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Padmanabhan D, Farwati M, Izath A, Al-Masry A, Kella D, Gamero S, Barout A, Assaf Y, Shetty D, Asirvatham S, Felmlee J, Watson R, Cha YM, Friedman P. P4126Safety of magnetic resonance imaging in patients with non-conditional cardiac implantable electronic devices: A systematic review and meta-analysis. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Recent guideline statements approve the performance of magnetic resonance imaging (MRI) in patients with non-conditional cardiac implantable electronic devices (CIEDs) under certain closely monitored conditions. Data from current registries may have lower power to discern changes that may occur in the CIED after the MRI.
Objective
We aimed to systematically review the literature to identify the adverse events and significance of changes in device function associated with performing MRI in patients with CIEDs
Methods
A comprehensive literature search of the databases was performed between 1980- 2017. Two independent reviewers selected studies and extracted data. A random-effects model was used for meta-analysis.
Results
A total of 7,422 patients underwent 8,865 MRI studies. No death occurred post MRI. Clinical adverse events were extremely rare (mostly less than 1%) and are summarized in Table 1. No significant changes in the pooled mean effect size estimate was noted for the changes in the lead parameters (pacing threshold, sensing and impedance)
Binary outcomes post magnetic resonance imaging in patients with non-conditional cardiac implantable electronic devices Outcome Sample size Number of patients Rate SE LL of CI UL of CI Death 7401 0 0 0 0 0 Atrial arrhythmia 7173 10 0.001 0.0004 0.0007 0.0024 Ventricular arrhythmia 7371 9 0.0012 0.0004 0.0006 0.0022 Oversensing 4981 17 0.0034 0.0008 0.0020 0.0053 Inhibition of pacing 7371 6 0.0008 0.0003 0.0003 0.0016 Lead Failure/Generator Failure 7475/7475 2/8 0.0002/0.0011 0.0001/0.0004 0.0001/0.0005 0.0009/0.002 Power on Reset 1388 105 0.0131 0.0014 0.0107 0.0161 Did not complete scan 6851 13 0.0019 0.0005 0.0011 0.0031 Chest pain 7080 11 0.0021 0.0004 0.0008 0.0027. Lead threshold rise (>0.5v/>50%-A/V) 5076/6246 12/16 0.0024/0.0026 0.0007/0.0006 0.0013/0.0015 0.0040/0.0041 Change in Battery voltage >0.04V 7132 42 0.0061 0.0009 0.0043 0.0079 Sensing decrease >50%-A/V 5087/5834 17/9 0.0033/0.0015 0.0008/0.0005 0.0020/0.0008 0.0052/0.0028 Impedance changes >50ohms/>50% 5810 22 0.0038 0.0008 0.0024 0.0057 Rise in cardiac enzymes 1703 26 0.0152 0.0030 0.0102 0.0219 A, atrial; V, ventricular; SE, standard Error; LL, lower limit; UL, upper limit; CI, Confidence intervals.
Conclusions
MRI in patients with non-conditional CIEDs can be performed with high degree of safety and low rate of clinical events when performed under standardized protocols
Acknowledgement/Funding
None
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Affiliation(s)
- D Padmanabhan
- Narayana Hrudayalaya Institute of Medical Sciences, Bangalore, India
| | - M Farwati
- Mayo Clinic, Rochester, United States of America
| | - A Izath
- Mayo Clinic, Rochester, United States of America
| | - A Al-Masry
- Mayo Clinic, Rochester, United States of America
| | - D Kella
- Mayo Clinic, Rochester, United States of America
| | - S Gamero
- Mayo Clinic, Rochester, United States of America
| | - A Barout
- Mayo Clinic, Rochester, United States of America
| | - Y Assaf
- Mayo Clinic, Rochester, United States of America
| | - D Shetty
- Narayana Hrudayalaya Institute of Medical Sciences, Bangalore, India
| | - S Asirvatham
- Mayo Clinic, Rochester, United States of America
| | - J Felmlee
- Mayo Clinic, Rochester, United States of America
| | - R Watson
- Mayo Clinic, Rochester, United States of America
| | - Y.-M Cha
- Mayo Clinic, Rochester, United States of America
| | - P Friedman
- Mayo Clinic, Rochester, United States of America
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Yasin O, Kella D, Isath A, Padmanabhan D, Hodge D, Cochuyt J, Mulpuru S, Cha Y, Friedman P. P2851Transvenous lead placement in the setting of venous obstruction: outcomes of tunneling technique versus venoplasty. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.1160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Venous stenosis is a well-recognized complication of transvenous leads when patients require lead revisions or device upgrade. In these cases, balloon venoplasty or alternative venous access with subcutaneous tunneling can be performed.
