bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ocular adnexal lymphoproliferative disease: a series of 73 cases
Authors: McKelvie Penelope A , McNab Alan , Francis Ian C , Fox Richard , O'Day Justin 
Published: September 2003

ABSTRACTBackground: This study involved 73 patients with lymphoproliferative lesions of the ocular adnexa. The lesions were categorized using the Revised European American Lymphoma classification of lymphoid tissues and analysed to determine the frequency and prognostic impact of tumour type, location, stage and patient's age and sex.Methods: The clinical, histopathological, immunohistochemical and phenotypic analysis by flow cytometry and follow‐up data were studied.Results: The ocular adnexal lymphoproliferative lesions included 70 lymphomas and six reactive lymphoid hyperplasia. Seventy‐nine per cent had stage IE disease, 4% stage II, 1.5% stage III and 15.5% stage IV. Five patients (7%) had a past history of systemic lymphoma. Major histological types were extranodal marginal zone lymphoma (MZL) in 44 (63%), follicular (FL) in 12 (17%), diffuse large B‐cell (DLBCL) in eight (11%), mantle cell (MCL) in two (3%), B‐cell chronic lymphocytic leukaemia (CLL)/small lymphocytic lymphoma in two (3%), peripheral T‐cell lymphoma (PTCL) one (1.5%) and natural killer cell lymphoma (NKCL) in one (1.5%). Longest survival was seen in those with low‐grade lymphomas (MZL and FL) and worst in PTCL and NKCL. Lymphoma‐related mortality was 2% for MZL, 33% for FL, 38% for DLBCL, and 100% for MCL, PTCL and NKCL. Systemic lymphoma was present prior to, at presentation or at subsequent follow up in 26/68 (39%) of all lymphoma patients, 17% for MZL, 38% for DLBCL, 83% for FL, and 100% for MCL, CLL, PTCL and NKCL.Conclusion: The majority of ocular adnexal lymphomas were low‐grade B‐cell lymphomas (MZL). Multivariate analysis showed that the only significant independent predictors of all causes of mortality were the histological type of lymphoma and the stage of disease at presentation.
The Auckland Cataract Study: demographic, corneal topographic and ocular biometric parameters
Authors: Riley Andrew F , Grupcheva Christina N , Malik Tahira Y , Craig Jennifer P , McGhee Charles NJ 
Published: September 2003

ABSTRACT Purpose: To determine patient demographics and the ocular biometric parameters in patients presenting for cataract surgery within the public hospital system, in a defined New Zealand population. Method: Prospective study of 502 eyes of 488 consecutive patients undergoing cataract surgery. A clinical assessment, including refraction, keratometry (K), A‐scan ultrasound and Orbscan II computerized topography was performed on each eye. Results: The mean age of the group was 74.9 ± 9.8 years (mean ± SD) with a female predominance (62%). Ethnic origin included 72% European, 8% Maori, 10% Pacific Islander, 4% Asian, 3% Indian and 3% other ethnic origins. The mean Log MAR visual acuity of eyes prior to cataract surgery was 0.88 ± 0.57 (approximately 6/48–1). Corneal topographic (keratometric) maps were classified into five groups: 34% round, 10% oval, 31% symmetrical bow tie, 12% asymmetrical bow tie and 13% irregular. The mean steepest K measurement was 44.1 ± 1.7 D, the median keratometric astigmatism 0.89 D (range 0.0–6.5 D) and the steepest corneal meridian was horizontal in 50% and vertical in 43%. Seven per cent of corneas were spherical. Refraction revealed a mean sphere of 0.0 ± 3.1 D and a mean cylinder of –1.2 (range 0.0–7.5 D). Refractive astigmatism was with‐the‐rule in 15%, against‐the‐rule in 50% and oblique in 15%, with 20% spherical. Axial length was a mean of 23.14 ± 1.03 mm. Conclusion: Patients presenting for cataract surgery in this study were predominantly elderly, female, of European Caucasian ethnicity and exhibited relatively poor corrected visual acuity in the affected eye. Interestingly, 41% of eyes demonstrated bow‐tie topographic patterns, largely exhibiting with‐the‐rule astigmatism. However, assessment by keratometry or refraction highlighted against‐the‐rule more frequently; this may have implications for combined cataract and astigmatic surgery. The mean axial length was slightly shorter than expected for a group of predominantly European ethnic origin, although the mean refractive error was emmetropic.
An evaluation of the safety and efficacy of botulinum toxin type A (BOTOX) when used to produce a protective ptosis
Authors: Ellis Mark F , Daniell Mark 
Published: September 2003

