WorldWideScience

Sample records for cardioverter defibrillator explantation

  1. Making post-mortem implantable cardioverter defibrillator explantation safe

    OpenAIRE

    Räder, Sune B.E.W.; Zeijlemaker, Volkert; Pehrson, Steen; Svendsen, Jesper H

    2009-01-01

    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 t...

  2. Making post-mortem implantable cardioverter defibrillator explantation safe

    DEFF Research Database (Denmark)

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

    2009-01-01

    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...... 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...

  3. Who Needs an Implantable Cardioverter Defibrillator?

    Science.gov (United States)

    ... this page from the NHLBI on Twitter. Who Needs an Implantable Cardioverter Defibrillator? Implantable cardioverter defibrillators (ICDs) ... before. Some people who have heart failure may need a CRT-D device. This device combines a ...

  4. Optimal Implantable Cardioverter Defibrillator Programming.

    Science.gov (United States)

    Shah, Bindi K

    Optimal programming of implantable cardioverter defibrillators (ICDs) is essential to appropriately treat ventricular tachyarrhythmias and to avoid unnecessary and inappropriate shocks. There have been a series of large clinical trials evaluating tailored programming of ICDs. We reviewed the clinical trials evaluating ICD therapies and detection, and the consensus statement on ICD programming. In doing so, we found that prolonged ICD detection times, higher rate cutoffs, and antitachycardia pacing (ATP) programming decreases inappropriate and painful therapies in a primary prevention population. The use of supraventricular tachyarrhythmia discriminators can also decrease inappropriate shocks. Tailored ICD programming using the knowledge gained from recent ICD trials can decrease inappropriate and unnecessary ICD therapies and decrease mortality.

  5. [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

  6. 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...

  7. An Entirely Subcutaneous Implantable Cardioverter-Defibrillator

    NARCIS (Netherlands)

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

    2010-01-01

    BACKGROUND 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, we conducted tw

  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. Living with an implantable cardioverter defibrillator

    DEFF Research Database (Denmark)

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

    2017-01-01

    Hospital were asked to complete a purpose-designed and standardized set of questionnaires. The level of satisfaction with information provision was high; only 13.1% were dissatisfied. Psychological support for patients (39.9%), their relatives (43.1%), and deactivation of the ICD towards end of life (47......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...

  10. The wearable cardioverter-defibrillator: current technology and evolving indications.

    Science.gov (United States)

    Reek, Sven; Burri, Haran; Roberts, Paul R; Perings, Christian; Epstein, Andrew E; Klein, Helmut U

    2016-10-04

    The wearable cardioverter-defibrillator has been available for over a decade and now is frequently prescribed for patients deemed at high arrhythmic risk in whom the underlying pathology is potentially reversible or who are awaiting an implantable cardioverter-defibrillator. The use of the wearable cardioverter-defibrillator is included in the new 2015 ESC guidelines for the management of ventricular arrhythmias and prevention of sudden cardiac death. The present review provides insight into the current technology and an overview of this approach.

  11. 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...... of the rehabilitation group for exercise capacity, general and mental health. The aim of this paper is to explore the long-term health effects and cost implications associated with the rehabilitation programme; more specifically, (i) to compare implantable cardioverter defibrillator therapy history and mortality...... between rehabilitation and usual care groups; (ii) to examine the difference between rehabilitation and usual care groups in terms of time to first admission; and (iii) to determine attributable direct costs. METHODS: Patients with first-time implantable cardioverter defibrillator implantation (n = 196...

  12. 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...

  13. 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.

  14. Interference of electronic apex locators with implantable cardioverter defibrillators

    NARCIS (Netherlands)

    Idzahi, K.; de Cock, C.C.; Shemesh, H.; Brand, H.S.

    2014-01-01

    Introduction The purpose of this in vitro study was to evaluate the potential electromagnetic interference of electronic apex locators (EALs) on implantable cardioverter defibrillators (ICDs). Methods Four different EALs were tested for their ability to interfere with the correct function of 3 diffe

  15. Dental management of a patient fitted with subcutaneous Implantable Cardioverter Defibrillator device and concomitant warfarin treatment

    OpenAIRE

    Altaf Hussain Shah; Hesham Saleh Khalil; Mohammed Zaheer Kola

    2015-01-01

    Automated Implantable Cardioverter Defibrillators (AICD), simply known as an Implantable Cardioverter Defibrillator (ICD), has been used in patients for more than 30 years. An Implantable Cardioverter Defibrillator (ICD) is a small battery-powered electrical impulse generator that is implanted in patients who are at a risk of sudden cardiac death due to ventricular fibrillation, ventricular tachycardia or any such related event. Typically, patients with these types of occurrences are on antic...

  16. 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....

  17. Lingular pneumonia obscured by implanted cardioverter-defibrillator: Lateral thinking.

    Science.gov (United States)

    Sewell, Laura; Harries, Ivan; Chandrasekaran, Barinathan

    2015-01-01

    A 56-year-old female with an implanted cardioverter-defibrillator was admitted with a short history suggestive of a diagnosis of pneumonia. An AP radiograph did not identify an area of consolidation. A subsequent lateral radiograph highlighted an extensive left-lingular-lobe consolidation that had been obscured by the cardiac device. This case highlights the fact that large devices can obscure significant pathology, and that lateral or cross-sectional imaging may be helpful in reaching a diagnosis.

  18. Lingular pneumonia obscured by implanted cardioverter-defibrillator: Lateral thinking

    OpenAIRE

    Laura Sewell, MD; Ivan Harries, MD; Barinathan Chandrasekaran, MD

    2015-01-01

    A 56-year-old female with an implanted cardioverter-defibrillator was admitted with a short history suggestive of a diagnosis of pneumonia. An AP radiograph did not identify an area of consolidation. A subsequent lateral radiograph highlighted an extensive left-lingular-lobe consolidation that had been obscured by the cardiac device. This case highlights the fact that large devices can obscure significant pathology, and that lateral or cross-sectional imaging may be helpful in reaching a diag...

  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. 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.

  1. 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.

  2. Spinal cord stimulation for refractory angina in a patient implanted with a cardioverter defibrillator.

    Science.gov (United States)

    Ferrero, Paolo; Grimaldi, Roberto; Massa, Riccardo; Chiribiri, Amedeo; De Luca, Anna; Castellano, Maddalena; Cardano, Paola; Trevi, Gian Paolo

    2007-01-01

    Spinal cord stimulation is currently used to treat refractory angina. Some concerns may arise about the possible interaction concerning the spinal cord stimulator in patients already implanted with a pacemaker or a cardioverter defibrillator. We are going to describe the successful implantation of a spinal cord stimulator in a patient previously implanted with a cardioverter defibrillator.

  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. Lingular pneumonia obscured by implanted cardioverter-defibrillator: Lateral thinking

    Directory of Open Access Journals (Sweden)

    Laura Sewell, MD

    2015-01-01

    Full Text Available A 56-year-old female with an implanted cardioverter-defibrillator was admitted with a short history suggestive of a diagnosis of pneumonia. An AP radiograph did not identify an area of consolidation. A subsequent lateral radiograph highlighted an extensive left-lingular-lobe consolidation that had been obscured by the cardiac device. This case highlights the fact that large devices can obscure significant pathology, and that lateral or cross-sectional imaging may be helpful in reaching a diagnosis.

  6. Magnets and implantable cardioverter defibrillators: What′s the problem?

    Directory of Open Access Journals (Sweden)

    Yiliam F Rodriguez-Blanco

    2013-01-01

    Full Text Available A growing number of surgical patients present to the operating room with implantable cardioverter defibrillators (ICD. Peri-operative care of these patients dictates that ICD function be suspended for many surgical procedures to avoid inappropriate, and possibly harmful, ICD therapy triggered by electromagnetic interference (EMI. An alternative to reprogramming the ICD is the use of a magnet to temporarily suspend its function. However, this approach is not without complications. We report a case where magnet use failed to inhibit ICD sensing of EMI, and a shock was delivered to the patient. Measures to decrease EMI, controversies regarding magnet use, and expert recommendations are discussed.

  7. Magnets and implantable cardioverter defibrillators: what's the problem?

    Science.gov (United States)

    Rodriguez-Blanco, Yiliam F; Souki, Fouad; Tamayo, Evelyn; Candiotti, Keith

    2013-01-01

    A growing number of surgical patients present to the operating room with implantable cardioverter defibrillators (ICD). Peri-operative care of these patients dictates that ICD function be suspended for many surgical procedures to avoid inappropriate, and possibly harmful, ICD therapy triggered by electromagnetic interference (EMI). An alternative to reprogramming the ICD is the use of a magnet to temporarily suspend its function. However, this approach is not without complications. We report a case where magnet use failed to inhibit ICD sensing of EMI, and a shock was delivered to the patient. Measures to decrease EMI, controversies regarding magnet use, and expert recommendations are discussed.

  8. 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....

  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...

  10. 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....

  11. 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

    Background: WEB-Based Distress Management Program for Implantable CARdioverter defibrillator Patients (WEBCARE) is a Web-based randomized controlled trial, designed to improve psychological well-being in patients with an implantable cardioverter defibrillator (ICD). As in other Web-based trials, ...

  12. Clinical efficacy and safety of an implantable cardioverter-defibrillator lead with a floating atrial sensing dipole

    DEFF Research Database (Denmark)

    Safak, Erdal; Schmitz, Dietmar; Konorza, Thomas;

    2013-01-01

    The concept of a single-lead implantable cardioverter-defibrillator (ICD), with a floating dipole, has been proven safe and functional.......The concept of a single-lead implantable cardioverter-defibrillator (ICD), with a floating dipole, has been proven safe and functional....

  13. The National Survey of Cardiac Pacemakers and Cardioverter Defibrillators

    Directory of Open Access Journals (Sweden)

    Gholamrerza Shafieian

    2006-07-01

    Full Text Available Background: Permanent pacemakers provide effective relief of symptoms and are life-saving in patients with symptomatic heart block. Implantable cardioverter defibrillators (ICD are also increasingly recognized as life-saving tools in various groups of patients with malignant ventricular tachyarrhythmias. Methods: As part of the “world survey on pacemaker and ICD implantations”, a survey of all device implantations in Iran during the year 2001 was performed. Data was collected and cross-checked through three sources i.e. direct contact with implanting physicians, pacemaker companies and the governmental pacemaker distributing body.Results: During the year studied, 1635 patients received permanent pacemakers. 88% were new implants at an estimated rate of 24 per million population. The mean age of patients was 65 years and 56.2% were male. 40 cardiologists and 19 surgeons implanted the pacemakers at 27 centers throughout the country. Complete heart block was consistently the most common indication at all centers (mean 56.1%, sick sinus syndrome being the next most common one (mean 20.8%. 69% of the pacemakers were single chamber pacemakers. Transvenous insertion of bipolar steroid-eluting passive fixation leads was the predominant practice at most centers. A total of 60 ICDs were implanted at 7 centers by 9 cardiologists. 45% of ICD implants were dual chamber devices.Conclusion: The survey is the only one available right now and provides useful information about the prevailing pacemaker and defibrillator implantation practice in Iran. Future surveys would be facilitated if a standardized implant registry such as that used in Europe were established in this country.

  14. [Primary prevention of sudden cardiac death through a wearable cardioverter-defibrillator].

    Science.gov (United States)

    Gabrielli, Domenico; Benvenuto, Manuela; Baroni, Matteo; Oliva, Fabrizio; Capucci, Alessandro

    2015-01-01

    Nowadays, the implantable cardioverter-defibrillator is the gold standard for the prevention of sudden cardiac death due to tachyarrhythmias. However, its use is not free from short and long-term risks. In the last years, the wearable cardioverter-defibrillator (WCD) has become a widespread option for patients who need a safe and reversible protection against ventricular tachyarrhythmias. Notwithstanding this, its everyday application is restricted by several limitations, including the risk of inappropriate shocks, the device size and the need for strict compliance of both patients and caregivers. In this review, we report the most relevant literature data on WCD usage along with the main fields of applications and future perspectives.

  15. Successful intermuscular implantation of subcutaneous implantable cardioverter defibrillator in a Japanese patient with pectus excavatum.

    Science.gov (United States)

    Kondo, Yusuke; Ueda, Marehiko; Winter, Joachim; Nakano, Miyo; Nakano, Masahiro; Ishimura, Masayuki; Miyazawa, Kazuo; Tateno, Kaoru; Kobayashi, Yoshio

    2017-02-01

    The entirely subcutaneous implantable cardioverter-defibrillator (ICD) system was developed to provide a life-saving defibrillation therapy that does not affect the heart and vasculature. The subcutaneous ICD is preferred over the transvenous ICD for patients with a history of recurrent infection presenting major life-threatening rhythms. In this case report, we describe the first successful intermuscular implantation of a completely subcutaneous ICD in a Japanese patient with pectus excavatum. There were no associated complications with the device implantation or lead positioning. Further, the defibrillation threshold testing did not pose any problem with the abnormal anatomy of the patient.

  16. 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 corr...

  17. 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

  18. 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

  19. 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

  20. 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...

  1. 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...

  2. 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...

  3. 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

  4. 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...

  5. 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

  6. Outcome of implantable cardioverter defibrillators in adults with congenital heart disease : a multi-centre study

    NARCIS (Netherlands)

    Yap, Sing-Chien; Roos-Hesselink, Jolien W.; Hoendermis, Elke S.; Budts, Werner; Vliegen, Hubert W.; Mulder, Barbara J. M.; van Dijk, Arie P. J.; Schalij, Martin J.; Drenthen, Willem

    2007-01-01

    Aims To investigate outcome and complications of implantable cardioverter defibrillators (ICDs) in adults with congenital heart disease (CHD) and to identify predictors of (in-) appropriate shocks. Methods and results Sixty-four CHD patients >= 18 years at first ICD implantation [63% tetralogy of Fa

  7. 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...

  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

    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......-defibrillator (ICD) alone among patients with left ventricular systolic dysfunction, prolonged intraventricular conduction, and mild heart failure. DESIGN: Markov decision model. DATA SOURCES: Clinical trials, clinical registries, claims data from Centers for Medicare & Medicaid Services, and Centers for Disease...

  9. 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

    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...... 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...

  10. Conservative Management of Skin Fistula Occurring After Internal Cardioverter Defibrillator Replacement

    OpenAIRE

    2012-01-01

    Skin fistula occurring after cardiac electronic device implantation is frequently related to pocket infection and this condition typically requires removal of device and lead(s). We report on a case of skin fistula occurring 3 weeks after internal cardioverter defibrillator replacement. Conservative management consisted of local care along with oral antibiotics without removal of device; this strategy resulted in complete healing and closure of the fistula.

  11. Psychological effects of implantable cardioverter defibrillator shocks. A review of study methods

    OpenAIRE

    Manzoni, Gian Mauro; Castelnuovo, Gianluca; Compare, Angelo; Pagnini, Francesco; Essebag, Vidal; Proietti, Riccardo

    2015-01-01

    Background: The implantable cardioverter defibrillator (ICD) saves lives but clinical experience suggests that it may have detrimental effects on mental health. The ICD shock has been largely blamed as the main offender but empirical evidence is not consistent, perhaps because of methodological differences across studies. Objective: To appraise methodologies of studies that assessed the psychological effects of ICD shock and explore associations between methods and results. Data Sources...

  12. 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.

  13. Psychological effects of implantable cardioverter defibrillator shocks. A review of study methods.

    OpenAIRE

    Gian Mauro eManzoni; Gianluca eCastelnuovo; Angelo eCompare; Francesco ePagnini; Vidal eEssebag; Riccardo eProietti

    2015-01-01

    BackgroundThe implantable cardioverter defibrillator (ICD) saves lives but clinical experience suggests that it may have detrimental effects on mental health. The ICD shock has been largely blamed as the main offender but empirical evidence is not consistent, perhaps because of methodological differences across studies. ObjectiveTo appraise methodologies of studies that assessed the psychological effects of ICD shock and explore associations between methods and results. Data Sources A compreh...

  14. Inappropriate implantable cardioverter defibrillator shock from a transcutaneous muscle stimulation device therapy.

    Science.gov (United States)

    Siu, Chung-Wah; Tse, Hung-Fat; Lau, Chu-Pak

    2005-06-01

    Inappropriate shock from implantable cardioverter defibrillator (ICD) may result from external electromagnetic interference (EMI), especially for unipolar ventricle sensing. Previous case reports and small in-vitro safety study suggested that endocardial bipolar lead system may be immune from EMI resulting from transcutaneous electrical neuromuscle stimulation (TENS) therapy. This report presents an unusual case of inappropriate discharge in a patient with ICD of endocardial bipolar lead system, receiving TENS from a commercially available device.

  15. Athletic participation in the young patient with an implantable cardioverter-defibrillator.

    Science.gov (United States)

    Lampert, Rachel; Law, Ian

    2017-01-01

    The decision of whether to allow a young patient with an implantable cardioverter-defibrillator to continue to participate in sports is complex and multi-factorial. The positive physical and psychosocial impact of sports participation must be weighed against the potential adverse events associated with implantable cardioverter-defibrillators. Arrhythmias appear to be more prevalent in athletes and occur more frequently during physical activity or competition/practice, but there is growing evidence that device therapy is effective in athletes across a wide range of competitive sports. Failure of a device to convert a life-threatening arrhythmia, major injury from a shock, and increased lead failure have thus far not been reported in the prospective Implantable Cardioverter-Defibrillator Sports Registry, but follow-up remains relatively short. Thoughtful consideration of disease state, arrhythmia risk, and the potential dangers of device therapy during the desired sports is imperative before allowing participation. Frank discussion with children and families regarding the possibility of shocks during sports, as well as at other times, is imperative. Ongoing and future studies will help guide these decisions.

  16. Dental management of a patient fitted with subcutaneous Implantable Cardioverter Defibrillator device and concomitant warfarin treatment.

    Science.gov (United States)

    Shah, Altaf Hussain; Khalil, Hesham Saleh; Kola, Mohammed Zaheer

    2015-07-01

    Automated Implantable Cardioverter Defibrillators (AICD), simply known as an Implantable Cardioverter Defibrillator (ICD), has been used in patients for more than 30 years. An Implantable Cardioverter Defibrillator (ICD) is a small battery-powered electrical impulse generator that is implanted in patients who are at a risk of sudden cardiac death due to ventricular fibrillation, ventricular tachycardia or any such related event. Typically, patients with these types of occurrences are on anticoagulant therapy. The desired International Normalized Ratio (INR) for these patients is in the range of 2-3 to prevent any subsequent cardiac event. These patients possess a challenge to the dentist in many ways, especially during oral surgical procedures, and these challenges include risk of sudden death, control of post-operative bleeding and pain. This article presents the dental management of a 60 year-old person with an ICD and concomitant anticoagulant therapy. The patient was on multiple medications and was treated for a grossly neglected mouth with multiple carious root stumps. This case report outlines the important issues in managing patients fitted with an ICD device and at a risk of sudden cardiac death.

  17. 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....

  18. 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....

  19. Capsule endoscopy in patients with cardiac pacemakers, implantable cardioverter defibrillators and left heart assist devices.

    Science.gov (United States)

    Bandorski, Dirk; Höltgen, Reinhard; Stunder, Dominik; Keuchel, Martin

    2014-01-01

    According to the recommendations of the US Food and Drug Administration and manufacturers, capsule endoscopy should not be used in patients carrying implanted cardiac devices. For this review we considered studies indexed (until 30.06.2013) in Medline [keywords: capsule endoscopy, small bowel endoscopy, cardiac pacemaker, implantable cardioverter defibrillator, interference, left heart assist device], technical information from Given Imaging and one own publication (not listed in Medline). Several in vitro and in vivo studies included patients with implanted cardiac devices who underwent capsule endoscopy. No clinically relevant interference was noticed. Initial reports on interference with a simulating device were not reproduced. Furthermore technical data of PillCam (Given Imaging) demonstrate that the maximum transmission power is below the permitted limits for cardiac devices. Hence, impairment of cardiac pacemaker, defibrillator or left ventricular heart assist device function by capsule endoscopy is not expected. However, wireless telemetry can cause dysfunction of capsule endoscopy recording. Application of capsule endoscopy is feasible and safe in patients with implanted cardiac devices such as pacemakers, cardioverter defibrillators, and left heart assist devices. Development of new technologies warrants future re-evaluation.

  20. The use of guideline recommended beta-blocker therapy in primary prevention implantable cardioverter defibrillator patients

    DEFF Research Database (Denmark)

    Ruwald, Anne-Christine; Gislason, Gunnar Hilmar; Vinther, Michael

    2017-01-01

    Aims: We aimed to examine the use of guideline recommended beta-blocker therapy prior to and after primary prevention implantable cardioverter defibrillator (ICD) implantation in a 'real-life' setting. Methods and results: From the Danish Pacemaker and ICD Registry we identified all 1st-time prim......Aims: We aimed to examine the use of guideline recommended beta-blocker therapy prior to and after primary prevention implantable cardioverter defibrillator (ICD) implantation in a 'real-life' setting. Methods and results: From the Danish Pacemaker and ICD Registry we identified all 1st......-time primary prevention ICD and cardiac resynchronization therapy defibrillator (CRT-D) implantations in Denmark from 2007-12 (n = 2935). Use of beta-blocker, type and dose was acquired through the Danish Prescription Registry. According to guideline recommendations, we defined target daily doses as ≥50 mg...... carvedilol and ≥200 mg metoprolol. Prior to implantation 2427 of 2935 (83%) patients received beta-blocker therapy, with 2166 patients (89%) having initiated treatment 3 months or more prior to implantation. The majority of patients was prescribed carvedilol (52%) or metoprolol (41%). Patients on carvedilol...

  1. Cardioverter-defibrillator implantation to treat cardiac fibroma-induced ventricular tachycardia in a 70-year-old woman.

    Science.gov (United States)

    Hakim, Fayaz Ahmad; Pandit, Anil; Mookadam, Farouk; Mamby, Sylvia

    2014-06-01

    Benign cardiac fibroma is rarely reported in adults. Its clinical symptoms are related to outflow obstruction or dysrhythmias. We present the case of a 70-year-old woman who had a syncopal episode from ventricular tachycardia caused by cardiac fibroma. Because of unfavorable tumor anatomy, the patient was not a candidate for surgical excision, and she declined orthotopic heart transplantation. To prevent sudden cardiac death, we placed an implantable cardioverter-defibrillator, and the patient remained well throughout the 2-year follow-up period. To our knowledge, this is the first report of implantable cardioverter-defibrillator therapy to treat an adult patient's unresectable cardiac fibroma.

  2. 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

    Background: Experienced emotions can affect the outcome of, and adherence to a cardiac rehabilitation program, and patients coping with an illness. With more awareness of the expressed emotions, health professionals might be better able to understand the reactions of patients and to improve...... 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...... the intensity of primary emotions in patients after implantation of an Implantable Cardioverter Defibrillator and 2) to compare them with both the intensity of primary emotions in patients with a recent Myocardial Infarction and with a healthy population. Method: The intensity of primary emotions in patients...

  3. Bilateral Subclavian Vein Occlusion in a SAPHO Syndrome Patient Who Needed an Implantable Cardioverter Defibrillator.

    Science.gov (United States)

    Ishizuka, Masato; Yamamoto, Yuko; Yamada, Shintaro; Maemura, Sonoko; Nakata, Ryo; Motozawa, Yoshihiro; Yamamoto, Keisuke; Takizawa, Masataka; Uozumi, Hiroki; Ikenouchi, Hiroshi

    2016-05-25

    A 79-year-old Asian man was hospitalized because of progressive exertional dyspnea with decreasing left ventricular ejection fraction and frequent non-sustained ventricular tachycardia. Pre-procedure venography for implantable cardioverter defibrillator (ICD) implantation showed occlusion of the bilateral subclavian veins. In consideration of subcutaneous humps in the sterno-clavicular area and palmoplantar pustulosis, we diagnosed him as having synovitis, acne, pustulosis, hyperostosis, osteitis (SAPHO) syndrome and speculated that it induced peri-osteal chronic inflammation in the sterno-clavicular area, resulting in occlusion of the adjacent bilateral subclavian veins. An automatic external defibrillator (AED) was installed in the patient's house and total subcutaneous ICD was considered. Venous thrombosis in SAPHO syndrome is not frequent but has been reported. To the best of our knowledge, this is the first case of bilateral subclavian vein occlusion in a SAPHO syndrome patient who needs ICD implantation.

  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. Psychological Functioning and Disease-Related Quality of Life in Pediatric Patients With an Implantable Cardioverter Defibrillator

    NARCIS (Netherlands)

    Koopman, H. M.; Vrijmoet-Wiersma, C. M. J.; Langius, J. N. D.; van den Heuvel, F.; Clur, S. A.; Blank, C. A.; Blom, N. A.; ten Harkel, A. D. J.

    2012-01-01

    The objective of this multicenter study was to evaluate psychological functioning and disease-related quality of life (DRQoL) in pediatric patients with an implantable cardioverter defibrillator (ICD) in The Netherlands. Thirty patients were investigated; the mean age was 16.3 years, and the mean du

  6. Conscious sedation as an anaesthetic technique in patients undergoing nonthoracotomy placement of automatic implantable cardioverter defibrillator : an initial experience.

    Directory of Open Access Journals (Sweden)

    Singh V

    2004-01-01

    Full Text Available Six adult patients with life threatening recurrent ventricular arrhythmias who underwent non- thoracotomy placement of automatic implantable cardioverter defibrillator under conscious sedation are reported. Our clinical experience, patient satisfaction, recovery profile, complications and cardiologist perception about the technique of conscious sedation is presented and discussed.

  7. Morphology discrimination in implantable cardioverter-defibrillators: Consistency of template match percentage during atrial tachyarrhythmias at different heart rates

    NARCIS (Netherlands)

    D.A.M.J. Theuns (Dominic); M. Rivero-Ayerza (Maximo); D. Goedhart (Dick); M. Miltenburg (Max); L.J.L.M. Jordaens (Luc)

    2008-01-01

    textabstractBackground: Morphology discrimination (MD) in implantable cardioverter-defibrillators (ICDs) is based on the comparison of the ventricular electrogram during tachycardia with a stored reference template obtained during baseline rhythm. However, the effect of heart rate on the template ma

  8. Economical aspect of PET/CT-guided diagnosis of suspected infective endocarditis in a patient with implantable cardioverter-defibrillator.

    Science.gov (United States)

    Farkowski, Michal M; Milkowski, Maciej; Dziuk, Mirosław; Pytkowski, Mariusz; Marciniak, Marta; Kraska, Alicja; Szwed, Hanna; Sterlinski, Maciej

    2014-01-01

    We present a case report of potential reduction of hospitalization costs due to utilization of PET/CT in a diagnostic work-up of a patient with an implantable cardioverter-defibrillator and suspicion of infective endocarditis. The PET/CT scan would have shorten hospital stay, prevented clinical complications and reduced the cost of hospitalization by 45%.

  9. 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...

  10. A review of economic evaluation models for cardiac resynchronization therapy with implantable cardioverter defibrillators in patients with heart failure

    NARCIS (Netherlands)

    Tomini, F.; van Asselt, A. D.

    2012-01-01

    OBJECTIVES: Cardiac resynchronization therapy with biventricular pacemaker (CRT-P) is considered an effective treatment for heart failure (HF). Adding implantable cardioverter defibrillators (CRT-D) may further reduce the risk of sudden cardiac death (SCD). However, economic evaluations have shown t

  11. 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...

  12. [The Wearable Cardioverter Defibrillator (WCD) for the prevention of sudden cardiac death -- a single center experience].

    Science.gov (United States)

    Reek, S; Meltendorf, U; Geller, J C; Wollbrück, A; Grund, S; Klein, H U

    2002-12-01

    The Wearable Cardioverter Defibrillator (WCD) is an external defibrillator that automatically detects and treats ventricular tachyarrhythmias without the need for assistance from a bystander while at the same time allowing the patient to ambulate freely. The main components of the system are the defibrillator unit and a chest belt with electrodes for arrhythmia detection and therapy delivery. Between December 1998 and October 2001, 84 patients used the device at our institution. The majority of patients had a history of acute myocardial infarction or coronary artery bypass surgery with an increased risk for sudden cardiac death or were awaiting heart transplantation. During a mean follow-up of 116+/-90 days, 7 episodes of ventricular tachyarrhythmias were detected and terminated successfully by the WCD in 5 patients. In 9720 days, there was one inappropriate shock due to oversensing of electrical noise. Four patients died during follow-up; none of them had a cardiac arrest while wearing the device. Five patients were excluded because of irregularities in device use. An ICD was implanted in 24 patients at the end of the follow-up period. The WCD is effective in detecting and treating ventricular tachyarrhythmias in patients with an intermittently increased risk for sudden cardiac death. Further use of the system in larger patient populations is needed to confirm its safety and cost effectiveness.

  13. 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......, respectively, a history of IAT at baseline and time-dependent development of in-trial IAT during follow-up in 1,264 patients with LBBB enrolled in the MADIT-CRT (Multicenter Automatic Defibrillator Implantation Trial With Cardiac Resynchronization Therapy) study. RESULTS: The overall beneficial effect of CRT...... of in-trial atrial tachyarrhythmias. (MADIT-CRT: Multicenter Automatic Defibrillator Implantation Trial With Cardiac Resynchronization Therapy; NCT00180271)....

  14. Strategic programming of detection and therapy parameters in implantable cardioverter-defibrillators reduces shocks in primary prevention patients - Results from the PREPARE (Primary Prevention Parameters Evaluation) study

    NARCIS (Netherlands)

    Wilkoff, Bruce L.; Williamson, Brian D.; Stern, Richard S.; Moore, Stephen L.; Lu, Fei; Lee, Sung W.; Birgersdotter-Green, Ulrika M.; Wathen, Mark S.; Van Gelder, Isabelle C.; Heubner, Brooke M.; Brown, Mark L.; Holloman, Keith K.

    2008-01-01

    Objectives Our purpose was to demonstrate that strategically chosen implantable cardioverter-defibrillator (ICD) ventricular tachycardia (VT) or ventricular fibrillation (VF) detection and therapy parameters can reduce the combined incidence of device-delivered shocks, arrhythmic syncope, and untrea

  15. 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...

  16. 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....

  17. 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

    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......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....../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...

  18. [Guidelines on the management of implantable cardioverter defibrillators at the end of life].

    Science.gov (United States)

    Datino, T; Rexach, L; Vidán, M T; Alonso, A; Gándara, Á; Ruiz-García, J; Fontecha, B; Martínez-Sellés, M

    2014-01-01

    This article is a joint document of the Spanish Society of Geriatrics and Gerontology, the Spanish Society of Palliative Care and the Section of Geriatric Cardiology of the Spanish Society of Cardiology. Its aim is to address the huge gap that exists in Spain with regard to the management of implantable cardioverter defibrillators (ICDs) in the final stages of life. It is increasingly common to find patients carrying these devices that are in the terminal stage of an advanced disease. This occurs in patients with advanced heart disease and subsequent heart failure refractory to treatment but also in a patient with an ICD who develops cancer disease, organ failure or other neurodegenerative diseases with poor short-term prognosis. The vast majority of these patients are over 65, so the paper focuses particularly on the elderly who are in this situation, but the decision-making process is similar in younger patients with ICDs who are in the final phase of their life.

  19. Epileptic seizure in a patient with an implantable cardioverter-defibrillator: Quo vadis right ventricular lead?

    Science.gov (United States)

    Wedekind, Horst; Rozhnev, Andrey; Kleine-Katthöfer, Peter; Kranig, Wolfgang

    2016-03-01

    The case of a 77-year-old man admitted for suspected epileptic seizure is reported. Patient history showed implantation of a single-chamber implantable cardioverter-defibrillator (ICD) after cardiac arrest in 2007 with replacement in 2012 due to battery depletion; the patient reported no previous syncope, unconsciousness or seizures. Interrogation records of the ICD showed five ventricular tachyarrhythmia episodes that corresponded to the "seizure". Further examination revealed incorrect position of the RV-lead. Diagnosis was a provoked epileptic seizure due to undersensing of ventricular tachycardia because of improper ICD lead implantation in the coronary sinus. Treatment consisted of implantation of a new device with an additional ICD lead into the right ventricle.

  20. 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

    -PATCH, CIDS, AVID, AMIOVIRT, SCD-HeFT, MADIT-II, and DEFINITE), evidence for an association between ICD shocks and quality of life is mixed, with some indication that the influence of shocks may depend largely on the interval between shocks and assessment of quality of life. In order to improve the clinical......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...... of life may not be as straightforward as previously assumed. Given that programming of the ICD is changing, leading to fewer shocks and improved quality of life, it may be timely to also examine the influence of other determinants (e.g., heart failure progression and the patient's psychological profile...

  1. 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

    further explained by the qualitative findings. Patients with better physical health learned how to interpret body signals and adjust exercise behavior and experienced increased physical capacity. Those with better mental health received support that assisted them to cope with the possibility of shock...... 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...

  2. 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

    of 1.1 definite BrS cases per 100 000 inhabitants. Most definite BrS patients were men (86%) and the median age at diagnosis was 48 years. A total of 35 definite BrS patients (81%) had an implantable cardioverter defibrillator (ICD) implanted and of these 9 (26%) experienced appropriate shocks and 3 (8......%) experienced inappropriate shocks during a median follow-up of 47 months. No patient died or experienced aborted sudden cardiac death during follow-up.ConclusionsWe report the first nationwide study of BrS patients. We found a low incidence of diagnosed definite BrS compared with estimates from ECG surveys....... Follow-up data show a lower rate of inappropriate therapies in ICD carriers than that reported in previous studies....

  3. 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......-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....

  4. Rationale and design of the PRAETORIAN trial: A Prospective, RAndomizEd comparison of subcuTaneOus and tRansvenous ImplANtable cardioverter- defibrillator therapy

    NARCIS (Netherlands)

    L.R.A. Olde Nordkamp (Louise R.A.); R.E. Knops (Reinoud); G.H. Bardy (Gust); Y. Blaauw (Yuri); L. Boersma (Lucas); J.S. Bos (Johannes); P.P.H.M. Delnoy (Peter Paul); P.F.H.M. van Pascal; A.H.G. Driessen (Antoine); J.R. de Groot (Joris); J.P.R. Herrman; L.J.L.M. Jordaens (Luc); K.M. Kooiman (Kirsten); A.H. Maass (Alexander); M. Meine (Mathias); Y. Mizusawa (Yuka); S.G. Molhoek (Sander); J. van Opstal (Jurjen); J.G.P. Tijssen (Jan); A.A.M. Wilde (Arthur)

    2012-01-01

    textabstractBackground: Implantable cardioverter-defibrillators (ICDs) are widely used to prevent fatal outcomes associated with life-threatening arrhythmic episodes in a variety of cardiac diseases. These ICDs rely on transvenous leads for cardiac sensing and defibrillation. A new entirely subcutan

  5. 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.

  6. Selective left ventricular sensing lead implantation to overcome undersensing of ventricular fibrillation during implantable cardioverter defibrillator implantation.

    Science.gov (United States)

    Steinberg, Christian; Philippon, François; O'Hara, Gilles; Molin, Franck

    2013-06-01

    Accurate sensing of malignant arrhythmia is critical for the appropriate delivery of therapy from implantable cardioverter defibrillators, and undersensing of ventricular tachyarrhythmias can have catastrophic consequences. Here, we present an unusual case of ventricular fibrillation undersensing from the right ventricular lead at multiple different implantation sites because of very low amplitude voltage signals during induced ventricular fibrillation. A left ventricular sensing electrode was implanted to allow correct sensing and therapy delivery.

  7. Obstetric hemorrhage in a case of hypertrophic obstructive cardiomyopathy with automatic implantable cardioverter defibrillator: Anaesthesia and intensive care management.

    Science.gov (United States)

    Mishra, Sandeep Kumar; Bhat, Ravindra R; Kavitha, Jayaram; Kundra, Pankaj; Parida, Satyen

    2016-01-01

    The physiological changes occurring during pregnancy and labor may reveal or exacerbate the symptoms of hypertrophic obstructive cardiomyopathy (HOCM). The addition of obstetric hemorrhage to this presents a unique challenge to the anesthesiologists and intensivists managing these patients in the operation theatres and the Intensive Care Units. Here we present a case of HOCM with automatic implantable cardioverter defibrillator in situ and postpartum hemorrhagic shock.

