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Sample records for bipolar pacemaker current

  1. Does bipolar pacemaker current activate blood platelets?

    DEFF Research Database (Denmark)

    Gjesdal, Grunde; Hansen, Annebirthe Bo; Brandes, Axel

    2009-01-01

    platelets and muscle cells contain actin and myosin filaments, and both cells are activated following calcium influx. Muscle cells open their calcium channels and contract when exposed to an electric current. Current through a bipolar pacemaker lead will expose a small volume of blood, including platelets...... to the pacemaker can. METHODS: Platelet-rich plasma was prepared from two healthy subjects. Platelet reactivity to the agonist ADP was tested in paired samples in an aggregometer in a case/control setup. RESULTS: Eighteen of 46 tested pairs of platelet-rich plasma showed increased reactivity in the paced sample......; 26 were unchanged while two showed decreased reactivity in the paced sample. Using a two-sided sign test, the null hypothesis was rejected (P = 0.0004). CONCLUSIONS: The study demonstrates increased reactivity to ADP in platelets exposed in vitro to stimulation by pacemaker current. The clinical...

  2. MRI-conditional pacemakers: current perspectives

    Directory of Open Access Journals (Sweden)

    Ferreira AM

    2014-05-01

    Full Text Available António M Ferreira,1,2 Francisco Costa,2 António Tralhão,2 Hugo Marques,3 Nuno Cardim,1 Pedro Adragão1,2 1Cardiology Department, Hospital da Luz, 2Cardiology Department, Hospital Santa Cruz- CHLO, 3Radiology Department, Hospital da Luz, Lisbon, Portugal Abstract: Use of both magnetic resonance imaging (MRI and pacing devices has undergone remarkable growth in recent years, and it is estimated that the majority of patients with pacemakers will need an MRI during their lifetime. These investigations will generally be denied due to the potentially dangerous interactions between cardiac devices and the magnetic fields and radiofrequency energy used in MRI. Despite the increasing reports of uneventful scanning in selected patients with conventional pacemakers under close surveillance, MRI is still contraindicated in those circumstances and cannot be considered a routine procedure. These limitations prompted a series of modifications in generator and lead engineering, designed to minimize interactions that could compromise device function and patient safety. The resulting MRI-conditional pacemakers were first introduced in 2008 and the clinical experience gathered so far supports their safety in the MRI environment if certain conditions are fulfilled. With this technology, new questions and controversies arise regarding patient selection, clinical impact, and cost-effectiveness. In this review, we discuss the potential risks of MRI in patients with electronic cardiac devices and present updated information regarding the features of MRI-conditional pacemakers and the clinical experience with currently available models. Finally, we provide some guidance on how to scan patients who have these devices and discuss future directions in the field. Keywords: pacemakers, magnetic resonance imaging, MRI, MRI-conditional devices, safety

  3. Electromagnetic interference with a bipolar pacemaker by an induction heating (IH) rice cooker.

    Science.gov (United States)

    Nagatomo, Toshihisa; Abe, Haruhiko; Kohno, Ritsuko; Toyoshima, Takeshi; Fujimoto, Hiroshi; Kondo, Shoichi; Kabashima, Narutoshi; Takeuchi, Masaaki; Tamura, Masahito; Okazaki, Masahiro; Otsuji, Yutaka

    2009-01-01

    Electromagnetic fields may interfere with normal pacemaker function. Despite new device designs and bipolar leads, electromagnetic interference (EMI) remains a concern when pacemaker recipients are exposed to various household appliances. We report the observation of EMI by an induction heating (IH) rice cooker in a patient with sick sinus syndrome who was the recipient of a bipolar dual chamber-pacing system. Stored electrograms revealed episodes of inappropriate ventricular pacing, all coinciding with the opening of an IH rice cooker. Recipients of implantable medical devices must be warned to handle IH rice cookers with caution.

  4. Pacemaker Created in Human Ventricle by Depressing Inward-Rectifier K+ Current: A Simulation Study

    Science.gov (United States)

    Zhang, Yue; Li, Qince; Zhang, Henggui

    2016-01-01

    Cardiac conduction disorders are common diseases which cause slow heart rate and syncope. The best way to treat these diseases by now is to implant electronic pacemakers, which, yet, have many disadvantages, such as the limited battery life and infection. Biopacemaker has been expected to replace the electronic devices. Automatic ventricular myocytes (VMs) could show pacemaker activity, which was induced by depressing inward-rectifier K+ current (IK1). In this study, a 2D model of human biopacemaker was created from the ventricular endocardial myocytes. We examined the stability of the created biopacemaker and investigated its driving capability by finding the suitable size and spatial distribution of the pacemaker for robust pacing and driving the surrounding quiescent cardiomyocytes. Our results suggest that the rhythm of the pacemaker is similar to that of the single cell at final stable state. The driving force of the biopacemaker is closely related to the pattern of spatial distribution of the pacemaker. PMID:26998484

  5. Pacemaker Created in Human Ventricle by Depressing Inward-Rectifier K+ Current: A Simulation Study

    Directory of Open Access Journals (Sweden)

    Yue Zhang

    2016-01-01

    Full Text Available Cardiac conduction disorders are common diseases which cause slow heart rate and syncope. The best way to treat these diseases by now is to implant electronic pacemakers, which, yet, have many disadvantages, such as the limited battery life and infection. Biopacemaker has been expected to replace the electronic devices. Automatic ventricular myocytes (VMs could show pacemaker activity, which was induced by depressing inward-rectifier K+ current (IK1. In this study, a 2D model of human biopacemaker was created from the ventricular endocardial myocytes. We examined the stability of the created biopacemaker and investigated its driving capability by finding the suitable size and spatial distribution of the pacemaker for robust pacing and driving the surrounding quiescent cardiomyocytes. Our results suggest that the rhythm of the pacemaker is similar to that of the single cell at final stable state. The driving force of the biopacemaker is closely related to the pattern of spatial distribution of the pacemaker.

  6. Hyperpolarization-Activated Current, , in Mathematical Models of Rabbit Sinoatrial Node Pacemaker Cells

    Directory of Open Access Journals (Sweden)

    Arie O. Verkerk

    2013-01-01

    Full Text Available A typical feature of sinoatrial (SA node pacemaker cells is the presence of an ionic current that activates upon hyperpolarization. The role of this hyperpolarization-activated current, , which is also known as the “funny current” or “pacemaker current,” in the spontaneous pacemaker activity of SA nodal cells remains a matter of intense debate. Whereas some conclude that plays a fundamental role in the generation of pacemaker activity and its rate control, others conclude that the role of is limited to a modest contribution to rate control. The ongoing debate is often accompanied with arguments from computer simulations, either to support one's personal view or to invalidate that of the antagonist. In the present paper, we review the various mathematical descriptions of that have been used in computer simulations and compare their strikingly different characteristics with our experimental data. We identify caveats and propose a novel model for based on our experimental data.

  7. Pacemaker neuron and network oscillations depend on a neuromodulator-regulated linear current

    Directory of Open Access Journals (Sweden)

    Shunbing Zhao

    2010-05-01

    Full Text Available Linear leak currents have been implicated in the regulation of neuronal excitability, generation of neuronal and network oscillations, and network state transitions. Yet, few studies have directly tested the dependence of network oscillations on leak currents or explored the role of leak currents on network activity. In the oscillatory pyloric network of decapod crustaceans neuromodulatory inputs are necessary for pacemaker activity. A large subset of neuromodulators is known to activate a single voltage-gated inward current IMI, which has been shown to regulate the rhythmic activity of the network and its pacemaker neurons. Using the dynamic clamp technique, we show that the crucial component of IMI for the generation of oscillatory activity is only a close-to-linear portion of the current-voltage relationship. The nature of this conductance is such that the presence or the absence of neuromodulators effectively regulates the amount of leak current and the input resistance in the pacemaker neurons. When deprived of neuromodulatory inputs, pyloric oscillations are disrupted; yet, a linear reduction of the total conductance in a single neuron within the pacemaker group recovers not only the pacemaker activity in that neuron, but also leads to a recovery of oscillations in the entire pyloric network. The recovered activity produces proper frequency and phasing that is similar to that induced by neuromodulators. These results show that the passive properties of pacemaker neurons can significantly affect their capacity to generate and regulate the oscillatory activity of an entire network, and that this feature is exploited by neuromodulatory inputs.

  8. Biomarkers for bipolar disorder: current insights

    Directory of Open Access Journals (Sweden)

    Duong A

    2015-11-01

    Full Text Available Angela Duong,1 Bushra Syed,1 Gustavo Scola2,3 1Department of Pharmacology and Toxicology, 2Department of Psychiatry, University of Toronto, 3Centre for Addiction and Mental Health, Toronto, ON, Canada Abstract: Currently, there exists a lack of definitive diagnostic tools for neuropsychiatric disorders, particularly molecular markers that could help assess the illness and develop more personalized treatments for different disorders. Understanding of the neurobiology and potential novel treatments for bipolar disorder (BD, one of the most complex psychiatric illnesses, remains poor. This review aims to compile the most reproducible findings regarding the molecular, genetic, and structural changes that occur in BD. Neuroimaging studies have indicated alterations in neural circuits, disrupted white matter integrity, alterations in reward activation, and decreased gray matter (GM volume. Genetic studies have identified variations in a number of genes that confer risk for BD development. Studies involving peripheral biomarkers include alterations in the levels of oxidative stress, inflammation, and neurotrophins. These potential molecular markers could be used as tools for diagnosis, to assess illness progression, and to help with the improvement of more specific and personalized treatments for patients with BD. Identification of biologically relevant markers could improve the quality of life of patients with BD and revolutionize public health. Keywords: biomarkers, neuroimaging, neural activation, gene regulation, microRNAs, oxidative stress, inflammation

  9. Limiting current density and water dissociation in bipolar membranes

    NARCIS (Netherlands)

    Strathmann, H.; Krol, J.J.; Rapp, H.-J.; Eigenberger, G.

    1997-01-01

    The behaviour of bipolar membranes in NaCl and Na2SO4 solutions is discussed. The membranes are characterized in terms of their limiting current densities. Below the limiting current density the electric current is carried by salt ions migrating from the transition region between the anion and the c

  10. Limiting current density and water dissociation in bipolar membranes

    OpenAIRE

    Strathmann, H.; Krol, J.J.; Rapp, H.-J.; Eigenberger, G.

    1997-01-01

    The behaviour of bipolar membranes in NaCl and Na2SO4 solutions is discussed. The membranes are characterized in terms of their limiting current densities. Below the limiting current density the electric current is carried by salt ions migrating from the transition region between the anion and the cation exchange layer of the bipolar membrane. In steady state these ions are replaced by salt ions transported from the bulk solutions into the transition region by diffusion and migration due to t...

  11. Current-voltage curve of a bipolar membrane at high current density

    NARCIS (Netherlands)

    Aritomi, T.; Boomgaard, van den Th.; Strathmann, H.

    1996-01-01

    The potential drop across a bipolar membrane was measured as a function of the applied current density. As a result, an inflection point was observed in the obtained current-voltage curve at high current density. This inflection point indicates that at high current densities water supply from outsid

  12. Thermal analytic model of current gain for bipolar junction transistor-bipolar static induction transistor compound device

    Institute of Scientific and Technical Information of China (English)

    Zhang You-Run; Zhang Bo; Li Ze-Hong; Lai Chang-Jin; Li Zhao-Ji

    2009-01-01

    This paper proposes a thermal analytical model of current gain for bipolar junction transistor-bipolar static induction transistor (BJT-BSIT) compound device in the low current operation. It also proposes a best thermal compensating factor to the compound device that indicates the relationship between the thermal variation rate of current gain and device structure. This is important for the design of compound device to be optimized. Finally, the analytical model is found to be in good agreement with numerical simulation and experimental results. The test results demonstrate that thermal variation rate of current gain is below 10% in 25℃C-85℃ and 20% in -55℃-25℃.

  13. Ionizing radiation effects on implanted pacemakers

    International Nuclear Information System (INIS)

    Fourteen multi-programmable pacemakers and 2 intercardial defibrillators were exposed to 60Co radiation, to 9 MeV electrons and to 6 MV and 10 MV photon radiation. The pacemakers were placed into a water phantom. The following parameters were examined: telemetry, battery, pulse frequency, pulse amplitude, and period at accumulated doses from 2 Gy to 100 Gy. It is concluded that pacemakers in CMOS/Bipolar technology and in 8μ CMOS technology should not be exposed to an absorbed dose exceeding 5 Gy, the latest generation of pacemakers in the 3μm technology will perform satisfactorily up to 70 Gy. (P.A.)

  14. Correlates of current suicide risk among Thai patients with bipolar I disorder: findings from the Thai Bipolar Disorder Registry

    Directory of Open Access Journals (Sweden)

    Suttajit S

    2013-11-01

    Full Text Available Sirijit Suttajit,1 Suchat Paholpak,2 Somrak Choovanicvong,3 Khanogwan Kittiwattanagul,4 Wetid Pratoomsri,5 Manit Srisurapanont1On behalf of the Thai Bipolar Registry Group1Department of Psychiatry, Chiang Mai University, Chiang Mai, 2Department of Psychiatry, Khon Kaen University, Khon Kaen, 3Srithanya Hospital, Nonthaburi, 4Khon Kaen Rajanagarindra Psychiatric Hospital, Khon Kaen, 5Chachoengsao Hospital, Chachoengsao, ThailandBackground: The Thai Bipolar Disorder Registry was a prospective, multisite, naturalistic study conducted in 24 hospitals across Thailand. This study aimed to examine the correlates of current suicide risk in Thai patients with bipolar I disorder.Methods: Participants were adult inpatients or outpatients with bipolar disorder, based on the Diagnosis and Statistical Manual of Mental Disorders, fourth edition. All were assessed by using the Mini International Neuropsychiatric Interview (MINI, version 5. The severity of current suicide risk was determined by using the total score of the MINI suicidality module. Mood symptoms were assessed by using the Young Mania Rating Scale and the Montgomery Asberg Depression Rating Scale.Results: The data of 383 bipolar I disorder patients were included in the analyses. Of these, 363 (94.8% were outpatients. The mean (standard deviation of the MINI suicide risk score was 1.88 (5.0. The demographic/clinical variables significantly associated with the MINI suicide risk scores included age, number of overall previous episodes, the Young Mania Rating Scale score, the Montgomery Asberg Depression Rating Scale scores, and the Clinical Global Impression Severity of Illness Scale for Bipolar Disorder mania score, depression score, and overall score. The variables affecting the differences of suicide risk scores between or among groups were type of first mood episode, a history of rapid cycling, anxiety disorders, and alcohol use disorders. The stepwise multiple linear regression model revealed

  15. Pacemaker activity of the human sinoatrial node: Role of the hyperpolarization-activated current, I-f

    NARCIS (Netherlands)

    A.O. Verkerk; A.C.G. van Ginneken; R. Wilders

    2009-01-01

    The mechanism of primary, spontaneous cardiac pacemaker activity of the sinoatrial node (SAN) has extensively been studied in several animal species, but is virtually unexplored in man. Understanding the mechanisms of human SAN pacemaker activity is important for developing new therapeutic approache

  16. [Sport for pacemaker patients].

