Optimal ablation settings of TactiFlex SE laser-cut irrigated-tip catheter: comparison with ThermoCool SmartTouch SurroundFlow porous irrigated-tip catheter

BACKGROUND

The TactiFlex SE catheter (TFSE, Abbott) with a contact force (CF) sensor and a laser-cut irrigated-tip has recently become available but lacks a lesion quality marker. This study aimed to explore distinctions in lesion characteristics between the TFSE and the ThermoCool SmartTouch SurroundFlow catheter (STSF, Biosense Webster), which utilizes a porous irrigated tip, and to assess the most effective application settings for the TFSE.

METHODS

Lesions were generated using varying settings of radiofrequency power (30-50 W), CF (10-20 g), application duration (10-40 s), and catheter orientation (perpendicular or parallel) in an ex vivo porcine model. Comparative analysis between the TFSE and STSF was conducted for lesion characteristics and incidence of steam pops using predictive models in regression analyses.

RESULTS

Among 720 applications, the TFSE exhibited a significantly lower incidence of steam pops compared to the STSF (0.6% vs. 36.8%, P < 0.001). Moreover, coefficients of determination (R2) for the TFSE were higher than those for the STSF concerning lesion depth (0.710 vs. 0.541) and volume (0.723 vs. 0.618). The lesion size generated with the TFSE was notably smaller than that with the STSF under identical application settings. Additionally, to achieve a lesion depth ≥ 4.0 mm, the TFSE required an application duration 8-12 s longer than the STSF under similar settings.

CONCLUSIONS

The TFSE demonstrated a lower incidence of steam pops and superior predictability in lesion size compared to the STSF. However, the TFSE necessitated a longer application duration than the STSF to achieve an adequate lesion size.

Distributions and number of drivers on real-time phase mapping associated with successful atrial fibrillation termination during catheter ablation for non-paroxysmal atrial fibrillation

BACKGROUND

Real-time phase mapping (ExTRa™) is useful in determining the strategy of catheter ablation for non-paroxysmal atrial fibrillation (AF). This study aimed to investigate the features of drivers of AF associated with its termination during ablation.

METHODS

Thirty-six patients who underwent catheter ablation for non-paroxysmal AF using online real-time phase mapping (ExTRa™) were enrolled. A significant AF driver was defined as an area with a non-passively activated ratio of ≥ 50% on mapping analysis in the left atrium (LA). All drivers were simultaneously evaluated using a low-voltage area, complex fractionated atrial electrogram (CFAE), and rotational activity by unipolar electrogram analysis. The electrical characteristics of drivers were compared between patients with and without AF termination during the procedure.

RESULTS

Twelve patients achieved AF termination during the procedure. The total number of drivers detected on the mapping was significantly lower (4.4 ± 1.6 vs. 7.4 ± 3.8, p = 0.007), and the drivers were more concentrated in limited LA regions (2.8 ± 0.9 vs. 3.9 ± 1.4, p = 0.009) in the termination group than in the non-termination group. The presence of drivers 2-6 with limited (≤ 3) LA regions showed a tenfold increase in the likelihood of AF termination, with 83% specificity and 67% sensitivity. Among 231 AF drivers, the drivers related to termination exhibited a greater overlap of CFAE (56.8 ± 34.1% vs. 39.5 ± 30.4%, p = 0.004) than the non-related drivers. The termination group showed a trend toward a lower recurrence rate after ablation (p = 0.163).

CONCLUSIONS

Rotors responsible for AF maintenance may be characterized in cases with concentrated regions and fewer drivers on mapping.

Clinical outcomes and predictors of delayed echocardiographic response to cardiac resynchronization therapy

INTRODUCTION

The clinical outcomes and mechanisms of delayed responses to cardiac resynchronization therapy (CRT) remain unclear. We aimed to investigate the differences in outcomes and gain insight into the mechanisms of early and delayed responses to CRT.

METHODS

This retrospective study included 110 patients who underwent CRT implantation. Positive response to CRT was defined as ≥15% reduction of left ventricular (LV) end-systolic volume on echocardiography at 1 year (early phase) and 3 years (delayed phase) after implantation. The latest mechanical activation site (LMAS) of the LV was identified using two-dimensional speckle-tracking radial strain analysis.

RESULTS

Seventy-eight (71%) patients exhibited an early response 1 year after CRT implantation. Of 32 non-responders in the early phase, 12 (38%) demonstrated a delayed response, and 20 (62%) were classified as non-responders after 3 years. During the follow-up time of 10.3 ± 0.5 years, the delayed and early responders had a similar prognosis of mortality and heart failure (HF) hospitalization. In contrast, non-responders had a worse prognosis. Multivariate analysis revealed that a longer duration (months) between initial HF hospitalization and CRT (odds ratio [OR]: 1.126; 95% confidence interval [CI]: 1.036-1.222; p = .005), non-exact concordance of LV lead location with LMAS (OR: 32.744; 95% CI: 1.101-973.518; p = .044), and pre-QRS duration (OR: 0.901; 95% CI: 0.827-0.981; p = .016) were independent predictors of delayed response to CRT compared with early response.

CONCLUSION

The prognoses were similar regardless of the response time after CRT. A longer history of HF, suboptimal LV lead position, and shorter pre-QRS duration were related to delayed response than early response.