  8. Psychological effects of implantable cardioverter defibrillator shocks. A review of study methods

    Science.gov (United States)

    Manzoni, Gian Mauro; Castelnuovo, Gianluca; Compare, Angelo; Pagnini, Francesco; Essebag, Vidal; Proietti, Riccardo

    2015-01-01

    Background: The implantable cardioverter defibrillator (ICD) saves lives but clinical experience suggests that it may have detrimental effects on mental health. The ICD shock has been largely blamed as the main offender but empirical evidence is not consistent, perhaps because of methodological differences across studies. Objective: To appraise methodologies of studies that assessed the psychological effects of ICD shock and explore associations between methods and results. Data Sources: A comprehensive search of English articles that were published between 1980 and 30 June 2013 was applied to the following electronic databases: PubMed, EMBASE, NHS HTA database, PsycINFO, Sciencedirect and CINAHL. Review Methods: Only studies testing the effects of ICD shock on psychological and quality of life outcomes were included. Data were extracted according to a PICOS pre-defined sheet including methods and study quality indicators. Results: Fifty-four observational studies and six randomized controlled trials met the inclusion criteria. Multiple differences in methods that were used to test the psychological effects of ICD shock were found across them. No significant association with results was observed. Conclusions: Methodological heterogeneity of study methods is too wide and limits any quantitative attempt to account for the mixed findings. Well-built and standardized research is urgently needed. PMID:25698991

  9. 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

  10. Changes in psychosocial distress in outpatients with heart failure with implantable cardioverter defibrillators.

    Science.gov (United States)

    Thomas, Sue A; Friedmann, Erika; Gottlieb, Stephen S; Liu, Fang; Morton, Patricia G; Chapa, Deborah W; Lee, Hyeon-Joo; Nahm, Eun-Shim

    2009-01-01

    Patients given implantable cardioverter defibrillators (ICDs) after arrhythmic events or sudden cardiac arrest (SCA) experience psychosocial distress. ICDs now are inserted for the primary prevention of SCA in patients with heart failure; the psychosocial impact of ICDs on patients with heart failure is unknown. Changes in psychosocial status in these ICD recipients were examined. ICD recipients (n = 57) completed depression, anxiety, and social support inventories every 6 months for up to 2 years. Initially, 35% of recipients were depressed and 45% of recipients were anxious. In linear mixed models, depression decreased over time overall but increased in those who experienced ICD shocks. Anxiety decreased in New York Heart Association class III ICD recipients but not in class II ICD recipients. Decreases in social support were related to age: the younger the patient the greater the decrease. A significant proportion of ICD recipients were depressed or anxious, or had diminished social support even after 2 years. Investigation of strategies to improve ICD recipients' psychosocial status is warranted.

  11. Indications for implantable cardioverter-defibrillators based on evidence and judgment.

    Science.gov (United States)

    Myerburg, Robert J; Reddy, Vivek; Castellanos, Agustin

    2009-08-25

    Implantable cardioverter-defibrillators (ICDs) are generally reliable medical devices that have the potential to add quality years of life for appropriate candidates. Indications for ICDs have emerged from a series of randomized clinical trials, observational data from cohorts of high-risk patients with less common diseases, and expert opinion based on limited data in uncommon disorders. The randomized trials are limited by inadequate stratification designs that resulted from insufficient funding availability. The result was outcomes that led to uneven applications, based in part on post-implant experience of device utilization. In this document, we explore the basis for the features of the evidence available to support ICD use, the role of clinical judgment in circumstances in which data are limited or lacking, and the need for additional research to improve the specificity of indications. Directions for new research initiatives are considered. In addition, a general overview of a clinical research paradigm is presented, in which the research and health care delivery arms of the health care enterprise combine in research design and funding, as the latter bears the impact of the outcomes of the former. Impact estimates during the design of trials, considering reasonable contingencies for outcomes, are suggested as a means of justifying the size, scope, and appropriate costs of studies. If we who are involved in clinical research and health care delivery do not resolve this problem, for both ICDs and other new therapies that appear in the future, society will do it for us.

  12. 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.

  13. 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.

  14. Single lead catheter of implantable cardioverter-defibrillator with floating atrial sensing dipole implanted via persistent left superior vena cava.

    Science.gov (United States)

    Malagù, Michele; Toselli, Tiziano; Bertini, Matteo

    2016-04-26

    Persistent left superior vena cava (LSVC) is a congenital anomaly with 0.3%-1% prevalence in the general population. It is usually asymptomatic but in case of transvenous lead positioning, i.e., for pacemaker or implantable cardioverter defibrillator (ICD), may be a cause for significant complications or unsuccessful implantation. Single lead ICD with atrial sensing dipole (ICD DX) is a safe and functional technology in patients without congenital abnormalities. We provide a review of the literature and a case report of successful implantation of an ICD DX in a patient with LSVC and its efficacy in treating ventricular arrhythmias.

  15. 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.

  16. 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.

  17. Rationale and design of the PRAETORIAN trial: A Prospective, RAndomizEd comparison of subcuTaneOus and tRansvenous ImplANtable cardioverter- defibrillator therapy

    OpenAIRE

    Olde Nordkamp, Louise R.A.; Knops, Reinoud; Bardy, Gust; Blaauw, Yuri; Boersma, Lucas; Bos, Johannes; Delnoy, Peter Paul; Pascal, P.F.H.M.; Driessen, Antoine; Groot, Joris; Herrman, J.P.R.; Jordaens, Luc; Kooiman, Kirsten; Maass, Alexander; Meine, Mathias

    2012-01-01

    textabstractBackground: Implantable cardioverter-defibrillators (ICDs) are widely used to prevent fatal outcomes associated with life-threatening arrhythmic episodes in a variety of cardiac diseases. These ICDs rely on transvenous leads for cardiac sensing and defibrillation. A new entirely subcutaneous ICD overcomes problems associated with transvenous leads. However, the role of the subcutaneous ICD as an adjunctive or primary therapy in patients at risk for sudden cardiac death is unclear....

  18. 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.

  19. Sustaining cyborgs: sensing and tuning agencies of pacemakers and implantable cardioverter defibrillators.

    Science.gov (United States)

    Oudshoorn, Nelly

    2015-02-01

    Recently there has been a renewed interest in cyborgs, and particularly in new and emerging fusions of humans and technologies related to the development of human enhancement technologies. These studies reflect a trend to follow new and emerging technologies. In this article, I argue that it is important to study 'older' and more familiar cyborgs as well. Studying 'the old' is important because it enables us to recognize hybrids' embodied experiences. This article addresses two of these older hybrids: pacemakers and implantable cardioverter defibrillators inserted in the bodies of people suffering from heart-rhythm disturbances. My concern with hybrid bodies is that internal devices seem to present a complex and neglected case if we wish to understand human agency. Their 'users' seem to be passive because they cannot exert any direct control over the working of their devices. Technologies inside bodies challenge a longstanding tradition of theorizing human-technology relations only in terms of technologies external to the body. Cyborg theory is problematic as well because most studies tend to conceptualize the cyborg merely as a discursive entity and silence the voices of people living as cyborgs. Inspired by feminist research that foregrounds the materiality of the lived and intimate relations between bodies and technologies, I argue that creating these intimate relations requires patients' active involvement in sustaining their hybrid bodies. Based on observations of these monitoring practices in a Dutch hospital and interviews with patients and technicians, the article shows that heart cyborgs are far from passive. On the contrary, their unique experience in sensing the entangled agencies of technologies and their own heart plays a crucial role in sustaining their hybrid bodies.

  20. 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 anxie...

  1. 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...

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

    NARCIS (Netherlands)

    M.T. Hoogwegt (Madelein); N. Kupper (Nina); D.A.M.J. Theuns (Dominic); L.J.L.M. Jordaens (Luc); S.S. Pedersen (Susanne)

    2012-01-01

    textabstractBeta-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.

  3. Serum-Based Oxylipins Are Associated with Outcomes in Primary Prevention Implantable Cardioverter Defibrillator Patients

    Science.gov (United States)

    Zhang, Yiyi; Guallar, Eliseo; Blasco-Colmenares, Elena; Harms, Amy C.; Vreeken, Rob J.; Hankemeier, Thomas; Tomaselli, Gordon F.; Cheng, Alan

    2016-01-01

    Introduction Individuals with systolic heart failure are at risk of ventricular arrhythmias and all-cause mortality. Little is known regarding the mechanisms underlying these events. We sought to better understand if oxylipins, a diverse class of lipid metabolites derived from the oxidation of polyunsaturated fatty acids, were associated with these outcomes in recipients of primary prevention implantable cardioverter defibrillators (ICDs). Methods Among 479 individuals from the PROSE-ICD study, baseline serum were analyzed and quantitatively profiled for 35 known biologically relevant oxylipin metabolites. Associations with ICD shocks for ventricular arrhythmias and all-cause mortality were evaluated using Cox proportional hazards models. Results Six oxylipins, 17,18-DiHETE (HR = 0.83, 95% CI 0.70 to 0.99 per SD change in oxylipin level), 19,20-DiHDPA (HR = 0.79, 95% CI 0.63 to 0.98), 5,6-DiHETrE (HR = 0.73, 95% CI 0.58 to 0.91), 8,9-DiHETrE (HR = 0.76, 95% CI 0.62 to 0.95), 9,10-DiHOME (HR = 0.81, 95% CI 0.65 to 1.00), and PGF1α (HR = 1.33, 95% CI 1.04 to 1.71) were associated with the risk of appropriate ICD shock after multivariate adjustment for clinical factors. Additionally, 4 oxylipin-to-precursor ratios, 15S-HEPE / FA (20:5-ω3), 17,18-DiHETE / FA (20:5-ω3), 19,20-DiHDPA / FA (20:5-ω3), and 5S-HEPE / FA (20:5-ω3) were positively associated with the risk of all-cause mortality. Conclusion In a prospective cohort of patients with primary prevention ICDs, we identified several novel oxylipin markers that were associated with appropriate shock and mortality using metabolic profiling techniques. These findings may provide new insight into the potential biologic pathways leading to adverse events in this patient population. PMID:27281224

  4. Outcomes in African-Americans Undergoing Cardioverter Defibrillators Implantation for Primary Prevention of Sudden Cardiac Death: Findings from The Prospective Observational Study of Implantable Cardioverter-Defibrillators (PROSE-ICD)

    Science.gov (United States)

    Zhang, Yiyi; Kennedy, Robert; Blasco-Colmenares, Elena; Butcher, Barbara; Norgard, Sanaz; Eldadah, Zayd; Dickfeld, Timm; Ellenbogen, Kenneth A.; Marine, Joseph E.; Guallar, Eliseo; Tomaselli, Gordon F.; Cheng, Alan

    2014-01-01

    Background Implantable cardioverter defibrillators (ICDs) reduce the risk of death in patients with left ventricular dysfunction. Little is known regarding the benefit of this therapy in African-Americans (AA). Objective To determine the association between African-American race and outcomes in a cohort of primary prevention cardioverter defibrillators (ICD) patients. Methods We conducted a prospective cohort study of patients with systolic heart failure who underwent ICD implantation for primary prevention of sudden cardiac death. The primary endpoint was appropriate ICD shock defined as a shock for rapid ventricular tachyarrhythmias. The secondary endpoint was all-cause mortality. Results There were 1,189 patients (447 AAs and 712 non-AAs) enrolled. Over a median follow-up of 5.1 years, a total of 137 patients experienced an appropriate ICD shock, and 343 died (294 of whom died without receiving an appropriate ICD shock). The multivariate adjusted hazard ratios (95% CI) comparing AAs vs. non-AAs were 1.24 (0.96 to 1.59) for all-cause mortality, 1.33 (1.02, 1.74) for all-cause mortality without receiving appropriate ICD shock, and 0.78 (0.51, 1.19) for appropriate ICD shock. Ejection fraction, diabetes, and hypertension appeared to explain 24.1% (10.1 to 69.5%), 18.7% (5.3 to 58.0%), and 13.6% (3.8 to 53.6%) of the excess risk of mortality in AAs, with a large proportion of the mortality difference remains unexplained. Conclusions In patients with primary prevention ICDs, AAs had an increased risk of dying without receiving an appropriate ICD shock compared to non-AAs. PMID:24793459

  5. Rationale and design of the PRAETORIAN trial : A Prospective, RAndomizEd comparison of subcuTaneOus and tRansvenous ImplANtable cardioverter-defibrillator therapy

    NARCIS (Netherlands)

    Nordkamp, Louise R. A. Olde; Knops, Reinoud E.; Bardy, Gust H.; Blaauw, Yuri; Boersma, Lucas V. A.; Bos, Johannes S.; Delnoy, Peter Paul H. M.; van Dessel, Pascal F. H. M.; Driessen, Antoine H. G.; de Groot, Joris R.; Herrman, Jean Paul R.; Jordaens, Luc J. L. M.; Kooiman, Kirsten M.; Maass, Alexander H.; Meine, Mathias; Mizusawa, Yuka; Molhoek, Sander G.; van Opstal, Jurjen; Tijssen, Jan G. P.; Wilde, Arthur A. M.

    2012-01-01

    Background Implantable cardioverter-defibrillators (ICDs) are widely used to prevent fatal outcomes associated with life-threatening arrhythmic episodes in a variety of cardiac diseases. These ICDs rely on transvenous leads for cardiac sensing and defibrillation. A new entirely subcutaneous ICD over

  6. 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.

  7. Programmed Ventricular Stimulation to Risk Stratify for Early Cardioverter-Defibrillator Implantation to Prevent Tachyarrhythmias following Acute Myocardial Infarction (PROTECT-ICD): Trial Protocol, Background and Significance.

    Science.gov (United States)

    Zaman, Sarah; Taylor, Andrew J; Stiles, Martin; Chow, Clara; Kovoor, Pramesh

    2016-11-01

    The 'Programmed Ventricular Stimulation to Risk Stratify for Early Cardioverter-Defibrillator Implantation to Prevent Tachyarrhythmias following Acute Myocardial Infarction' (PROTECT-ICD) trial is an Australian-led multicentre randomised controlled trial targeting prevention of sudden cardiac death in patients who have at least moderately reduced cardiac function following a myocardial infarct (MI). The primary objective of the trial is to assess whether electrophysiological study to guide prophylactic implantation of an implantable cardioverter-defibrillator (ICD) early following MI (first 40 days) will lead to a significant reduction in sudden cardiac death and non-fatal arrhythmia. The secondary objective is to assess the utility of cardiac MRI (CMR) in assessing early myocardial characteristics, and its predictive value for both inducible ventricular tachycardia (VT) at EPS and SCD/ non-fatal arrhythmia at follow-up.

  8. 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

    OBJECTIVE: To examine if the caregiving for patients with a left ventricular assist device (LVAD) is related to a poorer health status and more distress compared to patients with an implantable cardioverter defibrillator (ICD). BACKGROUND: Partners distress may influence patient outcomes and is t......OBJECTIVE: To examine if the caregiving for patients with a left ventricular assist device (LVAD) is related to a poorer health status and more distress compared to patients with an implantable cardioverter defibrillator (ICD). BACKGROUND: Partners distress may influence patient outcomes...... (F = 10.71, p = .001) but poorer mental health status (F = 14.82, p compared to ICD partners (F = 3.68, p = .05) at 6 months follow-up, also in adjusted analyses. There was no significant difference between groups on anxiety. CONCLUSION: Caregivers of LVAD...... patients show higher distress levels compared to caregivers of ICD patients. LVAD partners may have a need for support beyond what is offered currently in clinical practice....

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

    OpenAIRE

    Hoogwegt, Madelein; Kupper, Nina; Theuns, Dominic; Jordaens, Luc; Pedersen, Susanne

    2012-01-01

    textabstractBeta-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. Between 2003 a...

  10. 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....

  11. 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

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

    Science.gov (United States)

    Maia, A C C O; Braga, A A; Soares-Filho, G; Pereira, V; Nardi, A E; Silva, A C

    2014-04-01

    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.

  13. Safety Profile of Liver FibroScan in Patients with Cardiac Pacemakers or Implantable Cardioverter-Defibrillators

    Science.gov (United States)

    Pranke, Stephanie; Rashidi, Farid; Nosib, Shravan; Worobetz, Lawrence

    2017-01-01

    Background. Emerging evidence suggests that nonalcoholic fatty liver disease (NAFLD) is associated with coronary artery diseases and arrhythmias. The FibroScan (Echosens, France), a widely available, noninvasive device, is able to detect liver fibrosis and steatosis within this patient population. However, the FibroScan is currently contraindicated in patients with cardiac pacemakers (PM) or implantable cardioverter-defibrillators (ICD). Objective. To determine the safety profile of FibroScan testing in patients with PM or ICD. Methods. Consecutive outpatients undergoing routine device interrogations at a tertiary level teaching hospital underwent simultaneous liver stiffness measurements. PM or ICD performance data, device types, patient demographics, medical history, and previous laboratory and conventional liver imaging results were collected. Results. Analysis of 107 subjects with 33 different types of implanted cardiac devices, from 5 different companies (Medtronic, Sorin, ELA Medical, Boston Scientific, and St. Jude), did not demonstrate any adverse events as defined by abnormal device sensing/pacing or ICD firing. This population included high risk subjects undergoing active pacing (n = 53) and with right pectoral PM placement (n = 1). None of the subjects had any clinical signs of decompensated congestive heart failure or cirrhosis during the exam. Conclusion. TE with FibroScan can be safely performed in patients with PM or ICD.

  14. 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.

  15. 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.

  16. 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

  17. Inhibition of bradycardia pacing caused by far-field atrial sensing in a third-generation cardioverter defibrillator with an automatic gain feature.

    Science.gov (United States)

    Curwin, J H; Roelke, M; Ruskin, J N

    1996-01-01

    The diagnostic accuracy of implantable cardioverter defibrillators may be improved by automatically adjusting gain algorithms, which in general reduce the likelihood of oversensing while maintaining the ability to detect the low amplitude signals associated with ventricular fibrillation. We present a patient with a third-generation device who developed prolonged ventricular asystole arising as a complication of the automatic gain feature. During asystole the device automatically increased sensitivity in order to prevent undersensing of ventricular fibrillation, which in this case resulted in far-field sensing of atrial activity and inhibition of ventricular pacing.

  18. 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.

  19. 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.

  20. Potential clinical impact of cardiovascular magnetic resonance assessment of ejection fraction on eligibility for cardioverter defibrillator implantation

    Directory of Open Access Journals (Sweden)

    Joshi Subodh B

    2012-10-01

    Full Text Available Abstract Background For the primary prevention of sudden cardiac death, guidelines provide left ventricular ejection fraction (EF criteria for implantable cardioverter defibrillator (ICD placement without specifying the technique by which it should be measured. We sought to investigate the potential impact of performing cardiovascular magnetic resonance (CMR for EF on ICD eligibility. Methods The study population consisted of patients being considered for ICD implantation who were referred for EF assessment by CMR. Patients who underwent CMR within 30 days of echocardiography were included. Echocardiographic EF was determined by Simpson’s biplane method and CMR EF was measured by Simpson’s summation of discs method. Results Fifty-two patients (age 62±15 years, 81% male had a mean EF of 38 ± 14% by echocardiography and 35 ± 14% by CMR. CMR had greater reproducibility than echocardiography for both intra-observer (ICC, 0.98 vs 0.94 and inter-observer comparisons (ICC 0.99 vs 0.93. The limits of agreement comparing CMR and echocardiographic EF were – 16 to +10 percentage points. CMR resulted in 11 of 52 (21% and 5 of 52 (10% of patients being reclassified regarding ICD eligibility at the EF thresholds of 35 and 30% respectively. Among patients with an echocardiographic EF of between 25 and 40%, 9 of 22 (41% were reclassified by CMR at either the 35 or 30% threshold. Echocardiography identified only 1 of the 6 patients with left ventricular thrombus noted incidentally on CMR. Conclusions CMR resulted in 21% of patients being reclassified regarding ICD eligibility when strict EF criteria were used. In addition, CMR detected unexpected left ventricular thrombus in almost 10% of patients. Our findings suggest that the use of CMR for EF assessment may have a substantial impact on management in patients being considered for ICD implantation.

  1. 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.

  2. 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.

  3. 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.

  4. [Rehabilitation of patients with cardiac pacemakers and implanted cardioverter-defibrillators: recommendations for training, physiotherapeutic procedures and re-employment].

    Science.gov (United States)

    Reibis, R K; Kamke, W; Langheim, E; Völler, H

    2010-04-01

    Rehabilitation of patients with cardiac pacemakers (CP) or implantable cardioverter defibrillators (ICD) comprises secondary prevention of underlying cardiac disease, conditioning training activities and psychological education and includes furthermore the assessment of aggregate function, detection of any device malfunction as well as the return to work efforts. The extent to which the physical activities can be permitted is determined by both cardiopulmonary capacity and the primary arrhythmic indication. Under consideration of upper frequency limit, left ventricular dysfunction and the avoidance of mechanical exposure on device can and leads, an individually designed training programme is acceptable even on a high load level. Likewise, electrotherapeutic procedures due to musculoskeletal pain syndrome are not generally contraindicated, if differentiated limitations are respected. Beside the assessment of aggregate function and, if necessary, parameter optimization, psychologic intervention programs play an important role particularly in ICD-patients and can be utilized as an additive therapeutic module. Personalized recommendations for driving with an ICD are determined by the time interval since idex arrhythmia and the rhythmological risk profile as well as by the motor vehicle class. The return to work rate of CP and ICD patients is resumably influenced by the underlying cardiac disease and to a lesser extend by the implanted device. Except industrial jobs the risk of electromagnetic interference during the working process is low and can be objected by working place analysis including noise field measurement. Thus cardiac of CP and ICD patients should be used to a large extend for the recovery of individual physical and psychological integrity as well as for the organisation of reemployment.

  5. 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

  6. 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

  7. 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

    The temporal effect of heart failure (HF) hospitalization occurring at different time periods before implantation has not yet been studied in detail. The aim of the present study was to investigate the potential association between time from last HF hospitalization to device implantation and effe......The temporal effect of heart failure (HF) hospitalization occurring at different time periods before implantation has not yet been studied in detail. The aim of the present study was to investigate the potential association between time from last HF hospitalization to device implantation...... and 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...

  8. 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...

  9. 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.

  10. A Young Man Presenting with Pleuritic Chest Pain and Fever after Electrophysiological Study and Implantable Cardioverter-Defibrillator Placement: Diagnostic Difficulties and Value of Bedside Thoracic Sonography.

    Science.gov (United States)

    Faraone, Antonio; Fortini, Alberto

    2015-01-01

    We describe the case of a 23-year-old man presenting with recurrent pleuritic chest pain and prolonged fever after electrophysiology testing and placement of an implantable cardioverter-defibrillator because of a suspected arrhythmogenic right ventricular dysplasia. The clinical suspicion was initially directed toward pneumonia with pleural effusion and later toward an infection of the cardiac device complicated by septic pulmonary embolism. The definitive diagnosis of pulmonary embolism and infarction was suggested by a point-of-care thoracic sonography, performed at the bedside by a clinician caring for the patient, and then confirmed by contrast enhanced computed tomography, which also showed thrombosis of the left iliofemoral vein, site of percutaneous puncture for cardiac catheterization. Prolonged fever was attributable to a concomitant Epstein-Barr virus primary infection that acted as confounding factor. The present report confirms the value of bedside thoracic sonography in the diagnostic evaluation of patients with nonspecific respiratory symptoms.

  11. A Young Man Presenting with Pleuritic Chest Pain and Fever after Electrophysiological Study and Implantable Cardioverter-Defibrillator Placement: Diagnostic Difficulties and Value of Bedside Thoracic Sonography

    Directory of Open Access Journals (Sweden)

    Antonio Faraone

    2015-01-01

    Full Text Available We describe the case of a 23-year-old man presenting with recurrent pleuritic chest pain and prolonged fever after electrophysiology testing and placement of an implantable cardioverter-defibrillator because of a suspected arrhythmogenic right ventricular dysplasia. The clinical suspicion was initially directed toward pneumonia with pleural effusion and later toward an infection of the cardiac device complicated by septic pulmonary embolism. The definitive diagnosis of pulmonary embolism and infarction was suggested by a point-of-care thoracic sonography, performed at the bedside by a clinician caring for the patient, and then confirmed by contrast enhanced computed tomography, which also showed thrombosis of the left iliofemoral vein, site of percutaneous puncture for cardiac catheterization. Prolonged fever was attributable to a concomitant Epstein-Barr virus primary infection that acted as confounding factor. The present report confirms the value of bedside thoracic sonography in the diagnostic evaluation of patients with nonspecific respiratory symptoms.

  12. 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.

  13. Implantable cardioverter defibrillator - discharge

    Science.gov (United States)

    ... hair dryer, stove, CD player, remote controls, and microwave. There are several devices you should keep at ... Tell your provider about every shock you feel from your ICD. The settings of your ICD may need to be adjusted, or your medicines may need to ...

  14. Implantable cardioverter-defibrillator

    Science.gov (United States)

    ... the heart to beat in a more coordinated fashion. Why the Procedure is Performed An ICD is ... Controlling your high blood pressure Dietary fats explained Fast food tips Heart attack - discharge Heart disease - risk ...

  15. A priori expectancy bias and its relation to shock experience and anxiety: a naturalistic study in patients with an automatic implantable cardioverter defibrillator.

    Science.gov (United States)

    Pauli, P; Wiedemann, G; Dengler, W; Kühlkamp, V

    2001-09-01

    Patients with an automatic implantable cardioverter defibrillator (AICD) may offer an unique naturalistic opportunity to study whether expectancy biases develop because of precipitating aversive or traumatic experiences and/or because of elevated anxiety. An expectancy bias and its associations with AICD discharge and anxiety was examined in 24 AICD patients with a thought experiment. While patients without AICD discharge exhibited no expectancy bias, patients with discharge experiences were found to expect that stimuli depicting medical emergency situations will be followed by an aversive consequence. The magnitude of their expectancy bias was positively correlated with their anxiety level. In the group with AICD discharge, patients with low anxiety levels exhibited no bias, while patients with high anxiety levels exhibited a rather strong bias. It seems that the experience of an aversive or traumatic event, here an AICD discharge, is a necessary (but not sufficient) precipitating event for the development of an expectancy bias. If such an event happens, trait anxiety level presumably determines if and how strong the expectancy bias will be.

  16. 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.

  17. 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 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 majority

  18. 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.

  19. Implantable defibrillator therapy: more than defibrillation...

    NARCIS (Netherlands)

    D.A.M.J. Theuns (Dominic)

    2005-01-01

    textabstractDuring the past 25 years, the implantable cardioverter-defibrillator (ICD) has evolved from the treatment of last resort to the gold standard for patients at high risk for life­threatening ventricular tachyarrhythmias. Patients at high risk include those who survived life-threatening ven

  20. [Positive microvolt T-wave alternans as a marker of ventricular arrhythmia trigering during cardioverter-defibrillator implantation].

    Science.gov (United States)

    Wierzbowski, Robert; Michałkiewicz, Dariusz; Cholewa, Marian; Jacewicz, Katarzyna; Gniłka, Anna; Adamus, Jerzy

    2006-10-01

    Microvolt T-wave alternans (MTWA) is promising method for noninvasive assessment of arrhythmic risk, but its role hasn't established yet. The aim of this study was to establish the MTWA potency to predict the ventricular arrhythmia triggering during implantable cordioverter-defibrillator (ICD) implantation. Material and metods. The study group consisted of 21 patients, aged 63.0+/-8.0 years; EF was 38.0+/-12.8%. Seventeen of them had a history of myocardial infarction and 4 had non-ischemic cardiomyopathy. The reason for ICD implantation were secondary prevention due to nonfatal cardiac arrest caused by VF/VT in nineteen patients and in two patients ICD was implanted because of unexplained syncope and low EF (protocol of 50 Hz BURST and T SHOCK was applied. After ICD implantation the following tests were performed: ECG with HR, QRS and QTc evaluation, 24-hour ECG Holter monitoring with HRV assessment and MTWA evaluation during treadmill exercise test. Results. In the group with VT/VF induced by less aggressive protocol (EPS), group I (n = 10) MTWA was present in nine patients, in one the result of MTWA was indeterminate. In the group with VT/VF induced by more aggressive protocol, group II (n = 11) MTWA was present in four patients, indeterminate in four and absent in three. There was a significant (p = 0.017) difference between group I and II in the frequency of positive result of MTWA. There were no differences between the two groups according to time domain parameters of HRV such as SDNN, RMSSD and PNN50 and QTc. There was a significant difference between the two groups in time duration of QRS complexes, 118.9+/-14.7 vs. 105.6+/-11.5 accordingly (p more easily inducible by electrophysiologic study during ICD implantation. It is easier to induce ventricular arrhythmia when QRS complexes are wider, irrelevant to left ventricular dysfunction and autonomic function of the heart.

  1. 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

  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. 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....

  4. 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

  5. Subcutaneous Implantable Cardioverter-Defibrillator

    Science.gov (United States)

    ... Search Donate Circulation My alerts Sign In Join Facebook Twitter Home About this Journal Editorial Board General Statistics Circulation Doodle → Blip the Doodle Information for Advertisers Author Reprints Commercial Reprints Customer Service and Ordering ...

  6. Heart Rhythm UK position statement on clinical indications for implantable cardioverter defibrillators in adult patients with familial sudden cardiac death syndromes.

    Science.gov (United States)

    Garratt, Clifford J; Elliott, Perry; Behr, Elijah; Camm, A John; Cowan, Campbell; Cruickshank, Stephanie; Grace, Andrew; Griffith, Michael J; Jolly, Anne; Lambiase, Pier; McKeown, Pascal; O'Callagan, Peter; Stuart, Graham; Watkins, Hugh

    2010-08-01

    Whilst the decision regarding defibrillator implantation in a patient with a familial sudden cardiac death syndrome is likely to be most significant for any particular individual, the clinical decision-making process itself is complex and requires interpretation and extrapolation of information from a number of different sources. This document provides recommendations for adult patients with the congenital Long QT syndromes, Brugada syndrome, catecholaminergic polymorphic ventricular tachycardia, hypertrophic cardiomyopathy, and arrhythmogenic right ventricular cardiomyopathy. Although these specific conditions differ in terms of clinical features and prognosis, it is possible and logical to take an approach to determining a threshold for implantable cardioveter-defibrillator implantation that is common to all of the familial sudden cardiac death syndromes based on estimates of absolute risk of sudden death.

  7. The Clinical Application and Effect of Implantable Cardioverter Defibrillator(ICD)%经静脉植入埋藏式心脏复律除颤器的临床应用及效果观察

    Institute of Scientific and Technical Information of China (English)

    江自强

    2015-01-01

    Objective:to explore the clinical application and effect of implantable cardioverter defibrillator(icd). Methods:selecting and analyzing 80 cases of malignant ventricular arrhythmia, which are randomly divided into control group (treated with amiodarone) and treatment group(treated with the icd) . then comparing the effects. Results:the overall response rate(rr) of the treatment group is 95%, much higher than the other one(85%)(P0.05);yet after treatment, the heart rate of the treatment group is signiifcantly lower than the control group (P0.05);实验组治疗后心率,显著低于对照组(P<0.05);实验组治疗后Pr间期,显著高于对照组(P<0.05)。结论恶性室性心律失常采用静脉植入埋藏式心脏复律除颤器治疗效果理想,值得推广应用。

  8. 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...

  9. 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.

  10. 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.

  11. 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.

  12. The Cause Analysis and Countermeasures of Frequent Shocks in Patients with Implantable Cardioverter Defibrillator%埋藏式心脏除颤器患者频繁电击原因分析及对策

    Institute of Scientific and Technical Information of China (English)

    吴冬燕; 邢彩耐; 卢凤民; 付乃宽; 许静

    2014-01-01

    Objective To investigate the cause and countermeasures of frequent shocks in patients with implantable cardioverter defibrillators (ICD). Methods Eighty ICD patients with heart failure and malignant ventricular arrhythmias were followed up, including sixty-two male and eighteen female patients. There were 35 patients with single-chamber ICD, 23 with dual-chamber ICD and 22 with three-chamber ICD. Patients in this study were followed up for 1-6 years to analyze the reasons for ICD discharge. According to the specific circumstances, patients were treated. Results Twenty-three pa-tients in 80 patients suffered from shock treatment. Ten patients (12.5%) experienced frequent shocks. The causes of fre-quent shock included repeated episodes of ventricular tachycardia, invalid shock due to increased defibrillation threshold (DF) and false identification of the frequent episodes of paroxysmal ventricular tachycardia or arrhythmias. The management included the identification process adjustment of ventricular tachycardia and supraventricular tachycardia, increased num-bers of beats of ventricular tachycardia judgment and increase the basic pacing rate. The anti-arrhythmic drugs should be combinedly used, especially metoprolol and amiodarone. The ICD shock was significantly reduced after parameter optimiza-tion and anti-arrhythmic therapy. Conclusion The ICD shocks were effectively reduced with rational use of anti-arrhyth-mic drugs and valid ICD programming.%目的:探讨植入埋藏式心脏除颤器(ICD)的患者出现频繁放电的原因及处理方法。方法随访80例因心力衰竭或恶性室性心律失常植入ICD的患者,男62例,女18例,其中单腔ICD 35例,双腔ICD 23例,三腔ICD (CRTD)22例,随访1~6年,了解ICD的放电原因,并根据具体情况进行治疗。结果80例患者中有23例患者遭受电击,其中10例为频繁电击(24 h内电击≥3次或1年内电击≥5次),均为心脏猝死二级预防患者。

  13. Slow ventricular tachycardia in patients with implantable cardioverter defibrillator%植入植入型心律转复除颤器后慢频率室性心动过速的治疗策略

    Institute of Scientific and Technical Information of China (English)

    孙国建; 何浪; 陈宇宁; 欣明花; 付蕾; 钟诚; 沈法荣

    2016-01-01

    Objective This study aims to assess the incidence of slow ventricular tachycardia ( VT ) and its treatment strategies in implantable cardioverter defibrillator( ICD) patients. Methods All 353 patients with including single and dual-chamber ICD or cardiac resyncronization therapy defibrillator( CRT-D) were en-rolled in this study in Zhejiang Greentown Cardiovascular Hospital from January 2008 to December 2014. Pa-tients had a 3-zone detection configuration: monitoring non treatment(ventricular rate 120 to 180 bpm),anti-tachyarrhythmia pacing(ATP)-low energy shock zone(ventricular rate 180 to 200 bpm),and a ventricular fi-brillation zone.When VT burden was more than 10% and the ventricular rate was less than 160 bpm it needed to optimize the parameters to treat the slow VT. Patients were divided into group A ATP-low energy cardioverter groups(ATP1time-5 J-10 J-maximum energy shock);group B ATP-high energy(ATP 3 times-20 J-the largest energy). Results VT occurred in 102(29%)patients,slow VT occurred in 46(13.1%)patients.Parameters optimization was carried for slow VTs in 27(7. 6%)patients.One time ATP therapy success rate was 67% in group A,ATP+5 J success rate was 79%,ATP+5 J+10 J was 92%. Group B 3 times ATP success rate was 71%,ATP 3 times+20 J was 89%. Conclusion The slow VT had a high incidence in patients with ICD,espe-cially in patients who took up large doses of amiodarone andβreceptor blockers.For patients with heavier bur-den of slow VTs,ATP and small energy electric shock therapy may have greater benefit.%目的:探讨慢频率室性心动过速(室速)在植入植入型心律转复除颤器( ICD)患者中的发生率及治疗策略。方法入选浙江绿城心血管病医院心内科自2008年1月至2014年12月植入的除颤器[单、双腔ICD及心脏再同步治疗除颤器( CRT-D)]患者353例。所有一级预防和二级预防患者按既定不同方案设置参数。术后室速发作负荷≥10%且频率<160次/min定义为需优化参数治

  14. Role of implantable cardioverter defibrillator therapy in patients with long QT syndrome%植入型心律转复除颤器在长QT综合征患者中的应用

    Institute of Scientific and Technical Information of China (English)

    孙奇; 陈柯萍; 陈若菡; 华伟; 浦介麟; 张澍

    2008-01-01

    Objective To observe the role of implantable cardioverter defibrillator (ICD) therapy in patients with long QT syndrome. Methods ICD were planted in eight patients [4 men,4 women, mean age (27.3±25.9) years] with long QT syndrome. In the follow-up,the parameters of ICD were adjusted according to ICD therapy. Result During the follow-up of (27.3±25.9)months, ICD recorded 101 VT/VF episodes in 3 patients. With the traditional ICD programming,44 VF episodes were recorded. After the device parameters were adjusted according the VF episodes,57 VT and 2 VF episodes were recorded,most of them serf-terminated or terminated by low-energy shock. Electrical storm was presented in a patient,and we terminated it by increas-ing the base pacing rate. Inappropriate shocks due to T-wave oversensing were found in two patients,and it was avoided through adjusting the post-sensed Decay Delay. Conclusion Optimal device programming according to ICD therapy significantly decreases inappropriate ICD shocks and fewer unnecessary battery depletion and un-necessary shocks.%目的 总结阜外心血管病医院应用植入型心律转复除颤器(ICD)治疗长QT综合征(LQTS)患者的经验.方法 8例LQTS患者接受了ICD治疗,平均年龄(38.9±16.7)岁.在随访期间,根据具体情况,调整ICD的各项程控参数.结果 平均随访(27.3±25.9)个月,有3例患者出现了101次室性心动过速/心室颤动(VT/VF)事件.在出厂程控参数下,共记录到44次VF事件.重新设置VT/VF的识别及治疗参数后,共记录到57次VT事件,2次VF事件,大部分自行终止或经低能量转复成功.1例患者术后出现了电风暴,通过快速心室起搏,终止了尖端扭转性室性心动过速(Tdp)的反复发作.2例患者发生了因T波误感知导致的ICD误放电,通过延长感知灵敏度自动调整延迟,从而避免了T波误感知.结论 针对LQTS患者的发病特点,调整ICD的程控参数,可以提高疗效并减少ICD误放电.