    Science.gov (United States)

    Israel, C W

    2012-06-01

    Sport activity is an important issue in many patients with a pacemaker either because they performed sport activities before pacemaker implantation to reduce the cardiovascular risk or to improve the course of an underlying cardiovascular disease (e.g. coronary artery disease, heart failure) by sports. Compared to patients with an implantable cardioverter defibrillator (ICD) the risks from underlying cardiovascular disease (e.g. ischemia, heart failure), arrhythmia, lead dysfunction or inappropriate therapy are less important or absent. Sport is contraindicated in dyspnea at rest, acute heart failure, new complex arrhythmia, acute myocarditis and acute myocardial infarction, valvular disease with indications for intervention and surgery and comorbidities which prevent physical activity. Patients with underlying cardiovascular disease (including hypertension) should preferably perform types and levels of physical activity that are aerobic (with dynamic exercise) such as running, swimming, cycling instead of sport with high anaerobic demands and high muscular workload. In heart failure, studies demonstrated advantages of isometric sport that increases the amount of muscle, thereby preventing cardiac cachexia. Sport with a risk of blows to the chest or physical contact (e.g. boxing, rugby, martial arts) should be avoided. Implantation, programming and follow-up should respect specific precautions to allow optimal physical activity with a pacemaker including implantation of bipolar leads on the side contralateral to the dominant hand, individual programming of the upper sensor and tracking rate and regular exercise testing. PMID:22854824

  17. [Cognitive behavioral treatments of bipolar disorder: current knowledge and perspectives].

    Science.gov (United States)

    Khazaal, Y; Pomini, V

    2006-09-20

    A significant proportion of patients with bipolar disorder experience relapse, psychosocial impairment and persistent symptoms despite available pharmacotherapy. Prognosis is frequently worsened by poor adhesion to mood stabilizing agents. Cognitive and behavioural therapy (CBT) tends to diminish depressive symptoms, improve treatment adherence and reduce the risk of depressive and manic relapses. CBT effect appears to diminish in patients with a history of over twelve episodes. Most studies exclude patients with comorbid psychiatric disorder, rapid cycling, schizoaffective disorder or patients lacking adherence to mood stabilizing agents. Patients would benefit from development of CBT techniques focusing on the mentioned problems. PMID:17073177

  18. Subclavian Vein Stenosis/Occlusion Following Transvenous Cardiac Pacemaker and Defibrillator Implantation: Incidence, Pathophysiology and Current Management

    Directory of Open Access Journals (Sweden)

    Brian O'Leary

    2015-08-01

    Full Text Available Subclavian vein stenosis is a common, but usually asymptomatic, complication following cardiac device placement. In addition to reviewing the literature on incidence, pathogenesis and management options for this important clinical problem, we describe two cases of symptomatic subclavian vein occlusion following pacemaker/defibrillator placement and successful treatment with venoplasty and stenting.

  19. Current-voltage behaviour of bipolar membranes in concentrated salt solutions investigated with chronopotentiometry

    NARCIS (Netherlands)

    Wilhelm, F.G.; Vegt, van der N.F.A.; Strathmann, H.; Wessling, M.

    2002-01-01

    Chronopotentiometry is used as a tool to obtain detailed information on the transport behaviour of the bipolar membrane BP-1 in solutions of high sodium chloride concentration above the limiting current density. We discuss critically the interpretation of the observed transition times. The occurrenc

  20. Induced-charge electrokinetics, bipolar current, and concentration polarization in a microchannel-Nafion-membrane system

    Science.gov (United States)

    Park, Sinwook; Yossifon, Gilad

    2016-06-01

    The presence of a floating electrode array located within the depletion layer formed due to concentration polarization across a microchannel-membrane interface device may produce not only induced-charge electro-osmosis (ICEO) but also bipolar current resulting from the induced Faradaic reaction. It has been shown that there exists an optimal thickness of a thin dielectric coating that is sufficient to suppress bipolar currents but still enables ICEO vortices that stir the depletion layer, thereby affecting the system's current-voltage response. In addition, the use of alternating-current electro-osmosis by activating electrodes results in further enhancement of the fluid stirring and opens new routes for on-demand spatiotemporal control of the depletion layer length.

  1. Pacemakers and Implantable Defibrillators

    Science.gov (United States)

    ... need a cardiac pacemaker or an implantable cardioverter defibrillator (ICD). They are devices that are implanted in ... can act as both a pacemaker and a defibrillator. Many ICDs also record the heart's electrical patterns ...

  2. Bipolar Junction Transistors in Two-Dimensional WSe2 with Large Current and Photocurrent Gains.

    Science.gov (United States)

    Agnihotri, Pratik; Dhakras, Prathamesh; Lee, Ji Ung

    2016-07-13

    In the development of semiconductor devices, the bipolar junction transistor (BJT) features prominently as being the first solid state transistor that helped to usher in the digital revolution. For any new semiconductor, therefore, the fabrication and characterization of the BJT are important for both technological importance and historical significance. Here, we demonstrate a BJT device in exfoliated TMD semiconductor WSe2. We use buried gates to electrostatically create doped regions with back-to-back p-n junctions. We demonstrate two central characteristics of a bipolar device: current gain when operated as a BJT and a photocurrent gain when operated as a phototransistor. We demonstrate a current gain of 1000 and photocurrent gain of 40 and describe features that enhance these properties due to the doping technique that we employ. PMID:27336742

  3. Firing Patterns and Transitions in Coupled Neurons Controlled by a Pacemaker

    Institute of Scientific and Technical Information of China (English)

    LI Mei-Sheng; LU Qi-Shao; DUAN Li-Xia; WANG Qing-Yun

    2008-01-01

    @@ To reveal the dynamics of neuronal networks with pacemakers, the firing patterns and their transitions are investigated in a ring HR neuronal network with gap junctions under the control of a pacemaker. Compared with the situation without pacemaker, the neurons in the network can exhibit various firing patterns as the external current is applied or the coupling strength of pacemaker varies. The results are beneficial for understanding the complex cooperative behaviour of large neural assemblies with pacemaker control.

  4. How Does a Pacemaker Work?

    Science.gov (United States)

    ... the NHLBI on Twitter. How Does a Pacemaker Work? A pacemaker consists of a battery, a computerized ... these recordings to adjust your pacemaker so it works better for you. Your doctor can program the ...

  5. Hardware and Software of a Bipolar Current Source Controlled by PC

    Directory of Open Access Journals (Sweden)

    Mirjana Rajčić-Vujasinović

    2008-03-01

    Full Text Available This paper describes a realization of a bipolar current source developed by the paper's authors. The source is intended for use in galvanic and other industrial plants, where a pulse-reverse current supply (with the desired shape in time is required. A prototype of the device, which provides the outcome current intensity up to ± 50 A, has been constructed. The hardware of the source consists of a Pentium IV PC, a commercial ADDA converter, an interface of authors’ original construction as well as a current regulator. The application software is developed using a commercial packet LabView as the basis.

  6. Direct-current characteristics of pnp AlGaN/GaN heterojunction bipolar transistors

    International Nuclear Information System (INIS)

    AlGaN/GaN pnp heterojunction bipolar transistors were fabricated using a low-damage dry-etch process, and the dc characteristics measured up to 250 degree sign C. In the common-base mode, the collector current was approximately equal to the emitter current under all conditions. Although not optimized for power operations, the devices were tested up to power densities of ∼50 kW cm-2. The dc current gain was in the range 20-25 at room temperature. The pnp configuration avoids the problem of high base sheet resistance encountered with npn-AlGaN/GaN devices. (c) 2000 American Institute of Physics

  7. Direct-current characteristics of pnp AlGaN/GaN heterojunction bipolar transistors

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, A. P. [Department of Chemical Engineering, University of Florida, Gainesville, Florida 32611 (United States); Dang, G. T. [Department of Chemical Engineering, University of Florida, Gainesville, Florida 32611 (United States); Ren, F. [Department of Chemical Engineering, University of Florida, Gainesville, Florida 32611 (United States); Han, J. [Sandia National Laboratories, Albuquerque, New Mexico 87185 (United States); Baca, A. G. [Sandia National Laboratories, Albuquerque, New Mexico 87185 (United States); Shul, R. J. [Sandia National Laboratories, Albuquerque, New Mexico 87185 (United States); Cho, H. [Department of Materials Science and Engineering, University of Florida, Gainesville, Florida 32611 (United States); Monier, C. [Department of Materials Science and Engineering, University of Florida, Gainesville, Florida 32611 (United States); Cao, X. A. [Department of Materials Science and Engineering, University of Florida, Gainesville, Florida 32611 (United States); Abernathy, C. R. [Department of Materials Science and Engineering, University of Florida, Gainesville, Florida 32611 (United States)] (and others)

    2000-05-15

    AlGaN/GaN pnp heterojunction bipolar transistors were fabricated using a low-damage dry-etch process, and the dc characteristics measured up to 250 degree sign C. In the common-base mode, the collector current was approximately equal to the emitter current under all conditions. Although not optimized for power operations, the devices were tested up to power densities of {approx}50 kW cm-2. The dc current gain was in the range 20-25 at room temperature. The pnp configuration avoids the problem of high base sheet resistance encountered with npn-AlGaN/GaN devices. (c) 2000 American Institute of Physics.

  8. Bipolar disorder.

    Science.gov (United States)

    Grande, Iria; Berk, Michael; Birmaher, Boris; Vieta, Eduard

    2016-04-01

    Bipolar disorder is a recurrent chronic disorder characterised by fluctuations in mood state and energy. It affects more than 1% of the world's population irrespective of nationality, ethnic origin, or socioeconomic status. Bipolar disorder is one of the main causes of disability among young people, leading to cognitive and functional impairment and raised mortality, particularly death by suicide. A high prevalence of psychiatric and medical comorbidities is typical in affected individuals. Accurate diagnosis of bipolar disorder is difficult in clinical practice because onset is most commonly a depressive episode and looks similar to unipolar depression. Moreover, there are currently no valid biomarkers for the disorder. Therefore, the role of clinical assessment remains key. Detection of hypomanic periods and longitudinal assessment are crucial to differentiate bipolar disorder from other conditions. Current knowledge of the evolving pharmacological and psychological strategies in bipolar disorder is of utmost importance. PMID:26388529

  9. Leadless Cardiac Pacemakers: Back to the Future.

    Science.gov (United States)

    Miller, Marc A; Neuzil, Petr; Dukkipati, Srinivas R; Reddy, Vivek Y

    2015-09-01

    Despite significant advances in battery longevity, lead performance, and programming features since the first implanted permanent pacemaker was developed, the basic design of cardiac pacemakers has remained relatively unchanged over the past 50 years. Because of inherent limitations in their design, conventional (transvenous) pacemakers are prone to multiple potential short- and long-term complications. Accordingly, there has been intense interest in a system able to provide the symptomatic and potentially lifesaving therapies of cardiac pacemakers while mitigating many of the risks associated with their weakest link-the transvenous lead. Leadless cardiac pacing represents the future of cardiac pacing systems, similar to the transition that occurred from the use of epicardial pacing systems to the familiar transvenous systems of today. This review summarizes the current evidence and potential benefits of leadless pacing systems, which are either commercially available (in Europe) or under clinical investigation. PMID:26337997

  10. Regulating Current Rectification and Nanoparticle Transport Through a Salt Gradient in Bipolar Nanopores.

    Science.gov (United States)

    Lin, Chih-Yuan; Yeh, Li-Hsien; Hsu, Jyh-Ping; Tseng, Shiojenn

    2015-09-16

    Tuning of ion and nanoparticle transport is validated through applying a salt gradient in two types of nanopores: the inner wall of a nanopore has bipolar charges and its outer wall neutral (type I), and both the inner and outer walls of a nanopore have bipolar charges (type II). The ion current rectification (ICR) behavior of these nanopores can be regulated by an applied salt gradient: if it is small, the degree of ICR in type II nanopore is more significant than that in type I nanopore; a reversed trend is observed at a sufficiently large salt gradient. If the applied salt gradient and electric field have the same direction, type I nanopore exhibits two significant features that are not observed in type II nanopore: (i) a cation-rich concentration polarization field and an enhanced funneling electric field are present near the cathode side of the nanopore, and (ii) the magnitude of the axial electric field inside the nanopore is reduced. These features imply that applying a salt gradient to type I nanopore is capable of simultaneously enhancing the nanoparticle capture into the nanopore and reducing its translocation velocity inside, so that high sensing performance and resolution can be achieved.

  11. Bipolar square-wave current source for transient electromagnetic systems based on constant shutdown time

    Science.gov (United States)

    Wang, Shilong; Yin, Changchun; Lin, Jun; Yang, Yu; Hu, Xueyan

    2016-03-01

    Cooperative work of multiple magnetic transmitting sources is a new trend in the development of transient electromagnetic system. The key is the bipolar current waves shutdown, concurrently in the inductive load. In the past, it was difficult to use the constant clamping voltage technique to realize the synchronized shutdown of currents with different peak values. Based on clamping voltage technique, we introduce a new controlling method with constant shutdown time. We use the rising time to control shutdown time and use low voltage power source to control peak current. From the viewpoint of the circuit energy loss, by taking the high-voltage capacitor bypass resistance and the capacitor of the passive snubber circuit into account, we establish the relationship between the rising time and the shutdown time. Since the switch is not ideal, we propose a new method to test the shutdown time by the low voltage, the high voltage and the peak current. Experimental results show that adjustment of the current rising time can precisely control the value of the clamp voltage. When the rising time is fixed, the shutdown time is unchanged. The error for shutdown time deduced from the energy consumption is less than 6%. The new controlling method on current shutdown proposed in this paper can be used in the cooperative work of borehole and ground transmitting system.

  12. Compliance current dependence of conversion between bipolar, unipolar, and threshold resistance switching in Mn3O4 films

    Directory of Open Access Journals (Sweden)

    Shuxiang Wu

    2015-08-01

    Full Text Available We report deterministic conversion between bipolar, unipolar and threshold resistance switching in Pt/Mn3O4/Pt memory devices via tuning compliance current. The conversion between bipolar and unipolar switching is reversible, while that between memory switching and threshold switching is irreversible. The nonvolatile bipolar resistance switching behaviors could be attributed to modification of Schottky barrier at Pt/Mn3O4 interface due to the migration of positively charged oxygen vacancies. With the increase of current, the incomplete filament formed in the set operation of bipolar switching could continue to grow and until completely form. The subsequent rupture and formation of filament consisting of oxygen vacancies under electric field are responsible for the unipolar resistance switching. Further increase of compliance current causes the volatile threshold switching behavior in the Pt/Mn3O4/Pt devices, which could be originated from formation and rupture of filament consisting of Mn ions due to the high Joule heat generated by large current.