Different time course effect of autonomic nervous modulation after cryoballoon and hotballoon catheter ablations for paroxysmal atrial fibrillation

BACKGROUND

Few studies have reported on the quantitative evaluation of autonomic nerve modification after balloon ablation. Therefore, this study aimed to evaluate the effects of cryoballoon and hotballoon ablations on the autonomic nervous system (ANS) and their relationship with prognosis.

METHODS

We included 234 patients who underwent cryoballoon ablation (n = 190) or hotballoon ablation (n = 44) for paroxysmal atrial fibrillation. Heart rate variability (HRV) analysis was performed on all patients using a 3-min electrocardiogram at baseline, 1, 3, 6, and 12 months after ablation. HRV parameters and prognoses were compared between the two balloon systems.

RESULTS

Ln low-frequency (LF), Ln high-frequency (HF), standard deviation of the R-R intervals (SDNN), and RR intervals significantly decreased after 1 month in both groups, but the changes were more pronounced in the cryoballoon group than in the hotballoon group. In contrast, HRV indices in the hotballoon ablation group decreased gradually and reached their lowest point 3-to-6 months after the procedure, which was later than in the cryoballoon ablation group. The recurrence rate did not differ between the two groups. HRV parameters changed similarly in the cryoballoon group, regardless of recurrence. However, patients with recurrence had significantly higher SDNN and Ln LF at 12 months than those without recurrence in the hotballoon group (41.2 ± 39.3 ms vs. 18.5 ± 12.6 ms, p = 0.006, and 2.2 ± 0.7 ms² vs. 1.5 ± 0.7 ms², p = 0.003, respectively).

CONCLUSIONS

The time course of HRV changes differed between cryoballoon and hotballoon ablations. Hence, the two balloon systems may have distinct effects on the ANS and its role in prognosis.

A rare case of delayed complete lead dislodgement after deep septal pacing: A hidden risk of the specific procedure

Deep septal ventricular pacing is a recently developed physiological pacing modality with good efficacy; however, it has a potential risk of unusual complications. Here, we report a patient with pacing failure and spontaneous, complete lead dislodgement after >2 years of deep septal pacing, possibly caused by systemic bacterial infection and specific lead behavior in the septal myocardium. This case report may implicate a hidden risk of unusual complications in deep septal pacing.

A novel practical algorithm using machine learning to differentiate outflow tract ventricular arrhythmia origins

INTRODUCTION

Diagnosis of outflow tract ventricular arrhythmia (OTVA) localization by an electrocardiographic complex is key to successful catheter ablation for OTVA. However, diagnosing the origin of OTVA with a precordial transition in lead V3 (V3TZ) is challenging. This study aimed to create the best practical electrocardiogram algorithm to differentiate the left ventricular outflow tract (LVOT) from the right ventricular outflow tract (RVOT) of OTVA origin with V3TZ using machine learning.

METHODS

Of 498 consecutive patients undergoing catheter ablation for OTVA, we included 104 patients who underwent ablation for OTVA with V3TZ and identified the origin of LVOT (n = 62) and RVOT (n = 42) from the results. We analyzed the standard 12-lead electrocardiogram preoperatively and measured 128 elements in each case. The study population was randomly divided into training group (70%) and testing group (30%), and decision tree analysis was performed using the measured elements as features. The performance of the algorithm created in the training group was verified in the testing group.

RESULTS

Four measurements were identified as important features: the aVF/II R-wave ratio, the V2S/V3R index, the QRS amplitude in lead V3, and the R-wave deflection slope in lead V3. Among them, the aVF/II R-wave ratio and the V2S/V3R index had a particularly strong influence on the algorithm. The performance of this algorithm was extremely high, with an accuracy of 94.4%, precision of 91.5%, recall of 100%, and an F1-score of 0.96.

CONCLUSIONS

The novel algorithm created using machine learning is useful in diagnosing the origin of OTVA with V3TZ.

Depolarization and repolarization dynamics after His-bundle pacing: Comparison with right ventricular pacing and native ventricular conduction

Background

The current study aimed to evaluate changes in electrical depolarization and repolarization parameters after His‐bundle pacing (HBP) compared with right ventricular pacing (RVP) and its association with ventricular arrhythmia (VA).

Methods

Forty‐one patients (13 with HBP, 14 with RVP, and 14 controls [AAI mode]) were evaluated. After continuous pacing algorithm, QRS duration, QT interval, QTc, JT interval, T‐peak to T‐end (Tpe), and Tpe/QT ratio were measured on electrocardiography at baseline and 1 week, 1 month, and 6 months postoperatively. We investigated VA occurrence and adverse events after implantation.

Results

At 6 months, QRS duration was significantly shorter in the HBP (121.6 ± 15.6 ms) than in the RVP (150.1 ± 14.9 ms) group. The QT intervals were lower in the HBP (424.0 ± 40.9 ms) and control (405.9 ± 23.0 ms) groups than in the RVP (453.0 ± 40.2 ms) group. The Tpe and Tpe/QT ratios at 6 months differed significantly between the HBP and RVP groups (Tpe, 69.8 ± 19.7 ms vs 87.4 ± 11.9 ms and Tpe/QT, 0.16 ± 0.03 vs 0.19 ± 0.02, respectively). The Tpe and Tpe/QT ratios were similarly shortened in the HBP and control groups. VA occurred less frequently in the HBP (15%) and control (7.1%) groups than in the RVP (50%) group (p = 0.020). The non‐RVP group showed significantly lower rates of VA and major adverse events than the RVP group. Patients with VA demonstrated significantly longer QRS duration, QT interval, Tpe, and Tpe/QT at 6 months than those without VA.

