bluuebunny/crossref_metadata_2025 huggingface dataset:
Expression Pattern, Ethanol‐Metabolizing Activities, and Cellular Localization of Alcohol and Aldehyde Dehydrogenases in Human Pancreas: Implications for Pathogenesis of Alcohol‐Induced Pancreatic Injury
Authors: Chiang Chien‐Ping , Wu Chew‐Wun , Lee Shiao‐Pieng , Chung Chia‐Chi , Wang Chi‐Wei , Lee Shou‐Lun , Nieh Shin , Yin Shih‐Jiun
Published: March 2009

Background:  Alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH) are major enzymes responsible for metabolism of ethanol. Genetic polymorphisms of ADH1B, ADH1C, and ALDH2 occur among racial populations. The metabolic effect and metabolites contribute to pathogenesis of pancreatic injury. The goal of this study was to determine the functional expressions and cellular localization of ADH and ALDH families in human pancreas.

Methods:  Fifty five surgical specimens of normal pancreas as well as 15 samples each for chronic pancreatitis and pancreatic cancer from archival formalin‐fixed paraffin‐embedded tissue specimens were investigated. Class‐specific antibodies were prepared by affinity chromatographies from rabbit antisera raised against recombinant human ADH1C1, ADH4, ADH5, ADH7, ALDH1A1, ALDH2, and ALDH3A1. The isozyme expression patterns of ADH/ALDH were identified by isoelectric focusing, and the activities were assayed spectrophotometrically. The protein contents of ADH/ALDH isozymes were determined by immunoblotting, and the cellular localizations were detected by immunohistochemistry and histochemistry.

Results:  At 33 mM ethanol, pH 7.5, the activities were significantly different between allelic phenotypes of ADH1B. The activity of ALDH2‐inactive phenotypes was slightly lower than ALDH2‐active phenotypes at 200 μM acetaldehyde. The protein contents were in the following decreasing order: ALDH1A1, ALDH2, ADH1, and ADH5. ADH1B was detected in the acinar cells and ADH1C in the ductular, islet, and stellate cells. The expression of ADH1C appeared to be increased in the activated pancreatic stellate cells in chronic pancreatitis and pancreatic cancer.

Conclusions:  Alcohol dehydrogenase and ALDH family members are differentially expressed in the various cell types of pancreas. ADH1C may play an important role in modulation of activation of pancreatic stellate cells.
Glycine Receptors Contribute to Hypnosis Induced by Ethanol
Authors: Ye Jiang H. , Sokol Kimberly A. , Bhavsar Urvi
Published: March 2009

Background: Glycine is a major inhibitory neurotransmitter in the adult central nervous system (CNS), and its receptors (GlyRs) are well known for their effects in the spinal cord and the lower brainstem. Accumulating evidence indicates that GlyRs are more widely distributed in the CNS, including many supraspinal regions. Previous in vitro studies have demonstrated that ethanol potentiates the function of these brain GlyRs, yet the behavioral role of the brain GlyRs has not been well explored.

Methods: Experiments were conducted in rats. The loss of righting reflex (LORR) was used as a marker of the hypnotic state. We compared the LORR induced by systematic administration of ethanol and of ketamine in the absence and presence of the selective glycine receptor antagonist strychnine. Ketamine is a general anesthetic that does not affect GlyRs.

Results: Systemically administered (by intraperitoneal injection) ethanol and ketamine dose‐dependently induced LORR in rats. Furthermore, systemically administered (by subcutaneous injection) strychnine dose‐dependently reduced the percentage of rats exhibiting LORR induced by ethanol, increased the onset time, and decreased the duration of LORR. Strychnine had no effect, however, on the LORR induced by ketamine.

Conclusions: Given that hypnosis is caused by neuronal depression in upper brain areas, we therefore conclude that brain GlyRs contribute at least in part to the hypnosis induced by ethanol.
Ethanol Promotes Thiamine Deficiency‐Induced Neuronal Death: Involvement of Double‐Stranded RNA‐activated Protein Kinase
Authors: Ke Zun‐Ji , Wang Xin , Fan Zhiqin , Luo Jia
Published: March 2009

Background:  Heavy alcohol consumption causes cerebellar degeneration, and the underlying mechanism is unclear. Chronic alcoholism is usually associated with thiamine deficiency (TD) which is known to induce selective neurodegeneration in the brain. However, the role of TD in alcohol‐induced cerebellar degeneration remains to be elucidated. The double‐stranded RNA‐activated protein kinase (PKR) is a potent antiviral protein. Viral infection or binding to dsRNA causes PKR autophosphorylation and subsequent phosphorylation of the α‐subunit of eukaryotic translation factor‐2α, leading to inhibition of translation or apoptosis. PKR can also be activated by cellular stresses.

Methods:  In this study, we used an in vitro model, cultured cerebellar granule neurons (CGNs), to investigate the interaction between TD and ethanol and evaluate the contribution of their interaction to neuronal loss. TD was induced by treatment with amprolium in association with ethanol. Cell viability was determined by 3‐(4,5‐dimethylthiazol‐2yl)‐2,5‐diphenyl tetrazolium bromide assay. PKR expression/phosphorylation and subcellular distribution was analyzed with immunoblotting and immunocytochemistry.

Results:  Thiamine deficiency caused death of CGNs but ethanol did not. However, TD plus ethanol induced a much greater cell loss than TD alone. TD‐induced PKR phosphorylation and ethanol exposure significantly promoted TD‐induced PKR phosphorylation as well as its nuclear translocation. A selective PKR inhibitor not only protected CGNs against TD toxicity, but also abolished ethanol potentiation of TD‐induced loss of CGNs.