  13. Bipolar disorder

    OpenAIRE

    Goodwin, Frederick K; Ghaemi, S Nassir

    1999-01-01

    Bipolar disorder's unique combination of three characteristics - clear genetic diathesis, distinctive clinical features, early availability of an effective treatment (lithium) - explains its special place in the history of psychiatry and its contribution to the current explosive growth of neuroscience. This article looks at the state of the art in bipolar disorder from the vantage point of: (i) genetics (possible linkages on chromosomes 18 and 21q, polygenic hypothesis, research into genetic ...

  14. Pharmacological Analysis of the Activation and Receptor Properties of the Tonic GABACR Current in Retinal Bipolar Cell Terminals

    OpenAIRE

    Jones, Stefanie M.; Palmer, Mary J

    2011-01-01

    GABAergic inhibition in the central nervous system (CNS) can occur via rapid, transient postsynaptic currents and via a tonic increase in membrane conductance, mediated by synaptic and extrasynaptic GABA(A) receptors (GABA(A)Rs) respectively. Retinal bipolar cells (BCs) exhibit a tonic current mediated by GABA(C)Rs in their axon terminal, in addition to synaptic GABA(A)R and GABA(C)R currents, which strongly regulate BC output. The tonic GABA(C)R current in BC terminals (BCTs) is not dependen...

  15. Early intervention for bipolar disorder: current imperatives, future directions Intervenção precoce no transtorno bipolar: necessidades atuais, rumos futuros

    OpenAIRE

    Matthew Taylor; Rodrigo Affonseca Bressan; Pedro Mario Pan; Elisa Brietzke

    2011-01-01

    OBJECTIVES: The objective of this article is to discuss the rationale/background for early intervention in bipolar disorder. METHOD: Narrative review. RESULTS: There are often significant delays before the diagnosis of bipolar disorder is made and effective management initiated. Growing evidence from both preclinical and clinical literature points to a clear need for improved early identification and early intervention in bipolar disorder. Increasing efforts are being applied to the identific...

  16. Cytokines in bipolar disorder

    DEFF Research Database (Denmark)

    Munkholm, Klaus; Vinberg, Maj; Vedel Kessing, Lars

    2012-01-01

    BACKGROUND: Current research and hypothesis regarding the pathophysiology of bipolar disorder suggests the involvement of immune system dysfunction that is possibly related to disease activity. Our objective was to systematically review evidence of cytokine alterations in bipolar disorder according...... to affective state. METHODS: We conducted a systemtic review of studies measuring endogenous cytokine concentrations in patients with bipolar disorder and a meta-analysis, reporting results according to the PRISMA statement. RESULTS: Thirteen studies were included, comprising 556 bipolar disorder patients...

  17. Cardiac pacemaker power sources

    International Nuclear Information System (INIS)

    A review of chemical and radioisotope batteries used in cardiac pacemakers is presented. The battery systems are examined in terms of longevity, reliability, cost, size and shape, energy density, weight, internal resistance versus time, end-of-life voltage, chemical compatibility, and potential failure mechanisms

  18. Bipolar disorder: a review of current U.S. Food and Drug Administration approved pharmacotherapy

    Directory of Open Access Journals (Sweden)

    Aashal B. Shah

    2015-08-01

    Full Text Available Bipolar disorder (BD is a chronic disorder which usually has its onset in early adulthood. At one end of the spectrum is depression and at other is mania. Like many psychiatric illnesses, it is not treatable but its symptoms are completely manageable with medications. Commonly used drugs are mood stabilizers and atypical antipsychotics along with adjunctive medications such as anxiolytics and antidepressants. In general, a combination of these drugs is used for treatment. These drugs have significant adverse effects which add to the burden of the disease. Presently, there are 11 US Food and Drug Administration - approved drugs for management of acute mania, 3 for bipolar depression and 7 for bipolar maintenance. This review article details the use of these drugs in BD. [Int J Basic Clin Pharmacol 2015; 4(4.000: 623-631

  19. Aripiprazole as augmentation therapy in bipolar patients with current minor or subsyndromal mood symptoms

    OpenAIRE

    Schweitzer, Isaac; Sarris, Jerome; Tuckwell, Virginia; Maguire, Kay; Smith, Deidre; Ng, Chee

    2013-01-01

    Background This study aims to evaluate the effectiveness of aripiprazole augmentation of maintenance treatment for bipolar disorder in patients with minor or subsyndromal mood episodes while on a stable dose of a mood stabiliser and/or antidepressant. Methods All subjects had a diagnosis of bipolar I or II disorder (Diagnostic and Statistical Manual of Mental Disorders-4th Edition, Text Revision). Open-label aripiprazole was given over 8 weeks initially. The starting dose was 5 to 15 mg/day w...

  20. Early intervention for bipolar disorder: current imperatives, future directions Intervenção precoce no transtorno bipolar: necessidades atuais, rumos futuros

    Directory of Open Access Journals (Sweden)

    Matthew Taylor

    2011-10-01

    Full Text Available OBJECTIVES: The objective of this article is to discuss the rationale/background for early intervention in bipolar disorder. METHOD: Narrative review. RESULTS: There are often significant delays before the diagnosis of bipolar disorder is made and effective management initiated. Growing evidence from both preclinical and clinical literature points to a clear need for improved early identification and early intervention in bipolar disorder. Increasing efforts are being applied to the identification of those at high risk of onset of bipolar disorder. It is hoped that identification of an early prodrome of illness will allow preventative measures to be taken. CONCLUSIONS: There is a clear rationale for improved early identification and early intervention in bipolar disorder.OBJETIVOS: O objetivo do artigo é discutir os fundamentos para a intervenção precoce no transtorno bipolar. MÉTODO: Revisão narrativa. RESULTADOS: Frequentemente existe um atraso significativo com relação ao momento em que o transtorno bipolar é detectado e o início do tratamento. Evidências crescentes oriundas de estudos pré-clínicos e clínicos apontam para a clara necessidade de melhorar a detecção e o tratamento precoces no transtorno bipolar. Esforços também tem sido direcionados para a identificação de indivíduos em alto risco. Espera-se que a identificação do pródromo do transtorno bipolar permita a instauração de medidas preventivas. CONCLUSÕES: Existem bases claras para o investimento na melhora da detecção e tratamento precoces do transtorno bipolar.

  1. Effects of switching to aripiprazole from current atypical antipsychotics on subsyndromal symptoms and tolerability in patients with bipolar disorder.

    Science.gov (United States)

    Woo, Young Sup; Bahk, Won-Myong; Park, Young-Min; Chung, Sangkeun; Yoon, Bo-Hyun; Won, Seunghee; Lee, Jeong Goo; Lee, Hwang-Bin; Kim, Won; Jeong, Jong-Hyun; Lee, Kwanghun; Kim, Moon-Doo

    2016-09-01

    We evaluated the effectiveness of aripiprazole among bipolar patients who had switched to this medication as a result of difficulty maintaining on their prestudy atypical antipsychotics (AAPs) because of subsyndromal mood symptoms or intolerance. This study included 77 bipolar patients who were in syndromal remission with an AAP as monotherapy or with an AAP combined with a mood stabilizer(s) who needed to switch from their present AAP because of subsyndromal symptoms or intolerance. At 24 weeks after switching to aripiprazole, the remission rates on the Montgomery-Åsberg Depression Rating Scale (MADRS) and on both the MADRS and the Young Mania Rating Scale were increased significantly in the full sample and in the inefficacy subgroup. In the inefficacy subgroup, the MADRS score change was significant during the 24 weeks of study. Total cholesterol and prolactin decreased significantly after switching to aripiprazole. The proportion of patients who had abnormal values for central obesity and hypercholesterolemia decreased significantly from baseline to week 24. These findings suggest that a change from the current AAP to aripiprazole was associated with improvement in subsyndromal mood symptoms and several lipid/metabolic or safety profile parameters in patients with bipolar disorder with tolerability concerns or subsyndromal mood symptoms. PMID:27487259

  2. Low-temperature characteristics of the current gain of GaN/InGaN double-heterojunction bipolar transistors

    Science.gov (United States)

    Nishikawa, Atsushi; Kumakura, Kazuhide; Kasu, Makoto; Makimoto, Toshiki

    2009-05-01

    We investigated the temperature dependence of the current gain of npn-type GaN/InGaN double-heterojunction bipolar transistors (DHBTs) in the low-temperature region. The current gain increased with decrease in device temperature due to the reduction of the recombination current in the p-type base layer. The current gain reached as high as 5000 at 40 K, which is the highest among nitride-based HBTs. For conventional HBTs made of InP or GaAs, the current gain decreased with decreasing device temperature. However, no reduction of the current gain was observed in this study, suggesting that the minority carrier mobility in the p-type InGaN base layer has negative temperature dependence, presumably because the ionized impurity scattering is relatively unaffected owing to the carrier freezeout and the high activation energy of Mg in the p-InGaN base layer.

  3. Circadian rhythms in the neuorbiology of bipolar of bipolar disorder

    OpenAIRE

    Timothy, Joseph

    2015-01-01

    Daily rhythms of physiology and behaviour in mammals are orchestrated by a hierarchical network of cellular oscillators. The master pacemaker that defines local and systemic timing across the brain and body are the suprachiasmatic nuclei of the hypothalamus (SCN). Disruption to the timing of sleep and daily behavioural activity can manifest in a range of pathologies including neuropsychiatric disorders. Bipolar disorder (BPD) is once such neurological condition that exhibits profound associat...

  4. Attentional biases for emotional facial stimuli in currently depressed patients with bipolar disorder

    Directory of Open Access Journals (Sweden)

    Lemke Leyman

    2009-01-01

    Full Text Available En comparación con las numerosas investigaciones centradas en los factores de vulnerabilidad cognitiva que subyacen en el inicio y el desarrollo del trastorno depresivo mayor, los estudios que investigan el procesamiento disfuncional de la información emocional en el trastorno bipolar siguen siendo escasos. Por ello, el presente estudio experimental ha analizado la naturaleza y el curso temporal de los sesgos atencionales en pacientes depresivos con trastorno bipolar. Un total de catorce pacientes deprimidos con Trastorno Bipolar I (TB y catorce participantes controles no deprimidos (CN, emparejados en edad, sexo y nivel educativo, realizaron una modificación emocional de la tarea de señalización espacial. Las señales consistían en expresiones faciales de enfado, neutrales y positivas presentadas durante 200 y 1.000 ms. Los pacientes con TB mostraron un mayor efecto de validación de las señales en las caras de enfado y presentaron más dificultades a la hora de desvincular la atención de las expresiones faciales de enfado y de alegría en comparación con los participantes CN, que por el contrario, demostraron un «sesgo protector» distanciado de la información negativa. Este patrón diferenciado de procesamiento atencional solo se halló en la fase inicial del procesamiento de la información en una presentación de 200 ms de duración. Estos resultados demuestran la existencia de déficits en las fases iniciales del procesamiento atencional de la información emocional en pacientes deprimidos bipolares en comparación con los controles sanos.

  5. Water Dissociation Phenomena on a Bipolar Membrane——Current-voltage Curve in Relation with Ionic Transport and Limiting Current Density

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    The water dissociation mechanism on a bipolar membrane under the electrical field was investigated and characterized in terms of ionic transport and limiting current density. It is considered that the depletion layer exists at the junction of a bipolar membrane, which is coincided with the viewpoint of the most literatures, but we also consider that the thickness and conductivity of this layer is not only related with the increase of the applied voltage but also with the limiting current density. Below the limiting current density, the thickness of the depletion layer keeps a constant and the conductivity decreases with the increase of the applied voltage;while above the limiting current density, the depletion thickness will increase with the increase of the applied voltage and the conductivity keeps a very low constant. Based on the data reported in the literatures and independent determinations, the limiting current density was calculated and the experimental curves Ⅰ- Ⅴ in the two directions were compared with the theoretical calculations. It is demonstrated that above the limiting current density, the experimental results,either in the L-H direction or in the H-L direction, are consistent with the theoretical calculations; below the limiting current density, a slight deviation exists between the experimental and the theoretical results, and between the experimental results in the two directions. The change in Donnan potential due to the asymmetry of the mono-layers and the changes of ionic composition in the two directions is possibly responsible for this deviation.

  6. Current management of bipolar affective disorder: is it reflective of the BAP guidelines?

    Science.gov (United States)

    Farrelly, N; Dibben, C; Hunt, N

    2006-01-01

    In October 2003 the British Association of Psychopharmacology (BAP) published evidence-based guidelines on the management of bipolar disorder. The aim of this study was to assess whether the guidelines could provide the basis for examining clinical decisions and the extent to which practice accords with these guidelines. Case notes of out patients with bipolar disorder were reviewed. Demographic details, and treatment recommendations were determined. The management of affective episodes was evaluated and compared with BAP guidelines. In 84 subjects, 224 affective episodes were identified. Treatment was consistent with BAP guidelines in 72% of episodes. Mania was more likely to be managed in accordance with guidelines than depression or mixed episodes. The use of antidepressant medication was the most likely intervention to deviate from recommendations. Reasons for treatments at odds with the guidelines were identified. Our study demonstrates that clinical practice among a range of psychiatrists broadly reflects the guidelines that have been issued by the British Association of Psychopharmacology (BAP). The BAP guidelines offer a practical and auditable basis for the short- and long-term treatment of bipolar affective disorder.

  7. Prefronto-Cerebellar Transcranial Direct Current Stimulation Improves Sleep Quality in Euthymic Bipolar Patients: A Brief Report

    OpenAIRE

    Amedeo Minichino; Francesco Saverio Bersani; Francesco Spagnoli; Alessandra Corrado; Francesco De Michele; Wanda Katharina Calò; Martina Primavera; Baoran Yang; Laura Bernabei; Francesco Macrì; Lucilla Vergnani; Massimo Biondi; Roberto Delle Chiaie

    2014-01-01

    Introduction. Sleep problems are common in bipolar disorder (BD) and may persist during the euthymic phase of the disease. The aim of the study was to improve sleep quality of euthymic BD patients through the administration of prefronto-cerebellar transcranial direct current stimulation (tDCS). Methods. 25 euthymic outpatients with a diagnosis of BD Type I or II have been enrolled in the study. tDCS montage was as follows: cathode on the right cerebellar cortex and anode over the left dorsola...

  8. Current density and catalyst-coated membrane resistance distribution of hydro-formed metallic bipolar plate fuel cell short stack with 250 cm2 active area

    Science.gov (United States)

    Haase, S.; Moser, M.; Hirschfeld, J. A.; Jozwiak, K.

