bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of severe epilepsy on development: Recovery potential after successful early epilepsy surgery
Authors: Roulet‐Perez Eliane , Davidoff Véronique , Mayor‐Dubois Claire , Maeder‐Ingvar Malin , Seeck Margitta , Ruffieux Christiane , Villemure Jean‐Guy , Deonna Thierry 
Published: February 2010

SummaryPurpose:  Epilepsy surgery in young children with focal lesions offers a unique opportunity to study the impact of severe seizures on cognitive development during a period of maximal brain plasticity, if immediate control can be obtained. We studied 11 children with early refractory epilepsy (median onset, 7.5 months) due to focal lesion who were rendered seizure‐free after surgery performed before the age of 6 years.Methods:  The children were followed prospectively for a median of 5 years with serial neuropsychological assessments correlated with electroencephalography (EEG) and surgery‐related variables.Results:  Short‐term follow‐up revealed rapid cognitive gains corresponding to cessation of intense and propagated epileptic activity [two with early catastrophic epilepsy; two with regression and continuous spike‐waves during sleep (CSWS) or frontal seizures]; unchanged or slowed velocity of progress in six children (five with complex partial seizures and frontal or temporal cortical malformations). Longer‐term follow‐up showed stabilization of cognitive levels in the impaired range in most children and slow progress up to borderline level in two with initial gains.Discussion:  Cessation of epileptic activity after early surgery can be followed by substantial cognitive gains, but not in all children. In the short term, lack of catch‐up may be explained by loss of retained function in the removed epileptogenic area; in the longer term, by decreased intellectual potential of genetic origin, irreversible epileptic damage to neural networks supporting cognitive functions, or reorganization plasticity after early focal lesions. Cognitive recovery has to be considered as a “bonus,” which can be predicted in some specific circumstances.
Long‐term outcomes of children treated with the ketogenic diet in the past
Authors: Patel Amisha , Pyzik Paula L. , Turner Zahava , Rubenstein James E. , Kossoff Eric H. 
Published: February 2010

SummaryPurpose:  The ketogenic diet has well‐established short‐ and long‐term outcomes for children with intractable epilepsy, but only for those actively receiving it. However, no information exists about its long‐term effects years after it has been discontinued.Methods:  Living subjects were identified who were treated at the Johns Hopkins Hospital with the ketogenic diet from November 1993 to December 2008 for ≥1 month, and had discontinued it ≥6 months prior to this study. Of 530 patients who were eligible, 254 were successfully contacted by phone or e‐mail with a survey and request for laboratory studies.Results:  Questionnaires were completed by 101 patients, with a median current age of 13 years (range 2–26 years). Median time since discontinuing the ketogenic diet was 6 years (range 0.8–14 years). Few (8%) still preferred to eat high fat foods. In comparison to the 52% responder rate (>50% seizure reduction) at ketogenic diet discontinuation, 79% were now similarly improved (p = 0.0001). Ninety‐six percent would recommend the ketogenic diet to others, yet only 54% would have started it before trying anticonvulsants. Lipids were normal (mean total cholesterol 158 mg/dl), despite most being abnormal while on the ketogenic diet. The mean Z scores for those younger than age 18 years were −1.28 for height and −0.79 for weight. In those 18 years of age or older, the mean body mass index (BMI) was 22.2.Discussion:  This is the first study to report on the long‐term effects of the ketogenic diet after discontinuation. The majority of subjects are currently doing well with regard to health and seizure control.
Optimal Timing of Implantable Cardioverter‐Defibrillator Implantation After Myocardial Infarction: A Decision Analysis
Authors: PICCINI JONATHAN P. , AL‐KHATIB SANA M. , MYERS EVAN R. , ANSTROM KEVIN J. , BUXTON ALFRED E. , PETERSON ERIC D. , SANDERS GILLIAN D. 
Published: February 2010