Conclusions:  Ethanol promoted TD‐induced PKR activation and neuronal death. PKR may be a convergent protein that mediates the interaction between TD and ethanol.
Predictive Factors for Pure Steatosis in Alcoholic Patients
Authors: Naveau Sylvie , Thaury Juliette , Barri‐Ova Nadège , Balian Axel , Dauvois Barbara , Njiké‐Nakseu Micheline , Prévot Sophie , Agostini Hélène , Perlemuter Gabriel
Published: March 2009

Background:  Bearing in mind the mechanisms involved in nonalcoholic fatty liver disease, this study aims to verify whether metabolic syndrome or its various individual components are independent predictive factors for steatosis ≥10% in alcoholic patients.

Methods:  This study included 281 consecutive alcoholic patients with abnormal liver tests and either normal liver histology or steatosis <10% (n = 119) or steatosis ≥10% (n = 162). Logistic regression analysis was used to study the relationship between metabolic syndrome components and various risk factors and the presence of steatosis ≥10%. We assessed apolipoprotein A1 (ApoA‐1) levels, a major protein component of plasma high‐density lipoprotein (HDL), rather than HDL‐cholesterol levels.

Results:  Plasma ApoA‐1 levels (p < 0.01), body mass index (BMI) (p < 0.01), and waist circumference (p < 0.05) were significantly higher in patients with steatosis ≥10% than in patients with normal liver histology or steatosis <10%. A higher percentage of patients with steatosis ≥10% had high blood pressure (p = 0.003) than patients with normal liver histology or steatosis <10%. In the logistic regression, ApoA‐1 [odds ratio (OR) = 1.57 (1.10–2.22)], BMI [OR = 1.10 (1.01–1.23)], and high blood pressure [OR = 1.84 (1.10–3.06)] were positively and independently correlated with the presence of steatosis ≥10%. In the multivariate regression high blood pressure was independently and positively correlated with steatosis score (r = 0.55 ± 0.26; p < 0.05). On the other hand, when the presence of high blood pressure was the dependent variable, the presence of steatosis ≥10% positively and independently correlated with it [OR = 1.82 (1.05–3.15)].

Conclusion:  In alcoholic patients without fibrosis, ApoA‐1, BMI, and high blood pressure on the next morning after the admission were predictive of steatosis ≥10%. High blood pressure was the only metabolic syndrome component associated with the presence of alcoholic steatosis ≥10% and was not correlated with other metabolic syndrome components. These findings suggest that steatosis mechanisms are different in alcoholic and nonalcoholic fatty liver.
Alcohol‐Related Disorders in Beijing, China: Prevalence, Socio‐Demographic Correlates, and Unmet Need for Treatment
Authors: Xiang Yu‐Tao , Ma Xin , Lu Jin‐Yan , Cai Zhuo‐Ji , Li Shu‐Ran , Xiang Ying‐Qiang , Guo Hong‐Li , Hou Ye‐Zhi , Li Zhen‐Bo , Li Zhan‐Jiang , Tao Yu‐Fen , Dang Wei‐Min , Wu Xiao‐Mei , Deng Jing , Lai Kelly Y. C. , Ungvari Gabor S.
Published: March 2009

Background:  The study aimed to determine the prevalence of alcohol use, episodic heavy drinking, and alcohol dependence and their socio‐demographic correlates in Beijing, China.

Methods:  A total of 5,926 subjects were randomly selected in Beijing and interviewed using the Composite International Diagnostic Interview (CIDI 1.0). Data on basic socio‐demographic and current major medical conditions were also collected.

Results:  The 12‐month prevalence of alcohol use and episodic heavy drinking were 32.5 and 13.8%, respectively. The 12‐month and lifetime prevalence of alcohol dependence were 1.7 and 4.3%, respectively. Age above 24 years, male sex, being married and employed, low education level (junior high school, primary school or illiterate), rural residence, and having comorbid psychiatric disorders were all significantly associated with a higher likelihood of alcohol‐related disorders. Only 2.4% of the subjects with alcohol dependence were receiving treatment, and a mere 1.4% had sought treatment from mental health professionals.

Conclusions:  Nationwide surveys are urgently needed to further explore the prevalence of alcohol‐related disorders in China.
Analysis of transfusion reactions associated with prestorage‐pooled platelet components
Authors: Tormey Christopher A. , Sweeney Joseph D. , Champion Melanie H. , Pisciotto Patricia T. , Snyder Edward L. , Wu YanYun
Published: March 2009

BACKGROUND: The goal of this study was to assess transfusion reactions arising from prestorage‐pooled platelet (PSPP) infusions compared with apheresis single‐donor platelets (SDPs) and poststorage‐pooled, whole blood–derived random‐donor platelets (RDPs).

STUDY DESIGN AND METHODS: Over a span of 18 months, transfusion reaction records of patients receiving platelet (PLT) infusions were retrospectively reviewed at two academic, tertiary care hospitals. Chi‐square analysis was used for statistical comparisons; significance was a p value of less than 0.05.

RESULTS: For the two sites, 10,251 prestorage‐leukoreduced PLT products were infused including 4731 PSPPs, 3999 SDPs, and 1521 RDPs. Of the total infusions, 0.91% (93/10,251) were associated with a transfusion reaction. The aggregate transfusion reaction rate was 0.89% (42/4731) for PSPPs, 0.75% (30/3999) for SDPs, and 1.38% (21/1521) for RDPs. There were no significant differences in total reaction rate between PSPPs and the other PLT products (p > 0.05). Allergic transfusion reactions were the most common adverse event for PLT products evaluated (63/10,251; 0.61%) and febrile reactions were second most common (27/10,251; 0.26%). There were 2 suspected cases of sepsis (1 associated with PSPP and 1 associated with RDP; both culture negative) and 1 case of volume overload associated with RDP infusion. There were no significant differences in aggregate allergic or febrile reaction rates among the 93 PLT products evaluated (p > 0.05). No reports of transfusion‐related acute lung injury or hemolysis were noted.

