bluuebunny/crossref_metadata_2025_split huggingface dataset:
Remote Catheter Ablation of Parahisian Accessory Pathways Using a Novel Magnetic Navigation System—A Report of Two Cases
Authors: ERNST SABINE , HACHIYA HITOSHI , CHUN JULIAN K.R. , OUYANG FEIFAN 
Published: June 2005

Introduction: Ablation of anteroseptal (parahisian) pathways may be difficult using conventional catheters. Methods and Results: Two patients (51 and 20 years old) underwent ablation of a parahisian accessory pathway using the magnetic navigation system Niobe® (Stereotaxis, Inc.), which consists of two external permanent magnets (0.08 Tesla) that steer a small magnet embedded in the tip of the ablation catheter. A motor drive allows the advancement or retraction of the catheter. From the control room, the ablation was performed using a single radiofrequency current application (fluoroscopy 3.2 and 6.0 minutes, respectively). Conclusions: The Niobe magnetic navigation system was successfully used to perform completely remote controlled mapping and ablation of parahisian accessory pathways.
Embolic Events and Char Formation During Pulmonary Vein Isolation in Patients with Atrial Fibrillation: Impact of Different Anticoagulation Regimens and Importance of Intracardiac Echo Imaging
Authors: WAZNI OUSSAMA M. , ROSSILLO ANTONIO , MARROUCHE NASSIR F. , SAAD EDUARDO B. , MARTIN DAVID O. , BHARGAVA MANDEEP , BASH DIANNA , BEHEIRY SALWA , WEXMAN MARK , POTENZA DOMENICO , PISANO ENNIO , FANELLI RAFFAELE , BONSO ALDO , THEMISTOCLAKIS SAKIS , ERCIYES DEMET , SALIBA WALID I. , SCHWEIKERT ROBERT A. , BRACHMANN JOHANNES , RAVIELE ANTONIO , NATALE ANDREA 
Published: June 2005

Thromboembolic events are important complications of pulmonary vein isolation (PVI) procedures, occurring in up to 2.8% of patients. In this study, we report the incidence of char formation and embolic events with different anticoagulation protocols prospectively changed to reduce such complication. Methods: A total of 785 patients (mean age: 54 years, 83.5% male) underwent catheter‐based PVI for treatment of drug refractory, symptomatic atrial fibrillation (AF). PVI was performed utilizing different strategies including radiofrequency (RF) using temperature control energy delivery and RF using intracardiac echocardiography (ICE)‐guided power titration. Patients were divided based on the anticoagulation protocol into three groups: in group 1 (194 patients), activation coagulation time (ACT) was maintained between 250 and 300 seconds; in group 2 (180 patients), ACT was maintained between 300 and 350 seconds plus the IV infusion of eptifibatide (135 μg/kg bolus + 0.5 μg/kg/min); and in group 3 (411 patients), ACT was maintained between 350 and 400 seconds. Results: Char formation was detected in 69 patients of group 1, 5 of group 2, and 8 of group 3. An embolic event was observed in 7 patients of group 1, 3 of group 2, and 2 of group 3 (P = 0.01; group 1 vs group 3). Higher degree of anticoagulation with heparin was associated with a reduced incidence of embolic events even after removing the patients undergoing ICE‐guided ablation (P = 0.04). Conclusion: More aggressive anticoagulation with heparin reduced periprocedural embolic events. The use of platelet inhibition does not have incremental beneficial effect. None of the anticoagulation protocol abolished char formation.
Quantitative Assessment of Microvolt T‐Wave Alternans in Patients with Congestive Heart Failure
Authors: KLINGENHEBEN THOMAS , PTASZYNSKI PAWEL , HOHNLOSER STEFAN H. 
Published: June 2005