Purpose
Compare the outcomes of venoplasty vs. tunneling in patients requiring additional transvenous lead implantation.
Methods
A single center retrospective cohort study of all patients undergoing lead implantation/revision requiring venoplasty or tunneling from 2005–2017. Chi-squared and Wilcoxon Rank-Sum tests were used to compare categorical and continuous variables.
Results
Ninety five patients met our inclusion criteria (60 venoplasty & 35 tunneling). There was no difference in procedure success rates (p-value=0.98). Tunneling was associated with less fluoroscopy time but higher incidence of acute complications (0% vs. 23%, p-value=0.002) most requiring invasive intervention and/or blood product transfusion. Long term outcomes were comparable and related to lead failure or infection.
Outcomes for tunneling vs. venoplasty Variable Tunneling (n=35) Venoplasty (n=60) p-value Age Y 67 (23–84) 70 (29–91) 0.25 Male (%) 24 (69%) 41 (68%) 0.98 Number of existing leads 2.1 (1–4) 2.4 (0–4) 0.1 Age of oldest lead 7.0 (0–21) 7.2 (0–33) 0.73 Number of new leads 1.2 (1–3) 1.4 (1–3) 0.26 Fluoroscopy time (SD) min 29.2 (21.3) 39.7 (21.5) 0.012 Procedure success (%) 35 (100%) 55 (92%) 0.9 Acute complications (%) 8 (23%)1 0 (0%) 0.0002 Pocket hematoma/bleed 4 (11%)2 Hemothorax 2 (6%)3 Pericarditis 1 (3%) Lead compromise 1 (3%) Follow up M 18 (0–76) 28 (0–98) N/A Long term lead issues (%) 6 (17%) 10 (17%) 0.95 Long term complication requiring intervention 4 (11%) 8 (13%) N/A Procedure success: functional lead placed as a result of venoplasty or tunneling. 1Two patients required blood products. 2Two patients required invasive intervention. 3One patient required chest tube and the other ICU admission.
Conclusions
Balloon venoplasty is associated with similar rates of success and a less incidence of acute complications when compared subcutaneous tunneling.
Acknowledgement/Funding
NIH T32 Training Grant HL07111-40
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Affiliation(s)
- O Yasin
- Mayo Clinic, Rochester, United States of America
| | - D Kella
- Piedmont Heart Institute, Atlanta, United States of America
| | - A Isath
- St Luke's Roosevelt Hospital, New York, United States of America
| | | | - D Hodge
- Mayo Clinic, Rochester, United States of America
| | - J Cochuyt
- Mayo Clinic, Rochester, United States of America
| | - S Mulpuru
- Mayo Clinic, Rochester, United States of America
| | - Y Cha
- Mayo Clinic, Rochester, United States of America
| | - P Friedman
- Mayo Clinic, Rochester, United States of America
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Naksuk N, Desimone C, Witt C, Sugrue A, Kella D, Noseworthy P. P5792Risks factors for dofetilide-associated torsades de pointes among hospitalized patients with atrial fibrillation. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5792] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- N Naksuk
- Mayo Clinic, Division of Cardiovascular Disease, Rochester, United States of America
| | - C Desimone
- Mayo Clinic, Division of Cardiovascular Disease, Rochester, United States of America
| | - C Witt
- Mayo Clinic, Division of Cardiovascular Disease, Rochester, United States of America
| | - A Sugrue
- Mayo Clinic, Division of Cardiovascular Disease, Rochester, United States of America
| | - D Kella
- Mayo Clinic, Division of Cardiovascular Disease, Rochester, United States of America
| | - P Noseworthy
- Mayo Clinic, Division of Cardiovascular Disease, Rochester, United States of America
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4
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Padmanabhan D, Kella D, Naksuk N, Isath A, Kapa S, Deshmukh A, Mulpuru S, Felmlee J, Dalzell C, Olson N, Jondal M, Asirvatham S, Watson R, Cha YM, Friedman P. P3698Correlation of lead length with procedural safety outcomes of magnetic resonance imaging in patients with legacy pacemakers and defibrillators. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - D Kella
- Mayo Clinic, Rochester, United States of America
| | - N Naksuk
- Mayo Clinic, Rochester, United States of America
| | - A Isath
- Mayo Clinic, Rochester, United States of America
| | - S Kapa
- Mayo Clinic, Rochester, United States of America
| | - A Deshmukh
- Mayo Clinic, Rochester, United States of America
| | - S Mulpuru
- Mayo Clinic, Rochester, United States of America
| | - J Felmlee
- Mayo Clinic, Rochester, United States of America
| | - C Dalzell
- Mayo Clinic, Rochester, United States of America
| | - N Olson
- Mayo Clinic, Rochester, United States of America
| | - M Jondal
- Mayo Clinic, Rochester, United States of America
| | - S Asirvatham
- Mayo Clinic, Rochester, United States of America
| | - R Watson
- Mayo Clinic, Rochester, United States of America
| | - Y.-M Cha
- Mayo Clinic, Rochester, United States of America
| | - P Friedman
- Mayo Clinic, Rochester, United States of America