    2016-01-01

    An automotive fuel cell with an active area of 250 cm2 is investigated in a 4-cell short stack with a current and temperature distribution device next to the bipolar plate with 560 current and 140 temperature segments. The electrical conductivities of the bipolar plate and gas diffusion layer assembly are determined ex-situ with this current scan shunt module. The applied fuel cell consists of bipolar plates constructed of 75-μm-thick, welded stainless-steel foils and a graphitic coating. The electrical conductivities of the bipolar plate and gas diffusion layer assembly are determined ex-situ with this module with a 6% deviation in in-plane conductivity. The current density distribution is evaluated up to 2.4 A cm-2. The entire cell's investigated volumetric power density is 4.7 kW l-1, and its gravimetric power density is 4.3 kW kg-1 at an average cell voltage of 0.5 V. The current density distribution is determined without influencing the operating cell. In addition, the current density distribution in the catalyst-coated membrane and its effective resistivity distribution with a finite volume discretisation of Ohm's law are evaluated. The deviation between the current density distributions in the catalyst-coated membrane and the bipolar plate is determined.

  9. Protection of pacemaker wearers: effects on magnetic fields on the operation of implanted cardiac pacemakers

    International Nuclear Information System (INIS)

    The aim of this study was to assess the changes in the behavior of cardiac pacemakers exposed to 50 and 60 Hz magnetic fields generated by industrial current and 20 to 50 khz magnetic fields generated by a household in a booming period - the induction cook top - and to study the incidence of these changes in a population of subjects with implanted pacemakers. This will enabled to give patients advices about dealing with electric transport lines and facilities and with induction cook tops and to advise manufacturers about the risks involved

  10. Evolução do conceito e controvérsias atuais sobre o transtorno bipolar do humor Bipolar disorder: evolution of the concept and current controversies

    Directory of Open Access Journals (Sweden)

    José Alberto Del Porto

    2004-10-01

    Full Text Available O autor revê o conceito de transtorno bipolar como um processo em evolução. Suas raízes podem ser encontradas no trabalho de Araeteus da Capadócia, que assumia serem a melancolia e a mania duas formas da mesma doença. A compreensão atual da doença bipolar começou na França, através dos trabalhos de Falret (1851 e Baillarguer (1854. Os conceitos fundamentais de Kraepelin mudaram as bases da nosologia psiquiátrica, e o conceito unitário de Kraepelin sobre a insanidade maníaco-depressiva passou a ser amplamente aceito. Depois de Kraepelin, no entanto, as idéias de Kleist e Leonhard, na Alemanha, e o trabalho subseqüente de Angst, Perris e Winokur enfatizaram a distinção entre as formas monopolares e bipolares da depressão. Mais recentemente a ênfase mudou novamente para o espectro bipolar, que em suas formas leves expande-se às bordas dos temperamentos normais. Finalizando, o autor sumariza os aspectos polêmicos da nosologia da doença bipolar e seus limites com as esquizofrenias, a doença esquizoafetiva e as psicoses ciclóides.The author reviews the evolution of the concept of bipolar disorder as an ongoing process. Its roots can be found in the work of Araeteus of Capadocia, who assumed that melancholia and mania were two forms of the same disease. The modern understanding of bipolar disorder began in France, through the work of Falret (1851 and Baillarger (1854. The pivotal concepts of Emil Kraepelin changed the basis of psychiatric nosology, and Kraepelin's unitary concept of manic-depressive insanity was largely accepted. Kraepelin and Weigandt's ideas on mixed states were the cornerstone of this unitary concept. After Kraepelin, however, the ideas of Kleist and Leonhard, in Germany, as well as the work of Angst, Perris and Winokur, emphasized the distinction between unipolar and bipolar forms of depression. More recently, the emphasis has shifted again to the bipolar spectrum, which, in its mild forms, expanded to the

  11. The Bipolar Field-Effect Transistor:Ⅶ. The Unipolar Current Mode for Analog-RF Operation(Two-MOS-Gates on Pure-Base

    Institute of Scientific and Technical Information of China (English)

    Jie Binbin; Sah Chih-Tang

    2009-01-01

    This paper reports the DC steady-state current-voltage and conductance-voltage characteristics of a Bipolar Field-Effect Transistor (BiFET) under the unipolar (electron) current mode of operation, with bipolar (elec-tron and hole) charge distributions considered. The model BiFET example presented has two MOS-gates on the two surfaces of a thin pure silicon base layer with electron and hole contacts on both edges of the thin base. The hole contacts on both edges of the thin pure base layer are grounded to give zero hole current. This 1-transistor analog-RF Basic Building Block nMOS amplifier circuit, operated in the unipolar current mode, complements the 1-transistor digital Basic Build Block CMOS voltage inverter circuit, operated in the bipolar-current mode just presented by us.

  12. Therapeutic Mechanisms of Lithium in Bipolar Disorder: Recent Advances and Current Understanding.

    Science.gov (United States)

    Malhi, Gin S; Outhred, Tim

    2016-10-01

    Lithium is the most effective and well established treatment for bipolar disorder, and it has a broad array of effects within cellular pathways. However, the specific processes through which therapeutic effects occur and are maintained in bipolar disorder remain unclear. This paper provides a timely update to an authoritative review of pertinent findings that was published in CNS Drugs in 2013. A literature search was conducted using the Scopus database, and was limited by year (from 2012). There has been a resurgence of interest in lithium therapy mechanisms, perhaps driven by technical advancements in recent years that permit the examination of cellular mechanisms underpinning the effects of lithium-along with the reuptake of lithium in clinical practice. Recent research has further cemented glycogen synthase kinase 3β (GSK3β) inhibition as a key mechanism, and the inter-associations between GSK3β-mediated neuroprotective, anti-oxidative and neurotransmission mechanisms have been further elucidated. In addition to highly illustrative cellular research, studies examining higher-order biological systems, such as circadian rhythms, as well as employing innovative animal and human models, have increased our understanding of how lithium-induced changes at the cellular level possibly translate to changes at behavioural and clinical levels. Neural circuitry research is yet to identify clear mechanisms of change in bipolar disorder in response to treatment with lithium, but important structural findings have demonstrated links to the modulation of cellular mechanisms, and peripheral marker and pharmacogenetic studies are showing promising findings that will likely inform the exploration for predictors of lithium treatment response. With a deeper understanding of lithium's therapeutic mechanisms-from the cellular to clinical levels of investigation-comes the opportunity to develop predictive models of lithium treatment response and identify novel drug targets, and

  13. Cardiac pacemakers and nuclear batteries

    International Nuclear Information System (INIS)

    Following the introduction giving the indications for cardiac pacemaker therapy with special regard to the use of pacemakers powered by nuclear batteries, reference is made to the resulting radiation exposure of the patient. The activities of the Federal Health Office in this field such as recommendations and surveys including the entire Federal Republic are outlined. (orig.)

  14. Study of Cutoff Frequency of High Collector Current Density in SiGe Single-Heterojunction Bipolar Transistor

    Directory of Open Access Journals (Sweden)

    G. M. Khanduri

    2004-01-01

    Full Text Available The cutoff frequency performance of an NPN Si/SiGe/SiGe Single-heterojunction bipolar transistor (SiGe SHBT at high collector current densities has been analyzed using a 2-dimensional MEDICI device simulator. A conventional NPN Si/SiGe/Si Double-heterojunction bipolar transistor (SiGe DHBT having uniform 14%Ge in the base region has been investigated for comparison. The analysis shows the formation of a retarding potential barrier for minority carrier electrons at the basecollector heterojunction of the DHBT structure. Whereas, the base-collector homojunction of the SiGe SHBT structure, having a uniform 14%Ge profile in its base and collector, inhibits the formation of such a retarding potential barrier. The SHBT structure with a base-collector homojunction shows an Improved cutoff frequency at a high collector current density in comparison with conventional SiGe DHBT, which makes it more promising for high speed, scaled down, field-specific applications.

  15. Reuse of Occluded Veins During Permanent Pacemaker Lead Extraction: A New Indication for Femoral Lead Extraction

    OpenAIRE

    Staniforth, Andrew D; Schilling, Richard J

    2002-01-01

    Objectives: This study examined the utility of a novel technique for reuse of thrombosed veins when extracting permanent pacemaker leads via a femoral vein approach. Background: Although lead extraction permanent pacemaker using a femoral approach has advantages over the subclavian approach, it cannot be used to provide access for a new lead using currently employed techniques. This is important because up to 23% of patients have occluded veins after permanent pacemaker implantation. M...

  16. Echocardiographic Improvements with Pacemaker Optimization in the Chronic Post Cardiac Resynchronization Therapy Setting

    OpenAIRE

    Alan J. Bank; Burns, Kevin V; Kelly, Aaron S.; Andrea M. Thelen; Kaufman, Christopher L.; Stuart W. Adler

    2008-01-01

    The current study assessed the acute effects of pacemaker optimization (PMO) on cardiac function using echocardiographic (ECHO) tissue Doppler imaging (TDI) in the post CRT setting. Data were analyzed from 50 consecutive patients clinically referred for PMO. Patients underwent a sequential ECHO/TDIguided PMO study to determine optimal pacemaker settings. In 34 of 50 patients a change in pacemaker settings was made because of an objective improvement in ECHO/TDI findings.Overall, significant i...

  17. Effects of irradiation on the components of implantable pacemakers

    International Nuclear Information System (INIS)

    The purpose of this study was to examine the effects of irradiation on implantable pacemaker components. The pacemaker was divided into three components: lead wire and electrode, battery, and electrical circuit, and each component was irradiated by X-ray and electron beams, respectively. The pacemaker parameters were measured by both telemetry data of the programmer and directly measured data from the output terminal. The following results were obtained. For the lead wire and electrode, there was no effect on the pacemaker function due to irradiation by X-ray and electron beams. In the case of battery irradiation, there was no change in battery voltage or current up to 236 Gy X-ray dose. In the electrical circuit, the pacemaker reverted to the regular beating rate (fixed-rate mode) immediately after the start of X-ray irradiation, and it continued in this mode during irradiation. In patients with their own heartbeat rhythm, changing to the fixed-rate mode may cause dangerous conditions such as ventricular fibrillation. When the accumulated irradiation dose is increased, another failure can be seen in the output voltage of the pacemaker. The pacing output voltage dropped rapidly by about 40% at 30-88 Gy. Decreasing the output voltage results in pacing disorders, and heart failure may occur. In the telemetry data of the programmer, no change in output voltage could be detected, highlighting the difference between telemetry data and actual pacing data. (author)

  18. Bipolar Disorder.

    Science.gov (United States)

    Miller, Thomas H

    2016-06-01

    Bipolar disorder is a chronic mental health disorder that is frequently encountered in primary care. Many patients with depression may actually have bipolar disorder. The management of bipolar disorder requires proper diagnosis and awareness or referral for appropriate pharmacologic therapy. Patients with bipolar disorder require primary care management for comorbidities such as cardiovascular and metabolic disorders. PMID:27262007

  19. Functiogenesis of cardiac pacemaker activity.

    Science.gov (United States)

    Sakai, Tetsuro; Kamino, Kohtaro

    2016-07-01

    Throughout our investigations on the ontogenesis of the electrophysiological events in early embryonic chick hearts, using optical techniques to record membrane potential probed with voltage-sensitive dyes, we have introduced a novel concept of "functiogenesis" corresponding to "morphogenesis". This article gives an account of the framework of "functiogenesis", focusing on the cardiac pacemaker function and the functional organization of the pacemaking area. PMID:26719289

  20. Pharmacological analysis of the activation and receptor properties of the tonic GABA(CR current in retinal bipolar cell terminals.

    Directory of Open Access Journals (Sweden)

    Stefanie M Jones

    Full Text Available GABAergic inhibition in the central nervous system (CNS can occur via rapid, transient postsynaptic currents and via a tonic increase in membrane conductance, mediated by synaptic and extrasynaptic GABA(A receptors (GABA(ARs respectively. Retinal bipolar cells (BCs exhibit a tonic current mediated by GABA(CRs in their axon terminal, in addition to synaptic GABA(AR and GABA(CR currents, which strongly regulate BC output. The tonic GABA(CR current in BC terminals (BCTs is not dependent on vesicular GABA release, but properties such as the alternative source of GABA and the identity of the GABA(CRs remain unknown. Following a recent report that tonic GABA release from cerebellar glial cells is mediated by Bestrophin 1 anion channels, we have investigated their role in non-vesicular GABA release in the retina. Using patch-clamp recordings from BCTs in goldfish retinal slices, we find that the tonic GABA(CR current is not reduced by the anion channel inhibitors NPPB or flufenamic acid but is reduced by DIDS, which decreases the tonic current without directly affecting GABA(CRs. All three drugs also exhibit non-specific effects including inhibition of GABA transporters. GABA(CR ρ subunits can form homomeric and heteromeric receptors that differ in their properties, but BC GABA(CRs are thought to be ρ1-ρ2 heteromers. To investigate whether GABA(CRs mediating tonic and synaptic currents may differ in their subunit composition, as is the case for GABA(ARs, we have examined the effects of two antagonists that show partial ρ subunit selectivity: picrotoxin and cyclothiazide. Tonic and synaptic GABA(CR currents were differentially affected by both drugs, suggesting that a population of homomeric ρ1 receptors contributes to the tonic current. These results extend our understanding of the multiple forms of GABAergic inhibition that exist in the CNS and contribute to visual signal processing in the retina.

  1. Management of bipolar depression

    Directory of Open Access Journals (Sweden)

    Jae Seung Chang

    2011-01-01

    Full Text Available Patients with bipolar disorder spend more time in a depressed than manic state, even with individualized treatment. To date, bipolar depression is often misdiagnosed and ineffectively managed both for acute episodes and residual symptoms. This review attempts to summarize the current status of available treatment strategies in the treatment of bipolar depression. For acute and prophylactic treatment, a substantial body of evidence supports the antidepressive efficacy of lithium for bipolar disorders and its antisuicidal effects. Among numerous anticonvulsants with mood-stabilizing properties, valproate and lamotrigine could be first-line options for bipolar depression. Due to receptor profile, mood-stabilizing properties of second-generation antipsychotics have been explored, and up to date, quetiapine and olanzapine appear to be a reasonable option for bipolar depression. The usefulness of antidepressants in bipolar depression is still controversial. Current guidelines generally recommend the cautious antidepressant use in combination with mood stabilizers to reduce the risk of mood elevation or cycle acceleration. Results from clinical trials on psychosocial intervention are promising, especially when integrated with pharmacotherapy. Most patients with bipolar depression need individualized and combined treatment, although the published evidence on this type of treatment strategy is limited. Future studies on the utility of currently available agents and modalities including psychosocial intervention are required.

  2. Changes in Neuronal Excitability by Activated Microglia: Differential Na(+) Current Upregulation in Pyramid-Shaped and Bipolar Neurons by TNF-α and IL-18.