Introduction: T‐wave alternans has been shown to be linked to the genesis of ventricular tachyarrhythmias. Currently, only qualitative assessment of microvolt T‐wave alternans (MTWA) is recommended in clinical practise. Whether quantitave assessment of MTWA yields complementary information is unknown. Methods and Results: Noninvasive MTWA determination was performed in 204 consecutive patients with ischemic or nonischemic cardiomyopathy. Of those, 100 tested MTWA positive. In these recordings, MTWA magnitude was quantitatively assessed (alternans voltage, Valt). Patients were followed for a mean of 17 months. Ventricular tachyarrhythmic events constituted the study endpoint. Patients with nonischemic cardiomyopathy had a higher Valt than patients with ischemic cardiomyopathy (10.3 ± 9.2 [median 7.2] vs 6.2 ± 3.2 [median 4.6]μV; P = 0.007). The number of MTWA‐positive ECG leads was also higher in patients nonischemic cardiomyopathy (7.3 ± 2.4 [median 8] vs 6.0 ± 2.5 [median 6]; P = 0.016). Patients who suffered an arrhythmic event during follow‐up had higher MTWA voltages (10.8 ± 10.0 [median 8.8] vs 7.4 ± 5.7 [median 6.4]μV; P = 0.05) a higher number of MTWA‐positive ECG leads (7.6 ± 2.4 [median 8] vs 6.4 ± 2.5 [median 6]; P = 0.05) compared to patients with an uncomplicated course. Conclusion: Patients with nonischemic cardiomyopathy and patients with tachyarrhythmic complications have more extensive MTWA possibly reflecting more extensive myocardial damage and a higher arrhythmia propensity.
Efficacy and Safety of Radiofrequency Catheter Ablation of Atrioventricular Nodal Reentrant Tachycardia in the Elderly
Authors: ROSTOCK THOMAS , RISIUS TIM , VENTURA RODOLFO , KLEMM HANNO U. , WEISS CHRISTIAN , KEITEL ANNA , MEINERTZ THOMAS , WILLEMS STEPHAN 
Published: June 2005

Introduction: Atrioventricular nodal reentrant tachycardia (AVNRT) is the most common regular supraventricular tachycardia in the general population as well as in elderly patients. The purpose of the study was to investigate the success and complication rate particularly regarding the induction of an atrioventricular (AV) block by radiofrequency (RF) ablation in elderly patients with and without a preexisting AV block. Methods and Results: Between February 1998 and July 2004, all patients with symptomatic AVNRT referred for slow‐pathway ablation in our institution were included and divided into two groups: group 1 patients younger than 75 years (n = 508) and group 2 patients ≥75 years (n = 70).A preexisting prolonged PR interval was present in 17 (3.3%) patients of group 1 and in 26 (37%, P < 0.0001) patients of group 2. Following successful slow‐pathway ablation (follow‐up time group 1: 37 ± 22, group 2: 37 ± 24 months) no induction of an AV block was observed in group 2 but in four patients of group 1 (0.79%) a complete heart block was induced requiring a pacemaker implantation. In group 1, 15 (2.95%) patients with a recurrence of AVNRT were readmitted for a repeat ablation procedure. No recurrences occurred in group 2. Conclusion: Despite a higher incidence of preexisting prolonged PR intervals slow‐pathway ablation in elderly patients is both effective and safe and should be considered as the first line therapy also in this patient population
Ventricular Tachycardia Induced by Biventricular Pacing in Patient with Severe Ischemic Cardiomyopathy
Authors: MYKYTSEY ANDREW , MAHESHWARI PRADEEP , DHAR GAURAV , RAZMINIA MANSOUR , ZHEUTLIN TERRY , WANG TED , KEHOE RICHARD 
Published: June 2005

Introduction: Cardiac resynchronization therapy (CRT) is a new alternative which affords symptomatic improvement in two‐thirds of patients who exhibit medically refractory congestive heart failure (CHF) as well as significant prolongation of the QRS duration (>135 msec). As more experience with CRT accrues, unexpected complications of this promising therapy may become apparent. Herein, we describe a patient with severe ischemic cardiomyopathy and refractory CHF who developed incessant ventricular tachycardia (VT) after the initiation of biventricular pacing.The patient is a 75‐year‐old man who suffered an inferior myocardial infarction 6 years before presenting for CRT. He underwent a three‐vessel CABG in 1997. Subsequently, episodes of near syncopal sustained VT developed, for which he received a dual chamber ICD. In 2001 he developed refractory CHF and ECG revealed LBBB with a QRS duration of 195 msec. Shortly after the initiation of biventricular pacing, the patient developed multiple episodes of drug resistant monomorphic VT that could be terminated only transiently by ICD therapies.Ultimately, the only intervention, which proved to be effective in eliminating VT episodes, was inactivation of LV pacing. Despite subsequent therapeutic regimen of sotalol, lidocaine, tocainide, and quinidine all subsequent attempts to reactivate LV pacing resulted in prompt VT recurrence. Conclusion: This case represents a clear example of CRT induced proarrhythmia, which required inactivation of LV pacing for effective acute management. Such an intervention should be considered in CRT patients who exhibit a notable increase in drug refractory VT episodes.
Reduction of conjunctival bacterial flora by povidone‐iodine, ofloxacin and chlorhexidine in an outpatient setting
Authors: Barkana Yaniv , Almer Zina , Segal Ori , Lazarovitch Zipora , Avni Issac , Zadok David 
Published: June 2005