  15. [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.

  16. Living with Your Implantable Cardioverter Defibrillator (ICD)

    Science.gov (United States)

    ... you take and when. Download a printable medication tracker . Learn more about arrhythmia medications in general. Understanding ... and dentists that you have an ICD. Follow activity instructions Follow the restrictions on activity and any ...

  17. 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

  18. [Magnets, pacemaker and defibrillator: fatal attraction?].

    Science.gov (United States)

    Bergamin, C; Graf, D

    2015-05-27

    This article aims at clarifying the effects of a clinical magnet on pacemakers and Implantable Cardioverter Defibrillators. The effects of electromagnetic interferences on such devices, including interferences linked to electrosurgery and magnetic resonance imaging are also discussed. In general, a magnet provokes a distinctive effect on a pacemaker by converting it into an asynchronous mode of pacing, and on an Implantable Cardioverter Defibrillator by suspending its own antitachyarythmia therapies without affecting the pacing. In the operating room, the magnet has to be used cautiously with precisely defined protocols which respect the type of the device used, the type of intervention planned, the presence or absence of EMI and the pacing-dependency of the patient.

  19. 全自动远程家庭监测系统在植入心律转复除颤器患者中的应用%Home monitoring in patients with implantable cardioverter defibrillator or cardiac resynchronization therapy defibrillator

    Institute of Scientific and Technical Information of China (English)

    王凤梅; 李述峰; 王帆; 张烁

    2014-01-01

    目的 评价全自动远程家庭监测(HM)在植入心律转复除颤器(ICD)/心脏再同步治疗除颤器(CRT-D)患者中的应用.方法 随访23例植入了带有HM功能的ICD及CRT-D患者,分析HM所获得的日常信息和报警数据,观察其对系统相关事件、心律失常和心力衰竭(心衰)监测在内的临床相关事件的早期监测及临床干预的疗效.结果 对23例患者随访122~937(452.1±262.2)d,共接收报警信息1 991次,发现异常事件1 481次,其中96.4%是临床相关事件,1.5%为系统相关事件,无信息传输事件占2.1%.系统相关事件多为感知异常,其中发现左心室导线脱位1例.临床相关事件中心律失常报警事件占84.7%[室上性心律失常和心房颤动(房颤)事件较多],心衰报警事件占15.3%,以静息时心率升高及心脏再同步治疗心室起搏百分比降低为主.根据HM系统报警信息,电话联络患者65例次,优化参数11例次,指导调整药物治疗方案18例次,4例患者入院治疗.结论 对于植入ICD/CRT-D的患者,HM系统是一项必要的、安全可靠的远程监测方法,可以及时识别起搏系统相关异常、发现临床相关事件,可指导对患者进行早期临床干预,优化随访管理,提高患者生活质量.%Objective To evaluate the benefit of Home monitoring (HM) system in patients with implantable cardioverter defibrillator (ICD) or cardiac resynchronization therapy defibrillator(CRT-D).Methods Twentythree patients undergoing implantation of ICD or CRT-D with HM were enrolled,data automatically collected on a daily basis and alerts by HM were analyzed.Early detection and intervention effect of HM included arrhythmias or heart failure to clinical events and system related events.Results The mean follow-up duration was 122-937 (452.1±262.2) d,a total of 1 991 remote transmissions were received.Among these transmissions,1 481 abnormal events were reported,96.4% of events were clinical-related,and 1.5

  20. Reuse of pacemakers, defibrillators and cardiac resynchronisation devices

    Science.gov (United States)

    Sakthivel, R; Satheesh, Santhosh; Ananthakrishna Pillai, Ajith; Sagnol, Pascal; Jouven, Xavier; Dodinot, Bernard; Balachander, Jayaraman

    2017-01-01

    Objective Access to pacemakers remains poor among many patients in low/middle-income countries. Reuse of explanted pacemakers is a possible solution, but is still not widespread because of concerns regarding outcomes, especially infection. Our objective was to study early outcomes with implants using reused devices and compare them with those with implants using new devices. Methods We studied all patients who underwent implantation of a new or reused pacemaker, cardiac resynchronisation therapy (CRT) device or implantable cardioverter defibrillator (ICD) in the last 5 years at a single institution. We analysed outcomes related to infection, device malfunction and device-related death within 6 months after initial implantation. Results During the study period, 887 patients underwent device implant, including 127 CRT devices or ICDs. Of these, 260 devices (29.3%) were reused and the others were new. At 6 months, there were three device-related infections in implants using a new device. There were no infections among patients receiving a reused device. There were no device malfunctions or device-related deaths in either group. Conclusions We found no difference in rate of infection or device malfunction among patients getting a reused device as compared with those with a new device. This study reinforces the safety of reusing devices for implant including CRT and ICDs. PMID:28176981

  1. 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....

  2. Shock whilst gardening--implantable defibrillators & lawn mowers.

    Science.gov (United States)

    Von Olshausen, G; Lennerz, C; Grebmer, C; Pavaci, H; Kolb, C

    2014-02-01

    Electromagnetic interference with implantable cardioverter defibrillators (ICDs) can cause inappropriate shock delivery or temporary inhibition of ICD functions. We present a case of electromagnetic interference between a lawn mower and an ICD resulting in an inappropriate discharge of the device due to erroneous detection of ventricular fibrillation.

  3. 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...... evidence on the efficacy of psychological intervention in ICD patients and recommendations for future research....

  4. 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

  5. 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.

  6. 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.

  7. Evaluation and Management of Patients After Implantable Cardioverter-Defibrillator Shock%植入型心律转复除颤器放电后患者的诊治

    Institute of Scientific and Technical Information of China (English)

    Anil K. Gehi; Davendra Mehta; J. Anthony Gomes; 樊颖婕

    2007-01-01

    背景:多项大规模临床试验表明,植入型心律转复除颤器(implantable cardioverterdefibrillator,ICD)能够有效降低部分心脏病患者的死亡率.此后,ICD的植入量大幅增加,非电生理专科医生也因此经常会遇到实施ICD电转复除颤的患者.目的:在接受ICD电转复除颤的患者中评估诊疗策略.证据获取:采用下列医学主题词在PubMed和MEDLINE数据库中检索1990年1月至2006年9月发表的文献:defibrillators,implantable(除颤器,植入型);defibrillators,implantable/adverse effects(除颤器,植入型/不良反应);抗心律失常药物(anti-arrhythmic agents);电除颤(electric countershock);生活质量(quality of life);心动过速治疗(tachycardia therapy);运算法则(algorithm);室性心动过速/诊断(ventricular tachycardia/diagnosis);室上性心动过速/诊断(supraventricular tachycardia/diagnosis).排除病例报告,仅纳入英文文献.参考美国心脏病学会(American College of Cardiology)、美国心脏协会(American Heart Association)、心脏节律学会(Heart Rhythm Society)发布的建议、指南及所附参考文献,获得其他相关文献.证据综合:ICD恰当放电和误放电均有诸多原因.误放电可严重影响患者的生活质量.目前有多种ICD程控技术可有效控制ICD恰当放电和误放电的发生.采用抗心律失常药也能有效减少放电频率.结论:采用有效的ICD程控和抗心律失常药物可在保障ICD急救功能的同时减少ICD放电.对现有各种治疗手段有一个基本的了解是诊治接受ICD放电者的基础.

  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. Implantable cardioverter defibrillator for primary prevention of sudden cardiac death in the patients with chronic heart failure%植入型心律转复除颤器应用于慢性心力衰竭患者心脏性猝死一级预防的长期随访

    Institute of Scientific and Technical Information of China (English)

    王礼琳; 范洁; 赵金辅; 周启云; 张曦; 丁立群

    2012-01-01

    Objective To evaluate the clinical benefits of implantable cardioverter defibrillator for the primary prevention of sudden cardiac death(SCD) in the patients with chronic heart failure due to either ischemic or nonischemic dilated cardiomyopathy.Methods We retrospectively enrolled 56 patients who were diagnosed with chronic heart failure caused by either ischemic or nonischemic dilated cardiomyopathy from March 2002 to October 2011.Patients were graded NYHA class Ⅱ and Ⅲ,with left ventricular ejection fraction (LVEF) at 0.16 ~ 0.35 (0.29 ± 0.05).All patients voluntarily took standard medicine treatment of chronic heart failure and underwent implantable cardioverter defibrillator (ICD) implantation and initial parameters were set up.All enrolled patients were followed up at 1,3,and 6 months,and every 6 months thereafter.Results ICD was implanted via the subclavian vein successfully in all patients.During the follow-up period of 1 ~ 115 (44.05±35.16) months,11 patients had 26 episodes of ventricular fibrillation(19.6%),which were defibrillated successfully; 17 patients had 39 episodes of ventricular tachycardia(VT,30.4%),which were terminated successfully at 94.8%.Besides,failure of ICD termination of VT occurred in 1 patient for twice and the arrhythmia was self-terminated later.Inadequate shocks were found in 8 patients.Electrical storm occurred in 6 cases.ICD battery was exhausted in 16 patients and 10 patients accepted replacement of ICD.Eight patients died.Conclusions The patients with chronic heart failure due to either ischemic or nonischemic dilated cardiomyopathy are at high risk of SCD.ICD implantation can reduce the risk of SCD for the primary prevention.%目的 对植入型心律转复除颤器(ICD)应用于缺血性或非缺血性心肌病慢性心力衰竭患者心脏性猝死(SCD)一级预防价值进行长期随访观察.方法 2002年3月至2011年10月入选56例缺血性或非缺血性心肌病患者,心功能Ⅱ~Ⅲ级(NYHA

  10. 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

  11. 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

  12. 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

  13. 植入型心律转复除颤器在致心律失常性右心室心肌病患者中的应用%Implantable cardioverter defibrillator therapy in patients with arrhythmogenic right ventricular cardiomyopathy

    Institute of Scientific and Technical Information of China (English)

    孙奇; 陈柯萍; 陈若菡; 戴研; 华伟; 张澍

    2013-01-01

    Objective To evaluate the role of implantable cardioverter defibrillator(ICD) therapy in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC).Methods From Mar.2004 to Mar.2012,ARVC patients received ICD were enrolled in this study,and the clinical characteristics were collected.In the follow-up,we assessed the incidence,feature and ICD therapy in these patients.Results Eighteen patients were enrolled [12 men,6 women,mean age (46.4 ± 13.8) years].During the (46.6 ± 30.5) months followup period,ICD recorded 111 ventricular tachycardia (VT)/ventricular fibrillation (VF) episodes (1 VF,110 VT) in 6 patients.Among these,3 patients experienced 7 electrical storms(ES).Compare to patients without ICD therapy,C-reactive protein(CRP) level was higher in ICD therapy group.Among VT/VF episodes,12 episodes were terminated by shocks,99 episodes were terminated by anti-tachycardia pacing(ATP).Conclusions VT episodes were very common in ARVC patients,most of them could terminated by ATP.Repeated episodes of malignant arrhythmias in ARVC patients with ES were common.CRP level might be a significant predictor of appropriate ICD therapy in ARVC patients.%目的 总结阜外心血管病医院应用植入型心律转复除颤器(ICD)治疗致心律失常性右心室心肌病(ARVC)的经验.方法 入选我院2004年3月至2012年3月确诊并植入ICD的ARVC患者,收集临床资料,进行常规电话及门诊随诊.结果 共18例患者[男12例,女6例,平均年龄(46.4±13.8)岁]入选,平均随访(46.6±30.5)个月,有6例患者出现了111次室性心动过速(VT)/心室颤动(VF)事件,其中仅1次VF事件,其余均为VT事件,其中3例患者术后共出现了7次电风暴.ICD治疗组中的C反应蛋白(CRP)明显高于ICD未治疗组.111次VT/VF事件中,12次经电除颤终止心动过速,其余均通过抗心动过速起搏(ATP)终止了心动过速.结论 ARVC患者ICD植入后的VT/VF事件以VT为主,多数可经ATP终止;出现电风暴的ARVC患者

  14. Implantable cardioverter defibrillator therapy for primary prevention of sudden cardiac death in patients with heart failure%植入型心律转复除颤器在心力衰竭心脏性猝死一级预防中的作用初步观察

    Institute of Scientific and Technical Information of China (English)

    陈太波; 程康安; 高鹏; 刘博江; 范静波; 方全

    2010-01-01

    目的 总结我院应用植入型心律转复除颤器(ICD)进行心力衰竭心脏性猝死(SCD)一级预防的初步经验.方法 入选我院近3年因严重心力衰竭植入ICD进行SCD一级预防的患者,术后3个月进行ICD常规随访,以后每6个月随访1次.结果 入选患者22例,其中单腔ICD 15台,双腔ICD7台.22例患者随访时间3~28个月.记录ICD治疗事件21次,包括12次抗心动过速起搏(ATP)治疗和9次放电,只有1次ATP治疗患者具自觉症状.其中正确治疗(appropriate therapy)11次(52%)包括8次ATP治疗和3次放电,误治疗(inappropriate therapy)10次(48%).发生误治疗患者均为植入单腔ICD.结论 ICD可以安全有效地应用于心力衰竭SCD的一级预防,ICD误治疗事件是值得重视的临床问题,合理的ATP治疗可以提高患者的生活质量.%Objective To evaluate the effectiveness of implantable cardioverter defibrillator (ICD) therapy for primary prevention of sudden cardiac death (SCD) in patients with heart failure. Methods Twen-ty-two consecutive heart failure patients implanted with ICD for primary prevention of SCD in last 3 years were enrolled and followed up 3 months after implantation and every 6 months afterwards. Results Totally 22 cases were enrolled, including 15 with single-chamber ICD and 7 with dual-chamber ICD. Twenty-one ICD therapy events were documented during 3~28 months follow-up period, including 12 anti-tachycardia pacing (ATP) therapies and 9 shocks, and only one had symptoms. Eleven therapies (52%, 8 ATP therapies and 3 shocks) were classified as appropriate, and 10 (48%) as inappropriate. All inappropriate therapies were occurred in pa-tients implanted with single-chamber ICD. Conclusion In heart failure patients ICD for primary prevention of SCD was effective and appropriate. Relatively high incidence of inappropriate therapies remains a challenge. ATP therapy may improve the quality of life in ICD patients.

  15. Longevity of the Subcutaneous Implantable Defibrillator Long-Term Follow-Up of the European Regulatory Trial Cohort

    NARCIS (Netherlands)

    Theuns, Dominic A. M. J.; Crozier, Ian G.; Barr, Craig S.; Hood, Margaret A.; Cappato, Riccardo; Knops, Reinoud E.; Maass, Alexander H.; Boersma, Lucas V. A.; Jordaens, Luc

    2015-01-01

    Background The recent advent of subcutaneous implantable cardioverter defibrillators (S-ICDs) has provided investigators with a safe and effective new therapy in patients at risk of sudden cardiac death. At present, no data are available with regard to the longevity of these new devices. This study

  16. Sexual Health for Patients with an Implantable Cardioverter Defibrillator

    Science.gov (United States)

    ... Search Donate Circulation My alerts Sign In Join Facebook Twitter Home About this Journal Editorial Board General Statistics Circulation Doodle → Blip the Doodle Information for Advertisers Author Reprints Commercial Reprints Customer Service and Ordering ...

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

    Science.gov (United States)

    ... Search Donate Circulation My alerts Sign In Join Facebook Twitter Home About this Journal Editorial Board General Statistics Circulation Doodle → Blip the Doodle Information for Advertisers Author Reprints Commercial Reprints Customer Service and Ordering ...

  18. 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...

  19. 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...

  20. Defibrillation in children

    Directory of Open Access Journals (Sweden)

    Haskell Sarah

    2010-01-01

    Full Text Available Defibrillation is the only effective treatment for ventricular fibrillation (VF. Optimal methods for defibrillation in children are derived and extrapolated from adult data. VF occurs as the initial rhythm in 8-20% of pediatric cardiac arrests. This has fostered a new interest in determining the optimal technique for pediatric defibrillation. This review will provide a brief background of the history of defibrillation and a review of the current literature on pediatric defibrillation. The literature search was performed through PubMed, using the MeSH headings of cardiopulmonary resuscitation, defibrillation and electric countershock. The authors′ personal bibliographic files were also searched. Only published articles were chosen. The recommended energy dose has been 2 J/kg for 30 years, but recent reports may indicate that higher dosages may be more effective and safe. In 2005, the European Resuscitation Council recommended 4 J/kg as the initial dose, without escalation for subsequent shocks. Automated external defibrillators are increasingly used for pediatric cardiac arrest, and available reports indicate high success rates. Additional research on pediatric defibrillation is critical in order to be able to provide an equivalent standard of care for children in cardiac arrest and improve outcomes.

  1. 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...... and terminated. If unsuccessful, two effective 24 J shocks were administered. If DF was unsuccessful, the system was reconfigured and another DF testing was performed. An ICD shock energy of 40 J had to be programmed in all patients for treatment of spontaneous VT/VF episodes. The primary endpoint...... was the average efficacy of the first ICD shock for all true VT/VF episodes in each patient during follow-up. The secondary endpoints included the frequency of system revisions, total fluoroscopy, implantation time, procedural serious adverse events, and all-cause, cardiac, and arrhythmic mortality during follow...

  2. A Comparison of the Quality of Life of Patients With an Entirely Subcutaneous Implantable Defibrillator System Versus a Transvenous System (from the EFFORTLESS S-ICD Quality of Life Substudy)

    DEFF Research Database (Denmark)

    Pedersen, Susanne S.; Mastenbroek, Mirjam H; Carter, Nathan;

    2016-01-01

    The first clinical results from the Evaluation of Factors Impacting Clinical Outcome and Cost Effectiveness of the subcutaneous implantable cardioverter defibrillator (EFFORTLESS S-ICD) Registry on the entirely S-ICD system are promising, but the impact of the S-ICD system on patients' quality of...

  3. 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.

  4. 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)

  5. 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...

  6. Defibrillator Implantation in Patients with Nonischemic Systolic Heart Failure

    DEFF Research Database (Denmark)

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

    2016-01-01

    to coronary artery disease has been based primarily on subgroup analyses. The management of heart failure has improved since the landmark ICD trials, and many patients now receive cardiac resynchronization therapy (CRT). Methods In a randomized, controlled trial, 556 patients with symptomatic systolic heart......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...... failure (left ventricular ejection fraction, ≤35%) not caused by coronary artery disease were assigned to receive an ICD, and 560 patients were assigned to receive usual clinical care (control group). In both groups, 58% of the patients received CRT. The primary outcome of the trial was death from any...

  7. Case report: use caution when applying magnets to pacemakers or defibrillators for surgery.

    Science.gov (United States)

    Schulman, Peter M; Rozner, Marc A

    2013-08-01

    The application of a magnet to a pacemaker (intended to cause asynchronous pacing) or implanted cardioverter defibrillator (intended to prevent shocks) during surgery without a clear understanding of actual magnet function(s) or precautions can have unexpected, untoward, or harmful consequences. In this report, we present 3 cases in which inadequate assessment of cardiac implanted electronic device (CIED) function, coupled with magnet application, contributed to or resulted in inappropriate antitachycardia pacing or shocks, CIED damage, or patient injury. Although these cases might be rare, they reinforce the need for a timely, detailed preoperative review of CIED function and programming as recommended by the American Society of Anesthesiologists and the Heart Rhythm Society.

  8. 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

  9. 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...

  10. 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.

  11. The Entirely Subcutaneous Defibrillator – A New Generation and Future Expectations

    Science.gov (United States)

    Ali, Hussam; Lupo, Pierpaolo; Cappato, Riccardo

    2015-01-01

    Although conventional implantable cardioverter-defibrillators (ICDs) have proved effective in the prevention of sudden cardiac death (SCD), they still appear to be limited by non-trivial acute and long-term complications. The recent advent of an entirely subcutaneous ICD (S-ICD) represents a further step in the evolution of defibrillation technology towards a less-invasive approach. This review highlights some historical and current issues concerning the S-ICD that may offer a viable therapeutic option in selected patients at high risk of SCD and in whom pacing is not required. After the CE Mark and US Food and Drug Administration (FDA) approvals, the S-ICD is being implanted worldwide with growing clinical data regarding its safety and efficacy (the EFFORTLESS Registry). The recently developed new generation of S-ICD (EMBLEM, Boston Scientific) demonstrates favourable features including a smaller device, longer longevity and remote-monitoring compatibility. Further innovations in the S-ICD system and potential integration with leadless pacing may play an important role in defibrillation therapy and prevention of SCD in the near future. PMID:26835112

  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...

  13. 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

  14. 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.

  15. A Clinical Review of Implantable Cardioverter Defibrillators and Bi-Ventricular Pacemakers at one Institute

    Directory of Open Access Journals (Sweden)

    Ahmad Nasir

    2010-01-01

    Full Text Available Background: ICD/BVP indications are expanding. They areexpensive devices and historically, morbidities associated withtheir use were high. The starting experience at the Gold CoastHospital is being reviewed.Methods: A retrospective chart review of all the ICD/BVPsimplanted in the Gold Coast Hospital from 06/07/2007 –17/06/2008, with special emphasis on device indications andcomplications.Results: Devices implanted were (31. Primary preventiondevices (67%, secondary prevention devices (33%.Indications were; Non-ischemic Dilated Cardiomyopathy(35%, Out-of-hospital Cardiac Arrest (26%, Conscious VT(13%, Ischemic Dilated Cardiomyopathy (10%, In-hospitalCardiac Arrest (6%, Long-QT Syndrome (6% andCatecholamine-related Polymorphic VT (3%. Majorcomplications reported; lung contusion (1, left haemothorax(1, failed coronary sinus lead positioning (2, lead repositioning(2, atrial lead removal (1, left subclavian veinthrombosis (1, lead malfunction leading to VT under sensingand syncope (1. Device-administered therapies were eight;Inappropriate discharges (5, Appropriate discharges (1,successful Anti-tachycardia Pacing (2.Conclusions: We believe that ICDs are very effective lifesavingdevices but unfortunately they still are very expensiveand their use can be associated with significant morbiditiesespecially during the learning curve.

  16. 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....

  17. Circadian variations in the occurrence of ventricular tachyarrhythmias in patients with implantable cardioverter defibrillators.

    Science.gov (United States)

    Kozák, Milan; Krivan, Lubomír; Semrád, Borivoj

    2003-03-01

    A circadian distribution has been demonstrated in episodes of sudden cardiac death, acute myocardial infarction, ventricular premature complexes, heart rate variability, and ventricular tachyarrhythmias. The aim of this study was to evaluate the circadian distribution of ventricular tachyarrhythmia episodes in a population of ICD patients. Data were gathered from 72 patients (55 men, 17 women; mean age 62.7 +/- 12.2 years, mean LVEF 0.0037 +/- 0.0011) with ICDs implanted for standard indications. Patients were followed every 3 months over a mean period of 21 +/- 12.8 months. At each examination, symptoms at arrhythmia onset and perception of ICD therapy were recorded, and the ICD memory was interrogated. During follow-up, 1,023 episodes' of malignant ventricular arrhythmias were detected and effectively terminated, 506 of which were fully analyzed. A morning peak in ventricular tachyarrhythmias was demonstrated between 7:00 and 11:00 AM, and an afternoon peak between 6:00 and 7:00 PM. A significantly lower occurrence of VT was observed at 1:00 AM and between 4:00 and 6:00 AM. A circadian distribution in the occurrence of ventricular tachycardias was found. The three striking features of the data are: the early morning peak (about three hours after waking up), relatively stable incidence throughout waking hours, and decline in incidence in the previous period.

  18. Temporal complexity of repolarization and mortality in patients with implantable cardioverter defibrillators.

    Science.gov (United States)

    Perkiomaki, Juha S; Couderc, Jean-Philippe; Daubert, James P; Zareba, Wojciech

    2003-10-01

    Increased repolarization variability has been observed in various cardiac conditions. However, data on its relation to heart rate variability and on its value in predicting adverse outcomes in high risk patients are limited. Forty-seven patients with decreased left ventricular function and ICDs had high resolution 10-minute ECG recordings and were followed for 781 +/- 258 days (mean +/- SD) on average. The interval from the R peak to the T wave peak with maximum amplitude (RTmax) and from the R peak to the T wave offset (RToff) were determined automatically on a beat-to-beat basis. Temporal beat-to-beat RTmax and RToff variability were analyzed using traditional summary statistics, a complexity measure (approximate entropy [ApEn]), and the short-term scaling exponent (alpha1). Eight (17%) patients died and 16 (34%) patients experienced death/appropriate ICD shock during follow-up. RTmax-ApEn was significantly higher in patients who died compared with patients who survived (1.24 +/- 0.13 vs 1.01 +/- 0.21, respectively, P=0.008). When RTmax-ApEn was tested together with the alpha1 of the RR intervals, occurrence of ventricular arrhythmias before ICD implantation, and beta-blockers usage in the Cox regression analysis, it still independently predicted mortality; hazard ratio=3.36 (1.28-8.83, 95% CI, P=0.014) for every 0.10-increase in RTmax-ApEn. None of the repolarization variability parameters independently predicted death/appropriate ICD shocks. Increased temporal complexity of repolarization (RTmax-ApEn) independently predicts mortality in ICD patients.

  19. Employment Status and Sick Leave After First-Time Implantable Cardioverter Defibrillator Implantation

    DEFF Research Database (Denmark)

    Christensen, Anne Vinggaard; Øhlers, Anne Alexandrine; Zwisler, Ann-Dorthe;

    2017-01-01

    . METHOD: Patients with first-time ICD implantation were randomized to comprehensive cardiac rehabilitation or usual care. One year after ICD implantation, patients answered questions about employment status and sick leave. Differences were tested using the Student t test and the χ test. Predictors...... of employment status and sick leave were tested using logistic regression and linear regression models. RESULT: A total of 196 patients were randomized. The questionnaire was completed by 138 patients (70%). In total, 47% had worked before ICD implantation. After 1 year, 81% were still working and their mean...

  20. 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.

  1. 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

    Statin therapy is an important secondary prevention measure in cardiovascular disease. However, the side effects associated with statin use could potentially affect patients' quality of life. Little is known about the influence of statin therapy on the well-being and health status of cardiac pati...

  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. 77 FR 20873 - Qualification of Drivers; Application for Exemptions; Implantable Cardioverter Defibrillators

    Science.gov (United States)

    2012-04-06

    ... person has no current clinical diagnosis of myocardial infarction, angina pectoris, coronary... criteria indicate that: The term ``has no current clinical diagnosis of'' (1) a current cardiovascular.... The term ``known to be accompanied by'' is designed to include a clinical diagnosis of...

  4. 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

    based on the problem-solving principles of cognitive behavioral therapy. RESULTS: Two hundred eighty-nine patients (85% response rate) were randomized. The prevalence of anxiety and depression ranged between 11% and 30% and 13% and 21%, respectively. No significant intervention effects were observed...

  5. 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

    (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...

  6. 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

    factors have not been considered as potential risk markers that might enhance the prediction of sudden cardiac death. This article evaluates the evidence for a link between psychological vulnerability, ventricular tachyarrhythmias and mortality and the pathways that might explain such a link. This review......, but information on the psychological profile of the patient may help to optimize the management and care of these patients in clinical practice....

  7. 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...

  8. Possible Triggers and Temporal Patterns of Implantable Cardioverter Defibrillator Discharges: A Preliminary Study

    Science.gov (United States)

    1999-01-20

    there was a direct relationship between self-reported distress levels and occurrence of ectopic beats. These researchers later reported a negative...Furious (almost out of control. very angry, pounding table. slamming door) Very Angry (body tense, clenching fists or teeth ) Moderately angry (so...pounding table, slamming door) Very ADgry (body tense, clenching fists or teeth ) Moderately angry (so hassled it shows in your voice) Mlklly aDgry

  9. Dental management of a patient fitted with subcutaneous Implantable Cardioverter Defibrillator device and concomitant warfarin treatment

    Directory of Open Access Journals (Sweden)

    Altaf Hussain Shah

    2015-07-01

    This article presents the dental management of a 60 year-old person with an ICD and concomitant anticoagulant therapy. The patient was on multiple medications and was treated for a grossly neglected mouth with multiple carious root stumps. This case report outlines the important issues in managing patients fitted with an ICD device and at a risk of sudden cardiac death.

  10. 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

    .1] years) completed the Hospital Anxiety and Depression Scale 1 day before implantation. During follow-up, the ICD was interrogated at 3-month intervals. Cox proportional hazard regression analyses were used to examine the impact of depression on time to first appropriate ICD therapy and all-cause...... with an increased risk for all-cause mortality (unadjusted HR = 2.18, 95% CI = 1.36-3.49). Depression remained independently associated with all-cause mortality (HR = 1.94, 95% CI = 1.06-3.54, p = .031), after adjusting for demographic and clinical characteristics. Patients who remained depressed during the first 3...... months after implantation were at greatest risk for dying (HR = 2.88, 95% CI = 1.29-6.45, p = .010). Conclusions The current study showed that depression at the time of implant is not associated with time to first appropriate ICD therapy but almost doubled the risk for all-cause mortality in patients...

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

    Science.gov (United States)

    ... Search Donate Circulation My alerts Sign In Join Facebook Twitter Home About this Journal Editorial Board General Statistics Circulation Doodle → Blip the Doodle Information for Advertisers Author Reprints Commercial Reprints Customer Service and Ordering ...

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

    Science.gov (United States)

    ... Search Donate Circulation My alerts Sign In Join Facebook Twitter Home About this Journal Editorial Board General Statistics Circulation Doodle → Blip the Doodle Information for Advertisers Author Reprints Commercial Reprints Customer Service and Ordering ...

  13. Automated external cardioversion defibrillation monitoring in cardiac arrest: a randomized trial

    Directory of Open Access Journals (Sweden)

    Norvel Robert

    2008-06-01

    Full Text Available Abstract Background In-hospital cardiac arrest has a poor prognosis despite active electrocardiography monitoring. The initial rhythm of approximately 25% of in-hospital cardiopulmonary resuscitation (CPR events is pulseless ventricular tachycardia/ventricular fibrillation (VT/VF. Early defibrillation is an independent predictor of survival in CPR events caused by VT/VF. The automated external cardioverter defibrillator (AECD is a device attached by pads to the chest wall that monitors, detects, and within seconds, automatically delivers electric countershock to an appropriate tachyarrhythmia. Study Objectives • To evaluate safety of AECD monitoring in hospitalized patients. • To evaluate whether AECDs provide earlier defibrillation than hospital code teams. Methods The study is a prospective trial randomizing patients admitted to the telemetry ward to standard CPR (code team or standard CPR plus AECD monitoring (PowerHeart CRM. The AECD is programmed to deliver one 150 J biphasic shock to patients in sustained VT/VF. Data is collected using the Utstein criteria for cardiac arrest. The primary endpoint is time-to-defibrillation; secondary outcomes include neurological status and survival to discharge, with 3-year follow-up. Results To date, 192 patients have been recruited in the time period between 10/10/2006 to 7/20/2007. A total of 3,655 hours of telemetry data have been analyzed in the AECD arm. The AECD has monitored ambulatory telemetry patients in sinus rhythm, sinus tachycardia, supraventricular tachycardia, atrial flutter or fibrillation, with premature ventricular complexes and non-sustained VT without delivery of inappropriate shocks. One patient experienced sustained VT during AECD monitoring, who was successfully defibrillated (17 seconds after meeting programmed criteria. There are no events to report in the control arm. The patient survived the event without neurological complications. During the same time period, mean time to

  14. 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.

  15. 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.

  16. Study of Cardiac Defibrillation Through Numerical Simulations

    Science.gov (United States)

    Bragard, J.; Marin, S.; Cherry, E. M.; Fenton, F. H.

    Three-dimensional numerical simulations of the defibrillation problem are presented. In particular, in this study we use the rabbit ventricular geometry as a realistic model system for evaluating the efficacy of defibrillatory shocks. Statistical data obtained from the simulations were analyzed in term of a dose-response curve. Good quantitative agreement between our numerical results and clinically relevant values is obtained. An electric field strength of about 6.6 V/cm indicates a fifty percent probability of successful defibrillation for a 12-ms monophasic shock. Our validated model will be useful for optimizing defibrillation protocols.

  17. 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.

  18. Validation of defibrillator lead performance registry data

    DEFF Research Database (Denmark)

    Kristensen, Anders Elgaard; Larsen, Jacob Moesgaard; Nielsen, Jens Cosedis

    2017-01-01

    intervention. The validity of the less detailed overall reasons for lead interventions commonly used to report lead performance is also excellent. These findings indicate high registry data quality appropriate for scientific analysis and industry-independent post-marketing surveillance.......AIMS: The validity of registry data on defibrillator lead performance is described only sparsely, despite its clinical importance. This study investigated the validity of defibrillator lead performance registry data in a nationwide and population-based registry. METHODS AND RESULTS: We identified.......9% (95% CI: 85.2-90.2%) with a κ value of 0.82 (95% CI:0.78-0.86) representing an almost perfect match. CONCLUSION: The validity of data on defibrillator lead performance recorded in the DPIR is excellent for the specific types of lead intervention and good for the specific reasons for defibrillator lead...

  19. 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.

  20. [Research on automatic external defibrillator based on DSP].

    Science.gov (United States)

    Jing, Jun; Ding, Jingyan; Zhang, Wei; Hong, Wenxue

    2012-10-01

    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 achieved goals such as ECG signal real-time acquisition, ECG wave synchronous display, data delivering to U disk and automatic defibrillate when shockable rhythm appears, etc.

  1. Imaging of Ventricular Fibrillation and Defibrillation: The Virtual Electrode Hypothesis.

    Science.gov (United States)

    Boukens, Bastiaan J; Gutbrod, Sarah R; Efimov, Igor R

    2015-01-01

    Ventricular fibrillation is the major underlying cause of sudden cardiac death. Understanding the complex activation patterns that give rise to ventricular fibrillation requires high resolution mapping of localized activation. The use of multi-electrode mapping unraveled re-entrant activation patterns that underlie ventricular fibrillation. However, optical mapping contributed critically to understanding the mechanism of defibrillation, where multi-electrode recordings could not measure activation patterns during and immediately after a shock. In addition, optical mapping visualizes the virtual electrodes that are generated during stimulation and defibrillation pulses, which contributed to the formulation of the virtual electrode hypothesis. The generation of virtual electrode induced phase singularities during defibrillation is arrhythmogenic and may lead to the induction of fibrillation subsequent to defibrillation. Defibrillating with low energy may circumvent this problem. Therefore, the current challenge is to use the knowledge provided by optical mapping to develop a low energy approach of defibrillation, which may lead to more successful defibrillation.