    Science.gov (United States)

    Klapal, Lars; Igelhorst, Birte A; Dietzel-Meyer, Irmgard D

    2016-01-01

    Microglia are activated during pathological events in the brain and are capable of releasing various types of inflammatory cytokines. Here, we demonstrate that the addition of 5% microglia activated by 1 μg/ml lipopolysaccharides (LPS) to hippocampal cultures upregulates Na(+) current densities (INavD) of bipolar as well as pyramid-shaped neurons, thereby increasing their excitability. Deactivation of microglia by the addition of 10 ng/ml transforming growth factor-β (TGF-β) decreases INavD below control levels suggesting that the residual activated microglial cells influence neuronal excitability in control cultures. Preincubation of hippocampal cultures with 10 ng/ml tumor necrosis factor-α (TNF-α), a major cytokine released by activated microglia, upregulated INavD significantly by ~30% in bipolar cells, whereas in pyramid-shaped cells, the upregulation only reached an increase of ~14%. Incubation of the cultures with antibodies against either TNF-receptor 1 or 2 blocked the upregulation of INavD in bipolar cells, whereas in pyramid-shaped cells, increases in INavD were exclusively blocked by antibodies against TNF-receptor 2, suggesting that both cell types respond differently to TNF-α exposure. Since additional cytokines, such as interleukin-18 (IL-18), are released from activated microglia, we tested potential effects of IL-18 on INavD in both cell types. Exposure to 5-10 ng/ml IL-18 for 4 days increased INavD in both pyramid-shaped as well as bipolar neurons, albeit the dose-response curves were shifted to lower concentrations in bipolar cells. Our results suggest that by secretion of cytokines, microglial cells upregulate Na(+) current densities in bipolar and pyramid-shaped neurons to some extent differentially. Depending on the exact cytokine composition and concentration released, this could change the balance between the activity of inhibitory bipolar and excitatory pyramid-shaped cells. Since bipolar cells show a larger upregulation of

  3. Changes in neuronal excitability by activated microglia: Differential Na+ current up-regulation in pyramid-shaped and bipolar neurons by TNF-α and IL-18

    Directory of Open Access Journals (Sweden)

    Lars eKlapal

    2016-03-01

    Full Text Available Microglia are activated during pathological events in the brain and are capable of releasing various types of inflammatory cytokines. Here we demonstrate that the addition of 5% microglia activated by 1 µg/ml lipopolysaccharides (LPS to hippocampal cultures up-regulates Na+ current densities (INavD of bipolar as well as pyramid-shaped neurons, thereby increasing their excitability. Deactivation of microglia by the addition of 10 ng/ml transforming growth factor-β (TGF-β decreases INavD below control levels suggesting that the residual activated microglial cells influence neuronal excitability in control cultures. Preincubation of hippocampal cultures with 10 ng/ml tumor necrosis factor-α (TNF-α, a major cytokine released by activated microglia, up-regulated INavD significantly by ~30% in bipolar cells, whereas in pyramid-shaped cells the up-regulation only reached an increase of ~14%. Incubation of the cultures with antibodies against either TNF-receptor 1 or 2 blocked the up-regulation of INavD in bipolar cells, whereas in pyramid-shaped cells increases in INavD were exclusively blocked by antibodies against TNF-receptor 2, suggesting that both cell types respond differently to TNF-α exposure. Since additional cytokines, such as interleukin-18 (IL-18, are released from activated microglia we tested potential effects of IL-18 on INavD in both cell types. Exposure to 5-10 ng/ml IL-18 for 4 days increased INavD in both pyramid-shaped as well as bipolar neurons, albeit the dose-response curves were shifted to lower concentrations in bipolar cells. Our results suggest that by secretion of cytokines microglial cells up-regulate Na+ current densities in bipolar and pyramid-shaped neurons to some extent differentially. Depending on the exact cytokine composition and concentration released this could change the balance between the activity of inhibitory bipolar and excitatory pyramid-shaped cells. Since bipolar cells show a larger up-regulation of

  4. Modern pacemaker therapy

    Directory of Open Access Journals (Sweden)

    Mijatov Milan

    2010-01-01

    Full Text Available Introduction. Pacemakers are devices that modern medicine and cardiology cannot be imagined without. The technique of implantation comes to surgical procedure where all principles of asepsis and antisepsis have to be respected. Although some complications do happen, they are rather rare. Results. After the implantation of the device, the patient is not handicapped (unless the heart was additionally damaged. On the contrary, the patient returns to his work and functions normally within his family in most of the cases. The first medical appointment is scheduled a month after the implantation and the following are three and six months after. Types of devices. Today there are „new types of electrostimulation”- implantable cardioverter defibrillators and multisite electrostimulators. The former is implanted in patients at high risk of sudden cardiac death and the latter in patients with heart failure and left bundle branch block. Owing to these devices, the sudden cardiac death can be prevented successfully and the quality of a patient’s life is improved.

  5. Enhancement of Spontaneous Activity by HCN4 Overexpression in Mouse Embryonic Stem Cell-Derived Cardiomyocytes - A Possible Biological Pacemaker

    OpenAIRE

    Yukihiro Saito; Kazufumi Nakamura; Masashi Yoshida; Hiroki Sugiyama; Tohru Ohe; Junko Kurokawa; Tetsushi Furukawa; Makoto Takano; Satoshi Nagase; Hiroshi Morita; Kusano, Kengo F.; Hiroshi Ito

    2015-01-01

    Background Establishment of a biological pacemaker is expected to solve the persisting problems of a mechanical pacemaker including the problems of battery life and electromagnetic interference. Enhancement of the funny current (I f) flowing through hyperpolarization-activated cyclic nucleotide-gated (HCN) channels and attenuation of the inward rectifier K+ current (I K1) flowing through inward rectifier potassium (Kir) channels are essential for generation of a biological pacemaker. Therefor...

  6. A novel 4H-SiC lateral bipolar junction transistor structure with high voltage and high current gain

    Science.gov (United States)

    Deng, Yong-Hui; Xie, Gang; Wang, Tao; Sheng, Kuang

    2013-09-01

    In this paper, a novel structure of a 4H-SiC lateral bipolar junction transistor (LBJT) with a base field plate and double RESURF in the drift region is presented. Collector-base junction depletion extension in the base region is restricted by the base field plate. Thin base as well as low base doping of the LBJT therefore can be achieved under the condition of avalanche breakdown. Simulation results show that thin base of 0.32 μm and base doping of 3 × 1017 cm-3 are obtained, and corresponding current gain is as high as 247 with avalanche breakdown voltage of 3309 V when the drift region length is 30 μm. Besides, an investigation of a 4H-SiC vertical BJT (VBJT) with comparable breakdown voltage (3357 V) shows that the minimum base width of 0.25 μm and base doping as high as 8 × 1017 cm-3 contribute to a maximum current gain of only 128.

  7. Bipolar Disorder

    Science.gov (United States)

    Bipolar disorder is a serious mental illness. People who have it go through unusual mood changes. They go from ... down feeling is depression. The causes of bipolar disorder aren't always clear. It runs in families. ...

  8. Bipolar Disorder

    Science.gov (United States)

    ... types of psychotherapies. Other Treatment Options Electroconvulsive Therapy (ECT) : ECT can provide relief for people with severe bipolar ... been able to recover with other treatments. Sometimes ECT is used for bipolar symptoms when other medical ...

  9. Devices That May Interfere with Pacemakers

    Science.gov (United States)

    ... group of cellphone companies is studying that possibility. Bluetooth® headsets do not appear to interfere with pacemakers. ... group of cellphone companies is studying that possibility. Bluetooth® headsets do not appear to interfere with pacemakers. ...

  10. Structural tuning of nanogaps using electromigration induced by field emission current with bipolar biasing

    Energy Technology Data Exchange (ETDEWEB)

    Yagi, Mamiko; Ito, Mitsuki; Shirakashi, Jun-ichi, E-mail: shrakash@cc.tuat.ac.jp [Department of Electrical and Electronic Engineering, Tokyo University of Agriculture and Technology, Koganei, Tokyo 184-8588 (Japan)

    2015-07-07

    We report a new method for fabrication of Ni nanogaps based on electromigration induced by a field emission current. This method is called “activation” and is demonstrated here using a current source with alternately reversing polarities. The activation procedure with alternating current bias, in which the current source polarity alternates between positive and negative bias conditions, is performed with planar Ni nanogaps defined on SiO{sub 2}/Si substrates at room temperature. During negative biasing, a Fowler-Nordheim field emission current flows from the source (cathode) to the drain (anode) electrode. The Ni atoms at the tip of the drain electrode are thus activated and then migrate across the gap from the drain to the source electrode. In contrast, in the positive bias case, the field emission current moves the activated atoms from the source to the drain electrode. These two procedures are repeated until the tunnel resistance of the nanogaps is successively reduced from 100 TΩ to 48 kΩ. Scanning electron microscopy and atomic force microscopy studies showed that the gap separation narrowed from approximately 95 nm to less than 10 nm because of the Ni atoms that accumulated at the tips of both the source and drain electrodes. These results show that the alternately biased activation process, which is a newly proposed atom transfer technique, can successfully control the tunnel resistance of the Ni nanogaps and is a suitable method for formation of ultrasmall nanogap structures.

  11. Effects of irradiation on the components of implantable pacemakers

    CERN Document Server

    Kawamura, S; Kuga, N; Shiba, T; Hirose, T; Fujimoto, H; Toyoshima, T; Hyodo, K; Matoba, M

    2003-01-01

    The purpose of this study was to examine the effects of irradiation on implantable pacemaker components. The pacemaker was divided into three components: lead wire and electrode, battery, and electrical circuit, and each component was irradiated by X-ray and electron beams, respectively. The pacemaker parameters were measured by both telemetry data of the programmer and directly measured data from the output terminal. The following results were obtained. For the lead wire and electrode, there was no effect on the pacemaker function due to irradiation by X-ray and electron beams. In the case of battery irradiation, there was no change in battery voltage or current up to 236 Gy X-ray dose. In the electrical circuit, the pacemaker reverted to the regular beating rate (fixed-rate mode) immediately after the start of X-ray irradiation, and it continued in this mode during irradiation. In patients with their own heartbeat rhythm, changing to the fixed-rate mode may cause dangerous conditions such as ventricular fib...

  12. Temperature dependence of current-voltage characteristics of npn-type GaN /InGaN double heterojunction bipolar transistors

    Science.gov (United States)

    Nishikawa, Atsushi; Kumakura, Kazuhide; Makimoto, Toshiki

    2007-09-01

    We investigated the temperature dependence of the common-emitter current-voltage (I-V) characteristics of npn-type GaN /InGaN double heterojunction bipolar transistors. Although the current gain decreases with increasing measurement temperature, the current gain measured at 300°C is still as high as 308. The reduction of the current gain with temperature is attributed not only to the hole back-injection current from the base into the emitter but also to the shorter minority carrier diffusion length due to the increase in the carrier concentration of the p-InGaN base.

  13. Prefronto-Cerebellar Transcranial Direct Current Stimulation Improves Sleep Quality in Euthymic Bipolar Patients: A Brief Report

    Directory of Open Access Journals (Sweden)

    Amedeo Minichino

    2014-01-01

    Full Text Available Introduction. Sleep problems are common in bipolar disorder (BD and may persist during the euthymic phase of the disease. The aim of the study was to improve sleep quality of euthymic BD patients through the administration of prefronto-cerebellar transcranial direct current stimulation (tDCS. Methods. 25 euthymic outpatients with a diagnosis of BD Type I or II have been enrolled in the study. tDCS montage was as follows: cathode on the right cerebellar cortex and anode over the left dorsolateral prefrontal cortex (DLPFC; the intensity of stimulation was set at 2 mA and delivered for 20 min/die for 3 consecutive weeks. The Pittsburgh Sleep Quality Index (PSQI was used to assess sleep quality at baseline and after the tDCS treatment. Results. PSQI total score and all PSQI subdomains, with the exception of “sleep medication,” significantly improved after treatment. Discussion. This is the first study where a positive effect of tDCS on the quality of sleep in euthymic BD patients has been reported. As both prefrontal cortex and cerebellum may play a role in regulating sleep processes, concomitant cathodal (inhibitory stimulation of cerebellum and anodal (excitatory stimulation of DLPFC may have the potential to modulate prefrontal-thalamic-cerebellar circuits leading to improvements of sleep quality.

  14. Addition of a non-photic component to a light-based mathematical model of the human circadian pacemaker

    OpenAIRE

    St Hilaire, Melissa A.; Klerman, Elizabeth B.; Khalsa, Sat Bir; Wright, Kenneth P.; Czeisler, Charles A.; Kronauer, Richard E.

    2007-01-01

    Mathematical models have become vital to the study of many biological processes in humans due to the complexity of the physiological mechanisms underlying these processes and systems. While our current mathematical representation of the human circadian pacemaker has proven useful in many experimental situations, it uses as input only a direct effect of light on the circadian pacemaker. Although light (a photic stimulus) has been shown to be the primary synchronizer of the circadian pacemaker ...

  15. First Degree Pacemaker Exit Block

    Directory of Open Access Journals (Sweden)

    Johnson Francis

    2016-10-01

    Full Text Available Usually atrial and ventricular depolarizations follow soon after the pacemaker stimulus (spike on the ECG. But there can be an exit block due to fibrosis at the electrode - tissue interface at the lead tip. This can increase the delay between the spike and atrial or ventricular depolarization.

  16. Circadian Pacemaker – Temperature Compensation

    NARCIS (Netherlands)

    Gerkema, Menno P.; Binder, Marc D.; Hirokawa, Nobutaka; Windhorst, Uwe

    2009-01-01

    One of the defining characteristics of circadian pacemakers and indicates the independence of the speed of circadian clock processes of environmental temperature. Mechanisms involved, so far not elucidated in full detail, entail at least two processes that are similarly affected by temperature chang

  17. Neuroinflammation in bipolar disorders

    Directory of Open Access Journals (Sweden)

    Georgios D Kotzalidis

    2015-01-01

    Full Text Available Recent literature based on peripheral immunity findings speculated that neuroinflammation, with its connection to microglial activation, is linked to bipolar disorder. The endorsement of the neuroinflammatory hypotheses of bipolar disorder requires the demonstration of causality, which requires longitudinal studies. We aimed to review the evidence for neuroinflammation as a pathogenic mechanism of the bipolar disorder. We carried out a hyper inclusive PubMed search using all appropriate neuroinflammation-related terms and crossed them with bipolar disorder-related terms. The search produced 310 articles and the number rose to 350 after adding articles from other search engines and reference lists. Twenty papers were included that appropriately tackled the issue of the presence (but not of its pathophysiological role of neuroinflammation in bipolar disorder. Of these, 15 were postmortem and 5 were carried out in living humans. Most articles were consistent with the presence of neuroinflammation in bipolar disorder, but factors such as treatment may mask it. All studies were cross-sectional, preventing causality to be inferred. Thus, no inference can be currently made about the role of neuroinflammation in bipolar disorder, but a link is likely. The issue remains little investigated, despite an excess of reviews on this topic.

  18. [Future cardiac pacemakers – technical visions].