Conclusion

HBP showed better depolarization and repolarization stability than RVP.

Evaluation of the Novel Automated Anti-Tachycardia Pacing Algorithm Successfully Terminating Sustained Monomorphic Ventricular Tachycardia in an Electrophysiology Study

We report the usefulness of novel automated anti-tachycardia pacing (ATP) for ventricular tachycardia (VT) termination evaluated in an electrophysiology study. This intrinsic, automated ATP with an implanted cardiac resynchronization therapy-defibrillator successfully terminated the sustained VT, which had not been suppressed by repetitive burst pacing from the electrode catheter. The reproduction of programed pacing of the automated ATP by a right ventricular electrode catheter was effective in terminating VT, and this termination was absolute and reproducible. Further detailed assessment in an electrophysiology study could highlight the algorithm of the automated ATP and its possible benefit in terminating the reentrant VT.

Permanent His-bundle pacing using distal His-bundle electrogram-guided approach in patients with atrioventricular block

BACKGROUND

Permanent His-bundle pacing (HBP) is effective and safe; however, the success rate of HBP is low, especially in patients with infranodal block. This study aimed to assess the efficacy and feasibility of HBP implantation using an electrophysiological guided approach targeting a distal His-bundle electrogram (HBE) in patients with atrioventricular block (AVB).

METHODS

Thirty-four consecutive patients with AVB (infranodal block in 28 patients) who underwent HBP were enrolled. During implantation, we attempted to target the distal part of the HBE (distal HBE) beyond the block site based on unipolar mapping. The His-capture threshold was evaluated for 1 year after implantation.

RESULTS

HBP was achieved in 26 patients and in 21 patients (75%) with infranodal block. Detection of distal HBE was significantly higher in the successful HBP group than in the HBP failure group (65.4% vs. 0%, p = .001). Among 15 patients with intra-Hisian block, 14 patients (93%) successfully achieved HBP with distal HBE detection. During the 1-year follow-up period, an increase in His-capture threshold by ≥1.0 V at 1.0 ms occurred in five (19.2%) of 26 patients. The increased His-capture threshold group exhibited significantly less detection of distal HBE (20% vs. 76.2%; odds ratio 0.078, 95% confidence interval 0.07-0.87, p = .038) and a higher His-capture threshold at implantation (2.0 ± 1.1 V vs. 1.1 ± 0.9 V; odds ratio 1.702, 95% confidence interval 1.025-2.825, p = 0.04) than the non-increased His-capture threshold group.

CONCLUSION

HBP implantation guided by distal HBE approach may be feasible with subsequent stable pacing in patients with intra-Hisian and atrioventricular nodal block.

Incidence of Left Atrial Thrombus Development and Imaging Approach in Patients Scheduled for Repeat Catheter Ablation for Atrial Fibrillation

The risk for developing left atrial (LA) thrombi after initial catheter ablation for atrial fibrillation (AF) and requirements for imaging evaluation for thrombi screening at repeat ablation is unclear. This study aimed to assess the occurrence of thrombus development and frequency of any imaging study evaluating thrombus formation during repeat ablation for AF. Of 2,066 patients undergoing initial catheter ablation for AF with uninterrupted oral anticoagulation, 615 patients underwent repeat ablation after 258.0 (105.0-882.0) days. We investigated the factors associated with safety outcomes and requirements for thrombus screening. All patients underwent at least one imaging examination to screen for thrombi in the initial session; however, the examination rate decreased to 476 patients (77%) before the repeat session. The frequency of imaging evaluations was 5.0%, 11%, 21%, 84%, and 91% for transesophageal echocardiography and 18%, 33%, 49%, 98%, and 99% for any imaging modality at repeat ablation performed ≤60 days, ≤90 days, ≤180 days, >180 days, and >1 year after the initial session, respectively. Three patients (0.5%) developed LA thrombi at repeat ablation due to identifiable causes, and no patients experienced thromboembolic events when no imaging evaluation was performed. Multivariate analysis revealed that repeat ablation performed after >180 days, non-paroxysmal atrial arrhythmias, and lower left ventricular ejection fraction were predictors of thrombus development and severe spontaneous echocardiography contrast. In conclusion, the risk for thrombus development at repeat ablation for AF was low. There needs to be a risk stratification of the imaging screening for thrombi at repeat ablation.

Dynamic Changes in Electrocardiogram Parameters After Epicardial Substrate Catheter Ablation of Brugada Syndrome

BACKGROUND

Catheter ablation (CA) is effective for recurrent episodes of ventricular fibrillation (VF) in Brugada syndrome (BrS). VF development in BrS is associated with several electrocardiogram (ECG) abnormalities. This study investigated changes in ECG parameters in high-risk BrS patients who underwent epicardial CA.Methods and Results:In all, 27 BrS patients were implanted with an implantable cardioverter-defibrillator (ICD). Patients were divided into 2 groups: (1) an ablation group (n=11) that underwent epicardial CA because of VF recurrence; and (2) a primary prevention (PP) group (n=16) with ICD implantation only. ECG parameters were evaluated before and 12 months after CA and compared with ECG parameters in the PP group. The T wave peak-to-end interval was significantly longer and the number of abnormal spikes in leads V1-V3 at the second, third, and fourth intercostal spaces was greater in the ablation than PP group. After ablation, ST levels and the sum of abnormal spikes in leads V1-V3 were significantly decreased. The mean (±SD) number of ICD shocks decreased markedly during a mean follow-up period of 42.0 months (from 3.8±3.7 to 0.2±0.4/year). Four patients had an ICD shock following the ablation procedure. Greater reductions in ST-segment elevation and abnormal spikes were observed in the group without than with VF recurrence.

