Removal of temporary pacemaker after cardiac surgery in infants: A harmless procedure?

External pacemakers (PM) via temporary epicardial leads are routinely applied to infants and children during heart surgery, which usually, after an uneventful post surgical course, can be removed without complications. We report about two infants with complex congenital heart defects after cardiac surgery (arterial switch and Mustard operation for Transposition of the great arteries). Intraoperative these patients received temporary epicardial PM wires. Thirteen and 18 days post surgery, respectively, the PM wires were removed under electrocardiogram (ECG) monitoring. The patients showed acute ECG changes in terms of significant ST elevation during and after removing their pacing wires. Clinically, patients were stable and subsequent echocardiographic examination showed no evidence of myocardial dysfunction or pericardial effusion. In the course of time, patients showed no signs of arrhythmia or abnormal ECG changes. The decision to place temporary pacing wires during the cardiac surgery in patients with congenital heart defects should be considered carefully and their removal should occur under ECG monitoring as soon as the situation of the patient allows. It should be taken into consideration that a complication like this case may be related to delayed removal of temporary PM’s leads. © 2012 - IOS Press and the authors

N-glycome analysis detects dysglycosylation missed by conventional methods in SLC39A8 deficiency

Congenital disorders of glycosylation (CDG) are a growing group of inborn metabolic disorders with multiorgan presentation. SLC39A8‐CDG is a severe subtype caused by biallelic mutations in the manganese transporter SLC39A8, reducing levels of this essential cofactor for many enzymes including glycosyltransferases. The current diagnostic standard for disorders of N‐glycosylation is the analysis of serum transferrin. Exome and Sanger sequencing were performed in two patients with severe neurodevelopmental phenotypes suggestive of CDG. Transferrin glycosylation was analyzed by high‐performance liquid chromatography (HPLC) and isoelectric focusing in addition to comprehensive N‐glycome analysis using matrix‐assisted laser desorption ionization time of flight (MALDI‐TOF) mass spectrometry (MS). Atomic absorption spectroscopy was used to quantify whole blood manganese levels. Both patients presented with a severe, multisystem disorder, and a complex neurological phenotype. Magnetic resonance imaging (MRI) revealed a Leigh‐like syndrome with bilateral T2 hyperintensities of the basal ganglia. In patient 1, exome sequencing identified the previously undescribed homozygous variant c.608T>C [p.F203S] in SLC39A8. Patient 2 was found to be homozygous for c.112G>C [p.G38R]. Both individuals showed a reduction of whole blood manganese, though transferrin glycosylation was normal. N‐glycome using MALDI‐TOF MS identified an increase of the asialo‐agalactosylated precursor N‐glycan A2G1S1 and a decrease in bisected structures. In addition, analysis of heterozygous CDG‐allele carriers identified similar but less severe glycosylation changes. Despite its reliance as a clinical gold standard, analysis of transferrin glycosylation cannot be categorically used to rule out SLC39A8‐CDG. These results emphasize that SLC39A8‐CDG presents as a spectrum of dysregulated glycosylation, and MS is an important tool for identifying deficiencies not detected by conventional methods

Freeze-dried macroporous foam prepared from chitosan/xanthan gum/montmorillonite nanocomposites

Freeze-dried macroporous foams were prepared from an aqueous colloidal suspension of chitosan/xanthangum/Na+-montmorillonite nanoclay (MMT). The suspension formed gel structure as a consequence of freezing, named cryogel. Cryogel is defined as a gel formed due to the concentration increase of the substrates caused by the ice formation during freezing. This obtained cryogel was subsequently dried under vacuum condition to produce porous foam materials. Two freezing methods were employed in the present work in order to investigate the influence of the processing on sample characteristics, namely; contact freezing with a heat exchanger and immersion freezing in a cryo-bath. Based on the SEM observation, in the case of contact freezing; rapid freezing (−2 C/min) resulted in randomly aligned pores as compared to the pore alignment obtained in the case of slow freezing (−0.25 C/min); the mean pore size for rapid freezing and slowing freezing were 40 μm and 68 μm, respectively. However, in immersion freezing samples, aligned and bamboo-like straight structures with pore layer spacing of 22 μm were observed. The different microstructures significantly influenced the mechanical hardness of the prepared foams nanocomposites. The MMT dispersion within the bionanocomposites was found to be characteristically exfoliated from X-ray diffraction and electron microscopy analysis. Small angle X-ray diffraction data indicated that the polymeric networks were modified by the exfoliated MMT and the MMT also improved the hardness of the prepared foams

Checklist of beetles (Coleoptera) of Canada and Alaska. Second edition

Volume: 360Start Page: 1End Page: 4