Search

We report the case of a very late erosion of an Amplatzer septal occluder (ASO) device more than 8 years after implant, presenting without signs of cardiac tamponade. To date, this case represents the longest period between ASO device implantation and clinical presentation following erosion. The overall rate of device erosion remains low, and the majority reported so far has occurred early, but clinicians should remain alert to the possibility of very late erosion in patients with ASO devices., (Copyright © 2012 Wiley Periodicals, Inc.)

The clinical application of cardiac CT is increasing, but heart rate control is often required to prevent motion artefact. Here, we describe a protocol for heart rate control in patients undergoing outpatient CT coronary angiography (CTCA). Among 121 consecutive patients, 75 (61.9%) with a resting heart rate >60 beats per minute (bpm) required rate control medication. Our protocol called for oral metoprolol 100 mg to be given 60 min before scanning, with patients for whom beta-blockers were contraindicated receiving 240 mg oral verapamil. Additional 5 mg intravenous boluses (maximum for both drugs, 15 mg) were given if the heart rate remained >60 bpm prior to scanning. Of 71 patients treated with oral metoprolol, 59 (83%) achieved a rate 70 bpm at the time of scanning. No adverse events resulted from rate control medication. Image quality was closely related to heart rate. Severe motion artefact (Grade 3) occurred in only 0.9% of patients with a rate 70 bpm. In conclusion, the administration of oral metoprolol according to the described protocol is a safe and effective way of reducing heart rate and improving scan quality in the majority of patients undergoing CTCA.

Multislice computed tomography (MSCT) is an additional potential tool for the assessment of coronary artery disease. It can provide information about stenoses in coronary arteries and coronary artery bypass grafts, ventricular size and function, cardiac structure and masses, pulmonary vein anatomy, myocardial perfusion and coronary artery plaque. In this review the recent developments in CT technology that have made cardiac imaging possible are examined and the benefits of the latest 64-slice and dual-source CT scanners explained. Information on how to perform cardiac CT and evidence for its various clinical applications are given. Problems and limitations of cardiac CT and the radiation dose are discussed. Future developments and the likely impact of this rapidly evolving technique on clinical cardiology are considered.

Participants viewed a videotape of a simulated murder, and their recall (and confidence) was tested 1 week later with the cognitive interview. Results indicated that (a) the subset of statements assigned high confidence was more accurate than the full set of statements; (b) the accuracy benefit was limited to information that forensic experts considered relevant to an investigation, whereas peripheral information showed the opposite pattern; (c) the confidence-accuracy relationship was higher for relevant than for peripheral information; (d) the focused-retrieval phase was associated with a greater proportion of peripheral and a lesser proportion of relevant information than the other phases; and (e) only about 50% of the relevant information was elicited, and most of this was elicited in Phase 1.

The effects of irradiation on microbial populations in ground beef patties vacuum package and irradiated frozen at target doses of 0.0, 1.0, 3.0, 5.0, and 7.0 kGy were determined. Irradiated samples were stored at 4 or -18 degrees C for 42 days, and mesophilic aerobic plate counts (APCs) were periodically determined. Fresh ground beef (initial APC of 10(2) CFU/g) treated with 3.0, 5.0, and 7.0 kGy was acceptable (< 10(7) CFU/g) for 42 days at 4 degrees C. The 1.0 kGy-treated beef samples were acceptable microbiologically (< 10(7) CFU/g) after 42 days but developed an unacceptable off-odor after 21 days. Shelf life diminished in fresh ground beef patties with an initial APC of 10(4) CFU/g. Only beef patties treated with 7.0 kGy were found to be acceptable at 42 days. Beef patties treated at 1.0 and 3.0 kGy reached spoilage APC levels (> 10(7) CFU/g) by day 14 and 21, respectively, whereas patties treated at 5.0 kGy did not spoil until 42 days. The nonirradiated control samples for both batches of ground beef spoiled within 7 days. Microbial counts in ground beef patties stored at -18 degrees C did not change over the 42-day period. Shelf life of ground beef patties stored at 4 degrees C may be extended with gamma radiation, especially at 5.0 and 7.0 kGy. Initial microbial load in ground beef samples was an important shelf life factor.

Rations containing 0%, 6.2%, and 62% Penicillium citrinum contaminated corn were fed to White Leghorn chicks for 5 weeks. The 62% ration induced hemorrhaging throughout the digestive tract which resembled the lesions observed in acute cases of the poultry hemorrhagic syndrome. The 6.2% ration caused atrophy of lymphoid tissue, anemia, leucopenia, and fatty bone marrow which resembled the lesions observed in chronic cases of the poultry hemorrhagic syndrome. The syndrome was reproduced in chicks using ethanol and chloroform extracts of the P. citrinum contaminated corn.

Electron and plasma beams and neutral gas plumes were injected into the space environment by instruments on Spacelab 1, and various diagnostic measurements including television camera observations were performed. The results yield information on vehicle charging and neutralization, beam-plasma interactions, and ionization enhancement by neutral beam injection.

Day-old white Leghorn chicks were fed P. citrinum-contaminated corn at 3.88, 7.75, 31, or 62% levels in the ration for a period of 5 weeks. High treatment levels (31 and 62%) of contaminated corn in the ration caused severe growth depression, high mortality, and significant decreases in feed consumption. Necrosis of periportal and centrilobular hepatocytes, glomerular atrophy and hyperplasia, degeneration and necrosis of tubular cells, lymphoid depletion, suppression of hematopoiesis, necrosis of pancreatic acinar cells, and a cardiac and skeletal myopathy were observed microscopically in chicks fed 31 and 62% contaminated corn in the rations. Low levels of contaminated corn in the ration (3.88 and 7.75%) caused few clinical effects; however, liver and kidney changes were observed microscopically. Ultrastructural observation of affected tissues showed swelling of mitochondria, dilatation of the endoplasmic reticulum, increased numbers of autophagic vacuoles and paramyelin figures, and lipoprotein peroxidation of organelles. The toxin (s) present in the P. citrinum contaminated ration have not been identified.

The objective of this study was to determine if plasticized polyvinyl chloride film would support the growth of any of nine species of fungi. The film was suspended in distilled water with no nutrients or with glucose or ammonium sulfate. Spores of each of the test species were inoculated into the suspension medium, and the mixture was incubated at 30 degrees C for up to 18 weeks. Most species were found to be capable of utilizing the film for carbon or nitrogen when the other nutrient was supplied. Only two species, Aspergillus fischeri and Paecilomyces sp., were found to be capable of utilizing components of the film without added nutrients. Components of the polyvinyl chloride film were then incorporated into mineral salts medium to determine if these components could serve as carbon sources in the presence of ammonium nitrate. The only component found to be utilized by all the fungi as a carbon source was epoxidized oil, a plasticizer-stabilizer. Calcium-zinc stearate was an available carbon source for all except the Penicillium and Verticillium strains. The only other component utilized was a stearamide, which was metabolized solely by the Aspergillus sp. Only the stearamide contained enough nitrogen to serve as a primary source in the film. The compound, however, did not support growth of fungi in the presence of glucose. It was theorized that either the nitrogen of the stearamide was more readily available to the fungi in the whole film due to the presence of trace nutrients or the nitrogen was supplied by exogenous sources.