CONCLUSIONS

Improvements in surface ECG parameters appear to be associated with successful ablation in high-risk BrS patients.

The mechanism and prognosis of acute and late improvement in mitral regurgitation after cardiac resynchronization therapy

Cardiac resynchronization therapy (CRT) improves functional mitral regurgitation (MR); however, the mechanism and differences in acute and late improvement in MR are unclear. We aimed to evaluate the factors associated with the acute and late MR improvements and the prognosis of MR improvement after CRT. This retrospective study included 121 patients who underwent CRT implantation with full echocardiography assessment at baseline, 1 week, and 6 months after implantation. MR severity was classified into five grades (0: none to 4: severe). Two-dimensional speckle-tracking echocardiography with radial strain was used to assess dyssynchrony, and the time difference between the lateral and inferior segments at papillary muscle levels (TD_late-inf) was calculated. The MR improved 1 week and 6 months after CRT in 40 (33%) and 45 (37%) patients, respectively. On multivariate analyses, TD_late-inf (baseline-1 week) and SPWMD were independently associated with acute MR improvement. The %reduction in left ventricular end-systolic volume (LVESV) (baseline-6 months) and TD_late-inf (baseline-1 week) were independently correlated with late MR improvement. The patients with pre-MR grades 2-4 and improved MR after CRT showed significantly better prognosis in heart failure hospitalization. Cutoff values of ≥ 19.5 ms of the reduction of TD_late-inf and ≥ 30.8% of the %reduction of LVESV were significantly associated with the decrease in heart failure hospitalization. The improved interpapillary muscle activation time delay and volume reduction after CRT were associated with acute and late MR improvements. There may be different time course of recovery and distinct causes for late MR improvement.

Autopsy evaluation of the implantation site of a His bundle pacing lead demonstrating selective capture

Evaluations of His bundle pacing (HBP) lead location at autopsy examination have been rarely reported. We report an autopsy case of a 98-year-old man who underwent HBP implantation due to atrioventricular block and heart failure. Although selective HBP was achieved with an acceptable threshold, the stimulus-to-QRS interval was relatively longer without correction of the right bundle-branch block. A macroscopic examination revealed that the HBP lead was inserted on the ventricular side passing through the anteroseptal commissure of the tricuspid valve. Transthyretin cardiac amyloidosis may affect the distal conduction system resulting in a long stimulus-to-QRS interval during selective HBP.

An Attempt to Add Biological Functions by Genetic Engineering in Order to Produce High-Performance Bioreactor Cells for Hybrid Artificial Liver: Transfection of Glutamine Synthetase into Chinese Hamster Ovary (CHO) Cell

In the course of immortalization, hepatocyte cell lines lose their original differentiated functions, such as ammonia removal and urea formation, drug metabolism, serum protein synthesis, etc. (Enosawa et al., Cell Transplant. 5:S39-S40; 1996). With the aim of adding lost or deficient functions and producing cell lines for the bioreactor of a hybrid artificial liver, rat glutamine synthetase (GS) gene was transfected into Chinese hamster ovary (CHO) cells, because it is able to lower the ammonia level. The GS gene-inserted pSV2 plasmid was transfected into the CHO-K1 line by electroporation. Transfected CHO (GS-CHO) cells were cultured in a glutamine-free medium containing ammonia, glutamic acid, and the GS inhibitor methionine sulfoximine (MSX). The MSX concentration was increased stepwise from 25 μmol/L to 1600 μmol/L to amplify the GS gene. In several GS-CHO sublines resistant to 300-1600 μmol/L of MSX, the specific activities of GS were increased from 0.2 × 10-4 to 1.7-2.9 × 10-4 unit/106 cells. When the amplified GS-CHO cells were cultured in the ammonia-containing medium, a slow but steady decrease of the ammonia level was observed when the level was high. Finally, the prospect of genetically modulated cells for bioreactors in the hybrid artificial liver is discussed.

Localization of breast sentinel lymph nodes by MR lymphography with a conventional gadolinium contrast agent: Preliminary observations in dongs and humans

Purpose: To test the capability of an indirect MR lymphography (MRLG) using a conventional extracellular gadolinium (Gd)-based contrast agent for localizing breast sentinel lymph node (SLN).

Methods: A total of 1 and 0.5 ml of undiluted gadopentetate dimeglumine were injected subcutaneously into the two periareolar areas overlying each caudal mammary gland in 10 female dogs. Contiguous 2-mm-thick fast gradient echo MR images were acquired through the upper breast and axilla before and for 60 min after gentle massage at the injection sites, yielding 3D displays. The localized SLN was resected from the living animals, followed by post mortem examinations. MRLG (1 ml contrast agent injected) was also attempted in 5 female volunteers.

Results: Even with 0.5-ml contrast agent, the MRLG clearly visualized the connection of SLN and lymphatic vessels directly draining from the injection sites, and the remaining distant nodes, with the maximal enhancement peaks within 10 min after massage. The 3D images provided comprehensive anatomy of these lymphatic pathways in each axilla. Of the 20 SLN and 128 distant nodes visualized on the MRLG, all the SLN (100%) and 107 (83.5%) distant nodes could be resected pre- and post mortem, in good correlation with the locations and sizes on the MR images. MRLG also effectively localized SLN in the volunteers, without significant adverse effects.

