bluuebunny/crossref_metadata_2025 huggingface dataset:
Molecular dissection of the primary sink size and its related traits in rice
Authors: Xu J. L. , Yu S. B. , Luo L. J. , Zhong D. B. , Mei H. W. , Li Z. K.
Published: December 2004

The genetic mechanism underlying the relationship between three traits of the primary sink size ‐ spikelet number per panicle (SNP), panicle number per plant (PN), and 1000‐grain weight (GWT), and their 10 component traits in rice was dissected in 292 F13 recombinant inbred lines using a complete linkage map. A total of 43 genomic regions on 12 rice chromosomes were found to contain quantitative trait loci (QTLs) affecting the sink size traits, which revealed several important aspects of the genetic basis of sink capacity in rice. First, QTLs for SNP, PN and GWT were largely independent. Secondly, most QTLs affecting SNP and GWT showed close characteristics in both genomic locations and directions of effects to QTLs for their components, suggesting that pleiotropy, rather than linkage, was the primary genetic basis of the correlated panicle and grain traits. Thirdly, some QTLs affecting component traits did not contribute to SNP or GWT. In these cases, two or more QTLs with opposite effects on their component traits were detected, which could be due to either linkage or pleiotropy. Fourthly, some QTLs had large effects on panicle number (QPn4), panicle branching and length (QPbn3a, QPbn3b and QPb14), grain length and volume (QG13, QG15 and QGv2), and grain shape (QGs1 and QGs7), which were consistently detected in the related rice mapping populations and in different environments, providing good candidates and useful information for marker‐aided improvement of sink size and yield potential of rice.
Effect of the leaf rust resistance gene Lr28 on grain yield and bread‐making quality of wheat
Authors: Kumar A. A. , Raghavaiah P.
Published: December 2004

Near‐isogenic lines carrying the Lr28 gene developed in five genetic backgrounds were tested for 2 years with and without fungicide treatment. The Lr28 gene increased grain yield, 1000‐grain weight and number of effective tillers per plant under heavy leaf rust infection with no negative effects on yield and bread‐making quality in rust‐free plots. Although a reduction in dough development time was found to be associated with Lr28, it can still be used extensively in wheat breeding programmes.
Assessing in vivo Fertilizing Capacity of Liquid‐Preserved Boar Semen According to the ‘Hanover Gilt Model’
Authors: Ardón F , Döhring A , Le Thi X , Weitze KF , Waberski D
Published: December 2004

Contents

The goal of this study was to determine the ability of the Hanover gilt model to assess in vivo fertilizing capacity of preserved sperm and to consider whether any modifications to this model were needed. This model evaluates the fertilizing capacity of semen based on the fertilization rate, the rate of normal embryos and the accessory sperm count of 3–5‐day embryos. Its distinguishing characteristics are the use of one‐time insemination of sperm in reduced numbers, of spontaneously ovulating gilts and of ovulation detection through ultrasound examination of ovaries. Reduced sperm numbers allow for an accurate evaluation of the fertilizing potential of different semen treatments, thereby avoiding the compensatory effect of doses calibrated to maximize fertility. The model's usefulness was assessed in a trial run designed to compare the fertilizing capacity of liquid boar semen diluted into two different extenders. The diluent, the boar and the backflow, had no significant effect on any of the parameters studied. Gilts inseminated less than 24 h before ovulation had a significantly higher (p < 0.01) fertilization rate and accessory sperm cell count (p < 0.05) than those inseminated more than 24 h before ovulation. Very good/good embryos from homogeneous litters (only very good/good embryos were present) had a significantly higher (p < 0.01) accessory sperm count than those from heterogeneous litters (at least one embryo was of a different quality and/or oocytes were present). Both very good/good and degenerated/retarded embryos from heterogeneous litters had low accessory sperm numbers. This suggests that accessory sperm count is significantly related to the quality of the litter, but not to the quality of the embryo within gilts. It can be concluded that the Hanover gilt model is sensitive enough to show fertility differences (in this study, those associated with in vivo ageing of semen), while using relatively few gilts and little time.
Lung carcinoma metastasis presenting as a pineal region tumor
Authors: Kakita Akiyoshi , Kobayashi Keishi , Aoki Nobuki , Eguchi Ikuyo , Morita Takashi , Takahashi Hitoshi
Published: December 2004

An autopsy case is reported of pineal metastasis from lung adenocarcinoma, which is a rare manifestation of the disease. A 75‐year‐old man who had been found to have a lesion in the lung by chest CT 2 years previously, became aware of head heaviness and then suffered consciousness disturbance. Brain MRI revealed a solitary mass in the pineal region with hydrocephalus. At autopsy a midsagittal section of the brain disclosed a well‐circumscribed mass consisting of epithelial cells occupying the third ventricle. Although it should be recognized that such metastasis is very rare, the present case provides further information that might be useful for diagnosis.
Neuropathological study of the role of mast cells and histamine‐positive neurons in selective vulnerability of the thalamus and inferior colliculus in thiamine‐deficient encephalopathy
Authors: Meng Jin Song , Okeda Riki
Published: December 2004