    Science.gov (United States)

    Haeberlin, Andreas; Zurbuchen, Adrian; Pfenniger, Aloïs; Fuhrer, Jürg; Vogel, Rolf

    2015-08-01

    Cardiac pacemakers are routinely used for the treatment of bradyarrhythmias. Contemporary pacemakers are reliable and allow for a patient specific programming. However, pacemaker replacements due to battery depletion are common (~25 % of all implantation procedures) and bear the risk of complications. Batteryless pacemakers may allow overcoming this limitation. To power a batteryless pacemaker, a mechanism for intracorporeal energy harvesting is required. Such a generator may consist out of subcutaneously implanted solar cells, transforming the small amount of transcutaneously available light into electrical energy. Alternatively, intravascular turbines may harvest energy from the blood flow. Energy may also be harvested from the ventricular wall motion by a dedicated mechanical clockwork converting motion into electrical energy. All these approaches have successfully been tested in vivo. Pacemaker leads constitute another Achilles heel of contemporary pacemakers. Thus, leadless devices are desired. Miniaturized pacemaker circuits and suitable energy harvesting mechanisms (incorporated in a single device) may allow catheter-based implantation of the pacemaker in the heart. Such miniaturized battery- and leadless pacemakers would combine the advantages of both approaches and overcome major limitations of today’s systems. PMID:26227982

  19. Effect of Si interface surface roughness to the tunneling current of the Si/Si1-xGex/Si heterojunction bipolar transistor

    Science.gov (United States)

    Hasanah, Lilik; Suhendi, Endi; Tayubi, Yuyu Rahmat; Yuwono, Heru; Nandiyanto, Asep Bayu Dani; Murakami, Hideki; Khairrurijal

    2016-02-01

    In this work we discuss the surface roughness of Si interface impact to the tunneling current of the Si/Si1-xGex/Si heterojunction bipolar transistor. The Si interface surface roughness can be analyzed from electrical characteristics through the transversal electron velocity obtained as fitting parameter factor. The results showed that surface roughness increase as Ge content of virtual substrate increase This model can be used to investigate the effect of Ge content of the virtual substrate to the interface surface condition through current-voltage characteristic.

  20. Effect of Si interface surface roughness to the tunneling current of the Si/Si{sub 1-x}Ge{sub x}/Si heterojunction bipolar transistor

    Energy Technology Data Exchange (ETDEWEB)

    Hasanah, Lilik, E-mail: lilikhasanah@upi.edu; Suhendi, Endi; Tayubi, Yuyu Rahmat; Yuwono, Heru [Department of Physics Education, Universitas Pendidikan Indonesia, Jl. Setiabudhi 229 Bandung 40154 (Indonesia); Nandiyanto, Asep Bayu Dani [Department Kimia, Universitas Pendidikan Indonesia, Jl. Setiabudhi 229 Bandung 40154 (Indonesia); Murakami, Hideki [Graduate School of Advanced Sciences of Matter, Hiroshima University, Higashi-Hiroshima 739-8527 (Japan); Khairrurijal [Physics of Electronic Materials Research Division, Institut Teknologi Bandung, Bandung 40132 (Indonesia)

    2016-02-08

    In this work we discuss the surface roughness of Si interface impact to the tunneling current of the Si/Si{sub 1-x}Ge{sub x}/Si heterojunction bipolar transistor. The Si interface surface roughness can be analyzed from electrical characteristics through the transversal electron velocity obtained as fitting parameter factor. The results showed that surface roughness increase as Ge content of virtual substrate increase This model can be used to investigate the effect of Ge content of the virtual substrate to the interface surface condition through current-voltage characteristic.

  1. Low atrial septum pacing in pacemaker patients

    OpenAIRE

    Voogt, Willem Gijsbert de

    2006-01-01

    In patients with an indication for anti bradycardia pacing, atrial fibrillation (AF) is a common arrhythmia (30-50%) even in the absence of atrial tachy arrhythmias before pacemaker implantation. Pace prevention and pace intervention for atrial tachy arrhythmias could be an interesting adjuvant treatment in the prevention of the arrhythmia related complications. These treatment modalities when available in pacemaker systems could come at a relative low cost as the indication for pacemaker imp...

  2. [Telemedicine in pacemaker therapy and follow-up].

    Science.gov (United States)

    Schuchert, A

    2009-12-01

    Present-day remote systems for cardiovascular implantable electronic devices (CIEDs) provide, in contrast to previous solutions, a broad range of data about the patient and the implanted device ("remote control"). Telemedicine includes remote monitoring as well as remote follow-up: Remote monitoring is the continual interrogation of the device to detect patient- or device-related adverse events earlier than with standard follow-up visits. Remote follow-up aims to replace scheduled and unscheduled face-to-face follow-up visits due to the interrogation of the automatic pacemaker functions. Currently available remote systems, such as Home Monitoring, CareLink, Merlin.net, and Latitude, have in common that they interrogate the device, send these data to a server, and provide the data to the physician on a secured web site. Automatic wireless interrogation of the device is the preferred solution; however, the devices must have been equipped with a micro-antenna, which is usually restricted to more recent pacemaker models. Knowledge about remote control in pacemaker patients is limited, because most remote applications were evaluated in ICD and CRT patients. While the most frequently reported clinical event in pacemaker patients is atrial fibrillation, the impact in routine clinical follow-up still has to be evaluated in detail. Device-related adverse events are rare. Large, long-term, randomized trials are comparing remote and conventional approaches with the aim of demonstrating the benefits of telemedicine in this patient group.

  3. An Electrochromic Bipolar Membrane Diode.

    Science.gov (United States)

    Malti, Abdellah; Gabrielsson, Erik O; Crispin, Xavier; Berggren, Magnus

    2015-07-01

    Conducting polymers with bipolar membranes (a complementary stack of selective membranes) may be used to rectify current. Integrating a bipolar membrane into a polymer electrochromic display obviates the need for an addressing backplane while increasing the device's bistability. Such devices can be made from solution-processable materials.

  4. Pacemaker patients’ perspective and experiences in a pacemaker outpatient clinic in relation to test intervals of the pacemaker

    DEFF Research Database (Denmark)

    Lauberg, Astrid; Hansen, Tina; Pedersen, Trine Pernille Dahl

    an evident decline in quality of life regarding psychological and social aspects 6 month after the implantation in terms of cognitive function, work ability, and sexual activity. Mlynarski et al (2009) have found correlations between pacemaker implantation and anxiety and depression. Aim The aim...... the patients expect the nurses to check the technicalities of the pacemaker and talk about precautions. Long test intervals led to worry that the pacemaker was still working. The patients did not expect specialists to pay attention to psychological reactions as they did not find a correlation between...... the pacemaker and psychological reactions. Patients with pacemakers older than 3 months lacked communication with fellowmen. Conclusion The patients express receiving competent and professional treatment when visiting the outpatient clinic, there seems to be a discrepancy between the long test intervals...

  5. Pacemaker interactions induce reentrant wave dynamics in engineered cardiac culture

    Science.gov (United States)

    Borek, Bartłomiej; Shajahan, T. K.; Gabriels, James; Hodge, Alex; Glass, Leon; Shrier, Alvin

    2012-09-01

    Pacemaker interactions can lead to complex wave dynamics seen in certain types of cardiac arrhythmias. We use experimental and mathematical models of pacemakers in heterogeneous excitable media to investigate how pacemaker interactions can be a mechanism for wave break and reentrant wave dynamics. Embryonic chick ventricular cells are cultured invitro so as to create a dominant central pacemaker site that entrains other pacemakers in the medium. Exposure of those cultures to a potassium channel blocker, E-4031, leads to emergence of peripheral pacemakers that compete with each other and with the central pacemaker. Waves emitted by faster pacemakers break up over the slower pacemaker to form reentrant waves. Similar dynamics are observed in a modified FitzHugh-Nagumo model of heterogeneous excitable media with two distinct sites of pacemaking. These findings elucidate a mechanism of pacemaker-induced reentry in excitable media.

  6. The study of electroplating trivalent CrC alloy coatings with different current densities on stainless steel 304 as bipolar plate of proton exchange membrane fuel cells

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Hsiang-Cheng [Graduate School of Defense Science, Chung Cheng Institute of Technology, National Defense University, Taoyuan, Taiwan (China); Hou, Kung-Hsu, E-mail: khou@ndu.edu.tw [Department of Power Vehicle and Systems Engineering, Chung Cheng Institute of Technology, National Defense University, Taoyuan, Taiwan (China); Lu, Chen-En [Graduate School of Defense Science, Chung Cheng Institute of Technology, National Defense University, Taoyuan, Taiwan (China); Ger, Ming-Der [Department of Applied Chemistry and Materials Engineering, Chung Cheng Institute of Technology, National Defense University, Taoyuan, Taiwan (China)

    2014-11-03

    In this study, the trivalent Cr–C coatings were electroplated on stainless steel 304 (SS304) substrates for an application in bipolar plates (BPPs) that was because of coating's excellent electric conductivity and corrosion resistance. The images of scanning electron microscope showed that the thickness of the coatings was between 1.4 and 11.4 μm, which increased with increase of coating current density. The surface morphology of Cr–C plated at coating current density of 10 A/dm{sup 2} was smooth, crack- and pinhole-free, while cracks and pinholes appearing in networks were observed apparently in the deposits plated at a higher coating current density. Additionally, the C content in the coating decreased with increasing the coating current density. Moreover, the polarization curve with different coating current densities (10, 30, 50 A/dm{sup 2}) exhibited the coating prepared at 10 A/dm{sup 2} and 10 min possessing the best corrosion resistance (I{sub corr} = 9.360 × 10{sup −8} A/cm{sup 2}). The contact resistance of Cr–C plated at coating current density of 10 A/dm{sup 2} was the lowest (16.54 mΩ cm{sup 2} at 150 N cm{sup −2}), which showed great potential of application. The single cell test with Cr–C coated SS304 prepared at coating current density of 10 A/dm{sup 2} as BPPs showed the highest current density (about 791.532 mA/cm{sup 2}) and power density (about 270.150 mW/cm{sup 2}). - Highlights: • The Cr–C coatings on steel are electroplated for utilization as bipolar plate. • The electrical conductivity and corrosion resistance increase with carbon content. • The power density of Cr–C coated steel is superior to the bare steel.

  7. Bipolar Disorder

    Science.gov (United States)

    ... lows). These aren't the normal periods of happiness and sadness that everyone experiences from time to ... with long-lasting medical conditions (such as asthma , diabetes , or epilepsy ), teens with bipolar disorder need to ...

  8. Validation of the Netherlands pacemaker patient registry

    NARCIS (Netherlands)

    Dijk, WA; Kingma, T; Hooijschuur, CAM; Dassen, WRM; Hoorntje, JCA; van Gelder, LM

    1997-01-01

    This paper deals with the validation of the information stored in the Netherlands central pacemaker patient database. At this moment the registry database contains information on more than 70500 patients, 85000 pacemakers and 90000 leads. The validation procedures consisted of an internal consistenc

  9. Effects of base doping and carrier lifetime on differential current gain and temperature coefficient of 4H-SiC power bipolar junction transistors

    Science.gov (United States)

    Niu, X.; Fardi, H.

    2012-04-01

    4H-SiC NPN bipolar junction transistor (BJT) is studied systematically by performing two-dimensional numerical simulations. Several design issues are discussed. Depending on the doping concentration of the base and the carrier lifetimes, both positive and negative temperature coefficients in the common emitter current gain could exist in 4H-SiC NPN BJTs with aluminium-doped base. The temperature coefficients of the current gain at different base doping concentrations and different carrier lifetimes have been determined. A high base doping concentration can reduce the requirement for the carrier lifetime in order to obtain negative temperature coefficient in current gain. Device simulations are performed to evaluate the carrier lifetimes by fitting the measured output IC -VCE curves. An excellent fitting is obtained and the base electron lifetime and the emitter hole lifetime are extracted to be about 22 and 5.7 ns, respectively.

  10. Involvement of mitochondrial Na+-Ca2+ exchange in intestinal pacemaking activity

    Institute of Scientific and Technical Information of China (English)

    Byung Joo Kim; Jae Yeoul Jun; Insuk So; Ki Whan Kim

    2006-01-01

    AIM: Interstitial cells of Cajal (ICCs) are the pacemaker cells that generate slow waves in the gastrointestinal (GI) tract. We have aimed to investigate the involvement of mitochondrial Na+-Ca2+ exchange in intestinal pacemaking activity in cultured interstitial cells of Cajal.METHODS: Enzymatic digestions were used todissociate ICCs from the small intestine of a mouse. The whole-cell patch-clamp configuration was used to record membrane currents (voltage clamp) and potentials (current clamp) from cultured ICCs.RESULTS: Clonazepam and CGP37157 inhibited the pacemaking activity of ICCs in a dose-dependent manner.Clonazepam from 20 to 60 μmol/L and CGP37157 from 10 to 30 μmol/L effectively inhibited Ca2+ efflux from mitochondria in pacemaking activity of ICCs. The IC50S of clonazepam and CGP37157 were 37.1 and 18.2 μmol/L, respectively. The addition of 20 μmol/L NiCl2 to the internal solution caused a "wax and wane" phenomenon of pacemaking activity of ICCs.CONCLUSION: These results suggest that mitochondrial Na+-Ca2+ exchange has an important role in intestinal pacemaking activity.

  11. Pacemakers charging using body energy.

    Science.gov (United States)

    Bhatia, Dinesh; Bairagi, Sweeti; Goel, Sanat; Jangra, Manoj

    2010-01-01

    Life-saving medical implants like pacemakers and defibrillators face a big drawback that their batteries eventually run out and patients require frequent surgery to have these batteries replaced. With the advent of technology, alternatives can be provided for such surgeries. To power these devices, body energy harvesting techniques may be employed. Some of the power sources are patient's heartbeat, blood flow inside the vessels, movement of the body parts, and the body temperature (heat). Different types of sensors are employed, such as for sensing the energy from the heartbeat the piezoelectric and semiconducting coupled nanowires are used that convert the mechanical energy into electricity. Similarly, for sensing the blood flow energy, nanogenerators driven by ultrasonic waves are used that have the ability to directly convert the hydraulic energy in human body to electrical energy. Another consideration is to use body heat employing biothermal battery to generate electricity using multiple arrays of thermoelectric generators built into an implantable chip. These generators exploit the well-known thermocouple effect. For the biothermal device to work, it needs a 2°C temperature difference across it. But there are many parts of the body where a temperature difference of 5°C exists - typically in the few millimeters just below the skin, where it is planned to place this device. This study focuses on using body heat as an alternative energy source to recharge pacemaker batteries and other medical devices and prevent the possibility of life-risk during repeated surgery.

