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NUNO DIAS FERREIRA M.D. DANIEL CAEIRO M.D. LUÍS ADÃO M.D. MARCO OLIVEIRA M.D. HELENA GONÇALVES M.D. JOSÉ RIBEIRO M.D. MADALENA TEIXEIRA M.D. ANÍBAL ALBUQUERQUE M.D. JOÃO PRIMO M.D. PEDRO BRAGA M.D. LINO SIMÕES M.D. VASCO GAMA RIBEIRO M.D. 《Pacing and clinical electrophysiology : PACE》2010,33(11):1364-1372
Background: Previous reports have suggested the occurrence of cardiac conduction disorders and permanent pacemaker (PPM) requirement after transcatheter aortic valve implantation (TAVI). Based on a single‐center experience, we aim to assess the incidence of postprocedural conduction disorders, need for PPM, and its determinants after TAVI with a self‐expanding bioprosthesis. Methods: From August 2007 to October 2009, 32 consecutive patients underwent TAVI with the Medtronic CoreValve (MCV) System (Medtronic Inc., Minneapolis, MN, USA). Three patients paced at baseline and two cases of procedure‐related mortality were excluded. We analyzed the 12‐lead electrocardiogram at baseline, immediately after procedure and at discharge. Requirements for PPM were documented and potential clinical, electrophysiological, echocardiographic, and procedural predictors of PPM requirement were studied. Results: After TAVI, eight patients (29.6%) required PPM implantation due to high‐grade atrioventricular (AV) block. The prevalence of left bundle branch block increased from 13.8% to 57.7% directly after implantation (P = 0.001). Need for PPM was correlated to the depth of prosthesis implantation (r = 0.590; P = 0.001). At a cutoff point of 10.1 mm, the likelihood of pacemaker could be predicted with 87.5% sensitivity and 74% specificity and a receiver operator characteristic curve area of 0.86 ± 0.07 (P = 0.003). Of the seven patients with preexisting right bundle branch block (RBBB), four (57.1%) required PPM implantation after TAVI. Conclusions: High‐grade AV block requiring PPM implantation is a common complication following TAVI and could be predicted by a deeper implantation of the prosthesis. Patients with preexisting RBBB also seem to be at risk for the development of high‐grade AV block and subsequent pacemaker implantation. (PACE 2010; 1364–1372) 相似文献
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A. KIJLSTRA D. W. KNUTSON M. R. DAHA L. A. VAN ES 《Scandinavian journal of immunology》1979,10(5):421-429
The in vivo behaviour of well-defined immune complexes in rats was studied using complexes derived from DNP-conjugated bovine thyroglobulin (DNP-BTG) and purified specific goat anti-DNP IgG. Both clearance and glomerular localization were mainly dependent on the nature of the antigen. Soluble immune complexes formed with DNP17-BTG were cleared faster and showed a more marked localization in the glomerular mesangium than complexes formed with DNP3.4-BTG. A slight increase in the antibody to antigen ratio seemed to facilitate mesangial localization of soluble immune complexes. Insoluble immune complexes showed temporary localization as microemboli in the lumina of glomerular and peritubular capillaries. This study thus shows that not only the size and composition of the complexes but also the nature of the antigen within the complex can influence the clearance and organ localization of circulating immune complexes. 相似文献
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M. R. DAHA L. A. VAN ES H. M. HAZEVOET A. KIJLSTRA 《Scandinavian journal of immunology》1982,16(2):117-122
The capacity of human peripheral monocytes to degrade soluble immunoglobulin (IgG) aggregates (AIgG) was studied in vitro. Under serum-free conditions peripheral monocytes from normal donors were able to degrade soluble AIgG in a linear and time-dependent fashion. Addition of fresh human or fresh guinea-pig serum to the incubation mixtures caused a marked increase in degradation of the amount of soluble AIgG available. The stimulatory effect of fresh serum was complement-mediated, because it was abolished by heat treatment of the serum and was not seen when C4- or C3-deficient sera were tested. Functional inactivation of C3 receptors on the phagocytes by trypsin also abolished the complement-mediated stimulation, suggesting cooperation between Fc and C3 receptor in degradation of soluble AIgG. No significant differences were found between monocytes from normal donors and those from patients with systemic lupus erythematosus, as far as degradation is concerned in the presence of complement. 相似文献
