bluuebunny/crossref_metadata_2025_split huggingface dataset:
Measuring the Complexity of Atrial Fibrillation Electrograms
Authors: NG JASON , BORODYANSKIY ALEKSEY I. , CHANG ERIC T. , VILLUENDAS ROGER , DIBS SAMER , KADISH ALAN H. , GOLDBERGER JEFFREY J. 
Published: February 2010

AF Electrogram Complexity.  Introduction: Complex fractionated atrial electrograms (CFAE) have been identified as targets for atrial fibrillation (AF) ablation. Robust automatic algorithms to objectively classify these signals would be useful. The aim of this study was to evaluate Shannon's entropy (ShEn) and the Kolmogorov‐Smirnov (K‐S) test as a measure of signal complexity and to compare these measures with fractional intervals (FI) in distinguishing CFAE from non‐CFAE signals. Methods and Results: Electrogram recordings of 5 seconds obtained from multiple atrial sites in 13 patients (11 M, 58 ± 10 years old) undergoing AF ablation were visually examined by 4 independent reviewers. Electrograms were classified as CFAE if they met Nademanee criteria. Agreement of 3 or more reviewers was considered consensus and the resulting classification was used as the gold standard. A total of 297 recordings were examined. Of these, 107 were consensus CFAE, 111 were non‐CFAE, and 79 were equivocal or noninterpretable. FIs less than 120 ms identified CFAEs with sensitivity of 87% and specificity of 79%. ShEn, with optimal parameters using receiver‐operator characteristic curves, resulted in a sensitivity of 87% and specificity of 81% in identifying CFAE. The K‐S test resulted in an optimal sensitivity of 100% and specificity of 95% in classifying uninterpretable electrogram from all other electrograms. Conclusions: ShEn showed comparable results to FI in distinguishing CFAE from non‐CFAE without requiring user input for threshold levels. Thus, measuring electrogram complexity using ShEn may have utility in objectively and automatically identifying CFAE sites for AF ablation. (J Cardiovasc Electrophysiol, Vol. 21, pp. 649‐655, June 2010)
Disorders of the Autonomic Nervous System in Patients With Brugada Syndrome: A Pilot Study
Authors: KOSTOPOULOU ANNA , KOUTELOU MARIA , THEODORAKIS GEORGIOS , THEODORAKOS ATHANASIOS , LIVANIS EFTHIMIOS , MAOUNIS THEMISTOKLIS , CHAIDAROGLOU ANTIGONI , DEGIANNIS DIMITRIOS , VOUDRIS VASSILIS , KREMASTINOS DIMITRIOS , COKKINOS DENNIS 
Published: February 2010

Autonomic Disorders in Brugada Syndrome. Introduction: The aim of this study was to examine autonomic disorders in patients with Brugada syndrome by performing a cardiac sympathetic innervation evaluation, a head‐up tilt‐test (HUT) and heart rate variability (HRV) analysis.
Methods and Results:
We enrolled 20 patients with Brugada syndrome (mean age 42.5 ± 8.8 years), 9 with spontaneous and 11 with an induced type 1 electrocardiogram (ECG) in the setting of symptoms and 20 age‐matched controls. All subjects underwent a HUT with parallel measurements of plasma catecholamines and cortisol, a 123I‐metaiodobenzylguanidine single photon emission tomography, and HRV evaluation. Ten control subjects participated in the innervation portion of the study. The tilt‐test with clomipramine challenge was positive in 15 of 20 (75%) patients (7 spontaneous, 8 induced) and in 1 in controls (P < 0.01). A sympathoadrenal imbalance was shown in positive tests. The pattern of innervation in all groups was heterogenic and similar to controls with a trend towards lower measurements in patients with a spontaneous type 1 ECG and a positive HUT. HRV analysis did not reveal any significant differences during day and night. Four patients (20%) had sustained ventricular arrhythmias during a follow‐up of 31.1 ± 8.6 months, but no correlations with innervation or response to tilting were found.
Conclusion:
A high susceptibility to vasovagal syncope was observed in patients with Brugada syndrome, which could be disease‐related symptoms. Conversely, sympathetic innervation was observed to follow a physiological, heterogenic pattern; however, these factors did not have prognostic value for life‐threatening arrhythmias. (J Cardiovasc Electrophysiol, Vol. pp. 773‐780, July 2010)
Influence of Clinical and Procedural Predictors on Ventricular Tachycardia Ablation Outcomes: An Analysis From the Substrate Mapping and Ablation in Sinus Rhythm to Halt Ventricular Tachycardia Trial (SMASH‐VT)
Authors: TUNG RODERICK , JOSEPHSON MARK E. , REDDY VIVEK , REYNOLDS MATTHEW R. ,   on behalf of the SMASH‐VT Investigators
Published: February 2010

