Subcostal echocardiography to determine right ventricular pacing catheter position and control advancement of electrode catheters in intracardiac electrophysiologic studies: M mode and two dimensional studies

To assess the value of subcostal echocardiography in determining the position of a right ventricular pacing catheter, M mode and two dimensional echocardiography was performed from four different locations in 30 patients. Subcostal M mode echocardiography had a higher detection rate of the pacing catheter than did the precordial M mode examination. However, with M mode echocardiography it was not possible to determine the position of the pacing catheter from any of the locations. The subcostal two dimensional echocardiography demonstrated the full length of the pacing catheter in the right heart chambers and its anatomic position in all patients and proved superior to the precordial approach. This technique allowed the detection of complications related to pacing catheters. A pacing catheter ejected from the ventricular cavity was found in the inferior vena cava. Perforation of the ventricular septum with a bipolar electrode for temporary pacing was also diagnosed.

Subcostal two dimensional echocardiography was used in 20 patients as an additional technique for controlling the advancement of electrode catheters in right heart intracardiac electrophysiologic studies. The electrode catheters were successfully positioned at all routine sites in all patients except one. Thus, subcostal two dimensional echocardiography has advantages over fluoroscopy in the determination of pacing catheter position and in controlling the advancement of electrode catheters in intracardiac electrophysiologic studies.     

Booster immune response in children 6–7 years of age,randomly assigned to four groups with two MMR vaccines applied by aerosol or by injection

Importance

Aerosol immunization may be a useful tool to reach and sustain the elimination of measles, rubella, and congenital rubella syndrome. We compared booster seroresponses to aerosolized or injected MMR vaccines containing different strains of measles (Attenuvax or Edmonston–Zagreb) and mumps (Jeryl–Lynn or Leningrad–Zagreb).

Objective

To assess the safety and immunogenicity of two MMR: Vaccines administered by aerosol.

Methods

A randomized and controlled clinical trial was conducted to evaluate the safety and booster responses to the MMR SII (Serum Institute of India) and MMR II (Merck Sharp & Dhome) vaccines, both of which were administered by aerosol (ae) or injection (inj) to Mexican children aged 6–7 years in elementary schools. The seroresponses were evaluated by PRN (measles) and ELISA (rubella and mumps). Adverse events were followed-up for 28 days after the immunization.

Results

Two hundred and fifty-three of 260 children completed the one-month follow-up. All participants reached protective seropositivity for measles and rubella after immunization, and 98.3 to 100% reached protective seropositivity for mumps (p = 0.552). The proportions of the seroresponses (a 2-fold rise from the baseline antibody titers) to measles were 38.3% for MMR SII (ae), 31.3% for MMR II (ae), 37.5% for MMR SII (inj), and 44.6% for MMR II (inj) (p = 0.483). The seroresponses for rubella were 26.7% for MMR SII (ae), 31.3% for MMR II (ae), 46.9% for MMR SII (inj), and 40.0% for MMR II (inj) (p = 0.086). The seroresponse to mumps were 31.7% for MMR SII (ae), 25.0% for MMR II (ae), 48.4% for MMR SII (inj), and 53.9% for MMR II (inj) (p = 0.002). The difference in the seroresponse of a 4-fold rise from the baseline antibody titers was not statistically significant. Only mild adverse events were noted.

Conclusion

Aerosolized vaccines were as safe and as immunogenic as injected vaccines.

Protocol registration

CMN 2010-005 (National Regulatory Authority).     

Population genetic study from the Zagreb area using 3 STR systems

Population genetic studies were carried out on Caucasians from north-west Croatia (Zagreb-area) using the short tandem repeat (STR) systems HumTHO1, HumVWA and HumACTBP2. After electrophoresis in PAG, 6 alleles could be identified for HumTHO1 in a sample size of 100 unrelated individuals and 7 alleles were found for VWA. For ACTBP2, 25 alleles have been identified. No significant deviations from Hardy-Weinberg equilibrium could be observed.     

Age and intestinal retention of mercury and cadmium in rats

The site of cadmium and mercury retention in the intestine was determined in 6-day-old sucklings and 6-week-old weaned rats 6 days after oral administration of ^115mCd and ²⁰³Hg. The ileum was found to be the main site of intestinal retention of both cations in sucklings but not in weaned rats. Other age- and element-specific differences in the site of metal retention in the intestine were also found. These differences indicate that even in neonates, metal absorption might be a more specific process than previously assumed.     

Variability of chromosomes 1, 9, and 16 in children with malignant diseases

Heterochromatic segments of chromosomes #1, #9, and #16 were analyzed in 38 children with malignant disease and 42 healthy persons. The analysis was carried out on C-banded metaphases obtained by peripheral blood culture. Using a quantitative method of analysis, an association was established between C-segment length of chromosome #9 and malignant disease in children. A disturbed quantitative relation of C-heterochromatin of chromosomes #1, #9, and #16 was also found in the group of children with malignant disease.     

Drug-Eluting Balloons–A New Tool in the Treatment of Cardiac Allograft Vasculopathy: A Case Series

Percutaneous coronary intervention in patients with cardiac allograft vasculopathy is burdened with a lot of difficulties. Although they have allowed significant progress in comparison with plain balloon angioplasty and bare metal stents, drug-eluting stents have not fully overcome problems of diffuse lesions and small-vessel disease that are so common in transplant coronary artery disease. There is growing evidence that drug-eluting balloons might be a better choice for patients with small vessel atherosclerotic coronary disease and yet there is no experience with this technology in patients with cardiac allograft vasculopathy. Herein we report a case series of successful percutaneous coronary interventions in patients with cardiac allograft vasculopathy.