of three chili pepper cultivars (Capsicum annuum L., var. �X-235�, var. �PC-1� and var. �Pusa Jwala�. Among the genotypes of Capsicum L. var. �X-235� responded better than the var. �PC-1� and var. �Pusa Jwala�. MS medium containing BAP (4.0 mg/l and IAA (0.5 mg/l was found to be the best medium for the production of maximum number of shoot buds in all the genotypes of chili pepper i.e., 6.80�0.16 (var. �X-235�, 5.00�0.19 (var. �PC-1� and 4.80�0.12 (var. �Pusa Jwala�. The shoots were rooted on MS medium fortified with IBA (0.5 mg/l. Rooted plants were hardened and transplanted to the soil. The plants showed 80-90% survival during transplantation.

  14. In vitro neurotoxic effects of 1 GeV/n iron particles assessed in retinal explants.

    Science.gov (United States)

    Vazquez, M E; Kirk, E

    2000-01-01

    The heavy ion component of the cosmic radiation remains problematic to the assessment of risk in manned space flight. The biological effectiveness of HZE particles has yet to be established, particularly with regard to nervous tissue. Using heavy ions accelerated at the AGS of Brookhaven National Laboratory, we study the neurotoxic effects of iron particles. We exposed retinal explants, taken from chick embryos, to determine the dose response relationships for neurite outgrowth. Morphometric techniques were used to evaluate the in vitro effects of 1 GeV/a iron particles (LET 148 keV/micrometer). Iron particles produced a dose-dependent reduction of neurite outgrowth with a maximal effect achieved with a dose of 100 cGy. Doses as low as 10-50 cGy were able to induce reductions of the neurite outgrowth as compared to the control group. Neurite generation is a more sensitive parameter than neurite elongation, suggesting different mechanism of radiation damage in our model. These results showed that low doses/fluences of iron particles could impair the retinal ganglion cells' capacity to generate neurites indicating the highly neurotoxic capability of this heavy charged particle.

  15. In Vitro Callus Induction and Embryogenesis of Oil Palm (Elaeis guineensis Jacq. from Leaf Explants

    Directory of Open Access Journals (Sweden)

    DWI HAPSORO

    2011-06-01

    Full Text Available This research was to study in vitro callus induction and somatic embryogenesis in oil palm from leaf explants. Young leaf segments from mature oil palm were cultured on MS medium supplemented with different concentrations of 2,4-D with or without addition of 2 g/l activated charcoal (AC or 2,4-D and picloram. Embryogenesis induction was done using MS medium containing 2,4-D 450 M and benziladenine 4.4 M with 3g/l activated charcoal. The treatment of 2,4-D 15 M resulted in the highest percentage of callus induction. The treatment of 2,4-D and AC showed that 2,4-D 450 M and AC led to higher percentage of callus induction than that of 2,4-D 400 M and 2 g/l AC. Embryogenesis occured in 27 out of 250 clumps of primary callus was occurred after 2-3 times subcultures. Somatic embryo development occurred when the embryogenic callus was transferred on the same basal medium supplemented with casein hydrolysate with 1 M BA or growth regulator free basal medium with 2 g/l activated charcoal.

  16. Activin A induces Langerhans cell differentiation in vitro and in human skin explants.

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    Tiziana Musso

    Full Text Available Langerhans cells (LC represent a well characterized subset of dendritic cells located in the epidermis of skin and mucosae. In vivo, they originate from resident and blood-borne precursors in the presence of keratinocyte-derived TGFbeta. In vitro, LC can be generated from monocytes in the presence of GM-CSF, IL-4 and TGFbeta. However, the signals that induce LC during an inflammatory reaction are not fully investigated. Here we report that Activin A, a TGFbeta family member induced by pro-inflammatory cytokines and involved in skin morphogenesis and wound healing, induces the differentiation of human monocytes into LC in the absence of TGFbeta. Activin A-induced LC are Langerin+, Birbeck granules+, E-cadherin+, CLA+ and CCR6+ and possess typical APC functions. In human skin explants, intradermal injection of Activin A increased the number of CD1a+ and Langerin+ cells in both the epidermis and dermis by promoting the differentiation of resident precursor cells. High levels of Activin A were present in the upper epidermal layers and in the dermis of Lichen Planus biopsies in association with a marked infiltration of CD1a+ and Langerin+ cells. This study reports that Activin A induces the differentiation of circulating CD14+ cells into LC. Since Activin A is abundantly produced during inflammatory conditions which are also characterized by increased numbers of LC, we propose that this cytokine represents a new pathway, alternative to TGFbeta, responsible for LC differentiation during inflammatory/autoimmune conditions.