ICD Implant Timing. Background: The optimal timing of implantable cardioverter defibrillator (ICD) placement for the primary prevention of sudden cardiac death after myocardial infarction (MI) remains unknown.
Methods and Results:
We developed a Markov model to investigate the optimal timing of ICD implantation after MI (no ICD, ICD at 60 days, 6 months, and 1 year) in patients who meet current guidelines. Estimates of arrhythmic death (baseline risk 6%, range 1–20% per year), nonarrhythmic death, and ICD efficacy were based upon MADIT‐II and other contemporary post‐MI clinical trials. We used both deterministic and stochastic modeling processes in our analysis. After 10 years follow‐up, the baseline probability of survival was higher in those treated with ICD implantation versus not (42% vs 30%, P < 0.001). Survival was highest with ICD implantation at 60 days versus 6 months versus 1 year: 42.4%, 42.3%, and 42.0% (P = 0.0028). ICD implantation at 60 days provided a mean incremental survival of 0.28 months and 0.84 months per patient (compared with implantation at 6 months and 1 year). In sensitivity analyses, patients’ competing risk for nonarrhythmic death was the primary determinant of benefit from ICD implantation. Overall, ICD implantation at 60 days resulted in the greatest life expectancy over a wide range of plausible nonarrhythmic and arrhythmic death rates.
Conclusions:
The benefits of early ICD implantation are modest when compared with delayed implantation at 6 months/1 year. Our results suggest that making sure a patient receives an ICD, when appropriate, may be more important than the timing of the implantation procedure. (J Cardiovasc Electrophysiol, Vol. pp. 791‐798, July 2010)
Mapping of Atrial Tachycardia by Remote Magnetic Navigation in Postoperative Patients With Congenital Heart Disease
Authors: WU JINJIN , PFLAUMER ANDREAS , DEISENHOFER ISABEL , HOPPMANN PETRA , HESS JOHN , HESSLING GABRIELE 
Published: February 2010

Remote Magnetic Mapping in Congenital Heart Disease. Objectives: The purpose of this study was to investigate if remote magnetic navigation (RMN) offers a reduction of fluoroscopy time when used for atrial tachycardia (AT) mapping in a spectrum of patients with congenital heart disease (CHD) after “simple” or “complex” atrial surgery.
Background:
Data about AT mapping using RMN in larger populations of patients with CHD are scarce.
Methods:
RMN in combination with electroanatomic mapping was used for AT mapping in 22 patients. According to anatomic complexity, patients were classified into 3 groups: Group 1: patients after minor atrial surgery (n = 7); Group 2: patients after the Fontan operation (n = 9); and group 3: patients after the Senning/Mustard operation (n = 6).
Results:
Atrial mapping with a nonirrigated tip RMN catheter was completed successfully in all patients. In Group 1 no significant reduction in fluoroscopy time was noticed over time (mean fluoroscopy time 7.9 minutes). In the 15 patients of group 2 and group 3 with complex CHD, the fluoroscopy time for mapping in the last 9 patients (6.4 ± 2.8 minutes) was significantly shorter than in the first 6 patients (29.7 ± 10.5 minutes, P < 0.0001). Acutely successful ablation was achieved in 21 of 22 patients (97%) using the RMN catheter (n = 3) or a conventional catheter (n = 18) without procedural complications.
Conclusions:
RMN for AT mapping in patients with complex atrial anatomy leads to a significant reduction of fluoroscopy time. (J Cardiovasc Electrophysiol, Vol. pp. 751‐759, July 2010)
The Permanency of Pulmonary Vein Isolation Using a Balloon Cryoablation Catheter
Authors: AHMED HUMERA , NEUZIL PETR , SKODA JAN , D’AVILA ANDRE , DONALDSON DAVID M. , LARAGY MARGARET C. , REDDY VIVEK Y. 
Published: February 2010

