Long-term performance of the St Jude Riata 1580–1582 ICD lead family

Objective

Safety concerns about the Riata ICD shock lead were recently raised, with insulation failure due to conductor externalisation. Its incidence and presentation were assessed, and predictors of insulation failure and lead survival of the Riata 1580–1582 were studied, retrospectively, before the official recall.

Methods

All 374 patients at the Erasmus Medical Center between July 2003 and December 2007 with a 1580, 1581 or 1582 shock lead.

Results

The majority of the patients were male (78 %), with a median age of 60 years (IQR 52–70); primary prevention in 61 %. Median follow-up was 60.3 months (IQR 35.5–73.2), with 117 (31 %) patients dying. Electrical abnormalities (mainly noise, 65 %) were observed in 20/257 patients (7.8 %). Definite conductor externalisation was confirmed with fluoroscopy or chest X-ray in 16 patients, and in one after extraction. One patient presented with a drop in the high-voltage impedance trend with a short circuit of the ICD system during defibrillation testing, and needed to be shocked externally. In 8 more patients, conductor externalisation was found during an elective procedure. No predictors of externalisation could be found, except for the use of single coil (p = 0.02). Median time to conductor externalisation was 5 years (IQR 3.1–6.2). Lead externalisation was observed in 5.4 % (95 % CI 3.1–9.3) at 5 years and 22.7 % (95 % CI 13.6–36.6) at 8 years.

Conclusion

A high incidence of insulation defects associated with conductor externalisation in the Riata ICD lead family is observed. The mode of presentation is diverse. This type of insulation failure can lead to failure of therapy delivery.     

3q26.31–q29 duplication and 9q34.3 microdeletion associated with omphalocele,ventricular septal defect,abnormal first-trimester maternal serum screening and increased nuchal translucency: Prenatal diagnosis and aCGH characterization

We present prenatal diagnosis and array comparative genomic hybridization characterization of 3q26.31–q29 duplication and 9q34.3 microdeletion in a fetus with omphalocele, ventricular septal defect, increased nuchal translucency, abnormal first-trimester maternal screening and facial dysmorphism with distinct features of the 3q duplication syndrome and Kleefstra syndrome. The 26.61-Mb duplication of 3q26.31–q29 encompasses EPHB3, CLDN1 and CLDN16, and the 972-kb deletion of 9q34.3 encompasses EHMT1. We review the literature of partial trisomy 3q associated with omphalocele and discuss the genotype–phenotype correlation in this case.     

Molecular dynamics study on perfect and defective graphene/calcium-silicate-hydrate composites under tensile loading

ABSTRACT

Atomic models of graphene/calcium-silicate-hydrate (G/C-S-H) are constructed by embedding perfect or defective graphene in molecular structures of amorphous C-S-H. Molecular dynamics (MD) simulation is utilised to study mechanical properties of the G/C-S-H and the enhancing effect of perfect and defective graphene is compared. The effects of temperature and strain rate on perfect and defective G/C-S-H are also investigated and compared. The results from present simulations show that (i) the defective graphene has better enhancing effect in C-S-H than perfect one and it grows with the increase of defect sizes; (ii) the tensile strength of G/C-S-H decreases with the increase of temperature and the defective G/C-S-H is more susceptible to temperature than the perfect one; (iii) the ultimate strength and the failure strain increase significantly with the increase of strain rate and the effects of strain rate on perfect and defective G/C-S-H are similar. These findings provide important atomic insights for understanding the mechanical behaviours of G/C-S-H composite.     

Kinetic Monte Carlo simulation for the striation distribution of void defects in Czochralski silicon growth

Unique crystal-originated pit (COP) distribution, similar to a striation pattern, is well matched with the oxygen profile in experimental analysis. It shows the strong relationship between oxygen concentration and COP distribution. In this paper, we study the generation of void defects and the relationship between interstitial oxygen and vacancy using the kinetic lattice Monte Carlo (KLMC) method. The KLMC method has been applied extensively in various forms to the study of micro-defects in silicon wafers. It explained well the formation of void defects such as vacancy–oxygen complex and vacancy–vacancy complex. The formation of clusters is strongly affected by oxygen concentration, which showed the relationship between COP distribution and oxygen concentration. The unique COP distribution could be correctly explained with KLMC results, and this kind of meso-scale results has not yet been reported.     

