Immediate and short-term effects of transcatheter device closure of large atrial septal defect in senior people.

OBJECTIVES: We sought to evaluate the safety and efficacy in improving cardiac function and functional capacity with device closure of large atrial septal defects (ASD) in senior adults. BACKGROUND: Atrial septal defect accounts for about 10% of all congenital heart disease. It still remains unclear whether large ASD closure in senior people should be performed or not. Hence we aim to prospectively assess the safety and clinical status of senior patients after transcatheter closure in large ASD. PATIENTS AND INTERVENTIONS: This was a prospective study of all patients aged over 50 years who underwent device closure of a secundum large ASD between January 2013 and January 2018. Investigations including brain natriuretic peptide level, electrocardiography, chest X-ray, transthoracic echocardiogram, transesophageal echocardiogram, and 6-minute walk test were performed before and at 2 days and 4 weeks and 6 months after the procedure. RESULTS: Twenty patients (median age 68 years, 10 women) had transcatheter device closure of large ASD successfully. Median ASD size was 32 mm (range 30-39 mm). Median pulmonary artery pressure was 58 mm Hg (range 47-67 mm Hg). At 6 months, there was a significant change in right atrium size (P < .001) and right ventricle size (P < .01) and left ventricle size (P < .001) and also pulmonary artery pressure (P < .0001), New York Heart Association functional class improved (P = .03) in 19 patients and also significant improvement in 6-minute walk test distance (P < .001). There were no major complications. CONCLUSIONS: Our data showed that large ASD closure at senior people results in satisfactory cardiac remodeling and cardiac function improvement.

The correlation study between PCBs and δ15N values or FAs in fish collected from Dongting Lake.

The toxicity of polychlorinated biphenyls (PCBs) and their transformation have been intensively investigated in recent years. However, the potential mechanisms of biotransformation in a lake food web remain unclear. To explore the correlation between the PCBs and δ15N values or FAs, six fish species were collected from Dongting Lake, and various tissues were dissected to analyze the δ15N values, FAs and PCBs. Based on the wet weight (ww), the concentration of ∑PCBs115 ranged from 0.04 to 9.77 ng g-1, and the highest level was found in the gonad of Cyprinus carpio. The toxicity equivalent (TEQ) of PCBs ranged from 0.003 to 2.39 pg g-1, and the highest level was found in the fat of Silurus asotusy. The PCB levels in fish collected from Dongting Lake were at the low end of the global range. PCB28, 52, 95, 99, 101, 105 110, 118, 138, 153, 155 and 209 were found in all tissues. PCBs were distributed in a tissue-specific and species-specific manner in fish. PCB153 and 138 had a positive correlation with the TEQ in liver, gill, intestine and skin of fish on the basis of lipid weight (lw). Docosahexaenoic acid/eicosapentaenoic acid (DHA/EPA) and polyunsaturated fatty acid/saturated fatty acid (PUFA/SFA) had a positive correlation with some PCB congeners in the intestine. PCB52, ∑tetra-PCBs and Ind-PCBs had a positive correlation with the δ15N values in liver of fish on the basis of ww. PUFA/SFA and DHA/EPA might be indicators for the transfer of PCB congeners.

The correlation study between fatty acids and organochlorine pesticides or δ15N values in fish tissues from Dongting Lake, China.

Organochlorine pesticides (OCPs) are ubiquitous environmental contaminants, while their correlations with δ15N values and fatty acids (FAs) in fish tissues remain largely unexplored. In the present study, six species of fish for daily consumption were collected from Dongting Lake, and they were dissected to tissue samples to analyze the δ15N values, FAs and OCPs. The results showed that the δ15N values of fish were ranked in the same order in different fish tissues. The polyunsaturated fatty acids (PUFAs) had a different distribution pattern in fish tissues, while the saturated fatty acid (SFAs) and monounsaturated fatty acids (MUFAs) were not. The composition of HCHs in fish tissues exhibited a tissue-specific and species-specific manner, while such pattern was not detected for DDTs. The correlation analysis indicated that the ratio of DHA/EPA was increased with the increase of δ15N value in the muscle, liver, gill, skin and intestine, indicating the substance flow in freshwater ecosystem. In addition, there were significant positive correlations between the concentrations of some PUFAs and OCPs in the muscle, suggesting that people should pay attention to co-intake of OCPs when they supplemented the PUFAs needed by the human body through fish.

Causes and estimated incidences of sex-chromosome misdiagnosis in preimplantation genetic diagnosis of aneuploidy.

Preimplantation genetic diagnosis of aneuploidy (PGD-A) with comprehensive chromosome analysis has been known to improve pregnancy outcomes. Accuracy in detecting sex chromosomes becomes important when selecting against embryos at risk for sex-linked disorders. A total of 21,356 PGD-A cycles consisting of day-3 (cleavage) or day-5 (blastocyst) biopsies were received at the same laboratory for PGD-A via fluorescence in situ hybridization (FISH) or array comparative genome hybridization (aCGH) from multiple fertility centres. The misdiagnosis rates were 0.12% (Wilson 95% CI 0.05 to 0.25%) in day-3 FISH cycles, 0.48% (Wilson 95% CI 0.19 to 1.22%) in day-3 aCGH cycles and 0.0% (Wilson 95% CI 0 to 0.26) in day-5 aCGH cycles. Although rare, the likely causative biological event for true misdiagnosis is embryonic XX/XY mosaicism. Reanalysis of 1219 abnormal cleavage-stage research embryos revealed a 73% incidence of minor and major mosaicism. Only four (0.3%) embryos were found to be diploid and contained XX and XY cells that could potentially account for the misdiagnosis of sex. Our investigation identified errors leading to misdiagnosis and their attribution to specific events during PGD-A testing. The reported misdiagnosis rates suggest that PGD-A for sex determination is highly accurate, particularly when using aCGH applied to blastocyst biopsies.

Fluorescence in situ hybridization and spectral imaging analysis of human oocytes and first polar bodies.

We investigated the frequencies of abnormalities involving either chromosome 1, 16, 18, or 21 in failed-fertilized human oocytes. Although abnormalities involving chromosome 16 showed an age-dependent increase, results for the other chromosomes did not show statistically significant differences among the three age groups, <35 years, 35-39 years, and >39 years. The scoring of four chromosomes is likely to underestimate the true rate of aneuploid cells. Therefore, for a pilot study investigating a more-comprehensive analysis of oocytes and their corresponding first polar bodies, we developed a novel eight-probe chromosome enumeration scheme using fluorescence in situ hybridization and spectral imaging analysis.