Chronic PV Isolation With the Cryoballoon. Background: Because of its technical feasibility and presumed safety benefits, balloon cryoablation is being increasingly employed for pulmonary vein (PV) isolation. While acute isolation has been demonstrated in most patients, little data are available on the chronic durability of cryoballoon lesions.
Methods and Results:
Twelve atrial fibrillation patients underwent PV isolation using either a 23‐mm or 28‐mm cryoballoon. For each vein, after electrical isolation was verified with the use of a circular mapping cathether, 2 bonus balloon ablation lesions were placed. Gaps in balloon occlusion were overcome using either a spot cryocatheter or a “pull‐down” technique. A prespecified second procedure was performed at 8–12 weeks to assess for long‐term PV isolation. Acute PV isolation was achieved in all PVs in the patient cohort (n = 48 PVs), using the cryoballoon alone in 47/48 PVs (98%); a “pull‐down” technique was employed for 5 PVs (1 right superior pulmonary vein, 2 right inferior pulmonary veins, and 2 left inferior pulmonary veins). The gap in the remaining vein was ablated with a spot cryocatheter. During the second mapping procedure, 42 of 48 PVs (88%) remained isolated. One vein had reconnected in 2 patients, while 2 veins had reconnected in another 2 patients. All PVs initially isolated with the “pull‐down” technique remained isolated at the second procedure.
Conclusions:
Cryoballoon ablation allows for durable PV isolation with the use of a single balloon. With maintained chronic isolation in most PVs, it may represent a significant step toward consistent and lasting ablation procedures. (J Cardiovasc Electrophysiol, Vol. pp. 731‐737, July 2010)
Role of the Transient Outward Current in Regulating Mechanical Properties of Canine Ventricular Myocytes
Authors: DONG MIN , YAN SUJUAN , CHEN YAMEI , NIKLEWSKI PAUL J. , SUN XIAOYIN , CHENAULT KATHRYN , WANG HONG‐SHENG 
Published: February 2010

Ito and Myocyte Contractility.

Introduction:
The transient outward current (Ito) is a major repolarizing current in the heart. Reduction of Ito density is consistently observed in human heart failure (HF) and animal HF models. It has been proposed that Ito, via its influence on phase‐1 repolarization of the action potential, facilitates L‐type Ca2+ current (ICa–L) activation and sarcoplasmic reticulum Ca2+ release, and that its down‐regulation may contribute to the impaired contractility in failing heart.
Methods and Results:
We used the dynamic clamp to quantitatively examine the influence of Ito on the mechanical properties of canine left ventricular myocytes at 34°C. In endocardial myocytes, where the native Ito is small, simulation of an epicardial‐level artificial Ito accentuated the phase‐1 repolarization and significantly suppressed cell shortening. The peak amplitude of Ca2+ transient was also reduced in the presence of simulated Ito, although the rate of rise of the Ca2+ transient was increased. Conversely, subtraction, or “blockade” of the native Ito enhanced contractility in epicardial cells. These results agree with the inverse correlation between Ito levels and myocyte contractility and Ca2+ transient amplitude in epicardial and endocardial myocytes. Action potential clamp studies showed that the phase‐1 repolarization/Ito versus ICa–L relationship had an inverted‐J shape; small Ito enhanced peak ICa–L while moderate‐to‐large Ito decreased peak ICa–L and markedly reduced early Ca2+ influx.
Conclusion:
Our results show that epicardial‐level of Ito acts as a negative, rather than positive regulator of myocyte mechanical properties in canine ventricular myocytes. (J Cardiovasc Electrophysiol, Vol. 21, pp. 697‐703, June 2010)
Higher Rate of Recurrent Atrial Flutter and Atrial Fibrillation Following Atrial Flutter Ablation After Cardiac Surgery
Authors: AKTAS MEHMET K. , KHAN MOHAMMED N. , DI BIASE LUIGI , ELAYI CLAUDE , MARTIN DAVID , SALIBA WALID , CUMMINGS JENNIFER , SCHWEIKERT ROBERT , NATALE ANDREA 
Published: February 2010