Abstract.Purpose:  To compare the reduction of conjunctival bacterial flora by povidone‐iodine 4%, ofloxacin 0.3%, and chlorhexidine 0.05% for endophthalmitis prophylaxis before corneal suture removal in an outpatient setting. Methods:  In each group of 25 consecutive subjects who presented for outpatient ophthalmic evaluation, one eye was treated with either povidone‐iodine 4% (PI), ofloxacin 0.3% (Oflox) or chlorhexidine 0.05% (Chex). The other eye served as a control. Three minutes after treatment, cultures were taken from the inferior conjunctival sac in both eyes. Following incubation at 35 ° for 48 hours, the numbers of colonies were counted and compared. The difference in the numbers of colonies in each pair of treated and control eyes was assessed for each drug and compared. Results:  The reduction in colony‐forming units was highly significant for each of the three drugs tested (Wilcoxon signed‐ranks test; p < 0.0001). There was no significant difference between percent reduction by the three drugs (Kruskal–Wallis test; p = 0.68). Sterile cultures following preparation by PI, Oflox and Chex were obtained in 52%, 68% and 52%, respectively. Conclusions:  The regimens tested were similarly effective in reducing conjunctival commensals. They may all be considered as options for a quick prophylaxis against infection following suture removal in an outpatient setting.
Expression of basic fibroblast growth factor in rabbit corneal alkali wounds in the presence and absence of granulocytes
Authors: Gan Lisha , Fagerholm Per , Palmblad Jan 
Published: June 2005

Abstract.Purpose:  To study the expression of basic fibroblast growth factor (bFGF) in the early phases of corneal wound healing in the presence or absence of granulocytes. Methods:  A central penetrating corneal alkali wound was inflicted to one eye in each of 14 rabbits under general anaesthesia. Subsequently, seven of the rabbits were given fucoidin i.v. for 36 hours in order to block the selectins on the vascular endothelium, thus preventing blood granulocytes from entering the tissues. Then, corneas were prepared, stained for bFGF and evaluated by light microscopy. Results:  Whereas normal corneal epithelium expressed bFGF weakly, conjunctival epithelium did so strongly, particularly the goblet cells. The corneal endothelium showed medium staining, while keratocytes and vascular endothelial cells did not consistently express bFGF. After 36 hours of wound healing, a marked up‐regulation of bFGF expression was observed in the corneal epithelial and endothelial cells, as well as in the keratocytes, that were migrating into the wound. No other changes were noted. None of these features were modulated when granulocyte emigration was prevented by fucoidin administration. Conclusions:  The difference in bFGF expression between the corneal and conjunctival epithelium suggests a role for this growth factor in the barrier function at the limbus. Moreover, the specific presence of bFGF in cells migrating into the wound indicates the participation of bFGF in corneal wound healing. Expression of bFGF was independent of granulocytes.
Dominant optic atrophy: correlation between clinical and molecular genetic studies
Authors: Puomila Anu , Huoponen Kirsi , Mäntyjärvi Maija , Hämäläinen Petra , Paananen Reetta , Sankila Eeva‐Marja , Savontaus Marja‐Liisa , Somer Mirja , Nikoskelainen Eeva 
Published: June 2005

Abstract.Purpose:  To assess the clinical picture and molecular genetics of 14 Finnish families with dominant optic atrophy (DOA). Methods:  The clinical status of family members was based on the assessment of visual acuity, colour vision, visual fields and optic nerve appearance; 31 individuals were affected, two suspect and 21 unaffected. A total of 30 coding exons and exon− intron boundaries of the OPA1 gene were sequenced in order to detect mutations. Results:  Half the patients were diagnosed at the age of ≤ 20 years. Ten out of 20 affected individuals followed up for ≥ 6 years had a progressive disease and 10 had a stable disease. According to WHO criteria, 36% of the affected patients were visually handicapped. Eight OPA1 pathogenic mutations, all but one novel, and 18 neutral polymorphisms were detected. Conclusion:  The most sensitive indicators of DOA were optic disc pallor and dyschromatopsia. With molecular genetic analysis, asymptomatic mutation carriers and DOA cases with a mild clinical outcome were ascertained. No mutational hotspot or Finnish major mutation in the OPA1 gene could be demonstrated as most families carried a unique mutation. No obvious genotype− phenotype correlation could be detected. Detailed clinical assessment and exclusion of non‐DOA families prior to mutation screening are necessary for obtaining a high mutation detection rate.
Placing the Molteno implant in a long scleral tunnel to prevent postoperative tube exposure
Authors: Ollila Marko , Falck Aura , Airaksinen P. Juhani 
Published: June 2005

