Electrophysiological Mechanisms of Atrial Flutter

Atrial flutter (AFL) is a common arrhythmia in clinical practice. Several experimental models such as tricuspid regurgitation model, tricuspid ring model, sterile pericarditis model and atrial crush injury model have provided important information about reentrant circuit and can test the effect of antiarrhythmic drugs. Human atrial flutter has typical and atypical forms. Typical atrial flutter rotates around tricuspid annulus and uses the crista terminalis and sometimes sinus venosa as the boundary. The IVC-tricuspid isthmus is a slow conduction zone and the target of radiofrequency ablation. Atypical atrial flutter may arise from the right or left atrium. Right atrial flutter includes upper loop reentry, free wall reentry and figure of eight reentry. Left atrial flutter includes mitral annular atrial flutter, pulmonary vein-related atrial flutter and left septal atrial flutter. Radiofrequency ablation of the isthmus between the boundaries can eliminate these arrhythmias

Effect of Acupressure on Nausea, Vomiting, Anxiety and Pain among Post-cesarean Section Women in Taiwan

The purpose of this study was to examine the effectiveness of acupressure for controlling post-cesarean section (CS) symptoms, such as nausea and vomiting, anxiety perception and pain perception. A total of 104 eligible participants were recruited by convenience sampling of operating schedules at two hospitals. Participants assigned to the experimental group received acupressure, and those assigned to the control group received only postoperative nursing instruction. The experimental group received three acupressure treatments before CS and within the first 24 hours after CS. The first treatment was performed the night before CS, the second was performed 2-4 hours after CS, and the third was performed 8-10 hours after CS. The measures included the Rhodes Index of Nausea and Vomiting, Visual Analog Scale for Anxiety, State-Trait Anxiety Inventory, Visual Analog Scale for Pain, and physiologic indices. Statistical methods included percentages, mean value with standard deviation, t test and repeated measure ANOVA. The use of acupressure reduced the incidence of nausea, vomiting or retching from 69.3% to 53.9%, compared with control group (95% confidence interval = 1.65-0.11; p = 0.040) 2-4 hours after CS and from 36.2% to 15.4% compared with control group (95% confidence interval = 0.59-0.02; p = 0.024) 8-10 hours after CS. Results indicated that the experimental group had significantly lower anxiety and pain perception of cesarean experiences than the control group. Significant differences were found in all physiologic indices between the two groups. In conclusion, the utilization of acupressure treatment to promote the comfort of women during cesarean delivery is strongly recommended

Description of local dilatancy and local rotation of granular assemblies by microstretch modeling

AbstractThis study investigates the microstretch continuum modeling of granular assemblies while accounting for both the dilatant and rotational degrees of freedom of a macroelement. By introducing the solid volume fraction and the gyration radius of a granular system, the balance equations of the microstretch continuum are transformed into a new formulation of evolution equations comprising six variables: the solid volume fraction, the gyration radius, the velocity field, the averaged angular velocity, the rate of gyration radius, and the internal energy. The bulk microinertia density, the averaged angular velocity, and the microgyration tensor at a macroscopic point are obtained in terms of discrete physical quantities. The bulk part and the rotational part of the microgyration tensor are proposed as the two indices to measure the local dilatancy and local rotation of granular assemblies. It is demonstrated in the numerical simulation that the two indices can be used to identify the shear band evolution in a granular system under a biaxial compression

An Automatic Indirect Immunofluorescence Cell Segmentation System

Indirect immunofluorescence (IIF) with HEp-2 cells has been used for the detection of antinuclear autoantibodies (ANA) in systemic autoimmune diseases. The ANA testing allows us to scan a broad range of autoantibody entities and to describe them by distinct fluorescence patterns. Automatic inspection for fluorescence patterns in an IIF image can assist physicians, without relevant experience, in making correct diagnosis. How to segment the cells from an IIF image is essential in developing an automatic inspection system for ANA testing. This paper focuses on the cell detection and segmentation; an efficient method is proposed for automatically detecting the cells with fluorescence pattern in an IIF image. Cell culture is a process in which cells grow under control. Cell counting technology plays an important role in measuring the cell density in a culture tank. Moreover, assessing medium suitability, determining population doubling times, and monitoring cell growth in cultures all require a means of quantifying cell population. The proposed method also can be used to count the cells from an image taken under a fluorescence microscope

Cytokine Profile in Plasma Extracellular Vesicles of Parkinson's Disease and the Association with Cognitive Function

