Defibrillator electrode placement in the pleural cavity for a child.

Implantable cardioverter defibrillators are implanted in children to prevent sudden death due to life-threatening ventricular arrhythmias. Transvenous electrode placement is difficult for children because of the small vessel size. Especially, defibrillator electrode placement requires other innovative techniques. We successfully implanted a defibrillator electrode in the pleural cavity using a thoracoscopic approach for a 4-year-old child with sodium channelopathy.

Economical and preferred walking speed using body weight support apparatus with a spring-like characteristics.

BACKGROUND: A specific walking speed minimizing the U-shaped relationship between energy cost of transport per unit distance (CoT) and speed is called economical speed (ES). To investigate the effects of reduced body weight on the ES, we installed a body weight support (BWS) apparatus with a spring-like characteristics. We also examined whether the 'calculated' ES was equivalent to the 'preferred' walking speed (PWS) with 30% BWS. METHODS: We measured oxygen uptake and carbon dioxide output to calculate CoT values at seven treadmill walking speeds (0.67-2.00 m s- 1) in 40 healthy young males under normal walking (NW) and BWS. The PWS was determined under both conditions on a different day. RESULTS: A spring-like behavior of our BWS apparatus reduced the CoT values at 1.56, 1.78, and 2.00 m s- 1. The ES with BWS (1.61 ± 0.11 m s- 1) was faster than NW condition (1.39 ± 0.06 m s- 1). A Bland-Altman analysis indicated that there were no systematic biases between ES and PWS in both conditions. CONCLUSIONS: The use of BWS apparatus with a spring-like behavior reduced the CoT values at faster walking speeds, resulting in the faster ES with 30% BWS compared to NW. Since the ES was equivalent to the PWS in both conditions, the PWS could be mainly determined by the metabolic minimization in healthy young males. This result also derives that the PWS can be a substitutable index of the individual ES in these populations.

A high-risk patient with long-QT syndrome with no response to cardioselective beta-blockers.

We present a case of a high-risk 19-year-old female with long-QT syndrome (LQTS) with compound mutations. She had a history of aborted cardiac arrest and syncope and had received treatment with propranolol for 15 years. However, because she developed adult-onset asthma we tried to switch propranolol, a nonselective beta-blocker, to beta-1-cardioselective agents, bisoprolol and metoprolol. These resulted in both a markedly prolonged corrected QT interval and the development of LQTS-associated arrhythmias. Eventually, propranolol was reinitiated at a higher dose with the addition of verapamil, and she has had no further cardiac or asthmatic events for 5 years.

Solution-processed multilayer small-molecule light-emitting devices with high-efficiency white-light emission.

Recent developments in the field of π-conjugated polymers have led to considerable improvements in the performance of solution-processed organic light-emitting devices (OLEDs). However, further improving efficiency is still required to compete with other traditional light sources. Here we demonstrate efficient solution-processed multilayer OLEDs using small molecules. On the basis of estimates from a solvent resistance test of small host molecules, we demonstrate that covalent dimerization or trimerization instead of polymerization can afford conventional small host molecules sufficient resistance to alcohols used for processing upper layers. This allows us to construct multilayer OLEDs through subsequent solution-processing steps, achieving record-high power efficiencies of 36, 52 and 34 lm W(-1) at 100 cd m(-2) for solution-processed blue, green and white OLEDs, respectively, with stable electroluminescence spectra under varying current density. We also show that the composition at the resulting interface of solution-processed layers is a critical factor in determining device performance.

The incidence and characteristics of supraventricular tachycardia in left atrial isomerism: a high incidence of atrial fibrillation in young patients.

BACKGROUND: In left atrial isomerism (LAI), both atria show left atrial morphology. Although bradyarrhythmias are frequent and highly complex in LAI patients, previous studies have reported a low incidence of supraventricular tachycardia (SVT). METHODS: To evaluate the incidence and characteristics of SVT in LAI, we retrospectively evaluated the clinical characteristics of SVTs in 83 patients with LAI (age at last follow-up, 15.3±10.5 years). RESULTS: There were 27 SVTs in 19 patients (23%), including nine episodes of atrial fibrillation (AF) and eight non-reentrant SVTs. Sixteen of the 19 patients with SVT had histories of atriotomy, but the three patients with AF or non-reentrant tachycardia had no history of atriotomy. The rates of freedom from SVT were 66% and 59% at ages of 20 and 30 years, respectively; the corresponding rates for freedom from AF were 89% and 74%. In multivariate analysis, the predictors of SVT were age (OR, 1.14; 95% CI, 1.06-1.26; p=0.003) and sinus node dysfunction (SND) (OR, 3.88; 95% CI, 1.57-13.34; p=0.01). CONCLUSIONS: In patients with LAI, SVTs are common, and AF and non-reentrant SVTs are the major type of SVTs. The incidence of AF was high in young patients with LAI. The lack of anatomical barriers in the atria that allow the formation of macro-reentrant circuits may account for the higher incidence of AF and non-reentrant SVT than macro-reentrant tachycardia. Moreover, the increasing prevalence of SND with age should contribute to a higher incidence of SVT.