Procedural Predictors in SMASH‐VT. Background: The Substrate Mapping and Ablation in Sinus Rhythm to Halt Ventricular Tachycardia (SMASH‐VT) trial is the largest randomized trial in substrate‐based ablation. We performed a retrospective analysis of patients randomized to prophylactic ablation of ventricular tachycardia to determine the predictive value of clinical and procedural variables on outcomes.
Methods:
In patients treated with catheter ablation, we examined predictors of ICD‐therapy free survival using Cox proportional hazards models. Procedural variables tested included the scar location, number of VT morphologies (VTs) induced, tachycardia cycle length, catheter irrigation, catheter approach, procedural duration, and VT inducibility after ablation. Clinical variables including age, index arrhythmia, NYHA class, ejection fraction, prior revascularization, and baseline medication use were also analyzed.
Results:
Among 64 patients randomized to ablation, 61 received the assigned therapy and complete procedural data were available for 54 patients. Thirteen percent (7 of 54) experienced ICD therapies during 2‐year follow‐up. Patients with subsequent ICD therapies had significantly more VTs induced during the ablation procedure than those without (3.9 ± 2.1 vs 1.9 ± 1.8, P = 0.05). The hazard ratio for each additional VT induced was 1.51 (95% CI 1.07–2.13, P = 0.02). Two‐year Kaplan–Meier event‐free survival rates were 96% for 0–1 VTs induced, and 78% for two or more. The use of irrigated catheters was not predictive of ablation success.
Conclusion:
In this small retrospective analysis, the number of VTs induced during the procedure was predictive of 2‐year outcomes. This likely reflects a more complex arrhythmia substrate in patients who fail ablation. (J Cardiovasc Electrophysiol, Vol. pp. 799‐803, July 2010)
The Surface Electrocardiogram Predicts Risk of Heart Block During Right Heart Catheterization in Patients With Preexisting Left Bundle Branch Block: Implications for the Definition of Complete Left Bundle Branch Block
Authors: PADANILAM BENZY J. , MORRIS KENT E. , OLSON JEFF A. , RIPPY JANET S. , WALSH MARY NORINE , SUBRAMANIAN NATRAJAN , VIDAL ALEX , PRYSTOWSKY ERIC N. , STEINBERG LEONARD A. 
Published: February 2010

