Simulation of LV pacemaker lead in marginal vein: potential risk factors for acute dislodgement

Although left ventricular (LV) coronary sinus lead dislodgement remains a problem, the risk factors for dislodgement have not been clearly defined. In order to identify potential risk factors for acute lead dislodgement, we conducted dynamic finite element simulations of pacemaker lead dislodgement in marginal LV vein. We considered factors such as mismatch in lead and vein diameters, velocity of myocardial motion, branch angle between the insertion vein and the coronary sinus, degree of slack, and depth of insertion. The results show that large lead-to-vein diameter mismatch, rapid myocardial motion, and superficial insertion are potential risk factors for lead dislodgement. In addition, the degree of slack presents either a positive or negative effect on dislodgement risk depending on the branch angle. The prevention of acute lead dislodgment can be enforced by inducing as much static friction force as possible at the lead-vein interface, while reducing the external force. If the latter exceeds the former, dislodgement will occur. The present findings underscore the major risk factors for lead dislodgment, which may improve implantation criterion and future lead design.     

Reduction in wire tension caused by dynamic loading. An experimental Ilizarov frame study

Small diameter transosseous wires are main parts of the Ilizarov frame concept. Wire tensioning is essential to gain the necessary transversal stiffness, and the wire fixators are therefore important, coupling the wire to the ring. The ability of three different wire fixator designs to maintain wire tension under dynamic loading is described. The three fixator designs were combinations of two types of bolts and one washer. In a simplified frame set-up consisting of one ring and one wire, sixty wires were dynamically loaded in sequence with 200N for 450 times and wire tension was repeatedly measured. The tension loss employing the different fixator types at two wire pretension levels (883N, 1275N) was measured. Wire slippage in the fixators and the midpoint deflection angle of the wires were measured. Large differences in fixation ability were observed. Wire fixators holding a larger and rougher contact surface had significant smaller tension loss compared to fixators with a smaller and smother contact surface. Both plastic wire deformation and slippage causes tension loss with slippage as the main contributor. Wire fixators' design can be improved in order to maintain wire tension. Such improvement could be of clinical interest enhancing the mechanical stability of the fixator.     

Multiple recording of electromyograms in a chronic experiment

The authors describe electromyographic electrodes (EMG electrodes) for recording the activity of several muscles in chronic experiments on cats. An EMG electrode is a loop made of a silver wire 200 micron in diameter and 1.5-2 cm long, to which a flexible copper wire insulated with teflon 300 micron in diameter is soldered. The soldering site is insulated with biologically indifferent material. The EMG electrodes turned out fairly good in numerous experiments.     

Alterations in myocardial energy metabolism induced by the anti-cancer drug doxorubicin

Doxorubicin and other anthracyclines are among the most potent chemotherapeutic drugs for the treatment of acute leukaemia, lymphomas and different types of solid tumours such as breast, liver and lung cancers. Their clinical use is, however, limited by the risk of severe cardiotoxicity, which can lead to irreversible congestive heart failure. There is increasing evidence that essential components of myocardial energy metabolism are among the highly sensitive and early targets of doxorubicin-induced damage. Here we review doxorubicin-induced detrimental changes in cardiac energetics, with an emphasis on the emerging importance of defects in energy-transferring and -signalling systems, like creatine kinase and AMP-activated protein kinase.     

CRT_D介导室性心动过速的研究进展

心室再同步心脏转复除颤器（CRT）可有效改善心力衰竭（CHF）患者的运动耐量和生活质量,预防猝死,提高生存率,但_DCHFCRTD植入后由于心室激动顺序的改变,使QT间期延长、跨室壁复极离散度（TDR）增加,潜在致室性心律失常风险;且CHF患者通常存在心肌解剖改变,传导的不均一性,也为折返性心动过速的发生提供了维持的机制;而多次电击也可导致肌钙蛋白升高,引起心肌损伤,局部心肌复极离散度增加（DRVR）和QT间期延长,以及电除颤后心肌纤维化和急性细胞损伤,反复室速、室颤也会引起进行性左心功能不全、心肌细胞凋亡、恶化心律失常基质和增加心律失常易感性。CRT_D潜在致室性心律失常作用逐渐引起人们的重视,本文就近年来CRTD致室性心律失常的电生理机制与临床防治对策等做一综述。     