ABSTRACT Purpose: To evaluate the safety and efficacy of botulinum toxin type A (BOTOX, Allergan) when used to produce a protective ptosis in patients where a surgical tarsorrhaphy would otherwise be required. Methods: A total of 21 patients entered into the study. Doses of 2.5 and 5.0 units of BOTOX were injected into the levator palpebrae superioris muscle through the eyelid. The patients were followed daily where practical until a ptosis developed and then monitored 1–2 weekly until the ptosis was resolved. Injections were repeated, if necessary, until the underlying condition had healed. Results: Ptosis took an average ± SE of 4.0 ± 0.5 days to develop (range 2–8 days). Duration of ptosis was an average ± SE of 46.0 ± 12.1 days (range 1–206 days). The effective dosage was 5 units of BOTOX in 0.1 mL. In 16 patients, the ptosis produced by BOTOX was sufficient to allow the underlying disease to heal and a surgical tarsorrhaphy was avoided. One patient required a surgical tarsorrhaphy and three patients required other surgical intervention to correct the underlying condition. One patient was lost to follow up. Diplopia was seen in five patients but resolved in all cases. Conclusions: BOTOX was a suitable alternative to a surgical tarsorrhaphy.
Subjectivity and vulnerability: reflections on the foundation of ethical sensibility
Authors: Nortvedt Per 
Published: September 2003

AbstractThis paper investigates the possibility of understanding the rudimentary elements of clinical sensitivity by investigating the works of Edmund Husserl and Emmanuel Levinas on sensibility. Husserl's theory of intentionality offers significant reflections on the role of pre‐reflective and affective intuition as a condition for intentionality and reflective consciousness. These early works of Husserl, in particular his works on the constitution of phenomenological time and subjective time‐consciousness, prove to be an important basis for Levinas’ works on an ethics of alterity and infinite responsibility for the other person. In fact, it is difficult to understand the core of Levinasian ethics, of vulnerability as proximity, of ethical sensitivity as passivity and a suffering for the suffering of another, without understanding the influence from Husserl's work. Crucially, the paper will, on the basis of Levinasian ethics, establish an understanding of sensibility as vulnerability and receptivity that is fundamental also for understanding significant intuitions in clinical nursing. Clinical sensitivity and carefulness in nursing are shaped by the concrete and also bodily expressions of vulnerabilities in a receptivity that is pre‐reflective and pre‐ontological.
Pacing to Prevent Atrial Fibrillation
Authors: ISRAEL CARSTEN W. , HOHNLOSER STEFAN H. 
Published: September 2003

Introduction: Pacing has been proposed as a nonpharmacologic treatment option to prevent atrial tachyarrhythmias (ATs) in drug‐refractory patients. This article reviews the current state of pacing to prevent ATs. Methods and Results: Different pacing modalities have been assessed with regard to their ability to prevent AT: conventional DDDR pacing with elevated lower rate limit, biatrial pacing, dual‐site right atrial pacing, atrial septal pacing, and pacing with the use of dedicated pacing algorithms. Small studies suggest a benefit of conventional pacing for AT prevention in patients with bradycardia, but a randomized trial did not reveal any AT reduction by conventional pacing in patients without bradycardia. AT prevention by biatrial or dual‐site right atrial pacing has been reported in small studies, but randomized trials did not show a clear benefit of these pacing techniques. Small studies showed a reduced AT recurrence rate in patients with septal pacing at the triangle of Koch or at Bachmann's bundle. Two large randomized trials with preventive pacing algorithms showed a significant AT reduction compared to conventional pacing, but this was not confirmed in four trials. Conclusion: Pacing seems to be able to suppress ATs in a minority of patients; however, prospective identification of responders to different pacing modalities does not appear to be feasible at the present time. (J Cardiovasc Electrophysiol, Vol. 14, pp. S20‐S26, September 2003, Suppl.)
Mechanical Occlusion of the Left Atrial Appendage
Authors: OMRAN HEYDER , HARDUNG DAVID , SCHMIDT HARALD , HAMMERSTINGL CHRISTOPH , LÜDERITZ BERNDT 
Published: September 2003

