Ablation of ischemic ventricular tachycardia: evidence, techniques, results, and future directions

PURPOSE OF REVIEW This article summarizes current understanding of the arrhythmia substrate and effect of catheter ablation for infarct-related ventricular tachycardia, focusing on recent findings. RECENT FINDINGS Clinical studies support the use of catheter ablation earlier in the course of ischemic disease with moderate success in reducing arrhythmia recurrence and shocks from implantable defibrillators, although mortality remains unchanged. Ablation can be lifesaving for patients presenting with electrical storm. Advanced mapping systems with image integration facilitate identification of potential substrate, and several different approaches to manage hemodynamically unstable ventricular tachycardia have emerged. Novel ablation techniques that allow deeper lesion formation are in development. SUMMARY Catheter ablation is an important therapeutic option for preventing or reducing episodes of ventricular tachycardia in patients with ischemic cardiomyopathy. Present technologies allow successful ablation in the majority of patients, even when the arrhythmia is hemodynamically unstable. Failure of the procedure is often because of anatomic challenges that will hopefully be addressed with technological progress.

Chemical and isotopic compositions of hydrothermal manifestations and minerals from the Broken Spur hydrothermal field

A representative collection of hydrothermal manifestations was sampled practically from all hydrothermal mounds of the Broken Spur hydrothermal vent field with use of the Mir manned submersibles during three cruises of R/V Akademik Mstislav Keldysh. Mineral associations characteristic for different morphological types of sulfide ores from hydrothermal pipes, plates, and diffusers are assessed. Particular attention is paid to distribution of minor elements and their distribution patterns determined by mineralogical zonation. Measured isotopic composition of sulfur in sulfide minerals varies from 0.4 to 5.2 per mil that indicates their similarity with ores from the Snake Pit vent field and is related to dilution of hot ore-bearing solutions by seawater and reduction of water sulfate ions to H2S with heavy isotopic composition.

Whole rock analytical techniques and glas analytical techniques of silicic magmas from the South East Rift, Manus Basin

There has been much recent interest in the origin of silicic magmas at spreading centres away from any possible influence of continental crust. Here we present major and trace element data for 29 glasses (and 55 whole-rocks) sampled from a 40 km segment of the South East Rift in the Manus Basin that span the full compositional continuum from basalt to rhyolite (50-75 wt % SiO2). The glass data are accompanied by Sr-Nd-Pb, O and U-Th-Ra isotope data for selected samples. These overlap the ranges for published data from this part of the Manus Basin. Limited increases in Cl/K ratios with increasing SiO2, La-SiO2 and Yb-SiO2 relationships, and the oxygen isotope data rule out models in which the more silicic lavas result from partial melting of altered oceanic crust or altered oceanic gabbros. Rather, the data form a coherent array that is suggestive of closed-system fractional crystallization and this is well simulated by MELTS models run at 0.2 GPa and QFM (quartz-fayalite-magnetite buffer) with 1 wt % H2O, using a parental magma chosen from the basaltic glasses. Although some assimilation of altered oceanic crust or gabbro cannot be completely ruled out, there is no evidence that this plays an important role in the origin of the silicic lavas. The U-series disequilibria are dominated by 238U and 226Ra excesses that limit the timescale of differentiation to less than a few millennia. Overall, the data point to rapid evolution in relatively small magma lenses located near the base of thick oceanic crust; we speculate that this was coupled with relatively low rates of basaltic recharge. A similar model may be applicable to the generation of silicic magmas elsewhere in the ocean basins.

Geochemical data for drilled powder samples from two fossil Porites corals from Integrated Ocean Drilling Program Expedition 310

Fossil corals are unique archives of past seasonal climate variability, providing vital information about seasonal climate phenomena such as ENSO and monsoons. However, submarine diagenetic processes can potentially obscure the original climate signals and lead to false interpretations. Here we demonstrate the potential of laser ablation ICP-MS to rapidly detect secondary aragonite precipitates in fossil Porites colonies recovered by Integrated Ocean Drilling Program (IODP) Expedition 310 from submerged deglacial reefs off Tahiti. High resolution (100 µm) measurements of coralline B/Ca, Mg/Ca, S/Ca, and U/Ca ratios are used to distinguish areas of pristine skeleton from those afflicted with secondary aragonite. Measurements of coralline Sr/Ca, U/Ca and oxygen isotope ratios, from areas identified as pristine, reveal that the seasonal range of sea surface temperature in the tropical south Pacific during the last deglaciation (14.7 and 11 ka) was similar to that of today.