CONCLUSIONS: No difference in reactions rates was observed among PSPPs and the other PLT products. The transfusion reactions occurring in this population were not dependent on the type of PLT product infused.
Changes in Band 3 oligomeric state precede cell membrane phospholipid loss during blood bank storage of red blood cells
Authors: Karon Brad S. , Hoyer James D. , Stubbs James R. , Thomas David D.
Published: March 2009

BACKGROUND: Lipid loss in the form of vesicles contributes to the red blood cell (RBC) storage lesion, and this loss of lipid is correlated with changes in membrane protein function. Sensitive spectroscopic techniques were used to measure changes in Band 3 oligomeric state during storage of RBCs, compared to metabolic changes and phospholipid loss. The aim of the study was to determine whether changes in the macromolecular organization of membrane proteins occur before, coincident with, or after lipid loss during RBC storage.

STUDY DESIGN AND METHODS: Five RBC units were collected from normal volunteers and stored under standard blood bank conditions, and both metabolic changes and lipid loss were measured by multiple assays. Band 3 oligomeric state was assessed by time‐resolved phosphorescence anisotropy and fluorescence resonance energy transfer of eosin‐5‐maleimide–labeled RBC ghosts.

RESULTS: Extracellular pH decreased and extracellular potassium increased rapidly during cold storage of blood. Band 3 on the RBC membrane exhibited a shift from small to large oligomers early in the storage period and before detectable loss of phospholipid from the RBC membrane. The immobilized fraction of Band 3, that which is tethered to the cytoskeletal network via spectrin and ankyrin, did not change during cold storage.

CONCLUSION: Our results demonstrate that changes in the macromolecular organization of membrane proteins on the RBC occur early in storage, and these changes may induce phospholipid loss, irreversible morphologic changes, and loss of function during RBC storage.
Aorta and coronary angiographic follow‐up of children with severe hypercholesterolemia treated with low‐density lipoprotein apheresis
Authors: Stefanutti Claudia , Vivenzio Antonio , Giacomo Serafina Di , Mazzarella Bruno , Bosco Giovanna , Berni Andrea
Published: March 2009

BACKGROUND: In this single‐center, nonrandomized, prospective study, 11 children with severe genetic hypercholesterolemia, without previous cardiovascular disease events, were treated with low‐density lipoprotein apheresis (LDLa).

STUDY DESIGN AND METHODS: LDLa was given every 1 or 2 weeks for 2 to 17 years. Clinical cardiovascular events and coronary revascularization, as well as aortic and coronary angiographic findings and ejection fractions, were serially evaluated for 2 to 17 years.

RESULTS: Total cholesterol (TC) and LDL cholesterol levels at baseline were 826.1 ± 183.3 and 767.8 ± 181.9 mg/dL, respectively. After LDLa, these levels decreased to 122.6 ± 24.4 and 79.1 ± 20.7 mg/dL, respectively (both differences, p ≤ 0.001). There were no cardiac deaths, and 6 children were free from any coronary lesions. Nonfatal myocardial infarction was not observed, and coronary revascularization was not required in any patient. Regression of coronary stenosis in children with existing angiographically established lesions after treatment with LDLa was prospectively demonstrated. The statistical analysis applicable to a scoring model (overall atherogenic index [OAI]) highlighted a significant relation between values of 0 to 4 years relevant to the score (p ≤ 0.018) and a weaker significant statistic for the value of OAI between 0 and 2 years (p ≤ 0.03). The OAI score at baseline was significantly related to the basal values of TC (p = 0.015), LDL cholesterol (p = 0.015), and triglycerides (p = 0.01), but not of high‐density lipoprotein cholesterol (p = 0.075) as demonstrated by the logistic regression analysis (Cox and Snell pseudo‐R2 of 0.67).

CONCLUSION: LDLa interrupted the development of new aortic and coronary lesions in the native arteries and prevented cardiac events and the need for coronary revascularization in children without previous cardiovascular disease events.
Evaluation of immunohematologic routine methods using the new erythrocyte‐magnetized technology on the QWALYS 2 system
Authors: Schoenfeld Helge , Bulling Katia , Heymann Christian von , Neuner Bruno , Kalus Ulrich , Kiesewetter Holger , Pruss Axel
Published: March 2009

BACKGROUND: QWALYS 2 is a fully automated system for ABO/D grouping, Rh phenotyping, K typing, and antibody screening (ABS). Its new erythrocyte‐magnetized technology (EMT) is based on the use of magnetic nanoparticles and avoids centrifugation and washing steps.

STUDY DESIGN AND METHODS: Overall 499 blood samples were tested with our routine blood bank methods for ABO/D grouping, 313 samples for Rh phenotyping and K typing (microtiter plates; Olympus PK 7200), and 478 samples for ABS (gel centrifugation technique, DiaMed). All samples were tested in parallel with the EMT.

RESULTS: In 496 of 499 samples (99.4%), a complete concordance between the observed (QWALYS 2) and the expected results for ABO/D grouping was found. One sample with a weak A in an AB blood group and 2 samples with a weak D were not detected by the QWALYS system. Rh phenotyping and K tests revealed a 100% concordance. In the two ABS techniques, 427 samples were negative in both and 15 samples showed the same antibody specificity in both. Three immunoglobulin M antibodies were as expected negative in EMT and positive by DiaMed. In 32 cases (6.7%), false‐positive reactions were observed by EMT due to 22 unspecific reactions (4.6%) and 10 lipemic or fibrinic plasmas (2.1%). One autoantibody was found by EMT only.