The purpose of the present study was to examine the role of histamine in the pathogenesis of experimental thiamine‐deficient encephalopathy. By studying sagittal serial sections the authors were able to examine the topographical relationship between histamine‐positive neurons and fibers, the number of mast cells, and localized lesions in the thalamus (TH) and inferior colliculus (IC). Adult rats were given a thiamine‐deficient diet and pyrithiamine was given intraperitoneally (30 µg/100 g bodyweight per day), and the distribution of vulnerable regions and petechial bleeding was histologically examined by reconstruction of the sagittal serial sections. The distribution of mast cells and histamine‐positive neurons and fibers was examined immunohistochemically in control rats, and compared between the vulnerable and non‐vulnerable regions of the TH and tectum. Changes in the aforementioned measures during the thiamine‐deficient state were also examined. The blood–brain barrier was examined using antibodies against rat endothelial barrier antigen (EBA) and albumin. The density of histamine‐positive fibers in the vulnerable regions of the TH and IC was very low and not different from the non‐vulnerable regions, and the number of mast cells was significantly higher in the lateral portion of the TH than the medial portion of the TH. The numbers of mast cells increased on days 7–10 after the start of the experiment, and significantly decreased on days 14–21. Histamine‐positive neurons and fibers in the TH and IC also had the same changes. Bleeding of the IC occurred exclusively around arteries, and perivenous bleeding was absent. Albumin exudation and suppression of EBA expression of capillaries were found in the spongy lesions of the TH and IC. The role of histamine in selective vulnerability of the TH and IC in experimental thiamine‐deficient encephalopathy was not supported. Findings in the present study suggest that the spongy change is a primary event, and vascular changes are secondary.
Role of Chlamydia pneumoniae‐infected macrophages in atherosclerosis developments of the carotid artery
Authors: Kuroda Satoshi , Kobayashi Tohru , Ishii Nobuaki , Ikeda Jun , Shinohe Yumiko , Houkin Kiyohiro , Iwasaki Yoshinobu , Nagashima Kazuo
Published: December 2004

Chlamydia pneumoniae (C. pneumoniae) infection has been recently accepted as an important cause of atherosclerosis. However, the precise mechanisms remain unclear. The present study was aimed to clarify the distribution link among C. pneumoniae, chlamydial HSP 60, and activated macrophages. Atheromatous carotid plaques were obtained from 40 consecutive carotid endarterectomies (CEA). The specimens were prepared for HE and elastica–van Gieson staining. Parallel sections were stained immunocytochemically with monoclonal antibodies for a C. pneumoniae‐specific antigen, chlamydial HSP 60, activated macrophages, and smooth muscle cells. Immunoreactivity for the C. pneumoniae‐specific antigen was observed within the endothelial cells, activated macrophages, and smooth muscle cells in 36 of 40 specimens (90%). Chlamydial HSP 60 was found in all specimens positive for the C. pneumoniae‐specific antigen, and mainly co‐localized with the C. pneumoniae‐specific antigen within the activated macrophages. The present results suggest that C. pneumoniae is a key microbial organ that causes atheroma developments in the carotid artery. Chlamydia pneumoniae‐infected macrophages may come into the arterial intima and mediate inflammatory and autoimmune processes through the production of chlamydial HSP 60, leading to atherosclerosis.
LIPID‐LOWERING IMPROVES ENDOTHELIAL FUNCTION IN NEPHROTIC RANGE PROTEINURIA
Authors: Dogra G. , Herrmann S. , Playford D. , Irish A.B. , Watts G.F.
Published: December 2004

OBJECTIVE: To determine whether lipid‐modifying therapy with atorvastatin improves impaired endothelial function in patients with nephrotic range proteinuria (NRP).

METHODS: A sequential, open‐label study of the effects of atorvastatin on dyslipidaemia and endothelial dysfunction in 9 patients with NRP. Endothelial function was assessed at baseline, after 12 weeks of atorvastatin treatment and after an 8 week wash‐out period. Brachial artery endothelial function was studied by measuring post‐ischaemic flow‐mediated dilatation (FMD) using ultrasonography. Endothelium‐ independent, glyceryl trinitrate (GTN) mediated vasodilatation was also measured.

RESULTS: At baseline, median serum albumin was 31g/L (range 20‐40) and 24 hour protein excretion was 4.7g (1.0‐16.23). There was no significant change in serum creatinine and 24 hour protein excretion during the study. Total cholesterol (TC) and triglycerides (TG) were significantly lower following treatment with atorvastatin 20mg (20‐40): TC 8.1mmol/L (5.9‐14.9) vs. 5.2 (4.0‐8.6), TG 2.9mmol/L (1.3‐15.0) vs. 1.6 (1.0‐3.5), both p < 0.05. Brachial artery FMD improved significantly following atorvastatin treatment: 2.1% (‐1.2‐ 5.2%) to 4.7% (0.8‐16.3%), p < 0.05. At the end of the 8 week wash‐out, FMD had significantly deteriorated to 3.2% (‐2.8‐8.2), p < 0.05 vs. week 12 FMD, and was similar to pre‐treatment values. GTN mediated dilatation was unchanged through the study.

CONCLUSION: Atorvastatin significantly reduced the hyperlipidaemia of NRP. This was associated with improved conduit artery endothelial function after 12 weeks of treatment. This is consistent with the hypothesis that dyslipoproteinaemia is the primary cause of endothelial dysfunction in NRP.
Validity of DQ as an estimate of IQ in children with autistic disorder
Authors: Kurita Hiroshi , Osada Hirokazu , Shimizu Kaoru , Tachimori Hisateru
Published: December 2004

Abstract The purpose of the present paper was to test the validity of developmental quotients (DQ) on the Mental Development Scale for Infants and Young Children (MDSIYC) as an estimate of intelligence quotient (IQ). Correlations were carried out of its DQ with an IQ on the Japanese version of the Stanford–Binet in 94 children with Diagnostic and Statistical Manual of Mental Disorders (4th edn; DSM‐IV) autistic disorder. With IQ, DQ in the five MDSIYC areas (motor, play, socialization, self‐help, and speech) and full‐scale DQ (mean of five‐area DQ) had significant correlations (Pearson r) of 0.46, 0.56, 0.53, 0.46, 0.85, and 0.68, respectively, suggesting that speech DQ is the most valid estimate of IQ.
Basic FGF and Ki‐67 proteins useful for immunohistological diagnostic evaluations in malignant solitary fibrous tumor
Authors: Sun Yuliang , Naito Zenya , Ishiwata Toshiyuki , Maeda Shotaro , Sugisaki Yuichi , Asano Goro
Published: December 2004