  2. 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

  3. Technologic advances and program initiatives in public access defibrillation using automated external defibrillators.

    Science.gov (United States)

    White, R D

    2001-06-01

    Widespread provision of early defibrillation following cardiac arrest holds major promise for improved survival from ventricular fibrillation. The critical element in predicting a successful outcome is the rapidity with which defibrillation is achieved. A worldwide awareness of this potential and its advocacy by such organizations as the American Heart Association have been pivotal in the evolution of initiatives to make defibrillation more widely and more rapidly available. The feasibility of this initiative, known as public access defibrillation, is in large measure a direct consequence of major technologic advances in automated external defibrillators (AEDs). New low-energy waveforms with biphasic morphology have been shown to be more effective in terminating ventricular fibrillation and may do so with less myocardial injury. Placement of AEDs in a variety of nontraditional settings such as police cars, aircraft and airport terminals, and gambling casinos has been shown to yield an impressive number of survivors of cardiac arrest in ventricular fibrillation. Questions yet to be answered center on the appropriate disposition of AEDs in public access defibrillation settings, training and retraining issues, device maintenance, and collection of accurate data to document benefit and to identify areas of needed improvement or expansion of AED availability.

  4. [Cardiac Pacemakers, implantable defibrillators and IRM].

    Science.gov (United States)

    Frank, R; Hidden-Lucet, F; Himbert, C; Petitot, J C; Fontaine, G

    2003-04-01

    The IRM is formally contraindicated to the pacemaker and cardiac defibrillator wearers because of the risk of inhibition or inappropriate stimulations during the examination. However if the examination is essential, suitable programming of the apparatus and a constant monitoring of the heartbeat rate by a qualified doctor in cardiac stimulation must make it possible to avoid any accident.

  5. 75 FR 70015 - External Defibrillators; Public Workshop

    Science.gov (United States)

    2010-11-16

    ... of innovative AED features such as automated integration into local 9-1-1 systems. FDA will work with... consumers, to share perspectives. II. Topics for Discussion at the Public Workshop The public workshop will... signals, or enhance the use of external defibrillators? III. Transcripts Please be advised that as soon...

  6. 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...

  7. A shocking past: a walk through generations of defibrillation development.

    Science.gov (United States)

    Gutbrod, Sarah R; Efimov, Igor R

    2014-05-01

    Defibrillation is one of the most successful and widely recognized applications of electrotherapy. Yet the historical road to its first successful application in a patient and the innovative adaptation to an implantable device is marred with unexpected turns, political and personal setbacks, and public and scientific condemnation at each new idea. Driven by dedicated scientists and ever-advancing creative applications of new technologies, from electrocardiography to high density mapping and computational simulations, the field of defibrillation persevered and continued to evolve to the life-saving tool it is today. In addition to critical technological advances, the history of defibrillation is also marked by the plasticity of the theory of defibrillation. The advancing theories of success have propelled the campaign for reducing the defibrillation energy requirement, instilling hope in the development of a painless and harmless electrical defibrillation strategy.

  8. 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.

  9. Fast Electrocardiogram Amplifier Recovery after Defibrillation Shock

    Directory of Open Access Journals (Sweden)

    Ivan Dotsinsky

    2005-04-01

    Full Text Available A procedure for fast ECG amplifier recovery after defibrillation shocks was developed and simulated in the MATLAB environment. Exponentially decaying post-shock voltages have been recorded. Signals from the AHA database are taken and mixed with the recorded exponential disturbances. The algorithm applies moving averaging (comb filter on the compound input signal, thereby obtaining the samples of the disturbance. They are currently subtracted from the input signal. The results obtained show that its recovery is practically instantaneous.

  10. Psychometric analysis of the Patient Health Questionnaire in Danish patients with an implantable cardioverter defibrillator (The DEFIB-WOMEN study)

    DEFF Research Database (Denmark)

    Pedersen, Susanne S; Mathiasen, Kim; Christensen, Karl Bang;

    2016-01-01

    . The unidimensionality and the precision of the rescored PHQ-9 were confirmed. Items did not have any differential functioning (DIF) across educational level, age, indication for ICD implantation, and severity of heart failure that influence depression outcomes in patients with an ICD. One item exhibited DIF by gender....... Three items did not fit the partial credit model, but the generalized partial credit model could be fitted to the full item set. CONCLUSION: The unidimensionality and reliability of the Danish version of the PHQ-9 were confirmed. However, the associated consequences of the number of response options (3...

  11. The Screen-ICD trial. Screening for anxiety and cognitive therapy intervention for patients with implanted cardioverter defibrillator (ICD)

    DEFF Research Database (Denmark)

    Berg, Selina Kikkenborg; Herning, Margrethe; Svendsen, Jesper Hastrup;

    2016-01-01

    by Structured Clinical Interview for DSM Disorders (SCID). (3) Investigator-initiated randomised clinical superiority trial with blinded outcome assessment, with 1:1 randomisation to cognitive–behavioural therapy (CBT) performed by a cardiac nurse with CBT training, plus usual care or usual care alone...

  12. 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

    .26 to 4.15), cardiac resynchronization therapy (OR 1.92; 95% CI 1.05 to 3.52), New York Heart Association class III-IV (OR 2.47; 95% CI 1.36 to 4.48), diabetes (OR 2.09; 95% CI 1.01 to 4.29), Type D personality (OR 8.30; 95% CI 4.42 to 15.58), high levels of ICD concerns (OR 2.60; 95% CI 1.44 to 1...... Association class III-IV (OR 2.95; 95% CI 1.47 to 5.89), Type D personality (OR 7.98; 95% CI 3.98 to 16.04), and the use of psychotropic medication (OR 2.73; 95% CI 1.27 to 5.84) were independent correlates of persistent depression. In conclusion, symptomatic heart failure, psychological status...

  13. 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.

  14. Automatic mode switching of a dual chamber implantable cardioverter-defibrillator induced by a ventricular escape rhythm.

    Science.gov (United States)

    Barold, S Serge; Van Heuverswyn, Frederic; Stroobandt, Roland X

    2013-01-01

    This report describes a form of group beating induced by a St Jude dual chamber ICD which interpreted a ventricular escape rhythm (with retrograde conduction) as premature ventricular complexes (PVC). These pacemaker-defined PVCs activated the atrial pace-PVC algorithm in 2 steps. 1. The postventricular atrial refractory period (PVARP) was terminated upon detecting a retrograde P wave within its unblanked portion, and 2. An atrial stimulus was released 330ms after the end of the PVARP. This response resulted in automatic mode switching because the 330ms interatrial interval was shorter than the atrial tachycardia detection interval. The arrhythmia may be considered to represent an unusual form of pacemaker escape-capture bigeminy.

  15. Biomarker-based diagnosis of pacemaker and implantable cardioverter defibrillator pocket infections: A prospective, multicentre, case-control evaluation

    Science.gov (United States)

    Vrazic, Hrvoje; Haller, Bernhard; Braun, Siegmund; Petzold, Tobias; Ott, Ilka; Lennerz, Agnes; Michel, Jonathan; Blažek, Patrick; Deisenhofer, Isabel; Whittaker, Peter; Kolb, Christof

    2017-01-01

    Background The use of cardiac implantable electronic devices (CIED) has risen steadily, yet the rate of cardiac device infections (CDI) has disproportionately increased. Amongst all cardiac device infections, the pocket infection is the most challenging diagnosis. Therefore, we aimed to improve diagnosis of such pocket infection by identifying relevant biomarkers. Methods We enrolled 25 consecutive patients with invasively and microbiologically confirmed pocket infection. None of the patients had any confounding conditions. Pre-operative levels of 14 biomarkers were compared in infected and control (n = 50) patients. Our selected biomarkers included white blood cell count (WBC), C-reactive protein (CRP), procalcitonin (PCT), lipopolysaccharide binding protein, high-sensitivity C-reactive protein (HS-CRP), polymorphonuclear-elastase, presepsin, various interleukins, tumor necrosis factor α (TNF-α), and granulocyte macrophage colony-stimulating factor (GM-CSF). Results Of the 25 patients with isolated pocket infection (70±13years, 76% male, 40% ICDs), none presented with leukocytosis. In contrast, they had higher serum levels of HS-CRP (p = 0.019) and PCT (p = 0.010) than control patients. Median PCT-level was 0.06 ng/mL (IQR 0.03–0.07 ng/mL) in the study group versus 0.03 ng/mL (IQR 0.02–0.04 ng/mL) in controls. An optimized PCT cut-off value of 0.05 ng/mL suggests pocket infection with a sensitivity of 60% and specificity of 82%. In addition TNF-α- and GM-CSF-levels were lower in the study group. Other biomarkers did not differ between groups. Conclusion Diagnosis of isolated pocket infections requires clinical awareness, physical examination, evaluation of blood cultures and echocardiography assessment. Nevertheless, measurement of PCT- and HS-CRP-levels can aid diagnosis. However, no conclusion can be drawn from normal WBC-values. Clinical trial registration clinicaltrials.gov identifier: NCT01619267 PMID:28264059

  16. 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...

  17. 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, e...

  18. Clinical practice of defibrillator implantation after myocardial infarction: impact of implant time: results from the PreSCD II Registry†

    Science.gov (United States)

    Völler, Heinz; Kamke, Wolfram; Klein, Helmut U.; Block, Michael; Reibis, Rona; Treusch, Sven; Contzen, Klaus; Wegscheider, Karl

    2011-01-01

    Aims Current guidelines recommend implantable cardioverter-defibrillator (ICD) therapy for primary prevention of sudden cardiac death in patients with the reduced left ventricular function (LVEF ≤30%) not earlier than 40 days after myocardial infarction (MI). The aim of the prospective Prevention of Sudden Cardiac Death II (PreSCD II) registry was to investigate the clinical practice of ICD therapy in post-MI patients and to assess the impact on survival. Methods and results 10 612 consecutive patients (61 ± 12 years, 76% male) were enrolled 4 weeks or later after MI in 19 cardiac rehabilitation centres in Germany from December 2002 to May 2005. All patients with left ventricular ejection fraction (LVEF) ≤40% (n = 952) together with a randomly selected group of patients with preserved left ventricular function (n = 1106) were followed for 36 months. Cox proportional hazard models were used to correlate ICD implantation and survival with baseline characteristics. Of all patients studied, 75.9% were enrolled within 4–8 weeks, 10.7% more than 1 year after MI. Pre-specified Group 1 with an LVEF ≤30% consisted of 269 patients (2.5%), Group 2 with LVEF 31–40% of 727 patients (6.9%), and Group 3 with LVEF >40% of 1148 randomly selected patients from the cohort of 9616 patients with preserved LV function. After 36 months, only 142 patients (6.9%) had received an ICD; 82 (31.7%) of Group 1, 49 (7%) of Group 2, and 11 (1%) in Group 3. The ICD was implanted in 47% of all patients within 1 year after their index MI. Implantable cardioverter-defibrillator patients were predominantly characterized by low ejection fraction, but also by several other independent risk factors. Patients who received an ICD had an adjusted 44% lower mortality (hazard ratio 0.56, 95% confidence intervals 0.32–1.01; P = 0.053) than comparable patients without ICD therapy. All cause mortality of ICD recipients was significantly lower if the ICD was implanted later than 11 months after acute

  19. 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.

  20. The use of automated external defibrillators and public access defibrillators in the mountains: official guidelines of the international commission for mountain emergency medicine ICAR-MEDCOM.

    Science.gov (United States)

    Elsensohn, Fidel; Agazzi, Giancelso; Syme, David; Swangard, Michael; Facchetti, Gianluca; Brugger, Hermann

    2006-01-01

    In this article we propose guidelines for rational use of automated external defibrillators and public access defibrillators in the mountains. In cases of ventricular fibrillation and pulseless ventricular tachycardia, early defibrillation is the most effective therapy. Easy access to mountainous areas permits visitation by persons with high risks for sudden cardiac death, and medical trials show the benefit of exercising in moderate altitude. The introduction of public access defibrillators in popular areas in the mountains may lead to a reduction of fatal outcome of cardiac arrest. Public access defibrillators should be placed with priority in popular ski areas, in busy mountain huts and restaurants, at mass-participation events, and in remote but often-visited locations that do not have medical coverage. Automated external defibrillators should be available to first-responder groups and mountain-rescue teams. It is important that people know how to perform cardiopulmonary resuscitation and how to use public access defibrillators and automated external defibrillators.

  1. [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.

  2. 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.

  3. CALLUS INDUCTION FROM FLORAL EXPLANTS OF CUPUASSU

    Directory of Open Access Journals (Sweden)

    MARIA DAS GRAÇAS RODRIGUES FERREIRA

    2013-01-01

    Full Text Available There are few studies related to the in vitro cultivation of plants from theTheobroma genus and no effective micropropagation protocols for T.grandiflorum. The aim of this study was to evaluate the calli formation in cupuassu floral explants, targeting their organogenic or embryogenicdevelopment. Experiments were conducted in the Plant Tissue Culture Laboratory of EMBRAPA, Porto Velho, Rondônia, Brazil. Floral parts from unopened immature flower buds taken from seedless cupuassu trees were sterilized and employed as a source of explants. These explants were cultivated in Petri dishes in an induction medium consisting of MS salts and vitamins, supplemented with glycine(3 mg.L-1, lysine (0,4 mg.L-1, leucine (0,4 mg.L-1, arginine (0,4 mg.L-1, tryptophan (0,2 mg.L-1, 2,4-D (1 mg.L-1, kinetin (0,25 mg.L-1, coconut water (50 ml.L-1, sucrose (40 g.L-1, Gelrite (2,2 g.L-1 and pH adjusted to 5,8. Cultures were maintained in the dark for 3 weeks at 27°C and then subcultured for six weeks in medium without growth regulators supplemented with glycine (1 mg.L-1, lysine (0,2 mg.L-1, leucine (0,2 mg.L-1, arginine (0,2 mg.L-1, tryptophan (0,1 mg.L-1, coconut water (100 ml.L-1, sucrose (40 g.L-1, Gelrite (2,2 g.L-1 and pH 5,8. We used a completely randomized design with 10 replications of 5 explants per plate and four different explant sources: staminode, petal, ligule and ovary. As a result, we obtained a highercalli formation in theinduction medium when ovaries were used as source of explants. However, there was no development of somatic embryosor organogenic response in medium without growth regulators and further studies are being conducted.

  4. Development of a current-controlled defibrillator for clinical tests.

    Science.gov (United States)

    Fischer, M; Schönegg, M; Schöchlin, J; Bolz, A

    2002-01-01

    The work presented here is only a part of the development for a new current-controlled defibrillator. In the diploma thesis "Development and construction of a current-controlled defibrillator for clinical tests" the most important part was the control and safety of the defibrillator. To ensure a safe circuit design, a risk-analysis and a Failure Mode and Effects Analysis (FMEA) were necessary. Another major part was the programming of a microcontroller in embedded C and a programmable logic device in Very High Speed Integrated Circuit Description Language (VHDL). The circuit had to be constructed, and the defibrillator was optically decoupled from the laptop for safety reasons. The waveform-data can be transmitted to the microcontroller from the laptop, and the logged data is then transmitted back.

  5. Automated external defibrillators: technical considerations and clinical promise.

    Science.gov (United States)

    Takata, T S; Page, R L; Joglar, J A

    2001-12-04

    Early defibrillation is the most important determinant of survival for victims of cardiac arrest due to ventricular fibrillation. The automated external defibrillator (AED) was developed as the result of the American Heart Association's Public Access Defibrillation initiative. The goal of this initiative is to place AEDs in strategic locations so that laypersons with minimal training could promptly defibrillate victims of cardiac arrest. Because of changes in design and the use of alternative waveforms for defibrillation, the modern AED is compact and portable, simple to use, and highly efficacious; in addition, it requires little maintenance. Automated external defibrillators have been used successfully by traditional and nontraditional responders as well as laypersons. In special environments, such as casinos and commercial aircraft, AEDs have performed particularly well. State and federal legislation has eased concerns about AED use by extending legal protection to AED users under Good Samaritan laws. Since the experience continues to be positive, AEDs are being used in increasingly diverse community locations, and public awareness is growing. The American Heart Association's initiative is progressing rapidly.

  6. Awareness among resident doctors with regards to cardiac defibrillators

    Directory of Open Access Journals (Sweden)

    Garg Rakesh

    2010-01-01

    Full Text Available Background and Aims: Electrical defibrillation is the most important therapy for patients in cardiac arrest. The audit was aimed to assess awareness among residents with respect to routine preuse checking of cardiac defibrillators. Materials and Methods: The audit was conducted at a multispeciality tertiary care referral and teaching center by means of a printed questionnaire from anaesthesiology residents. A database was prepared and responses were analyzed. Results: Eighty resident doctors participated in the audit. Most (97.8% of the residents were sure of the presence of a defibrillator in the operation room (OR; 70% of postgraduates (PGs were aware of the location of the defibrillator in the OR as compared to 83.7% of the senior resident (SRs. Also, 32.1% residents routinely check the availability of a defibrillator. The working condition of the defibrillator was checked by 21.7% of the residents; 25.3% ensured delivery of the set charge. Further, 8.2% of residents ensured availability of both adult and paediatric paddles. About 27.8% of residents ensured the availability of appropriate conducting gel and 53.8% residents were of the opinion that the responsibility of checking the functioning and maintenance of the defibrillators lies with themselves. Some 22% thought that both doctors and technical staff should share the responsibility, while 19.5% opined that it should be the responsibility of the technical staff. Conclusion: All medical equipment is to be tested prior to initial use and periodically thereafter. An extensive, recurring training program, and continued attention to the training of clinical personnel is required to ensure that they are proficient in the operation and testing of specific defibrillator models in their work area. We conclude that apart from awareness of the use of the equipment we are using, its preuse testing is must. All resident doctors should be aware of the presence and adequate functioning of the

  7. 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.

  8. 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...

  9. Marketing defibrillation training programs and bystander intervention support.

    Science.gov (United States)

    Sneath, Julie Z; Lacey, Russell

    2009-01-01

    This exploratory study identifies perceptions of and participation in resuscitation training programs, and bystanders' willingness to resuscitate cardiac arrest victims. While most of the study's participants greatly appreciate the importance of saving someone's life, many indicated that they did not feel comfortable assuming this role. The findings also demonstrate there is a relationship between type of victim and bystanders' willingness to intervene. Yet, bystander intervention discomfort can be overcome with cardiopulmonary resuscitation and defibrillation training, particularly when the victim is a coworker or stranger. Further implications of these findings are discussed and modifications to public access defibrillation (PAD) training programs' strategy and communications are proposed.

  10. 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.

  11. 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.

  12. 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...

  13. 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...

  14. 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.

  15. Tissue Culture Responses from Different Explants of Rice

    Institute of Scientific and Technical Information of China (English)

    WANG Xiu-hong; SHI Xiang-yuan; WU Xian-jun

    2005-01-01

    Different culture explants, including anther, young panicle, young embryo, and mature embryo, from 19 rice varieties were used for callus induction and green plantlet differentiation. The culture efficiency differed significantly among the four types of explants, and varied from genotype to genotype. Callus induction frequency presented significantly positive correlation each between anther and young panicle, anther and mature embryo, and young panicle and young embryo. Green plantlet differentiation showed no relationship between different types of explants. In addition, no relationship was found between callus induction frequency and green plantlet differentiation frequency.

  16. 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.

  17. 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

  18. Intraocular lens explantation or exchange: indications, postoperative interventions, and outcomes

    Directory of Open Access Journals (Sweden)

    Refik Oltulu

    2015-06-01

    Full Text Available ABSTRACT Purpose: To analyze the indications for explantation or exchange of intraocular lenses (IOLs, which were originally implanted for the correction of aphakia during cataract extraction. Methods: All cases that involved intraocular lens explantation or exchange in one institution between January 2008 and December 2014 were analyzed retrospectively. Results: In total, 93 eyes of 93 patients were analyzed. The median time interval between implantation and explantation of the anterior chamber intraocular lenses (AC IOL and posterior chamber intraocular lenses (PC IOL was 83.40 ± 83.14 months (range: 1-276 months and 55.14 ± 39.25 months (range: 1-168 months, respectively. Pseudophakic bullous keratopathy (17 eyes, 38.6% and persistent iritis (12 eyes, 27.8% in the AC IOL group and dislocation or decentration (30 eyes, 61.2% and incorrect IOL power (nine eyes, 18.4% in the PC IOL group were the most common indications for explantation of IOLs. The mean logMAR best corrected visual acuity (BCVA improved significantly from 1.30 preoperatively to 0.62 postoperatively in the PC IOL group (p<0.001 but did not improve significantly in the AC IOL group (p=0.186. Conclusions: The primary indication for IOL explantation or exchange was pseudophakic bullous keratopathy in the AC IOL group and was dislocation or decentration in the PC IOL group. PC IOL explantation or exchange is safe and improves visual acuity.

  19. 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.

  20. Worldwide experience with a totally subcutaneous implantable defibrillator

    DEFF Research Database (Denmark)

    Lambiase, Pier D; Barr, Craig; Theuns, Dominic A M J

    2014-01-01

    AIMS: 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 internationa...... event rates and inappropriate shock rates comparable with those reported for conventional ICDs. Clinical trial registration URL: http://www.clinicaltrials.gov. Unique identifier NCT01085435....

  1. The role of automated external defibrillators in dental practice.

    Science.gov (United States)

    Boyd, Barry C; Fantuzzo, Joseph J; Votta, Timothy

    2006-01-01

    Dental practices are seeing an increasing number of elderly and medically compromised patients, making it likely that staff will be called upon to respond to medical emergencies in the office, including cardiac arrest. Out-of-hospital cardiac arrests account for nearly half of all cardiovascular deaths in the United States. In adult cardiac arrest victims, the most frequent cause of sudden cardiac arrest is ventricular dysrhythmia, either ventricular tachycardia or ventricular fibrillation. The survival rate for sufferers of out-of-hospital cardiac arrests is a dismal 1% to 5% to hospital discharge. A majority of people who survive to discharge sustain significant morbidity. Untreated ventricular fibrillation degenerates into asystole, which is often refractory to resuscitative efforts and represents a terminal event. The development and availability of the automated external defibrillator (AED) represents a promising advance in the pre-hospital early defibrillation of victims of sudden cardiac arrest in a variety of settings, often remote from hospitals or EMS personnel. Given the medically compromised segment of the population treated in many dental practices today, it is imperative that dental practitioners and allied health providers become trained in the recognition and prompt initiation of emergency care, including basic life support with early defibrillation. The AED is becoming more accessible, with increasingly widespread availability, training in its use and relative ease of operation, making the goal of increased survival one in which dental health professionals can play a part.

  2. Clinical management of electromagnetic interferences in patients with pacemakers and implantable cardioverter-defibrillators: review of the literature and focus on magnetic resonance conditional devices.

    Science.gov (United States)

    Corzani, Alessandro; Ziacchi, Matteo; Biffi, Mauro; Allaria, Luca; Diemberger, Igor; Martignani, Cristian; Bratten, Tara; Gardini, Beatrice; Boriani, Giuseppe

    2015-10-01

    The number of cardiac implantable electronic devices (CIEDs) has greatly increased in the last 10 years. Many electronic devices used in daily activities generate electromagnetic interferences (EMIs) that can interact with CIEDs. In clinical practice, it is very important to know the potential sources of EMIs and their effect on CIEDs in order to understand how to manage or mitigate them. A very important source of EMI is magnetic resonance (MR), which is considered nowadays the diagnostic gold standard for different anatomical districts. In this review, we focused on the effects of EMI on CIEDs and on the clinical management. Moreover, we made a clarification about MR and CIEDs.In patients with CIEDs, EMIs may cause potentially serious and even life-threatening complications (inappropriate shocks, device malfunctions, inhibition of pacing in pacemaker-dependent patients) and may rarely dictate device replacement. The association of inappropriate shocks with increased mortality highlights the importance of minimizing the occurrence of EMI. Adequate advice and recommendations about the correct management of EMIs in patients with CIEDs are required to avoid all complications during hospitalization and in daily life. Furthermore, the article focused on actual management about MR and CIEDs.

  3. 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

    , sex, previous MI or angina, hypertension, diabetes, systolic blood pressure, heart rate, NYHA functional class and non-Q wave infarct on electrocardiogram. Distinct survival curves were obtained for 3 risk groups based on the median and inter-quartile range for the prognostic index. In the high...

  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

    and depression. Treatment and care possibilities seem to be lacking. Studies indicate that non-pharmacological interventions such as exercise training and psychoeducation possess the potential of reducing sexual dysfunction in patients with heart disease. The CopenHeartSF trial will investigate the effect......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. 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

    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......, with 82% of participants being men. Of the participants, 37% participated in a rehabilitation program, and 21% were sedentary compared with 8% in the reference population (Pphysical exercise guidelines. Low physical activity was predicted by primary prevention...... indication (odds ratio [OR]=2.5; 95% confidence interval [CI], 1.3-4.7) and higher comorbidity (OR=2.1; 95% CI, 1.0-4.1; Pphysical activity was associated with increased mortality (OR=3.9; 95% CI, 1.11-13.71; Psex...

  6. A novel method for coral explant culture and micropropagation.

    Science.gov (United States)

    Vizel, Maya; Loya, Yossi; Downs, Craig A; Kramarsky-Winter, Esti

    2011-06-01

    We describe here a method for the micropropagation of coral that creates progeny from tissue explants derived from a single polyp or colonial corals. Coral tissue explants of various sizes (0.5-2.5 mm in diameter) were manually microdissected from the solitary coral Fungia granulosa. Explants could be maintained in an undeveloped state or induced to develop into polyps by manipulating environmental parameters such as light and temperature regimes, as well as substrate type. Fully developed polyps were able to be maintained for a long-term in a closed sea water system. Further, we demonstrate that mature explants are also amenable to this technique with the micropropagation of second-generation explants and their development into mature polyps. We thereby experimentally have established coral clonal lines that maintain their ability to differentiate without the need for chemical induction or genetic manipulation. The versatility of this method is also demonstrated through its application to two other coral species, the colonial corals Oculina patigonica and Favia favus.

  7. 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.

  8. Correlated response of in vitro regeneration capacity from different source of explants inCucumis melo.

    Science.gov (United States)

    Molina, R V; Nuez, F

    1995-01-01

    The variation among and within different populations of the regeneration ability from leaf, cotyledon and hypocotyl explants has been studied. A control population and two lines selected by their regeneration capacity from leaf explants were used. Significant differences among the plants of the control population,for the organogenic response, were detected. The regeneration capacity varies depending on the type of explant. Selection in order to improve the regeneration frequency from leaf explants also raises the organogenic response in the other explant types. This result suggests the presence of a partial common genetic system controlling the regeneration frequency of the diverse types of explants.

  9. High-dose lidocaine does not affect defibrillation efficacy: implications for defibrillation mechanisms.

    Science.gov (United States)

    Ujhelyi, M R; Sims, J J; Miller, A W

    1998-04-01

    This study assessed the effect of low (10 mg.kg-1.h-1) and very high (18 mg.kg-1.h-1) doses of lidocaine on defibrillation energy requirements (DER) to relate changes in indexes of sodium-channel blockade with changes in DER values using a dose-response study design. In group 1 (control; n = 6 pigs), DER values were determined at baseline and during treatment with 5% dextrose in water (D5W) and with D5W added to D5W. In group 2 (n = 7), DER values were determined at baseline and during treatment with low-dose lidocaine followed by high-dose lidocaine. In group 3 (n = 3), DER values were determined at baseline and high-dose lidocaine. Group 3 controlled for the order of lidocaine treatment with the addition of high-dose lidocaine after baseline. DER values in group 1 did not change during D5W. In group 2, low-dose lidocaine increased DER values by 51% (P = 0.01), whereas high-dose lidocaine added to low-dose lidocaine reduced DER values back to within 6% of baseline values (P = 0.02, low dose vs. high dose). DER values during high-dose lidocaine in group 3 also remained near baseline values (16.2 +/- 2.7 to 12.9 +/- 2.7 J), demonstrating that treatment order had no impact on group 2. Progressive sodium-channel blockade was evident as incremental reduction in ventricular conduction velocity as the lidocaine dose increased. Lidocaine also significantly increased ventricular fibrillation cycle length as the lidocaine dose increased. However, the greatest increase in DER occurred when ventricular fibrillation cycle length was minimally affected, demonstrating a negative correlation (P = 0.04). In summary, lidocaine has an inverted U-shaped DER dose-response curve. At very high lidocaine doses, DER values are similar to baseline and tend to decrease rather than increase. Increased refractoriness during ventricular fibrillation may be the electrophysiological mechanism by which high-dose lidocaine limits the adverse effects that low-dose lidocaine has on DER values

  10. Contact dermatitis after implantable cardiac defibrillator implantation for ventricular tachycardia.

    Science.gov (United States)

    Dogan, Pinar; Inci, Sinan; Kuyumcu, Mevlut Serdar; Kus, Ozgur

    2016-02-01

    Pacemaker contact sensitivity is a rare condition. Less than 30 reports of pacemaker skin reactions have been described. We report a 57-year-old woman who underwent an implantable cardiac defibrillator (ICD) implantation for ventricular tachycardia. A skin patch test was positive on almost all components of the pacemaker system. She was treated with topical corticosteroids and skin lesions resolved within 2 weeks. Because of widespread use of various devices, we will see this more often and therefore it is important to recognize this problem and its effective management.

  11. Long-term efficacy of implantable cardiac resynchronization therapy plus defibrillator for primary prevention of sudden cardiac death in patients with mild heart failure: an updated meta-analysis.

    Science.gov (United States)

    Sun, Wei-Ping; Li, Chun-Lei; Guo, Jin-Cheng; Zhang, Li-Xin; Liu, Ran; Zhang, Hai-Bin; Zhang, Ling

    2016-07-01

    Previous studies of implantable cardiac resynchronization therapy plus defibrillator (CRT-D) therapy used for primary prevention of sudden cardiac death have suggested that CRT-D therapy is less effective in patients with mild heart failure and a wide QRS complex. However, the long-term benefits are variable. We performed a meta-analysis of randomized trials identified in systematic searches of MEDLINE, EMBASE, and the Cochrane Database. Three studies (3858 patients) with a mean follow-up of 66 months were included. Overall, CRT-D therapy was associated with significantly lower all-cause mortality than was implantable cardioverter defibrillator (ICD) therapy (OR, 0.78; 95 % CI, 0.63-0.96; P = 0.02; I (2) = 19 %). However, the risk of cardiac mortality was comparable between two groups (OR, 0.74; 95 % CI, 0.53-1.01; P = 0.06). CRT-D treatment was associated with a significantly lower risk of hospitalization for heart failure (OR, 0.67; 95 % CI, 0.50-0.89; P = 0.005; I (2) = 55 %). The composite outcome of all-cause mortality and hospitalization for heart failure was also markedly lower with CRT-D therapy than with ICD treatment alone (OR, 0.67; 95 % CI, 0.57-0.77; P failure events in patients with mild heart failure with a wide QRS complex. However, long-term risk of cardiac mortality was similar between two groups. More randomized studies are needed to confirm these findings, especially in patients with NYHA class I heart failure or patients without LBBB.

  12. IN VITRO REGENERATION CASTOR (RICINUS COMMUNIS L.) USING COTYLEDON EXPLANTS

    Science.gov (United States)

    A novel plant regeneration protocol was established for castor (Ricinus communis L.), an important oilseed crop. Mature seed-derived cotyledon explants produced adventitious shoots when placed on Murashige and Skoog (MS) medium containing thidiazuron (TDZ). The rate of shoot regeneration was maximal...

  13. The Removal of Hydrogel Explants: An Analysis of 467 Consecutive Cases

    NARCIS (Netherlands)

    Crama, N.; Klevering, B.J.

    2016-01-01

    PURPOSE: To describe the complications associated with hydrogel explants and to describe the indications, surgical technique, and risks involved in the removal of a hydrogel explant. DESIGN: Single-center, retrospective interventional case series. PARTICIPANTS: Patients who underwent surgical remova

  14. Automated external defibrillators in the Australian fitness industry.

    Science.gov (United States)

    Norton, Kevin I; Norton, Lynda H

    2008-04-01

    Sudden cardiac arrest (SCA) occurs in many thousands of Australians each year. Scientific evidence shows an increased survival rate for individuals who receive electrical defibrillation in the first few minutes after SCA. In the last decade automated (rhythm-detecting) external defibrillators (AEDs) have become available that are portable and affordable. Although still relatively rare, there is still the potential that SCA may occur when a person undertakes physical activity. Consequently, health/fitness centres are increasingly recognised as higher risk sites that may benefit from placement of AEDs. There are no laws in Australia requiring health/fitness centres to install AEDs. However, several international and professional organisations have "strongly encouraged" larger centres to install AEDs. Guidelines and algorithms are presented to help estimate the risk of SCA in fitness centres. Fitness centre placement is particularly important if the clientele is older or has a 'high-risk' profile, for example, clients with cardiovascular, respiratory or metabolic disease. International negligence case law and duty of care principles suggests the standard of care required in health/fitness centres may be increasing. Therefore, it may be prudent to install AEDs in larger centres and those in which higher risk groups are physically active.

  15. 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

  16. 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.

  17. 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.

  18. 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...

  19. 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.

  20. 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.

  1. Optimizing a Drone Network to Deliver Automated External Defibrillators.

    Science.gov (United States)

    Boutilier, Justin J; Brooks, Steven C; Janmohamed, Alyf; Byers, Adam; Buick, Jason E; Zhan, Cathy; Schoellig, Angela P; Cheskes, Sheldon; Morrison, Laurie J; Chan, Timothy C Y

    2017-03-02

    Background -Public access defibrillation programs can improve survival after out-of-hospital cardiac arrest (OHCA), but automated external defibrillators (AEDs) are rarely available for bystander use at the scene. Drones are an emerging technology that can deliver an AED to the scene of an OHCA for bystander use. We hypothesize that a drone network designed with the aid of a mathematical model combining both optimization and queuing can reduce the time to AED arrival. Methods -We applied our model to 53,702 OHCAs that occurred in the eight regions of the Toronto Regional RescuNET between January 1st 2006 and December 31st 2014. Our primary analysis quantified the drone network size required to deliver an AED one, two, or three minutes faster than historical median 911 response times for each region independently. A secondary analysis quantified the reduction in drone resources required if RescuNET was treated as one large coordinated region. Results -The region-specific analysis determined that 81 bases and 100 drones would be required to deliver an AED ahead of median 911 response times by three minutes. In the most urban region, the 90th percentile of the AED arrival time was reduced by 6 minutes and 43 seconds relative to historical 911 response times in the region. In the most rural region, the 90th percentile was reduced by 10 minutes and 34 seconds. A single coordinated drone network across all regions required 39.5% fewer bases and 30.0% fewer drones to achieve similar AED delivery times. Conclusions -An optimized drone network designed with the aid of a novel mathematical model can substantially reduce the AED delivery time to an OHCA event.