CONCLUSION: The EMT is reliably suited to ABO/D grouping, Rh phenotyping, and K testing and is suitable to detect immunoglobulin G red blood cell alloantibodies as well. The rate of false‐positive reactions in ABS due to lipemic and fibrinic samples needs to be reduced.
Intellectual Property, Architecture, and the Management of Technological Transitions: Evidence from Microsoft Corporation
Authors: MacCormack Alan , Iansiti Marco
Published: March 2009

Many studies highlight the challenges facing incumbent firms in responding effectively to major technological transitions. Though some authors argue that these challenges can be overcome by firms possessing what have been called dynamic capabilities, little work has described in detail the critical resources that these capabilities leverage or the processes through which these resources accumulate and evolve. This paper explores these issues through an in‐depth exploratory case study of one firm that has demonstrated consistently strong performance in an industry that is highly dynamic and uncertain. The focus for the present study is Microsoft, the leading firm in the software industry. The focus on Microsoft is motivated by providing evidence that the firm's product performance has been consistently strong over a period of time in which there have been several major technological transitions—one indicator that a firm possesses dynamic capabilities. This argument is supported by showing that Microsoft's performance when developing new products in response to one of these transitions—the growth of the World Wide Web—was superior to a sample of both incumbents and new entrants. Qualitative data are presented on the roots of Microsoft's dynamic capabilities, focusing on the way that the firm develops, stores, and evolves its intellectual property. Specifically, Microsoft codifies knowledge in the form of software “components,” which can be leveraged across multiple product lines over time and accessed by firms developing complementary products. The present paper argues that the process of componentization, the component “libraries” that result, the architectural frameworks that define how these components interact, and the processes through which these components are evolved to address environmental changes represent critical resources that enable the firm to respond to major technological transitions. These arguments are illustrated by describing Microsoft's response to two major technological transitions.
Flexibility, Structuration, and Simultaneity in New Product Development
Authors: Biazzo Stefano
Published: March 2009

A large body of research has pointed out the need for a contingent approach in the design of new product development processes, highlighting the risk of simply accepting a normative perspective that leads to the identification and diffusion of decontextualized “best practices.” In the literature there are contrasting views regarding the identification of the characteristics of product innovation processes in extremely uncertain and dynamic conditions. Some studies propose a fascinating dichotomy: the contraposition between flexible processes and Stage‐Gate®processes. They maintain that Stage‐Gate®processes are characterized by “early and sharp” product definition and clear separation between concept development and implementation (detail design and production ramp‐up), whereas flexible development models seek to delay the concept freeze point and overlap product development stages going beyond concurrent engineering. Other studies have arrived at seemingly conflicting results; the suitability of the early and sharp product definition approach in turbulent environments is debated without supporting the dichotomy between flexible processes and Stage‐Gate®processes. Moreover, additional reasons for questioning the contraposition between Stage‐Gate®and flexible processes come from a series of studies on the management of discontinuous innovation. The aim of the present study was to develop a conceptual framework that can overcome this widely accepted but controversial dichotomy. The framework is based on the recognition of the orthogonality among three analytical dimensions: organizational, informational, and temporal. The organizational dimension refers to the structuration of the process. The informational dimension deals with classifying the development activities and investigating the firm's product definition approach (early and sharp mode vs. late freeze mode). The temporal dimension relates to the execution strategies of development tasks. The three‐dimensional framework enables us to better understand the complex relationships between the degree of structuration in process design (organizational dimension), the degree of intersection between problem‐formulation and problem‐solving in product definition (informational dimension), and different types of execution strategies (temporal dimension).
Search for the Optimal Right Ventricular Pacing Site: Design and Implementation of Three Randomized Multicenter Clinical Trials
Authors: KAYE GERRY , STAMBLER BRUCE S. , YEE RAYMOND
Published: March 2009

Background: The optimal site to permanently pace the right ventricle (RV) has yet to be determined. To address this issue, three randomized prospective multicenter clinical trials are in progress comparing the long‐term effects of RV apical versus septal pacing on left ventricular (LV) function. The three trials are Optimize RV Selective Site Pacing Clinical Trial (Optimize RV), Right Ventricular Apical and High Septal Pacing to Preserve Left Ventricular Function (Protect Pace), and Right Ventricular Apical versus Septal Pacing (RASP).

Methods: Patients that require frequent or continuous ventricular pacing are randomized to RV apical or septal pacing. Optimize RV excludes patients with LV ejection fraction <40% prior to implantation, whereas the other trials include patients regardless of baseline LV systolic function. The RV septal lead is positioned in the mid‐septum in Optimize RV, the high septum in Protect Pace, and the mid‐septal inflow tract in RASP. Lead position is confirmed by fluoroscopy in two planes and adjudicated by a blinded panel. The combined trials will follow approximately 800 patients for up to 3 years.

Results: The primary outcome in each trial is LV ejection fraction evaluated by radionuclide ventriculography or echocardiography. Secondary outcomes include echo‐based measurements of ventricular/atrial remodeling, 6‐minute hall walk distance, brain natriuretic peptide levels, and clinical events (atrial tachyarrhythmias, heart failure, stroke, or death).

Conclusion: These selective site ventricular pacing trials should provide evidence of the importance of RV pacing site in the long‐term preservation of LV function in patients that require ventricular pacing and help to clarify the optimal RV pacing site.
Use of Implantable Cardioverter‐Defibrillator in Inherited Arrhythmogenic Diseases: Data from Italian ICD Registry for the Years 2001–6
Authors: PROCLEMER ALESSANDRO , GHIDINA MARCO , FACCHIN DOMENICO , REBELLATO LUCA , CORRADO DOMENICO , GASPARINI MAURIZIO , GREGORI DARIO
Published: March 2009

Background: Previous studies have demonstrated the lifesaving role of an implantable cardioverter‐defibrillator (ICD) in high‐risk patients with genetic arrhythmogenic diseases.