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Abruzzo LV; Schmidt K; Weiss LM; Jaffe ES; Medeiros LJ; Sander CA; Raffeld M 《Blood》1993,82(1):241-246
We describe a patient with angioimmunoblastic lymphadenopathy with dysproteinemia (AILD), who subsequently developed large-cell immunoblastic lymphoma of B-cell immunophenotype. At the time of the initial diagnosis, histologic examination of an inguinal lymph node showed typical features of AILD, and there was no evidence of a monoclonal B-cell population by immunohistochemical analysis. In situ hybridization and Southern blot analysis for Epstein-Barr virus (EBV) were negative. At autopsy 2 years later, the patient had widespread lymph node and organ involvement by large-cell immunoblastic lymphoma of B-cell immunophenotype. Southern blot analysis performed on DNA extracted from lymph nodes, liver, and spleen showed two patterns of Ig heavy chain and kappa light chain gene rearrangements. The T-cell receptor beta chain gene was in the germline configuration. Analysis with an EBV terminal repeat region probe showed two clonal populations that paralleled the Ig gene rearrangement studies. Double-labeling immunohistochemistry and in situ hybridization confirmed the presence of EBV within the neoplastic B cells. The data support the hypothesis that EBV was not etiologically related to AILD in this case, and that EBV proliferation may occur after the onset of the disease. Further, the data suggest that some B-cell lymphomas that arise in the setting of AILD resemble EBV-associated B-cell lymphomas that arise in other immunodeficiency states. 相似文献
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High‐Resolution HLA Typing for Sensitized Patients: Advances in Medicine and Science Require Us to Challenge Existing Paradigms 下载免费PDF全文
R. J. Duquesnoy H. M. Gebel E. S. Woodle P. Nickerson L. A. Baxter‐Lowe R. A. Bray F. H. J. Claas D. D. Eckels J. J. Friedewald S. V. Fuggle J. A. Gerlach J. J. Fung M. Kamoun D. Middleton R. Shapiro A. R. Tambur C. J. Taylor K. Tinckam A. Zeevi 《American journal of transplantation》2015,15(10):2780-2781
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Valéria Martins Araújo CARNEIRO Ana Cristina Barreto BEZERRA Maria do Carmo Machado GUIMAR?ES Maria Imaculada MUNIZ-JUNQUEIRA 《Journal of applied oral science : revista FOB》2012,20(5):503-509
Phagocytosis by neutrophils and monocytes constitutes the main defense mechanism
against bacterial challenges in periodontitis. Phagocytosis by neutrophils has
already been evaluated, whereas phagocytic function of monocytes has hardly been
addressed so far.
Objectives
The aim of this study was to assess phagocytosis by neutrophils and monocytes in periodontitis.Material and Methods
The sample included 30 subjects with severe periodontitis and 27 control subjects without periodontal disease. The phagocytic index (PhI) was calculated as the mean number of adhered/ingested Saccharomyces cerevisiae per phagocytozing monocyte or neutrophil multiplied by the percentage of phagocytes involved in phagocytosis.Results
A significant reduction in phagocyte functions was observed in individuals with periodontitis. The median of PhI of neutrophils using non-sensitized S. cerevisiae was 3 for the control group, and 1.5 for the periodontitis group (p=0.01, Mann-Whitney test). The median of PhI of monocytes with non-sensitized S. cerevisiae was 26.13 for the control group, and 13.23 for the periodontitis group (p=0.03, Mann Whitney test). The median of PhI of monocytes assessed with sensitized S. cerevisiae was 97.92 for the control group and 60.1 for the periodontitis group (p=0.005, t-test).Conclusion
The data demonstrated a reduction in the function of phagocytes, suggesting a decrease in immune defenses in periodontitis. 相似文献9.
Camila Santos PEREIRA Marcos Vinícius Macedo de OLIVEIRA Lucas Oliveira BARROS Gabriela Alencar BANDEIRA Sérgio Henrique Sousa SANTOS John R. BASILE André Luiz Sena GUIMAR?ES Alfredo Maurício Batista DE PAULA 《Journal of applied oral science : revista FOB》2013,21(5):416-421