Plasma extracellular vesicles (EVs) containing various molecules, including cytokines, can reflect the intracellular condition and participate in cell-to-cell signaling, thus emerging as biomarkers for Parkinson’s disease (PD). Inflammation may be a crucial risk factor for PD development and progression. The present study investigated the role of plasma EV cytokines as the biomarkers of PD. This cross-sectional study recruited 113 patients with PD, with mild to moderate stage disease, and 48 controls. Plasma EVs were isolated, and the levels of cytokines, including pro-interleukin (IL)-1β, IL-6, IL-10, tumor necrosis factor (TNF)-α, and transforming growth factor (TGF)-β1, were evaluated. Patients with PD had significantly increased plasma EV pro-IL-1β and TNF-α levels compared with controls after adjustment for age and sex. Despite the lack of a significant association between plasma EV cytokines and motor symptom severity in patients with PD, cognitive dysfunction severity, assessed using the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment, was significantly associated with plasma EV pro-IL-1β, IL-6, IL-10, and TNF-α levels. This association was PD specific and not found in controls. Furthermore, patients with PD cognitive deficit (MMSE < 26) exhibited a distinguished EV cytokine profile compared to those without cognitive deficit. The findings support the concept of inflammatory pathogenesis in the development and progression of PD and indicate that plasma EV cytokines may serve as PD biomarkers in future

Influence of Storm Surge on the Inundated Potential in the Coastland

Source: ICHE Conference Archive - https://mdi-de.baw.de/icheArchiv

Characteristics of virtual unipolar electrograms for detecting isthmus block during radiofrequency ablation of typical atrial flutter

AbstractObjectivesThe purpose of this study was to investigate the characteristics of the second component of local virtual unipolar electrograms recorded at the ablation line during coronary sinus (CS) pacing after radiofrequency ablation (RFA) of the cavotricuspid isthmus (CTI) for typical atrial flutter (AFL).BackgroundRadiofrequency ablation of the CTI can produce local double potentials at the ablation line. The second component of unipolar electrograms represents the approaching wavefront in the right atrium opposite the pacing site. We hypothesized that the morphologic characteristics of the second component of double potentials would be useful in detecting complete CTI block.MethodsRadiofrequency ablation of the CTI was performed in 52 patients (males = 37, females = 15, 62 ± 12 years) with typical AFL. The noncontact mapping system (Ensite 3000, Endocardial Solutions, St. Paul, Minnesota) was used to guide RFA. Virtual unipolar electrograms along the ablation line during CS pacing after RFA were analyzed. Complete or incomplete CTI block was confirmed by the activation sequence on the halo catheter and noncontact mapping.ResultsThree groups were classified after ablation. Group I (n = 37) had complete bidirectional CTI block. During CS pacing, the second component of unipolar electrograms showed an R or Rs pattern. Group II (n = 12) had incomplete CTI block. The second component of unipolar electrograms showed an rS pattern. Group III (n = 3) had complete CTI block with transcristal conduction. The second component of unipolar electrograms showed an rSR pattern.ConclusionsA predominant R-wave pattern in the second component of unipolar double potentials at the ablation line indicates complete CTI block, even in the presence of transcristal conduction

Biomechanical comparison of lumbar spine instability between laminectomy and bilateral laminotomy for spinal stenosis syndrome – an experimental study in porcine model

<p>Abstract</p> <p>Background</p> <p>The association of lumbar spine instability between laminectomy and laminotomy has been clinically studied, but the corresponding <it>in vitro </it>biomechanical studies have not been reported. We investigated the hypothesis that the integrity of the posterior complex (spinous process-interspinous ligament-spinous process) plays an important role on the postoperative spinal stability in decompressive surgery.</p> <p>Methods</p> <p>Eight porcine lumbar spine specimens were studied. Each specimen was tested intact and after two decompression procedures. All posterior components were preserved in Group A (Intact). In Group B (Bilateral laminotomy), the inferior margin of L4 lamina and superior margin of L5 lamina were removed, but the L4–L5 supraspinous ligament was preserved. Fenestrations were made on both sides. In Group C (Laminectomy) the lamina and spinous processes of lower L4 and upper L5 were removed. Ligamentum flavum and supraspinous ligament of L4–L5 were removed. A hydraulic testing machine was used to generate an increasing moment up to 8400 N-mm in flexion and extension. Intervertebral displacement at decompressive level L4–L5 was measured by extensometer</p> <p>Results</p> <p>The results indicated that, under extension motion, intervertebral displacement between the specimen in intact form and at two different decompression levels did not significantly differ (<it>P </it>> 0.05). However, under flexion motion, intervertebral displacement of the laminectomy specimens at decompression level L4–L5 was statistically greater than in intact or bilateral laminotomy specimens (<it>P </it>= 0.0000963 and <it>P </it>= 0.000418, respectively). No difference was found between intact and bilateral laminotomy groups. (<it>P </it>> 0.05).</p> <p>Conclusion</p> <p>We concluded that a lumbar spine with posterior complex integrity is less likely to develop segment instability than a lumbar spine with a destroyed anchoring point for supraspinous ligament.</p