Aim: To evaluate the clinical data of patients with hypertrophic cardiomyopathy (HCM), arrhythmogenic right ventricular cardiomyopathy (ARVD/C), idiopathic ventricular arrhythmia (IDIO‐VA) including Brugada syndrome, short QT syndrome, and long QT syndrome (LQT) enrolled in the Italian ICD Registry in the years 2001–6.

Methods: The survey collected prospectively clinical data and technical characteristics of ICD implants on the basis of EURID form.

Results: The number of patients was 1,274 in the HCM group, 520 in the ARVD/C group, 460 in the IDIO‐VA group, and 245 in the LQT group. Primary prevention involved 29.5% of patients in the HCM group, 15.9% in the ARVD/C group, 16.9% in the IDIO‐VA group, and 16.6% in the LQT group, respectively. Ventricular tachycardia and ventricular fibrillation were reported in 49.0% and 24.8% in the HCM group, 72.9% and 20.0% in the ARVD/C group, 48.2% and 42.9% in the IDIO‐VA group, and 21.2% and 61.6% in the LQT group, respectively. Single‐, dual‐, and triple‐chamber ICDs were implanted in 41.5%, 47.6%, and 10.9% in the HCM group; 57.9%, 36.7%, and 5.4% in the ARVD/C group; 55.0%, 45.0%, and 0% in the IDIO‐VA group; and 57.4%, 42.6%, and 0% in LQT group, respectively.

Conclusion: ICD therapies in the years 2001–6 for patients with inherited arrhythmia syndromes were utilized in Italy in a still‐limited number of patients. Secondary prevention represented the major indication for ICD implant and the majority of patients were treated by single‐chamber ICDs.
Usefulness of a Pacing Guidewire to Facilitate Left Ventricular Lead Implantation in Cardiac Resynchronization Therapy
Authors: DE COCK CAREL C. , RES JAN C. J. , HENDRIKS MATTHIJS L. , ALLAART CORNELIS P.
Published: March 2009

Background: Intraoperative measurements of left ventricular (LV) pacing and sensing values were assessed using a novel 0.014‐inch guidewire (Visionwire®, Biotronik GmbH, Berlin, Germany) enabling pacing and sensing at the distal tip before final LV lead implantation.

Methods: Twenty‐two consecutive patients selected for cardiac resynchronization therapy were studied.

Results: Significant correlation was found between the LV pacing threshold as assessed by the Visionwire® and values after final LV lead implantation (r = 0.92, P < 0.001). Correlation for LV sensing was also significant (r = 0.72, P < 0.001). No significant correlation was present with respect to phrenic nerve stimulation. However, no phrenic nerve stimulation at 10 V/0.5 ms using the Visionwire® identified 88% of patients without phrenic nerve stimulation at 10 V/0.5 ms with subsequent LV lead measurements.

Conclusion: This technique may facilitate transvenous LV lead implantation by preventing implantation in a unsuitable target vessel with respect to pacing and sensing values or phrenic nerve stimulation, thereby reducing procedure and fluoroscopy time.
Safety and Imaging Quality of MRI in Pediatric and Adult Congenital Heart Disease Patients with Pacemakers
Authors: PULVER AARON F. , PUCHALSKI MICHAEL D. , BRADLEY DAVID J. , MINICH L. LUANN , SU JASON T. , SAAREL ELIZABETH V. , WHITAKER PATRICIA , ETHERIDGE SUSAN P.
Published: March 2009

Background:

Magnetic resonance imaging (MRI) is a standard of care in evaluating many disease processes. Given concerns about device damage or movement, programming changes, lead heating, inappropriate pacing, and image artifact, MRI is contraindicated in pacemaker patients. Despite this, studies have demonstrated safety and efficacy of MRI in adults with acquired heart disease and endocardial pacing leads. We sought to evaluate MRI use in congenital heart disease (CHD) patients with predominantly epicardial pacing leads.

Methods:

From July 2007 to October 2008, MRI (1.5 Tesla) was performed in 11 patients without alternative imaging modality who were not pacemaker dependent or possessing abandoned leads. Pacing was disabled during MRI. An electrophysiologist monitored electrocardiogram and hemodynamic parameters throughout each study. Device and lead function were evaluated before and after MRI, and at subsequent clinic visits.

Results:

Eleven MRIs (four cardiac, seven noncardiac) were performed in eight patients. Mean patient age was 16.5 ± 9.2 years (range 1.7–24.5) with five patients under the age of 16 years. Diagnoses included structural CHD in six patients and long QT syndrome and congenital heart block in one each. There were three dual‐ and five single‐ (three atrial, two ventricular) chamber devices, two endocardial, and nine epicardial leads. No inappropriate pacing or significant change in generator or lead parameters was noted. All MRI studies were of diagnostic quality.

Conclusion:

Diagnostic quality MRI can be performed safely in nonpacemaker‐dependent CHD patients with predominantly epicardial leads. Further studies will define safe practice measures in this population, as well as in CHD patients with pacemaker dependency.
Analysis of Atrioventricular Nodal Reentrant Tachycardia with Variable Ventriculoatrial Block: Characteristics of the Upper Common Pathway
Authors: MORIHISA KENJI , YAMABE HIROSHIGE , UEMURA TAKASHI , TANAKA YASUAKI , ENOMOTO KOJI , KAWANO HIROAKI , NAGAYOSHI YASUHIRO , KAIKITA KOICHI , SUMIDA HITOSHI , SUGIYAMA SEIGO , OGAWA HISAO
Published: March 2009

Background: The precise nature of the upper turnaround part of atrioventricular nodal reentrant tachycardia (AVNRT) is not entirely understood.

Methods: In nine patients with AVNRT accompanied by variable ventriculoatrial (VA) conduction block, we examined the electrophysiologic characteristics of its upper common pathway.