Conclusion: An indirect MRLG using small volumes of conventional Gd-based contrast agent may have potential for accurate identification and surgical biopsy of breast SLN.

[Coronary Artery Bypass Grafting for In-stent Restenosis Probably Caused by Allergic Response;Report of a Case]

A 58-year-old female presented to our hospital with recurrence of chest pain. She had undergone coronary intervention using biolimus-eluting-stent for total occlusion of the left anterior descending artery(LAD) 3 years before. Since then in-stent restenosis had repeated 4 times in 3 years. In the interim, another everolimus-eluting-stent had been placed on the same lesion. The contact metal allergic patch test revealed the existence of allergic response to nickel and cobalt which were the structural components of these stents. She underwent off-pump coronary artery bypass grafting, and these stents were removed. The invasions of macrophages and eosinophils around the stent-s were pathologically proven. One year after surgery she is doing well without angina or allergic symptom. These observations suggested the allergic reaction of the coronary artery against the stents.

Enhancement of antibody production by growth factor addition in perfusion and hollow-fiber culture systems

The effects of the high-molecular-weight growth factors, transferrin and bovine serum albumin (BSA), on antibody production were analyzed quantitatively in continuous hollow-fiber cultivation over a period of 60 days. Transferrin enhanced cell growth but had no significant effect on the specific antibody production rate, whereas BSA significantly enhanced antibody production. The antibody production rate was increased 4- and 14-fold respectively by feeding BSA at 2 and 5 g L(-1) into the EC side of the system (the side connected to the cell-containing outer part of the hollow-fiber unit) compared with the production achieved without BSA. Addition of 5 g L(1) BSA into the IC side of the system (the side connected to the inner part of the hollow-fiber unit) resulted in a 2.5-fold increase in the antibody production rate. The effect of BSA was also analyzed using the perfusion culture system with a separation unit. When fresh medium containing either 2 or 5 g L(-1) BSA was fed into the reactor, both the specific growth rate and specific death rate increased, while the specific antibody production rate was increased 2- and 25-fold, respectively, by feeding BSA at these two concentrations compared with no addition. Comparing the two systems, the increase in the antibody production rate achieved with the hollow-fiber system was threefold greater than that in the perfusion culture system with the same concentration of BSA feeding. (c) 1995 John Wiley & Sons, Inc.

Maximum virginiamycin production by optimization of cultivation conditions in batch culture with autoregulator addition

A strategy for optimization of non-growth-associated production in batch culture employing an empirical approach was developed through the study of virginiamycin production. The strategy is formulated with two aims: attaining a high cell concentration at the beginning of the production phase without decrease in production activity; and enhancing the production activity during the production phase. As a practical example, the goal of a maximum virginiamycin (M and S) production in the batch culture of Streptomyces virginiae was set. To attain a high cell concentration in the production phase of the batch culture, that is, to extend the growth phase for as long as possible, the optimum composition and concentration of the complex medium, especially the yeast extract (YE) concentration, were first investigated. Dissolved oxygen (DO) concentration control was also a parameter considered in maintaining the production activity during the production phase. In addition, to enhance the production activity, an optimum addition strategy of an autoregulator, virginiae butanolide-C (VB-C), was investigated. Combining these measures, the optimum cultivation conditions were found to be an initial YE concentration in the complex medium of 45 g/L, the shot addition of 300 mug/L of VB-C 11.5 h after the start of the batch culture, and a DO concentration maintained above 2 mg/L. The maximum concentrations of virginiamycin M and S were about ninefold those obtained under nonoptimum cultivation conditions. Nonoptimum cultivation conditions consisted of an initial YE concentration one sixth (7.5 g/L) that of the optimum cultivation conditions, and no VB-C addition. These conditions were used as representative of the standard cultivation of virginiamycin in this study. The strategy developed here will be applicable to the production of other antibiotics, especially to the cultivation of Streptomyces species, in which a hormonelike signal material (an autoregulator) plays an important role in antibiotic production. (c) 1996 John Wiley & Sons, Inc.

Evaluation of stable and highly productive gene amplified CHO cell line based on the location of amplified genes

In order to establish an easy and quick construction method for obtaining a stable and highly productive gene-amplified recombinant Chinese Hamster Ovary (CHO) cell line, variouskinds of stepwise methotrexate (MTX) selection were carriedout. The specific growth and production rates of the cell were compared with each other, and the distribution of the amplified gene location was determined using fluorescence in situ hybridization (FISH). The specific growth andproduction rates of the cell pool reached the highest levels under the selection condition in which the stepwise increase in the MTX concentration was most gradual; about 82% of amplified genes were observed near the telomeric region. During long-term cultivation without MTX, the percentage ofamplified genes near the telomeric region hardly changed, butthat of amplified genes at other regions decreased. Based on these results, stable and highly productive cell pools could be easily and quickly constructed and amplified and gradual stepwise increase of the MTX concentration. In addition, the FISH technique was powerful tool to evaluate highly productiveand stable gene-amplified cells based on the chromosomal location of the amplified gene.