  12. Pacemakers charging using body energy

    Directory of Open Access Journals (Sweden)

    Dinesh Bhatia

    2010-01-01

    Full Text Available Life-saving medical implants like pacemakers and defibrillators face a big drawback that their batteries eventually run out and patients require frequent surgery to have these batteries replaced. With the advent of technology, alternatives can be provided for such surgeries. To power these devices, body energy harvesting techniques may be employed. Some of the power sources are patient′s heartbeat, blood flow inside the vessels, movement of the body parts, and the body temperature (heat. Different types of sensors are employed, such as for sensing the energy from the heartbeat the piezoelectric and semiconducting coupled nanowires are used that convert the mechanical energy into electricity. Similarly, for sensing the blood flow energy, nanogenerators driven by ultrasonic waves are used that have the ability to directly convert the hydraulic energy in human body to electrical energy. Another consideration is to use body heat employing biothermal battery to generate electricity using multiple arrays of thermoelectric generators built into an implantable chip. These generators exploit the well-known thermocouple effect. For the biothermal device to work, it needs a 2°C temperature difference across it. But there are many parts of the body where a temperature difference of 5°C exists - typically in the few millimeters just below the skin, where it is planned to place this device. This study focuses on using body heat as an alternative energy source to recharge pacemaker batteries and other medical devices and prevent the possibility of life-risk during repeated surgery.

  13. Tobacco Use in Bipolar Disorder

    Science.gov (United States)

    Thomson, Daniel; Berk, Michael; Dodd, Seetal; Rapado-Castro, Marta; Quirk, Shae E.; Ellegaard, Pernille K.; Berk, Lesley; Dean, Olivia M.

    2015-01-01

    Tobacco use in mental health in general and bipolar disorder in particular remains disproportionally common, despite declining smoking rates in the community. Furthermore, interactions between tobacco use and mental health have been shown, indicating the outcomes for those with mental health disorders are impacted by tobacco use. Factors need to be explored and addressed to improve outcomes for those with these disorders and target specific interventions for people with psychiatric illness to cease tobacco smoking. In the context of bipolar disorder, this review explores; the effects of tobacco smoking on symptoms, quality of life, suicidal behaviour, the biological interactions between tobacco use and bipolar disorder, the interactions between tobacco smoking and psychiatric medications, rates and factors surrounding tobacco smoking cessation in bipolar disorder and suggests potential directions for research and clinical translation. The importance of this review is to bring together the current understanding of tobacco use in bipolar disorder to highlight the need for specific intervention. PMID:25912533

  14. Bipolar Disorder and Childhood Trauma

    Directory of Open Access Journals (Sweden)

    Evrim Erten

    2015-06-01

    Full Text Available Bipolar disorder is a chronic disorder in which irregular course of depressive, mania or mixed episodes or a complete recovery between episodes can be observed. The studies about the effects of traumatic events on bipolar disorder showed that they had significant and long-term effects on the symptoms of the disorder. Psychosocial stress might change the neurobiology of bipolar disorder over time. The studies revealed that the traumatic events could influence not only the onset of the disorder but also the course of the disorder and in these patients the rate of suicide attempt and comorbid substance abuse might increase. Bipolar patients who had childhood trauma had an earlier onset, higher number of episodes and comorbid disorders. In this review, the relationship between childhood trauma and bipolar disorder is reviewed. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2015; 7(2: 157-165

  15. Persistently active, pacemaker-like neurons in neocortex

    Directory of Open Access Journals (Sweden)

    Morgane Le Bon-Jego

    2007-10-01

    Full Text Available The neocortex is spontaneously active, however, the origin of this self-generated, patterned activity remains unknown. To detect potential pacemaker cells, we use calcium imaging to directly identify neurons that discharge action potentials in the absence of synaptic transmissionin slices from juvenile mouse visual cortex. We characterize 60 of these neurons electrophysiologically and morphologically, finding that they belong to two classes of cells: one class composed of pyramidal neurons with a thin apical dendritic tree and a second class composed of ascending axon interneurons (Martinotti cells located in layer 5. In both types of neurons, persistent sodium currents are necessary for the generation of the spontaneous activity. Our data demonstrate that subtypes of neocortical neurons have intrinsic mechanisms to generate persistent activity. Like in central pattern generators (CPGs, these neurons may act as pacemakers to initiate or pattern spontaneous activity in the neocortex.

  16. Pacemaker

    Science.gov (United States)

    ... travels, it causes the heart to contract and pump blood. Each electrical signal normally begins in a group ... the atria (AY-tree-uh), contract. This contraction pumps blood into the heart's two lower chambers, the ventricles ( ...

  17. Pacemaker failure associated with therapeutic radiation

    International Nuclear Information System (INIS)

    A 48-year-old white man with a multiprogrammable Intramedics 259-01 pacemaker was treated for inoperable lung cancer with a course of cobalt-60 radiotherapy (total 3500 rad). Several weeks subsequent to his last radiation treatment, the patient presented to the emergency department with chest and abdominal pain, shortness of breath, hypotension, and tachycardia. A paced tachycardia was noted, and application of a magnet over the pacemaker completely inhibited its function, allowing a normal sinus rhythm to ensue and the patient's symptoms to be relieved. Pacemaker failure probably was a complication of radiotherapy

  18. The development of a system for the evaluation of electromagnetic interference with pacemaker function: hazards in the aircraft environment.

    Science.gov (United States)

    McDeller, A G; Toff, W D; Hobbs, R A; Robb, D J; Camm, A J

    1989-01-01

    It has been recognized for many years that the electromagnetic (EM) environment within aircraft presents a potential hazard to the subject with a pacemaker. Most of the information currently available is, however, several years old and may not be strictly relevant to modern pacemakers and the electromagnetic environment found in today's civil aircraft. In mid 1986 it was therefore decided to investigate the effect on a number of currently available unipolar pacemakers of typical levels of electromagnetic interference encountered in civil aircraft. PMID:2746623

  19. Bipolar Disorder in Turkey

    Directory of Open Access Journals (Sweden)

    Bulent Kadri Gultekin

    2014-06-01

    Full Text Available Assessment of studies related with bipolar disorder in Turkey did not reveal an epidemiologically qualified field study. Most of the studies are hospital based or clinical studies which did not include a systematical scanning and did not aim to collect any epidemiological data and transfer information to health authorities. The generalizability of these studies to our community is far from being valid and reliable. On the other hand, a profile which will be created by reviewing the findings of these studies performed in various regions of Turkey will have a contribution to knowing the and ldquo;unique to us and rdquo; features of bipolar disorder and determining cultural risk factors. All this information can constitute a basis for formation and development of public mental health services related with bipolar disorder. In Turkey, the need for epidemiologically significant, polycentric, public sampled studies with broad participation is indispensable. Although our psychiatric epidemiology and clinical studies include necessary scientific basis, they are not powerful enough to evaluate the authentic and progressional relations such as rapid urbanization and immigration. The aim of this review is to evaluate and discuss prominent epidemiological findings, deficiencies and possibile future activities related with studies conducted in Turkey about bipolar disorder.. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2014; 6(2.000: 199-209

  20. Transtorno bipolar

    OpenAIRE

    Alda Martin

    1999-01-01

    Os resultados de estudos de famílias sugerem que o transtorno bipolar tenha uma base genética. Essa hipótese foi reforçada em estudos de adoção e de gêmeos. A herança do transtorno bipolar é complexa, envolve vários genes, além de apresentar heterogeneidade e interação entre fatores genéticos e não-genéticos. Achados, que já foram replicados, já implicaram os cromossomos 4, 12, 18 e 21, entre outros, na busca por genes de suscetibilidade. Os resultados mais promissores foram obtidos através d...

  1. Transtorno bipolar

    Directory of Open Access Journals (Sweden)

    Alda Martin

    1999-01-01

    Full Text Available Os resultados de estudos de famílias sugerem que o transtorno bipolar tenha uma base genética. Essa hipótese foi reforçada em estudos de adoção e de gêmeos. A herança do transtorno bipolar é complexa, envolve vários genes, além de apresentar heterogeneidade e interação entre fatores genéticos e não-genéticos. Achados, que já foram replicados, já implicaram os cromossomos 4, 12, 18 e 21, entre outros, na busca por genes de suscetibilidade. Os resultados mais promissores foram obtidos através de estudos de ligação. Por outro lado, os estudos de associação geraram dados interessantes, mas ainda vagos. Os estudos de populações de pacientes homogêneos e a melhor definição do fenótipo deverão contribuir para avanços futuros. A identificação dos genes relacionados ao transtorno bipolar irá permitir o melhor entendimento e tratamento dessa doença.

  2. Biological rhythm disturbance in remitted bipolar patients

    OpenAIRE

    Rosa, Adriane R; Comes, Mercè; Torrent, Carla; Solè, Brisa; Reinares, Maria; Pachiarotti, Isabella; Salamero, Manel; Kapczinski, Flávio; Colom, Francesc; Vieta, Eduard

    2013-01-01

    Background Biological rhythm disturbance is common in bipolar patients and seems to affect the course and prognosis of the illness negatively. The main aim of the current study was to assess biological rhythms in remitted bipolar patients. We also assessed whether there was an association between clinical variables or functioning and biological rhythms in remitted bipolar participants. Methods The Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN) was used to assess biologi...

  3. 心脏起搏器围术期预防性应用抗生素现状调查%Current status of perioperative antibiotic prophylaxis for permanent pacemaker implantation

    Institute of Scientific and Technical Information of China (English)

    陈柯萍; 樊晓寒; 华伟; 张澍

    2013-01-01

    Objective The aim of this survey was to describe the current status of perioperative antibiotic prophylaxis for permanent pacemaker (PPM) implantation in our clinical practice.Methods From January to March in 2012,questionnaires were sent by e-mails to directors of PPM implanting hospitals,for clinical details with respect to use of antibiotics around implantation.Data would be verified via telephone,e-mail or follow-up if no response or some doubts existed.Results Available questionnaires were returned from135 hospitals.Before or during procedure,112 of the 135 centers (82.9%) gave prophylactic antibiotics to patients,while 14 hospitals (10.4%) used postoperative antibiotics and 9 (6.7%) with no prescription of antibiotics.The first/second generation cephalosporins or penicillins were used in significant proportion (79.2%) of hospitals.Other options included the third generation cephalosporins (6.7%) and quinolones (2.2%).As for the onset time,in 74.1% of the hospitals antibiotics were administered 0.5 to 2.0 hours prior to implantation,with 5.2% 3 to 6 hours before procedure,3.7% at implantation,10.3% post operation.The duration also showed great variation in different hospitals.Single dose of antibiotics prescription before or during procedure was given in 10 centers (7.9%).The duration was over 72 hours in seventeen hospitals and ranged from 24 to 72 hours in the rest hospitals.Intra-pocket antibiotic infusion at implantation was used in forty-eight centers (35.6%),and most (81.3%) were gentamicin.Conclusion There are no guidelines on the antibiotics prophylaxis in PPM implantation,such as indication,choice,timing and duration,resulting in wide variation in practice.In majority of the hospitals prophylactic antibiotics were used prior to implantation and β-lactam antibiotic for a board antibacterial spectrum was selected which covering staphylococcus aureus.However,further studies are required to determine the duration of antibiotics

  4. Uniform pacemaker and ICD information system in the Netherlands

    NARCIS (Netherlands)

    Cam, H; Wa, D; Callaos, N; Farsi, D; EshaghianWilner, M; Hanratty, T; Rishe, N

    2003-01-01

    The Central Pacemaker Patient Registry (CPPR) in the Netherlands (founded in 1977) collects information of pacemaker patients from all 110 Dutch hospitals. It contains data of over 98.000 patients, 118.500 pacemakers, 1.950 ICD's and 131.000 leads. Initially data was entered manually. As local datab

  5. Uniform pacemaker and ICD information system in the Netherlands

    NARCIS (Netherlands)

    Hooijschuur, CAM; Dijk, WA; van der Velde, W; Sanon, B; Ammeraal, C; Dassen, WRM; Spruijt, HJ; Murray, A

    2002-01-01

    In the Netherlands the Central Pacemaker Patient Registry (CPPR) collects information of pacemaker and ICD (Implantable Cardio Defibrillator) patients from all 109 Dutch hospitals. Many pacemaker clinics are using a computer to store their implant and follow-up data in a database. Because the device

  6. Setups for in vitro assessment of RFID interference on pacemakers

    Science.gov (United States)

    Mattei, E.; Censi, F.; Delogu, A.; Ferrara, A.; Calcagnini, G.

    2013-08-01

    The aim of this study is to propose setups for in vitro assessment of RFID (radiofrequency identification) interference on pacemakers (PM). The voltage induced at the input stage of the PM by low-frequency (LF) and high-frequency (HF) RFID transmitters has been used to quantify the amount of the interference. A commercial PM was modified in order to measure the voltage at its input stage when exposed to a sinusoidal signal at 125 kHz and 13.56 MHz. At both frequencies, two antennas with different dimensions (diameter = 10 cm and 30 cm, respectively) were used to generate the interfering field, and the induced voltage was measured between the lead tip and the PM case (unipolar voltage), and between the tip and ring electrodes (bipolar voltage). The typical lead configurations adopted in similar studies or proposed by international standards, as well as lead paths closer to actual physiological implants were tested. At 125 kHz, the worst-case condition differs for the two antennas: the 10 cm antenna induced the highest voltage in the two-loop spiral configuration, whereas the 30 cm antenna in the 225 cm2 loop configuration. At 13.56 MHz, the highest voltage was observed for both the antennas in the 225 cm2 loop configuration. Bipolar voltages were found to be lower than the unipolar voltages induced in the same configurations, this difference being not as high as one could expect from theoretical considerations. The worst-case scenario, in terms of the induced voltage at the PM input stage, has been identified both for LF and HF readers, and for two sizes of transmitting antennas. These findings may provide the basis for the definition of a standard implant configuration and a lead path to test the EMI effects of LF and HF RFID transmitters on active implantable devices.

  7. Bipolar Disorder and Obsessive Compulsive Disorder Comorbidity

    Directory of Open Access Journals (Sweden)

    Necla Keskin

    2014-08-01

    Full Text Available The comorbidity of bipolar disorder and anxiety disorders is a well known concept. Obsessive-compulsive disorder is the most commonly seen comorbid anxiety disorder in bipolar patients. Some genetic variants, neurotransmitters especially serotonergic systems and second-messenger systems are thought to be responsible for its etiology. Bipolar disorder alters the clinical aspects of obsessive compulsive disorder and is associated with poorer outcome. The determination of comorbidity between bipolar disorder and obsessive compulsive disorder is quite important for appropriate clinical management and treatment. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2014; 6(4.000: 429-437

  8. Neutrality in bipolar structures

    DEFF Research Database (Denmark)

    Montero, Javier; Rodríguez, J. Tinguaro; Franco, Camilo;

    2014-01-01

    In this paper, we want to stress that bipolar knowledge representation naturally allows a family of middle states which define as a consequence different kinds of bipolar structures. These bipolar structures are deeply related to the three types of bipolarity introduced by Dubois and Prade, but our...