Tip size of ion-exchanger based K+-selective microelectrodes. II. Effects on measurement of evoked [K+]0 transients

Double-barreled ion-exchanger based K+-selective microelectrodes (K+ ISMs) of a variety of tip diameters were used to provide an experimental test of predictions that microelectrode tip induced tissue damage influences the magnitude of measured [K+]0 increases. The measured magnitude of stimulation induced [K+]0 rises in the rat optic nerve depended on the tip diameter of the measuring K+ ISM; smaller tipped K+ ISMs tended to measure larger rises of [K+]0 than bigger tipped K+ ISMs. When stimulated [K+]0 increases were simultaneously recorded with 2 K+ ISMs of different tip size, the smaller tipped K+ ISM recorded [K+]0 increases that were, on average, 14% larger than the increases measured by the bigger tipped K+ ISM. In view of these results, and those presented in the previous paper, investigators should standardize the tip sizes of the ISMs used in their experiments.     

Choice of Tethering Material Influences the Magnitude and Significance of Treatment Effects in Whitefly Electrical Penetration Graph Recordings

The electrical penetration graphing or electropenetrography (EPG) technique is essential for understanding interactions of hemipteran insects with their host plants. Typically, 10–12.5 μm diameter gold wire is used as the tethering material in EPG studies. This wire was originally chosen based on suitability for aphids, but application of the EPG technique to other insects necessitates testing of alternative tethering materials that permit natural foraging and probing behavior. Whiteflies are one group for which EPG studies are increasing, with most researchers using 10 or 12.5 μm diameter gold wire even though these insects are smaller than aphids and very different in mobility. However, 2.5 μm diameter Wollaston process platinum wire has been used for a subset of EPG studies and seems to permit more natural movement and feeding behaviors. Here, we compared EPG variables derived from recordings of the sweet potato whitefly (Bemisia tabaci) tethered with 12.5 μm diameter gold wire or 2.5 μm diameter platinum wire. On a suitable host, gold-tethered whiteflies had reduced phloem phases, which are indicative of host plant acceptance, compared to platinum-tethered whiteflies. When we included a treatment known to reduce plant quality (methyl jasmonate application), platinum-tethered whiteflies exhibited expected reductions in EPG variables related to host acceptance, while gold-tethered whiteflies either had no response, or the opposite response. Our results indicate that tethering material strongly influences the outcome of EPG experiments, with important consequences for evaluations of host plant resistance, putative instances of plant virus manipulation, and feeding variables associated with virus transmission.     

Molecular simulation of size-selective gas adsorption in idealised carbon nanotubes

Molecular simulations were used to examine the adsorption of diatomic molecules (nitrogen and oxygen) and similarly sized gases (argon and methane) in pores with van der Waals diameters similar in size to the gas diameters. Idealised carbon nanotubes were used to model generic pores, to better understand the effect of pore diameter on guest adsorption in the absence of defects, specific adsorption sites, or variations in pore diameter that often complicate studies of gas adsorption in other porous materials. Molecular dynamics simulations of open nanotubes show that argon and methane are able to enter tubes whose diameters are slightly smaller than the gas diameters. Diatomic gases are able to enter tubes that are significantly smaller than their kinetic diameters with the molecular axis aligned parallel to the nanotube. The results indicate that size-selective adsorption of these gases is theoretically possible, although differences in pore diameters of only a few tenths of an Angstrom are required. Grand canonical Monte Carlo simulations of a 3.38 Å nanotube indicate significant uptake by argon and oxygen, but not nitrogen or methane. The adsorption of nitrogen and methane gradually increases as the nanotube diameter approaches 4.07 Å, and all gases fully saturate a 4.54 Å nanotube. Of the nanotubes studied, the largest adsorption enthalpy for any gas corresponds to the 4.54 Å nanotube, with significantly lower enthalpies seen in the 5.07 Å nanotube. These results suggest an ideal pore diameter for each gas based on the gas–pore van der Waals interaction energies. Trends in the ideal diameter correlate with the minimum tube diameter accessible to each gas.     