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Kella D, Gruner-Hegge N, Padmanabhan D, Mehta R, Hodge D, Meludini R, Rihal C, Mulpuru S, Deshmukh A, Ammash N, Greene E, Friedman P. P1218Incidence and Risk Factors for Renal Dysfunction after Direct Current Cardioversion of Atrial Fibrillation. Europace 2018. [DOI: 10.1093/europace/euy015.700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- D Kella
- Mayo Clinic, Cardiology, Rochester, United States of America
| | | | - D Padmanabhan
- Mayo Clinic, Cardiology, Rochester, United States of America
| | - R Mehta
- Mayo Clinic, Cardiology, Rochester, United States of America
| | - D Hodge
- Mayo Clinic, Cardiology, Rochester, United States of America
| | - R Meludini
- Mayo Clinic, Cardiology, Rochester, United States of America
| | - C Rihal
- Mayo Clinic, Cardiology, Rochester, United States of America
| | - S Mulpuru
- Mayo Clinic, Cardiology, Rochester, United States of America
| | - A Deshmukh
- Mayo Clinic, Cardiology, Rochester, United States of America
| | - N Ammash
- Mayo Clinic, Cardiology, Rochester, United States of America
| | - E Greene
- Mayo Clinic, Cardiology, Rochester, United States of America
| | - P Friedman
- Mayo Clinic, Cardiology, Rochester, United States of America
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Gruner-Hegge N, Kella D, Padmanabhan D, Hodge D, Prado J, Aguayo R, Friedman P. 119Antiarrythmia Device use in Myotonic Dystrophy population: A Single Center Experience. Europace 2018. [DOI: 10.1093/europace/euy015.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - D Kella
- Mayo Clinic, Cardiology, Rochester, United States of America
| | - D Padmanabhan
- Mayo Clinic, Cardiology, Rochester, United States of America
| | - D Hodge
- Mayo Clinic, Cardiology, Rochester, United States of America
| | - J Prado
- The GRAACC Hospital, São Paulo, Brazil
| | - R Aguayo
- The GRAACC Hospital, São Paulo, Brazil
| | - P Friedman
- Mayo Clinic, Cardiology, Rochester, United States of America
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Kella D, Padmanabhan D, Mulpuru S, Cha Y, Friedman P. P927Venoplasty to facilitate transvenous lead placement: a single-center experience. Europace 2018. [DOI: 10.1093/europace/euy015.528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- D Kella
- Mayo Clinic, Cardiology, Rochester, United States of America
| | - D Padmanabhan
- Mayo Clinic, Cardiology, Rochester, United States of America
| | - S Mulpuru
- Mayo Clinic, Cardiology, Rochester, United States of America
| | - Y Cha
- Mayo Clinic, Cardiology, Rochester, United States of America
| | - P Friedman
- Mayo Clinic, Cardiology, Rochester, United States of America
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8
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Thome T, Kella D, Cha Y, Friedman P. P405Remote monitoring of patients with an advisory leadless pacemaker without remote follow-up capabilities utilizing a smartphone enabled ECG. Europace 2018. [DOI: 10.1093/europace/euy015.216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- T Thome
- Mayo Clinic, Rochester, United States of America
| | - D Kella
- Mayo Clinic, Rochester, United States of America
| | - Y Cha
- Mayo Clinic, Rochester, United States of America
| | - P Friedman
- Mayo Clinic, Rochester, United States of America
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9
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Naksuk N, Yogeswaran V, Tan N, Lekhakul A, El-Harasis M, Gaba P, Kella D, Kapa S, McLeod C. P6412Right ventricular dysfunction is a major predictor of sudden cardiac death in patients with acute cardiac illness. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p6412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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10
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Naksuk N, Schleifer W, Kancharla K, Padmanabhan D, Kella D, Chacko P, Vargas E, Hodge D, Monahan K, Packer D. P197Longer duration of persistent atrial fibrillation episodes prior to catheter ablation is associated with lower freedom of atrial arrhythmias after catheter ablation. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.p197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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11
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Kella D, Miyamoto K, Killu A, Hodge D, Deshmukh A, Kapa S, Munger T, Asirvatham S, Friedman P. P928The effect of right ventricular size and function on percutaneous pericardial access outcomes for electrophysiology procedure: A single center experience. Europace 2017. [DOI: 10.1093/ehjci/eux151.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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12
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Algranati M, Feldman H, Kella D, Malkin E, Miklazky E, Naaman R, Vager Z, Zajfman J. Structure and Photochemistry of C4as Studied by the Coulomb Explosion Imaging Method. Isr J Chem 2013. [DOI: 10.1002/ijch.199000009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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13