  2. Public access defibrillators and fire extinguishers: are comparisons reasonable?

    Science.gov (United States)

    Mell, Howard K; Sayre, Michael R

    2008-01-01

    Sudden cardiac death is a major cause of mortality in the United States of America (Circulation 2008;117:e25-146) with approximately 310000 deaths related to coronary heart disease occurring in emergency departments or in the prehospital environment annually. Several organizations have directed resources toward the treatment of sudden cardiac arrest through a paradigm that has come to be known as the "chain of survival"-prompt activation of emergency response by telephone 911, early bystander cardiopulmonary resuscitation, early defibrillation, and timely advanced cardiac life support (Circulation 1991;83:1832-1847). The ready availability of automated external defibrillators (AEDs) has been advocated as a key component of this chain. Some authors have suggested a "fire extinguisher model" for AED deployment (Circulation 1998;98:2334-2351; Resuscitation 1995;30:151-156; Ann Intern Med 2001;135:990-998). In this model, AEDs are prominently displayed in public places for use by laypersons, much like fire extinguishers. For example, in Chicago's O'Hare Airport, AEDs are placed alongside fire extinguishers in the public concourse (N Engl J Med 2002;347:1242-1247). Advocates of this model suggest that advancing this practice would be a means to widely disbourse life-saving technology that is easy to use. Several experts have questioned this model, suggesting that the cost-effectiveness of distributing AEDs this widely would be prohibitive (BMJ 2002;325:515; Curr Opin Cardiol 2007;22:5-10; BMJ 2003;326:162; Int J Technol Assess Health Care 2007;23:362-367) and may not be more effective than more targeted distribution of AEDs. This literature review will examine the available data on both AEDs and fire extinguishers to determine if these comparisons are reasonable as a means of guiding public policy.

  3. 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.

  4. Usual interstitial pneumonia end-stage features from explants with radiologic and pathological correlations.

    Science.gov (United States)

    Rabeyrin, Maud; Thivolet, Françoise; Ferretti, Gilbert R; Chalabreysse, Lara; Jankowski, Adrien; Cottin, Vincent; Pison, Christophe; Cordier, Jean-François; Lantuejoul, Sylvie

    2015-08-01

    Idiopathic pulmonary fibrosis (IPF) is the most frequent and severe idiopathic interstitial pneumonia, with typical high-resolution computed tomography (HRCT) features and histologic pattern of usual interstitial pneumonia (UIP); its main differential diagnosis is fibrotic nonspecific interstitial pneumonia (F-NSIP). Usual interstitial pneumonia was mainly described from lung biopsies, and little is known on explants. Twenty-two UIP/IPF explants were analyzed histologically and compared with previous open lung biopsies (OLBs; n = 11) and HRCT (n = 19), when available. Temporospatial heterogeneity and subpleural and paraseptal fibrosis were similarly found in UIP/IPF explants and OLB (91%-95%). Fibroblastic foci were found in 82% of OLBs and 100% of explants, with a higher mean score in explants (P = .023). Honeycombing was present in 64% of OLBs and 95% of explants, with a higher mean score in explants (P = .005). Almost 60% of UIP/IPF explants showed NSIP areas and 41% peribronchiolar fibrosis; inflammation, bronchiolar metaplasia, and vascular changes were more frequent in UIP/IPF explants; and Desquamative Interstitial Pneumonia (DIP)-like areas were not common (18%-27%). Numerous large airspace enlargements with fibrosis were frequent in UIP/IPF explants (59%). On HRCT, honeycombing was observed in 95% of the cases and ground-glass opacities in 53%, correlating with NSIP areas or acute exacerbation at histology. Six patients had combined IPF and emphysema. Lesions were more severe in UIP/IPF explants, reflecting the worsening of the disease. Usual interstitial pneumonia/IPF explants more frequently presented with confounding lesions such as NSIP areas, peribronchiolar fibrosis, and airspace enlargements with fibrosis sometimes associated with emphysema.

  5. 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...... opacification, the findings were calcifications in 2 of the 3 lenses (66.6%) and proteins in 2 lenses (66.6%). Conclusions A marked variation in surface changes was observed by SEM. Findings did not correlate with cause for explantation. Scanning electron microscopy is a useful tool that provides exclusive...

  6. 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.

  7. 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.

  8. 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.

  9. Effect of Metoprolol Versus Carvedilol on Outcomes in MADIT-CRT (Multicenter Automatic Defibrillator Implantation Trial With Cardiac Resynchronization Therapy)

    DEFF Research Database (Denmark)

    Ruwald, Martin H; Ruwald, Anne-Christine H; Jøns, Christian;

    2013-01-01

    This study sought to compare the effects of metoprolol and carvedilol in the MADIT-CRT (Multicenter Automatic Defibrillator Implantation Trial With Cardiac Resynchronization Therapy) study.......This study sought to compare the effects of metoprolol and carvedilol in the MADIT-CRT (Multicenter Automatic Defibrillator Implantation Trial With Cardiac Resynchronization Therapy) study....

  10. 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.

  11. Virtual electrodes around anatomical structures and their roles in defibrillation

    Science.gov (United States)

    Vigmond, Edward; Bishop, Martin

    2017-01-01

    Background Virtual electrodes from structural/conductivity heterogeneities are known to elicit wavefront propagation, upon field-stimulation, and are thought to be important for defibrillation. In this work we investigate how the constitutive and geometrical parameters associated with such anatomical heterogeneities, represented by endo/epicardial surfaces and intramural surfaces in the form of blood-vessels, affect the virtual electrode patterns produced. Methods and results The steady-state bidomain model is used to obtain, using analytical and numerical methods, the virtual electrode patterns created around idealized endocardial trabeculations and blood-vessels. The virtual electrode pattern around blood-vessels is shown to be composed of two dominant effects; current traversing the vessel surface and conductivity heterogeneity from the fibre-architecture. The relative magnitudes of these two effects explain the swapping of the virtual electrode polarity observed, as a function of the vessel radius, and aid in the understanding of the virtual electrode patterns predicted by numerical bidomain modelling. The relatively high conductivity of blood, compared to myocardium, is shown to cause stronger depolarizations in the endocardial trabeculae grooves than the protrusions. Conclusions The results provide additional quantitative understanding of the virtual electrodes produced by small-scale ventricular anatomy, and highlight the importance of faithfully representing the physiology and the physics in the context of computational modelling of field stimulation. PMID:28253365

  12. [Training program on cardiopulmonary resuscitation with the use of automated external defibrillator in a university].

    Science.gov (United States)

    Boaventura, Ana Paula; Miyadahira, Ana Maria Kazue

    2012-03-01

    Early defibrillation in cardiopulmonary resuscitation (CPR) receives increasing emphasis on its priority and rapidity. This is an experience report about the implementation of a training program in CPR using a defibrillator in a private university. The training program in basic CPR maneuvers was based on global guidelines, including a theorical course with practical demonstration of CPR maneuvers with the defibrillator, individual practical training and theoretical and practical assessments. About the performance of students in the practical assessment the mean scores obtained by students in the first stage of the course was 26.4 points, while in the second stage the mean was 252.8 points, in the theoretical assessment the mean in the first stage was 3.06 points and in the second 9.0 points. The implementation of programs like this contribute to the effective acquisition of knowledge (theory) and skill (pratice) for the care of CPR victims.

  13. 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.

  14. Complex Tricuspid Valve Repair in Patients With Pacer Defibrillator-Related Tricuspid Regurgitation.

    Science.gov (United States)

    Raman, Jaishankar; Sugeng, Lissa; Lai, David T M; Jeevanandam, Valluvan

    2016-04-01

    Tricuspid valve regurgitation in patients with heart failure or in those undergoing complex cardiac operations is associated with increased morbidity and mortality. We report our results with a technique of repairing the tricuspid valves while retaining the pacer defibrillator lead. Patients had tricuspid valve repairs that included repositioning of the pacer defibrillator lead, approximation of septal and inferior/posterior leaflets in a modified cleft repair, and implantation of a tricuspid annuloplasty ring. This procedure was performed in more than 42 patients with good success.

  15. 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 exercise (42% vs. 0%), and with improved 30-day survival (69% vs. 15%, p=0.001). Among those presenting with a shockable rhythm, 20 (65%) had Return of Spontaneous Circulation upon arrival of EMS and 8 (26%) were conscious, which emphasizes the diagnostic value of ECG downloads from AEDs. Survival could...

  16. EXPLANTATION OF MESANGIAL CELL HILLOCKS - A METHOD FOR OBTAINING HUMAN MESANGIAL CELLS IN CULTURE

    NARCIS (Netherlands)

    MULLER, EW; KIM, Y; MICHAEL, AF; VERNIER, RL; VANDERHEM, GK; VANDERWOUDE, FJ

    1992-01-01

    A simple method is presented for selective cell culture of human mesangial cells using explanatation of mesangial cell hillocks. Glomeruli which had been incubated with collagenase were explanted on plastic tissue culture flasks. Three to 6 weeks after explantation, a rapidly growing multilayer of e

  17. 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...

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

    Directory of Open Access Journals (Sweden)

    Jan J. Rybczyński

    2011-01-01

    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. [The effect of Solcoseryl on explant cultures of the hippocampus].

    Science.gov (United States)

    Lindner, G; Grosse, G; Goworek, K; Franz, C; Liebezeit, K

    1979-01-01

    Explants of hippocampus from fetal rats were cultivated in Maximow chambers in semisynthetic medium up to 12 days in vitro. The cultures were fixed Bouin, slided 15 micron, coloured with Klüver-Barrera and some morphological parameters were tested. 1. The nerve fiber index increased by influence of 1% Solcoseryl in relation to control cultures, which growed in minimal medium. An essential stimulation was observed by application of placentar serum and embryonal extract into the culture medium. 2. Die decrease of the number of neurons and glial cells per unit of area and a small decrease of the area of neuron nuclei was discussed in relation to the effect of the pharmacon Solcoseryl on O2- consumption. 3. Solcoseryl (firm Solco AG, Base) is an extract of calf blood. It can not substitute other tissue extracts.

  20. 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.

  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. 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...

  3. 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 treatin...

  4. Overcoming Spatial and Temporal Barriers to Public Access Defibrillators Via Optimization

    NARCIS (Netherlands)

    Sun, Christopher L.F.; Demirtas, Derya; Brooks, Steven C.; Morrison, Laurie J.; Chan, Timothy C.Y.

    2016-01-01

    Background Immediate access to an automated external defibrillator (AED) increases the chance of survival for out-of-hospital cardiac arrest (OHCA). Current deployment usually considers spatial AED access, assuming AEDs are available 24 h a day. Objectives The goal of this study was to develop an o

  5. Comparison of the effects of removal of chest hair with not doing so before external defibrillation on transthoracic impedance.

    Science.gov (United States)

    Sado, Daniel M; Deakin, Charles D; Petley, Graham W; Clewlow, Frank

    2004-01-01

    Chest hair contributes significantly to transthoracic impedance (TTI) during defibrillation. The magnitude of this effect has not been established using external paddles. We compared TTI in 40 men before elective cardiac surgery, and before and after shaving their chests. Chest hair causes a significant increase in TTI during external defibrillation, the magnitude of the effect being related to both the quantity of hair and force applied to the defibrillation paddles. When the chests of nonhirsute patients were shaved, a decrease in TTI occurred, which was probably related to the creation of low-impedance pathways through skin abrasions.

  6. 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.

  7. 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.

  8. An ex vivo porcine nasal mucosa explants model to study MRSA colonization.

    Directory of Open Access Journals (Sweden)

    Pawel Tulinski

    Full Text Available Staphylococcus aureus is an opportunistic pathogen able to colonize the upper respiratory tract and skin surfaces in mammals. Methicillin-resistant S. aureus ST398 is prevalent in pigs in Europe and North America. However, the mechanism of successful pig colonization by MRSA ST398 is poorly understood. To study MRSA colonization in pigs, an ex vivo model consisting of porcine nasal mucosa explants cultured at an air-liquid interface was evaluated. In cultured mucosa explants from the surfaces of the ventral turbinates and septum of the pig nose no changes in cell morphology and viability were observed up to 72 h. MRSA colonization on the explants was evaluated followed for three MRSA ST398 isolates for 180 minutes. The explants were incubated with 3×10(8 CFU/ml in PBS for 2 h to allow bacteria to adhere to the explants surface. Next the explants were washed and in the first 30 minutes post adhering time, a decline in the number of CFU was observed for all MRSA. Subsequently, the isolates showed either: bacterial growth, no growth, or a further reduction in bacterial numbers. The MRSA were either localized as clusters between the cilia or as single bacteria on the cilia surface. No morphological changes in the epithelium layer were observed during the incubation with MRSA. We conclude that porcine nasal mucosa explants are a valuable ex vivo model to unravel the interaction of MRSA with nasal tissue.

  9. 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.

  10. 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.

  11. 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

  12. Enzymatic Cell Isolation and Explant Cultures of Rat Calvarial Osteoblast Cells

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    Osteoblast cells were isolated from the calvarial bones of newborn Wistar rats and cultured in vitro via both collagenase digestion method and explant technique, and a comparative study was carried out on the two culture methods. The biologic characteristics of tbs osteoblast cells were studied via cell number counting,morphology observation, alkaline phosphatase staining of the cells and alizarine- red staining of the calcified nodules. The results show that osteoblast cells can be cultured in vitro via collagenase digestion method and explant technique, and the obtained cells are of good biologic characteristics. In comparison with the explant techniqne,the operative procedure of the enzymatic digestion method is more complicated. The digestion time must be carefully controlled. However, with this method, one can obtain a lager number of cells in a short time. The operative procedure of the explant technique is simpler, but it usually takes longer time to obtain cells of desirable number.

  13. Callogenesis in stem explants of Eucalyptus grandis (Hill ex Maiden showing resilience in oxide calluses

    Directory of Open Access Journals (Sweden)

    Regina Paula Willemen Pereira

    Full Text Available Callogenesis was achieved using growth regulators at different concentrations to obtain the best characteristics regarding the calluses texture aspect with the main objective to produce friable calluses from stem explants of Eucalyptus grandis. Stem segments of approximately 1 cm were excised from 30-day seedlings. The treatments were prepared based on the MS medium added with TDZ alone or combined with AIA; 2,4-D; ANA. Each treatment consisted of five repetitions with five explants per plate. After 210 days of in vitro culture, the calluses were evaluated visually and by manipulation for texture. The explants that did not produce calluses were those exposed to treatments with 2,4-D 50.0 µM; TDZ 3.0 µM and in absence of a growth regulator (control.The best protocols for maintenance of friable calluses of stem explants of Eucalyptus grandis under the conditions performed in this work were those using only TDZ.

  14. In vitro direct shoot regeneration from proximal, middle and distal segment of Coleus forskohlii leaf explants

    OpenAIRE

    Krishna, Gaurav; P. Sairam Reddy; Anoop Nair, N.; P. W. Ramteke; Bhattacharya, P. S.

    2010-01-01

    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 supplem...

  15. An early look at the Organ Procurement and Transplantation Network explant pathology form data.

    Science.gov (United States)

    Harper, Ann M; Edwards, Erick; Washburn, W Kenneth; Heimbach, Julie

    2016-06-01

    In April 2012, the Organ Procurement and Transplantation Network (OPTN) implemented an online explant pathology form for recipients of liver transplantation who received additional wait-list priority for their diagnosis of hepatocellular carcinoma (HCC). The purpose of the form was to standardize the data being reported to the OPTN, which had been required since 2002 but were submitted to the OPTN in a variety of formats via facsimile. From April 2012 to December 2014, over 4500 explant forms were submitted, allowing for detailed analysis of the characteristics of the explanted livers. Data from the explant pathology forms were used to assess agreement with pretransplant imaging. Explant data were also used to assess the risk of recurrence. Of those with T2 priority, 55.7% were found to be stage T2 on explant. Extrahepatic spread (odds ratio [OR] = 6.8; P < 0.01), poor tumor differentiation (OR = 2.8; P < 0.01), microvascular invasion (OR = 2.6; P < 0.01), macrovascular invasion (OR = 3.2; P < 0.01), and whether the Milan stage based on the number and size of tumors on the explant form was T4 (OR = 2.4; P < 0.01) were the strongest predictors of recurrence. In conclusion, this analysis confirms earlier findings that showed an incomplete agreement between pretransplant imaging and posttransplant pathology in terms of HCC staging, though the number of patients with both no pretransplant treatment and no tumor in the explant was reduced from 20% to <1%. In addition, several factors were identified (eg, tumor burden, age, sex, region, ablative therapy, alpha-fetoprotein, Milan stage, vascular invasion, satellite lesions, etc.) that were predictive of HCC recurrence, allowing for more targeted surveillance of high-risk recipients. Continued evaluation of these data will help shape future guidelines or policy recommendations. Liver Transplantation 22 757-764 2016 AASLD.

  16. Harms and responsibilities associated with battery-operated implants (BOI): who controls postmortem explantation?

    Science.gov (United States)

    Bramstedt, Katrina A

    2013-01-01

    The postmortem issues raised by battery-operated implants (BOI) are complex and issues of consent, setting (clinical vs research), and environmental risks have received little attention in bioethics literature. Analyzing the issues, the following are argued: (1) Patients receiving BOIs should sign a consent form that includes a requirement for postmortem explant of the device; (2) BOI consent forms should require the explanted devices be returned to their manufacturers for Returned Product Analysis; (3) Failure to explant and analyze devices from the research setting fails the research goal of generation of knowledge for the benefit of future patients; (4) Failure to explant and analyze devices from the clinical setting allows product defects to be potentially hidden from patients, families, clinicians, manufacturers, and regulatory agencies; (5) Bodies buried with BOIs potentially harm the environment; (6) Religious or philosophical objections to autopsy should not supersede the duty to explant and analyze BOIs; (7) The concepts herein for BOIs could potentially extend to non-BOI if the device has failure modes that can lead to a potentially life-threatening event or can cause permanent debilitating health issues, and the burial or cremation of the device poses environmental harm. In these situations, neither the patient (premortem) nor family (postmortem) should have the right to refuse explant.

  17. In Vitro Spermatogenesis in Explanted Adult Mouse Testis Tissues.

    Science.gov (United States)

    Sato, Takuya; Katagiri, Kumiko; Kojima, Kazuaki; Komeya, Mitsuru; Yao, Masahiro; Ogawa, Takehiko

    2015-01-01

    Research on in vitro spermatogenesis is important for elucidating the spermatogenic mechanism. We previously developed an organ culture method which can support spermatogenesis from spermatogonial stem cells up to sperm formation using immature mouse testis tissues. In this study, we examined whether it is also applicable to mature testis tissues of adult mice. We used two lines of transgenic mice, Acrosin-GFP and Gsg2-GFP, which carry the marker GFP gene specific for meiotic and haploid cells, respectively. Testis tissue fragments of adult GFP mice, aged from 4 to 29 weeks old, which express GFP at full extension, were cultured in medium supplemented with 10% KSR or AlbuMAX. GFP expression decreased rapidly and became the lowest at 7 to 14 days of culture, but then slightly increased during the following culture period. This increase reflected de novo spermatogenesis, confirmed by BrdU labeling in spermatocytes and spermatids. We also used vitamin A-deficient mice, whose testes contain only spermatogonia. The testes of those mice at 13-21 weeks old, showing no GFP expression at explantation, gained GFP expression during culturing, and spermatogenesis was confirmed histologically. In addition, the adult testis tissues of Sl/Sld mutant mice, which lack spermatogenesis due to Kit ligand mutation, were cultured with recombinant Kit ligand to induce spermatogenesis up to haploid formation. Although the efficiency of spermatogenesis was lower than that of pup, present results showed that the organ culture method is effective for the culturing of mature adult mouse testis tissue, demonstrated by the induction of spermatogenesis from spermatogonia to haploid cells.

  18. Comparison of mechanism of break up and cycle length in defibrillation success

    Science.gov (United States)

    Melkus, Natalya; Puwal, Steffan

    2012-10-01

    Heart fibrillation is an often fatal condition which can be modeled by chaotic electrical activity; spiral waves of electrical activity rotate, break-up, and meander on tissue. As they do, they produce a chaotic distribution of electrical activity, negatively affecting physical contraction (blood pumping). Fenton, et al. studied several mechanisms of this wave breakup, including ``far from tip'' and ``Doppler shift.'' We used Fenton et al.'s mathematical model and the different modes of breakup proposed by Fenton to simulate fibrillation and to determine if the cycle length of the activity or the type of mechanism was more significant in defibrillation. Our data supports the conclusion that the cycle length is the more important factor in defibrillation.

  19. [Interferences and cardiac pacemakers--defibrillators. Results of in vivo experiments and radio frequencies].

    Science.gov (United States)

    Trigano, J A

    2003-04-01

    Interference with cardiac pacemakers and defibrillators by cellular phone and electronic article surveillance systems is shown in experimental studies with disparate findings. Interaction occurrence in real life is a convincing but rare experience. Device model, distance, power output and technology of the source are different and sometimes uncontrollable factors. As a result it remains difficult to quantify the true incidence of interaction and associated health risk. Nevertheless, simple recommendations commonly help the patients to prevent the interference.

  20. Preparation of Cellulose Nanofibrils from Bamboo Pulp by Mechanical Defibrillation for Their Applications in Biodegradable Composites.

    Science.gov (United States)

    Guimarães, Mario; Botaro, Vagner Roberto; Novack, Kátia Monteiro; Neto, Wilson Pires Flauzino; Mendes, Lourival Marin; Tonoli, Gustavo H D

    2015-09-01

    There is a growing interest in cellulose nanofibrils from renewable sources for various industrial applications. However, there is a lack of information on cellulose arising from bamboo pulps. Nanofibrils from refined bamboo pulps, including bleached, unbleached, and unrefined/unbleached, were obtained by mechanical defibrillation for use in biodegradable composites. The influence of industrial processes, such as pulping and refining of unbleached pulps, as well as of alkali pretreatments and bleaching of refined pulps, on the chemical composition of the samples was analyzed. Morphological, structural, thermal, optical and viscometric properties were investigated as a function of the number of passages of refined/bleached suspensions through a defibrillator. For the unbleached suspensions, the effects of refining and bleaching on the properties of nanofibrils were evaluated, fixing the number of passages through the defibrillator. Microscopic studies demonstrated that nanoscale cellulose fibers were obtained from both pulps, with a higher yield for the refined/bleached and refined/unbleached pulp, at the expense of the unbleached/unrefined pulps. The study showed that, in addition to the effectiveness of the pre-treatments, there was an increase in the production efficiency of nanofibrils, as well as in the transparency of the bleached suspensions, while viscosity, thermal stability and crystallinity had reduced levels as the number of passages through the defibrillator increased, showing a gradual improvement in the transition from the micro- to the nano-scale. The present study contributed to the different methods that are available for the production of bamboo cellulose nanofibrils, which can be used in the production of biodegradable composites for various applications.

  1. Efficient culture protocol for plant regeneration from cotyledonary petiole explants of Jatropha curcas L.

    Directory of Open Access Journals (Sweden)

    Ying Liu

    2016-09-01

    Full Text Available A high-frequency and reproducible protocol for induction of adventitious shoot buds and plant regeneration from cotyledonary petiole explants of Jatropha curcas L. has been developed. The cotyledonary petiole explants of J. curcas cultured directly on medium supplemented with thidiazuron (TDZ induce regeneration of poor quality shoot buds that have a low regeneration frequency. However, treating the explants with high concentrations (10–60 mg/L of TDZ solution for certain time periods (5–80 min significantly increased the regeneration frequency and improved the quality of the regenerated shoot buds. The best shoot buds induction (88.42% and number of shoot buds (12.67 per explant were observed when in vitro explants were treated with 20 mg/L TDZ solution for 20 min before being transferred on hormone-free medium after 30 days. Regeneration was also influenced by the orientation (horizontal or vertical of the explants on the medium, and by the origin of the cotyledonary petioles (in vitro or in vivo used for the preparation of explants. We performed subsequent experiments for elongation and rooting of the regenerated shoot buds. Addition of L-arginine to the medium was conducive to the elongation of the shoot buds. A concentration of 7.5 mg/L L-arginine yielded the best results. The elongated shoots could initiate roots to become intact plantlets in half-strength Murashige and Skoog medium containing 0.1 mg/L indole-3-butyric acid. After acclimatization, these plantlets could be transplanted to the soil and the growth was normal. Therefore, application of the methods described here helped to increase plant regeneration efficiency.

  2. 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.

  3. Reactivation of HSV-1 following explant of tree shrew brain.

    Science.gov (United States)

    Li, Lihong; Li, Zhuoran; Li, Xin; Wang, Erlin; Lang, Fengchao; Xia, Yujie; Fraser, Nigel W; Gao, Feng; Zhou, Jumin

    2016-06-01

    Herpes Simplex Virus type I (HSV-1) latently infects peripheral nervous system (PNS) sensory neurons, and its reactivation leads to recurring cold sores. The reactivated HSV-1 can travel retrograde from the PNS into the central nervous system (CNS) and is known to be causative of Herpes Simplex viral encephalitis. HSV-1 infection in the PNS is well documented, but little is known on the fate of HSV-1 once it enters the CNS. In the murine model, HSV-1 genome persists in the CNS once infected through an ocular route. To gain more details of HSV-1 infection in the CNS, we characterized HSV-1 infection of the tree shrew (Tupaia belangeri chinensis) brain following ocular inoculation. Here, we report that HSV-1 enters the tree shrew brain following ocular inoculation and HSV-1 transcripts, ICP0, ICP4, and LAT can be detected at 5 days post-infection (p.i.), peaking at 10 days p.i. After 2 weeks, ICP4 and ICP0 transcripts are reduced to a basal level, but the LAT intron region continues to be expressed. Live virus could be recovered from the olfactory bulb and brain stem tissue. Viral proteins could be detected using anti-HSV-1 antibodies and anti-ICP4 antibody, during the acute stage but not beyond. In situ hybridization could detect LAT during acute infection in most brain regions and in olfactory bulb and brain stem tissue well beyond the acute stage. Using a homogenate from these tissues' post-acute infection, we did not recover live HSV-1 virus, supporting a latent infection, but using a modified explant cocultivation technique, we were able to recover reactivated virus from these tissues, suggesting that the HSV-1 virus latently infects the tree shrew CNS. Compared to mouse, the CNS acute infection of the tree shrew is delayed and the olfactory bulb contains most latent virus. During the acute stage, a portion of the infected tree shrews exhibit symptoms similar to human viral encephalitis. These findings, together with the fact that tree shrews are closely

  4. 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

  5. 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

  6. Ex Vivo Produced Oral Mucosa Equivalent by Using the Direct Explant Cell Culture Technique

    Directory of Open Access Journals (Sweden)

    Kamile Öztürk

    2012-09-01

    Full Text Available Objective: The aim of this study is the histological and immunohistochemical evaluation of ex vivo produced oral mucosal equivalents using keratinocytes cultured by direct explant technique.Material and Methods: Oral mucosa tissue samples were obtained from the keratinized gingival tissues of 14 healthy human subjects. Human oral mucosa keratinocytes from an oral mucosa biopsy specimen were dissociated by the explant technique. Once a sufficient population of keratinocytes was reached, they were seeded onto the type IV collagen coated “AlloDerm” and taken for histological and immunohistochemical examinations at 11 days postseeding of the keratinocytes on the cadaveric human dermal matrix.Results: Histopathologically and immunohistochemically, 12 out of 14 successful ex vivo produced oral mucosa equivalents (EVPOME that consisted of a stratified epidermis on a dermal matrix have been developed with keratinocytes cultured by the explant technique.Conclusion: The technical handling involved in the direct explant method at the beginning of the process has fewer steps than the enzymatic method and use of the direct explant technique protocol for culturing of human oral mucosa keratinocyte may be more adequate for EVPOME production.

  7. In vitro assessment of the soft tissue/implant interface using porcine gingival explants.

    Science.gov (United States)

    Abdulmajeed, Aous A; Willberg, Jaana; Syrjänen, Stina; Vallittu, Pekka K; Närhi, Timo O

    2015-01-01

    The biologic seal of peri-implant soft tissue is crucial for long-term prognosis of oral implants. This in vitro study describes a novel tissue culture model using porcine gingival explants to evaluate the soft tissue/implant interface. Two different types of substrates were investigated: (a) plain polymer: BisGMA-TEGDMA (50-50 %) and (b) unidirectional fiber-reinforced composite (FRC). Porcine gingival explants were obtained from a local slaughterhouse. The experimental implants (n = 4) were inserted into the middle of freshly excised porcine gingival explants and cultured at the air/liquid interface up to 14 days. Porcine gingival explants with no implants served as baseline controls. The specimens were fixed and processed for the preparation of undecalcified samples. Histological analysis of the soft tissue/implant interface was carried out using a light-microscope. Microscopic evaluation suggests that the gingival explants established epithelial and connective tissue attachment to both implant types over the incubation period. FRC surfaces seemed to have a favorable tissue response with a sign of an outward epithelial migration. However, tissue degeneration was observed at the end of the experiment. In conclusion, this in vitro model maintains mucosal viability and ability to histologically evaluate soft tissue attachment to biomaterials rendering it a time efficient and cost effective model that may reduce the need for animal experiments.

  8. Development of a murine ocular posterior segment explant culture for the study of intravitreous vector delivery.

    Science.gov (United States)

    Denk, Nora; Misra, Vikram; Sandmeyer, Lynne S; Bauer, Bianca B; Singh, Jaswant; Forsyth, George W; Grahn, Bruce H

    2015-01-01

    The objective of this study was to develop a murine retinal/choroidal/scleral explant culture system to facilitate the intravitreous delivery of vectors. Posterior segment explants from adult mice of 2 different age groups (4 wk and 15 wk) were cultured in serum-free medium for variable time periods. Tissue viability was assessed by gross morphology, cell survival quantification, activated caspase-3 expression, and immunohistochemistry. To model ocular gene therapy, explants were exposed to varying transducing units of a lentiviral vector expressing the gene for green fluorescent protein for 48 h. Explant retinal cells remained viable for approximately 1 wk, although the ganglion cell layer developed apoptosis between 4 and 7 d. Following vector infusion into the posterior segment cups, viral transduction was noted in multiple retinal layers in both age groups. An age of donor mouse influence was noted and older mice did not transduce as well as younger mice. This explant offers an easily managed posterior segment ocular culture with minimum disturbance of the tissue, and may be useful for investigating methods of enhancing retinal gene therapy under controlled conditions.

  9. Effects of the re-innervation of organotypic skin explants on the epidermis.

    Science.gov (United States)

    Lebonvallet, Nicolas; Boulais, Nicholas; Le Gall, Christelle; Pereira, Ulysse; Gauché, Dominique; Gobin, Eric; Pers, Jacques-Olivier; Jeanmaire, Christine; Danoux, Louis; Pauly, Gilles; Misery, Laurent

    2012-02-01

    The nervous system takes part in skin homeostasis and interacts with skin cells. In in vitro organotypic skin models, these interactions are lost owing to the absence of nerve endings. We have developed an in vitro organotypic skin model based on a re-innervated human skin explant using primary sensory neurons from the dorsal root ganglia of rats. After 10 days of co-culture between skin explant and neurons, a dense network of nerve fibres was observed. The epidermis and dermis presented nerve fibres associated with cellular body from sensory neurons introduced in the co-culture. Epidermal thickness, cell density and quality of re-innervated skin explant were all higher when skin explants were re-innervated by sensory neurons at 10 days of culture. Proliferation of epidermal cell was not modified, but the apoptosis was significantly diminished. Hence, this innovative model of co-cultured skin explants and neurons allows better epidermal integrity and could be useful for studies concerning interactions between the skin and its peripheral nervous system.

  10. 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...

  11. Registry of Malignant Arrhythmias and Sudden Cardiac Death - Influence of Diagnostics and Interventions

    Science.gov (United States)

    2016-11-30

    Ventricular Tachycardia; Ventricular Fibrillation; Sudden Cardiac Death; Coronary Angiography; Electrophysiologic Testing (EP); Catheter Ablation; Percutaneous Coronary Intervention (PCI); Internal Cardioverter Defibrillator (ICD)

  12. Heart attack

    Science.gov (United States)

    ... Saunders; 2014:chap 51. Read More Arrhythmias Cardiogenic shock Diabetes Hardening of the arteries Heart failure - overview High blood pressure Implantable cardioverter-defibrillator Lipoprotein- ...

  13. 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.

  14. Complications after cardiac implantable electronic device implantations

    DEFF Research Database (Denmark)

    Kirkfeldt, Rikke Esberg; Johansen, Jens Brock; Nohr, Ellen Aagaard;

    2014-01-01

    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...

  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. In vitro organogenesis and somatic embryogenesis from leaf explants of Leucosceptrum canum sm.

    Science.gov (United States)

    Pal, A; Banerjee, A; Dhar, K

    1985-10-01

    Plantlets were obtained from leaf explants of a Labiatae tree - Leucosceptrum canum Sm. using plant tissue culture techniques. Two types of calli proliferated from the leaf explants when grown on different media, one of which was amenable to somatic embryogenesis. Differentiation of the embryoids started from the fourth passage of culture and continued up to the seventh passage. The number of embryoids decreased with the age of the callus. The capacity of such embryoids to form entire plantlets was studied using different nutrient mileux. Embryoids formed plantlets on Murashige and Skoog's (MS) medium fortified with benzylaminopurine plus indolebutyric acid. Organogenesis was observed in shoot-buds derived from explants of in vitro regenerated plantlets on MS basal medium supplemented with benzylaminopurine. Culture regenerated plantlets were transferred to MS medium without sucrose and growth hormones; finally transferred to pots containing sterile vermiculite where they are growing.

  17. Micropropagation of Araucaria excelsa R. Br. var. glauca Carrière from orthotropic stem explants.

    Science.gov (United States)

    Sarmast, Mostafa Khoshhal; Salehi, Hassan; Khosh-Khui, Morteza

    2012-07-01

    The objectives of the present work were in vitro propagation of Araucaria excelsa R. Br. var. glauca Carrière (Norfolk Island pine) with focus on the evaluation of the mean number of shoots per explant (MNS/E) and mean length of shoots per explants (MLS/E) produced by different parts of the orthotropic stem of A. excelsa R. Br. var. glauca in response to plant growth regulators. Norfolk Island pine axillary meristems responded very well to the 2-iso-pentenyl adenine (2iP) and thidiazuron (TDZ) levels. Explants taken from stem upper segments in the media containing 2iP had a higher MNS/E (3.47) and MLS/E (6.27 mm) in comparison to those taken from stem lower segments, which were 0.71 and 0.51 mm, respectively. Using 0.045 μM TDZ in the MS medium not only resulted in 4.60 MNS/E with 7.08 mm MLS/E but proliferated shoots showed a good performance as well. Investigating the best position of stem explant on mother plant as well as the best concentrations of growth regulators were performed which were useful for efficient micropropagation of this plant. Thirty three percent of explants were rooted in the MS medium containing 3 % sucrose, supplemented with 7.5 μM of both NAA and IBA for 2 weeks before transferring to a half strength MS medium without any growth regulator. Plantlets obtained were acclimatized and transferred to the greenhouse with less than 20 % mortality. This procedure considered the first successful report for regeneration and acclimatization of A. excelsa R. Br. var. glauca plantlet through main stem explants.

  18. 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.

  19. 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...

  20. 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.

  1. In vitro white spot syndrome virus (WSSV) replication in explants of the heart of freshwater crab, Paratelphusa hydrodomous.

    Science.gov (United States)

    Nathiga Nambi, K S; Abdul Majeed, S; Sundar Raj, N; Taju, G; Madan, N; Vimal, S; Sahul Hameed, A S

    2012-08-01

    Explants from different organs of freshwater crab, Paratelphusa hydrodomous were prepared to establish an in vitro system for replication of white spot syndrome virus (WSSV) of shrimp. Heart explants were maintained for 53 days without any morphological changes in EX-CELL™ 405 medium with and without serum whereas the explants of eye muscle, gill, shell membrane and appendage muscle died within 15 days of culture period. The heart explants on different days of culture were exposed to WSSV for 10 days to study the viral replication. The infection of WSSV in explants of the heart was confirmed by PCR, RT-PCR, Western blot, histology, immunohistochemistry, bioassay and transmission electron microscopy. The WSSV was quantified by real-time PCR and indirect ELISA. The WSSV inoculum prepared from the heart explants of crab caused significant mortality in Penaeus monodon in challenge experiments and the results indicate that the WSSV which replicated in the heart explants of freshwater crab maintains its infectivity as in marine shrimp. The results indicate that the heart explants of P. hydrodomous would be a good alternative to whole animals for production of WSSV.