LBBB and Heart Block. Background: Patients with left bundle branch block (LBBB) undergoing right heart catheterization can develop complete heart block (CHB) or right bundle branch block (RBBB) in response to right bundle branch (RBB) trauma. We hypothesized that LBBB patients with an initial r wave (≥1 mm) in lead V1 have intact left to right ventricular septal (VS) activation suggesting persistent conduction over the left bundle branch. Trauma to the RBB should result in RBBB pattern rather than CHB in such patients.
Methods:
Between January 2002 and February 2007, we prospectively evaluated 27 consecutive patients with LBBB developing either CHB or RBBB during right heart catheterization. The prevalence of an r wave ≥1 mm in lead V1 was determined using 118 serial LBBB electrocardiographs (ECGs) from our hospital database.
Results:
Catheter trauma to the RBB resulted in CHB in 18 patients and RBBB in 9 patients. All 6 patients with ≥1 mm r wave in V1 developed RBBB. Among these 6 patients q wave in lead I, V5, or V6 were present in 3. Four patients (3 in CHB group and 1 in RBBB group) developed spontaneous CHB during a median follow‐up of 61 months. V1 q wave ≥1 mm was present in 28% of hospitalized complete LBBB patients.
Conclusions:
An initial r wave of ≥1 mm in lead V1 suggests intact left to right VS activation and identifies LBBB patients at low risk of CHB during right heart catheterization. These preliminary findings indicate that an initial r wave of ≥1 mm in lead V1, present in approximately 28% of ECGs with classically defined LBBB, may constitute a new exclusion criterion when defining complete LBBB. (J Cardiovasc Electrophysiol, Vol. pp. 781‐785, July 2010)
Implantable Cardioverter‐Defibrillator in Patients With Hypertrophic Cardiomyopathy: Efficacy and Complications of the Therapy in Long‐Term Follow‐up
Authors: SYSKA PAWEŁ , PRZYBYLSKI ANDRZEJ , CHOJNOWSKA LIDIA , LEWANDOWSKI MICHAŁ , STERLIŃSKI MACIEJ , MACIĄG ALEKSANDER , GEPNER KATARZYNA , PYTKOWSKI MARIUSZ , KOWALIK ILONA , MĄCZYŃSKA‐MAZURUK RENATA , RUZYŁŁO WITOLD , SZWED HANNA 
Published: February 2010

ICD in Hypertrophic Cardiomyopathy Patients. Introduction: Although implantable cardioverter‐defibrillators (ICDs) are used in sudden cardiac death (SCD) prevention in high‐risk patients with hypertrophic cardiomyopathy (HCM), long‐term results as well as precise risk stratification are discussed in a limited number of reports. The aim of the study was to assess the incidence of ICD intervention in HCM patients with relation to clinical risk profile.
Methods and Results:
We studied 104 consecutive patients with HCM implanted in a single center. The mean age of study population was 35.6 (SD, 16.2) years with the average follow‐up of 4.6 (SD, 2.6) years. ICD was implanted for secondary (n = 26) and primary (n = 78) prevention of SCD. In the secondary prevention group, 14 patients (53.8%) experienced at least 1 appropriate device intervention (7.9%/year). In the primary prevention (PP) group appropriate ICD discharges occurred in 13 patients (16.7%) and intervention rate was 4.0%/year. Nonsustained VT was the only predictive risk factor (RF) for an appropriate ICD intervention in the PP (positive predictive value 22%, negative predictive value 96%). No significant difference was observed in the incidence of appropriate ICD discharges between PP patients with 1, 2, or more RF. Complications of the treatment included: inappropriate shocks (33.7%), lead dysfunction (12.5%), and infections: 4.8% of patients. Four patients died during follow‐up.
Conclusion:
ICD therapy is effective in SCD prevention in patients with HCM, although the complication rate is significant. Nonsustained ventricular tachycardia seems to be the most predictive RF for appropriate device discharges. Number of RF did not impact the incidence of appropriate ICD interventions. (J Cardiovasc Electrophysiol, Vol. 21, pp. 883‐889, August 2010)
Detection of invasive protein profile of Streptococcus pyogenes M1 isolates from pharyngitis patients
Authors: HASEGAWA TADAO , OKAMOTO AKIRA , KAMIMURA TAKUYA , TATSUNO ICHIRO , HASHIKAWA SHIN‐NOSUKE , YABUTANI MITSUTAKA , MATSUMOTO MASAKADO , YAMADA KEIKO , ISAKA MASANORI , MINAMI MASAAKI , OHTA MICHIO 
Published: February 2010