Effects of magnetic field and pressure on the intermediate valence state of YbPd

High field magnetization, magnetoresistance and pressure effects of magnetic susceptibility, thermal expansion and electrical resistivity were examined for the intermediate valence system YbPd, which undergoes two first-order transitions at T(1) = 125 K and T(2) = 105 K. Analyses of high field magnetization suggest that half of the Yb atoms have magnetic moments below 100 K up to 55 T. The Yb valence state and the first-order transitions are stable up to 55 T. On the other hand, T(1) and T(2) decrease with increasing pressure and the first-order transitions disappear at around 4 GPa. Above the critical pressure, the experimental results suggest that the intermediate valence state persists down to the lowest temperature or a heavy fermion state is formed. We will show that most experimental results are explained reasonably by assuming the first-order transitions as a valence order transition of Yb. The magnetic ordering temperature is decreased with increasing pressure, in contrast to other Yb intermediate valence or Kondo systems. This may be correlated with the instability of the valence ordered state in this compound.

Evaluation of a lattice Boltzmann method in a complex nanoflow

In order to establish a cost-effective strategy to simulate complex flows in continuum to slip and transitional regimes, the present study assesses the performance of a lattice Boltzmann method (LBM) formerly discussed by the present authors' group [Niu, Phys. Rev. E 76, 036711 (2007)]. This LBM is based on a diffuse scattering wall boundary condition, a regularization procedure, and an effective relaxation time associated with the Knudsen number. The present assessment is on its regularization procedure and third-order truncated system based on the two-dimensional twenty-one discrete velocity (D2Q21) model for the Cartesian lattices. The test flow cases are force-driven Poiseuille flows, the Couette flows and a flow around a square cylinder situated in a nanochannel. For producing the reference data of the square cylinder flow, the molecular dynamics simulation using Lennard-Jones potential is also performed. Although the flow profiles and the slip velocities of the Poiseuille flows and the Couette flows are more accurately predicted by the third-order truncated system, the general velocity profiles around the square cylinder are also well predicted by the second-order truncated system based on the two-dimensional nine discrete velocity (D2Q9) model. It is also confirmed that without the regularization process, the entire flow field prediction suffers unphysical momentum oscillations around the square cylinder.

Pressure and magnetic field dependence of valence and magnetic transitions in EuPtP

The hexagonal layered compound, EuPtP, exhibits two valence transitions, at T₁ = 235 K and T₂ = 190 K, and an antiferromagnetic order at T(N) = 8.6 K. We have examined the effects of magnetic field and pressure, and the specific heat. Analysis of the high-field experiments confirms that half of Eu are in a divalent state at the lowest temperature, and that the number of Eu(² + ) increases discontinuously at T₂ and T₁ with increasing temperature. The magnetic entropy reaches ~ 22 J K⁻¹ mol⁻¹ at room temperature, which is larger than that expected for J = 7/2 of Eu(²+ ) (17.3 J K⁻¹ mol⁻¹). This is in good agreement with the magnetic entropy deduced from the interconfigurational fluctuation model, which explains the valence transition in Eu(Pd(₁- x)Pt(x))₂Si₂. The application of pressure shifts T₁ and T₂ higher and suppresses the intermediate phase (β phase, T₂ < T < T₁), whereas it does not change the properties of the low-temperature phase (γ phase, T < T₂) and the T(N).

High-field magnetization of a two-dimensional spin frustration system, Ni(5)(TeO(3))(4)X(2) (X = Br, Cl)

The high-field magnetization, M(H), of Ni(5)(TeO(3))(4)X(2) (X =  Br, Cl) was measured by using a pulse magnet. These compounds have a two-dimensional crystal structure and a distorted Kagome spin frustrated system which is built from the Ni(2+) ions (S = 1). The Néel transition temperatures are T(N)∼28 and 23 K for X =  Br and Cl, respectively. When T<T(N), we observe step-like transitions, at H(c)∼11 and 10 T for X =  Br and Cl, respectively. On the other hand, for T>T(N), the field-dependent magnetization curves behave like a monotonically increasing straight line up to 55 T. The H(c) value is close to those obtained in previous spin resonance studies in which a model of a spin-flop scenario was proposed to explain the field-dependent resonance spectra. With the earlier model a further transition at around 23 T was predicted; however, our observations did not show any plateau behaviors, saturation or other anomalies up to 55 T, suggesting that the further transition possibly exists in a much higher field region.

Functional mechanism of lung mosaic CT attenuation: assessment with deep-inspiration breath-hold perfusion SPECT-CT fusion imaging and non-breath-hold Technegas SPECT

BACKGROUND

The functional mechanism of lung mosaic computed tomography attenuation (MCA) in pulmonary vascular disease (PVD) and obstructive airway disease (OAD) has not yet been fully clarified.

PURPOSE

To clarify the mechanism of MCA in these diseases by assessing the relationship between regional lung function and CT attenuation change at MCA sites with the use of automated deep-inspiratory breath-hold (DIBrH) perfusion single-photon emission computed tomography (SPECT)-CT fusion images and non-breath-hold Technegas SPECT.

MATERIAL AND METHODS

Subjects were 42 PVD patients (31 pulmonary thromboembolism, four primary/two secondary pulmonary hypertension, and five Takayasu arteritis), 12 OAD patients (five acute asthma, four obliterative bronchiolitis, and three bronchiectasis), and 12 normal controls, all of whom had MCA on DIBrH CT. The relationship between regional lung function and CT attenuation change at the lung slices with MCA was assessed using DIBrH perfusion SPECT-CT fusion images and non-breath-hold Technegas SPECT. The severity of perfusion defects with or without MCA was quantified by regions-of-interest analysis.

