Hemodynamic monitoring by intracardiac impedance measured by cardiac resynchronization defibrillators: Evaluation in a controlled clinical setting (BIO.Detect HF II study)

BackgroundIn patients with cardiac resynchronization therapy defibrillators (CRT-Ds), intracardiac impedance measured by dedicated CRT-D software may be used to monitor hemodynamic changes. We investigated the relationship of hemodynamic parameters assessed by intracardiac impedance and by echocardiography in a controlled clinical setting.MethodsThe study enrolled 68 patients (mean age, 66 ± 9 years; 74% males) at 12 investigational sites. The patients had an indication for CRT-D implantation, New York Heart Association class II/III symptoms, left ventricular ejection fraction 15%–35%, and a QRS duration ≥150 ms. Two months after a CRT-D implantation, hemodynamic changes were provoked by overdrive pacing. Intracardiac impedance was recorded at rest and at four pacing rates ranging from 10 to 40 beats/min above the resting rate. In parallel, echocardiography measurements were performed. We hypothesized that a mean intra-individual correlation coefficient (r_mean) between stroke impedance (difference between end-systolic and end-diastolic intracardiac impedance) measured by CRT-D and the aortic velocity time integral (i.e., stroke volume) determined by echocardiography would be significantly larger than 0.65.ResultsThe hypothesis was evaluated in 40 patients with complete data sets. The r_mean was 0.797, with a lower confidence interval bound of 0.709. The study hypothesis was met (p = 0.007). A stepwise reduction of stroke impedance and stroke volume was observed with increasing heart rate.ConclusionsIntracardiac impedance measured by implanted CRT-Ds correlated well with the aortic velocity time integral (stroke volume) determined by echocardiography. The impedance measurements bear potential and are readily available technically, not requiring implantation of additional material beyond standard CRT-D system.     

Phosphatase Resistance of ERK2 Brain Kinase PK40erk2

Abstract: We have previously shown that a brain protein kinase, termed PK40, catalyzes the multiple phosphorylation of the KSP-repeat site of neurofilaments (NFs) and also can transform τ proteins into the paired helical filament-like state as found in Alzheimer's disease (AD) brains. Protein sequence analysis suggests that PK40 is a form of the extracellular signal-regulated kinase ERK2. A subpopulation of ERK2 species in soluble brain fractions can be efficiently phosphorylated and activated in cell-free systems, simply by adding Mg²⁺-ATP. Two phosphoisoforms of PK40^erk2 are formed in this process, which have a reduced gel mobility, very much like the ERK2 form obtained in cell culture by stimulation with growth factors. One of these low-mobility forms cannot be inactivated with protein phosphatase 2A (PP2A) or with tyrosine phosphatases. The second form can be slowly inactivated by PP2A. In this case two Ser/Thr phosphates are removed at different rates during inactivation: One phosphate is very quickly removed to result in the formation of a high-mobility 39-kDa ERK2 species without consequence for activity; the other, slowly removed Ser/Thr phosphate controls the activity but has no effect on the gel mobility of ERK2. These results show that forms of ERK2 exist with properties different from the previously characterized ERK2 (p42^mapk) from stimulated cell cultures. The active ERK2 forms produced in the presence of Mg²⁺-ATP alone could provide an explanation for the existence of constitutive ERK2-like NF phosphorylation in vivo. Excessive formation of an ERK2 species resistant to inactivation by PP2A might be relevant to the persistent pathological τ hyperphosphorylation in AD.     

Über die Resistenz pflanzlicher Plasmen gegen Vanadium

Zusammenfassung Die Untersuchung zeigt, daß die Resistenz gegen Vanadylsulfat bei verschiedenen Pflanzen charakteristische Unterschiede aufweist. Die Resistenzgrenzen schwanken bei Blütenpflanzen in einem Bereich von 1 bis 0,0001% VOSO₄, während Laub- und Lebermoose zumeist in 3% dieser Lösung noch leben und manchmal sogar noch durch 5- und 10%ige Lösungen innerhalb von 48 Stunden keine merkbaren Schädigungen erfahren.Die Nekrosebilder der Epidermiszellen der Blütenpflanzen sind recht mannigfaltig und zum Teil wohl durch die Reaktion verschiedener Zellsaftstoffe mit dem Vanadylsulfat bedingt. Anthokyangefärbte Zellen verhalten sich nicht einheitlich. Man findet Entfärbungen der toten Zellen, Umfärbungen oder auch Entmischungen und Bildung verschiedenartiger Niederschläge.Das Vanadium erweist sich nach den bisherigen Erfahrungen als ein geeigneter Stoff, um im Verein mit anderen Teststoffen, wie Verbindungen von Bor, Zink, Mangan und Chrom, in charakteristischen Resistenz-kombinationen im Dienste der vergleichenden Protoplasmatik verschiedene pflanzliche Plasmasorten beschreibend zu erfassen.