Hasegawa T, Okamoto A, Kamimura T, Tatsuno I, Hashikawa S‐N, Yabutani M, Matsumoto M, Yamada K, Isaka M, Minami M, Ohta M. Detection of invasive protein profile of Streptococcus pyogenes M1 isolates from pharyngitis patients. APMIS 2010; 118: 167–78.Streptococcal toxic shock syndrome (STSS) is a re‐emerging infectious disease in Japan and many other developed countries. Epidemiological studies have revealed that the M1 serotype of Streptococcus pyogenes is the most dominant causative isolate of STSS. Recent characterization of M1 isolates revealed that the mutation of covS, one of the two‐component regulatory systems, plays an important role in STSS by altering protein expression. We analyzed the M1 S. pyogenes clinical isolates before or after 1990 in Japan, using two‐dimensional gel electrophoresis (2‐DE) and pulsed‐field gel electrophoresis (PFGE). PFGE profiles were different between the isolates before and after 1990. Markedly different profiles among isolates after 1990 from STSS and pharyngitis patients were detected. Sequence analysis of two‐component regulatory systems showed that covS mutations were detected not only in STSS but also in three pharyngitis isolates, in which proteins from the culture supernatant displayed the invasive type. The mutated CovS detected in the pharyngitis isolates had impaired function on the production of streptococcal pyrogenic exotoxin B (SpeB) analyzed by 2‐DE. These results suggest that several covS mutations that lead to the malfunction of the CovS protein occurred even in pharyngeal infection.
Overexpression of TrkB promotes the progression of colon cancer
Authors: YU YINGJIAO , ZHANG SIYANG , WANG XUEMEI , YANG ZHIWEI , OU GUOCHENG 
Published: February 2010

Yu Y, Zhang S, Wang X, Yang Z, Ou G. Overexpression of TrkB promotes the progression of colon cancer. APMIS 2010; 118: 188–95.Studies have confirmed that TrkB plays important roles in facilitating metastasis in various types of malignant tumors. In the present study, 30 cases of colon cancer and matched non‐tumors were examined for the expression of TrkB by Western blot. The expression of TrkB was also examined in 90 colon tumor sections by immunohistochemical methods, and D2‐40 staining was used to evaluate the correlation between TrkB expression and lymphatic vessel density. To investigate the effects of TrkB on the progression of colon cancer, siRNA specific for TrkB was transfected into LoVo cells, and proliferation, apoptosis and invasion of trasfected cells were examined using MTT [3‐(4,5‐Dimethylthiazol‐2‐yl)‐2,5‐diphenyltetrazolium bromide], flow cytometry and Transwell assays, respectively. Our results showed that TrkB was up‐regulated in colon tumors compared with the non‐tumorous counterparts, and the overexpression of TrkB was closely correlated with lymphatic vessel density (LVD) and metastasis. Inhibition of TrkB by siRNA increased the apoptotic rates of transfected cells, while the numbers of proliferative and invasive cells were decreased. In summary, our data suggest that overexpression of TrkB in colon cancer possibly plays roles in inhibiting apoptosis, promoting proliferation and invasion, facilitating tumor progression by lymphangiogenesis‐associated metastasis.
Mitotic arrest defective protein 2 expression abnormality and its clinicopathologic significance in human osteosarcoma
Authors: YU LING , GUO WEI‐CHUN , ZHAO SHENG‐HAO , TANG JIN , CHEN JIA‐LU 
Published: February 2010

Yu L, Guo W‐C, Zhao S‐H, Tang J, Chen J‐L. Mitotic arrest defective protein 2 expression abnormality and its clinicopathologic significance in human osteosarcoma. APMIS 2010; 118: 222–29.Osteosarcoma is the most common primary malignancy of bone. Overexpression of mitotic arrest defective protein 2 (MAD2) is found in many human neoplasms, but its role in the oncogenesis of osteosarcoma is an untouched topic. The objective of this research was to observe the expression of MAD2 in human osteosarcoma and explore its clinicopathologic significance. MAD2 expression was analyzed in 48 primary osteosarcoma cases (19 osteoblastic osteosarcomas, 17 chondroblastic osteosarcomas and 12 fibroblastic osteosarcomas) using immunohistochemistry. A total of 20 normal bone specimens formed a control group. MAD2 was commonly overexpressed in human osteosarcoma. Immunopositivity was higher in tumors with lower differentiation and higher clinical stage. Increased expression of MAD2 was associated with earlier metastasis and poorer survival. Our findings provide evidence that MAD2 contributes to the pathogenesis and development of human osteosarcoma, Testing may have a clinical role in predicting prognosis, selecting appropriate chemotherapeutic strategies and providing novel strategies for osteosarcoma therapy.
A boy born with multiple lesions of atrophoderma
Authors: Pavone Piero , Romantshik Olga , Caltabiano Rosario , Micali Giuseppe , De Pasquale Rocco , Pavone Lorenzo , Ruggieri Martino 
Published: February 2010