Results: Tachycardia was induced by atrial burst and/or extrastimulus followed by atrial‐His jump, and the earliest atrial electrogram was observed at the His bundle site in all patients. Twelve incidents of VA block: Wenckebach VA block (n = 7), 2:1 VA block (n = 4), and intermittent (n = 1) were observed. In two of seven Wenckebach VA block, the retrograde earliest atrial activation site shifted from the His bundle site to coronary sinus ostium just before VA block. Prolongation of His‐His interval occurred during VA block in 11 of 12 incidents. After isoproterenol administration, 1:1 VA conduction resumed in all patients. Catheter ablation at the right inferoparaseptum eliminated antegrade slow pathway conduction and rendered AVNRT noninducible in all patients.

Conclusion: Selective elimination of the slow pathway conduction at the inferoparaseptal right atrium may suggest that the subatrial tissue linking the retrograde fast and antegrade slow pathways forms the upper common pathway in AVNRT with VA block.
QTc Dispersion in Hyperthyroidism and Its Association with Pulmonary Hypertension
Authors: GUNTEKIN UNAL , GUNES YILMAZ , TUNCER MUSTAFA , SIMSEK HAKKI , GUMRUKCUOGLU HASAN ALI , ARSLAN SEVKET , GUNES AHMET
Published: March 2009

Background:Several studies have reported that hyperthyroidism is associated with prolonged QT interval corrected by the heart rate (QTc) and pulmonary hypertension (PHT).

Methods:Forty‐seven patients with newly diagnosed overt hyperthyroidism and 20 healthy people were enrolled in the study. Transthoracic echocardiography, 12‐lead surface electrocardiogram, and thyroid hormone levels were studied at the time of enrollment and after achievement of euthyroid state with propylthiouracil treatment.

Results:Baseline clinical characteristics were similar. However, heart rate (90.5±19.6 vs 79.2±13.7 bpm, P = 0.024), pulmonary artery systolic pressure (PASP) (26.0±12.0 vs 10.6±4.0 mmHg, P < 0.001), E deceleration time (DT) (191.8±25.6 vs 177.0±10.7 ms, P = 0.016), isovolumetric relaxation time (IVRT) (91.38±12.3 vs 79.6±10.5 ms, P<0.001), and QTc dispersion (QTcD) (50.3±17.2 vs 38.9±11.6 ms, P = 0.009) were significantly higher in hyperthyroid patients compared to control group. Heart rate (to 74.1±13.8, P<0.001), QTcD (to 37.3±10.1 ms, P<0.001), DT (to 185.3±19.7 ms, P = 0.008), IVRT (to 88.6±10.3 ms, P = 0.056), and PASP (23.1±10.1 mmHg P<0.001) were significantly decreased after achievement of euthyroid state. Although PHT was present in 16 patients before treatment only six patients still had PHT during euyhyroid state. Compared to patients with normal PASP, QTcD was significantly longer in patients with PHT (56.5±15.8 vs 37.9±12.8 mmHg P<0.001). There were also significant correlations between QTcD and presence of PHT (r = 0.516, P<0.001) and PASP (r = 0.401, P = 0.009).

Conclusions:Hyperthyroidism is a reversible cause of PHT and diastolic dysfunction. Increased QTcD observed in hyperthyroidism may be associated with PHT and diastolic dysfunction. These abnormal findings in hyperthyroidism often normalize with the achievement of euthyroid state.
Predictors of Atrial Tachyarrhythmias in Subjects with Type 1 ECG Pattern of Brugada Syndrome
Authors: LETSAS KONSTANTINOS P. , WEBER REINHOLD , ASTHEIMER KLAUS , MIHAS CONSTANTINOS C. , STOCKINGER JOCHEM , BLUM THOMAS , KALUSCHE DIETRICH , ARENTZ THOMAS
Published: March 2009

Background:

Previous studies have demonstrated a high incidence of atrial tachyarrhythmias (ATs) in patients with Brugada syndrome (BS). The present study aimed to investigate whether various 12‐lead electrocardiogram (ECG) and electrophysiological parameters may help to differentiate subjects with a high probability to develop ATs.

Methods and Results:

The clinical records of 38 individuals (31 males, age 44.4 ± 13.9) with spontaneous (n = 15) or ajmaline‐induced (n = 23) type 1 ECG pattern of BS were analyzed. During a mean follow‐up period of 4.6 ± 2.2 years, nine subjects suffered ATs (24%). Six subjects displayed paroxysmal atrial fibrillation and three typical atrial flutter. Among the studied 12‐lead ECG parameters, subjects with ATs exhibited increased values of P‐wave duration in lead II, P‐wave dispersion, PR interval in leads II, QRS duration in leads II and V2, Tpeak‐end interval in lead II, and Tpeak‐end dispersion of the 12 leads in relation to those without ATs (P < 0.05). Among the assessed electrophysiological parameters, atrial‐His (AH) and His‐ventricular (HV) intervals were significantly prolonged in subjects with ATs (P < 0.05). Multiple Cox proportional hazards analysis revealed that P‐wave duration in lead II, P‐wave dispersion, Tpeak‐end in lead II, Tpeak‐end dispersion of the 12 leads, as well as AH and HV intervals are independent predictors of ATs in subjects with BS (P < 0.05). Cut‐off point analysis showed that an HV interval≥56 ms displayed the highest predictive ability (P < 0.01).