Atrial Flutter After Cardiac Surgery. Introduction: Atrial flutter (AFL) is common after cardiac surgery. However, the types of post‐cardiac surgery AFL, its response to catheter‐based radiofrequency ablation, and its relationship to atrial fibrillation (AF) are unknown. Methods and Results: We retrospectively studied all patients who underwent mapping and ablation for AFL after cardiac surgery from January 1990 to July 2004. One hundred randomly selected patients without prior cardiac surgery (PCS) who underwent mapping and ablation of AFL served as the control population. A total of 236 patients formed the study population (mean age 62 + 13 years, 22% female) and 100 patients formed the control population (mean age 60 + 13 years, 25% female). The majority of patients without PCS had cavo‐tricuspid isthmus (CTI)‐dependent AFL when compared to patients with PCS (93% vs 72%, respectively, P < 0.0001). In contrast, scar‐related AFL was more common in patients with PCS as compared to patients without PCS (22% vs 3%, P < 0.0001). Predictors of scar related AFL in multivariable regression analysis included PCS and left‐sided AFL. Acute success rates and complications were similar between the groups. When compared to patients with AFL ablation without PCS, those that had AFL after PCS had higher rates of recurrence of both AFL (1% vs 12%, P < 0.0001; mean time to recurrence 1.85 years) and AF (16% vs 28%, P = 0.02; mean time to recurrence 2.67 years). Conclusion: Despite ablation of AFL, patients with PCS have a higher rate of AFL and AF when compared to patients without PCS who underwent ablation of atrial flutter during long‐term follow‐up. (J Cardiovasc Electrophysiol, Vol. pp. 760‐765, July 2010)
Impact of Pharmacological Autonomic Blockade on Complex Fractionated Atrial Electrograms
Authors: KNECHT SÉBASTIEN , WRIGHT MATTHEW , MATSUO SEIICHIRO , NAULT ISABELLE , LELLOUCHE NICOLAS , SACHER FRÉDÉRIC , KIM STEVEN J. , MORGAN DENNIS , AFONSO VALTINO , SHINZUKE MIYAZAKI , HOCINI MÉLÈZE , CLÉMENTY JACQUES , NARAYAN SANJIV M. , RITTER PHILLIPE , JAÏS PIERRE , HAÏSSAGUERRE MICHEL 
Published: February 2010

Autonomic Blockade During Atrial Fibrillation. Introduction: The influence of the autonomic nervous system on the pathogenesis of complex fractionated atrial electrograms (CFAE) during atrial fibrillation (AF) is incompletely understood. This study evaluated the impact of pharmacological autonomic blockade on CFAE characteristics.
Methods and Results:
Autonomic blockade was achieved with propanolol and atropine in 29 patients during AF. Three‐dimensional maps of the fractionation degree were made before and after autonomic blockade using the Ensite Navx® system. In 2 patients, AF terminated following autonomic blockade. In the remaining 27 patients, 20,113 electrogram samples of 5 seconds duration were collected randomly throughout the left atrium (10,054 at baseline and 10,059 after autonomic blockade). The impact of autonomic blockade on fractionation was assessed by blinded investigators and related to the type of AF and AF cycle length. Globally, CFAE as a proportion of all atrial electrogram samples were reduced after autonomic blockade: 61.6 ± 20.3% versus 57.9 ± 23.7%, P = 0.027. This was true/significant for paroxysmal AF (47 ± 23% vs 40 ± 22%, P = 0.003), but not for persistent AF (65 ± 22% vs 62 ± 25%, respectively, P = 0.166). Left atrial AF cycle length prolonged with autonomic blockade from 170 ± 33 ms to 180 ± 40 ms (P = 0.001). Fractionation decreases only in the 14 of 27 patients with a significant (>6 ms) prolongation of the AF cycle length (64 ± 20% vs 59 ± 24%, P = 0.027), whereas fractionation did not reduce when autonomic blockade did not affect the AF cycle length (58 ± 21% vs 56 ± 25%, P = 0.419).
Conclusions:
Pharmacological autonomic blockade reduces CFAE in paroxysmal AF, but not persistent AF. This effect appears to be mediated by prolongation of the AF cycle length. (J Cardiovasc Electrophysiol, Vol. pp. 766‐772, July 2010)
Reduction of Ventricular Sodium Current in a Mouse Model of HIV
Authors: GRANDY SCOTT A. , BROUILLETTE JUDITH , FISET CÉLINE 
Published: February 2010