3,3'-Bicarbazole-based host materials for high-efficiency blue phosphorescent OLEDs with extremely low driving voltage.

Four types of functionalized 3,3'-bicarbazole derivatives are prepared and investigated as a host material for blue phosphorescent OLEDs. By using a 3,3'-bicarbazole derivative/FIrpic film as an emissive layer, high power efficiency of 46 lm W(-1) (45 cd A(-1), EQE 20%) with an extremely low driving voltage at 3.1 V is obtained at 100 cd m(-2).

Hyponatremia and its association with the neurohormonal activity and adverse clinical events in children and young adult patients after the Fontan operation.

BACKGROUND: Hyponatremia (HN) is relatively common in adults with congenital heart disease and is a powerful predictor of mortality. However, the precise relationship of HN to the Fontan pathophysiology remains unknown. PURPOSE: Our study aimed to clarify the association of HN to the Fontan pathophysiology. METHODS AND RESULTS: We measured the plasma sodium (Na) level in 169 consecutive Fontan patients (78 children) and HN (≤137 mEq/L) was observed in 50 patients (30% of the total patients, 31% of the children). The HN patients showed a lower peak oxygen uptake (VO(2) ) with a greater New York Heart Association class (P < .0001). The plasma level of norepinephrine (NE), rennin activity (PRA), arginine vasopressin, central venous pressure (CVP) and medications were associated with the Na levels and the NE, PRA, and diuretic use were the independent determinants (P < .01-.0001). The plasma B-type natriuretic peptide was not correlated with the Na levels. In the children, diuretic use and the PRA independently determined the Na levels without any association to the CVP or peak VO(2) . During a median follow-up of 2.1 years, the HN in addition to the CVP and peak VO(2) independently predicted the unscheduled hospitalizations in all patients, while the HN was the only independent predictor of the hospitalizations in the adult patients (hazard ratio: 3.1, 95% confidence interval 1.2-8.0, P = .021). CONCLUSIONS: Child and adult Fontan patients exhibited a high prevalence for HN that closely reflected some neurohumoral activation and predicted adverse clinical events, especially in adult Fontan patients.

Three-dimensional echocardiographic pictures of isolated double-orifice mitral valve.

We present a case of a 12-year-old boy with a rare form of cardiac anomaly, isolated double-orifice mitral valve. He was referred to our hospital at 1.5 years old because of heart murmur. Two-dimensional echocardiography showed double-orifice mitral valve without any associated cardiac anomalies. He has been followed carefully without any medication for 11 years. He has had no symptoms and an excellent natural course thus far.

Control of charge transfer in a series of Ru2(II,II)/TCNQ two-dimensional networks by tuning the electron affinity of TCNQ units: a route to synergistic magnetic/conducting materials.

The isostructural series of two-dimensional (2-D) fishnet-type network compounds, [{Ru(2)(O(2)CCF(3))(4)}(2)(TCNQR(x))] x n(solv) (R(x) = H(4), 1; Br(2), 2; Cl(2), 3; F(2), 4; F(4), 5), has been synthesized from the reactions of a paddlewheel diruthenium(II, II) complex, [Ru(2)(II,II)(O(2)CCF(3))(4)], and neutral TCNQ derivatives (TCNQR(x) = 2,3,5,6- or 2,5-halogen-substituted 7,7,8,8-tetracyanoquinodimethane) under anaerobic conditions. Corresponding Rh compounds 1-Rh-5-Rh, which are diamagnetic and redox-inactive, were also synthesized for the purpose of comparison with 1-5. According to the electron affinity of TCNQR(x), which is related to its first reduction potential, the Ru(2) series (1-5) has the requisite driving force for charge transfer from [Ru(2)(II,II)(O(2)CCF(3))(4)] to TCNQR(x), which can lead to a mixed-valence state of [{Ru(2)(4.5+)}-(TCNQR(x)(*-))-{Ru(2)(4.5+)}] for the 2-D network. Such a charge (or electron) transfer results in magnetic exchange interactions between [Ru(2)] units (S = 1 for [Ru(2)(II,II)] and S = 3/2 for [Ru(2)(II,III)](+)) via TCNQR(x)(*-) S = 1/2 radicals that lead to long-range magnetic ordering in the layer. In the present series, only 5 demonstrated the full electron transfer (1-e(-) transfer) to the mixed-valence state, whereas other members are essentially in the state [{Ru(2)(4+)}-(TCNQR(x)(0))-{Ru(2)(4+)}]. Whereas 1-4 are paramagnetic, 5 is a metamagnet undergoing 3-D long-range antiferromagnetic ordering at 95 K (= T(N)) and reverts to a magnetic-field-induced ferromagnetic state exhibiting coercivity up to 60 K. This result is consistent with the fact that TCNQF(4) has the strongest electron affinity among the TCNQR(x) molecules. Even in neutral forms, however, 1-4 can be observed to undergo thermally and/or field-activated charge transfers from [Ru(2)(II,II)] to TCNQR(x) to give semiconductors with an activation energy of 200-300 meV, which is a driving force to transport electrons over the lattice. As determined by their conducting properties, the ease of thermally and/or field-activated charge transfers is on the order of 1 < 4 < 2 approximately = 3 << 5, which is in agreement with the order of electron affinity of TCNQR(x). Indeed, a magnetic anomaly with short-range order associated with the localization of charge-transferred electrons was revealed in the low-temperature susceptibility data for 2 and 3. Finally, 5 was subjected to terahertz time-domain spectroscopy, the data from which revealed that transport hopping electrons scattered at high temperatures interact with magnetically ordered spins with the scattering being suppressed at T(N), at which temperature the real part of the complex electronic conductivity (sigma(1)) and dielectric permeability (epsilon(1)) are dramatically altered. From these collective data, we conclude that molecular design based on an interunit charge transfer in a paramagnetic lattice is an efficient route to the design of materials with synergism between magnetic and conducting properties.