Chemistry and boron isotope ratios of Izu arc front volcanic rocks

The process of fluid release from the subducting slab beneath the Izu arc volcanic front (Izu VF) was examined by measuring B concentrations and B isotope ratios in the Neogene fallout tephra (ODP Site 782A). Both were measured by secondary ion mass spectrometry, in a subset of matrix glasses and glassy plagioclase-hosted melt inclusions selected from material previously analyzed for major and trace elements (glasses) and radiogenic isotopes (Sr, Nd, Pb; bulk tephra). These tephra glasses have high B abundances (~10-60 ppm) and heavy delta11B values (+4.5? to +12.0?), extending the previously reported range for Izu VF rocks (delta11B, +7.0? to +7.3?). The glasses show striking negative correlations of delta11B with large ion lithophile element (LILE)/Nb ratios. These correlations cannot be explained by mixing two separate slab fluids, originating from the subducting sediment and the subducting basaltic crust, respectively (model A). Two alternative models (models B and C) are proposed. Model B proposes that the inverse correlations are inherited from altered oceanic crust (AOC), which shows a systematic decrease of B and LILE with increasing depth (from basaltic layer 2A to layer 3), paralleled by an increase in delta11B (from ~ +1? to +10? to +24?). In this model, the contribution of sedimentary B is insignificant (<4% of B in the Izu VF rocks). Model C explains the correlation as a mixture of a low-delta11B (~ +1?) 'composite' slab fluid (a mixture of metasediment- and metabasalt-derived fluids) with a metasomatized mantle wedge containing elevated B (~1-2 ppm) and heavy delta11B (~ +14?). The mantle wedge was likely metasomatized by 11B-rich fluids beneath the outer forearc, and subsequently down dragged to arc front depths by the descending slab. Pb-B isotope systematics indicate that, at arc front depths, ~ 53% of the B in the Izu VF is derived from the wedge. This implies that the heavy delta11B values of Izu VF rocks are largely a result of fluid fractionation, and do not reflect variations in slab source provenance (i.e. subducting sediment vs. basaltic crust). Since the B content of the peridotite at the outer forearc (7-58 ppm B, mean 24 +/- 16 ppm) is much higher than beneath the arc front (~1-2 ppm B), the hydrated mantle wedge must have released a B-rich fluid on its downward path. This 'wedge flux' can explain (1) the across-arc decrease in B and delta11B (e.g. Izu, Kuriles), without requiring a progressive decrease in fluid flux from the subducting slab, and (2) the thermal structure of volcanic arcs, as reflected in the B and delta11B variations of volcanic arc rocks.

Geochemistry of microtektites from Victoria Land Transantarctic Mountains

We extended the petrographic and geochemical dataset for the recently discovered Transantarctic Mountain microtektites in order to check our previous claim that they are related to the Australasian strewn field. Based on color and composition, the 465 microtektites so far identified include two groups of transparent glass spheres less than ca. 800 µm in diameter: the most abundant pale-yellow, or normal, microtektites, and the rare pale-green, or high-Mg, microtektites. The major element composition of normal microtektites determined through electron microprobe analysis is characterized by high contents of silica (SiO2 = 71.5 ± 3.6 (1 sigma) wt%) and alumina (Al2O3 = 15.5 ± 2.2 (1 sigma) wt%), low total alkali element contents (0.50-1.85 wt%), and MgO abundances <6 wt%. The high-Mg microtektites have a distinctly higher MgO content >10 wt%. Transantarctic Mountain microtektites contain rare silica-rich (up to 93 wt% SiO2) glassy inclusions similar to those found in two Australasian microtektites analyzed here for comparison. These inclusions are interpreted as partially digested, lechatelierite-like inclusions typically found in tektites and microtektites. The major and trace element (by laser ablation - inductively coupled plasma - mass spectrometry) abundance pattern of the Transantarctic Mountain microtektites matches the average upper continental crust composition for most elements. Major deviations include a strong to moderate depletion in volatile elements including Pb, Zn, Na, K, Rb, Sr and Cs, as a likely result of severe volatile loss during the high temperature melting and vaporization of crustal target rocks. The normal and high-Mg Transantarctic Mountain microtektites have compositions similar to the most volatile-poor normal and high-Mg Australasian microtektites reported in the literature. Their very low H2O and B contents (by secondary ion mass spectrometry) of 85 ± 58 (1 sigma) ?g/g and 0.53 ± 0.21 ?g/g, respectively, evidence the extreme volatile loss characteristically observed in tektites. The Sr and Nd isotopic compositions of multigrain samples of Transantarctic Mountain microtektites are 87Sr/86Sr ~ 0.71629 and 143Nd/144Nd ~ 0.51209, and fall into the Australasian tektite compositional field. The Nd model age calculated with respect to the chondritic uniform reservoir (CHUR) is TNdCHUR ~ 1.1 Ga, indicating a Meso-Proterozoic crustal source rock, as was derived for Australasian tektites as well. Coupled with the Quaternary age from the literature, the extended dataset presented in this work strengthens our previous conclusion that Transantarctic Mountain microtektites represent a major southward extension of the Australasian tektite/microtektite strewn field. Furthermore, the significant depletion in volatile elements (i.e., Pb, B, Na, K, Zn, Rb, Sr and Cs) of both normal and high-Mg Transantarctic Mountain microtektites relative to the Australasian ones provide us with further confirmation of a possible relationship between high temperature-time regimes in the microtektite-forming process and ejection distance.