  2. Low-intensity pulsed ultrasound (LIPUS) and pulsed electromagnetic field (PEMF) treatments affect degeneration of cultured articular cartilage explants

    NARCIS (Netherlands)

    Tan, Lijun; Ren, Yijin; Kooten, van Theo G.; Grijpma, Dirk W.; Kuijer, Roel

    2015-01-01

    Purpose: Articular cartilage has some capacity for self-repair. Clinically used low-intensity pulsed ultrasound (LIPUS) and pulsed electromagnetic field (PEMF) treatments were compared in their potency to prevent degeneration using an explant model of porcine cartilage. Methods: Explants of porcine

  3. A qualitative study to identify barriers to deployment and student training in the use of automated external defibrillators in schools

    DEFF Research Database (Denmark)

    Zinckernagel, Line; Hansen, Carolina Malta; Rod, Morten Hulvej;

    2017-01-01

    participants, nine school leaders, and 16 teachers at eight different secondary schools in Denmark (2012-2013). Thematic analysis was used to identify regular patterns of meaning using the technology acceptance model and focusing on the concepts of perceived usefulness and perceived ease of use. RESULTS...... is suitable for defibrillator training. They were also ambiguous about deployment of defibrillators at schools. Those only accounting for the risk of students, considering their schools to be small, and that time for professional help was limited, found the relevance to be low. Due to safety concerns, some...

  4. Displacement of death in public space by lay people using the automated external defibrillator.

    Science.gov (United States)

    Timmons, Stephen; Crosbie, Brian; Harrison-Paul, Russell

    2010-03-01

    This paper reports on a study where a technology, the Automated External Defibrillator (AED), enables a socially troubling death in public space to be moved to a more acceptable location. This was a qualitative study, using semi-structured interviews with lay (non-medical) people, in a variety of locations, who had been trained to use an AED. The AED, and its use by lay people, means that the time and place of death from heart attack can be changed from a location like a railway station or shopping centre to the ambulance or hospital. Thus the lay people involved can act as what Timmermans (1999) terms 'death brokers'.

  5. 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.

  6. 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

  7. 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.

  8. 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.

  9. 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. ...

  10. 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.

  11. 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.

  12. Investigating the Skoog-Miller Model for Organogenesis Using Sweet Potato Root Explants.

    Science.gov (United States)

    Delany, William; And Others

    1994-01-01

    Describes an experiment in which groups of students in a plant tissue culture course worked together to test application of the Skoog-Miller model (developed by Skoog and Miller in regeneration of tobacco experiments to demonstrate organogenesis) to sweet potato root explants. (ZWH)

  13. In vitro regeneration of Centaurium erythraea Rafn from shoot tips and other seedling explants

    Directory of Open Access Journals (Sweden)

    Ewelina Piątczak

    2011-01-01

    Full Text Available Various explants from 30-day-old seedlings of Centaurium erythraea Rafn were evaluated for their morphogenetic capacity under in vitro culture conditions. Shoot formation from shoot tip explants was achieved mainly through adventitious bud differentiation. The highest number of shoots (up to 43.3 ± 2.2 from a single shoot tip was obtained on Murashige and Skoog medium (MS supplemented with indole-3-acetic acid (IAA (0.57 μM and 6-benzylaminopurine (BAP (4.4 μM. Adventitious shoot regeneration was also achieved through organogenesis from calluses obtained from hypocotyls, cotyledons, roots and leaves on MS medium containing IAA (2.85 μM and BAP (0.88 μM. Significant differences were noted between explant types in their effects on shoot regeneration. In the primary culture, the best response was obtained either from calluses derived from roots or leaves (44.4 ± 4.5 and 40.2 ± 6.0 shoots per callus, respectively. The number of subcultures of inoculated calluses affected both the multiplication rate (the number of shoots/explant and shoot morphology (the frequency of shoot hyperhydricity. Shoots rooted with the frequency of 94-100% after culture on MS medium without growth regulators. Plantlets were successfully acclimatized (97% under high relative humidity and then moved to the greenhouse.

  14. Explant culture of human peripheral lung. I. Metabolism of benzo[alpha]pyrene

    DEFF Research Database (Denmark)

    Stoner, G.D.; Harris, C.C.; Autrup, Herman

    1978-01-01

    Human lung explants have been maintained in vitro for a period of 25 days. Autoradiographic studies indicated that the broncholar epithelial cells, type 2 alveolar epithelial cells, and stromal fibroblasts incorporated 3H-thymidine during the culture. After 7 to 10 days, type 2 cells were the pre...

  15. 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.

  16. 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

    . 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...

  17. Induction of in vitro shoots of Billbergia euphemiae E. Morren (Bromeliaceae from leaf explants

    Directory of Open Access Journals (Sweden)

    Mariela Justiniano Simão

    2016-10-01

    Full Text Available Bromeliads are an important group for the maintenance of the Atlantic Forest, with many threatened species due to exacerbated extraction and destruction of their natural habitats. Considering the need of developing protocols for the conservation of these species, the aim of this work was to evaluate the effect of different growth regulators in the in vitro induction of shoots of Billbergia euphemiae. Leaf explants were excised from seedlings derived from in vitro germination and grown on MS medium supplemented with NAA (0, 1 or 2 μM and BA (0, 2, 4 or 6 μM combinations. The evaluation of the number of shoots per explant, shoot length, number of leaves per shoot and longest leaf length average was carried out after 30 and 60 days of culture. The best in vitro responses were observed in the presence of 1 μM NAA after 60 days of culture, which induced the best production of shoots per explant (16.39, as well as the highest rates of shoot length (1.08 cm, number of leaves per shoot (5.00 and the longest leaf length (0.56 cm. This work determined the best conditions for shoot production from leaf explants of B. euphemiae, being the first report on micropropagation of this species.

  18. 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.

  19. Detection of basal and potassium-evoked acetylcholine release from embryonic DRG explants.

    Science.gov (United States)

    Bernardini, Nadia; Tomassy, Giulio Srubek; Tata, Ada Maria; Augusti-Tocco, Gabriella; Biagioni, Stefano

    2004-03-01

    Spontaneous and potassium-induced acetylcholine release from embryonic (E12 and E18) chick dorsal root ganglia explants at 3 and 7 days in culture was investigated using a chemiluminescent procedure. A basal release ranging from 2.4 to 13.8 pm/ganglion/5 min was detected. Potassium application always induced a significant increase over the basal release. The acetylcholine levels measured in E12 explants were 6.3 and 38.4 pm/ganglion/5 min at 3 and 7 days in culture, respectively, while in E18 explant cultures they were 10.7 and 15.5 pm/ganglion/5 min. In experiments performed in the absence of extracellular Ca2+ ions, acetylcholine release, both basal and potassium-induced, was abolished and it was reduced by cholinergic antagonists. A morphometric analysis of explant fibre length suggested that acetylcholine release was directly correlated to neurite extension. Moreover, treatment of E12 dorsal root ganglion-dissociated cell cultures with carbachol as cholinergic receptor agonist was shown to induce a higher neurite outgrowth compared with untreated cultures. The concomitant treatment with carbachol and the antagonists at muscarinic receptors atropine and at nicotinic receptors mecamylamine counteracted the increase in fibre outgrowth. Although the present data have not established whether acetylcholine is released by neurones or glial cells, these observations provide the first evidence of a regulated release of acetylcholine in dorsal root ganglia.

  20. Culture of human adipose tissue explants leads to profound alteration of adipocyte gene expression.

    Science.gov (United States)

    Gesta, S; Lolmède, K; Daviaud, D; Berlan, M; Bouloumié, A; Lafontan, M; Valet, P; Saulnier-Blache, J S

    2003-03-01

    Primary culture of adipose tissue has often been used to investigate pharmacological and nutritional regulation of adipocyte gene expression. Possible alteration of adipocyte gene expression by primary culture on its own has not been explored in detail. In order to address this issue, explants were prepared from human subcutaneous adipose tissue recovered from plastic surgery and maintained for 0 to 48 h in DMEM supplemented with 10 % serum. At different time points, adipocytes were isolated from the explants by collagenase digestion, and mRNA expression and lipolysis were studied. Culture was associated with an accumulation of tumor necrosis factor-alpha (TNFalpha) in the culture medium, an increase in anaerobic glycolysis, and an increase in the basal lipolysis. In parallel, a rapid and dramatic decrease in the level of mRNA encoding for several adipocyte-specific proteins such as adipocyte lipid-binding protein, hormone-sensitive lipase, lipoprotein lipase, and peroxisome proliferation activating receptor-gamma2 was observed in isolated adipocytes. These downregulations were reminiscent of a dedifferentiation process. In parallel, primary culture was associated with an increase in adipocyte beta-actin, TNFalpha, glucose transporter-1 and hypoxia-induced factor-1alpha mRNAs. Treatment of explants with agents that increase cAMP (isobutylmethylxanthine and forskolin) prevented TNFalpha production and expression and culture-induced alterations of adipocyte gene expression. These data show that primary culture of human adipose tissue explants dramatically alters adipocyte gene expression.

  1. 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.

  2. 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.

  3. Increased angiogenic response in aortic explants of collagen XVIII/endostatin-null mice.

    Science.gov (United States)

    Li, Qing; Olsen, Bjorn R

    2004-08-01

    Endostatin, a proteolytic fragment of basement membrane-associated collagen XVIII, has been shown to be a potent angiogenesis inhibitor both in vivo and in vitro when given at high concentrations. The precise molecular mechanisms by which it functions and whether or not it plays a role in physiological regulation of angiogenesis are not clear. In mice with targeted null alleles of Col18a1, there appears to be no major abnormality in vascular patterns or capillary density in most organs. Furthermore, the growth of experimental tumors is not increased. However, a detailed analysis of induced angiogenesis in these mice has not been performed. Therefore, we compared the angiogenic responses induced by in vitro culture of aortic explants from collagen XVIII/endostatin-null mice (ko) to wild-type (wt) littermates. We found a twofold increase in microvessel outgrowth in explants from ko mice, relative to wt explants. This increased angiogenesis was reduced to the wt level by the addition of low levels (0.1 microg/ml) of recombinant mouse or human endostatin during the culture period. To address cellular/molecular mechanisms underlying this difference in angiogenic response between ko and wt mice, we isolated endothelial cells from both strains and compared their biological behavior. Proliferation assays showed no difference between the two types of endothelial cells. In contrast, adhesion assays showed a striking difference in their ability to adhere to fibronectin suggesting that collagen XVIII/endostatin may regulate interactions between endothelial cells and underlying basement membrane-associated components, including fibronectin, such that in the absence of collagen XVIII/endostatin, endothelial cells are more adhesive to fibronectin. In the aortic explant assay, characterized by dynamic processes of microvessel elongation and regression, this may result in stabilization of newly formed vessels, reduced regression, and a net increase in microvessel outgrowth in

  4. Dissection and culture of mouse dopaminergic and striatal explants in three-dimensional collagen matrix assays.

    Science.gov (United States)

    Schmidt, Ewoud R E; Morello, Francesca; Pasterkamp, R Jeroen

    2012-03-23

    Midbrain dopamine (mdDA) neurons project via the medial forebrain bundle towards several areas in the telencephalon, including the striatum(1). Reciprocally, medium spiny neurons in the striatum that give rise to the striatonigral (direct) pathway innervate the substantia nigra(2). The development of these axon tracts is dependent upon the combinatorial actions of a plethora of axon growth and guidance cues including molecules that are released by neurites or by (intermediate) target regions(3,4). These soluble factors can be studied in vitro by culturing mdDA and/or striatal explants in a collagen matrix which provides a three-dimensional substrate for the axons mimicking the extracellular environment. In addition, the collagen matrix allows for the formation of relatively stable gradients of proteins released by other explants or cells placed in the vicinity (e.g. see references 5 and 6). Here we describe methods for the purification of rat tail collagen, microdissection of dopaminergic and striatal explants, their culture in collagen gels and subsequent immunohistochemical and quantitative analysis. First, the brains of E14.5 mouse embryos are isolated and dopaminergic and striatal explants are microdissected. These explants are then (co)cultured in collagen gels on coverslips for 48 to 72 hours in vitro. Subsequently, axonal projections are visualized using neuronal markers (e.g. tyrosine hydroxylase, DARPP32, or βIII tubulin) and axon growth and attractive or repulsive axon responses are quantified. This neuronal preparation is a useful tool for in vitro studies of the cellular and molecular mechanisms of mesostriatal and striatonigral axon growth and guidance during development. Using this assay, it is also possible to assess other (intermediate) targets for dopaminergic and striatal axons or to test specific molecular cues.

  5. Autonomic boundary conditions for ventricular fibrillation and their implications for a novel defibrillation technique.

    Science.gov (United States)

    Naggar, Isaac; Uchida, Sae; Kamran, Haroon; Lazar, Jason; Stewart, Mark

    2012-11-01

    The sympathetic and parasympathetic divisions of the autonomic nervous system modulate cardiac rhythm and the probability of arrhythmia occurrence. Both increased sympathetic drive and hypoxia increase the likelihood for ventricular fibrillation (VF). Vagus nerve stimulation (VNS) can protect from fatal arrhythmias via cholinergic and nitrergic action. We sought to determine boundary conditions for VF and defibrillation by autonomic manipulations accompanied or not by hypoxic changes in urethane-anesthetized rats. VF was induced with (1) vagotomy, (2) systemic high-dose (>15 mg/kg) isoproterenol, and (3) hypoxemia. When VNS (50 Hz) produced cardiac standstill, it converted every VF episode (59/59). A nitric oxide synthase inhibitor did not reduce VNS efficacy (13/14 episodes converted), but addition of atropine reduced VNS efficacy (11/27 episodes converted). VF can be induced by autonomic derangements only under constrained conditions, including sympathetic over-activation, reduced parasympathetic input, and hypoxemia. VNS can provide an alternative method to defibrillate via its cholinergic action.

  6. [Recurrent refractory ventricular fibrillation: how many times is it necessary to defibrillate?].

    Science.gov (United States)

    Moreno-Millán, E; Castarnado-Calvo, M; Moreno-Cano, S; Pozuelo-Pozuelo, S

    2010-04-01

    Recurrent ventricular fibrillation is that which persists after three consecutive defibrillation attempts. It generally appears in almost 25% of all heart arrests and entails high mortality. Use of amiodarone during resuscitation maneuvers is recommended, this having better results than lidocaine. Neither procainamide nor bretylium should be used in this type of arrhythmia, however beta blockers or magnesium can be used when ischemic heart disease or hypomagnesiemia, respectively, is suspected as the cause. We present the case of a male patient with a background of heart disease (stent in circunflex 8 years earlier) that began with an episode of primary ventricular fibrillation when entering the Emergency Service. He was given 35 shocks of 360 J, without using thoracic compressions at any time since he recovered an effective post-shock pulse with normal neurological condition. Amiodarone and thrombolytics (tenecteplase) were administered during the intervention, achieving favorable resolution after 52 min, once stabilized showing an electrocardiogram of acute coronary syndrome without ST elevation and verifying obstruction of the right coronary artery in the catheterism, on which a stent was placed. He was discharged from the hospital six days after with no neurological sequels. In agreement with the 2005 International Liaison Committee on Resuscitation Recommendations, the resuscitation maneuvers and electrical shocks should be continued while there is a defibrillable rhythm, as occurred in our patient.

  7. 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

  8. 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.

  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.

  10. Acetylcholine causes rooting in leaf explants of in vitro raised tomato (Lycopersicon esculentum Miller) seedlings.

    Science.gov (United States)

    Bamel, Kiran; Gupta, Shrish Chandra; Gupta, Rajendra

    2007-05-30

    The animal neurotransmitter acetylcholine (ACh) induces rooting and promotes secondary root formation in leaf explants of tomato (Lycopersicon esculentum Miller var. Pusa Ruby), cultured in vitro on Murashige and Skoog's medium. The roots originate from the midrib of leaf explants and resemble taproot. ACh at 10(-5) M was found to be the optimum over a wide range of effective concentrations between 10(-7) and 10(-3) M. The breakdown products, choline and acetate were ineffective even at 10(-3) M concentration. ACh appears to have a natural role in tomato rhizogenesis because exogenous application of neostigmine, an inhibitor of ACh hydrolysis, could mimic the effect of ACh. Neostigmine, if applied in combination with ACh, potentiated the ACh effect.

  11. Efficient plant regeneration from cotyledon explants of bottle gourd (Lagenaria siceraria Standl.).

    Science.gov (United States)

    Han, J-S; Oh, D-G; Mok, I-G; Park, H-G; Kim, C K

    2004-11-01

    Using cotyledon explants excised from seedlings germinated in vitro, an efficient plant regeneration system via organogenesis was established for bottle gourd (Lagenaria siceraria Standl.). Maximum shoot regeneration was obtained when the proximal parts of cotyledons from 4-day-old seedlings were cultured on MS medium with 3 mg/l BA and 0.5 mg/l AgNO(3) under a 16-h photoperiod. After 3-4 weeks of culture, 21.9-80.7% of explants from the five cultivars regenerated shoots. Adventitious shoots were successfully rooted on a half-strength MS medium with 0.1 mg/l IAA for 2-3 weeks. Flow cytometric analysis revealed that most of the regenerated plants derived from culture on medium with AgNO(3) were diploid.

  12. One-stage explant-implant procedure of exposed porous orbital implants

    DEFF Research Database (Denmark)

    Toft, Peter B; Rasmussen, Marie L Roed; Prause, Jan Ulrik

    2011-01-01

    ) orbital implant from January 2000 to February 2009 were included. The patient records were reviewed; patients were interviewed by telephone and invited for a clinical examination. Histopathological examination was carried out on the removed implants. Main outcome measures were: presence of exposure......Purpose:  To investigate the risks of implant exposure after a combined explant-implant procedure in patients with an exposed porous orbital implant. Methods:  Twenty-four consecutive patients who had a combined explant-implant procedure of an exposed hydroxyapatite (21) or porous polyethylene (3...... of the new implant or not, patient graded satisfaction with the cosmetic result, and presence of poor motility. Results:  None of the new implants became exposed or infected in the follow-up period of 25 [3-94] months (median [range]). The patients scored their satisfaction with the cosmetic result...

  13. 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.

  14. In vitro mutagenesis in citrus breeding: I. Gamma rays sensitivity of cultivar pera explants; Uso de mutagenese in vitro no melhoramento de citros: I. sensibilidade a raios gama de explantes do cultivar pera

    Energy Technology Data Exchange (ETDEWEB)

    Tulmann Neto, A.; Mendes, B.M.J.; Ando, A. [Centro de Energia Nuclear na Agricultura (CENA), Piracicaba, SP (Brazil); Cristofani, M. [Instituto Agronomico de Campinas, SP (Brazil)

    1994-12-31

    In order to obtain basic data for future research in mutation breeding through in vitro technology in sweet orange, gamma rays sensitivity of different types of plants were analysed. After irradiation the following observations were carried out: response of explants, number of embryoids and adventitious buds, callus weight and rooting formation. Different results were obtained accordingly to the explant used and are presented. (author). 21 refs., 6 tabs.

  15. Bordetella avium Causes Induction of Apoptosis and Nitric Oxide Synthase in Turkey Tracheal Explant Cultures

    OpenAIRE

    Miyamoto, David M.; Ruff, Kristin; Beach, Nathan M.; Dorsey-Oresto, Angella; Masters, Isaac; Temple, Louise M.

    2011-01-01

    Bordetellosis is an upper respiratory disease of turkeys caused by Bordetella avium in which the bacteria attach specifically to ciliated respiratory epithelial cells. Little is known about the mechanisms of pathogenesis of this disease, which has a negative impact in the commercial turkey industry. In this study, we produced a novel explant organ culture system that was able to successfully reproduce pathogenesis of B. avium in vitro, using tracheal tissue derived from 26 day-old turkey embr...

  16. Protoplast Isolation in Lupin ( Lupinus mutabilis Sweet): Determination of Optimum Explant Sources and Isolation Conditions

    OpenAIRE

    BABAOĞLU, Mehmet

    2000-01-01

    Effects of cultural factors on the yield, viability and division of protoplasts were investigated in Lupinus mutabilis Sweet containing a high protein content as well as a reasonable oil content which may make this species an alternative crop to soybean in Turkey. Explants from different in vitro seedling parts were evaluated on the suitability of protoplast isolation and viability. Leaf mesophyll was the most suitable tissue as a protoplast source. Pectinases as well as cellulases were es...

  17. 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.

  18. Characteristic of c-Kit+ progenitor cells in explanted human hearts

    OpenAIRE

    Matuszczak, Sybilla; Czapla, Justyna; Jarosz-Biej, Magdalena; Wiśniewska, Ewa; Cichoń, Tomasz; Smolarczyk, Ryszard; Kobusińska, Magdalena; Gajda, Karolina; Wilczek, Piotr; Śliwka, Joanna; Zembala, Michał; Zembala, Marian; Szala, Stanisław

    2014-01-01

    According to literature data, self-renewing, multipotent, and clonogenic cardiac c-Kit+ progenitor cells occur within human myocardium. The aim of this study was to isolate and characterize c-Kit+ progenitor cells from explanted human hearts. Experimental material was obtained from 19 adult and 7 pediatric patients. Successful isolation and culture was achieved for 95 samples (84.1 %) derived from five different regions of the heart: right and left ventricles, atrium, intraventricular septum,...

  19. Aescin Content in Embryogenic Callus and in Embryoids from Leaf Explants of Aesculus hippocastanum.

    Science.gov (United States)

    Profumo, P; Caviglia, A M; Gastaldo, P; Dameri, R M

    1991-02-01

    HPLC determinations of the aescin contents in calli and embryoids from leaf explants of AESCULUS HIPPOCASTANUM L. were carried out in order to determine whether it was possible to obtain aescin-forming proliferations IN VITRO. The results indicate that embryogenic calli and embryoids derived from them produce an amount of active principle higher than that of horse-chestnut seeds. The data are discussed in terms of the relation between tissue differentiation and secondary metabolites biosynthesis.

  20. Aescin formation in calli and embryoids from cotyledon and stem explants of Aesculus hippocastanum L.

    Science.gov (United States)

    Profumo, P; Caviglia, A M; Gastaldo, P

    1994-11-01

    Aescin in calli and embryoids obtained from both cotyledon and stem explants of Aesculus hippocastanum were investigated by HPLC. Determinations were carried out on tissues cultured in agarized medium supplemented with growth substances (2,4-dichlorophenoxyacetic acid; kinetin; 1-naphthaleneacetic acid). The results indicate that aescin was produced in all the analysed samples. The amount of active principle present in some samples was higher than that found in horse-chestnut seeds.

  1. 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).......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)....

  2. Bordetella avium causes induction of apoptosis and nitric oxide synthase in turkey tracheal explant cultures.

    Science.gov (United States)

    Miyamoto, David M; Ruff, Kristin; Beach, Nathan M; Stockwell, Stephanie B; Dorsey-Oresto, Angella; Masters, Isaac; Temple, Louise M

    2011-09-01

    Bordetellosis is an upper respiratory disease of turkeys caused by Bordetella avium in which the bacteria attach specifically to ciliated respiratory epithelial cells. Little is known about the mechanisms of pathogenesis of this disease, which has a negative impact in the commercial turkey industry. In this study, we produced a novel explant organ culture system that was able to successfully reproduce pathogenesis of B. avium in vitro, using tracheal tissue derived from 26 day-old turkey embryos. Treatment of the explants with whole cells of B. avium virulent strain 197N and culture supernatant, but not lipopolysaccharide (LPS) or tracheal cytotoxin (TCT), specifically induced apoptosis in ciliated cells, as shown by annexin V and TUNEL staining. LPS and TCT are known virulence factors of Bordetella pertussis, the causative agent of whooping cough. Treatment with whole cells of B. avium and LPS specifically induced NO response in ciliated cells, shown by uNOS staining and diaphorase activity. The explant system is being used as a model to elucidate specific molecules responsible for the symptoms of bordetellosis.

  3. 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.

  4. Phytic acid decreases deoxynivalenol and fumonisin B1-induced changes on swine jejunal explants

    Directory of Open Access Journals (Sweden)

    Elisângela Olegário da Silva

    2014-01-01

    Full Text Available The purpose of the present study was to investigate the effects of phytic acid (IP6 on morphological and immunohistochemical parameters on intestinal explants exposed to deoxynivalenol (DON and fumonisin B1 (FB1. The jejunal explants were exposed for 4 h to different treatments: control, DON (10 μM, DON plus 2.5 mM or 5 mM IP6, FB1 (70 μM, and FB1 plus 2.5 mM or 5 mM IP6. Both mycotoxins induced significant intestinal lesions and decreased villi height. The presence of 2.5 mM and 5 mM IP6 significantly inhibited the morphological changes caused by the mycotoxins. DON induced a significant increase in caspase-3 (83% and cyclooxygenase-2 (71.3% expression compared with the control. The presence of 5 mM IP6 induced a significant decrease in caspase-3 (43.7% and Cox-2 (48% expression compared with the DON group. FB1 induced a significant increase in caspase-3 expression (47% compared to the control, whereas IP6 induced no significant change in this expression. A significant decrease in cell proliferation was observed when explants were exposed to 5 mM of IP6 in comparison with the DON and FB1 groups. The present data provide evidence that phytic acid modulates the toxic effects induced by DON and FB1 on intestinal tissue.

  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. Optimization of Agrobacterium mediated genetic transformation of cotyledonary node explants of Vigna radiata.

    Science.gov (United States)

    Yadav, Sushil Kumar; Katikala, Sweety; Yellisetty, Varalaxmi; Kannepalle, Annapurna; Narayana, Jyothi Lakshmi; Maddi, Vanaja; Mandapaka, Maheswari; Shanker, Arun Kumar; Bandi, Venkateswarlu; Bharadwaja, Kirti Pulugurtha

    2012-12-01

    A reproducible and highly efficient protocol for genetic transformation mediated by Agrobacterium has been established for greengram (Vigna radiata L. Wilczek). Double cotyledonary node (DCN) explants were inoculated with Agrobacterium tumefaciens strain LBA 4404 harboring a binary vector pCAMBIA 2301 containing neomycin phosphotransferase (npt II) gene as selectable marker, β-glucuronidase (GUS) as a reporter (uidA) gene and annexin 1 bj gene. Important parameters like optical density of Agrobacterium culture, culture quantity, infection medium, infection and co-cultivation time and acetosyringone concentration were standardized to optimize the transformation frequency. Kanamycin at a concentration of 100 mg/l was used to select transformed cells. Transient and stable GUS expressions were studied in transformed explants and regenerated putative plants, respectively. Transformed shoot were produced on regeneration medium containing 100 mg/l kanamycin and 250 mg/l cefotaxime and rooted on ½ MS medium. Transient and constitutive GUS expression was observed in DCN explants and different tissues of T(0) and T(1) plants. Rooted T(0) and T(1) shoots confirming Polymerase Chain Reaction (PCR) positive for npt II and annexin 1bj genes were taken to maturity to collect the seeds. Integration of annexin gene into the greengram genome was confirmed by Southern blotting.

  7. Pistacia lentiscus fruit oil reduces oxidative stress in human skin explants caused by hydrogen peroxide.

    Science.gov (United States)

    Ben Khedir, S; Moalla, D; Jardak, N; Mzid, M; Sahnoun, Z; Rebai, T

    2016-10-01

    We investigated the efficacy of Pistacia lentiscus fruit oil (PLFO) for protecting human skin from damage due to oxidative stress. PLFO contains natural antioxidants including polyphenols, sterols and tocopherols. We compared the antioxidant potential of PLFO with extra virgin olive oil (EVOO). Explants of healthy adult human skin were grown in culture with either PLFO or EVOO before adding hydrogen peroxide (H2O2). We also used cultured skin explants to investigate the effects of PLFO on lipid oxidation and depletion of endogenous antioxidant defense enzymes including glutathione peroxidase (GPx), superoxide dismutase (SOD) and catalase (CAT) one day after 2 h exposure to H2O2. We found that PLFO scavenged radicals and protected skin against oxidative injury. PLFO exhibited greater antioxidant and free radical scavenging activity than EVOO. Skin explants treated with PLFO inhibited H2O2 induced MDA formation by inhibition of lipid oxidation. In addition, the oil inhibited H2O2 induced depletion of antioxidant defense enzymes including GPx, SOD and CAT. We found that treatment with PLFO repaired skin damage owing to its antioxidant properties.

  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. Structures of benzo(a)pyrene-nucleic acid adducts formed in human and bovine bronchial explants

    DEFF Research Database (Denmark)

    1977-01-01

    obtained evidence that the same derivative is involved in the binding of BP to the DNA of human bronchial explants, although details of the specific isomer involved and of the structure of the adduct were not reported. We describe here studies on RNA and DNA adducts formed by human bronchial explants...... and provide evidence that the structures of the major adducts are similar to those formed in the analogous bovine system....

  11. 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.

  12. 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

  13. 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.

  14. 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

  15. 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

  16. 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.

  17. 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.

  18. 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

    2011-01-01

    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.

  19. Simulação da soja geneticamente modificada tolerante ao glyphosate por meio do cultivo de explantes Simulation of the transgenic soybean tolerant to glyphosate through explant cultivation

    Directory of Open Access Journals (Sweden)

    Sérgio C. Siqueira

    1999-04-01

    Full Text Available O objetivo do experimento consistiu na simulação in vitro da soja transgênica tolerante ao glyphosate, através do cultivo de explantes em meios de cultura contendo aminoácidos aromáticos. As avaliações basearam-se nos efeitos do glyphosate sobre sementes oriundas de explantes de soja (Glycine max (L. Merr. cv. UFV-16. Para tanto, explantes de soja foram cultivados em meios de cultura líquidos com pH em torno de 5,0. Cada explante constou de um legume completamente expandido contendo duas sementes de aproximadamente 100 mg, conectada a um segmento de caule de 45 mm de comprimento. Os tratamentos testados foram: A = glutamina (Gln; B = Gln + fenilalanina (Phe + tirosina (Tyr + triptofano (Trp; C = Gln + glyphosate; D = Gln + Phe + Tyr + Trp + glyphosate. O experimento foi conduzido sob irradiância de 80 mmol-2s-1 a 25oC por 204 horas. Nos tratamentos que receberam aminoácidos aromáticos e glutamina, o herbicida não afetou as massas fresca e seca das sementes, como também, não afetou seus constituintes bioquímicos (proteínas, óleo, ácidos graxos, carboidratos e clorofilas. Portanto, a suplementação exógena de aminoácidos aromáticos suprime os efeitos fitotóxicos do glyphosate sobre explantes de soja, permitindo estudos sobre o seu modo de ação e metabolismo nas sementes, uma vez que os explantes se comportaram analogamente à soja transgênica não suscetível ao herbicida.The objective of this experiment consisted in simulation in vitro of the transgenic soybean tolerant to glyphosate through explant cultivation in culture medium containing aromatic amino acids. The effects of glyphosate on soybean (Glycine max (L. Merrill were evaluated in seeds harvested from explants of cv UFV-16. The soybean explants were cultivated in liquid medium culture with pH about 5.0. Each explant consisted of one fruit completely expanded, containing two seeds of 100 mg approximately, and connected to a stem segment of 45 mm length. The

  20. 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.

  1. Propagation of goldenrod (Solidago canadensis L. from leaf and nodal explants

    Directory of Open Access Journals (Sweden)

    Jun Li

    2012-02-01

    Full Text Available Goldenrod (Solidago canadensis L. is an invasive plant species in many countries except North America but a cut-flower species worldwide. There is a need to generate and propagate goldenrod clones efficiently for research and commercial purposes. A callus induction and plantlet regeneration system was developed by studying the influence of explant type and different concentrations of plant growth regulators. The highest callus production from leaf segments was obtained on Murashige and Skoog’s medium (MS medium supplemented with 1.0 mg/L naphthalene acetic acid (NAA and 1.0 mg/L 6-benzylaminopurine (BA. Adventitious shoots could be regenerated directly from leaf explants without an intermediate callus phase with the highest shoot induction percentage of 87.2%. The largest number of adventitious shoots per leaf explant (3.2 was obtained on MS medium supplemented with 0.4 mg/L NAA and 2.0 mg/L BA. MS medium supplemented with 0.1 mg/L NAA and 1.0 mg/L BA was the best medium for axillary shoot regeneration from nodal segments. The highest root number and longest roots occurred on half-strength MS without the addition of any growth regulator. Rooted plantlets were then transferred to a soil-based growth medium, placed in a greenhouse, and acclimatized with 100% success. All surviving plants grew normally without showing any morphological varia­tion when compared to those grow from seed. This regeneration protocol may be used to produce certain biotypes of goldenrod suitable for genetic transformation rapid propagation of goldenrod for commercial purposes or for screening fungi and toxins as potential biocontrol agents against this weed.

  2. Glucocorticoids affect 24 h clock genes expression in human adipose tissue explant cultures.

    Directory of Open Access Journals (Sweden)

    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.

  3. 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.

  4. 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.

  5. 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.

  6. 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

  7. Outcome of total knee replacement following explantation and cemented spacer therapy

    Directory of Open Access Journals (Sweden)

    Ghanem, Mohamed

    2016-03-01

    Full Text Available Background: Infection after total knee replacement (TKR is one of the serious complications which must be pursued with a very effective therapeutic concept. In most cases this means revision arthroplasty, in which one-setting and two-setting procedures are distinguished. Healing of infection is the conditio sine qua non for re-implantation. This retrospective work presents an assessment of the success rate after a two-setting revision arthroplasty of the knee following periprosthetic infection. It further considers drawing conclusions concerning the optimal timing of re-implantation.Patients and methods: A total of 34 patients have been enclosed in this study from September 2005 to December 2013. 35 re-implantations were carried out following explantation of total knee and implantation of cemented spacer. The patient’s group comprised of 53% (18 males and 47% (16 females. The average age at re-implantation time was 72.2 years (ranging from 54 to 85 years. We particularly evaluated the microbial spectrum, the interval between explantation and re-implantation, the number of surgeries that were necessary prior to re-implantation as well as the postoperative course. Results: We reported 31.4% (11 reinfections following re-implantation surgeries. The number of the reinfections declined with increasing time interval between explantation and re-implantation. Patients who developed reinfections were operated on (re-implantation after an average of 4.47 months. Those patients with uncomplicated course were operated on (re-implantation after an average of 6.79 months. Nevertheless, we noticed no essential differences in outcome with regard to the number of surgeries carried out prior to re-implantation. Mobile spacers proved better outcome than temporary arthrodesis with intramedullary fixation.Conclusion: No uniform strategy of treatment exists after peri-prosthetic infections. In particular, no optimal timing can be stated concerning re

  8. 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.

  9. 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.

  10. Ascorbic acid inhibits the squamous metaplasia that results from treatment of tracheal explants with asbestos or benzo[a]pyrene-coated asbestos.

    Science.gov (United States)

    Holtz, G; Bresnick, E

    1988-01-01

    Hamster tracheal explants were maintained in culture in the presence or absence of benzo[a]pyrene (BP), crocidolite asbestos, or BP-coated crocidolite. Dose-dependent squamous metaplasia was observed in the treated samples. L-Ascorbic acid and DL-alpha-tocopherol were able to partially protect the tracheal explants from the metaplastic response induced by crocidolite. Furthermore, ascorbic acid reduced the extent of metaplasia observed in hamster tracheal explants that were exposed to BP-crocidolite.

  11. 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.

  12. Low Energy Multi-Stage Atrial Defibrillation Therapy Terminates Atrial Fibrillation with Less Energy than a Single Shock

    Science.gov (United States)

    Li, Wenwen; Janardhan, Ajit H.; Fedorov, Vadim V.; Sha, Qun; Schuessler, Richard B.; Efimov, Igor R.