Solitary fibrous tumor (SFT) is an uncommon soft tissue tumor initially reported in the pleura but recently described in other sites in the body. Morphological distinction between benign and malignant SFT is often difficult. An immunohistochemical study was performed in pleural and extrapleural sites. The aim of this study was to determine if an immunohistochemical method is helpful in distinguishing benign SFT from malignant SFT, and providing valid information to predict the prognosis associated with malignant SFT. Twenty‐four cases of benign (14 patients) and malignant (10 patients) SFT in the pleura, pelvic space, prostate and other sites of soft tissue were analyzed. Tumors from 10 patients were diagnosed as malignant on the basis of markedly increased cellularity, mitotic activity (>4/10 high‐power fields), nuclear pleomorphism and areas of necrosis. Immunohistochemically, we found a mean basic fibroblast growth factor (bFGF) labeling index of 48.67% (48.67 ± 8.52%) for benign SFT and 74.5% (74.5 ± 6.92%) for malignant SFT (P < 0.05). We also found a mean Ki‐67 labeling index of 1.9% (1.9 ± 0.43%) for benign SFT and 6.11% (6.11 ± 1.05%) for malignant SFT (P < 0.05). Our results suggest that bFGF and Ki‐67 are diagnostically relevant to the evaluation of malignant SFT and these proteins are thought to be potentially useful markers for prognosis of SFT.
Cutaneous and pulmonary sarcoidosis in a Hong Kong Chinese woman with silicone breast prostheses
Authors: CHANG Kwok‐Chiu , CHAN Kam‐Tim , CHONG Lai‐Yin , LAU Kam‐Shing , TAM Cheuk‐Ming , LAM Chak‐Wah
Published: December 2004

Abstract:  Sarcoidosis is rarely reported in Hong Kong. We report cutaneous and pulmonary sarcoidosis in a 54‐year‐old Chinese woman, who presented with papular lesions over the face and neck. She had silicone breast augmentation surgery 4 years earlier. Skin biopsy revealed granulomatous inflammation and anti‐tuberculosis treatment was started empirically but stopped 2 months later owing to a poor response. A right supraclavicular lymph node was aspirated and revealed granulomatous inflammation. The CXR was normal initially but subsequently showed diffuse reticulonodular opacities and a small right‐sided pleural effusion. High‐resolution CT of the thorax showed mediastinal lymphadenopathy and diffuse perilymphatic nodular opacities consistent with sarcoidosis. Sputum mycobacterial culture was negative. Fibreoptic bronchoscopy showed no endobronchial lesion but the transbronchial biopsy showed granulomatous inflammation with no evidence of infection, malignancy or foreign body. Pulmonary function tests were normal except for impairment of transfer factor. One year later, most of the cutaneous lesions had healed spontaneously. The CXR showed partial improvement of the right pleural opacification but little change in the lung field. The features of sarcoidosis and its association with silicone are reviewed.
Fatal pneumonia caused by Burkholderia cepacia 9 months after resection of aspergilloma
Authors: ISHIZUKA Tamotsu , OYAMA Tatsuya , SATO Minoru , HISADA Takeshi , TAKAGI Hitoshi , HAMADA Tetsuya , KIMURA Takao , KASHIWABARA Kenji , MORI Masatomo
Published: December 2004

Abstract:  A 69‐year‐old man developed an episode of severe community‐acquired pneumonia 9 months after resection of aspergilloma. Although Aspergillus fumigatus was also isolated in the pleural cavity, it did not invade the remaining lung parenchyma. The patient developed progressive bilateral pneumonia leading to death from respiratory failure. Burkholderia cepacia was considered as prime pathogen, as it was repeatedly cultured from sputum and tracheal secretions, as well as the autopsy lung. B. cepacia is resistant to most antibiotics, and seldom causes pneumonia in patients without cystic fibrosis or chronic granulomatous disease. The precise reason that this apparently immunocompetent patient developed B. cepacia pneumonia remains unknown.
Effect of the proteolytic enzyme serrapeptase in patients with chronic airway disease
Authors: NAKAMURA Seiichi , HASHIMOTO Yasushi , MIKAMI Masashi , YAMANAKA Eiichi , SOMA Tomoyuki , HINO Mitsunori , AZUMA Arata , KUDOH Shoji
Published: December 2004

Objectives:  The proteolytic enzyme serrapeptase (SER) is widely used in clinical practice in Japan. We investigated the effect of SER on sputum properties and symptoms in patients with chronic airway diseases.

Methods:  This study was an open‐labelled trial with a non‐treatment control group. Patients were randomly assigned to oral treatment with (n = 15) and without (n = 14) SER 30 mg/day for 4 weeks. Patients collected sputum samples for about 4 h in the morning on the day the trial began and 4 weeks later. We measured the amount of sputum by weighing. Part of each sputum sample was weighed and then completely dried and reweighed. The percentage solid component, viscosity and elasticity of the sputum were measured. Mucociliary transportability index was measured using ciliated bovine trachea ex vivo. Sputum smears were also prepared to count sputum neutrophils. Patients’ symptoms were assessed by a questionnaire that used a visual analogue scale.

Results:  After 4 weeks of SER treatment, sputum weight in the morning, percentage solid component, viscosity and elasticity of sputum, sputum neutrophil count, frequency of coughing and frequency of expectoration significantly decreased. The mean mucociliary transportability index increased from 13.3 ± 1.8 to 24.4 ± 2.5 (P = 0.0103).

Conclusions:  SER may exert a beneficial effect on mucus clearance by reducing neutrophil numbers and altering the viscoelasticity of sputum in patients with chronic airway diseases.
Control of an outbreak of BCG complications in Gaza
Authors: DAOUD Walid
Published: December 2004

Objective:  We aim to describe Bacille Calmette Guerin (BCG) complications in Gaza using two studies: one during an outbreak and the other after control of the possible contributing factors to this outbreak.

Methodology:  The first study was conducted on 6145 newborn infants vaccinated in 21 primary care centres in Gaza with BCG vaccine, Pasteur Paris, batch number 5122 from July to October 2001. The study was repeated after changing the BCG vaccine and training 63 nurses from November to December 2001. The training program included theoretical lectures on BCG and tuberculosis and practical training in strict intradermal injection. The second study included 6877 newborn infants vaccinated with BCG vaccine, batch number 101023, Denmark, from January to April 2002.