Interim analysis and sample size reassessment

This article deals with sample size reassessment for adaptive two-stage designs based on conditional power arguments utilizing the variability observed at the first stage. Fisher's product test for the p-values from the disjoint samples at the two stages is considered in detail for the comparison of the means of two normal populations. We show that stopping rules allowing for the early acceptance of the null hypothesis that are optimal with respect to the average sample size may lead to a severe decrease of the overall power if the sample size is a priori underestimated. This problem can be overcome by choosing designs with low probabilities of early acceptance or by midtrial adaptations of the early acceptance boundary using the variability observed in the first stage. This modified procedure is negligibly anticonservative and preserves the power.     

Measuring surface potential components necessary for transmembrane current computation using microfabricated arrays

This study was designed to test the feasibility of using microfabricated electrodes to record surface potentials with sufficiently fine spatial resolution to measure the potential gradients necessary for improved computation of transmembrane current density. To assess that feasibility, we recorded unipolar electrograms from perfused rabbit right ventricular free wall epicardium (n = 6) using electrode arrays that included 25-microm sensors fabricated onto a flexible substrate with 75-microm interelectrode spacing. Electrode spacing was therefore on the size scale of an individual myocyte. Signal conditioning adjacent to the sensors to control lead noise was achieved by routing traces from the electrodes to the back side of the substrate where buffer amplifiers were located. For comparison, recordings were also made using arrays built from chloridized silver wire electrodes of either 50-microm (fine wire) or 250-microm (coarse wire) diameters. Electrode separations were necessarily wider than with microfabricated arrays. Comparable signal-to-noise ratios (SNRs) of 21.2 +/- 2.2, 32.5 +/- 4.1, and 22.9 +/- 0.7 for electrograms recorded using microfabricated sensors (n = 78), fine wires (n = 78), and coarse wires (n = 78), respectively, were found. High SNRs were maintained in bipolar electrograms assembled using spatial combinations of the unipolar electrograms necessary for the potential gradient measurements and in second-difference electrograms assembled using spatial combinations of the bipolar electrograms necessary for surface Laplacian (SL) measurements. Simulations incorporating a bidomain representation of tissue structure and a two-dimensional network of guinea pig myocytes prescribed following the Luo and Rudy dynamic membrane equations were completed using 12.5-microm spatial resolution to assess contributions of electrode spacing to the potential gradient and SL measurements. In those simulations, increases in electrode separation from 12.5 to 75.0, 237.5, and 875.0 microm, which were separations comparable to the finest available with our microfabricated, fine wire, and coarse wire arrays, led to 10%, 42%, and 81% reductions in maximum potential gradients and 33%, 76%, and 96% reductions in peak-to-peak SLs. Maintenance of comparable SNRs for source electrograms was therefore important because microfabrication provides a highly attractive methods to achieve spatial resolutions necessary for improved computation of transmembrane current density.     

Nonelectrolyte Permeability, Sodium Influx, Electrical Potentials, and Axolemma Ultrastructure in Squid Axons of Various Diameters

The penetration of ¹⁴C-labeled ethylene glycol, erythritol, mannitol, and sucrose was measured in giant axons of various diameters isolated from the hindmost stellar nerves of Doryteuthis plei squid. Axon diameter depends mainly on the age of the squid. The influx of ²²Na, some electrical properties, and the ultrastructure of the axolemma were also studied. The results confirm our previous observation that in medium sized axons of D. plei stimulation causes an increase in the permeability to the penetration of erythritol, mannitol, and sucrose. They also demonstrate that the magnitude of the increase in the penetration of these probing molecules diminishes progressively as the axon diameter increases. The diminution in permeability may be due to a reduction in size of the pathways used by nonelectrolytes to enter the axon. No effect of stimulation on the ethylene glycol permeability is observed. The sodium influx and electrical properties are independent of axon size. The ultrastructural study shows that the axolemma thickness increases with axon diameter. The present experiments indicate that the nonelectrolyte permeability of stimulated axons depends on nerve fiber properties related to axon diameter and on the size of the hydrophilic nonelectrolyte probe.     