    2011-01-01

    Background Implantable device therapy of atrial fibrillation (AF) is limited by pain from high-energy shocks. We developed a low-energy multi-stage defibrillation therapy and tested it in a canine model of AF. Methods and Results AF was induced by burst pacing during vagus nerve stimulation. Our novel defibrillation therapy consisted of three stages: ST1 (1-4 low energy biphasic shocks), ST2 (6-10 ultra-low energy monophasic shocks), and ST3 (anti-tachycardia pacing). Firstly, ST1 testing compared single or multiple monophasic (MP) and biphasic (BP) shocks. Secondly, several multi-stage therapies were tested: ST1 versus ST1+ST3 versus ST1+ST2+ST3. Thirdly, three shock vectors were compared: superior vena cava to distal coronary sinus (SVC>CSd), proximal coronary sinus to left atrial appendage (CSp>LAA) and right atrial appendage to left atrial appendage (RAA>LAA). The atrial defibrillation threshold (DFT) of 1BP shock was less than 1MP shock (0.55 ± 0.1 versus 1.38 ± 0.31 J; p =0.003). 2-3 BP shocks terminated AF with lower peak voltage than 1BP or 1MP shock and with lower atrial DFT than 4 BP shocks. Compared to ST1 therapy alone, ST1+ST3 lowered the atrial DFT moderately (0.51 ± 0.46 versus 0.95 ± 0.32 J; p = 0.036) while a three-stage therapy, ST1+ST2+ST3, dramatically lowered the atrial DFT (0.19 ± 0.12 J versus 0.95 ± 0.32 J for ST1 alone, p=0.0012). Finally, the three-stage therapy ST1+ST2+ST3 was equally effective for all studied vectors. Conclusions Three-stage electrotherapy significantly reduces the AF defibrillation threshold and opens the door to low energy atrial defibrillation at or below the pain threshold. PMID:21980076

  13. 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.

  14. 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.

  15. 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.

  16. 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

  17. Millicurrent stimulation of human articular chondrocytes cultivated in a collagen type-I gel and of human osteochondral explants

    Directory of Open Access Journals (Sweden)

    Silny Jiri

    2010-08-01

    Full Text Available Abstract Background Here we investigate the effect of millicurrent treatment on human chondrocytes cultivated in a collagen gel matrix and on human osteochondral explants. Methods Human chondrocytes from osteoarthritic knee joints were enzymatically released and transferred into a collagen type-I gel. Osteochondral explants and cell-seeded gel samples were cultivated in-vitro for three weeks. Samples of the verum groups were stimulated every two days by millicurrent treatment (3 mA, sinusoidal signal of 312 Hz amplitude modulated by two super-imposed signals of 0.28 Hz, while control samples remained unaffected. After recovery, collagen type-I, type-II, aggrecan, interleukin-1β, IL-6, TNFα and MMP13 were examined by immunohistochemistry and by real time PCR. Results With regard to the immunostainings 3 D gel samples and osteochondral explants did not show any differences between treatment and control group. The expression of all investigated genes of the 3 D gel samples was elevated following millicurrent treatment. While osteochondral explant gene expression of col-I, col-II and Il-1β was nearly unaffected, aggrecan gene expression was elevated. Following millicurrent treatment, IL-6, TNFα, and MMP13 gene expression decreased. In general, the standard deviations of the gene expression data were high, resulting in rarely significant results. Conclusions We conclude that millicurrent stimulation of human osteoarthritic chondrocytes cultivated in a 3 D collagen gel and of osteochondral explants directly influences cell metabolism.

  18. 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.

  19. In vitro isolation and cultivation of rabbit tracheal epithelial cells using tissue explant technique.

    Science.gov (United States)

    Shi, Hong-Can; Lu, Dan; Li, Hai-Jia; Han, Shi; Zeng, Yan-Jun

    2013-04-01

    Epithelial cells from tracheal mucosa offer significant potential as a cell source in development of tissue-engineered trachea. The purpose of this study was to investigate and optimize a suitable culture system for tracheal epithelial cells, including the methods of primary culture, passage, identification, and cryopreservation. Epithelial cells were isolated from rabbit tracheal mucosa using tissue explant technique and were subjected to immunohistochemistry, immunofluorescence, and cryopreservation after purification. Epithelial cells reached confluency at 14-15 d. Immunohistochemical staining for cytokeratin showed brown yellow-positive cytoplasm and blue-counterstained nuclei, while immunofluorescence staining for cytokeratin showed green-positive cytoplasm and clear cell outline, indicating that the cultured cells had properties of epithelial cells. After recovery, epithelial cells exhibited high survival and viability. The results demonstrated that in vitro isolation and cultivation model was successfully established to provide high proliferative capacity, typical morphology and characteristics of tracheal epithelial cells from trachea mucosa by the use of the tissue explant technique.

  20. Ultrastructural Localization of Polygalacturonase in Ethylene-Stimulated Abscission of Tomato Pedicel Explants

    Directory of Open Access Journals (Sweden)

    Ming-Fang Qi

    2014-01-01

    Full Text Available Polygalacturonase (PG is crucial in plant organ abscission process. This paper investigated the cellular and subcellular localization of PG in ethylene-stimulated abscission of tomato pedicel explants. Confocal laser scanning microscopy of abscission zone sections with the fluorescent probe Cy3 revealed that PG was initially accumulated in parenchyma cells in cortical and vascular tissues after 8 h of ethylene treatment and then extended throughout the abscission zone when the abscission zone separated at 24 h after ethylene treatment. At the subcellular level, transmission electron microscopy with immunogold staining showed that PG showed abundant accumulation in the cortical and vascular tissues at 8 h after ethylene treatment, and the distribution area extended to the central parenchyma cells at 16 h after ethylene treatment. In addition, PGs were observed in the distal and proximal parts of the tomato pedicel explants throughout the abscission process. The results provided a visualized distribution of PG in the pedicel abscission zone and proved that PG was closely related to abscission.

  1. A comparative study of candidal invasion in rabbit tongue mucosal explants and reconstituted human oral epithelium.

    Science.gov (United States)

    Jayatilake, J A M S; Samaranayake, Y H; Samaranayake, L P

    2008-06-01

    The purpose of this study is to compare the light and scanning electron microscopic (SEM) features of tissue invasion by three Candida species (C. albicans, C. tropicalis, and C. dubliniensis) in two different tissue culture models: rabbit tongue mucosal explants (RTME) and reconstituted human oral epithelium (RHOE). Tongue mucosal biopsies of healthy New Zealand rabbits were maintained in explant culture using a transwell system. RHOE was obtained from Skinethic Laboratory (Nice, France). RTME and RHOE were inoculated with C. albicans, C. tropicalis, and C. dubliniensis separately and incubated at 37 degrees C, 5% CO(2), and 100% humidity up to 48 h. Light microscopic and SEM examinations of uninfected (controls) and infected tissues were performed at 24 and 48 h. C. albicans produced characteristic hallmarks of pathological tissue invasion in both tissue models over a period of 48 h. Hyphae penetrated through epithelial cells and intercellular gaps latter resembling thigmotropism. SEM showed cavitations on the epithelial cell surfaces particularly pronounced at sites of hyphal invasion. Some hyphae on RTME showed several clusters of blastospores attached in regular arrangements resembling "appareil sporifere". C. tropicalis and C. dubliniensis produced few hyphae mainly on RTME but they did not penetrate either model. Our findings indicate that multiple host-fungal interactions such as cavitations, thigmotropism, and morphogenesis take place during candidal tissue invasion. RTME described here appears to be useful in investigations of such pathogenic processes of Candida active at the epithelial front.

  2. 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.

  3. 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.

  4. 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.

  5. 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.

  6. 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.

  7. An efficient regeneration and rapid micropropagation protocol for Almond using dormant axillary buds as explants.

    Science.gov (United States)

    Choudhary, Ravish; Chaudhury, Rekha; Malik, Surendra Kumar; Sharma, Kailash Chandra

    2015-07-01

    An efficient in vitro protocol was standardized for Almond (Prunus dulcis) propagation using dormant axillary buds as explants. Explants were cultured on Murashige and Skoog (MS) and woody plant medium (WPM) supplemented with different concentration/combination(s) of phytohormones. MS basal medium showed lowest shoot induction and took longest duration for shoot initiation. Multiple shoots were induced in MS medium supplemented with the combination of BAP (0.5 mgL(-1)). Cultures showed poor response for rooting in all combinations of plant growth regulators (PGRs) and took 90 days for initiation. Rooting was higher in half strength of MS than in full-strength. The highest root induction (33.33%) was recorded in half MS medium supplemented with 0.1 mgL(-1) IBA (indole-3-butyric acid) followed by full strength of MS medium (20%) supplemented with IBA (0.1 mgL(-1)). α-Naphthalene acetic acid (NAA) was less effective for rooting than IBA. The highest root induction (25%) was found in half strength of MS medium supplemented with 0.1 mgL(-1) NAA followed by full strength of MS medium (20%). The protocol developed would be of use in mass propagation of almond and also support in vitro conservation.

  8. Effects of the mesonephros and insulin-like growth factor I on chondrogenesis of limb explants.

    Science.gov (United States)

    Geduspan, J S; Solursh, M

    1993-04-01

    The mesonephros has been shown to have a growth-promoting influence in vivo on limb outgrowth. This influence has been studied in detail using an organ culture system. The results show that in the presence of the mesonephros limb explants formed larger cartilages than cultures without mesonephros. Furthermore, with mesonephros, morphology of the cartilages is comparable to that of skeletal elements in vivo while cartilages formed in cultures lacking mesonephros were amorphous. The mesonephric influence also promoted the formation of a well-organized extracellular matrix in the cartilage while cartilage in cultures without mesonephros formed an abnormal appearing matrix. Cartilage matrices in cultures with or without mesonephros were immunoreactive to type IX and type II collagens, cartilage proteoglycan PGH, and link protein although cultures lacking mesonephros had a very restricted distribution of type IX collagen immunoreactivity. Despite the different distribution of type IX collagen, long-form-type IX collagen transcripts appeared similar in both types of culture based on in situ hybridization. The mesonephric effect on limb explants could be partially duplicated by the addition of insulin-like growth factor I (IGF-I) to cultures without mesonephros. Furthermore, the mesonephric influence on cartilage growth and morphological differentiation could be blocked by the addition of a blocking antibody to IGF-I to cultures with mesonephros. The results support the hypothesis that IGF-I is one of the growth factors produced by the mesonephros which may play a role in early limb development and chondrogenesis.

  9. Establishing axenic cultures from mature pecan embryo explants on media with low water availability.

    Science.gov (United States)

    Obeidy, A A; Smith, M A

    1990-12-01

    Endophytic fungi associated with mature pecan (Carya illinoensis (Wangenh.) C. Koch) nuts prevented successful, contaminant-free in vitro culture of embryo expiants, even after rigorous surface disinfestation of the nuts and careful aseptic shelling. Disinfestation with sodium hypochlorite after shell removal was also unsuccessful, because even dilute concentrations which were ineffective against the fungal contaminants prevented subsequent growth from the embryo. Explanting media with low water availability which would not sustain growth of fungal contaminants, but supported growth from mature pecan embryos, were developed as an alternative disinfestation method. The explanting media were supplemented with 0.9-1.5% agar, and other media components were selectively omitted to test their influence on water availability and fungal growth. Disinfestation of up to 65% of the cultures was accomplished, depending on the medium formulation, compared to 100% loss to contamination on control medium (0.5% agar). A complete medium (containing sucrose, salts, vitamins, 18 μM BAP, and 5 μM IBA) with 1.5% agar provided control of contamination, and encouraged subsequent regeneration from the embryo expiants, which remained free of contaminant growth through subsequent subcultures.

  10. 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.

  11. Prospective nationwide fluoroscopic and electrical longitudinal follow-up of recalled Riata defibrillator leads in Denmark

    DEFF Research Database (Denmark)

    Larsen, Jacob M.; Nielsen, Jens Cosedis; 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...... is a dynamic process despite long lead dwell time. ECs are associated with a higher risk of electrical abnormalities. Therefore, lead replacement should be considered, especially in patients with a long life expectancy....... 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...

  12. 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.

  13. 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.

  14. 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.

  15. 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.

  16. 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.

  17. Comparison of human nasal epithelial cells grown as explant outgrowth cultures or dissociated tissue cultures in vitro.

    Science.gov (United States)

    Jiao, Jian; Meng, Na; Wang, Hong; Zhang, Luo

    2013-12-01

    The purpose of this study was to compare cell growth characteristics, ciliated cell differentiation, and function of human nasal epithelial cells established as explant outgrowth cultures or dissociated tissue cultures. Human nasal mucosa of the uncinate process was obtained by endoscopy and epithelial cell cultures were established by explant outgrowth or dissociated tissue culture methods. Epithelial cell growth characteristics were observed by inverted phase contrast microscopy. Ciliated cell differentiation was detected by β-tubulin IVand ZO-1 immunocytochemistry. Basal and ATP-stimulated ciliary beat frequency (CBF) was measured using a highspeed digital microscopic imaging system. Both the explant and dissociated tissue cultures established as monolayers with tight junctions and differentiated cell composition, with both types of cultures comprising ciliated and non-ciliated epithelial cells. Fibroblasts were also frequently found in explant cultures but rarely seen in dissociated tissue cultures. In both culture systems, the highest ciliated cell density appeared at 7th-10th culture day and declined with time, with the lifespan of ciliated cells ranging from 14 to 21 days. Overall, 10% of the cells in explant cultures and 20% of the cells in the dissociated tissue cultures were ciliated. These two cultures demonstrated similar ciliary beat frequency values at baseline (7.78 ± 1.99 Hz and 7.91 ± 2.52 Hz, respectively) and reacted equivalently following stimulation with 100 μM ATP. The results of this study indicate that both the explant outgrowth and dissociated tissue culture techniques are suitable for growing well-differentiated nasal ciliated and non-ciliated cells, which have growth characteristics and ciliary activity similar to those of nasal epithelial cells in vivo.

  18. 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...

  19. 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.

  20. Explanted diseased livers - a possible source of metabolic competent primary human hepatocytes.

    Science.gov (United States)

    Kleine, Moritz; Riemer, Marc; Krech, Till; DeTemple, Daphne; Jäger, Mark D; Lehner, Frank; Manns, Michael P; Klempnauer, Jürgen; Borlak, Jürgen; Bektas, Hueseyin; Vondran, Florian W R

    2014-01-01

    Being an integral part of basic, translational and clinical research, the demand for primary human hepatocytes (PHH) is continuously growing while the availability of tissue resection material for the isolation of metabolically competent PHH remains limited. To overcome current shortcomings, this study evaluated the use of explanted diseased organs from liver transplantation patients as a potential source of PHH. Therefore, PHH were isolated from resected surgical specimens (Rx-group; n = 60) and explanted diseased livers obtained from graft recipients with low labMELD-score (Ex-group; n = 5). Using established protocols PHH were subsequently cultured for a period of 7 days. The viability and metabolic competence of cultured PHH was assessed by the following parameters: morphology and cell count (CyQuant assay), albumin synthesis, urea production, AST-leakage, and phase I and II metabolism. Both groups were compared in terms of cell yield and metabolic function, and results were correlated with clinical parameters of tissue donors. Notably, cellular yields and viabilities were comparable between the Rx- and Ex-group and were 5.3±0.5 and 2.9±0.7×106 cells/g liver tissue with 84.3±1.3 and 76.0±8.6% viability, respectively. Moreover, PHH isolated from the Rx- or Ex-group did not differ in regards to loss of cell number in culture, albumin synthesis, urea production, AST-leakage, and phase I and II metabolism (measured by the 7-ethoxycoumarin-O-deethylase and uracil-5'-diphosphate-glucuronyltransferase activity). Likewise, basal transcript expressions of the CYP monooxygenases 1A1, 2C8 and 3A4 were comparable as was their induction when treated with a cocktail that consisted of 3-methylcholantren, rifampicin and phenobarbital, with increased expression of CYP 1A1 and 3A4 mRNA while transcript expression of CYP 2C8 was only marginally changed. In conclusion, the use of explanted diseased livers obtained from recipients with low labMELD-score might represent

  1. 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.

  2. Hypertonic saline does not reverse the sodium channel blocking actions of lidocaine: evidence from electrophysiologic and defibrillation studies.

    Science.gov (United States)

    Ujhelyi, M R; Schur, M; Frede, T; Bottorff, M B; Gabel, M; Markel, M L

    1997-01-01

    Studies have shown that increasing extracellular sodium concentration can partially reverse sodium channel blockade. However, there is conflicting in vitro evidence in this regard for lidocaine. The effects of lidocaine on cardiac electrophysiology and defibrillation were studied in a basal and hypernatremic state to determine reversibility of sodium channel blockade. Electrophysiologic studies measured right ventricular effective refractory period at 350 ms pacing cycle length and QRS interval, JT interval, and monophasic action potential duration during sinus rhythm and right ventricular pacing (350 ms cycle length) in 14 pentobarbital-anesthetized swine (25-30 kg). Defibrillation threshold (DFT) was measured by quantitating successful conversion of sustained ventricular fibrillation to normal sinus rhythm. Each pig was randomly assigned to a treatment group with three study phases; group 1 = baseline, lidocaine (20 mg/kg/h), and lidocaine plus placebo (D5W; n = 7); and group 2 = baseline, lidocaine, and lidocaine plus hypertonic saline (2-3 mM/kg/h; n = 7). In groups 1 and 2, lidocaine infused alone significantly (p Lidocaine alone reduced right ventricular action potential duration (APD) in groups 1 and 2 (214 +/- 18 to 206 +/- 20 ms; p lidocaine, DFT and QRS duration values were unaffected (14.7 +/- 5.4 to 16.1 +/- 3.7 J and 103 +/- 12 to 100 +/- 11 ms, respectively). However, APD and JT intervals returned to basal values when hypertonic saline was added to lidocaine (212 +/- 8 to 225 +/- 13; p Lidocaine slowed ventricular conduction velocity and reduced APD. The administration of hypertonic saline to increase extracellular sodium concentrations failed to reverse the effect of lidocaine on conduction-velocity slowing or elevated DFT values. Hypertonic saline did reverse the effects of lidocaine on repolarization parameters. These data suggest that shortening of repolarization is not a mechanism by which lidocaine makes it more difficult to defibrillate the

  3. 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.

  4. 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.

  5. 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.

  6. 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.

  7. 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.

  8. 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...... levels of IL-6, TNF-a and PGE(2) in the media from inguinal ATEs co-cultured with primary rat hepatocytes were higher than that in the media from epididymal ATEs co-cultured with hepatocytes, although the significant difference was only seen in PGE(2). Lipolysis, measured as glycerol release, was similar...... 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...

  9. Micropropagation of Origanum acutidens (HAND.-MAZZ.) IETSWAART using stem node explants.

    Science.gov (United States)

    Yildirim, Mehmet Ugur

    2013-01-01

    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.

  10. 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

    a stronger cytotoxic response and higher level of insulin resistance in the co-cultured hepatocytes. In conclusion, our results reveal depot-dependent effects of ATEs on co-cultured primary hepatocytes, which in part may be related to a more pronounced infiltration of stromal vascular cells (SVCs......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...... levels of IL-6, TNF-a and PGE(2) in the media from inguinal ATEs co-cultured with primary rat hepatocytes were higher than that in the media from epididymal ATEs co-cultured with hepatocytes, although the significant difference was only seen in PGE(2). Lipolysis, measured as glycerol release, was similar...

  11. 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.

  12. The effects of ascorbic acid on cartilage metabolism in guinea pig articular cartilage explants.

    Science.gov (United States)

    Clark, Amy G; Rohrbaugh, Amy L; Otterness, Ivan; Kraus, Virginia B

    2002-03-01

    Ascorbic acid has been associated with the slowing of osteoarthritis progression in guinea pig and man. The goal of this study was to evaluate transcriptional and translational regulation of cartilage matrix components by ascorbic acid. Guinea pig articular cartilage explants were grown in the presence of L-ascorbic acid (L-Asc), D-isoascorbic acid (D-Asc), sodium L-ascorbate (Na L-Asc), sodium D-isoascorbate (Na D-Asc), or ascorbyl-2-phosphate (A2P) to isolate and analyze the acidic and nutrient effects of ascorbic acid. Transcription of type II collagen, prolyl 4-hydroxylase (alpha subunit), and aggrecan increased in response to the antiscorbutic forms of ascorbic acid (L-Asc, Na L-Asc, and A2P) and was stereospecific to the L-forms. Collagen and aggrecan synthesis also increased in response to the antiscorbutic forms but only in the absence of acidity. All ascorbic acid forms tended to increase oxidative damage over control. This was especially true for the non-nutrient D-forms and the high dose L-Asc. Finally, we investigated the ability of chondrocytes to express the newly described sodium-dependent vitamin C transporters (SVCTs). We identified transcripts for SVCT2 but not SVCT1 in guinea pig cartilage explants. This represents the first characterization of SVCTs in chondrocytes. This study confirms that ascorbic acid stimulates collagen synthesis and in addition modestly stimulates aggrecan synthesis. These effects are exerted at both transcriptional and post-transcriptional levels. The stereospecificity of these effects is consistent with chondrocyte expression of SVCT2, shown previously to transport L-Asc more efficiently than D-Asc. Therefore, this transporter may be the primary mechanism by which the L-forms of ascorbic acid enter the chondrocyte to control matrix gene activity.

  13. Uso de mutagênese "in vitro" no melhoramento de citros: I. Sensibilidade a raios gama de explantes do cultivar pêra "In vitro" mutagenesis in citrus breeding: gamma rays sensitivity of cultivar pêra explants

    Directory of Open Access Journals (Sweden)

    Augusto Tulmann Neto

    1994-01-01

    Full Text Available Para futuros trabalhos com indução de mutação "in vitro", determinou-se a sensibilidade de diferentes explantes do cultivar de laranja Pêra (Citrus sinensis Osbeck a raios gama visando a escolha das doses a utilizar. Para isso, após a irradiação, avaliou-se o número de explantes responsivos, de embrióides e de brotações adventícias, a massa do calo e a formação de enraizamento. Resultados diferentes foram obtidos de acordo com o tecido empregado. Assim, para a irradiação de nucelos, recomenda-se o uso de doses entre 20 e 40 Gy; em calos embriogênicos, de 120 Gy e, para a irradiação de cotilédones de embriões nucelares, a dose situa-se ao redor de 40 Gy.In order to obtain basic data for future research in mutation breeding through "in vitro" technology in sweet orange cv. Pêra, gamma rays sensitivity of different types of explants was analyzed. After irradiation the following observations were carried out: response of explants, number of embryoids and adventitious buds, callus weight and rooting formation. Different results were obtained according the explant used. For irradiated nucellus, the dose was 20-40 Gy and for embryogenic callus 120 Gy is indicated. For irradiation of cotyledons originated from nucellar embryoids the use of 40 Gy of gamma rays was recommended.

  14. Conversion of neural plate explants to pre-placodal ectoderm-like tissue in vitro.

    Science.gov (United States)

    Shigetani, Yasuyo; Wakamatsu, Yoshio; Tachibana, Toshiaki; Okabe, Masataka

    2016-09-02

    Neural crest and cranial sensory placodes arise from ectodermal epithelium lying between the neural plate and non-neural ectoderm (neural border). BMP signaling is important for both an induction of the neural border and a subsequent induction of the neural crest within the neural border. In contrast, FGF signaling is important for the neural border induction and the following induction of the pre-placodal ectoderm (PPE), which later gives rise to the cranial sensory placodes. While previous studies have demonstrated that the neural plate explants could be converted to the neural crest cells by adding BMP4 in a culture medium, there is no report showing a similar conversion of the neural plate to the PPE. We therefore examined the effect of FGF2 along with BMP4 on the rostral neural plate explants and found that the explants became the simple squamous epithelia, which were characterized by the desmosomes/tonofilaments in membranes of adjacent cells. Such epithelia expressed sets of neural border markers and the PPE genes, suggesting that the neural plate explants were converted to a PPE-like tissue. This method will be useful for further studying mechanisms of PPE induction and subsequent specifications of the cranial placodes.

  15. Human low density lipoprotein as a substrate for in vitro steroidogenesis assays with fathead minnow ovary explants

    Science.gov (United States)

    Gonad explant in vitro steroidogenesis assays are used as part of a multifaceted strategy to detect endocrine active chemicals capable of altering steroid hormone synthesis. An in vitro steroidogenesis assay used in our laboratory involves exposing fathead minnow (FHM) gonad exp...

  16. 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

  17. 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.

  18. 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.

  19. 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.

  20. Effects of donor plant age and explants on in vitro culture of Cedrela montana Moritz ex Turcz

    Directory of Open Access Journals (Sweden)

    Sofía Basto

    2012-12-01

    Full Text Available To evaluate the organogenic potential of Cedrela montana Moritz ex Turcz. Explants from mature (10-20 year-old and juvenile (7-18 month-old trees were collected. The first grouping included buds, leaves, and nodes derived from juvenile basal offshoots and rejuvenated shoots from cuttings. The second, included leaves, petioles, nodes, internodes and nodes of in vitro elongated shoots. The highest organogenic potential was observed in nodes from juvenile trees: 45.8% of explants presented axillary bud elongation, while 56.2% presented rooting in a growth regulator free culture medium. Fifty-one percent of elongated shoots produced adventitious shoots with 0.5 μM NAA and 0.5 μM BA; 30% with 0.5 μM NAA and 1 μM BA; and 30% with 1 μM BA. Twenty percent presented roots with 0.5 μM NAA. Root formation was stimulated in a medium supplemented with activated charcoal (5 gL-1. The acclimatization of eighty percent of plantlets regenerated from nodes, and of 72.5% in vitro generated shoots was successful. On the contrary, mature trees material presented low organogenic response. Axillary bud elongation was recorded just in 10.7% of explants from juvenile shoots and in 6.7% of explants from rejuvenated shoots. The age of donor plant and type of explant affect the organogenic potential of C. montana. This study contributes to the understanding of this species’ response under in vitro conditions.

  1. Position paper for management of elderly patients with pacemakers and implantable cardiac defibrillators Groupe de rythmologie et stimulation cardiaque de la Société française de cardiologie et Société française de gériatrie et gérontologie.

    Science.gov (United States)

    Fauchier, Laurent; Alonso, Christine; Anselme, Frédéric; Blangy, Hugues; Bordachar, Pierre; Boveda, Serge; Clementy, Nicolas; Defaye, Pascal; Deharo, Jean-Claude; Friocourt, Patrick; Gras, Daniel; Halimi, Franck; Klug, Didier; Mansourati, Jacques; Obadia, Benjamin; Pasquié, Jean-Luc; Pavin, Dominique; Sadoul, Nicolas; Taieb, Jérôme; Piot, Olivier; Hanon, Olivier

    2016-09-01

    Despite the increasingly high rate of implantation of pacemakers (PM) and cardioverter-defibrillators (ICD) in elderly patients, data supporting their clinical and cost-effectiveness in this age stratum are ambiguous and contradictory. We reviewed the data regarding the applicability, safety, and effectiveness of the conventional pacing, ICD and cardiac resynchronization therapy (CRT) in elderly patients. Although peri-procedural risk may be slightly higher in the elderly, the procedure of implantation of PMs and ICDs is still relatively safe in this age group. In older patients with sinus node disease, a general consensus is that dual chamber pacing, along with the programming of an algorithm to minimise ventricular pacing is preferred. In very old patients presenting with intermittent or suspected AV block, VVI pacing may be appropriate. In terms of correcting potentially life-threatening arrhythmias, the effectiveness of ICD therapy is comparable in older and younger individuals. However, the assumption of persistent ICD benefit in the elderly population is questionable, as any advantage of the device on arrhythmic death may be attenuated by a higher total non-arrhythmic mortality. While septuagenarians and octogenarians have higher annual all-cause mortality rates, ICD therapy may remain effective in selected patients at high risk of arrhythmic death and with minimum comorbidities despite advanced age. ICD implantation among the elderly, as a group, may not be cost-effective, but the procedure may reach cost-effectiveness in those expected to live >5-7 years after implantation. The elderly patients usually experience a significant functional improvement after CRT, similar to that observed in middle-aged patients. Management of CRT non responders remains globally the same, while considering a less aggressive approach in terms of re interventions (revision of LV lead placement, addition of a RV or LV lead, LV endocardial pacing configuration). Overall, age

  2. Position paper for management of elderly patients with pacemakers and implantable cardiac defibrillators: Groupe de Rythmologie et Stimulation Cardiaque de la Société Française de Cardiologie and Société Française de Gériatrie et Gérontologie.

    Science.gov (United States)

    Fauchier, Laurent; Alonso, Christine; Anselme, Frederic; Blangy, Hugues; Bordachar, Pierre; Boveda, Serge; Clementy, Nicolas; Defaye, Pascal; Deharo, Jean-Claude; Friocourt, Patrick; Gras, Daniel; Halimi, Franck; Klug, Didier; Mansourati, Jacques; Obadia, Benjamin; Pasquié, Jean-Luc; Pavin, Dominique; Sadoul, Nicolas; Taieb, Jerome; Piot, Olivier; Hanon, Olivier

    2016-10-01

    Despite the increasingly high rate of implantation of pacemakers (PMs) and implantable cardioverter defibrillators (ICDs) in elderly patients, data supporting their clinical and cost-effectiveness in this age stratum are ambiguous and contradictory. We reviewed the data regarding the applicability, safety and effectiveness of conventional pacing, ICDs and cardiac resynchronization therapy (CRT) in elderly patients. Although periprocedural risk may be slightly higher in the elderly, the implantation procedure for PMs and ICDs is still relatively safe in this age group. In older patients with sinus node disease, the general consensus is that DDD pacing with the programming of an algorithm to minimize ventricular pacing is preferred. In very old patients presenting with intermittent or suspected atrioventricular block, VVI pacing may be appropriate. In terms of correcting potentially life-threatening arrhythmias, the effectiveness of ICD therapy is similar in older and younger individuals. However, the assumption of persistent ICD benefit in the elderly population is questionable, as any advantageous effect of the device on arrhythmic death may be attenuated by higher total non-arrhythmic mortality. While septuagenarians and octogenarians have higher annual all-cause mortality rates, ICD therapy may remain effective in selected patients at high risk of arrhythmic death and with minimum comorbidities despite advanced age. ICD implantation among the elderly, as a group, may not be cost-effective, but the procedure may reach cost-effectiveness in those expected to live more than 5-7years after implantation. Elderly patients usually experience significant functional improvement after CRT, similar to that observed in middle-aged patients. Management of CRT non-responders remains globally the same, while considering a less aggressive approach in terms of reinterventions (revision of left ventricular [LV] lead placement, addition of a right ventricular or LV lead, LV

  3. 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.

  4. In vitro plant regeneration of Albizia lebbeck (L. from seed explants

    Directory of Open Access Journals (Sweden)

    S. Perveen

    2013-07-01

    Full Text Available Objectives: An efficient and reproducible regeneration protocol for rapid multiplication of Albizia lebbeck (L. was developed by using intact seed explants.Methods: Murashige and Skoog's (MS medium supplemented with different hormones (BA, Kn, GA3 and TDZ was used for the induction of multiple shoots from the seed explants. Ex-vitro rooting was performed by using pulse treatment method in auxins (IBA and NAA and the complete plantlets were transferred to the field.Results: High frequency direct shoot induction was found in aseptic seed cultures of A. lebbeck on Murashige and Skoog medium supplemented with 5.0 µM TDZ (Thiadiazuron. Seeds were germinated after 7 days of culture and induced maximum 8 shoots from the region adjacent to the apex of the primary shoot of the seedling upto 25 days of incubation. Proliferating shoot cultures with increased shoot length was established by sub-culture of excised sprouting epicotyls on MS medium supplied with reduced concentrations of TDZ. Maximum shoot regeneration frequency (76 % with  highest number of shoots (21 and shoot length (5.1 cm per sprouting epicotyl was observed in the MS medium supplemented with 0.5 µM TDZ after 8 weeks of culture. Different concentrations of Indole-3-butyric acid (IBA and α-naphthalene acetic acid (NAA were tested to determine the optimal conditions for ex-vitro rooting of the microshoots. The best treatment for maximum ex-vitro root induction frequency (81 % was accomplished with IBA (250 µM pulse treatment given to the basal end of the microshoots for 30 min followed by their transfer in plastic cups containing soilrite and eventually established in normal garden soil + soilrite (1:1 with 78 % survival rate. In addition, histological study was undertaken to gain a better understanding of the regenerated shoots from the epicotyl region.Conclusion: The findings will be fruitful in getting a time saving and cost effective protocol for the in vitro propagation of Albizia

  5. Explant analysis of the Biomet Magnum/ReCap metal-on-metal hip joint

    Science.gov (United States)

    Hunt, B. J.; Richardson, V. M.; Langton, D. J.; Smith, E.; Joyce, T. J.

    2017-01-01

    Objectives The high revision rates of the DePuy Articular Surface Replacement (ASR) and the DePuy ASR XL (the total hip arthroplasty (THA) version) have led to questions over the viability of metal-on-metal (MoM) hip joints. Some designs of MoM hip joint do, however, have reasonable mid-term performance when implanted in appropriate patients. Investigations into the reasons for implant failure are important to offer help with the choice of implants and direction for future implant designs. One way to assess the performance of explanted hip prostheses is to measure the wear (in terms of material loss) on the joint surfaces. Methods In this study, a coordinate measuring machine (CMM) was used to measure the wear on five failed cementless Biomet Magnum/ReCap/ Taperloc large head MoM THAs, along with one Biomet ReCap resurfacing joint. Surface roughness measurements were also taken. The reason for revision of these implants was pain and/or adverse reaction to metal debris (ARMD) and/or elevated blood metal ion levels. Results The mean wear rate of the articulating surfaces of the heads and acetabular components of all six joints tested was found to be 6.1 mm3/year (4.1 to 7.6). The mean wear rate of the femoral head tapers of the five THAs was 0.054 mm3/year (0.021 to 0.128) with a mean maximum wear depth of 5.7 µm (4.3 to 8.5). Conclusion Although the taper wear was relatively low, the wear from the articulating surfaces was sufficient to provide concern and was potentially large enough to have been the cause of failure of these joints. The authors believe that patients implanted with the ReCap system, whether the resurfacing prosthesis or the THA, should be closely monitored. Cite this article: S. C. Scholes, B. J. Hunt, V. M. Richardson, D. J. Langton, E. Smith, T. J. Joyce. Explant analysis of the Biomet Magnum/ReCap metal-on-metal hip joint. Bone Joint Res 2017;6:113–122. DOI: 10.1302/2046-3758.62.BJR-2016-0130.R2. PMID:28246095

  6. 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

  7. 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

  8. ORGANOGÊNESE IN VITRO DE Citrus EM FUNÇÃO DE CONCENTRAÇÕES DE BAP E SECCIONAMENTO DO EXPLANTE CITRUS IN VITRO ORGANOGENESIS RELATED TO BAP CONCENTRATIONS AND EXPLANT SECTION

    Directory of Open Access Journals (Sweden)

    THAÍS LACAVA DE MOURA

    2001-08-01

    Full Text Available O sucesso de técnicas biotecnológicas no melhoramento in vitro de Citrus depende diretamente do desenvolvimento de protocolos eficientes para regeneração de plantas. Objetivou-se avaliar o efeito de concentrações de 6-benzilaminopuria (BAP na organogênese in vitro de limão-'Cravo' e laranja-'Pêra', bem como o efeito do seccionamento do explante em laranja-'Valência'. Para o limão-'Cravo', foram utilizados como explante, segmentos internodais de plântulas germinadas in vitro, cultivados em meio MT e variando-se as concentrações de BAP em 0; 2,5; 5; 7,5 e 10 mg.L-1. Nas laranjas-'Pêra' e 'Valência' os explantes foram segmentos do epicótilo de plântulas germinadas in vitro. Os explantes de laranja-'Pêra' foram cultivados em meio MT variando-se as concentrações de BAP em 0; 1; 2; 3 e 4 mg.L-1. Para a laranja-'Valência', metade dos explantes foram seccionados e cultivados em meio MT acrescido de 1,0 mg.L-1 de BAP. Todas as brotações obtidas foram alongadas no meio de cultura MT + 25 g.L-1 de sacarose + 1 mg.L-1 de ácido giberélico (GA3 e enraizadas no meio MT + 25 g.L-1 de sacarose + 0,5 g.L-1 de carvão ativado + 1 mg.L-1 de ácido naftaleno acético (ANA. O melhor resultado para o número de brotações adventícias foi obtido na concentração 2,5 mg.L-1 de BAP para limão-'Cravo', e nas concentrações 1,0 e 2,0 mg.L-1 de BAP para laranja-'Pêra'. O seccionamento dos explantes favoreceu a organogênese in vitro da laranja-'Valência', porém as brotações apresentaram menor índice de enraizamento.The establishment of efficient plant regeneration protocols is essential for the success and application of in vitro breeding biotechnologies in Citrus. The objective of this work was to verify the effect of 6-benzilaminopurine (BAP on the in vitro organogenesis of Rangpur lime (Citrus limonia (L. Osbeck and 'Pera' sweet orange (Citrus sinensis (L. Osbeck, and the effect of cutting the explant on the in vitro organogenesis of

  9. Flask sealing on in vitro seed germination and morphogenesis of two types of ornamental pepper explants

    Directory of Open Access Journals (Sweden)

    Diego Silva Batista

    Full Text Available ABSTRACT: The influence of flask sealing and explant source on the in vitro morphogenesis of pepper, were evaluated in Capsicum annuum. Seeds were sterilized and inoculated in Murashige and Skoog media supplemented with vitamins, myo-inositol, sucrose, and agar. Gas exchange was evaluated in the germination stage by comparing 3 flask-sealing systems: rigid polypropylene lids (PLs without vents, PLs with 1 vent, and PLs with 2 vents covered with membranes. In the regeneration stage, cotyledon and hypocotyl segments were transferred to the organogenesis-inducing media, being the different sealing types also tested in a factorial scheme. Photosynthetic pigments, morphological and hystological analyses were conducted for each treatment. Plants maintained in glass flasks capped with vented lids showed more vigorous growth and differentiated anatomical structures. These treatments resulted in taller plants, higher numbers and more expanded leaves, higher fresh and dry weights, and an increase in photosynthetic pigments. Cultivation of C. annuum in flasks with reduced gas exchange was more effective on callus induction. During the regeneration stage, hypocotyls were more effective than cotyledons. Sealing type influenced the morphogenic responses of pepper, demonstrating that an increase in gas exchange has a positive effect on biomass production and acclimatization of the plantlets.