Results:  During the outbreak, BCG complications occurred in 225 infants with a complication rate of 36.61 per 1000 vaccinations. The mean age at presentation was 4 months. The commonest complications were regional lymphadenitis in 138 (61.33%) infants, local abscess in 48 (21.33%) infants, local ulcer in 26 (11.56%) infants, keloid scar in 12 (5.33%) infants and one (0.44%) infant who died from disseminated disease had severe combined immunodeficiency. In the follow‐up study, BCG complications occurred in 43 infants with a complication rate of 6.25 per 1000 vaccinations, which is significantly lower (P < 0.001) than that during the initial outbreak.

Conclusion:  The study supports the use of a less virulent vaccine and proper vaccination techniques to minimize the incidence of BCG complications. The training of nurses in strict intradermal injection should be maintained and the proper selection of those receiving the vaccines should be considered to avoid the vaccination of any infant with immunodeficiency.
Changes in the activity of sperm nitric oxide synthase in the oviductal reservoir during ovulation
Authors: Oh‐Oka Tadasuke , Saxena Dinesh Kumar , Tanii Ichiro , Yoshinaga Kazuya , Toshimori Kiyotaka
Published: December 2004

Background:  The oviductal isthmus is known to act as a sperm reservoir in several mammalian species including mice, but it is still unclear how sperm are released from the reservoir after ovulation. Recently, nitric oxide (NO) was reported to have important roles as a mediator in various sperm functions, including hyperactivation and capacitation. Therefore, we have investigated the change of the activity of nitric oxide synthase (NOS) of sperm of the isthmus in relation to ovulation under in vivo fertilization conditions.

Methods and Results:  The sperm were collected from the isthmus and uterus of the female mated before or after ovulation. The NOS activity change was evaluated by using the β‐nicotinamide adenine dinucleotide phosphate‐diaphorase staining method, and sperm NOS activity was quantified by using NIH image software. The results showed that, in the reservoir, the peak intensity of sperm NOS activity was higher after ovulation (135.5 ± 22.4) than before ovulation (102.7 ± 15.5; P ≤ 0.05). After ovulation, the number of free sperm in the isthmus increased, and these sperm expressed strong NOS activity.

Conclusion:  The change of sperm NOS activity is related to their release from the epithelium of the oviductal reservoir. (Reprod Med Biol 2003; 2: 75–81)
Proportion of Candidates for Cardiac Resynchronization Therapy
Authors: ERDOGAN ALI , RUECKLEBEN SEBASTIAN , TILLMANNS HARALD H. , WALDECKER BERND
Published: December 2004

ERDOGAN, A.,

et al.

: Proportion of Candidates for Cardiac Resynchronization Therapy.
Biventricular pacing has been used as an adjunct to standard heart failure therapy in symptomatic patients with left bundle branch block (LBBB). Estimates of the number of patients for whom this treatment is appropriate are unavailable, but are of clinical and socioeconomic importance. LBBB combined with a low (<0.35) ejection fraction was found in 7,121 consecutive patients referred for elective diagnostic angiography in 1996 through 2000 from a total population of about 125,000 residents. Patients with LBBB (n = 289, 4%) had lower ejection fractions (0.53 ± 0.23) in comparison with patients without LBBB (P < 0.0001). The ejection fraction was <0.35 in 558 (8%) patients. LBBB was combined with a low ejection fraction in 96 (1.4%) patients (i.e., 19 patients per year and about 15 patients per year per 100,000 residents). Of these 96 patients, 80 had normal sinus rhythm, 82 had mitral regurgitation (grade > II), 86 were <75 years of age, and 68 had coronary artery disease. Holter recordings performed in 47 of 96 patients showed nonsustained VT in 28 (60%). LBBB, low ejection fraction, sinus rhythm, and age <75 years were found in 71 (1%) patients (i.e., 11 patients per year per 100,000 residents). The prevalence of LBBB combined with severely impaired left ventricular ejection function is about 1–2% in patients who undergo cardiac catheterization. The authors estimate that biventricular pacing might be considered as an adjunct to standard heart failure therapy in five to ten patients per year per 100,000 residents in industrial countries. About half of these patients are potential candidates for implantation of cardioverter defibrillators combined with permanent pacing. (PACE 2003; 26[Pt. II]:152–154)
Comparison of the Cardiopulmonary Response to Exercise in Recipients of Dual Sensor DDDR Pacemakers Versus a Healthy Control Group
Authors: PAGE ERIC , DEFAYE PASCAL , BONNET JEAN‐LUC , DURAND CATHERINE , AMBLARD AMEL
Published: December 2004

PAGE, E.,

et al.:

