Staphylococcus bacteremia without evidence of cardiac implantable electronic device infection

1. Download : Download high-res image (198KB)
2. Download : Download full-size image

     

Technical issues and new devices of ESD of early gastric cancer

Endoscopic submucosal dissection(ESD) is a highly refined technique compared to conventional endoscopic mucosal resection.It enables complete resection of early gastric cancer(EGC) which has no possibility of lymph node metastasis.Indication for ESD of EGC generally entails early gastric cancer confined to the mucosa with well differentiated histology,though there are clinically suitable expanded criteria.As ESD requires specific skill and expertise,endoscopists need to be familiarized with basic methods an...     

The Lillehei Heart Institute: Building on the Shoulders of Giants

Scientific revolutions require a series of paradigm shifts that are promoted by a series of discoveries. These discoveries, paradigm shifts, and scientific revolutions are dependent on timing, environment, and innovative pioneers. More than 50 years ago, a series of discoveries led to such a paradigm shift at the University of Minnesota which in turn revolutionized the field of cardiovascular medicine forever. Today, this spirit of innovation and discovery is alive and thriving at the Lillehei Heart Institute at the University of Minnesota.     

Inappropriate shock for myopotential over-sensing in a patient with subcutaneous ICD

Inappropriate ICD shocks are common adverse events; they are mainly due to supraventricular arrhythmias and secondly are related to noise, undersensing, oversensing, device malfunctions. We present a case of inappropriate device therapy due to myopotential oversensing in a patient with a subcutaneous ICD (s-ICD). A 58 years old male with an s-ICD during the device interrogation showed a previous episode of suspected sustained ventricular tachycardia at 210 bpm, which was effectively treated with ICD shock. The patient experienced the electrical shock while holding a big gas-cylinder in his arms. The EGM analysis revealed many irregular ventricular signals of low amplitude lasting for 24 s and interrupted by the shock. The device showed no malfunctions. This is the first case report of inappropriate S-ICD shock related to myopotential over-sensing. By recording intracardiac EGM, we demonstrated that the noise was created by the activity of the pectorals muscles.     

Selective Cerebrospinal Fluid Hypothermia: Bioengineering Development and In Vivo Study of an Intraventricular Cooling Device (V-COOL)

Hypothermia is a promising therapeutic strategy for severe vasospasm and other types of non-thrombotic cerebral ischemia, but its clinical application is limited by significant systemic side effects. We aimed to develop an intraventricular device for the controlled cooling of the cerebrospinal fluid, to produce a targeted hypothermia in the affected cerebral hemisphere with a minimal effect on systemic temperature. An intraventricular cooling device (acronym: V-COOL) was developed by in silico modelling, in vitro testing, and in vivo proof-of-concept application in healthy Wistar rats (n = 42). Cerebral cortical temperature, rectal temperature, and intracranial pressure were monitored at increasing flow rate (0.2 to 0.8 mL/min) and duration of application (10 to 60 min). Survival, neurological outcome, and MRI volumetric analysis of the ventricular system were assessed during the first 24 h. The V-COOL prototyping was designed to minimize extra-cranial heat transfer and intra-cranial pressure load. In vivo application of the V-COOL device produced a flow rate-dependent decrease in cerebral cortical temperature, without affecting systemic temperature. The target degree of cerebral cooling (− 3.0 °C) was obtained in 4.48 min at the flow rate of 0.4 mL/min, without significant changes in intracranial pressure. Survival and neurological outcome at 24 h showed no significant difference compared to sham-treated rats. MRI study showed a transient dilation of the ventricular system (+ 38%) in a subset of animals. The V-COOL technology provides an effective, rapid, selective, and safe cerebral cooling to a clinically relevant degree of − 3.0 °C.Supplementary InformationThe online version contains supplementary material available at 10.1007/s13311-022-01302-y.