RESULTS

On DIBrH CT and perfusion SPECT, in contrast to no noticeable CT attenuation abnormality and fairly uniform perfusion in controls, 60 MCA and 274 perfusion defects in PVD patients, and 18 MCA and 61 defects in OAD patients were identified, with a total of 77 ventilation defects on Technegas SPECT in all patients. SPECT-CT correlation showed that, throughout the 78 MCA sites of all patients, lung perfusion was persistently decreased at low CT attenuation and preserved at intervening high CT attenuation, while lung ventilation was poorly correlated with CT attenuation change. The radioactivity ratios of reduced perfusion and the intervening preserved perfusion at the 78 perfusion defects with MCA were significantly lower than those at the remaining 257 defects without MCA (P<0.0001).

CONCLUSION

Although further validation is required, our results indicate that heterogeneous pulmonary arterial perfusion may be a dominant mechanism of MCA in PVD and OAD.

Novel mutations in a Japanese patient with CD19 deficiency

Common variable immunodeficiency (CVID) is a heterogeneous disorder characterized by recurrent bacterial infections, hypogammaglobulinemia and low to normal numbers of circulating B cells. Mutations in the ICOS, TACI and CD19 genes have recently been identified in <10% of CVID patients. We, herein, describe two novel CD19 gene disruptions in an 8-year-old Japanese boy, who had been clinically diagnosed as having CVID at the age of 5 years. Flow-cytometric analysis demonstrated absence of CD19 and reduced CD21 expression on CD20-postive peripheral blood B cells. Mutation analysis of CD19 revealed a mutation in the splice acceptor site of intron 5 (IVS5-1G>T) of the maternal allele, resulting in skipping of exon 6, and a truncated protein product. The paternal allele was disrupted by a gross deletion encompassing at least the ATP2A1, CD19 and NFATC2IP genes. The patient had a small number of IgD(-) CD27(+) memory B cells, in which somatic mutation were detected. His B cells showed substantial proliferation upon stimulation, but reduced IgG and IgA production in vitro. These findings extend the mutation spectrum of the CD19 deficiency to four, and confirm the homogeneity of the CD19 deficiency as a unique type of CVID.

Changes in mechanical properties of poly-l-lactic acid mini-plate under functional load simulating sagittal splitting ramus osteotomy

The purpose of this study was to investigate how the characteristics of a poly-l-lactic acid mini-plate changed with dynamic loading in an environment with hydrolytic degradation. A mandible osteosynthesis model was prepared with specimen poly-l-lactic acid mini-plates to simulate sagittal splitting ramus osteotomy. The model was then subjected to dynamic loading, and changes in specimen shape and surface quality were observed. Specimen bending strength was then measured, and degree of hydrolytic degradation estimated. Neither dynamic loading nor degree of load clearly affected degree of hydrolytic degradation. The specimens maintained their original shape and bending strength for up to 4 weeks with dynamic loading of 40 N or less in an environment with hydrolytic degradation. At 8 weeks, under the same conditions, the specimens showed cracks or fractures, or both, together with a clear decrease in bending strength. The results suggest that dynamic loading causes cracking in a poly-l-lactic acid mini-plate, and that growth of these cracks decreases bending strength over time, leading to fatigue fracture.

Cutaneous drainage lymphatic map with interstitial multidetector-row computed tomographic lymphography using iopamidol: preliminary results

We performed preliminary tests of the feasibility of multi-detector computed tomographic lymphography (MDCT-LG) with interstitial injection of iopamidol for mapping cutaneous lymphatic drainage pathways. MDCT-LG images were obtained following cutaneous injection of a total of 1ml iopamidol bilaterally into hind legs of 10 dogs. The locations of the first draining lymph nodes were marked on the skin under MDCT-LG guidance. Five dogs served for postmortem examination of lymphatic anatomy, and the remaining 5 underwent MDCT-LG after ligation of the afferent lymphatic vessels of the first draining popliteal nodes. Clinically, MDCT-LG was attempted in 6 patients with cutaneous malignant melanoma and compared with Tc-99m-human serum albumin lymphoscintigraphy. MDCT-LG clearly visualized the first draining lymph nodes and their afferent lymphatic vessels draining from the contrast injection sites with detailed underlying anatomy in all dogs. At surgery, all these first draining nodes could be found at predicted locations under MDCT-LG guidance. MDCT-LG showed rerouting of lymphatic vessels after ligation of the afferent lymph vessels of the popliteal nodes in the second 5 dogs. Clinically, MDCT-LG also allowed accurate mapping and biopsy of the first draining nodes from primary tumors at predicted locations, with minimal skin incision. Lymphoscintigraphy failed to identify these nodes due to overlapping radioactivity of clustered nodes or transport of the radiotracer to subsequent distant nodes in 4 patients. Although a more extensive study is warranted for further validation, preoperative interstitial MDCT-LG appears to have the potential feasibility for accurate sentinel lymph node mapping and biopsy in patients with cutaneous melanoma.

Modified Weiss's equation for strength-duration curve in magnetic stimulation

There is increasing interest in the use of magnetic stimulation as a modality for clinical examination and therapy. It is desirable that the eddy current density produced by a change in the strength of a magnetic field should be greater than the excitability threshold of the muscles or nerves to be stimulated. The eddy current waveform differs from rectangular current waveform common in electrical applications. Little basic study has been done on the effects of magnetic stimulation on threshold values, chronaxies and other aspects of the eddy current waveforms. In this paper, the authors have attempted to measure the strength-duration curve (S-D curve) of eddy currents on the sural muscle of the bullfrog and have proposed a new S-D curve formula for eddy currents in place of Weiss's equation for rectangular current waveforms.

