ABSTRACT
We visualized a dynamic process of fatty acid uptake of brown adipocytes using a time-lapse ultra-broadband multiplex coherent anti-Stokes Raman scattering (CARS) spectroscopic imaging system with an onstage incubator. Combined with the deuterium labeling technique, the intracellular uptake of saturated fatty acids was traced up to 9 h, a substantial advance over the initial multiplex CARS system, with an analysis time of 80 min. Characteristic metabolic activities of brown adipocytes, such as resistance to lipid saturation, were elucidated, supporting the utility of the newly developed system.
Subject(s)
Adipocytes, Brown/cytology , Adipocytes, Brown/metabolism , Fatty Acids/metabolism , Incubators , Lipid Metabolism , Spectrum Analysis, Raman , Animals , Cell Line , Mice , Time-Lapse ImagingABSTRACT
INTRODUCTION: At the time of generator replacement, after ICD implantation for primary prevention, many patients may no longer meet implantation criteria. We investigated the occurrence of ICD therapy after generator replacement in patients initially implanted ICD for primary prevention. METHODS: Patients from 3 hospitals undergoing ICD generator replacement, who were initially implanted for primary prevention, were retrospectively evaluated for occurrence of appropriate ICD therapy after generator replacement. Patients were categorized as to whether or not they had appropriate ICD therapy during their first battery life, and by their left ventricular ejection fraction (LVEF) before generator replacement. RESULTS: Data from 168 patients were analyzed, with average follow-up after generator replacement of 41.2 ± 26.5 months. Seventy-six (45.2%) patients had ventricular arrhythmia episodes (>180 beats per minutes) and 63 (37.5%) received appropriate ICD therapy during the first battery life. Among 105 patients without ICD therapy before generator replacement, those with an LVEF ≤35% before ICD replacement had higher occurrence of ICD therapy after generator replacement than patients with an LVEF ≥36%. Patients who no longer met primary prevention ICD indications (no ICD therapy and LVEF ≥36% before generator replacement) showed a lower risk for ICD therapy after generator replacement (11.6% over 5-year follow-up). CONCLUSIONS: In patients without ICD therapy before generator replacement, low LVEF (≤35%) contributed to future ICD therapy. In patients initially undergoing ICD implantation for primary prevention, history of ICD therapy during the first battery life and LVEF should be utilized for risk stratification at the time of generator replacement.
Subject(s)
Arrhythmias, Cardiac/therapy , Death, Sudden, Cardiac/prevention & control , Defibrillators, Implantable , Device Removal , Electric Countershock/instrumentation , Electric Power Supplies , Primary Prevention/instrumentation , Aged , Arrhythmias, Cardiac/diagnosis , Arrhythmias, Cardiac/mortality , Arrhythmias, Cardiac/physiopathology , Electric Countershock/adverse effects , Electric Countershock/mortality , Female , Humans , Kaplan-Meier Estimate , Male , Middle Aged , Proportional Hazards Models , Prosthesis Design , Prosthesis Failure , Retrospective Studies , Risk Factors , Stroke Volume , Time Factors , Treatment Outcome , United States , Ventricular Function, LeftABSTRACT
BACKGROUND: The carboplatin (CBDCA) dosage is usually calculated using the formula of Calvert. Instead of the glomerular filtration rate (GFR), 24-h creatinine clearance (24 CLcr) is often used in this formula, which is calculated based on 24-h urine collection in clinical practice. OBJECTIVE: We studied the adequacy of 24 CLcr in calculating the appropriate dosage of CBDCA using the formula of Calvert and compared CLcr and GFR using various substitutable predictive formulas (the formulae of Cockcroft and Gault, Yasuda, Orita, Jellife, Mawer, MDRD, and modified MDRD) when we were not able to use 24 CLcr. METHODOLOGY: We retrospectively studied 193 patients who received CBDCA as chemotherapy during the period April 2004 through November 2006. We evaluated the adequacy of 24-h urine collection for measurement of creatinine production and excretion. We also evaluated the appropriate urine collection within a 15% range of the difference. The correlation between the appropriate 24 CLcr resulting in the urine collection and the CLcr or GFR was examined using past predictive formulae in the patients with appropriate urine collection. RESULTS: The accuracy of 24 CLcr was evaluated in 83 patients (43%). There was a significant correlation between CLcr or GFR using various predictive formulas and the appropriate 24 CLcr. There was an especially close and significant correlation with the formulae of Cockcroft and Gault and Yasuda (r>0.950, p<0.001). CONCLUSION: When using the Calvert formula, the accuracy of 24 CLcr should be evaluated. Patients evaluated as having inaccurate urinary collection should use the formulae of Cockcroft and Gault and Yasuda.