Introduction: Oral anticoagulation therapy reduces significantly the risk of thromboembolism in patients with atrial fibrillation. However, effective oral anticoagulation therapy is not feasible in all patients. The interventional occlusion of the left atrial appendage may reduce the risk of thromboembolism in the latter patients. The aim of this prospective study was to assess the feasibility, safety, and technical aspects of interventionally occluding the left atrial appendage. Methods and Results: The left atrial appendage was interventionally occluded with the new PLAATO device in nine patients. Serial transthoracic and transesophageal echocardiographic studies and neurologic assessment were performed prior to and during the procedure, and <48 hours, 3 months, 6 months, and 1 year after the procedure. Contraindications to oral anticoagulation were bleeding complications in 6 of 9 cases, cerebral aneurysm in 1, and allergies to warfarin therapy in 2 of 9. Baseline echocardiographic studies demonstrated spontaneous echo contrast grade 3 ± 1, peak emptying velocities of 0.26 ± 0.12 m/sec, and excluded atrial thrombi in all cases. Interventional occlusion was feasible in all cases. One patient had a minor plexus paresis that resolved within 4 weeks after the procedure. Neurologic assessment during a mean follow‐up of 5 ± 4.4 months did not demonstrate any new neurologic complications. Serial echocardiographic assessment excluded the formation of thrombi on the implanted device and demonstrated its complete thrombosis after 6 months. One patient developed a minimal pericardial effusion 48 hours after the procedure that resolved within 3 months. Conclusion: Interventional occlusion of the left atrial appendage is feasible and safe in patients with atrial fibrillation and contraindications to oral anticoagulation therapy. Furthermore, no neurologic complications, development of atrial thrombi, or thrombus formation on the device were observed during follow‐up. Future prospective studies are needed to clarify the long‐term treatment effect of this new technique. (J Cardiovasc Electrophysiol, Vol. 14, pp. S56‐S59, September 2003, Suppl.)
Cardiac Electrophysiologic Abnormalities in the CREBA133 Transgenic Mouse Model of Idiopathic Dilated Cardiomyopathy
Authors: ZHU WEI , LEPORE JOHN J. , SABA SAMIR , JOSEPH SAJU , LINK MARK S. , HOMOUD MUNTHER K. , ESTES N.A. MARK , WANG PAUL J. , LEIDEN JEFFREY M. 
Published: September 2003

Introduction: We hypothesized that the transgenic mice expressing a dominant‐negative form of the CREB transcription factor (CREBA133) under the control of the cardiac myocyte‐specific α‐MHC promoter and displaying dilated cardiomyopathy would exhibit electrophysiologic abnormalities similar to those observed in human cardiomyopathy. Methods and Results: Invasive electrophysiologic studies were performed on two age groups of mice: 11‐week‐old mice (n = 20, 9 transgenic mice and 11 wild‐type controls) and 17‐week‐old mice (n = 16, 7 transgenic mice and 9 wild‐type controls). Five additional transgenic mice underwent ambulatory ECG monitoring to determine the cause of death. The 11‐week‐old CREBA133 transgenic mice had longer PR and AH intervals than 11‐week‐old wild‐type controls (P < 0.001), whereas at 17 weeks of age the transgenic mice also demonstrated increased HV intervals and widened QRS duration (P < 0.05). At both 11 weeks and 17 weeks of age, AV Wenckebach cycle length, 2:1 AV cycle length, and AV nodal functional and effective refractory periods were significantly longer in transgenic mice than in controls (P < 0.05). Although no ventricular arrhythmias were inducible at 11 weeks of age, at 17 weeks of age, ventricular tachycardia was induced in 4 of the 7 CREBA133 transgenic mice but in none of the 9 wild‐type controls. All 5 CREBA133 transgenic mice that underwent ambulatory ECG monitoring revealed high‐grade AV block, but not ventricular arrhythmia, at the time of death. Conclusion: These data suggest that CREBA133 transgenic mice manifest abnormalities of AV nodal and infra‐Hisian conduction and inducibility of ventricular arrhythmia, which are characteristics of human dilated cardiomyopathy. (J Cardiovasc Electrophysiol, Vol. 14, pp. 982‐989, September 2003)
Combined Head‐Up Tilt and Lower Body Negative Pressure as an Experimental Model of Orthostatic Syncope
Authors: LELORIER PAUL , KLEIN GEORGE J. , KRAHN ANDREW , YEE RAYMOND , SKANES ALLAN , SHOEMAKER J. KEVIN 
Published: September 2003

