No abstract

No abstract

The present study was undertaken to reveal the magnesium distribution in human bone. Sixty human ribs, obtained from subjects aged 10-80 years of age, were used. Transverse sections were prepared from the middle region of the human ribs. Adjacent sections were ground to a thickness of about 1000 microns. One section was used for magnesium determination by atomic absorption spectrophotometry, and the other was used for analysis with X-ray microanalysis. Thirty micron thick samples were abraded continuously from the periosteal and the endosteal surfaces by abrasive microsampling, as previously described by Weatherell et al. Results showed that magnesium concentrations were higher in both the periosteal and endosteal surfaces and did not change with age in general, although it tended to be higher among teenagers and lower over 80 years old.

A highly sensitive silver technique for glial cytoplasmic inclusions (GCI) in olivopontocerebellar atrophy (OPCA) was applied to tissues from 15 patients with neurodegenerative disorders including OPCA, Joseph disease, Alzheimer's disease (AD), Huntington's chorea, Pick disease and three control non-neurological subjects. Brain tissue from both OPCA and AD impregnated positively. Neurons, astroglia and oligodendroglia in the putamen, pontine nucleus and inferior olivary nucleus all impregnated in addition to white matter oligodendroglia. Neuronal inclusions in the pontine nucleus appeared as compact or fibrillary masses, and GCI-bearing oligodendroglia and astrocytes showed homogeneously impregnated somata. The myelinated pontocerebellar tract and the white matter surrounding the inferior olivary nucleus contained a small number of impregnated nerve fibres with a hollow structure, which resembled the myelin sheath. Immunocytochemical studies to clarify these argyrophilic structures in the OPCA subjects employed paired helical filament (PHF), microtubule associated proteins (MAPs), MAP1, MAP2, MAP5, tau, ubiquitin, neurofilament (200 or 70 kilodaltons) and myelin basic protein (MBP) antisera. GCI-bearing white matter oligodendroglia expressed PHF, tau, MAP5 and ubiquitin immunoreactives and non-argyrophilic astroglia were positive for MAP5 antiserum alone. In the putamen, pontine nuclei and inferior olivary nuclei, impregnated neurons as well as the GCI-bearing oligodendroglia immunostained with PHF, tau, MAP5 and ubiquitin antisera and impregnated astroglia were also immunoreactive to these antisera except for being tau negative in the putamen. Silver impregnated nerve fibres showed only MBP immunoreactivity. These findings indicate that the argyrophilia in the OPCA subjects closely correlates with PHF and tau immunoreactivities.

Background Additional benefit of cryoballoon left atrial roof line ablation (CB‐RA) beyond cryoballoon pulmonary vein isolation (CB‐PVI) is suggested in patients with persistent atrial fibrillation (PsAF). We sought to investigate the feasibility of CB‐RA for PsAF and to determine the ablation area. Methods and Results Fifty‐three PsAF patients (67[58.5–75.5] years, 36 men, 11 longstanding PsAF) underwent CB‐PVI. Subsequently, 44(83.0%) out of 53 patients underwent additional CB‐RA. Voltage maps were created in all patients with a high‐resolution mapping system. The total number and duration of CB‐RAs were 3.9 ± 0.7 and 468 ± 84 s. LA roof areas were complete low voltage areas (LVAs) /scar in 37/44(84.1%) patients (“complete roof modification”). The normal LA posterior wall (LAPW) voltage area was 6.1(4.1–8.4) cm2, and the %LAPW isolation area was 61.0(47.2–71.7)%. The %LAPW isolation area was significantly greater in CB‐RA patients than those without (64.0[54.2–73.2] vs. 45.0[39.5–50.5]%, p = .041) despite significantly larger LAs in the former group. The %LAPW isolation area was significantly greater in patients with transverse LA diameters < 45 mm than those ≥ 45 mm (p < .0001). The single procedure 1‐year AF freedom was 87.4% (22.5% on antiarrhythmic drug) and tended to be higher in CB‐RA patients than those without. Among the 44 CB‐RA patients, it was significantly higher in patients with a complete roof modification than those without (94.4% vs. 75.0%, p = .0049). One CB‐RA patient experienced a delayed cardiac tamponade requiring drainage at 4‐months post‐procedure. Conclusions CB‐RA significantly expanded the LAPW isolation area, and a complete roof modification resulted in a high arrhythmia freedom in PsAF patients.

No abstract

Background: The utility of pressure waveform analyses to assess pulmonary vein (PV) occlusions has been reported in cryoballoon PV isolation (CB‐PVI) using first‐generation CBs. This prospective randomized study compared the procedural and clinical outcomes of pressure‐guided and conventional CB‐PVI. Methods and Results: Sixty patients with paroxysmal atrial fibrillation underwent CB‐PVI with 28‐mm second‐generation CBs. PV occlusions were assessed either by real‐time pressure waveforms without contrast utilization (pressure‐guided group) or contrast injections (conventional group) and randomly assigned. Before the randomization, 24 patients underwent pressure‐guided CB‐PVIs. In the derivation study, a vein occlusion was obtained in 88/96 (91.7%) PVs among which 86 (97.7%) were successfully isolated by the application. In the validation study, the nadir balloon temperature and total freezing time did not significantly differ per PV between the two groups. The positive predictive value of the vein occlusion for predicting successful acute isolations was similar (93 of 103 [90.2%] and 89 of 98 [90.8%] PVs; P = 1.000), but the negative predictive value was significantly higher in pressure‐guided than angiographical occlusions (14 of 17 [82.3%] vs 7 of 22 [31.8%]; P = .003). Both the procedure (57.7 ± 14.2 vs 62.6 ± 15.8 minutes; P = .526) and fluoroscopic times (16.3 ± 6.4 vs 20.1 ± 6.1; P = .732) were similar between the two groups, however, the fluoroscopy dose (130.6 ± 97.7 vs 353.2 ± 231.4 mGy; P < .001) and contrast volume used (0 vs 17.5 ± 7.7 mL; P < .001) were significantly smaller in the pressure‐guided than conventional group. During 27.8 (5‐39) months of follow‐up, the single procedure arrhythmia freedom was similar between the two groups (P = .438). Conclusions: Pressure‐guided second‐generation CB‐PVIs were similarly effective and as safe as conventional CB‐PVIs. This technique required no contrast utilization and significantly reduced radiation exposure more than conventional CB‐PVIs.

No abstract