Comparison of the Cardiopulmonary Response to Exercise in Recipients of Dual Sensor DDDR Pacemakers Versus a Healthy Control Group.
The authors previously have shown in healthy subjects that age related loss of muscular strength did not alter the chronotropic response during treadmill exercise, whether with sudden onset of effort, as in the chronotropic assessment exercise protocol (CAEP) or more gradual effort as in the Harbor exercise protocol. This study was performed to verify that in patients suffering from chronotropic insufficiency, and in absence of other effort‐limiting disorders, “physiologic” pacing enables a cardiorespiratory response comparable to that of age‐matched healthy subjects. Furthermore, the aim of the study was to confirm that the response of a new dual sensor‐based pacing system was properly adapted to the metabolic demand, whether during CAEP or during Harbor test, by subjecting patients to both protocols. All study participants were able to undergo treadmill exercise testing, had normal cardiopulmonary function tests at rest, and no cardiac, muscular, or pulmonary disease. A healthy group (control) included 16 subjects (mean age 70.4 ± 3.9 years), and the test group (pacemaker [PM]) included 9 subjects (mean age 67.1 ± 10.8 years) permanently paced for isolated chronotropic insufficiency with a dual sensor pacing system. All subjects underwent CAEP and Harbor tests with measurements of gas exchange, 24 hours apart, in randomized order. All subjects reached an appropriate level of exercise, as expressed by mean lactate plasma concentrations, which were slightly higher in the control than the PM group during CAEP (4.9 ± 1.9 vs 3.7 ± 1.9 mmol/L, NS) and Harbor (5.3 ± 1.9 vs 3.8 ± 1.8 mmol/L, P < 0.05) tests. No statistical difference was observed in VO2 and VE at peak exercise between the two groups during either test. In the PM group, heart rate at peak exercise and metabolic reserve slope were higher during the CAEP than the Harbor protocol. These two measurements were significantly lower than in the control group. The PM group also had lower plasma lactate concentrations and dyspnea/fatigue scores. The Harbor test seems less suitable than the CAEP test to study the chronotropic response of pacemakers with dual sensors during exercise. A high performance of the new dual sensor‐based pulse generator was confirmed in this physically fit patient population, whose peak heart rate was considerably higher than in other similar studies. (PACE 2003; 26[Pt. II]:239–243)
Bepridil Prevents Paroxysmal Atrial Fibrillation by a Class III Antiarrhythmic Drug Effect
Authors: YOSHIDA TORU , NIWANO SHINICHI , INUO KIMIATSU , SAITO JUNKO , KOJIMA JISHO , IKEDA‐MURAKAMI KAZUKO , HARA HIDEYUKI , IZUMI TOHRU
Published: December 2004

YOSHIDA, T., et al.: Bepridil Prevents Paroxysmal Atrial Fibrillation by a Class III Antiarrhythmic Drug Effect.
Background: Bepridil, a multiple ion‐channel blocker, has been reported to prevent paroxysmal atrial fibrillation (PAF). The f‐f interval of PAF during treatment with bepridil versus class Ic antiarrhythmic drugs was compared. Methods: Fifty‐two patients with PAF were randomized to bepridil, 200 mg/day

(n = 14)

versus flecainide, 100 to 200 mg/day

(n = 15)

or pilsicainide, 75 to 150 mg/day
(n = 23)
. The drug was considered effective when symptomatic episodes of PAF were decreased to < 50% during a follow‐up of 2 to 6 months. The f‐f interval was measured in 12‐lead ECGs of initial PAF episodes. Results: Bepridil and Ic were effective in 10 of 14 (71.4%) and 24 of 38 patients (63.2%), respectively (ns). In the Ic group, the f‐f interval was longer in successfully

(114 ± 48  ms)

than in unsuccessfully

(68 ± 25  ms)

treated patients

(P = 0.002)

. In the bepridil group, the f‐f interval was shorter in successfully

(84 ± 27  ms)

than unsuccessfully

(155 ± 68  ms)

treated patients

(P = 0.015)

. When comparing unsuccessfully treated patients, the f‐f interval in the bepridil group was significantly longer than in the Ic group

(P = 0.007)

. Conclusions: Bepridil was as effective as Ic drugs in the prevention of PAF. Because it was more effective in smaller (functional) than larger (anatomical) reentrant circuits, the effect of bepridil was considered to be mainly attributable to a class III antiarrhythmic action. (PACE 2003; 26[Pt. II]:314–317)
Standardized Stimulation Protocol to Predict the Long‐Term Success of Radiofrequency Ablation of Postinfarction Ventricular Tachycardia
Authors: O'DONNELL DAVID , BOURKE JOHN P. , FURNISS STEVE S.
Published: December 2004

O'DONNELL, D., et al.: Standardized Stimulation Protocol to Predict the Long‐Term Success of Radiofrequency Ablation of Postinfarction Ventricular Tachycardia.
Background: The ability to predict the success of radiofrequency ablation (RFA) is an essential step in the management of ventricular tachycardia (VT) in patients with ischemic heart disease. Methods: This study tested a standardized programmed stimulation protocol and pre‐specified definitions of procedural outcome. Consecutive patients referred for RFA of delayed post infarction VT were enrolled. Programmed stimulation was performed at the beginning and the end of an RFA procedure, and consisted of an 8 beat drive followed by up to 5 extrastimuli. Immediate success was defined as no inducible monomorphic VT, and a modified result was defined as the inducibility of VT with >2 extrastimuli beyond those required at baseline. Procedural failure was defined when these criteria were not met. Recurrences of sustained VT and arrhythmic deaths were monitored during long‐term follow‐up. Results: The study enrolled 112 patients. Immediate procedural success was achieved in 38%, a modified result in 34%, and procedural failure in 28% of patients. During a mean follow‐up of 78 ± 16 months, recurrent sustained VT was observed in 25 patients. VT recurrence was 3% (3/79) in patients with a successful or modified result, compared with 67% (22/33) in those who had undergone unsuccessful procedures (P < 0.001). Conclusions: This standardized stimulation protocol and definitions of procedural success, enabled us to predict with high accuracy a VT recurrence‐free long‐term follow‐up. This may have implications in recommending devices or other treatments after RFA for postinfarction VT. (PACE 2003; 26[Pt. II]:348–351)
End Tidal CO2 Is a Quantitative Measure of Cardiac Arrest
Authors: SEHRA RUCHIR , UNDERWOOD KAREN , CHECCHIA PAUL
Published: December 2004

SEHRA, R., et al.: End Tidal CO2 Is a Quantitative Measure of Cardiac Arrest.
Purpose of the study: Predictors of severity of cardiac arrest or efficacy of cardiopulmonary resuscitation are few. Respiratory end tidal CO2 (ETCO) is a marker of pulmonary blood flow and, possibly, cardiac arrest. The purpose of this study was to evaluate ETCO as a quantitative marker of cardiac arrest in a human model of ventricular fibrillation (VF). Methods: Thirty‐one cardiac arrest/VF episodes (mean BP < 40 mmHg) in 8 men and 3 women mean age = 42 ± 24 years, mean left ventricular ejection fraction = 39%) undergoing defibrillator (ICD) implant for ventricular tachycardia or previous cardiac arrest were evaluated with continuous ETCO monitoring during defibrillation threshold testing. All patients but one were intubated. Results: Significant differences