Introduction: The combination of head‐up tilt and incremental lower body negative pressure has shown promise in the diagnosis of orthostatic hypotension and neurocardiogenic syncope, although prior methodologies limited conclusions as to the reproducibility of the test. The aim of this study was to assess the efficacy and reproducibility of a protocol combining tilt and stages of incremental lower body negative pressure. Methods and Results: Ten volunteers (6 men and 4 women; mean age 21 ± 1 years) participated in the study, which was composed of three sessions, 1 month apart, each consisting of 60° tilt followed by lower body suction in incremental levels of −10 mmHg for 5 minutes at each level. The primary outcome variable was the time to presyncope. Secondary variables were the levels of heart rate, blood pressure, cerebral blood flow, and end‐tidal CO2 at each level of the test. Presyncope could be achieved in all subjects. The mean times to presyncope were 24.6 ± 1.4 minutes, 26.2 ± 1.8 minutes, and 31.8 ± 1.6 minutes and were not different across tests (P = 0.3). Intrasubject variability was assessed by determining the mean average deviation from the mean, which was 3.2 ± 2.0 minutes. Changes in heart rate, blood pressure, end‐tidal CO2, and cerebral blood flow were consistent with repeat testing. Conclusion: Lower body negative pressure combined with head‐up tilt in a staged protocol can safely and reliably induce presyncope in all normal subjects tested. The test is a potent and reproducible investigational tool for inducing hypotension and transient cerebral hypoperfusion. (J Cardiovasc Electrophysiol, Vol. 14, pp. 920‐924, September 2003)
Ventricular Flutter Induced During Electrophysiologic Studies in Patients with Old Myocardial Infarction:
Authors: VISKIN SAMI , ISH‐SHALOM MAYA , KOIFMAN EDWARD , ROZOVSKI URI , ZELTSER DAVID , GLICK AHARON , FINKELSTEIN ARIEL , HALKIN AMIR , FISH ROMAN , BELHASSEN BERNARD 
Published: September 2003

Introduction: Induction of ventricular flutter during electrophysiologic (EP) studies (similar to that of ventricular fibrillation [VF]) often is viewed as a nonspecific response with limited prognostic significance. However, data supporting this dogma originate from patients without previously documented ventricular tachyarrhythmias. We examined the significance of ventricular flutter in patients with and without spontaneous ventricular arrhythmias. Methods and Results: We conducted a cohort study of all patients with myocardial infarction (MI) undergoing EP studies at our institution. Of 344 consecutive patients, 181 had previously documented spontaneous sustained ventricular arrhythmias, 61 had suspected ventricular arrhythmias, and 102 had neither. Ventricular flutter was induced in 65 (19%) of the patients. Left ventricular ejection fraction was highest among patients with inducible VF (35 ± 13), lowest for patients with inducible sustained monomorphic ventricular tachycardia (SMVT; 27 ± 9), and intermediate for patients with inducible ventricular flutter (30 ± 10). Similarly, the coupling intervals needed to induce the arrhythmia were shortest for VF (200 ± 28 msec), intermediate for ventricular flutter (209 ± 27 msec), and longest for SMVT (230 ± 35 msec). During 5 ± 8 years of follow‐up, the risk for ventricular tachycardia/VF was high for patients with SMVT and ventricular flutter and low for patients with inducible VF and noninducible patients (46%, 34%, 17%, and 14%, P < 0.005). Conclusion: Patients with inducible ventricular flutter appear to be “intermediate” between patients with inducible VF and patients with SMVT in terms of clinical and electrophysiologic correlates. However, the prognostic value of inducible ventricular flutter is comparable to that of SMVT. (J Cardiovasc Electrophysiol, Vol. 14, pp. 913‐919, September 2003)
Computational Model of the Ventricular Action Potential in Adult Spontaneously Hypertensive Rats
Authors: PADMALA SRIKANTH , DEMIR SEMAHAT S. 
Published: September 2003

Introduction: Cardiac hypertrophy has substantial clinical significance because many hypertrophic cells have markedly prolonged repolarization behavior, which may lead to increased risk for cardiac arrhythmias. Spontaneously hypertensive rat (SHR) is one model of hypertension that is studied extensively and is considered to be the best laboratory model of human hypertension. We extended our previously published model of the rat ventricular myocyte to simulate the effects of hypertrophy in SHR. Methods and Results: In SHR it has been shown that the membrane capacitance is increased, the density of transient outward K+ current is decreased, the sarcoplasmic reticulum Ca2+ ATPase activity is reduced, and the cell volumes are increased compared to those of the normal rat. We introduced these changes into our previous model of the rat ventricular myocyte and simulated the ventricular action potential of SHR. Our results demonstrated increased action potential duration (APD) and increased peak systolic value of the intracellular calcium transient in SHR. Simulations with reduced extracellular K+ concentration ([K+]o) have shown that there is increased APD shortening in SHR compared to that of the normal rat. Conclusions: Our computational model qualitatively simulated the electrophysiologic changes observed in SHR and provided the plausible mechanistic linkage between the prolonged APD and increased inotropy. Our model results also demonstrated the electrophysiologic changes observed with reduced [K+]o in SHR, a finding that is clinically significant in hypertensive patients with left ventricular hypertrophy undergoing diuretic treatment. (J Cardiovasc Electrophysiol, Vol. 14, pp. 990‐995, September 2003)
Reentrant Tachycardia in Pulmonary Veins of Patients with Paroxysmal Atrial Fibrillation
Authors: TAKAHASHI YOSHIHIDE , IESAKA YOSHITO , TAKAHASHI ATSUSHI , GOYA MASAHIKO , KOBAYASHI KENZABUROU , FUJIWARA HIDEOMI , HIRAOKA MASAYASU 
Published: September 2003

