Étude du comportement électromécanique du ventricule gauche canin sous différents modes de stimulation

La thérapie de resynchronisation cardiaque (CRT) est un traitement qui diminue la mortalité et améliore la qualité de vie des patients atteints d’insuffisance cardiaque et présentant un dyssynchronisme de la contraction ventriculaire gauche. Malgré le succès de cette thérapie, plus de 30% des patients ne présentent pas l’amélioration désirée. Plusieurs études portant sur le synchronisme électrique ou mécanique de la contraction ont été effectuées mais peu d’entres elles se sont attardées sur le couplage électromécanique à l'échelle macroscopique. Ce projet a comme objectif d’observer le comportement électromécanique des ventricules canins en présence d’un resynchronisateur cardiaque. Un logiciel a été développé pour permettre l’analyse des informations provenant de la cartographie endocardique sans contact et de la ventriculographie isotopique tomographique chez 12 sujets canins insuffisants. Pour observer la réponse mécanique suite à l’activation électrique, nous avons premièrement recalé les surfaces issues des 2 modalités. Ensuite, nous avons défini les limites du cycle cardiaque, analysé les signaux électriques et les courbes de déplacement de la paroi endocardique. Le début de la contraction est défini par un déplacement radial de 10% vers le centre du ventricule. Les résultats démontrent que la durée d’activation du ventricule gauche et la largeur du QRS augmentent en présence d’une stimulation externe et que les délais électromécaniques sont indépendants dans les modes de stimulation étudiés (sinusal, LVbasal, RVapex ou BIV) avec une moyenne de 84,56±7,19 ms. Finalement, nous avons noté que la stimulation basolatérale procure une fonction cardiaque optimale malgré une durée prolongée du QRS.

Petrological parameters of sands and sandstones from DSDP and ODP holes in arc-related areas

Detrital modes for 524 deep-marine sand and sandstone samples recovered on circum-Pacific, Caribbean, and Mediterranean legs of the Deep Sea Drilling Project and the Ocean Drilling Program form the basis for an actualistic model for arc-related provenance. This model refines the Dickinson and Suczek (1979) and Dickinson and others (1983) models and can be used to interpret the provenance/tectonic history of ancient arc-related sedimentary sequences. Four provenance groups are defined using QFL, QmKP, LmLvLs, and LvfLvmiLvl ternary plots of site means: (1) intraoceanic arc and remnant arc, (2) continental arc, (3) triple junction, and (4) strike-slip-continental arc. Intraoceanic- and remnant-arc sands are poor in quartz (mean QFL%Q < 5) and rich in lithics (QFL%L > 75); they are predominantly composed of plagioclase feldspar and volcanic lithic fragments. Continental-arc sand can be more quartzofeldspathic than the intraoceanic- and remnant-arc sand (mean QFL%Q values as much as 10, mean QFL%F values as much as 65, and mean QmKP%Qm as much as 20) and has more variable lithic populations, with minor metamorphic and sedimentary components. The triple-junction and strike-slip-continental groups compositionally overlap; both are more quartzofeldspathic than the other groups and show highly variable lithic proportions, but the strike-slip-continental group is more quartzose. Modal compositions of the triple junction group roughly correlate with the QFL transitional-arc field of Dickinson and others (1983), whereas the strike-slip-continental group approximately correlates with their dissected-arc field.

Gas hydrates at DSDP Leg 84

On DSDP Leg 84, gas hydrates were found at three sites (565, 568, and 570) and were inferred, on the basis of inorganic and organic geochemical evidence, to be present at two sites (566 and 569); no evidence for gas hydrates was observed at Site 567. Recovered gas hydrates appeared as solid pieces of white, icelike material occupying fractures in mudstone or as coarse-grained sediment in which the pore space exhibited rapid outgassing. Also a 1.05-m-long core of massive gas hydrate was obtained at Site 570. Downhole logging indicated that this hydrate was actually 3 to 4 m thick. Measurements of the amount of methane released during the decomposition of these recovered samples clearly showed that gas hydrates had been found. The distribution of evolved hydrocarbon gases indicated that Structure I gas hydrates were present because of the apparent inclusion of methane and ethane and exclusion of propane and higher molecular weight gases. The water composing the gas hydrates was fresh, having chlorinities ranging from 0.5 to 3.2 per mil. At Sites 565, 568, and 570, where gas hydrates were observed, the chlorinity of pore water squeezed from the sediment decreased with sediment depth. The chlorinity profiles may indicate that gas hydrates can often occur finely dispersed in sediments but that these gas hydrates are not recovered because they do not survive the drilling and recovery process. Methane in the gas hydrates found on Leg 84 was mainly derived in situ by biogenic processes, whereas the accompanying small amounts of ethane likely resulted from low-temperature diagenetic processes. Finding gas hydrates on Leg 84 expands observations made earlier on Leg 66 and particularly Leg 67. The results of all of these legs show that gas hydrates are common in landward slope sediments of the Middle American Trench from Mexico to Costa Rica.