Computed tomography in the evaluation of cochlear structural features in cochlear implantation

Temporal bone computed tomographic scans were studied in 136 deaf patients of different age and sex, including 56 patients (39 children and 17 adults) rehabilitated with cochlear implantation (CI). The mean values of the cochlear parameters that are important for the results of a surgical CI stage, namely: the diameter of the cochlear base (DCB), the diameter of the basal helix, the height of the cochlea, the angle between the cochlear base and the promontorial wall, were calculated. These parameters were compared in different age groups. A correlation was determined for each of the studied parameters and for the depth of intracochlear insertion of electrodes. There was a significant correlation between DCB and the depth of insertion of the electrodes of CI22M and CI24M cochlear implants. DBC at which the active part of the electrode chain of an implant could be significantly more frequently placed in the tympanic scala of the cochlea was estimated.     

Ice‐storm disturbance and long‐term forest dynamics in the Adirondack Mountains

Ice storms cause periodic disturbance to temperate forests of eastern North America. They are the primary agents of disturbance in some eastern forests. In this paper, a forest gap model is employed to explore consequences of ice storms for the long‐term dynamics of Tsuga canadensis‐northem hardwoods forests. The gap model LINKAGES was modified to simulate periodic ice storm disturbance in the Adirondack Mountains of New York. To adapt the gap model for this purpose, field data on ice storm disturbance are used to develop a polytomous logistic regression model of tree damage. The logistic regression model was then incorporated into the modified forest gap model, LINK ADIR, to determine the type of damage sustained by each simulated tree. The logistic regression model predicts high probabilities of bent boles or severe bole damage (leaning, snapping, or uprooting) in small‐diameter trees, and increasing probability of canopy damage as tree size increases. Canopy damage is most likely on gentle slopes; the probability of severe bole damage increases with increasing slope angle. In the LINKADIR simulations, tree damage type determines the probability of mortality; trees with severe bole damage are assigned the highest mortality rate. LINKADIR predicts Tsuga canadensis dominance in mesophytic old‐growth forests not disturbed by ice storms. When ice storms are simulated, the model predicts Acer saccharum‐dominated forests with higher species richness. These results suggest that ice storms may function as intermediate disturbances that enhance species richness in forested Adirondack landscapes.     

Function of mature coronary collateral vessels and cardiac performance in the exercising dog

Formation of extensive collateral vessels after chronic constriction of a coronary artery in dogs can provide for similar increases in blood flow to native and collateralized regions of myocardium during exertion. Previous investigations have not compared myocardial blood flow and cardiac functional responses during exercise in constricted and nonconstricted (sham) animals. Thus we evaluated left ventricular performance and myocardial blood flow at rest and during mild, moderate, and severe exertion in sham-operated dogs and in dogs 2-3 mo after placement of an Ameroid occluder around the proximal left circumflex artery. Changes in double product, maximal left ventricular dP/dt, and pressure-work index were similar in both groups for each level of exertion. Despite similar increases in estimated myocardial O2 demand and similar diastolic perfusion pressures, average transmural myocardial blood flow increased less in the constrictor animals, particularly during severe exercise (2.74 +/- 0.22 vs. 1.45 +/- 0.29 ml X min-1 X g-1). The smaller increases in blood flow occurred equally in native and collateralized regions as well as in the papillary muscles and boundary areas between the native and collateralized regions. The differences in flow in the native and collateralized regions were uniform across the wall of the myocardium. We also observed smaller increases in stroke volume and cardiac output in the constrictor group, disparities which increased with increasing exertion (stroke volume, severe exercise = 0.92 +/- 0.13 vs. 0.53 +/- 0.09 ml/kg). We postulate that myocardial active hyperemia is limited either because the coronary vessels remaining after chronic circumflex occlusion cannot dilate sufficiently or that there is inappropriate active vasoconstriction during severe exertion.(ABSTRACT TRUNCATED AT 250 WORDS)     