  17. Micropropagation of Origanum acutidens (HAND.-MAZZ. IETSWAART Using Stem Node Explants

    Directory of Open Access Journals (Sweden)

    Mehmet Ugur Yildirim

    2013-01-01

    Full Text Available Origanum acutidens (HAND.-MAZZ. IETSWAART is a promising ornamental plant that can be widely used in landscape management. It is endemic to Eastern Anatolian region of Turkey. Tissue culture has not been used to micropropagate it. The study reports stem node explants from one-week-old seedlings of the plant for successful micropropagation. The stem nodes were cultured on MS medium containing 0.6, 1.2, 1.8, and 2.4 mg/L BAP with 0.2 mg/L NAA. Visible effects of culture media on shoot proliferation were recorded. Shoot regeneration rate was maximum on MS medium containing 1.80 mg/L BAP-0.2 mg/L NAA. The micropropagated shoots were rooted on MS medium containing 0.2 mg/L NAA. All microrooted plantlets survived during acclimatisation on peat moss. It was concluded that O. acutidens can be successfully micropropagated under in vitro conditions.

  18. Ex vivo hepatic venography for hepatocellular carcinoma in livers explanted for liver transplantation

    Directory of Open Access Journals (Sweden)

    Takatsuki Mitsuhisa

    2011-09-01

    Full Text Available Abstract Background Hepatocellular carcinoma (HCC is supposed to have a venous drainage system to a portal vein, which makes intrahepatic metastasis possible. However, the mechanism of extrahepatic recurrence, including the possibility of a direct route to the systemic circulation from the HCC nodules, remains unclear. Therefore, we performed retrograde hepatic venography for HCC in livers that had been explanted for liver transplantation in order to explore the possible direct connection between the hepatic vein and HCC nodules. Methods Of 105 living-donor liver transplantations (LDLT performed up to July, 2009 at the Department of Surgery, Nagasaki University Hospital, dynamic hepatic venography was performed with contrast media under fluoroscopy for the most recent 13 cases with HCC. The presence of a tumor stain for each HCC case was evaluated and compared with the histological findings of HCC. Results Hepatic venography revealed a tumor stain in 2 of 13 cases (15%. Neither showed any microscopic tumor invasion of HCC into the hepatic vein. In the other 11 cases, there were 4 microscopic portal venous invasions and 2 microscopic hepatic venous invasions. No patients have shown HCC recurrence in follow-up (median period, 13 months. Conclusion Using ex vivo hepatic venography, a direct connection to the hepatic vein from HCC in whole liver was revealed in 2 cases without demonstrated histopathological invasion to hepatic vein for the first time in the literature. The finding suggests that there is direct spillage of HCC cells into the systemic circulation via hepatic vein.

  19. Culturated rat cerebral cortex explants and their application in the study of SPECT scan radiopharaceuticals

    International Nuclear Information System (INIS)

    In this thesis mechanics that result in the distinct localization of radiopharmaceuticals within the brain have been investigated. In order to 'get more insight' in uptake and binding of radiopharmaceuticals bu brain tissue, use has been made of the tissue culture technique. Tissue culture privides the opportunity of doing experiments with brain tissue under stable conditions, in the absence of a blood-brain barrier, and without interference by cerebral blood flow. The present thesis is presented in two sections. The first part focusses on longterm culture of 'organotypic' cerebral neocortex tissue, obtained from neonatal rat brain and explanted into a chemically defined medium. Procedures were developed which enabled culturing of this tissue without the occurence of central necrosis and with the preservation of a characteristic histiotypic organization. Morphological characteristics of the cultures were described and measured at various ages in vitro. In the second part, the cultures were used to study mechanisms that might contribute to the tissue uptake of radiopharmaceuticals which are in clinical use for SPECT brain imaging. (author). 369 refs.; 50 figs.; 13 tabs

  20. In vitro neurotoxic effects of 1 GeV/n iron particles assessed in retinal explants.

    Science.gov (United States)

    Vazquez, M E; Kirk, E

    2000-01-01

    The heavy ion component of the cosmic radiation remains problematic to the assessment of risk in manned space flight. The biological effectiveness of HZE particles has yet to be established, particularly with regard to nervous tissue. Using heavy ions accelerated at the AGS of Brookhaven National Laboratory, we study the neurotoxic effects of iron particles. We exposed retinal explants, taken from chick embryos, to determine the dose response relationships for neurite outgrowth. Morphometric techniques were used to evaluate the in vitro effects of 1 GeV/a iron particles (LET 148 keV/micrometer). Iron particles produced a dose-dependent reduction of neurite outgrowth with a maximal effect achieved with a dose of 100 cGy. Doses as low as 10-50 cGy were able to induce reductions of the neurite outgrowth as compared to the control group. Neurite generation is a more sensitive parameter than neurite elongation, suggesting different mechanism of radiation damage in our model. These results showed that low doses/fluences of iron particles could impair the retinal ganglion cells' capacity to generate neurites indicating the highly neurotoxic capability of this heavy charged particle. PMID:11542855