Mineralogy and geochemistry of weathered serpentinites in DSDP Leg 84 sediments

At Sites 566, 567, and 570 of Leg 84, ophiolitic serpentinite basement was covered by a sequence of serpentinitic mud that was formed by weathering of the serpentinites under sea- or pore-water conditions. Several mineralogical processes were observed: (1) The serpentinitic mud that consists mainly of chrysotile was formed from the lizardite component of the serpentinites by alteration. (2) Slightly trioctahedral smectites containing nonexpandable mica layers, trioctahedral smectites containing nonexpandable chlorite layers, and swelling chlorites were presumably formed from detrital chlorite and/or serpentine. (3) The occurrence of tremolite, chlorite, analcime, and talc can be attributed to reworking of gabbroic ophiolite rocks. (4) Dolomite, aragonite, and Mg-calcite, all authigenic, occur in the serpentinitic mud.

Isotopic analysis of core gases at DSDP Leg 84 Holes

Methane carbon-isotopic compositions (d13C values relative to the PDB standard) at Sites 565, 566, 567, and 569 were lighter (enriched in 12C) than -60 per mil, indicating a biogenic origin. In the deeper sections at Sites 568 and 570, d13C values were heavier, approaching -40 per mil, and therefore suggest a thermogenic source. A significant thermogenic source was discounted, however, because the carbon dioxide d13C values in these sections were also anomalously heavy, suggesting that the methane may have formed biogenically by reduction of the heavy carbon dioxide. d13C values of ethane and higher hydrocarbons were measured in several sections from Sites 566 and 570 that contained sufficient C2-C4 hydrocarbon concentrations. Ethane values in six sections (245-395 m sub-bottom) from Site 570 were fairly uniform, ranging from -24 to -26 per mil. These values are among the heaviest ethane values reported for natural gases. The isobutane/ n-butane and isopentane/n-pentane ratios of the core gases suggested that the C2-C5 hydrocarbons are thermally produced by low-temperature chemical diagenesis of indigenous organic matter. This process apparently generates isotopically heavy C2-C5 hydrocarbons. High gas concentrations in the serpentinite basement rocks at Sites 566 and 570 appear to have resulted from migrated biogenic methane gas containing small amounts of immature C2-C5 hydrocarbons.

(Table 1) Interstitial water geochemistry at DSDP Leg 84 Holes

On DSDP Leg 84, drilling was conducted at three gas-hydrate-bearing sites on the Middle America Trench slope off Costa Rica (Site 565) and off Guatemala (Sites 568 and 570). At Site 569, on the mid-slope off Guatemala, hydrates may be present, according to the seismic profile (GUA-13), although the pore-water composition does not provide clear evidence. Sites 566 and 567, on the lower Guatemala Trench slope, appear to be free of hydrates, except in fractures of serpentinite at the bottom of Hole 566. Hydrate-bearing Sites 565, 568, and 570 show the effects of hydrate decomposition on pore-water chemistry that have been established during previous drilling at Sites 496 and 497 on the Guatemala Trench slope. These include a chlorinity decrease and d18O increase downsection. The new results, however, reveal more complex relationships between the chlorinity decrease and d18O increase than previously recognized. At Site 565, d18O values decrease in the middle section of the hole, whereas chlorinity continues to decrease from the top to near the bottom of the hole. Early diagenetic alteration of volcanic glass is suggested as a mechanism for the unexpected minimum in the O-isotope curve. Multiple fractionation by the pore-water/hydrate system is required to explain d18O-values greater than 2.7 per mil at the bottom of Hole 568, because with a fractionation factor of alpha = 1.0027, this is the maximum figure a single-stage fractionation could produce. In situ water samples from hydrate zones in most cases failed to display the elevated salinities expected for the residual pore waters not involved in hydrate formation. This is probably because the in situ sampling device still allows a systematic pressure drop sufficient to trigger hydrate decomposition in the immediate vicinity of the sample port.