Abstract.Purpose:  The purpose of this study was to retrospectively evaluate whether it is possible to decrease the risk of Molteno tube erosion through the conjunctiva by using a new technique where the silicone tube is inserted into a scleral tunnel instead of being covered only by the conjunctiva. Methods:  We reviewed Molteno implants carried out at the University Hospital of Oulu, in 332 patients who underwent traditional Molteno implantation between October 1986 and October 1998 and 92 patients who underwent surgery with the new technique between November 1998 and April 2001. Results:  With our former technique, conjunctival erosions occurred in 15 eyes of 15 patients (4.5%) after a median follow‐up of 3.5 months (range 1–72 months); no conjunctival complications were discovered in patients who underwent surgery using the new technique during a median follow‐up of 22 months (range 10–39 months). (p = 0.038, two‐sample test of proportions). Conclusion:  Inserting the Molteno tube into a scleral tunnel prevents tube extrusion through the conjunctiva in eyes with Molteno implants. The technique for making the scleral tunnel is described.
Alpha‐1‐‐antitrypsin in aqueous humour from patients with corneal allograft rejection
Authors: Funding Mikkel , Vorum Henrik , Nexø Ebba , Ehlers Niels 
Published: June 2005

Abstract.Purpose:  To investigate the presence and concentration of α1‐antitrypsin in aqueous humour at the time of corneal rejection and to compare results obtained from patients with reversible and irreversible rejection. Methods:  Samples of aqueous humour were obtained from 17 patients with acute corneal endothelial allograft rejection. The presence of α1‐antitrypsin in aqueous humour was confirmed by immunoblotting and measured employing a sandwich ELISA. Total protein concentrations in aqueous humour were measured using Bradford's method. The outcome of corneal rejection episodes was determined 1 month after diagnosing corneal rejection and described as reversible or irreversible rejection. Results:  α1‐antitrypsin was detected in aqueous humour. Patients with reversible rejection had significantly higher α1‐antitrypsin concentration than patients with irreversible rejection (p = 0.044). There was no significant difference in total protein concentrations (p = 0.745), and no correlation was found between α1‐antitrypsin and total protein concentrations (p = 0.368). Conclusions:  α1‐antitrypsin in aqueous humour seems to signal a favourable outcome of corneal rejection. The possible mechanism is discussed.
Ethmoidal osteoma with intraorbital extension: excision through a transcutaneous paranasal incision
Authors: Karapantzos Ilias , Detorakis Efstathios T. , Drakonaki Eleni E. , Ganasouli Dimitra L. , Danielides Vassilios , Kozobolis Vassilios P. 
Published: June 2005

Abstract.Purpose:  To describe a case of conjunctival hyperaemia and proptosis of the right eye. Methods:  Three‐dimensional computed tomography (CT) was performed to reveal the size and position of a lesion of osseous density extending into the right orbit. The lesion was then excised using a right paranasal transcutaneous approach. Results:  The pathology report suggested ethmoidal osteoma. The postoperative course was uncomplicated and the lesion did not recur during a 5‐year follow‐up period. Repeated postoperative ophthalmic examinations revealed preservation of visual acuity and visual fields postoperatively. Discussion:  Diagnosis is based on imaging studies, especially CT and three‐dimensional CT scans. A three‐dimensional CT scan is critical in understanding the actual dimensions of the tumour and its relations with other structures. Surgical removal is indicated in cases with orbital matrix compression and displacement. A transcutaneous paranasal approach allows for increased exposure of affected structures.
Chromosomal imbalances in some benign orbital tumours
Authors: Rødahl Eyvind , Lybæk Helle , Arnes Jarle , Ness Gro Oddveig 
Published: June 2005