Introduction: Although slow automatic pulmonary vein (PV) activity dissociated from the atrium after achievement of PV isolation in patients with atrial fibrillation (AF) has been reported, little is known about dissociated PV tachycardia. The aim of this study was to investigate the inducibility and the mechanism of sustained PV tachycardia (SPVT). Methods and Results: One hundred thirty‐two patients with drug‐refractory paroxysmal AF underwent PV isolation by radiofrequency catheter ablation. Programmed stimulation was performed in 269 PVs of 110 of these patients after achievement of PV isolation. In 7 PVs (2.6%; left superior PV: n = 2, right superior PV: n = 4, right inferior PV: n = 1) of 7 (6.4%) of 110 patients, 18 SPVTs were induced. Fifteen regular SPVTs (mean cycle length 152 ± 34 msec) were induced in 6 of 7 PVs, and 3 irregular SPVTs (cycle length range: 94–276 msec) were induced in 3 of 7 PVs. In 2 PVs, both regular and irregular SPVTs were induced. SPVT was terminated by burst pacing in 4 PVs, and entrainment was observed during regular SPVT in 5 PVs. Slow PV automatic activity dissociated from the atrium and decremental conduction properties were shown in all 7 PVs. The shortest pacing cycle length with 1:1 capture was ≤150 msec in 6 of 7 PVs. Conclusion: Reentrant tachycardia can occur in some isolated PVs with both decremental conduction properties and short refractory periods, which suggests that reentry may be one of the mechanisms of PV arrhythmogenicity. (J Cardiovasc Electrophysiol, Vol. 14, pp. 927‐932, September 2003)
Sleep Quality Among Patients Treated with Implantable Atrial Defibrillation Therapy:
Authors: SERBER, M.A. EVA R. , SEARS SAMUEL F. , SOTILE REBECCA O. , BURNS JASON L. , SCHWARTZMAN DAVID S. , HOYT ROBERT H. , ALVAREZ LUIS G. , UJHELYI MICHAEL R. 
Published: September 2003

Introduction: The Medtronic ICD‐AT has atrial/ventricular therapies, which can be programmed to deliver atrial defibrillation during sleep, intended to potentially decrease shock anxiety/pain and lifestyle disruption. However, these shocks may diminish sleep quality. This study examined atrial shock characteristics (i.e., mode, frequency), AF symptoms, and psychological factors as determinants of sleep quality. Methods and Results: The 96 ICD‐AT patients were mostly men (72%; M age 65 ± 12 years) and implanted for 1.6 years (SD = 0.8 years). Patients were divided into shock groups based on the proportion of mode (≥90%) of total atrial shocks received. Patients were grouped into either automatic‐nocturnal shock group (8 P.M.–8 A.M.; n = 35) or manual‐awake shock group (n = 42). Psychological measures included Pittsburgh Sleep Quality Index (PSQI), Center for Epidemiology Studies‐Depression Scale, State‐Trait Anxiety Inventory, and Illness Intrusiveness Rating Scale. Atrial fibrillation disease burden was assessed via atrial symptom score and atrial shock use. PSQI global scores were similar between manual (7.67 ± 2.53) and automatic shock (8.20 ± 2.93) groups. A multiple hierarchical regression analysis indicated that no atrial shock variables were predictive of sleep quality; yet, both AF symptom (B = 0.226, P = 0.040) and depression (B = 0.392, P = 0.034) scores predicted diminished sleep quality, accounting for 42% of the variance in global sleep quality (P < 0.001). Conclusion: These results suggest that atrial defibrillation therapy does not have a deleterious impact on sleep. However, the significance of AF symptoms and depression indicate that comprehensive care of both physical and psychological symptomatology may improve sleep quality in ICD‐AT patients. (J Cardiovasc Electrophysiol, Vol. 14, pp. 960‐964, September 2003)