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Pedersen HB, Brink C, Andersen LH, Bjerre N, Hvelplund P, Kella D, Shen H. Experimental investigation of radiative lifetimes of vibrational levels at the electronic ground state of C2−. J Chem Phys 1998. [DOI: 10.1063/1.477207] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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14
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Kella D, Vejby-Christensen L, Johnson PJ, Pedersen HB, Andersen LH. The Source of Green Light Emission Determined from a Heavy-Ion Storage Ring Experiment. Science 1997. [DOI: 10.1126/science.276.5318.1530] [Citation(s) in RCA: 110] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- D. Kella
- Institute of Physics and Astronomy, University of Aarhus, DK 8000, Aarhus C, Denmark
| | - L. Vejby-Christensen
- Institute of Physics and Astronomy, University of Aarhus, DK 8000, Aarhus C, Denmark
| | - P. J. Johnson
- Institute of Physics and Astronomy, University of Aarhus, DK 8000, Aarhus C, Denmark
| | - H. B. Pedersen
- Institute of Physics and Astronomy, University of Aarhus, DK 8000, Aarhus C, Denmark
| | - L. H. Andersen
- Institute of Physics and Astronomy, University of Aarhus, DK 8000, Aarhus C, Denmark
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15
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Andersen LH, Heber O, Kella D, Pedersen HB, Vejby-Christensen L, Zajfman D. Production of Water Molecules from Dissociative Recombination of H3O + with Electrons. Phys Rev Lett 1996; 77:4891-4894. [PMID: 10062661 DOI: 10.1103/physrevlett.77.4891] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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16
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Kella D, Johnson PJ, Pedersen HB, Vejby-Christensen L, Andersen LH. Branching Ratios for Dissociative Recombination of 15N14 N+. Phys Rev Lett 1996; 77:2432-2435. [PMID: 10061952 DOI: 10.1103/physrevlett.77.2432] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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17
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Vejby-Christensen L, Kella D, Mathur D, Pedersen HB, Schmidt HT, Andersen LH. Electron-impact detachment from negative ions. Phys Rev A 1996; 53:2371-2378. [PMID: 9913148 DOI: 10.1103/physreva.53.2371] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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18
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Levin J, Kella D, Vager Z. Interpretation of data in multidimensional spaces and its application to Coulomb-explosion imaging. Phys Rev A 1996; 53:1469-1475. [PMID: 9913037 DOI: 10.1103/physreva.53.1469] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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19
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Zajfman D, Feldman H, Heber O, Kella D, Majer D, Vager Z, Naaman R. Electron Photodetachment Cross Sections of Small Carbon Clusters: Evidence for Nonlinear Isomers. Science 1992; 258:1129-31. [PMID: 17789083 DOI: 10.1126/science.258.5085.1129] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Absolute cross sections for photodetachment of negative carbon clusters are reported for Cn (n = 3, ..., 8). The results indicate that various neutral isomers exist, some with electron affinities as low as 1 electron volt. The method of production plays an important role in the characteristics of carbon clusters.
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20
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Algranati M, Feldman H, Kella D, Malkin E, Miklazky E, Naaman R, Vager Z, Zajfman J. The structure of C4 as studied by the Coulomb explosion method. J Chem Phys 1989. [DOI: 10.1063/1.456597] [Citation(s) in RCA: 63] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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21
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Kumar N, Kella D, Kinsella JE. A method for the controlled cleavage of disulfide bonds in proteins in the absence of denaturants. J Biochem Biophys Methods 1985; 11:251-63. [PMID: 3840816 DOI: 10.1016/0165-022x(85)90007-7] [Citation(s) in RCA: 33] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
A simple method was developed for the controlled cleavage of protein disulfide bonds and the simultaneous blockage of the free sulfhydryl groups in the absence of a denaturant. The disulfide bonds of bovine serum albumin were cleaved unsymmetrically at pH 7.0 using 0.1 M sulfite in 0.1 M phosphate buffer and the free sulfhydryl groups formed were sulfonated in an oxidation-reduction cycle using molecular oxygen and 400 microM cupric sulfate as a catalyst. The reaction was affected by cupric ion concentration, sulfite concentration, reaction pH and temperature. The standardized method was successfully used to cleave the disulfide bonds of other proteins pepsin, trypsin, and chymotrypsin. The method is reliable and can be used for achieving progressive cleavage of disulfide bonds in proteins without employing a denaturant.
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