Abstract.Purpose:  To examine benign orbital tumours for chromosomal imbalances. Methods:  Specimens obtained from orbital tumours were screened for chromosomal imbalances using high resolution comparative genomic hybridization (CGH). The imbalances detected by CGH were confirmed by using fluorescence in situ hybridization (FISH) and loss of heterozygosity (LOH) analysis. Results:  Chromosomal gains or losses were seen in 4/6 pleomorphic adenomas (gains at 8q; losses at 4p, 5p, 8p, 11p and 14q), 2/4 schwannomas (losses at 16p and 22q), and 1/9 cavernous haemangiomas (losses at 13q). Compared to previous studies of pleomorphic adenomas using G‐band analysis, chromosomal imbalances were more frequently detected by using CGH. Gains of 8q11−q22 and losses of 4p15−pter, 11p12−p15, and 14q12−q23 in pleomorphic adenomas, losses of 16p12−p13 in schwannomas, and losses of 13q32−qter in cavernous haemangiomas have not been reported previously. Conclusions:  A range of chromosomal imbalances was detected even within tumours of the same histological subtype. We did not observe common chromosomal gains or losses that were characteristic for orbital presentation of the tumours. The clinical relevance of the abnormalities is uncertain, but they may indicate the position of genes that could play a role in tumour development.
Duration of face‐down positioning after macular hole surgery: a comparison between 1 week and 3 days
Authors: Krohn Jørgen 
Published: June 2005

Abstract.Purpose:  To investigate whether shortening the duration of face‐down positioning from 1 week to 3 days affects the anatomical success rate of macular hole surgery. Methods:  A total of 53 consecutive eyes in 50 patients with full thickness macular holes of 2–24 months' (average 10 months) duration were included in the study. In 20 eyes (37.7%) the hole had been present for more than 1 year. All patients were operated with vitrectomy, removal of the posterior hyaloid and a complete fluid‐gas exchange. Peeling of the internal limiting membrane (ILM) was not performed. Postoperatively, the duration of face‐down positioning differed between two consecutive groups of patients. The first group (29 patients) was instructed to keep their heads face‐down for 7 days, while the second group (24 patients) maintained face‐down positioning for only 3 days. Results:  Overall, 90.6% of the macular holes closed with one operation. The macular hole closed successfully in 27 (93.1%) of the 29 eyes in the 1‐week group and in 21 (87.5%) of the 24 eyes in the 3‐day group (p > 0.05). Conclusion:  Although the frequency of hole closure differed slightly in the two study groups, the difference was far from statistically significant. Thus, the results indicate that 3 days of strict face‐down positioning are sufficient to achieve closure of even longstanding macular holes without removal of the ILM.
The cut‐and‐paste method for primary pterygium surgery: long‐term follow‐up
Authors: Koranyi Gabor , Seregard Stefan , Kopp Eva Dafgård 
Published: June 2005

Abstract.Objective:  To evaluate the recurrence rate, reoperation rate and side‐effects of a novel technique for pterygium surgery. Design:  Retrospective study. Participants:  The study included 461 eyes of 381 patients operated for primary nasal pterygium by the same surgeon between 1994 and 2003 and followed for 23 ± 20 months (range 6–112 months). Methods:  Autologous conjunctival grafts harvested at the superotemporal limbus were used to cover the sclera after pterygium excision. Using a retrospective chart review, the outcome after attaching the transplant to the sclera with a fibrin tissue adhesive (n = 325) was compared to the outcome after graft attachment using absorbable sutures (n = 136). Main outcome measures:  Recurrence rate, reoperation rate and complications. Results:  The recurrence rate was 5.3% in the glue group and 13.5% in the suture group (p = 0.01). The reoperation rates were 1.2% and 3.3%, respectively (p = 0.31). Complications, such as transient transplant oedema and persistent corneal epithelial defects, occurred equally in both groups. Conclusion:  Using a fibrin tissue adhesive instead of sutures when attaching the conjunctival transplant in primary pterygium surgery results in a significantly lower recurrence rate.
Nordic research in ophthalmology
Authors: Heijl Anders , Algvere Peep V. , Alm Albert , Andersen Nis , Bauer Birgitta , Carlsson Jan‐Olof , Ehinger Berndt , Eide Nils , Fledelius Hans , Foerster Michael , Hjortdal Jesper , Holmström Gerd , Høvding Gunnar , Kivelä Tero , La Cour Morten , Lindblom Bertil , Møller‐Pedersen Torben , Nikoskelainen Eeva , Prause Jan Ulrik , Riise Ruth , Rosenberg Thomas , Seregard Stefan , Stefánsson Einar , Tarkkanen Ahti , Tervo Timo , Tornqvist Kristina , Zetterström Charlotta 
Published: June 2005

Abstract. Nordic ophthalmologists and vision scientists are active in many fields of eye research. This is most evident at the biannual Nordic Congress of Ophthalmology, most recently held in Malmö in June 2004. The authors here review some of the research in vision and ophthalmology presented at this meeting or published recently by Nordic scientists. This paper does not represent a comprehensive review of all Nordic research in the field, but attempts to give an overview of some of the activities underway in eye research in this part of the world.