Multipole expansion of strongly focussed laser beams

Multipole expansion of an incident radiation field-that is, representation of the fields as sums of vector spherical wavefunctions-is essential for theoretical light scattering methods such as the T-matrix method and generalised Lorenz-Mie theory (GLMT). In general, it is theoretically straightforward to find a vector spherical wavefunction representation of an arbitrary radiation field. For example, a simple formula results in the useful case of an incident plane wave. Laser beams present some difficulties. These problems are not a result of any deficiency in the basic process of spherical wavefunction expansion, but are due to the fact that laser beams, in their standard representations, are not radiation fields, but only approximations of radiation fields. This results from the standard laser beam representations being solutions to the paraxial scalar wave equation. We present an efficient method for determining the multipole representation of an arbitrary focussed beam. (C) 2003 Elsevier Science Ltd. All rights reserved.

Topographic plasticity in primary visual cortex is mediated by local corticocortical connections

The placement of monocular laser lesions in the adult cat retina produces a lesion projection zone (LPZ) in primary visual cortex (V1) in which the majority of neurons have a normally located receptive field (RF) for stimulation of the intact eye and an ectopically located RF ( displaced to intact retina at the edge of the lesion) for stimulation of the lesioned eye. Animals that had such lesions for 14 - 85 d were studied under halothane and nitrous oxide anesthesia with conventional neurophysiological recording techniques and stimulation of moving light bars. Previous work suggested that a candidate source of input, which could account for the development of the ectopic RFs, was long-range horizontal connections within V1. The critical contribution of such input was examined by placing a pipette containing the neurotoxin kainic acid at a site in the normal V1 visual representation that overlapped with the ectopic RF recorded at a site within the LPZ. Continuation of well defined responses to stimulation of the intact eye served as a control against direct effects of the kainic acid at the LPZ recording site. In six of seven cases examined, kainic acid deactivation of neurons at the injection site blocked responsiveness to lesioned-eye stimulation at the ectopic RF for the LPZ recording site. We therefore conclude that long-range horizontal projections contribute to the dominant input underlying the capacity for retinal lesion-induced plasticity in V1.

Diode laser treatment of pre-threshold and threshold retinopathy of prematurity

Purpose: Retinopathy of prematurity (ROP) is a sight-threatening condition of premature infants. This study aimed to investigate the efficacy of diode laser photocoagulation in the treatment of pre-threshold and threshold ROP. Methods: A retrospective review was conducted of patients who underwent diode laser treatment for ROP by one author (GAG) from 1992 to 2000. During this time, 2137 babies

Accessing chain length dependent termination rate coefficients of methyl methacrylate (MMA) via the reversible addition fragmentation chain transfer (RAFT) process