(P < 0.001)

were noted between ETCO values prior (mean 37.2 ± 6.8 mmHg) versus during VF (mean 27.1 ± 5.9 mmHg), and during VF versus return of spontaneous circulation (mean 36.6 ± 6.6 mmHg). ETCO decreased by 23%± 8% from pre‐VF to during VF. It increased by 37%± 16% during VF to return of spontaneous circulation. These changes were significantly different

(P < 0.001)
. Conclusion: Significant changes in ETCO were measured during VF arrest. ETCO can predict acute cardiac arrest in a quantitative manner. (PACE 2003; 26[Pt. II]:515–517)
ICD Leads:
Authors: GRADAUS RAINER , BREITHARDT GÜNTER , BÖCKER DIRK
Published: December 2004

GRADAUS, R., et al.: ICD Leads: Design and Chronic Dysfunctions.
The treatment of ventricular tachyarrhythmias has changed over the last 10 years. Implantable cardioverter defibrillators (ICDs), once used only as a last resort therapy, have now become the treatment of choice. This change occurred before the first results of randomized studies on ICD therapy in patients with life‐threatening ventricular tachyarrhythmias were published by the end of 1997. Technological advances of ICD therapy, in particular the development of transvenous leads, were to a large extent responsible for this change. Modern leads are characterized by their multilumen design that incorporates straight wires and coiled conductors into a single electrode body. Conductors and insulation are sheathed with additional insulation layers. The most frequently used insulating materials are silicone, polyurethane, and fluoropolymers. Lead failures are an important complication of ICD therapy. Fractured conductors, compression, creeping, or insulation defects from abrasion can cause such lead dysfunctions. Chronically implanted leads will inevitably have an increased risk of failure due to defects despite all technological advances. In the light of improving survival figures in patients with ventricular tachyarrhythmias and increasing numbers of ICD implantations, lead failures are becoming a clinical problem of ever increasing importance. Therefore, the question of which lead types necessitate extraction when a certain failure occurs and which leads can be left in place. Despite continuous improvements in lead extraction systems and growing experience in their use, the extraction of any pacemaker or ICD lead is associated with some risk of complications. (PACE 2003; 26[Pt. I]:649–657)
Mechanism of Decrease in the Atrial Potential After Implantation of a Single‐Lead VDD Pacemaker:
Authors: HIGASHI YUKEI , SATO TOKUTADA , SHIMOJIMA HISA , TAKEYAMA YOUICHI , GOTO KO , MITSUYA TOSHIAKI , SAGAWA FUMIAKI , ISHIKAWA RYOKICHI , ISHIKAWA YUMI
Published: December 2004

HIGASHI, Y., et al.: Mechanism of Decrease in the Atrial Potential After Implantation of a Single‐Lead VDD Pacemaker: Atrial Histological Changes After Implantation of a VDD Pacemaker Lead in Dogs.
The single‐lead VDD pacemaker system (VDDPS) enables atrial synchronous ventricular pacing with only one lead in patients with an atrioventricular block. There are some cases in which the atrial potential decreases after implantation of a VDDPS, making physiological pacing difficult. The mechanism of this decrease has not been elucidated yet. To elucidate the possible relationship between the decrease of the atrial potential after implantation of a VDDPS and histopathological changes of the atrium. We implanted a VDDPS from the jugular vein under anesthesia in 10 adult dogs. The tip of the pacing lead was fixed in the right ventricular apex of the heart under fluoroscopic guidance. Then, the lead was ligated and fixed to the jugular vein at a point where a favorable atrial potential was obtained. The end of the lead was passed from the neck to the back subcutaneously; then pulled outside and fixed there to measure the atrial potential. The atrial potential was measured using a pacing system analyzer under anesthesia on days

3 (n = 9)

and

7 (n = 8)
, as well as on weeks2 (n = 6), 3 (n = 4), and4 (n = 3), after the implantation. The heart was removed from the dogs on day3 (n = 2), day7 (n = 2), week2 (n = 2), and week4 (n = 4)to examine the atrial histological findings. The atrial potential was2.7 ± 0.7 mVat the time of the implantation,1.7 ± 1.1 mV (P < 0.05)on day 3, and1.7 ± 0.7 mVon week 4 after the implantation. Macroscopically, the pacemaker lead was covered with thrombus, and adhered to the atrial wall in 80% of animals. Microscopically, the endocardium was hypertrophic due to fibrous tissue; besides RBC extravasation, inflammatory cells infiltration and degeneration of myocardial cells, were observed under the endocardium. Inflammatory changes developed in the atrial wall after implantation of the VDDPS, and this seemed to be one of the mechanisms for the decrease of the atrial potential of the VDDPS. (PACE 2003; 26:685–691)
Circadian Variations in the Occurrence of Ventricular Tachyarrhythmias in Patients with Implantable Cardioverter Defibrillators
Authors: KOZÁK MILAN , KŘIVAN LUBOMÍR , SEMRÁD BOŘIVOJ
Published: December 2004

KOZÁK, M., et al.: Circadian Variations in the Occurrence of Ventricular Tachyarrhythmias in Patients with Implantable Cardioverter Defibrillators.
A circadian distribution has been demonstrated in episodes of sudden cardiac death, acute myocardial infarction, ventricular premature complexes, heart rate variability, and ventricular tachyarrhythmias. The aim of this study was to evaluate the circadian distribution of ventricular tachyarrhythmia episodes in a population of ICD patients. Data were gathered from 72 patients (55 men, 17 women; mean age

62.7 ± 12.2

years, mean LVEF

0.0037 ± 0.0011

) with ICDs implanted for standard indications. Patients were followed every 3 months over a mean period of