Conclusion:

Our findings demonstrate that simple 12‐lead ECG and electrophysiological parameters may easily be applied to identify high‐risk subjects with BS ECG phenotype to develop ATs.
Five Years of Catheter Ablation Procedures in South‐Western Europe: Meta‐Analysis of National Registries
Authors: INAMA GIUSEPPE , PEDRINAZZI CLAUDIO , ADRAGAO PEDRO , ALVAREZ MIGUEL , ARRIBAS FERNANDO , BONHORST DANIEL , ELVAS LUIS , LANDOLINA MAURIZIO , MERINO JOSÈ L. , RODRIGUEZ ENRIQUE , DE SOUSA JOAO , GULIZIA MICHELE
Published: March 2009

Background:

Radiofrequency catheter ablation is a well‐established approach to treating several types of cardiac arrhythmias. The aim of our study was to provide data on the diffusion of catheter ablation procedures in clinical practice through a meta‐analysis of National Registries of electrophysiological procedures performed over a 5‐year period, from 2000 to 2005.

Methods:

We found only two national registries of catheter ablation procedures published in the journals indexed in PubMed: The Spanish Catheter Ablation Registry and the Portuguese National Registry on Cardiac Electrophysiology. In addition, we included in our analysis the data from the Italian Registry of Electrophysiological Procedures.

Results and Conclusions:

This meta‐analysis revealed a steady increase in the total number of catheter ablation procedures, particularly for the ablation of atrial flutter, of tachycardia due to double nodal pathways, and of the left atrial substrate in atrial fibrillation. However, the progress of catheter ablation and the impetus for additional research and development of new approaches and technologic advances requires further data on clinical indications, methodologic approach, complications, and long‐term success rate in the real world.
Atrial Tachycardias Encountered in the Context of Catheter Ablation for Atrial Fibrillation Part II: Mapping and Ablation
Authors: KNECHT SÉBASTIEN , VEENHUYZEN GEORGE , O'NEILL MARK D. , WRIGHT MATTHEW , NAULT ISABELLE , WEERASOORIYA RUKSHEN , MIYAZAKI SHINSUKE , SACHER FRÉDÉRIC , HOCINI MÉLÈZE , JAÏS PIERRE , HAÏSSAGUERRE MICHEL
Published: March 2009

Over the past decade, there has been an exponential increase in the number of catheter ablation procedures performed for atrial fibrillation (AF). While for paroxysmal AF, proximal pulmonary vein isolation is sufficient in the majority of cases, ablation of persistent and longstanding AF requires an extensive surgical‐like procedure. This approach is correlated with a high rate of AF termination; however, this is achieved at the cost of at least one atrial tachycardia (AT) during the index procedure or during the patient's follow‐up in the vast majority of cases. As these ATs are often multiple, complex, and frequently more symptomatic than AF, they constitute the last and frequently the most difficult step in ablation for patients with persistent AF. This review concentrates on the practical approaches to the treatment of AT in the context of AF ablation and provides an algorithm that aims at facilitating mapping and ablation strategies using conventional electrophysiological tools.
Analysis of Pacing/Defibrillator Lead Failure Using Device Diagnostics and Pacing Maneuvers
Authors: CHUNG EUGENE H. , CASAVANT DAVID , JOHN ROY M.
Published: March 2009

Patients with Medtronic Sprint Fidelis (Medtronic Inc., Minneapolis, MN, USA) lead failures present with oversensing, resulting in pacing inhibition and inappropriate shocks. We present a case of lead noise from the right ventricular (RV) ring conductor, resulting in multiple inappropriate shocks with subsequent pacing inhibition and syncope. RV pacing lead impedance at no point exceeded 1,000 ohms. We found that increased noise and oversensing was more likely to be induced when pacing at higher pulse widths. RV pacing outputs at lower pulse widths may decrease susceptibility to noise generation and prove an effective temporizing measure in pacing‐dependent patients.
Fatal Outcome in a Pacemaker‐Dependent Patient
Authors: UNDAVIA MANISH , FISCHER AVI , MEHTA DAVENDRA
Published: March 2009

The recent advisory of Medtronic Sprint Fidelis leads has resulted in significant controversy over proper management of patients. The current manufacture's guidelines recommend programming specific device alerts with close follow‐up and implantable cardioverter‐defibrillator lead replacement in patients with evidence of breach in lead integrity. Recently, several studies have identified significant limitations in this method of surveillance. We report the case of a pacemaker‐dependent patient with an ischemic cardiomyopathy, who presented with cardiac arrest and evidence of fracture of the pace/sense portion of a Sprint Fidelis lead during postmortem interrogation. Likely mechanisms leading to his ultimate demise are discussed.
Limitation of Programmed Alerts to Predict ICD Lead Failures
Authors: VLAY STEPHEN C.
Published: March 2009

A 75‐year‐old man with a Sprint Fidelis ICD lead (Medtronic Inc., Minneapolis, MN, USA) experienced inappropriate shocks after sudden failure of the right ventricular (RV) pace‐sense connector resulting in noise. Interrogation of the implantable cardioverter‐defibrillator pulse generator revealed that the 3 AM daily measurement of RV pacing impedance was slightly higher (750 Ω) than the baseline (∼450–550Ω)(although below the recommended alert level of 1,000Ω) and markedly higher at 4 AM (1,552Ω) when therapies were delivered. The event occurred before the patient could be alerted by the audible tones. Thus, the manufacturer's recommended impedance monitoring alert parameters will not predict all lead failures.
Surgical Catheter Ablation of Ventricular Tachycardia Using Left Thoracotomy in a Patient with Hindered Access to the Left Ventricle
Authors: MAURY PHILIPPE , MARCHEIX BERTRAND , DUPARC ALEXANDRE , HÉBRARD AURÉLIEN , PAQUIE CAROLINE , MONDOLY PIERRE , ROLLIN ANNE , DELAY MARC
Published: March 2009