The RAFT-CLD-T methodology is demonstrated to be not only applicable to 1-substituted monomers such as styrene and acrylates, but also to 1,1-disubstituted monomers such as MMA. The chain length of the terminating macromolecules is controlled by CPDB in MMA bulk free radical polymerization at 80 degrees C. The evolution of the chain length dependent termination rate coefficient, k(t)(i,i), was constructed in a step-wise fashion, since the MMA/CPDB system displays hybrid behavior (between conventional and living free radical polymerization) resulting in initial high molecular weight polymers formed at low RAFT agent concentrations. The obtained CLD of k(t) in MMA polymerizations is compatible with the composite model for chain length dependent termination. For the initial chain-length regime, up to a degree of polymerization of 100, k(t) decreases with alpha (in the expression k(t)(i,i) = k(t)(0) . i(-alpha)) being close to 0.65 at 80 degrees C. At chain lengths exceeding 100, the decrease is less pronounced (affording an alpha of 0.15 at 80 degrees C). However, the data are best represented by a continuously decreasing nonlinear functionality implying a chain length dependent alpha.

Modeling diffraction and imaging of laser beams by the mode-expansion method

We present a new method of modeling imaging of laser beams in the presence of diffraction. Our method is based on the concept of first orthogonally expanding the resultant diffraction field (that would have otherwise been obtained by the laborious application of the Huygens diffraction principle) and then representing it by an effective multimodal laser beam with different beam parameters. We show not only that the process of obtaining the new beam parameters is straightforward but also that it permits a different interpretation of the diffraction-caused focal shift in laser beams. All of the criteria that we have used to determine the minimum number of higher-order modes needed to accurately represent the diffraction field show that the mode-expansion method is numerically efficient. Finally, the characteristics of the mode-expansion method are such that it allows modeling of a vast array of diffraction problems, regardless of the characteristics of the incident laser beam, the diffracting element, or the observation plane. (C) 2005 Optical Society of America.

COMPARAÇÃO ENTRE A APLICAÇÃO ÚNICA E FRACIONADA DO LASER DE BAIXA INTENSIDADE NA MOVIMENTAÇÃO DENTÁRIA EM RATOS

O laser de baixa intensidade (LBI) tem demonstrado efeitos bioestimulatórios na movimentação ortodôntica, acelerando a resposta celular e, reduzindo o tempo de tratamento. Entretanto, o uso do LBI seria mais efetivo com maior potência, menor tempo (única irradiação), ou a junção da menor potência e tempo em aplicação fracionada? Este estudo visou quantificar a movimentação de molares de 64 ratos e suas alterações histológicas, submetidos a uma força ortodôntica, liberada por meio de uma mola fechada de níquel-titânio (Niti/25gf), calibrada em 20gf. Os animais foram divididos em quatro grupos (cada grupo com 16 ratos), de acordo com os seguintes protocolos de irradiação do laser GaAlAs(780nm): grupo controle , submetidos à movimentação ortodôntica mas sem aplicação do LBI ; grupo total 1 (P=60mW/DE=15J/cm²/Et=6J/t=100seg), com a movimentação ortodôntica associada à única aplicação do LBI laser (P=60mW/DE=15J/cm²/Et=6J/t=100seg) no dia zero. Grupo total 2 em que o LBI foi aplicado no dia 0, segundo o protocolo P=20mW/DE=15J/cm²/E=6J/t=300seg;,; e Grupo fracionado em que o LBI foi aplicado nos dias 0, 3 e 7, empregando-se o protocolo (P=20mW/DE=5J/cm²/E=2J/t=100seg). Os sacrifício dos ratos foi realizado em quatro momentos (dias 1,4,8 e 15), sendo que 4 ratos de cada grupo foi sacrificado em cada um dos dias. A quantidade de movimentação ortodôntica foi mensurada in loco por meio de paquímetro digital, antes da instalação das molas e, imediatamente após o sacrifício dos animais. Para o exame histológico, as maxilas foram removidas, preparadas e coradas pelo sistema H/E. Os resultados foram avaliados pela Análise de Variância, seguida do teste Tukey (p<0,05). O grupo fracionado apresentou maior movimentação dentária frente aos demais nos dias 4 e 8, sendo que os grupos total 1 e 2 demonstraram maior movimentação dentária que o controle somente no dia 8. Não houve diferença estatisticamente significante entre os grupos total 1 e 2 em todo o período avaliado. Este estudo concluiu que, o laser de baixa intensidade acelerou a movimentação dentária, salientando-se o efeito da aplicação fracionada em relação às aplicações únicas.