The effect of anti-hypertensive drug treatment on brown adipocyte diameter and locule distribution in rats

To determine the effects of sympathoplegic anti-hypertensive drug treatment on brown adipose tissue morphology, groups of adult male Wistar-Kyoto (WKY) and spontaneous hypertensive (SHR) rats were orally administered a solution containing 2.3 microM reserpine, 0.5 M hydralazine and 1.68 mM hydrochlorothiazide ad libitum or tap water and brown adipocyte diameter and extent of fat loculization were determined 3 weeks later. Pulse rates of rats were significantly greater in SHR than WKY and were unaffected by treatment, while drug treatment resulted in significant decreases in mean arterial pressure of both groups at the end of the study. Mean adipocyte diameters were smaller in untreated SHR than WKY and drug treatment of both groups was associated with increases in adipocyte diameter and cytological change from physiologically more active to less active cells. These drug-induced alterations in BAT morphology area consistent with decreased sympathetic activity and suggest that thermogenic capacity of brown adipose tissue may be pharmacologically modified, thereby altering an animal's capacity for energy expenditure.     

Matrix metalloproteinases and membrane damage markers in sera of patients with acute myocardial infarction

Coronary artery disease is a multifunctional disease and represents one of the leading causes of death worldwide. Oxidative stress appears as an etiological factor for myocardial damage during acute myocardial infarction. Some data suggest that acute coronary syndromes may also be influenced by matrix metalloproteinases through degradation of the fibrous cap of vulnerable atherosclerotic lesions. It has been indicated that gelatinases A and B play a key role in acute myocardial infarction and deoxyribonuclease I has been postulated to be a novel early phase marker of disease. The aim was to study activity of gelatinases A and B in acute myocardial infarction and its association with some membrane damage markers. Seventy-five patients with disease and seventy-five healthy controls were enrolled. Activities of lactate dehydrogenase, malate dehydrogenase, and deoxyribonuclease I were estimated using standard spectrophotometric assay and isoforms of lactate and malate dehydrogenases were determined using direct zymography. Activity of dehydrogenases was significantly higher in patients, while deoxyribonuclease I was lower. Isoform 2 of lactate dehydrogenase was significantly higher in the patient group. Gelatinases A and B were detected only in patients group. The results suggest determination of serum malate dehydrogenase activity to be used as an additional parameter for acute myocardial infarction diagnosis. Those findings suggest important role of gelatinases A and B as biomarkers of early stage of acute myocardial infarction together with membrane damage parameters.     

Acute cerebral artery constriction in the spontaneously hypertensive rat following blood and plasma administration into the subarachnoid space

The purpose of the present study was to demonstrate, using a vascular casting technique, acute vasoconstrictive changes in the cerebral vasculature 1 h following whole-blood or plasma infusion into the subarachnoid space of conscious spontaneously hypertensive rats. Vascular casts from animals infused (over 20 min) with 0.45 ml of heparinized autologous arterial blood or plasma exhibited incomplete filling, while casts from saline-infused controls exhibited virtually no filling defects. Significant elevations in intracranial pressure were noted in blood, but not in plasma- or saline-infused rats. Two characteristic forms of constriction occurred, depending upon the vessel lumen diameter. Vessels with lumen diameters >100 µm were flattened longitudinally with deep endothelial nuclear imprints, while smaller vessels had focal circular constrictions resembling beads. Arterial cast filling terminated in vessels with lumen diameters from 70 to 20 µm with focal signs of constriction at or near the point of cast termination. The results indicate that the presence of both blood and plasma in the subarachnoid space produces acute small-artery constriction. This phenomenon is due to a noncellular blood component and does not correlate with increases in intracranial pressure.     

