Ventricular pacing inhibition by oversensing due to diaphragmatic myopotential during deep inspiration

AbstractAn 80-year-old man, who had dilated cardiomyopathy with right ventricular (RV) dilatation, underwent implantable cardioverter defibrillator (ICD) implantation for advanced atrioventricular block and primary prevention of sudden cardiac death. Tined and screw-in leads were placed on the right atrial appendage and RV apex, respectively. Ventricular pacing inhibition was detected after surgery due to oversensing by diaphragmatic myopotential occurring only during deep inspiration. We performed re-surgery and switched the screw-in lead for a tined lead. The diaphragmatic myopotential decreased, thereby improving oversensing by diaphragmatic myopotential and ventricular pacing inhibition. It might be beneficial to use a tined lead when placing the ventricular lead at the RV apex for implantation of a pacemaker or ICD if oversensing of diaphragmatic myopotential is observed using a screw-in lead.<Learning objective: Oversensing due to diaphragmatic myopotential is rarely observed. However if it occurs, it becomes a critical problem, which causes pacemaker inhibition or inappropriate ICD shock. However, the method of preventing this problem is unknown. In this case, we demonstrated that a tined-lead may be useful for the prevention of oversensing by diaphragmatic myopotential.

The Outcome of the Treatments of Chest Trauma Patients

Ninety-nine patients with chest trauma were clinically evaluated in terms of their prognoses. In accordance with advances in thoracic surgery, the survival rates were remarkably improved. However, six deaths were encountered in this series. The causes of deaths were attributable to associated injuries extend to two or three regions including the head and the abdomen so that precise detection and proper treatments should be made as quickly as possible. In conclusion, the prognoses of serious chest trauma patients are influenced by the presence and the degree of concomitant injuries as well as proper urgent managements

Clinical Aspect of Peripheral Cholangiocarcinoma: A Study of 7 Hepatectomy Cases

To clarify the features and problems presented by a peripheral cholangiocarcinoma (CCC), seven patients with hepatectomy from the First Department of Surgery, Nagasaki University School of Medicine (6 patients), and from Department of Surgery, National Ureshino Hospital (one patient) were reviewed. Men predominate with ratio of 5:2, and an average age was 65.4 years. Tumor location was left lateral segment in 4 patients, right lobe, middle lobe and posterior segment in one, respectively. Three patients were associated with hepatolithiasis. Underlying liver disease was found in 4 patients (57%); cirrhosis in 3 patients, and chronic hepatitis in one. Initial symptoms were abdominal pain, fever and palpable abdominal mass. In imaging modalities available, the detection rates of tumor were 100% in CT and 67% in US and angiography, respectively. Combination of MRI and CT clearly showed tumor characteristics. The serum CEA was slightly elevated in 5 patients (83%), but serum CA19-9 rose strikingly in 3 patients. Most tumors showed an infiltrating growth along intrahepatic bile duct, with a portal vein thrombus and/or satellite tumors frequently. In 3 patients, early recurrence with intrahepatic metastasis occured within the first 6 months. The patient of poorly differentiated adenocarcinoma containing a squamous or signet ring cell carinoma showed an extremely poor prognosis. This study suggests that early detection of small CCC and an extended resection are the most important factors for the survival of patient

Clinical Analysis of Perforated Intestinal Behcet Disease

Clinical pattern of perforated intestinal Behcet disease was analyzed in the five patients who underwent surgery in terms of preoperative symptoms, the condition of perforation, the extent of resection and recurrence. In the experienced patients, recurrences were included in four of the five patients in spite of treatment. Perforation was based on deep multiple ulcers, characteristic of the punchedout type. It is emphasized that intestinal Behcet disease is more likely to occur as a catastrophic event of perforation which requires an urgent operation, and more extensive resection is mandatory for prevention of recurrence

Esophageal Carcinomas with Synchronous and Metachronous Primary Malignant Carcinomas in Other Organs