Hypothermic manipulation of bone cement can extend the handling time during vertebroplasty

BACKGROUND: Polymethylmethacrylate (PMMA) is commonly used for clinical applications. However, the short handling time increases the probability of a surgeon missing the crucial period in which the cement maintains its ideal viscosity for a successful injection. The aim of this article was to illustrate the effects a reduction in temperature would have on the cement handling time during percutaneous vertebroplasty. METHODS: The injectability of bone cement was assessed using a cement compressor. By twisting the compressor, the piston transmits its axial load to the plunger, which then pumps the bone cement out. The experiments were categorized based on the different types of hypothermic manipulation that were used. In group I (room temperature, sham group), the syringes were kept at 22°C after mixing the bone cement. In group 2 (precooling the bone cement and the container), the PMMA powder and liquid, as well as the beaker, spatula, and syringe, were stored in the refrigerator (4°C) overnight before mixing. In group 3 (ice bath cooling), the syringes were immediately submerged in ice water after mixing the bone cement at room temperature. RESULTS: The average liquid time, paste time, and handling time were 5.1 ± 0.7, 3.4 ± 0.3, and 8.5 ± 0.8 min, respectively, for group 1; 9.4 ± 1.1, 5.8 ± 0.5, and 15.2 ± 1.2 min, respectively, for group 2; and 83.8 ± 5.2, 28.8 ± 6.9, and 112.5 ± 11.3 min, respectively, for group 3. The liquid and paste times could be increased through different cooling methods. In addition, the liquid time (i.e. waiting time) for ice bath cooling was longer than for that of the precooling method (p < 0.05). CONCLUSIONS: Both precooling (i.e. lowering the initial temperature) and ice bath cooling (i.e. lowering the surrounding temperature) can effectively slow polymerization. Precooling is easy for clinical applications, while ice bath cooling might be more suitable for multiple-level vertebroplasty. Clinicians can take advantage of the improved injectability without any increased cost

Protein subcellular localization prediction of eukaryotes using a knowledge-based approach

<p>Abstract</p> <p>Background</p> <p>The study of protein subcellular localization (PSL) is important for elucidating protein functions involved in various cellular processes. However, determining the localization sites of a protein through wet-lab experiments can be time-consuming and labor-intensive. Thus, computational approaches become highly desirable. Most of the PSL prediction systems are established for single-localized proteins. However, a significant number of eukaryotic proteins are known to be localized into multiple subcellular organelles. Many studies have shown that proteins may simultaneously locate or move between different cellular compartments and be involved in different biological processes with different roles.</p> <p>Results</p> <p>In this study, we propose a knowledge based method, called KnowPred_site, to predict the localization site(s) of both single-localized and multi-localized proteins. Based on the local similarity, we can identify the "related sequences" for prediction. We construct a knowledge base to record the possible sequence variations for protein sequences. When predicting the localization annotation of a query protein, we search against the knowledge base and used a scoring mechanism to determine the predicted sites. We downloaded the dataset from ngLOC, which consisted of ten distinct subcellular organelles from 1923 species, and performed ten-fold cross validation experiments to evaluate KnowPred_site's performance. The experiment results show that KnowPred_siteachieves higher prediction accuracy than ngLOC and Blast-hit method. For single-localized proteins, the overall accuracy of KnowPred_siteis 91.7%. For multi-localized proteins, the overall accuracy of KnowPred_siteis 72.1%, which is significantly higher than that of ngLOC by 12.4%. Notably, half of the proteins in the dataset that cannot find any Blast hit sequence above a specified threshold can still be correctly predicted by KnowPred_site.</p> <p>Conclusion</p> <p>KnowPred_sitedemonstrates the power of identifying related sequences in the knowledge base. The experiment results show that even though the sequence similarity is low, the local similarity is effective for prediction. Experiment results show that KnowPred_siteis a highly accurate prediction method for both single- and multi-localized proteins. It is worth-mentioning the prediction process of KnowPred_siteis transparent and biologically interpretable and it shows a set of template sequences to generate the prediction result. The KnowPred_siteprediction server is available at <url>http://bio-cluster.iis.sinica.edu.tw/kbloc/</url>.</p