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Background The incidence, predictors, and clinical impact of lead break during transvenous lead extraction (TLE) were previously unknown. Methods We included consecutive patients who underwent TLE between September 2013 and July 2019 at our institute. Lead break during removal was defined as lead stretching and becoming misshapen, as assessed by fluoroscopy. Results A total of 246 patients underwent TLE for 501 leads. At a patient level, complete success was achieved in 226 patients (91.9%). At a lead level, 481 leads (96.0%) were completely removed and 101 leads (20.1%) were broken during the procedure. Of 392 identified pacemaker leads, 71 (18.3%) were broken during the TLE procedure. A multivariable analysis confirmed high lead age (odds ratio [OR] 1.12, 95% confidence interval (CI) 1.07‐1.17; P, The extraction of cardiac implantable electronic device leads due to infections, malfunctions, and recalls is common, and can lead to complications such as lead break resulting in incomplete lead removal and cardiac tamponade. We found that older lead age, co‐radial leads, passive leads, and non‐polyurethane leads were independent predictors of lead break during extraction. These findings will guide clinicians to make appropriate choices of procedure and take greater care when these risk factors are present.

Objectives The Erection Hardness Score (EHS) can assess erectile hardness with a single question and is readily used in routine clinical practice. We investigated the correlation between EHS and both erectile function and metabolic risk, lifestyle, and other factors. Methods This study included 548 men who underwent a complete standard medical checkup at our hospital between July 1, 2016, and August 31, 2018, and answered the question about erectile hardness. The following variables were evaluated: age, erectile hardness on the EHS, erectile function on the Sexual Health Inventory for Men (SHIM), current medical history (diabetes, hypertension, dyslipidemia, heart disease, stroke), metabolic risk factors (abdominal circumference, hyperglycemia, high blood pressure, lipid abnormality), and lifestyle factors. First, to examine the correlation between erectile hardness and erectile function, the mean SHIM score by EHS grade was determined for each age group. Then, an analyses was performed to examine the association between erectile hardness and age, current medical history, metabolic risk factors, and lifestyle factors. Results In each age group, a lower EHS grade was associated with a lower mean SHIM score. Lipid abnormality, diabetes, and age were independent risk factors for decreased erectile hardness. Conclusion The EHS as a measure of erectile hardness was correlated with erectile functional as assessed using the SHIM, and current diabetes and lipid abnormality were independent risk factors for decreased erectile hardness. However, neither dyslipidemia nor lipid abnormality is listed as a risk factor in the ED guidelines. Traditionally, lipid abnormality was assessed based mainly on the presence or absence of current hyper-lipidemia and serum total cholesterol level. Today, the diagnostic criteria for metabolic syndrome proposed by the World Health Organization, International Diabetes Federation, and Japanese Society of Internal Medicine also recommend the use of serum triglyceride and HDL cholesterol levels, instead of total cholesterol level, for evaluating lipid abnormality. I think the assessment of lipid abnormality should be used triglyceride and HDL cholesterol levels, instead of total cholesterol level. Disclosure Work supported by industry: no.

To improve energy efficiency, flow control techniques for skin-friction drag and heat transfer with regard to wall turbulence are essential. This study performs direct numerical simulation of turbulent channel flows. The traveling-wave-like body force is employed as the flow control technique to break the similarity between momentum and heat transfer. The traveling wave control mimics the self-excited thin film in the corresponding experimental study. When the wave traveled slowly along the downstream direction, the skin-friction drag, heat transfer, and analogy factor were found to increase. Moreover, these parameters increased with an increase in the reference height of the traveling wave ( hw). Flow visualization shows turbulence enhancement owing to the increase in hw. Three-component decomposition elucidates the difference between the control effect on the Reynolds shear stress and the turbulent heat flux.

We report the case of a 74-year-old man with a previously implanted pacemaker lead. He had undergone Medtronic™ Micra Transcatheter Pacing System (TPS, Medtronic plc, MN, USA) implantation because of lead fracture. We implanted a new TPS and retrieved the dislodged one. We used a multiple-loop snare (EN snare®) and an 8.5F steerable sheath (Agilis NXT; St. Jude Medical, St Paul, MN, USA). The TPS was obstructed by the chordae tendineae of the tricuspid valve and the pacemaker lead. We pushed the TPS to the apex site; this enabled us to move the TPS away from the chordae tendineae and pacemaker lead. The TPS body was caught in the inferior vena cava and was successfully retrieved. To our knowledge, this is the first case reporting TPS retrieval in a heart with preexisting lead. Keywords: Dislodgement, Transcatheter pacing system, TPS retrieval

Cardiac rhythm management devices (pacemakers) are being increasingly implanted worldwide not only for symptomatic bradycardia, but also for the management of arrhythmia and heart failure. Despite the overall safety, transvenous lead extraction (TLE) remains a challenging procedure with inherent

As the population ages, the number of elderly patients with implantable cardiac devices referred for transvenous lead extraction will dramatically increase in Japan. We report the safety and effectiveness of transvenous lead extraction in octogenarians. Between 2005 and 2017, we collected data of

During ripening many important physic-chemical changes contribute to fruit quality, and they are precisely determined by gene expression. Specific genes are essential to normal ripening; however, information on gene expression about the majority of tropical fruit, such as bananas and mangoes is limited. In this way, the present study was undertaken with the objective to provide preliminary access to the changes in expression of some genes potentially relevant to banana and mango ripening. To simultaneously evaluate the changes in gene expression, a small collection of genes related to ethylene biosynthesis, starch mobilization, cell wall disassembly, pigment synthesis and ascorbate metabolism was assembled in nylon membranes and probed with cDNA from unripe and ripe fruit. Some interesting differences were observed between gene expression in bananas and mangoes. In relation to starch metabolism, banana a-amylase was induced during ripening while phosphorylase was more induced in mangoes. Similarly, expression of cell wall-related genes for polygalacturonase and expansin were also different in those fruits. Fructanfructosyltransferase, chalcone synthase, and ascorbate oxidase genes were also induced in ripening mangoes, but not in bananas. Although the number of sequences involved was relatively small, this simple and feasible approach provided interesting preliminary data that can be starting points for more in depth studies.