AbstractAims:  The Atrophodermas include a large group of disorders appearing as localized or widespread depressed skin areas and characterized by underlying dermal atrophy. The present study aims to report a peculiar form of previously unreported focal dermal atrophy.Methods:  We studied over a period of 5 years a boy who manifested, since birth, multiple hypopigmented cutaneous atrophic lesions of the atrophoderma type in a mosaic distribution over the body and the legs.Results:  This boy did no develop other cutaneous or systemic stigmata except for an idiopathic thrombocytopenic purpura (ITP) manifested at age 2 years. Full serum, metabolic and infective analyses; full ophthalmological examination; ultrasound examination of the heart and internal organs; skeletal x‐rays; brain magnetic resonance imaging; and DNA analysis of the PORCN (Focal Dermal Hypoplasia ‐ FDH) gene in this boy yielded normal results. Pathological analysis of multiple skin specimens from an affected area revealed slightly reduced dermal thickness; hyperpigmentation of the basal layer; homogenized and disarrayed collagen bundles; perivascular chronic infiltrates of lymphocytes and histiocytes; and normal skin appendages. Currently, the child is healthy; he has mildly improved skin status with less‐evident skin depression throughout the lesion areas and no further complication has been recorded. The histological and clinical appearance of the skin lesions and the course were against any known disorder in the group of the atrophodermas.Conclusions:  The cutaneous lesions seen in this boy represent a possibly new congenital skin disorder characterized by multiple, benign areas of focal dermal atrophy in a mosaic distribution.
Increased prevalence of burnout symptoms in parents of chronically ill children
Authors: Lindström C , Åman J , Norberg AL 
Published: February 2010

AbstractAim:  To examine the prevalence of burnout symptoms in the context of parenting a chronically ill child.Methods:  A total of 252 parents of children with Type 1 Diabetes Mellitus and 38 parents of children with Inflammatory Bowel Diseases participated in a population‐based study. A control group consisted of 124 randomly selected parents of healthy children. We used self‐report questionnaires to assess symptoms of burnout.Results:  The main finding was that significantly more parents of children with chronic diseases (36%) scored for clinical burnout, compared with parents of healthy children (20%). Burnout symptoms were most prominent among mothers of children with diabetes, although fathers of children with diabetes and mothers and fathers of children with inflammatory bowel diseases also reported higher levels of various burnout symptoms.Conclusion:  Burnout may be a useful model for understanding long‐term parental responses and should be acknowledged among the different types of psychological consequences of the multi‐faceted experience of parenting a child with chronic illness. Gender seems to influence the risk of burnout symptoms. Continued research about other background factors, and how the parents’ situation changes over time are warranted. In the clinic, we need to draw attention to the group of parents who may suffer from burnout.
Cytokine levels in neonatal necrotizing enterocolitis and long‐term growth and neurodevelopment
Authors: Lodha A , Asztalos E , Moore AM 
Published: February 2010