21 ± 12.8

months. At each examination, symptoms at arrhythmia onset and perception of ICD therapy were recorded, and the ICD memory was interrogated. During follow‐up, 1,023 episodes of malignant ventricular arrhythmias were detected and effectively terminated, 506 of which were fully analyzed. A morning peak in ventricular tachyarrhythmias was demonstrated between 7:00 and 11:00 am, and an afternoon peak between 6:00 and 7:00 pm. A significantly lower occurrence of VT was observed at 1:00 am and between 4:00 and 6:00 am. A circadian distribution in the occurrence of ventricular tachycardias was found. The three striking features of the data are: the early morning peak (about three hours after waking up), relatively stable incidence throughout waking hours, and decline in incidence in the previous period. (PACE 2003; 26:731–735)
Nonautomatic Focal Atrial Tachycardia:x
Authors: KAMMERAAD JANNEKE A. E. , BALAJI SESHADRI , OLIVER RONALD P. , CHUGH SUMEET S. , HALPERIN BLAIR D. , KRON JACK , McANULTY JOHN H.
Published: December 2004

KAMMERAAD, J.A.E., et al.: Nonautomatic Focal Atrial Tachycardia: Characterization and Ablation of a Poorly Understood Arrhythmia in 38 Patients.
Nonautomatic focal atrial tachycardia (NAFAT) is a rare and poorly understood arrhythmia either due to microreentry or triggered mechanism. NAFAT was defined as a focal atrial tachycardia which was inducible with pacing maneuvers in the electrophysiology lab. We reviewed the charts and EP study reports of all 38 patients with NAFAT, who underwent an EP study at our center between April 1994 and September 2000. Patients were predominantly female (n = 31, 82%), aged 11–78 years (median 46). The mean age at presentation was 31 years (range 7–71 years). None of the patients had structural heart disease or had undergone prior heart surgery. Electroanatomic mapping (EAM) was performed in 22 patients and showed no scars in the atrium. A total of 45 foci were identified (range 1–3 foci/patient). Anatomically NAFAT foci were predominantly right atrial

(n = 35)

rather than left

(n = 10)
. The NAFAT cycle length ranged from 270 to 490 (mean ± SD; 380 ± 69 ms) and was significantly lower in patients younger than 24 years of age. Ablation, attempted for 42 foci was successful in 33 (79%). The success rate in the EAM group was 20/25 foci (80%) compared to 13/18 (72%) in the non‐EAM group. In conclusion, NAFAT is a rare arrhythmia which predominantly affects women with no other associated cardiac disease. It mainly occurs in the right atrium, affects all ages and is amenable to catheter ablation. (PACE 2003; 26:736–742)
Long RP Tachycardia After Injury of Accessory Atrioventricular Pathway Conduction by Radiofrequency Catheter Ablation
Authors: CHEN HUNG‐YI , TAI CHING‐TAI , CHEN SHIH‐ANN
Published: December 2004

CHEN, H.‐Y., et al.: Long RP Tachycardia After Injury of Accessory Atrioventricular Pathway Conduction by Radiofrequency Catheter Ablation.
(PACE 2003; 26:765–767)
Prevalence of T Wave Alternans in Healthy Subjects
Authors: WEBER STEFAN , TILLMANNS HARALD , WALDECKER BERND
Published: December 2004

WEBER, S.,

et al

.: Prevalence of T Wave Alternans in Healthy Subjects.
Beat‐to‐beat variations in the amplitude of the T wave (T wave alternans [TWA]) have been associated with malignant ventricular arrhythmias in patients with structural heart disease. TWA has also been observed sporadically in healthy persons during strenuous exercise. Therefore, it was the aim of this study to investigate the prevalence of TWA in healthy subjects at rest and during exercise. TWA was assessed in 48 healthy volunteers with a mean age of 30 ± 8 years (21–53 years) using the CH2000 system for measurement of microvolt level TWA. TWA was not observed in any individual at rest. Short transient intervals of TWA were observed during exercise in five (10.4%) subjects. Sustained TWA was observed in two (4.2%) individuals. In one of these two individuals sustained TWA was recorded at heart rates >110 beats/min. In the other TWA was observed at an onset heart rate of <110 beats/min, and therefore, was considered alternans positive. The prevalence of exercise related sustained TWA in healthy, young individuals is low (2.1%). Short transient intervals of TWA were observed in about 10% of healthy volunteers. These transient episodes of TWA had no clinical impact with respect to a higher vulnerability to ventricular arrhythmias. (PACE 2003; 26[Pt. I]:49–52)
Sequential Ablation of Orthodromic Atrioventricular Tachycardia and Ectopic Atrial Tachycardia with a Single Application of Radiofrequency Energy
Authors: KOMIYA NORIHIRO , AMENOMORI KENTARO , NAKAO KOUJIRO , MATSUO KIYOTAKA , HAYANO MOTONOBU , YANO KATSUSUKE
Published: December 2004

KOMIYA, N.,

et al.
: Sequential Ablation of Orthodromic Atrioventricular Tachycardia and Ectopic Atrial Tachycardia with a Single Application of Radiofrequency Energy. A 62‐year‐old woman with Wolff‐Parkinson‐White syndrome had two types of tachycardia; ectopic AT and orthodromic‐type AVRT. A radiofrequency application 2 cm inside the coronary sinus ostium eliminated ectopic AT and accessory pathway conduction at once. (PACE 2003; 26[Pt. I]:108–109)
Congenital laryngotracheo‐oesophageal cleft: successful ventilation with the Laryngeal Mask AirwayTM
Authors: Jöhr Martin , Berger Thomas M. , Ruppen Wilhelm , Schlegel Christoph
Published: December 2004

A congenital laryngotracheo‐oesophageal cleft is a rare airway malformation which results from incomplete separation of the larynx and trachea from the hypopharynx and oesophagus. Patients usually present with stridor, aspiration and cyanosis associated with feeding. For early diagnosis, a high index of suspicion is needed. Unless an appropriate diagnostic approach is taken, the diagnosis can be missed. The successful ventilation of a neonate with the Laryngeal Mask AirwayTM is described.
The prolonged use of the laryngeal mask airway in a neonate with airway obstruction and Treacher Collins syndrome
Authors: Bucx Martin J.L. , Grolman W. , Kruisinga Frea H. , Lindeboom Jerôme A.H. , Van Kempen Anne A.M.W
Published: December 2004