Catheter ablation (CA) is an effective and widely used treatment strategy for paroxysmal atrial fibrillation (PAF). According to some papers, PAF is associated with distinct mechanistic and prognostic criteria in different patient subgroups. Compared with men, women with PAF have greater

Radiofrequency (RF) ablation of the atrioventricular nodal slow pathway is the accepted treatment for atrioventricular nodal reentrant tachycardia (AVNRT), with success rates greater than 90%. The major risk is atrioventricular nodal block requiring permanent pacemaker implantation. Cryoablation is

Controlling the amount of chromium to be deposited on tin and iron substrates is important for the production of special steel sheet for welded can material, partially tin precoated and then fully coated with chromium. The deposition behaviour of chromium on tin and iron substrates was studied by means of the polarization behaviour of tin and iron in a chromium coating bath. For stable deposition, a higher current density is required on tin than on iron due to the higher hydrogen over-voltage on tin. Ageing in air after tin coating and preliminary electrolysis under the potential range of reduction of Cr6+ to Cr0 in a chromium coating bath are effective in facilitating the formation of a cathode film and encouraging the deposition. A study on a continuous coating line showed that the amount of chromium to be deposited on tin and iron can be industrially controlled by a process involving a lower current density in the first step and a higher current density in the second.

The amino acid structure of regulatory light chain which is essential to express the phosphorylation-mediated regulation of smooth muscle actomyosin ATPase was studied. Regulatory light chain of smooth muscle heavy meromyosin (HMM) was truncated by either lysylendopeptidase or trypsin. Lysylendopeptidase cleaved the regulatory light chain initially at the C-terminal side of lysine 6 (Lys C(1)-HMM) and subsequently at the C-terminal side of lysine 12 (Lys C(2)-HMM). On the other hand, trypsin cleaved at the C-terminal side of arginine 16 (tryp-HMM). While the actin activated ATPase activity of Lys C(1)-HMM and Lys C(2)-HMM was markedly activated by phosphorylation, that of tryp-HMM was not activated by phosphorylation. The exchange of cleaved regulatory light chain of tryp-HMM with undigested regulatory light chain restored the phosphorylation-mediated regulation on the actin activated ATPase activity. The regulatory light chain of the undigested HMM was also exchanged with the trypsin-digested regulatory light chain and this abolished the phosphorylation dependence of acto-HMM ATPase activity. These results show that the amino acid sequence arginine 13-arginine 16 is essential to express the regulation of actin activated ATPase of smooth muscle myosin which is mediated by the phosphorylation at serine 19 of the regulatory light chain.

Fuel Source circular pans. 2.0m2. The objective of the tests was to provide the data for use in evaluating the environmental effects of lubricant oil fires in the compartment. Fifty-one tests were conducted to research the environmental effects (atmospheric temperature, radiation heat flux and so forth) on the surroundings with the various size fuel pans and compartments and the various air exchange rates. The concentration of the smoke and CO were also measured in the tests. Test results showed that the radiation heat flux from the high temperature gas and soots was greater than that from the flame because the later was interrupted by the smoke. The gradients of atmospheric temperature were hardly observed in the horizontal temperature distribution but were observed in the vertical temperature distribution in the compartment. It appeared that the concentrations of smoke and CO were able to be estimated from the ratio of burning rate and air supply rate. From the test results, we have developed a conventional and conservative method to evaluate the environmental effects of lubricant oil fire in the compartment.

A membrane protein with a molecular weight of 40,000 (40K protein) was induced concurrently with cell filamentation by cyclic AMP (cAMP) in a fic mutant. In the crp mutant and the wild-type strain, cell filamentation by cAMP was not observed, and the 40K protein was not induced. Induction of the 40K protein is regulated by the cAMP-cAMP receptor protein complex and is closely related to cell filamentation by cAMP in the fic mutant.

If you take the oscillographs of the arc current or voltage during the welding whith the automatic or hand welder, you will find the ripple in the arc voltage though the arc current is constant. Ripple occurs as such in the case of D. C. source, while it is superposed to the commercial frequency with A. C. source. Up to the present, the above phenomenon has been simply reduced to the spattering of the metal, the influence of the electric source, or the effect of the automatic welder. It seems, however, that there are problems which are inexplicable by the above explanations. For example, the period of the ripple is under 1/100 sec., while the response time is as long as 17/100 sec.The Authors attribnted it to the self-regulation of the arc, and according to their theory, the. spattering of the metal should be included in this self-regulation.Under the reasonable assumption, they have tried the mathematical analysis, and recognized that it satisfactorily coincides with the experimental results.

Reducing sugars induced alkali-labile sites in DNA. The DNA reacted with D-fructose 6-phosphate or D-fructose in the presence of Cu2+ was cleaved by the treatment with aqueous piperidine at 90 degrees C for 30 min. Alkali-labile sites were induced frequently at the pyrimidine residues, especially at the pyrimidine residues in pyrimidine-purine (5'----3') sequences. Transition metal ions such as Cu2+ and oxygen radicals such as hydrogen peroxide were possibly involved in the induction of alkali-labile sites.