Oxygen tolerance of an implantable polymer/enzyme composite glutamate biosensor displaying polycation-enhanced substrate sensitivity

Biosensors were fabricated at neutral pH by sequentially depositing the polycation polyethyleneimine (PEI), the stereoselective enzyme L-glutamate oxidase (GluOx) and the permselective barrier poly-ortho-phenylenediamine (PPD) onto 125-microm diameter Pt wire electrodes (Pt/PEI/GluOx/PPD). These devices were calibrated amperometrically at 0.7 V versus SCE to determine the Michaelis-Menten parameters for enzyme substrate, l-glutamate (Glu) and co-substrate, dioxygen. The presence of PEI produced a 10-fold enhancement in the detection limit for Glu (approximately 20 nM) compared with the corresponding PEI-free configurations (Pt/GluOx/PPD), without undermining their fast response time (approximately 2 s). Most remarkable was the finding that, although some designs of PEI-containing biosensors showed a 10-fold increase in linear region sensitivity to Glu, their oxygen dependence remained low.     

Effects of long-term intake of a fine-grained diet on the mouse masseter muscle

Muscle fibers of the masseter muscle of mice which had been fed a fine-grained diet for various periods were studied histochemically and morphometrically. The diameters of both extrafusal and intrafusal muscle fibers decreased with time in mice fed a fine-grained diet, compared with those of control mice. In animals maintained on the special diet for 160 days after weaning at the 20th postnatal day, the effects of the diet on the diameter of muscle spindles were severe, and the diameter of each type of red and white fibers was significantly smaller than those of control animals. But a significant difference was not recognized in the diameter of intermediate fibers between control and treated mice. Unexpectedly, white fibers having a smaller diameter than red fibers were observed in diet-fed mice after the 180th postnatal day, although white fibers having such small diameter were not detectable in control animals. Succinic dehydrogenase activities were decreased in both extrafusal and intrafusal fibers of experimental animals. Moreover, muscle spindles with no annulospiral endings were increased in number in mice fed the diet for 130 and 160 days after weaning, although those spindles also increased in control animals. The diameters of outer capsules and primary endings were also significantly decreased in the animals kept on the diet for a long time. These effects of the fine-grained diet on the mouse masseter muscle became severer with time.     

Effect of pedicle screw diameter on screw fixation efficacy in human osteoporotic thoracic vertebrae

The selection of an ideal screw size plays a crucial role in the success of spinal instrumentation as larger diameter screws are thought to provide better fixation strength but increase the risk of pedicle failure during insertion. On the other hand, smaller diameter screws are with lesser risk of pedicle breakage but are thought to compromise the stability of the instrumentation. By investigating the relationship between screw diameter and the pullout strength of pedicle screws after fatigue loading, this study seeks to find quantitative biomechanical data for surgeons in determining the most ideal diameter size screws when performing surgical implementations on osteoporotic vertebrae.Twenty-seven osteoporotic (BMD ranged: 0.353–0.848 g/cm²) thoracic vertebrae (T3-T8) were harvested from 5 human cadavers. Two sizes of poly-axial screws (5.0 mm × 35 and 4.35 mm × 35) were implanted into each pedicles of the vertebrae by an experienced surgeon. Specimens were randomly distributed into control group, fatigue group of 5000 and 10,000 cycles with peak-to-peak loadings of 10–100 N at 1 Hz. Each specimen was then axial pullout tested at a constant rate of 5 mm/min. The ultimate pullout strength (N) & stiffness (N/mm) were obtained for analysis.The results showed that although the larger diameter screws achieved superior pullout strength immediately after the implantation, both sizes of screws exhibited comparable pullout strengths post fatigue loading. This indicates that the smaller diameter screws may be considered for surgical techniques performed on osteoporotic vertebrae for reduced risk of pedicle breakage without sacrificing fixation strength.