High dietary arachidonic acid levels affect the process of eye migration and head shape in pseudoalbino Senegalese sole Solea senegalensis early juveniles

The effect of high dietary levels of arachidonic acid (ARA) on the eye migration and cranial bone remodelling processes in Senegalese sole Solea senegalensis early juveniles (age: 50 days post hatch) was evaluated by means of geometric morphometric analysis and alizarin red staining of cranial skeletal elements. The incidence of normally pigmented fish fed the control diet was 99·1 ± 0·3% (mean ± s.e .), whereas it was only 18·7 ± 7·5% for those fed high levels of ARA (ARA‐H). The frequency of cranial deformities was significantly higher in fish fed ARA‐H (95·1 ± 1·5%) than in those fed the control diet (1·9 ± 1·9%). Cranial deformities were significantly and negatively correlated with the incidence of normally pigmented animals (r² = ?0·88, P < 0·001, n = 16). Thus, fish displaying pigmentary disorders differed in the position of their eyes with regard to the vertebral column and mouth axes, and by the interocular distance and head height, which were shorter than in fish not displaying pigmentary disorders. In addition to changes in the positioning of both eyes, pseudoalbino fish showed some ARA‐induced osteological differences for some of the skeletal elements from the splanchnocranium (e.g. right premaxillary, dentary, angular, lacrimal, ceratohyal and branchiostegal rays) and neurocranium (e.g. sphenotic, left lateral ethmoid and left frontal) by comparison to normally pigmented specimens. Pseudoalbino fish also had teeth in both lower and upper jaws. This is the first study in Pleuronectiformes that describes impaired metamorphic relocation of the ocular side eye, the right eye in the case of S. senegalensis, whereas the left eye migrated into the ocular side almost normally.     

Shape and volume of craniofacial cavities in intentional skull deformations

Intentional cranial deformations (ICD) have been observed worldwide but are especially prevalent in preColombian cultures. The purpose of this study was to assess the consequences of ICD on three cranial cavities (intracranial cavity, orbits, and maxillary sinuses) and on cranial vault thickness, in order to screen for morphological changes due to the external constraints exerted by the deformation device. We acquired CT‐scans for 39 deformed and 19 control skulls. We studied the thickness of the skull vault using qualitative and quantitative methods. We computed the volumes of the orbits, of the maxillary sinuses, and of the intracranial cavity using haptic‐aided semi‐automatic segmentation. We finally defined 3D distances and angles within orbits and maxillary sinuses based on 27 anatomical landmarks and measured these features on the 58 skulls. Our results show specific bone thickness patterns in some types of ICD, with localized thinning in regions subjected to increased pressure and thickening in other regions. Our findings confirm that volumes of the cranial cavities are not affected by ICDs but that the shapes of the orbits and of the maxillary sinuses are modified in circumferential deformations. We conclude that ICDs can modify the shape of the cranial cavities and the thickness of their walls but conserve their volumes. These results provide new insights into the morphological effects associated with ICDs and call for similar investigations in subjects with deformational plagiocephalies and craniosynostoses. Am J Phys Anthropol 151:110–119, 2013. © 2013 Wiley Periodicals, Inc.     

年龄增长对GRK5基因缺陷小鼠海马内肿胀轴突丛形成与积累的影响

目的研究G蛋白偶联受体（G protein-coupled receptors）激酶5（GPCR kinase-5,GRK5）基因缺陷和老化交互作用对阿尔茨海默病（Alzheimer＇s disease,AD）早期的病理改变-海马内肿胀轴突丛（swollen axonal clusters,SACs）出现和积累的影响。方法选取5、6、7、9、12～13、18—19月龄雌性GRK5基因敲除小鼠（GRK5 Knockout,GRK5KO）作为观察对象,另选取年龄匹配的雌性野生型（wild type,WT）小鼠为对照,每个年龄段GRK5KO和WT小鼠各4只。用抗人神经原纤维缠结（neurofibrillary tangles,NFTs）特异性抗体的免疫荧光染色方法观察海马内SACs的变化。结果所有小鼠随着年龄增长,海马内SACs逐渐增加;GRKSKO小鼠组海马内NFT^＋ SACs数量较WT型小鼠组显著增加（P〈0．01）;双因素方差分析显示遗传性GRK5基因缺陷和老化双因素对海马内NFT^＋SACs的影响有显著协同效应（P〈0．01）。结论在促进早期AD病理发生的过程中,GRK5缺陷和老化双因素共同加剧了雌性GRKSKO小鼠海马内SACs的形成与积累。     

兔食管静脉曲张模型的建立

目的建立新西兰兔的食管静脉曲张模型,为下一步的临床研究提供可靠的小型动物模型。方法采用门静脉左支完全夹闭法造模,并通过外观、超声、胃镜等检查检验手段对造模结果加以评估。结果术后8周存活动物100%可见食管静脉曲张。结论通过门静脉左支夹闭法,基本可以建立兔食管静脉曲张模型。     

An Unusual,Fangless Short-tailed Snake(Squamata,Serpentes, Homalopsidae) from Sumatra,Indonesia

Two genera of fangless homalopsid snakes Brachyorrhos and Calamophis from eastern Indonesia have been described as basal members of the clade. A third genus belonging to this group from Sumatra, Indonesia is described here based upon morphology. Fangless homalopsid snakes share 19 dorsal scale rows at mid-body, fused dorsal scales above the cloaca, 5 to 7 upper labials, divided anal plate, divided subcaudals, 15–21 teeth on the dentary, frontal bone about 23% of skull length and other morphological characters that suggest they are related. All the three genera are known only from Indonesia. The new genus and species have a distinctive skull morphology with an absent premaxilla, a more depressed skull, and a larger eye than are present in Brachyorrhos.