We report the case of a patient presenting with incessant monomorphic ventricular tachycardia resistant to antiarrhythmic drugs, and in whom usual percutaneous vascular or pericardial access to the left ventricle was hindered by mechanical aortic and mitral prosthetic valves. Because an epicardial location was suspected by electrocardiogram features and because access to the target area through the coronary sinus was not possible, we decided to perform a surgically based radiofrequency (RF) ablation. Catheter mapping of the epicardial surface through surgical left lateral thoracotomy in the operating room confirmed the epicardial location of the arrhythmogenic substrate and allowed successful RF ablation of the clinically incessant tachycardia. Combined surgical and electrophysiological approach should therefore be performed when RF ablation is needed in case of unadvisable, difficult, or failed nonsurgical percutaneous access.
Impact of Radiation Processing on Starch
Authors: Bhat Rajeev , Karim A.A.
Published: March 2009

ABSTRACT:  It is envisaged that there will be a considerable demand in the near future for modified starches. To meet the demand, the chemical modification of starch, including cross‐linking, has been widely used to obtain desirable traits that are suitable for various food applications. Radiation processing, being a physical process, is an environmentally friendly alternative to chemical modification. It is economically viable, safe, and possesses several advantages over other conventional methods employed for modification and cross‐linking. Irradiation of starch leads to the attainment of such desired functional attributes as reduction of viscosity, high water solubility, and others. This review provides insight into the impact of gamma, electron beam, and ultraviolet irradiation on the physicochemical and functional properties of starch. It also highlights the importance and the exciting new opportunities afforded by radiation treatments as a physical means for the modification of starch.
Application of DNA‐Based Methods to Identify Fish and Seafood Substitution on the Commercial Market
Authors: Rasmussen Rosalee S. , Morrissey Michael T.
Published: March 2009

ABSTRACT:  Fish and seafood substitution has become an important concern in domestic and international marketplaces, in part due to increased international trade, per capita seafood consumption, and production of processed foods. In many cases, seafood substitution is a form of economic deception, where highly prized species are substituted with those of lesser value. To prevent illegal species substitution, a number of DNA‐based methods have been developed to detect fish and seafood species in commercial products. These methods, along with common gene targets, have been reviewed previously in this journal. The current article is meant to build upon earlier discussions by providing a comprehensive review of the application of these DNA‐based methods to the discovery of fish and seafood substitution on the commercial market. Popular food uses, potential substitution cases, and peer‐reviewed research articles published to date are discussed for all major species groups of concern, including flatfish, gadoids, scombroids, salmonids, percoids, sturgeons, sharks, eels, and bivalves. The use of DNA‐based methods to monitor commercial whale meat products is also reviewed.
The Public Sphere as Wilderness: Le Musée du quai Branly
Authors: Shelton Anthony Alan
Published: March 2009

This article has the dual purpose of first describing the Musée du quai Branly and secondly critically evaluating its espoused intentions, its reception and its potential disciplinary, political and museological implications. The first part of the essay is approached through the analysis of a selection of newspaper reviews, and a comparison between these and institutionally sanctioned views of the Museum as expressed by some of its principal functionaries and instigators. The essay concludes by discussing whether the function and organization of the museum as a public space significantly differs from earlier projects undertaken on the eve of the 21st century.
Expression of Concern
Authors: Jackson Jason Baird
Published: March 2009

This Expression of Concern relates to the article “Historical Ambivalence in a Tribal Museum” by Larry Nesper (DOI: 10.1525/mua.2005.28.2.1).
Glass‐to‐Metal Seal Interfacial Analysis using Electron Probe Microscopy for Reliable Solid Oxide Fuel Cells
Authors: Widgeon Scarlett J. , Corral Erica L. , Spilde Michael N. , Loehman Ronald E.
Published: March 2009

The chemical compatibility between sealing glasses and interconnect materials for solid oxide fuel cells (SOFCs) has been studied in SOFC environments. Two borate‐based glass compositions were sealed to interconnect materials, 441 stainless‐steel (441SS) and Mn1.5Co1.5O4‐coated 441SS. The Mn1.5Co1.5O4‐coated 441SS coupons were analyzed as‐received using X‐ray diffraction (XRD) and electron probe microanalysis (EPMA) to obtain structural information and concentration profiles, respectively. The concentration profiles and the lack of Fe‐containing phases present in the XRD spectrum show Fe is present throughout the coating, suggesting that Fe is partially substituted in the Mn1.5Co1.5O4 spinel. The glass–metal coupons were heat treated in air at 750°C for 500 h. The specimens were analyzed by EPMA and scanning electron microscope (SEM) to obtain images of the glass microstructure at the interface, to verify seal adherence, and to record concentration profiles across the glass–metal interface, with an emphasis on Cr. In total, four seal configurations were tested and analyzed, and in all cases the glasses remained well adhered to the metal and coating, and there was no microstructural evidence of new reaction phases present at the interface. There was slight diffusion of Cr from the 441SS into the sealing glasses, and Cr diffusion was hindered by the coating on the coated 441SS samples.
Crystalline Intermediate Phases in the Sol–Gel‐Based Synthesis of La2NiO4+δ
Authors: Efimov Konstantin , Arnold Mirko , Martynczuk Julia , Feldhoff Armin
Published: March 2009

X‐ray diffraction and transmission electron microscopy were applied to investigate a sol–gel synthetic process for the mixed oxygen ion and electron conductor La2NiO4+δ with a K2NiF4 structure type. The development of the La2NiO4+δ is elucidated considering the influence of calcination temperatures and dwell times. Following the thermal decomposition of nitrate and organic precursors in an intermediate step, the lanthanum nickel oxide is obtained after a short dwell time above 750°C. This occurs by the transformation of an ultrafinely dispersed powder consisting of lanthanum oxycarbonate, lanthanum oxide, and nickel oxide. The pure La2NiO4+δ phase was obtained by similar solid‐state reactions between nanocrystalline powder particles at just 950°C.