A comparison of the hazard perception ability of matched groups of healthy drivers aged 35 to 55, 65 to 74, and 75 to 84 years

We examined differences in response latencies obtained during a validated video-based hazard perception driving test between three healthy, community-dwelling groups: 22 mid-aged (35-55 years), 34 young-old (65-74 years), and 23 old-old (75-84 years) current drivers, matched for gender, education level, and vocabulary. We found no significant difference in performance between mid-aged and young-old groups, but the old-old group was significantly slower than the other two groups. The differences between the old-old group and the other groups combined were independently mediated by useful field of view (UFOV), contrast sensitivity, and simple reaction time measures. Given that hazard perception latency has been linked with increased crash risk, these results are consistent with the idea that increased crash risk in older adults could be a function of poorer hazard perception, though this decline does not appear to manifest until age 75+ in healthy drivers.

A Raman and infrared spectroscopic study of the mineral delvauxite CaFe3+4(PO4,SO4)2(OH)8•4-6H2O- a ‘colloidal’ mineral

The mineral delvauxite CaFe3+4(PO4,SO4)2(OH)8•4-6H2O has been characterised by Raman spectroscopy and infrared spectroscopy. The mineral is associated with the minerals diadochite and destinezite. Delvauxite appears to vary in crystallinity from amorphous to semi-crystalline. The mineral is often X-ray non-diffracting. The minerals are found in soils and may be described as ‘colloidal’ minerals. Vibrational spectroscopy enables determination of the molecular structure of delvauxite. Bands are assigned to phosphate and sulphate stretching and bending modes. Two symmetric stretching modes for both the phosphate and sulphate symmetric stretching modes support the concept of non-equivalent phosphate and sulphate units in the mineral structure. Multiple water bending and stretching modes imply that non-equivalent water molecules in the structure exist with different hydrogen bond strengths.

Is the mineral borickyite (Ca,Mg)(Fe3+,Al)4(PO4,SO4,CO3)(OH)8•3-7.5H2O the same as delvauxite CaFe3+4(PO4,SO4)2(OH)8•4-6H2O?

The two minerals borickyite and delvauxite CaFe3+4(PO4,SO4)2(OH)8•4-6H2O have the same formula. Are the minerals identical or different? The minerals borickyite and delvauxite have been characterised by Raman spectroscopy. The minerals are related to the minerals diadochite and destinezite. Both minerals are amorphous. Delvauxite appears to vary in crystallinity from amorphous to semi-crystalline. The minerals are often X-ray non-diffracting. The minerals are found in soils and may be described as ‘colloidal’ minerals. Vibrational spectroscopy enables an assessment of the molecular structure of borickyite and delvauxite. Bands are assigned to phosphate and sulphate stretching and bending modes. Multiple water bending and stretching modes imply that non-equivalent water molecules in the structure exist with different hydrogen bond strengths. The two minerals show differing spectra and must be considered as different minerals.

Percutaneous coronary intervention with drug-eluting stents or coronary artery bypass surgery in subjects with type 2 diabetes : evaluation of: Farkouth ME, Domanski M, Sleeper LA, et al. Strategies for multivessel revascularization in patients with diabetes. N Engl J Med 2012;367(25):2375-84, and Contini GA, Nicolini F, Fortuna D, et al. Five-year outcomes of surgical or percutaneous myocardial revascularization in diabetic patients. Int J Cardiol 2012. [Epub ahead of print]

There is debate as to whether percutaneous coronary intervention (PCI) with drug-eluting stents or coronary artery bypass surgery (CABG) is the best procedure for subjects with type 2 diabetes and coronary artery disease requiring revascularization. There is some evidence that following these procedures there is less further revascularization with CABG than PCI in subjects with diabetes. Two recent studies; the FREEDOM (Future Revascularization Evaluation in patients with Diabetes mellitus: Optimal Management of Multivessel Disease) trial, and a trial using a real world diabetic population from a Registry, have shown that the benefits of CABG over PCI in subjects with type 2 diabetes extends to lower rates of death and myocardial infarct, in addition to lower rates of revascularization. However, the rates of stroke may be higher with CABG than PCI with drug-eluting stents in this population. Thus, if CABG is going to be preferred to PCI in subjects with type 2 diabetes and multivessel coronary disease, consideration should be given to how to reduce the rates of stroke with CABG.

Tombstone of David Benjamin; Strangriede Cemetery (R 84.7); Hannover Cemeteries Tombs

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