AbstractObjective:  To investigate if circulating cytokines are related to growth and neurodevelopmental outcome following necrotizing enterocolitis (NEC).Study design:  Pro‐inflammatory cytokine levels were measured prospectively in 40 neonates and compared with neurodevelopmental outcome. Cytokine levels were measured at the onset of feeding intolerance (Group II, n = 17) or NEC (Group III, n = 10) and at weeks 2–3 in control infants (Group I, n = 13). Neurodevelopmental outcome was assessed at the age of 24–28 months. Data were analysed using descriptive statistics, non‐parametric tests and Student t‐test.Results:  Median birth weights (range) in groups I, II and III were 1120 (525–1564) g, 1068 (650–1937) g and 1145 (670–2833) g, and median gestational ages (range) were 28 (24–35) weeks 28 (24–35) weeks and 28 (25–37) weeks respectively. NEC occurred in 10 infants. Serum IL‐6 (interleukin‐6) was elevated in group III, (p = 0.03). Significant developmental delay was found in 12% of the infants in Group II and 20% of the infants in Group III, but no infant in group I. Five infants in group III with NEC (50%), had head ultrasound abnormalities. At 1 year of age, growth, weight and head circumference were significantly different in Group III, however, at two years of age, only height was significantly different, p < 0.02. Although there was wide variation, neonatal cytokine levels tended to be greater in the infants later found to have abnormal cognitive and psychomotor outcomes.Conclusion:  This study suggests that increased serum levels of pro‐inflammatory cytokines may play a role in the poor growth and neurodevelopment associated with this high‐risk population.
Length of the treatment and number of doses per day as major determinants of child adherence to acute treatment
Authors: Chappuy H , Tréluyer J‐M , Faesch S , Giraud C , Chéron G 
Published: February 2010

AbstractObjective:  To determine the rate of aftercare adherence to prescriptions from a paediatric emergency department and to identify predictors for nonadherence.Methods:  Patients discharged from a French paediatric emergency department with at least one oral drug prescription were included. A telephone interview questionnaire was used to determine whether the child had received the treatments according to the prescription. Adherence was assessed according to three items: frequency of drug administration, length of treatment and drug administering method. Complete adherence was defined as adherence to the three items mentioned above, and nonadherent as nonadherent to at least one of the items. Influence of age, sex, pathology, language spoken at home, type of medical insurance, type of medication prescribed, diagnosis, dissatisfaction with the explanation of the medical problem, number of prescribed medications, length of the treatment and number of doses per day was assessed.Results:  One hundred and five telephone interviews were exploited. The children were 60 boys (57%) and 45 girls (43%). The ages of these 105 children were between 0.2 and 12 years. The most common diagnoses were asthma and pulmonary infection. Complete adherence with the prescription was 36.2%. Three factors were significantly associated with nonadherence (p < 0.05): length of treatment, number of doses per day and male sex.Conclusion:  This study suggests that simplifying treatment schedules is an effective strategy for improving compliance in paediatric emergency departments.
Correlation between 6‐min walk test and exercise stress test in healthy children
Authors: Limsuwan A , Wongwandee R , Khowsathit P 
Published: February 2010

AbstractAim:  To investigate the correlation between 6‐min walk test (SMWT) and incremental treadmill exercise stress test (EST) as indicators for the functional capacity in children.Methods:  Healthy children aged 9–12 years were included. The anthropometric data, SMWT and EST were prospectively measured using the standard protocols. Various parameters were analysed to define the correlation between SMWT and EST.Results:  A total of 100 subjects (53 boys) aged 10.3 ± 1.0 years participated in the study. The SMWT distance was 586.1 ± 44.0 m. Height (r = 0.59, R2 = 35%), length of the leg (r = 0.64, R2 = 41%), heart rate at the end of SMWT (r = 0.59, R2 = 35%) and heart rate difference at the end of SMWT (r = 0.71, R2 = 50%) were found to have significant correlation with SMWT distance. The estimated maximal oxygen consumption (eVO2) obtained during the EST tended to be greater in boys than in girls. Among the parameters obtained during EST, maximal heart rate (r = 0.33, R2 = 11%) and the eVO2 (r = 0.54, R2 = 53%) were found to have significant correlation with SMWT.Conclusions:  SMWT distance is significantly correlated with the eVO2 obtained during the EST. This indicates that SMWT is also one of the predictive markers for EST performance.