Seventeen patients with 10 synchronous and 7 metachronous double cancers with carcinomas of the esophagus were surgically treated in the First Department of Surgery, Nagasaki University School of Medicine. All patients were men with an average of age 68.5. The incidence of double cancers with carcinoma of the esophagus accounted for 12.7% in a total of 134 of this series. The three triple cancers were included. Of the three, one was synchronous triple cancers in the esophagus, the stomach and the colon. The outcome was not necessarily satisfactory. Two had recurrence 3 and 5 months after surgery, but one is still alive for 33 months, free from carcinoma

Kantis: A new Australopithecus site on the shoulders of the Rift Valley near Nairobi, Kenya

ケニア・ナイロビ郊外で初めて発見されたアウストラロピテクス. 京都大学プレスりリス. 2016-03-24.Most Plio-Pleistocene sites in the Gregory Rift Valley that have yielded abundant fossil hominins lie on the Rift Valley floor. Here we report a new Pliocene site, Kantis, on the shoulder of the Gregory Rift Valley, which extends the geographical range of Australopithecus afarensis to the highlands of Kenya. This species, known from sites in Ethiopia, Tanzania, and possibly Kenya, is believed to be adapted to a wide spectrum of habitats, from open grassland to woodland. The Kantis fauna is generally similar to that reported from other contemporaneous A. afarensis sites on the Rift Valley floor. However, its faunal composition and stable carbon isotopic data from dental enamel suggest a stronger C4 environment than that present at those sites. Although the Gregory Rift Valley has been the focus of paleontologists' attention for many years, surveys of the Rift shoulder may provide new perspective on African Pliocene mammal and hominin evolutio

Dietary Lactoferrin Alleviates Age-Related Lacrimal Gland Dysfunction in Mice

BACKGROUND: Decrease in lacrimal gland secretory function is related to age-induced dry eye disease. Lactoferrin, the main glycoprotein component of tears, has multiple functions, including anti-inflammatory effects and the promotion of cell growth. We investigated how oral administration of lactoferrin affects age-related lacrimal dysfunction. METHODS AND FINDINGS: Twelve-month-old male C57BL/6Cr Slc mice were randomly divided into a control fed group and an oral lactoferrin treatment group. Tear function was measured at a 6-month time-point. After euthanasia, the lacrimal glands were subjected to histological examination with 8-hydroxy-2'-deoxyguanosine (8-OHdG) antibodies, and serum concentrations of 8-OHdG and hexanoyl-lysine adduct (HEL) were evaluated. Additionally, monocyte chemotactic protein-1(MCP-1) and tumor necrosis factor-α (TNF-α) gene expression levels were determined by real-time PCR. The volume of tear secretion was significantly larger in the treated group than in the control. Lactoferrin administration reduced inflammatory cell infiltration and the MCP-1 and TNF-α expression levels. Serum concentrations of 8-OHdG and HEL in the lactoferrin group were lower than those in the control group and were associated with attenuated 8-OHdG immunostaining of the lacrimal glands. CONCLUSION: Oral lactoferrin administration preserves lacrimal gland function in aged mice by attenuating oxidative damage and suppressing subsequent gland inflammation

Effects of Structural Factors on TV Commercial Processing

Metrics such as understanding of the ad or purchase intent are widely used as a benchmark of effectiveness in TV commercial testing. However, it is quite rare that we are able to clearly understand why the benchmarks scores are high or low. This study investigates how structural variables relating to salience asymmetries in the visual presentation of TV commercials affect the processing of TV commercials. Asymmetries of cognitive salience suggest that brand information, which tends to be non-human, inanimate, and abstract, has difficulty in gaining TV commercial viewers attention. In this study we seek for effective ways to lead viewers to process brand information within TV commercial. The commercials examined for this purpose are those for products in two cosmetic product categories, namely lipstick and foundation. Based on the hierarchy of cognitive salience we present the hypothetical structural factors which appeal to the reference point ability and effectively lead consumers to process brand information. We tested these hypotheses by psychological experiments. Each commercial was tested among 51 to 54 participants. A total sample of 211 usable questionnaires was obtained. Results suggest that when celebrities are effectively used as a salient reference point accompanied by structural factors that successively shift the attention to brand information, understanding of product benefits is enhanced. An example of such a structural factor that showed significant contribution to understanding of product benefits (p <. 01) was the structural factor The last half of the commercial does not have consecutive cuts showing full views of celebrities