  10. 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.

  11. Activin A induces Langerhans cell differentiation in vitro and in human skin explants.

    Directory of Open Access Journals (Sweden)

    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.

  12. 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.

  13. 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.

  14. Visible effects of rapamycin (sirolimus) on human skin explants in vitro.

    Science.gov (United States)

    Peramo, Antonio; Marcelo, Cynthia L

    2013-03-01

    In this manuscript, we report observations of the effects of rapamycin in an organotypic culture of human skin explants. The tissues were cultured for 5 days at the air-liquid interface or in submersed conditions with media with and without rapamycin at 2 nM concentration. Histological analysis of tissue sections indicated that rapamycin-treated samples maintained a better epidermal structure in the upper layers of the tissue than untreated samples, mostly evident when skin was cultured in submersed conditions. A significant decrease in the number of positive proliferative cells using the Ki67 antigen was observed when specimens were treated with rapamycin, in both air-liquid and submersed conditions but apoptosis differences between treated and untreated specimens, as seen by cleaved caspase-3 positive cells, were only observed in submersed specimens. Finally, a decrease and variability in the location in the expression of the differentiation marker involucrin and in E-cadherin were also evident in submersed samples. These results suggest that the development of topical applications containing rapamycin, instead of systemic delivery, may be a useful tool in the treatment of skin diseases that require reduction of proliferation and modulation or control of keratinocyte differentiation.

  15. 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.

  16. Efficient soybean regeneration and Agrobacterium-mediated transformation using a whole cotyledonary node as an explant.

    Science.gov (United States)

    Zhang, Fuli; Chen, Can; Ge, Honglian; Liu, Jinmei; Luo, Yunling; Liu, Kun; Chen, Long; Xu, Kedong; Zhang, Yi; Tan, Guangxuan; Li, Chengwei

    2014-01-01

    An optimized regeneration and Agrobacterium-mediated transformation protocol based on whole cotyledonary node explants was developed in soybean (Glycine max) cultivar Zhong Huang 13. Adding 6-benzylaminopurine (BAP) in a germinating medium could significantly increase regeneration efficiency; the optimal BAP concentration for shoot formation was 0.5 mg/L. The concentrations of plant growth regulators in a shoot induction medium were optimized by the orthogonal test [L9 (3(3))]. The best combination for shoot regeneration was a medium of Murashige & Skoog salts with B5 vitamins (MSB) supplemented with 3.5 mg/L BAP, 0.2 mg/L indole-3-butyric acid (IBA), and 0.2 mg/L kinetin (KT). Under this favorable condition, one node could regenerate 28-30 shoots. Soybean whole cotyledonary nodes were transformed by inoculation with A. tumefaciens strain EHA105 harboring a vector pBI121 containing a β-glucuronidase gene (gus). GUS assay, polymerase chain reaction, and Southern blot analysis indicated that the gus gene was transformed into soybean plants with 23.1% transformation efficiency. Transgenic plants could be obtained within 5-6 weeks, which was about 4 weeks less than that of a traditional single cotyledonary node method.

  17. The effect of protease inhibitors on the induction of osteoarthritis-related biomarkers in bovine full-depth cartilage explants

    DEFF Research Database (Denmark)

    He, Yi; Zheng, Qinlong; Jiang, Mengmeng

    2015-01-01

    Objective The specific degradation of type II collagen and aggrecan by matrix metalloproteinase (MMP)-9, -13 and ADAMTS-4 and -5 (aggrecanase-1 and -2) in the cartilage matrix is a critical step in pathology of osteoarthritis (OA). The aims of this study were: i) To investigate the relative...... contribution of ADAMTS-4 and ADAMTS-5 to cartilage degradation upon catabolic stimulation; ii) To investigate the effect of regulating the activities of key enzymes by mean of broad-spectrum inhibitors. Methods Bovine full-depth cartilage explants stimulated with tumor necrosis factor alpha (TNF......I (ADAMTS-degraded aggrecan), AGNxII (MMP-degraded aggrecan), and CTX-II (MMP-derived type II collagen) were quantified in the explants-conditioned media. Results We found that: i) Active ADAMTS-4, MMP-9, -13 were released in the late stage of TNF-α/ OSM stimulation, whereas no significant active ADAMTS-5...

  18. Hypotonic challenge modulates cell volumes differently in the superficial zone of intact articular cartilage and cartilage explant.

    Science.gov (United States)

    Turunen, Siru M; Lammi, Mikko J; Saarakkala, Simo; Koistinen, Arto; Korhonen, Rami K

    2012-05-01

    The objective of this study was to evaluate the effect of sample preparation on the biomechanical behaviour of chondrocytes. We compared the volumetric and dimensional changes of chondrocytes in the superficial zone (SZ) of intact articular cartilage and cartilage explant before and after a hypotonic challenge. Calcein-AM labelled SZ chondrocytes were imaged with confocal laser scanning microscopy through intact cartilage surfaces and through cut surfaces of cartilage explants. In order to clarify the effect of tissue composition on cell volume changes, Fourier Transform Infrared microspectroscopy was used for estimating the proteoglycan and collagen contents of the samples. In the isotonic medium (300 mOsm), there was a significant difference (p integrity of the mechanical environment of chondrocytes.

  19. Effect of growth regulators and explant origin on in vitro propagation of Ceratonia siliqua L. via cuttings

    Directory of Open Access Journals (Sweden)

    Boussaid M.

    2008-01-01

    Full Text Available The present work was undertaken to develop a basic and simple protocol for micropropagation of Ceratonia siliqua. Axillaries bud sprouting and shoot development were stimulated on MS supplemented with BAP (0.5 mg.l-1, IBA (0.1 mg.l-1 and GA3 (0.5 mg.l-1, shoot multiplication was obtained on MS supplemented with BAP (2 mg.l-1 and rooting of microshoots was achieved on MS supplemented with IBA (2 mg.l-1 and charcoal (2 mg.l-1. The best results were obtained with herbaceous explants taken from juvenile trees. Significant differences in proliferation, multiplication and rooting due to the type and origin of explant and to the concentration of growth regulators were found.

  20. Changes of free, soluble conjugated and bound polyamine titers of jojoba explants under sodium chloride salinity in vitro.

    Science.gov (United States)

    Roussos, Peter A; Pontikis, Constantine A

    2007-07-01

    Jojoba (Simmondsia chinensis L.) single node explants were cultured in a basal medium supplemented with 17.8 microM 6-benzyladenine and four levels of sodium chloride concentration (0, 56.41, 112.82 and 169.23 mM). The free, the soluble conjugated and the insoluble bound forms of polyamines (PAs) (putrescine (Put), spermidine (Spd) and spermine (Spm)) were determined monthly during a 3-month proliferation stage. Free Put and Spd were found in higher levels in the control treatment, while Spm content was higher in the salt treatments. All soluble conjugated PAs were found to be in lower concentrations in explants growing on medium supplemented with salt, while the opposite was true for the insoluble bound PAs. It appeared that certain PAs and PAs forms could play a significant role in the adaptation mechanism of jojoba under saline conditions.

  1. In vitro plant regeneration of two cucumber (Cucumis sativum L. genotypes: Effects of explant types and culture medium

    Directory of Open Access Journals (Sweden)

    Grozeva Stanislava

    2014-01-01

    Full Text Available The effect of different phytohormone concentrations on callusogenesis and organogenesis in two cucumber genotypes were studied. It was established that the rate of plant regeneration depends on genotype, explant type and culture medium. Hypocotyls were found to be more responsive than cotyledons in morphogenesis. In vitro planlet-regenerants have been obtained in hypocotyls explants on culture medium with 1.0 and 2.0 mgL-1 BA for cultivar Gergana and in 1.0 and 3.0 mgL-1K-line 15B. Induction of regeneration in cotyledons were established only in cultivar Gergana on culture medium supplemented with 3.0 mgL-1 BA and in combination of 0.5 mgL-1IAA.

  2. An efficient and reproducible indirect shoot regeneration from female leaf explants of Simmondsia chinensis, a liquid-wax producing shrub.

    Science.gov (United States)

    Bala, Raman; Beniwal, Vijay Singh; Laura, Jitender Singh

    2015-04-01

    Simmondsia chinensis (Link) Schneider is a perennial, dioecious, drought resistant and multipurpose seed oil crop grown in arid and semi-arid conditions throughout the world. A reproducible and more efficient method for indirect shoot organogenesis from female leaf explants has been standardized. The leaf explants cultured on Murashige and Skoog (MS) medium with 1.0 mg l(-1) 2,4-dichlorophenoxyacetic acid (2,4-D) alone produced the highest frequency of callus compared with 1.5 mg l(-1) IBA. Maximum proliferation of callus was observed on MS medium containing a combination of 1.0 mg l(-1) 2,4-D with 0.5 mg l(-1) BAP. For shoot differentiation, the proliferated callus was subcultured on MS medium supplemented with 6-benzylaminopurine (BAP) (1.0-4.0 mg l(-1)) along with 40 mg l(-1) adenine sulphate as additive or in combination with α-naphthalene acetic acid (NAA) or Indole-3-butyric acid (IBA). Optimum shoots differentiated from callus was obtained on MS medium supplemented with 2.0 mg l(-1) BAP and 0.2 mg l(-1) NAA. On this medium, 100 % cultures were responded with an average number of 14.44 shoots per explant with their mean length of 4.78 cm. In vitro rooting (6.22 roots per explant) was achieved on half strength MS medium containing 2 % sucrose with 3.0 mg l(-1) IBA and 300 mg l(-1) activated charcoal (AC). Rooted plantlets were successfully hardened under control conditions and acclimatized under field conditions with 90 % success rate. The present protocol is highly efficient, reproducible and economically viable for large scale production of female plants.

  3. Plant regeneration of non-toxic Jatropha curcas—impacts of plant growth regulators, source and type of explants

    KAUST Repository

    Kumar, Nitish

    2011-01-28

    Jatropha curcas is an oil bearing species with multiple uses and considerable economic potential as a biofuel plant, however, oil and deoiled cake are toxic. A non-toxic variety of J. curcas is reported from Mexico. The present investigation explores the effects of different plant growth regulators (PGRs) viz. 6-benzyl aminopurine (BAP) or thidiazuron (TDZ) individually and in combination with indole-3-butyric acid (IBA), on regeneration from in vitro and field-grown mature leaf explants, in vitro and glasshouse-grown seedlings cotyledonary leaf explants of non-toxic J. curcas. In all the tested parameters maximum regeneration efficiency (81.07%) and the number of shoot buds per explants (20.17) was observed on 9.08 μM TDZ containing Murashige and Skoog’s (MS) medium from in vitro cotyledonary leaf explants. The regenerated shoot buds were transferred to MS medium containing 10 μM kinetin (Kn), 4.5 μM BAP and 5.5 μM α-naphthaleneacetic acid (NAA) for shoot proliferation. The proliferated shoots could be elongated on MS medium supplemented with 2.25 μM BAP and 8.5 μM IAA. Rooting was achieved when the basal cut end of elongated shoots were dipped in half strength MS liquid medium containing different concentrations and combinations of IBA, IAA and NAA for four days followed by transfer to growth regulators free half strength MS medium supplemented 0.25 mg/l activated charcoal. The rooted plants could be established in soil with more than 90% survival rate.

  4. Organotypic explant culture of adult rat retina for in vitro investigations of neurodegeneration, neuroprotection and cell transplantation

    OpenAIRE

    sprotocols

    2015-01-01

    This protocol details a method for isolating retinal tissue from adult rats as an organotypic culture to study neurobiological processes in mature tissue. It combines the efficiency and control common to in vitro techniques with close imitation of the in vivo environment. Eyes from adult rats are enucleated and the neural retina is isolated. Tissue is cut into quarters, yielding eight retinal explants per animal, and cultured at a fluid/air interface on organotypic culture membranes. Explanta...

  5. Effect of gamma rays on different explants of callus treatment of multiple shoots in Cucumis melo cv. Bathasa.

    Science.gov (United States)

    Venkateshwarlu, M

    2008-09-01

    A mutagenesis programme was carried out using physical mutagens (gamma rays) on Cucumis melo cv. Bathasa. In irradiated seeds the number of shoots formed in the lower doses was significantly higher than the controls. Decrease in the number of shoots and shoot bud formation was observed with higher doses in all the explants studies. There was complete lethality in the 10, 15 and 20 kR doses. In irradiated stem cultures the maximum number of shoots were observed in 2 kR. The number of shoots decreased with increasing doses of irradiation. At higher doses of 4 and 5kR, light green compact callus was formed in almost all the explants. The effect of lower doses of gamma irradiation on shoot bud formation and rooting efficiency from nodal explants cultured on MS +2.0 mgl(-1) L-glutamic acid + 0.5 mgl(-1) BAP, stimulation of shoot and root induction were studied. The number of shoots and root lengths decreased with the increasing dosage of irradiation. The irradiated callus was grown on solidified MS medium with containing 2.0 mgl(-1) BAP + 1.0 mgl(-1) IAA. There was a significant stimulation of growth in the callus at lower doses. At higher doses like 15 and 20 kRs growth was drastically reduced.

  6. In vitro effect of biogenic silver nanoparticles on sterilisation of tobacco leaf explants and for higher yield of protoplasts.

    Science.gov (United States)

    Bansod, Sunita; Bawskar, Manisha; Rai, Mahendra

    2015-08-01

    Isolation of protoplasts from leaves is useful in plant research. The standard reference methods for isolation of protoplasts are tedious, cause cell damage, are low-yield, time consuming and prone to microbial contamination. To overcome this problem, the authors used silver nanoparticles (AgNPs) for the control of microbial contamination and with low concentration of enzyme mixture for rapid release of protoplasts. The leaf explants were sterilised with 95% ethanol for 30 s followed by biologically synthesised AgNPs (1, 5, 10 and 15 mg/l) for 10 to 20 min. The authors found that 10 mg/l concentration of AgNPs treatment on explants showed remarkable inhibitory effect on microbial contamination with high level of tolerance. Moreover, during protoplasts isolation, the addition of 10 mg/l AgNPs in leaf incubation buffer yielded 34% viable protoplasts in 3 h. This is the first report of AgNPs synthesis from waste plant medium, which was applied for the sterilisation of explants and rapid isolation of protoplasts.

  7. Direct regeneration of Periwinkle (Catharanthus roseus via node explants culture and different combinations of plant growth regulators

    Directory of Open Access Journals (Sweden)

    M. Talebi

    2012-09-01

    Full Text Available Periwinkle (Catharanthus roseus L., Apocynaceae contains more than 130 different terpenoid indole alkaloids (TIAs, of which two dimeric alkaloids, Vinblastine and Vincristine, have antineoplastic activity and are useful in treatment of various cancers. Specific production of some alkaloids in differentiated tissues such as leaf and stem led to use direct regeneration of explants in order to increase the production of these important alkaloids in the plant. In this research, 30 combinations of plant growth regulators and activated charcoal were used in MS media for direct regeneration of node explants. Application of BAP in media containing 1 g/l activated charcoal showed the best direct regeneration of node explants and shoot proliferation. Although application of activated charcoal is necessary for periwinkle growth in media due to many phenolic compounds, but it has negative effects on adsorption of plant growth regulators and consequently reduce shoot proliferation. Therefore, it seems that 1 g/l activated charcoal is an appropriate concentration for preparing shoot proliferation media. In addition, transporting regenerated shoots to culture media containing NAA resulted in increasing shoot length. Proliferated shoots rooted in media without PGR and with 2 g/l activated charcoal and acclimated with environmental conditions after transferring to the soil.

  8. DIRECT IN VITRO SHOOTS PROLIFERATION OF CHICK PEA (CICER ARIETINUM L. FROM SHOOT TIP EXPLANTS INDUCED BY THIDIAZURON

    Directory of Open Access Journals (Sweden)

    Shaheena Parveen

    2012-01-01

    Full Text Available A rapid, simple and efficient protocol for direct in vitro multiple shoot induction and plantlet regeneration was achieved from shoot tip explants of Cicer arietinum. The shoot tips were cultured on MS medium fortified with Thidiazuron (TDZ (1.0-7.0 mg/L for multiple shoot induction. Multiple shoots proliferation was best observed at 3.0 mg/L TDZ from the shoot tip explants within three weeks of culture. Shoot number per explant ranged between 2 and 10. Individual shoots were aseptically excised and sub cultured in the same media for shoot elongation. The elongated shoots were transferred to Indole Butyric Acid (IBA (1.0mg/L–5.0mg/L for root induction. Rooting was observed within two weeks of culture. Rooted plantlets were successfully hardened under culture conditions and subsequently established in the field conditions. The recorded survival rate of the plants was 86%. Plants looked healthy with no visually detectable phenotypic variations.

  9. Cholangiocarcinoma Secondary to Primary Sclerosing Cholangitis in Explanted Livers: A Single-Center Study in the South of Iran

    Directory of Open Access Journals (Sweden)

    Geramizadeh

    2015-12-01

    Full Text Available Background Primary sclerosing cholangitis (PSC is a chronic disease, characterized by chronic inflammation and fibrosis of bile duct epithelial cells. This is a significant contributory factor to the development of malignancy, most commonly cholangiocarcinoma (CCA, which is the second most common malignant liver tumor. Objectives For the first time in Iran, we intend to describe our experience with cases of PSC, with and without CCA, in explanted livers, and compare our results with those found in other areas of the world. Patients and Methods The study population comprised 181 individuals with a diagnosis of PSC who had undergone liver transplantation in the main liver transplant center of Iran, the largest center of hepatobiliary surgery in the south of that country, over a 3-year period between 2012 and 2014. All explanted livers, with and without CCA, were evaluated. Results Of the 181 patients, 16 were found to have CCA, two of whom had been diagnosed after pathologic study of the explanted livers. Therefore it appeared that 8.8% of the patients with PSC in our center had developed CCA before liver transplantation. Conclusions A comparison of our results with those obtained from other centers in both Western and Asian countries (which reported CCA in 3.6% - 36.5% of patients with PSC, shows that the incidence of CCA in the patients we studied is intermediate.

  10. Thidiazuron: A potent cytokinin for efficient plant regeneration in Himalayan poplar (Populus ciliata Wall. using leaf explants

    Directory of Open Access Journals (Sweden)

    Gaurav Aggarwal

    2012-11-01

    Full Text Available Populus species are important resource for certain branches of industry and have special roles for scientific study on biological and agricultural systems. The present investigation was undertaken with an objective of enhancing the frequency of plant regeneration in Himalayan poplar (Populus ciliata Wall.. The effect of Thiadizuron (TDZ alone and in combination with adenine and α-Naphthalene acetic acid (NAA were studied on the regeneration potential of leaf explants. A high efficiency of shoot regeneration was observed in leaf (80.00% explants on MS basal medium supplemented with 0.024 mg/l TDZ and 79.7 mg/l adenine. Elongation and multiplication of shoots were obtained on Murashige and Skoog (MS basal medium, containing 0.5 mg/l 6. Benzyl aminopurine (BAP + 0.2mg/l Indole 3-acetic acid (IAA + 0.3 mg/l Gibberellic acid (GA3. High frequency root regeneration from in vitro developed shoots was observed on MS basal medium supplemented with 0.10 mg/l Indole 3-butyric acid(IBA. Maximum of the in vitro rooted plantlets were well accomplished to the mixture of sand: soil (1:1 and exhibited similar morphology with the field plants. A high efficiency plant regeneration protocol has been developedfrom leaf explants in Himalayan poplar (Populus ciliata Wall..

  11. Effect of ZnO nanoparticles on Brassica nigra seedlings and stem explants: growth dynamics and antioxidative response

    Directory of Open Access Journals (Sweden)

    Hira eZafar

    2016-04-01

    Full Text Available Nanoparticles (NPs have diverse properties in comparison to respective chemicals due to structure, surface area ratio, morphology, and reactivity. Toxicological effects of metallic NPs to organisms including plants have been reported. However, to the authors’ knowledge there is no report on the effect of NPs on in vitro culture of plant explants. In this study, ZnO NPs at 500-1500 mg/L badly affected Brassica nigra seed germination and seedling growth and raised antioxidative activities and antioxidants concentrations. On the other hand, culturing the stem explants of B. nigra on Murashige and Skoog (MS medium in presence of low concentration of ZnO NPs (1-20 mg/L produced white thin roots with thick root hairs. At 10 mg/L ZnO NPs shoots emergence was also observed. The developed calli/roots showed 79% DPPH (2,2-diphenyl-1-picryl hydrazyl radical scavenging activity at 10 mg/L. While total antioxidant and reducing power potential were also significantly different in presence of ZnO NPs. Non enzymatic antioxidative molecules, phenolics (up to 0.15 µg GAE/mg FW and flavonoids (up to 0.22 µg QE/mg FW, also raised and found NPs concentration dependent. We state that ZnO NPs may induce roots from explants cultured on appropriate medium and can be cultured for production of valuable secondary metabolites.

  12. Effects of variations in culture media and hormonal treatments upon callus induction potential in endosperm explant of Barringtonia racemosa L.

    Institute of Scientific and Technical Information of China (English)

    Nurul Izzati Osman; Norrizah Jaafar Sidik; Asmah Awal

    2016-01-01

    Objective: To induce callus from the medicinally valuable species, Barringtonia racemosa L.(B. racemosa) whereby the formation of callus is essential for micropropagation studies and in vitro plant secondary metabolites production.Methods: The callus induction potential in B. racemosa was assessed from endosperm explant cultured on different culture media and plant hormonal treatments. Lloyd and Mc Cown’s woody plant medium and Murashige and Skoog’s medium were used in the study as culture media. On the other hand, various concentrations and combinations of2,4-dichlorophenoxyacetic acid(1.0–2.0 mg/L) and kinetin(0.5–2.5 mg/L) had been incorporated in the culture media to exert the effects of auxin and cytokinin on callus induction.Results: From the present study, it was found that the profuse [(1.681 ± 0.770) g fresh weight,(0.239 ± 0.239) g dry weight] and friable callus formation was optimally produced with desirable morphology and considerable percentage of callus induction(56.70%) in endosperm explants cultured on 1.0 mg/L 2,4-dichlorophenoxyacetic acid and 1.5 mg/L kinetin in Murashige and Skoog’s medium.Conclusions: A reliable protocol for inducing callus formation of profuse and friable morphology in endosperm explant of B. racemosa had therefore been successfully established.

  13. Evaluation of taper joints with combined fatigue and crevice corrosion testing: Comparison to human explanted modular prostheses

    Energy Technology Data Exchange (ETDEWEB)

    Reclaru, L., E-mail: lucien.reclaru@pxgroup.com [PX Group S.A., Dep R and D Corrosion and Biocompatibility Group, Bd. des Eplatures 42, CH-2304 La Chaux-de-Fonds (Switzerland); Brooks, R.A. [Orthopaedic Research, Addenbrooke' s Hospital, University of Cambridge, Box 180 Hills Road, CB2 0QQ Cambridge (United Kingdom); Zuberbühler, M. [Smith and Nephew Orthopaedics AG, Schachenalle 29, 5001 Aarau (Switzerland); Eschler, P.-Y.; Constantin, F. [PX Group S.A., Dep R and D Corrosion and Biocompatibility Group, Bd. des Eplatures 42, CH-2304 La Chaux-de-Fonds (Switzerland); Tomoaia, G. [University of Medicine and Pharmacy Iuliu Hateganu of Cluj-Napoca, Dept. of Orthopaedics and Traumatology, Cluj-Napoca (Romania)

    2014-01-01

    The requirement for revision surgery of total joint replacements is increasing and modular joint replacement implants have been developed to provide adjustable prosthetic revision systems with improved intra-operative flexibility. An electrochemical study of the corrosion resistance of the interface between the distal and proximal modules of a modular prosthesis was performed in combination with a cyclic fatigue test. The complexity resides in the existence of interfaces between the distal part, the proximal part, and the dynamometric screw. A new technique for evaluating the resistance to cyclic dynamic corrosion with crevice stimulation was used and the method is presented. In addition, two components of the proximal module of explanted Ti6Al4V and Ti6Al7Nb prostheses were investigated by optical and electron microscopy. Our results reveal that: The electrolyte penetrates into the interface between the distal and proximal modules during cyclic dynamic fatigue tests, the distal module undergoes cracking and corrosion was generated at the interface between the two models; The comparison of the explanted proximal parts with the similar prostheses evaluated following cyclic dynamic crevice corrosion testing showed that there were significant similarities indicating that this method is suitable for evaluating materials used in the fabrication of modular prostheses. - Highlights: • Electrochemical crevice corrosion testing combined with fatigue test conducted on Ti6Al7Nb and Ti6Al4V modular prostheses • Cations released from integral prostheses • Comparison of human explanted modular prostheses with the similar prostheses evaluated in cyclic dynamic crevice corrosion.

  14. An efficient protocol devised for rapid callus induction from leaf explants of Biophytum sensitivum (lDC.

    Directory of Open Access Journals (Sweden)

    Sirigiri Chandra Kala

    2014-03-01

    Full Text Available The Cell cultures are used extensively for in vitro secondary metabolite productions were obtained from callus tissue through cell suspension culture.  The establishment of callus cultures has considerable potential for the production of known and novel secondary metabolites. The objective of the study was to scientifically assess callus culture of Biophytum sensitivum (L DC. was established from leaf explants with different growth regulators greatly influenced the growth of callus cultures. The callus from leaf explants is induced by inoculating the young leaf bits on MS medium supplemented with various auxins (2, 4- Dichlorophenoxyacetic acid (2, 4-D, α-Naphthalene Acetic Acid (NAA and Indole Buteric Acid (IBA, cytokinins (6-Benzyladenine (BA and Kinetin (KN and cytokinin-auxin combination (BA+NAA in different concentrations were (0.5 to 5.0 mg/l used. BA 1mg/l, in combination with NAA (1.0 mg/l also produced maximum amount of callus.  So, this research is concluded that the plant leaf explants cultured on MS medium with 1 mg/ l  BA with 0.5 mg/l NAA was found most efficient for callus induction, provided calli with quite good in texture and friable in nature.

  15. Plantlet regeneration from mature zygotic embryos and embryonic explants of masson pine (Pinus massoniana Lamb.)

    Institute of Scientific and Technical Information of China (English)

    HUANGJIANQIU; ZHIMINGWEI; 等

    1994-01-01

    Excised zygotic embryos,cotyledons and hypocotyls of juvenile seedlings of masson pine were grown on DCR medium supplemented with several concentrations of various plant phytohormones.BA(1.0mg/L) in combination with NAA(0.05mg/L) in DCR medium was found to increase the formation of adventitious buds from mature zygotic embryos,but most of them were formed at the tips of embryonic cotyledons.Adventitious buds were obtained from cotyledons and hypocotyls from juvenile seedlings when they were cultured on DCR medium containing BA 3-5 mg/L and NAA 0.1-0.2 mg/L.Elongation of buds were observed on hormone-free DCR medium with or without activated charcoal(0.5%).Root initiation was achieved with full or half strength DCR medium supplemented with IBA 1.0 mg/L and NAA 0.25-0.5 mg/L.Approximately 11-20 axillary buds formed on each explant when juvenile seedling explants were treated(3-20h) with BA 50-100 mg/L,followed by transfer to hormone-free DCR medium.The maximum number of shoots obtained per explant within six months was 33.

  16. Indirect organogenesis from various explants of Hildegardia populifolia (Roxb. Schott & Endl. – A threatened tree species from Eastern Ghats of Tamil Nadu, India

    Directory of Open Access Journals (Sweden)

    A.R. Lavanya

    2014-12-01

    Full Text Available Hildegardia species are an important resource for fiber industry. This investigation was conducted to develop a plant regeneration protocol for Hildegardia populifolia (Roxb. Schott & Endl. via indirect organogenesis Callus was obtained from leaf, internode and petiole explants, among these explants internode explant gave best result on MS medium supplemented with different concentrations of 2,4-Dichlorophenoxy acetic acid (2,4-D. The highest percentage (100% of regeneration was obtained with benzyladenine (BA (2.0 mg/l + indole-3-acetic acid (IAA (0.1 mg/l + glutamine (25 mg/l + thidiazuron (TDZ (0.5 mg/l from internode explants. Shootlets were highly rooted on MS medium supplemented with 3.0 mg/l indole-3-butyric acid (IBA. In vitro rooted seedlings were successfully acclimatized. This in vitro regeneration system will facilitate further development of reliable procedures for this genus.

  17. The effects of Brazilian propolis on etiological agents of mastitis and the viability of bovine mammary gland explants.

    Science.gov (United States)

    Fiordalisi, Samira A L; Honorato, Luciana A; Loiko, Márcia R; Avancini, César A M; Veleirinho, Maria B R; Machado Filho, Luiz C P; Kuhnen, Shirley

    2016-03-01

    The objective of this study was to evaluate in vitro the antimicrobial activity of Brazilian propolis from Urupema, São Joaquim, and Agua Doce (Santa Catarina State) and green propolis from Minas Gerais State, and the effects of propolis on bovine mammary gland explant viability. The propolis samples differed in flavonoid content and antioxidant activity. Green propolis showed the highest content of flavonoids, followed by the sample from São Joaquim. The propolis from Urupema showed the lowest flavonoid content along with the lowest antioxidant activity. The total phenolics were similar across all studied samples. Despite phytochemical differences, the propolis samples from Minas Gerais, São Joaquim, and Urupema presented the same level of antimicrobial activity against Staphylococcus aureus strains. The reduction in S. aureus growth was, on average, 1.5 and 4 log10 times at 200 and 500 μg/mL, respectively. At concentrations of 1,000 μg/mL, all propolis reduced bacterial growth to zero. On the other hand, when the propolis were tested against strains of Escherichia coli, the samples presented weak antimicrobial activity. Mammary explants were maintained in culture for 96h without a loss in viability, demonstrating the applicability of the model in evaluating the toxicity of propolis. The origin and chemical composition of the propolis had an effect on mammary explant viability. We encountered inhibitory concentrations of 272.4, 171.8, 63.85, and 13.26 μg/mL for the propolis from Água Doce, Urupema, São Joaquim, and Mina Gerais, respectively. A clear association between greater antimicrobial activity and toxicity for mammary explants was observed. Of all propolis tested, the Urupema sample was noteworthy, as it showed antimicrobial activity at less toxic concentrations than the other samples, reducing bacterial growth to an average of 9.3 × 10(2) cfu/mL after 6h of contact using 200 μg/mL of extract. The results demonstrate the potential for Brazilian

  18. Replication of avian, human and swine influenza viruses in porcine respiratory explants and association with sialic acid distribution

    Directory of Open Access Journals (Sweden)

    Nauwynck Hans J

    2010-02-01

    Full Text Available Abstract Background Throughout the history of human influenza pandemics, pigs have been considered the most likely "mixing vessel" for reassortment between human and avian influenza viruses (AIVs. However, the replication efficiencies of influenza viruses from various hosts, as well as the expression of sialic acid (Sia receptor variants in the entire porcine respiratory tract have never been studied in detail. Therefore, we established porcine nasal, tracheal, bronchial and lung explants, which cover the entire porcine respiratory tract with maximal similarity to the in vivo situation. Subsequently, we assessed virus yields of three porcine, two human and six AIVs in these explants. Since our results on virus replication were in disagreement with the previously reported presence of putative avian virus receptors in the trachea, we additionally studied the distribution of sialic acid receptors by means of lectin histochemistry. Human (Siaα2-6Gal and avian virus receptors (Siaα2-3Gal were identified with Sambucus Nigra and Maackia amurensis lectins respectively. Results Compared to swine and human influenza viruses, replication of the AIVs was limited in all cultures but most strikingly in nasal and tracheal explants. Results of virus titrations were confirmed by quantification of infected cells using immunohistochemistry. By lectin histochemistry we found moderate to abundant expression of the human-like virus receptors in all explant systems but minimal binding of the lectins that identify avian-like receptors, especially in the nasal, tracheal and bronchial epithelium. Conclusions The species barrier that restricts the transmission of influenza viruses from one host to another remains preserved in our porcine respiratory explants. Therefore this system offers a valuable alternative to study virus and/or host properties required for adaptation or reassortment of influenza viruses. Our results indicate that, based on the expression of Sia

  19. Induction of shoot buds, multiplication and plantlet formation in seedling explants of bell pepper (Capsicum annuum L. cv. Bryza in vitro

    Directory of Open Access Journals (Sweden)

    Andrzej Gatz

    2014-01-01

    Full Text Available In vitro shoot bud induction and multiplication as well as plantlets formation from different parts of 21-d old seedlings (shoot tip, cotyledonary node, distal part of cotyledon, acropetal section of hypocotyl of Capsicum annuum L., cv. Bryza were compared. During 4 weeks of primary explant culture on initiation media, first shoot bud primordia appeared; they reminded leaf primordia and subsequently some of them underwent enlargement, some developed into leaves and leaf-like structures (mainly on cotyledon explants. The highest number of shoot bud primordia was noted on cotyledonary node explants, but they were smaller than those on the remaining types of the explants. The best response of shoot regeneration showed cotyledon explants on which most of shoot buds were formed in each from four treated passages. From shoot buds on elongation media after 4 weeks of culture rooted rosettes of leaves were achieved, and the extension of the culture time to eight weeks without subculture caused that the rosettes developed into plantlets. Throughout four successive passages plantlets were obtained from cotyledon and shoot tip explants.

  20. Efficient plant regeneration protocol through callus for Saussurea obvallata (DC.) Edgew. (Asteraceae): effect of explant type, age and plant growth regulators.

    Science.gov (United States)

    Dhar, Uppeandra; Joshi, Mitali

    2005-06-01

    A callus induction and in vitro plantlet regeneration system for the endangered state flower of Uttaranchal (Saussurea obvallata) was optimized by studying the influence of explant type (root, hypocotyl, cotyledon and leaf), age and different concentrations of plant growth regulators. Explants from 10 to 15-day-old seedlings showed maximum callus induction. Callus formation and shoot differentiation was initiated on Murashige-Skoog (MS) medium containing 6-benzyladenine (BA) and alpha-naphthalene acetic acid (NAA) in all explant types. The best results were obtained using leaf explants: 100% callusing was achieved in MS medium supplemented with 2.5 microM BA and 1.0 microM NAA, and 100% differentiation along with a multiplication rate of 12 shoots per explant with a combination of 5.0 microM BA and 1.0 microM NAA. However, the results reflected the existence of high inter-explant variability in response to growth regulators. In vitro rooting of shoots was achieved at an efficiency of 100% in one-half strength MS medium supplemented with 2.5 microM indole-3-butyric acid. Application of this protocol has potential for mass multiplication of the target species in a limited time period.