Upper airway obstruction and difficult tracheal intubation are often encountered in patients with Treacher Collins syndrome (mandibulofacial dysostosis). In this case report, the use of a laryngeal mask airway (LMATM) in a 10‐day‐old newborn with severe Treacher Collins syndrome and acute airway obstruction is described. It successfully relieved the airway obstruction and was left in situ for an exceptionally long period of 4 days. The difficult decisions with respect to the management of the airway and specifically the role of the laryngeal mask are described. In our opinion, in some newborns with severe mandibulofacial disorders and upper airway obstruction, where conservative airway management procedures have failed, the laryngeal mask can be considered not only to relieve the obstruction but also to buy time until there is full insight into the medical condition and its consequences.
Intraoperative ketorolac is an effective substitute for fentanyl in children undergoing outpatient adenotonsillectomy
Authors: Keidan Ilan , Zaslansky Ruth , Eviatar Ephraim , Segal Samuel , Sarfaty Shlomo M.
Published: December 2004

Background : In this prospective randomized double‐blind study, we compared the incidence of emesis and 48‐h recovery profiles after a single dose of ketorolac vs fentanyl in dexamethasone‐pretreated children undergoing ambulatory adenoidectomy and laser‐assisted tonsillectomy (ADLAT). We evaluated the hypothesis that avoiding the use of opioids and replacing them with an equianalgesic dose of ketorolac, a nonsteroidal anti‐inflammatory drug, would reduce the incidence of postoperative nausea and vomiting (PONV).

Methods : Fifty‐seven ASA I and II children aged 1.710 years who underwent ADLAT were randomized to receive either intravenous ketorolac (1 mg·kg−1) or fentanyl (2 μg·kg−1) for pain control during a standardized general anaesthetic with propofol infusion. The early (postanaesthesia care unit, day surgical area) and late postoperative courses were compared between the groups.

Results : The incidence of PONV was low and equal in both groups. Postoperative pain scores were equal at all stages of followup. Agitation scores in the postanaesthesia care unit were significantly higher in the ketorolac group, but this had no effect on the late variables of behaviour studied.

Conclusions : Ketorolac showed no advantage over fentanyl in reducing the incidence of PONV in children undergoing ADLAT.
Atrial Tachycardia Successfully Treated by Electrical Isolation of the Superior Vena Cava
Authors: GERSTENFELD EDWARD P. , REN JIAN‐FANG , MARCHLINSKI FRANCIS E.
Published: December 2004

GERSTENFELD, E.P., et al.: Atrial Tachycardia Successfully Treated by Electrical Isolation of the Superior Vena Cava.
This case report describes a patient with an atrial tachycardia that was difficult to induce and that originated from the superior vena cava. Although the patient had frequent episodes of tachycardia, the tachycardia induced in the electrophysiological laboratory was nonsustained and could not be adequately localized for focal ablation. A circumferential mapping catheter was used to guide electrical isolation of the superior vena cava from the right atrium, curing the tachycardia. Electroanatomic mapping and intracardiac echocardiography were used to monitor the ablation and document patency of the superior vena cava throughout the ablation. (PACE 2003; 26[Pt. I]:906–910)
Recurrent Syncope in a Patient After Myocardial Infarction
Authors: CREDNER SUSANNE C. , LEHMANN RALF , GRUBB BLAIR P. , HOHNLOSER STEFAN H. , KLINGENHEBEN THOMAS
Published: December 2004

CREDNER, S.C., et al.: Recurrent Syncope in a Patient After Myocardial Infarction.
A patient with ischemic cardiomyopathy presented with burning pain of his body surface with consecutive orthostatic intolerance and recurrent syncopes. A diagnosis of acute autonomic dysfunction was made and the patient was treated with midodrine, resulting in restoration of orthostatic tolerance after 6 weeks of therapy. (PACE 2003; 26[Pt. I]:920–921)
Rapid Atrial Pacing Does Not Decrease the Atrial Defibrillation Threshold
Authors: FRYKMAN VIVEKA , DARPÖ BÖRJE , AYERS GREGORY M. , BERGFELDT LENNART , LINDE CECILIA , ROSENQVIST MÅRTEN
Published: December 2004

The aim of the study was to evaluate the effect of preshock atrial pacing on the atrial defibrillation threshold (DFT) during internal cardioversion of AF. The implantable atrial defibrillator has been added to the therapeutic options for patients with recurrent episodes of persistent AF. Although the device is efficient in restoring sinus rhythm, patient discomfort is a limitation. Methods that lower the ADFT are needed. Eleven patients with AF underwent internal cardioversion. In a randomized, crossover design, ADFT testing was performed, applying a step‐up protocol starting at 100 V. Rapid atrial pacing was performed with a right atrial catheter for 20 seconds at 90% of the average cycle length of the fibrillatory waves and was immediately followed by a biphasic defibrillation shock. At each energy level, pacing + shock was compared to shock only, until the level at which sinus rhythm was restored by both modes. The step‐up protocol was thereafter repeated using the inverse sequence of the two modes. A total of 19 ADFTs were obtained. For 10 the ADFT was lower with pacing + shock, in 4 equal and in 5 higher, than with shock only. The ADFT (mean ± SD) with pacing + shock was

260 ± 84

V

(3.4 ± 2.9 J)

and did not differ from shock only:

268 ± 85

V

(3.8 ± 3.0 J) (P > 0.05)
. The coefficient of variation and the coefficient of reproducibility for pacing + shock was 16% and 60 V, respectively, and for shock only 17% and 61 V. Rapid atrial pacing did not influence the internal ADFT in AF. The randomized, crossover protocol used was reproducible between different modes, and seems useful when testing the impact of different interventions on the ADFT. (PACE 2003; 26[Pt. I]:1461–1466)