MH2P2O7 (M = Co, Ni): metamagnetic interaction between the zigzag octahedral chains.

CoH2P2O7 and NiH2P2O7, which contain edge-sharing zigzag octahedral chains, were hydrothermally synthesized and structurally characterized. Both compounds exhibit field-induced metamagnetic behavior because of the strong intrachain ferromagnetic and relatively weak interchain antiferromagnetic interactions.

Ferromagnetic ordering in a new nickel polyborate NiB12O14(OH)10.

A new nickel polyborate, NiB12O14(OH)10 was synthesized using boric acid as a flux. This material has two-dimensional borate layers with a quasi-square lattice of Ni2+. The Ni2+ ions locate in the plane of the two-dimensional layer, bridged through BnO(n+1) chains in the plane and connected with the three-membered ring borate groups out of the plane. The dc and ac magnetic susceptibility, magnetization and specific heat measurements show that this material undergoes a weak ferromagnetic phase transition at Tc = 5.8 K. At T < Tc, a metamagnetic phase transition is observed at about 5 T, associated by a spin-flop, suggesting the ferromagnetic ordering is induced by an antiferromagnetic interaction. A broad maximum in the ac susceptibility at TM = 23-24 K indicates an intermediate short-range ordering.

La4Cu(3-x)Zn(x)MoO12: zinc-doped cuprates with Kagomé lattices.

Two solid solutions, La4Cu(3-x)Zn(x)MoO12 (0.05 < or = x < or = 0.20, SS1) and La4Cu(3-x)Zn(x)MoO12 (0.30 < or = x < or = 2.40, SS2), were synthesized at ambient pressure and at temperatures from 1025 to 1200 degrees C by traditional solid-state reactions. Their structures were determined from X-ray powder diffraction with the help of electron and neutron diffraction. The atomic arrangements of SS1 and SS2 are similar, but their space groups are different, Pmnm for SS1 and P-1 for SS2, respectively. The copper, zinc, and molybdenum are coordinated by oxygen in corner-sharing trigonal bipyramids that are sandwiched between layers of lanthanum cations. In the transition metal cations layer of SS2, the copper and zinc cations order into a Kagomé-like lattice of triangular clusters. The magnetism has been measured from 2 to 300 K and is highly influenced by the geometric arrangement of the Cu(II) and Zn(II) cations. The number of free electrons per three Cu atoms is close to one for all samples in SS1 and SS2 indicating that the system can be well expressed by independent Cu(II)3 clusters. Spontaneous magnetization was observed in the system.

Metallic conductivity and ferromagnetic interaction of iron(III) d spins in the needle crystals of (ethylenedithiotetrathiafulvalenoquinone-1,3-dithiolemethide)(2).FeBr(4) salt.

The 2:1 charge-transfer (CT) salts (1(2).FeBr(4) and 1(2).GaBr(4)) of ethylenedithiotetrathiafulvalenoquinone-1,3-dithiolemethide (1) with FeBr(4)(-) and GaBr(4)(-) counteranions were obtained as needle crystals, whose structures are almost the same as each other. The 1 molecules form a one dimensionally stacked column with alternation of their molecular axis direction, while the counteranions are aligned in parallel with the 1-stacked columns with the direction of their distorted-tetrahedral geometry maintained. The room-temperature electrical conductivities measured on the single crystals of 1(2).FeBr(4) and 1(2).GaBr(4) were 4.6 and 2.1 S cm(-1), respectively. From the temperature dependences of their electrical conductivities in both cases the electrical conducting properties were metallic between ca. 170 and 300 K, but below ca. 170 K converted to be semiconducting and continued till 5 K, although the activation energies are very small (4-10 meV). For 1(2).FeBr(4) very weak and antiferromagnetic interaction occurred between the d spins of FeBr(4)(-) ions in the temperature range of ca. 1-300 K. However, below ca. 15 K the ferromagnetic interaction was reversely preferential possibly by participation of the pi spin of 1.