Effect of HIV on Cardiac Sodium Current. Introduction: Cardiac arrhythmias have been reported in AIDS patients. Arrhythmias can arise from alterations in ventricular Na+ channel function. However, it is unknown whether HIV affects cardiac Na+ channel function. Therefore, the purpose of this study was to characterize the effect of HIV on ventricular Na+ current (INa) in a transgenic model of HIV (CD4C/HIV mice), which exhibit a severe AIDS‐like disease.
Methods and Results:
Patch‐clamp techniques were used to examine INa and action potentials (AP) in ventricular myocytes isolated from HIV and wild‐type (WT) mice. In HIV myocytes peak INa was reduced (at −50 mV: HIV, −55.3 ± 4.3 pA/pF, n = 15; WT, −79.4 ± 5.2 pA/pF, n = 16, P < 0.05), whereas late INa was similar in both groups (HIV, −4.3 ± 0.4 pA/pF; WT, −4.4 ± 0.4 pA/pF, n = 22/group). AP amplitude (HIV 91.5 ± 4.7 mV, n = 12; WT 104.4 ± 3.1 mV, n = 15, P < 0.05) and the maximal velocity of the AP upstroke (Vmax; HIV, 57.2 ± 9.3 mV/ms, n = 12; WT, 113.5 ± 8 mV/ms, n = 15, P < 0.05) were decreased in HIV myocytes. ECG recordings revealed that the QRS complex was prolonged in HIV mice (HIV, 15.7 ± 0.2 ms, n = 22; WT, 14.1 ± 0.5 ms, n = 10, P < 0.05). The serum levels of interleukin‐1β were elevated in HIV mice (HIV, 18.1 ± 3.1 pg/mL, n = 3; WT, 5.1 ± 1.1 pg/mL, n = 4, P < 0.05) in line with previous evidence that suggests that elevated levels of cytokines can affect cardiac ion currents.
Conclusion:
Overall, our observations suggest that elevated levels of proinflammatory cytokines in CD4C/HIV mice could alter Na+ channel function, thus altering cardiac depolarization and contribute to the generation of arrhythmias. (J Cardiovasc Electrophysiol, Vol. 21, pp. 916‐922, August 2010)
Enhancer of zeste homolog 2 expression is associated with tumor cell proliferation and metastasis in gastric cancer
Authors: CHOI JUNG HYE , SONG YOUNG SOO , YOON JIN SUN , SONG KANG WON , LEE YOUNG YIUL 
Published: February 2010

Choi JH, Song YS, Yoon JS, Song KW, Lee YY. Enhancer of zeste homolog 2 expression is associated with tumor cell proliferation and metastasis in gastric cancer. APMIS 2010; 118: 196–202.The enhancer of zeste homolog 2 (EZH2), a member of the polycomb group of proteins, plays an important role in cell proliferation and cell cycle regulation. EZH2 is overexpressed in aggressive forms of prostate, breast, bladder, and endometrial cancers. However, the role of EZH2 expression in gastric cancer has not been fully determined. This study was conducted to investigate the correlation between EZH2 and cell cycle‐related molecules, and the clinical value of EZH2 expression in gastric cancer. We analyzed EZH2 expression using Western blotting in AGS, MKN‐28, SNU‐16, SNU‐484, SNU‐601, and SNU‐638 gastric cancer cell lines. After transfection of EZH2 siRNA into MKN‐28 cells, the change in cell cycle‐related molecules was assessed by Western blot analysis. Expression of EZH2, Ki‐67, and p53 was determined by immunohistochemical staining of tissue microarrays from specimens of 137 cases of resected gastric cancer. We found high expressions of EZH2 in all of the tested gastric cancer cell lines. RNA interference of EZH2 induced upregulation of p53 and HDAC1 and downregulation of cyclin D1 and cyclin E. High EZH2 expression was observed in 60.6% of gastric cancers and in 6.7% of non‐neoplastic gastric tissues (p < 0.01); 40.1% were positive for p53 in gastric cancers. High EZH2 expression was correlated with Ki‐67 and p53 expressions and was significantly associated with distant metastases and non‐signet ring cells. Our results suggest that high EZH2 expression is associated with tumor cell proliferation and metastasis in gastric cancer.
Diversity of Veillonella spp. from subgingival plaque by polyphasic approach
Authors: LEUCKFELD INGA , PASTER BRUCE J. , KRISTOFFERSEN ANNE K. , OLSEN INGAR 
Published: February 2010