Measurement of association rate constant of antibody-antigen interaction in solution based on enzyme-linked immunosorbent assay

A simple and rapid method based on enzyme-linked immunosorbent assay (ELISA) was developed for measuring the association rate constant of antibody-antigen interactions. An antibody and its antigen are mixed in a solution to initiate the equilibrium reaction. At different time intervals, the amount of the free antibody in the reaction mixture is estimated by an indirect ELISA. The association rate constant was estimated by nonlinear regression against an equation introduced from the derivation of the mass balance of antigen-antibody interaction. This method can determine the association rate constant of antibodies with a dissociation rate constant up to 5 x 10(-3) s(-1). The association rate constant of a single-chain Fv (scFv) to its antigen, bovine pancreatic ribonuclease A (RNase A), determined by the present method agreed well with those determined by the fluorescence polarization method and surface plasmon resonance method. No significant difference in the association rate constant was found between the soluble anti-RNase A scFv and the same scFv displayed on a phage (5.65 +/- 0.54 x 10(4) M(-1) s(-1) and 5.96 +/- 0.56 x 10(4) M(-1) s(-1), respectively).

A kinetic model for a biopanning process considering antigen desorption and effective antigen concentration on a solid phase

A phage display library is a powerful tool for screening ligands such as antibodies and peptides that specifically recognize a target. In this study, we established a kinetic model describing the affinity selection process of phage display libraries and verified the model experimentally. Desorption of target molecules from a solid phase and orientation of the epitopes of adsorbed target molecules are taken into account in this model. The ratio of the effective antigen density to the total antigen density was estimated to be 0.0127(+/-)0.0018 when bovine pancreatic ribonuclease A (RNase A) adsorbed on polystyrene beads was recognized by an anti-RNase A single-chain Fv phage antibody. The model can faithfully describe the recovery of the phage antibody in a round of biopanning based on the effective concentration of RNase A on the beads, the desorption rate constant of RNase A from the beads, the dissociation constant and dissociation rate constant of the phage antibody from RNase A, and the time for blocking, equilibrium and washing in the biopanning process. A recommended biopanning protocol based on the model is also described.

Constrained optimization of L-lysine production based on metabolic flux using a mathematical programming method

Constrained optimization for microbial fermentation was studied. For optimization, we used not the maximum principle but a nonlinear programming method because of the need to consider many metabolic reactions. In the case of L-lysine fermentation, the optimization problem in L-lysine production was formulated as a nonlinear programming problem. In general, the state equations based on material balances are represented as differential equations, but such equations which are dependent on time can not be applied to a nonlinear programming problem. Therefore, the state equations were made discrete in a time base, and a new single vector which is not dependent on time was substituted. From these formulae, the objective function and the constraints using nonlinear programming problem were defined as the amount of L-lysine produced, and as a metabolic reaction model and empirical equations, respectively. Computer program was developed to solve this constrained nonlinear programming problem. The applied algorithm of the computer programming was a sequential quadratic programming method (SQP method). When the constrained nonlinear programming problem is solved using the SQP method, the maximum amount of L-lysine produced and the optimal feeding rate of L-threonine could be calculated. From the calculated results, it was clear that introduction of the equality and inequality constraints was easy. L-Lysine at a concentration up to 75.3 g/l could be produced when the fermentation was carried out under optimal conditions.

Study on optimization for current distribution in magnetic stimulation therapy for urinary incontinence

It has been reported that magnetic stimulation effectively eliminates urinary incontinence. However, this type of therapy has not been established as a practical treatment for urinary incontinence because of its poor power conversion efficiency and the leakage of current to regions other than that of the target of stimulation. It is therefore necessary to develop magnetic stimulators that are more efficient in stimulating the sphincter muscles and the peripheral nerves, and are more convenient than those presently available. By using a large-diameter coil, the magnetic stimulation method offers a larger current distribution over a wider area of the target region than electrical stimulation method, and the placement of the coil can be relatively easily changed to obtain better therapeutic results. We attempted, with a computer simulation model of the female abdomen, to simulate the distribution of the induced current density on the basis of biological tissue conductivity. We determined which method of stimulation is the most efficient by varying the stimulator coil location and size. A genetic algorithm (GA) was used for optimization.

Detection of genetically modified maize DNA fragments in the intestinal contents of pigs fed StarLink CBH351

We tried to detect DNA fragments derived from maize in the intestinal contents of pigs fed genetically modified (GM) StarLink CBH351 maize (SL) or non-GM maize. Intestinal contents of 8 SL and 8 non-GM maize-fed pigs were collected at slaughter, and the genes of the recombinant cry9C and the maize intrinsic zein (Zel) were assayed by polymerase chain reaction (PCR) 3 times with a total of 4 primer pairs of different expected lengths. The cry9C gene (either 103 or 170 bp) was detected in the rectal contents (with a frequency of 25-37.5%) and in the cecal contents (25-50%) of the pigs fed SL. In a similar fashion, the zein (Zel) gene (either 242 or 329 bp) was detected in the rectal contents (with a frequency of 31.3%) and in the cecal contents (25-37.5%) of pigs fed on SL non-GM maize. These results suggested that ingested DNA was not totally degraded, but is present in a form detectable by PCR.