Leuckfeld I, Paster BJ, Kristoffersen AK, Olsen I. Diversity of Veillonella spp. from subgingival plaque by polyphasic approach. APMIS 2010; 118: 230–42.In a biofilm such as the subgingival microflora, strain‐specific properties or factors induced by the host may impart a survival advantage to some bacterial strains. Periodontal disease has been associated with chronic obstructive pulmonary disease (COPD) and we previously found high amounts of Veillonella in the subgingival microflora of COPD subjects. Differentiation of Veillonella is difficult. The aims of this study were to identify subgingival Veillonella isolates by phenotypic, genetic typing and molecular genetic methods, and further, to assess if Veillonella strain properties or identity correlated with periodontal disease or COPD. From 22 subjects, 26 subgingival Veillonella isolates and one pulmonary isolate were analysed. The majority of the subgingival Veillonella isolates were identified as Veillonella parvula. Genotyping showed heterogeneity within strains of the same species. A subgingival and pulmonary isolate in one COPD subject was found to be genetically identical strains of V. parvula. Scanning electron microscopy of the lung biopsy confirmed single small cocci adhering or coaggregating with larger cocci on the airway epithelium. Apart from a variation in cellular fatty acid composition of six subgingival isolates from periodontitis subjects, no correlation between the subgingival Veillonella strains or genotypes and the presence of either periodontitis or COPD was found. In conclusion, V. parvula was the predominant subgingival Veillonella species with high genetic variability within strains of the same species. Subgingival V. parvula can translocate to the lungs; however, Veillonella identity or genotype did not correlate with periodontal disease or COPD.
‘Epidermotropism’ vs. ‘exocytosis’ of lymphocytes 101: definition of terms
Authors: Fung Maxwell A. 
Published: February 2010

The terms ‘epidermotropism’ and ‘exocytosis’ are commonly used to describe intraepithelial lymphocytes in the mycosis fungoides (MF) variant of cutaneous T cell lymphoma (CTCL). However, both terms have not been uniformly or consistently defined. In this study, definitions of both terms were requested from 34 experts. In definitions provided by 19 responders, ‘epidermotropism’ correlated with MF/CTCL, and ‘exocytosis’ correlated with benign conditions. Use of these terms often reflected the observer's interpretation, as they were not always used in purely descriptive fashion.Fung MA. ‘Epidermotropism’ vs. ‘exocytosis’ of lymphocytes 101: definition of terms.
Cognitive outcome at 2 years of age in Finnish infants with very low birth weight born between 2001 and 2006
Authors: Munck P , Haataja L , Maunu J , Parkkola R , Rikalainen H , Lapinleimu H , Lehtonen L ,   the PIPARI Study Group
Published: February 2010

AbstractAim:  To study cognitive outcome of premature, very low birth weight (VLBW) infants in relation to parental education and neonatal data.Methods:  A regional cohort of 182 VLBW infants born between 2001 and 2006 was followed up. Brain ultrasounds (US) were examined serially until term age and brain magnetic resonance imaging at term age. Neurological status was examined systematically. Cognitive development was assessed using the Mental Developmental Index (MDI) of Bayley Scales at 2 years of corrected age. A total of 192 healthy full‐term (FT) controls were assessed with the MDI at 2 years of age.Results:  The mean MDI in VLBW infants was 101.7 (SD 15.4), which was lower compared with FT controls (109.8, SD 11.7, p < 0.001). In regression analysis of the demographic and medical data of VLBW infants, postnatal corticosteroids (p = 0.04), intestinal perforation (p = 0.03) and major brain pathology (p = 0.02) were negatively associated with the MDI. In VLBW infants, the prevalence of neurodevelopmental impairment was 9.9% (3.3% MDI below 70, 7.1% cerebral palsy, 2.2% hearing aid, no blind infants).Conclusion:  Cognitive development of VLBW infants seemed to have improved in comparison with earlier publications, but it differed from the FT controls. Neonatal factors affected cognitive development. Therefore, updated regional follow‐up data are important for clinicians.