  9. Influence of the Dermis Thickness on the Results of the Skin Treatment with Monopolar and Bipolar Radiofrequency Currents

    Directory of Open Access Journals (Sweden)

    Ilja L. Kruglikov

    2016-01-01

    Full Text Available Electrically layered tissue structure significantly modifies distribution of radiofrequency (RF current in the dermis and in the subcutaneous adipose tissue comparing to that in a homogeneous medium. On the basis of the simple model of RF current distribution in a two-layer skin containing dermis and subcutis, we assess the influence of the dermal thickness on the current density in different skin layers. Under other equal conditions, current density in the dermis is higher for the skin having thinner dermis. This contradicts the main paradigm of the RF theory stating that treatment results are mainly dependent on the maximal temperature reached in a target tissue, since the best short- and long-term clinical results of RF application to the skin were reported in the areas having thicker dermis. To resolve this contradiction, it is proposed that the long-term effect of RF can be realized through a structural modification of the subcutaneous fat depot adjacent to the treated skin area. Stimulation of these cells located near the interface dermis/subcutis will demand the concentration of applied RF energy in this area and will require the optimal arrangement of RF electrodes on the skin surface.

  10. Thomson semiconductors bipolar IC strategy to 1986

    Science.gov (United States)

    Dellamussia, J. P.

    1984-04-01

    The strategy to develop and market bipolar integrated circuits through 1986 by thomson semiconductors is discussed. Current technology and future research on prototype microprocessors using bipolar integrated circuits is evaluated. The physical properties of the circuits such as heat dissipation, energy consumption rates and response times are studied.

  11. Transvenous Pacemaker Lead Removal in Pacemaker Lead Endocarditis with Large Vegetations: A Report of Two Cases

    OpenAIRE

    Cho, Hyunsoo; Kim, Mihyun; Uhm, Jae-Sun; Pak, Hui-Nam; Lee, Moon-Hyoung; Joung, Boyoung

    2014-01-01

    Pacemaker lead endocarditis is treated with total removal of the infected device and proper antibiotics. The outcomes of patients undergoing percutaneous lead extraction for large vegetations (>2 cm) have not yet been shown. In this case report, we present two patients with pacemaker lead endocarditis with large vegetations of maximum diameter 2.4 cm and 3.2 cm. The first patient had multiple vegetations attached to the tricuspid and mitral valves and developed septic emboli to the brain, lun...

  12. Amorphous silicon germanium carbide photo sensitive bipolar junction transistor with a base-contact and a continuous tunable high current gain

    Energy Technology Data Exchange (ETDEWEB)

    Bablich, A., E-mail: andreas.bablich@uni-siegen.de [Department of Electrical and Computer Engineering, Institute for Microsystem Technologies, University of Siegen, Hoelderlinstrasse 3, 57076 Siegen (Germany); Merfort, C., E-mail: merfort@imt.e-technik.uni-siegen.de [Department of Electrical and Computer Engineering, Institute for Microsystem Technologies, University of Siegen, Hoelderlinstrasse 3, 57076 Siegen (Germany); Eliasz, J., E-mail: jacek.eliasz@student.uni-siegen.de [Department of Electrical and Computer Engineering, Institute for Microsystem Technologies, University of Siegen, Hoelderlinstrasse 3, 57076 Siegen (Germany); Schäfer-Eberwein, H., E-mail: heiko.schaefer@uni-siegen.de [Department of Electrical and Computer Engineering, Institute of High Frequency and Quantum Electronics, University of Siegen, Hoelderlinstrasse 3, 57076 Siegen (Germany); Haring-Bolivar, P., E-mail: peter.haring@uni-siegen.de [Department of Electrical and Computer Engineering, Institute of High Frequency and Quantum Electronics, University of Siegen, Hoelderlinstrasse 3, 57076 Siegen (Germany); Boehm, M., E-mail: markus.boehm@uni-siegen.de [Department of Electrical and Computer Engineering, Institute for Microsystem Technologies, University of Siegen, Hoelderlinstrasse 3, 57076 Siegen (Germany)

    2014-05-02

    In this paper, the design, fabrication and characterization of an amorphous silicon germanium carbide (a-SiGeC:H) photo sensitive bipolar junction transistor (PS-BJT) with three terminals are presented. Whereas the current gain of similar transistor devices presented in the past (Wu et al., 1984; Hwang et al., 1993; Nascetti and Caputo, 2002; Chang et al., 1985a,b; Wu et al, 1985; Hong et al., 1990) can only be controlled with photo induced charge generation, the n–i–δp–i–n structure developed features a contacted base to provide the opportunity to adjust the current gain optically and electrically, too. Electron microscope-, current-/voltage- and spectral measurements were performed to study the PS-BJT behavior and calculate the electrical and optical current gain. The spectral response maximum of the base–collector diode has a value of 170 mA/W applying a base–collector voltage of − 1 V and is located at 620 nm. The base–emitter diode reaches a sensitivity of 25.7 mA/W at 530 nm with a base-emitter voltage of − 3 V. The good a-Si:H transport properties are validated in a μτ-product of 4.6 × 10{sup −6} cm{sup 2} V s, which is sufficient to reach a continuous base- and photo-tunable current gain of up to − 126 at a base current of I{sub B} = + 10 nA and a collector–emitter voltage of V{sub CE} = − 3 V. The transistor obtains a maximum collector current of − 65.5 μA (V{sub CE} = − 3 V) and + 56.2 μA (V{sub CE} = + 3 V) at 10,000 lx 5300 K white-light illumination. At 3300 lx, the electrical current gain reaches a value of + 100 (V{sub CE} = + 2 V) at I{sub B} = 10 nA. With a negative base current of I{sub B} = − 10 nA the electrical gain can be adjusted between 87 (V{sub CE} = + 2 V) and − 106 (V{sub CE} = -3 V), respectively. When no base charge is applied, the transistor is “off” for V{sub CE} > − 3 V. Reducing the base current increases the electrical current gain. Operating with a voltage V{sub CE} of just ± 2 V

  13. Amorphous silicon germanium carbide photo sensitive bipolar junction transistor with a base-contact and a continuous tunable high current gain

    International Nuclear Information System (INIS)

    In this paper, the design, fabrication and characterization of an amorphous silicon germanium carbide (a-SiGeC:H) photo sensitive bipolar junction transistor (PS-BJT) with three terminals are presented. Whereas the current gain of similar transistor devices presented in the past (Wu et al., 1984; Hwang et al., 1993; Nascetti and Caputo, 2002; Chang et al., 1985a,b; Wu et al, 1985; Hong et al., 1990) can only be controlled with photo induced charge generation, the n–i–δp–i–n structure developed features a contacted base to provide the opportunity to adjust the current gain optically and electrically, too. Electron microscope-, current-/voltage- and spectral measurements were performed to study the PS-BJT behavior and calculate the electrical and optical current gain. The spectral response maximum of the base–collector diode has a value of 170 mA/W applying a base–collector voltage of − 1 V and is located at 620 nm. The base–emitter diode reaches a sensitivity of 25.7 mA/W at 530 nm with a base-emitter voltage of − 3 V. The good a-Si:H transport properties are validated in a μτ-product of 4.6 × 10−6 cm2 V s, which is sufficient to reach a continuous base- and photo-tunable current gain of up to − 126 at a base current of IB = + 10 nA and a collector–emitter voltage of VCE = − 3 V. The transistor obtains a maximum collector current of − 65.5 μA (VCE = − 3 V) and + 56.2 μA (VCE = + 3 V) at 10,000 lx 5300 K white-light illumination. At 3300 lx, the electrical current gain reaches a value of + 100 (VCE = + 2 V) at IB = 10 nA. With a negative base current of IB = − 10 nA the electrical gain can be adjusted between 87 (VCE = + 2 V) and − 106 (VCE = -3 V), respectively. When no base charge is applied, the transistor is “off” for VCE > − 3 V. Reducing the base current increases the electrical current gain. Operating with a voltage VCE of just ± 2 V, the device presented in this paper obtains no optical gain with an incident

  14. Permanent transvenous pacemaker implantation in forty dogs

    International Nuclear Information System (INIS)

    Permanent transvenous cardiac pacemakers were implanted in 40 dogs. Electrocardiographic diagnoses included persistent atrial standstill (3 dogs), sick sinus syndrome (8 dogs), and high-grade second-degree or third-degree atrioventricular (AV) block (29 dogs). Thirteen dogs were alive and well 4 to 42 months after pacemaker implantation (mean, 16.9 months). The mean and median survival times of the 26 dogs that died or were euthanatized during the study were 17.9 months and 13 months, respectively. Most of these dogs succumbed to problems unrelated to the arrhythmia and pacemaker implant. One dog was lost to follow-up. Complications associated with permanent transvenous pacemaker implantation included lead dislodgement, infection, hematoma formation, skeletal muscle stimulation, ventricular arrhythmia, migration of the pulse generator, and skin erosion. Lead dislodgement was the most common complication, occurring in 7 of 9 dogs paced using untined electrode leads and in 6 of 30 dogs paced using tined leads. Lead dislodgement did not occur in the only dog paced using an actively fixed endocardial lead. It was concluded that permanent transvenous cardiac pacing is a feasible, less traumatic alternative to epimyocardial pacing in dogs, but that successful use of this technique requires careful implantation technique and anticipation of the potential complications

  15. Intrapericardial pacemaker in a 2-kilogram newborn.

    Science.gov (United States)

    Gil-Jaurena, Juan-Miguel; Castillo, Rafael; Rubio, Lorena

    2012-08-01

    A 2-kilogram child had a pacemaker implanted by a subxyphoid approach with the generator located under the rectus sheath. Days later, the battery eroded the abdominal wall and the peritoneum. The whole system was removed and a new one was implanted inside the pericardium on an emergent basis.

  16. Low atrial septum pacing in pacemaker patients

    NARCIS (Netherlands)

    Voogt, Willem Gijsbert de

    2006-01-01

    In patients with an indication for anti bradycardia pacing, atrial fibrillation (AF) is a common arrhythmia (30-50%) even in the absence of atrial tachy arrhythmias before pacemaker implantation. Pace prevention and pace intervention for atrial tachy arrhythmias could be an interesting adjuvant trea

  17. Integrated neurobiology of bipolar disorder

    Directory of Open Access Journals (Sweden)

    Vladimir eMaletic

    2014-08-01

    Full Text Available From a neurobiological perspective there is no such thing as bipolar disorder. Rather, it is almost certainly the case that many somewhat similar, but subtly different, pathological conditions produce a disease state that we currently diagnose as bipolarity. This heterogeneity—reflected in the lack of synergy between our current diagnostic schema and our rapidly advancing scientific understanding of the condition—limits attempts to articulate an integrated perspective on bipolar disorder. However, despite these challenges, scientific findings in recent years are beginning to offer a provisional unified field theory of the disease. This theory sees bipolar disorder as a suite of related neurodevelopmental conditions with interconnected functional abnormalities that often appear early in life and worsen over time. In addition to accelerated loss of volume in brain areas known to be essential for mood regulation and cognitive function, consistent findings have emerged at a cellular level, providing evidence that bipolar disorder is reliably associated with dysregulation of glial-neuronal interactions. Among these glial elements are microglia—the brain’s primary immune elements, which appear to be overactive in the context of bipolarity. Multiple studies now indicate that inflammation is also increased in the periphery of the body in both the depressive and manic phases of the illness, with at least some return to normality in the euthymic state. These findings are consistent with changes in the HPA axis, which are known to drive inflammatory activation. In summary, the very fact that no single gene, pathway or brain abnormality is likely to ever account for the condition is itself an extremely important first step in better articulating an integrated perspective on both its ontological status and pathogenesis. Whether this perspective will translate into the discovery of innumerable more homogeneous forms of bipolarity is one of the great

  18. Generation of cardiac pacemaker cells by programming and differentiation.

    Science.gov (United States)

    Husse, Britta; Franz, Wolfgang-Michael

    2016-07-01

    A number of diseases are caused by faulty function of the cardiac pacemaker and described as "sick sinus syndrome". The medical treatment of sick sinus syndrome with electrical pacemaker implants in the diseased heart includes risks. These problems may be overcome via "biological pacemaker" derived from different adult cardiac cells or pluripotent stem cells. The generation of cardiac pacemaker cells requires the understanding of the pacing automaticity. Two characteristic phenomena the "membrane-clock" and the "Ca(2+)-clock" are responsible for the modulation of the pacemaker activity. Processes in the "membrane-clock" generating the spontaneous pacemaker firing are based on the voltage-sensitive membrane ion channel activity starting with slow diastolic depolarization and discharging in the action potential. The influence of the intracellular Ca(2+) modulating the pacemaker activity is characterized by the "Ca(2+)-clock". The generation of pacemaker cells started with the reprogramming of adult cardiac cells by targeted induction of one pacemaker function like HCN1-4 overexpression and enclosed in an activation of single pacemaker specific transcription factors. Reprogramming of adult cardiac cells with the transcription factor Tbx18 created cardiac cells with characteristic features of cardiac pacemaker cells. Another key transcription factor is Tbx3 specifically expressed in the cardiac conduction system including the sinoatrial node and sufficient for the induction of the cardiac pacemaker gene program. For a successful cell therapeutic practice, the generated cells should have all regulating mechanisms of cardiac pacemaker cells. Otherwise, the generated pacemaker cells serve only as investigating model for the fundamental research or as drug testing model for new antiarrhythmics. This article is part of a Special Issue entitled: Cardiomyocyte Biology: Integration of Developmental and Environmental Cues in the Heart edited by Marcus Schaub and Hughes Abriel.

  19. Generation of cardiac pacemaker cells by programming and differentiation.

    Science.gov (United States)

    Husse, Britta; Franz, Wolfgang-Michael

    2016-07-01

    A number of diseases are caused by faulty function of the cardiac pacemaker and described as "sick sinus syndrome". The medical treatment of sick sinus syndrome with electrical pacemaker implants in the diseased heart includes risks. These problems may be overcome via "biological pacemaker" derived from different adult cardiac cells or pluripotent stem cells. The generation of cardiac pacemaker cells requires the understanding of the pacing automaticity. Two characteristic phenomena the "membrane-clock" and the "Ca(2+)-clock" are responsible for the modulation of the pacemaker activity. Processes in the "membrane-clock" generating the spontaneous pacemaker firing are based on the voltage-sensitive membrane ion channel activity starting with slow diastolic depolarization and discharging in the action potential. The influence of the intracellular Ca(2+) modulating the pacemaker activity is characterized by the "Ca(2+)-clock". The generation of pacemaker cells started with the reprogramming of adult cardiac cells by targeted induction of one pacemaker function like HCN1-4 overexpression and enclosed in an activation of single pacemaker specific transcription factors. Reprogramming of adult cardiac cells with the transcription factor Tbx18 created cardiac cells with characteristic features of cardiac pacemaker cells. Another key transcription factor is Tbx3 specifically expressed in the cardiac conduction system including the sinoatrial node and sufficient for the induction of the cardiac pacemaker gene program. For a successful cell therapeutic practice, the generated cells should have all regulating mechanisms of cardiac pacemaker cells. Otherwise, the generated pacemaker cells serve only as investigating model for the fundamental research or as drug testing model for new antiarrhythmics. This article is part of a Special Issue entitled: Cardiomyocyte Biology: Integration of Developmental and Environmental Cues in the Heart edited by Marcus Schaub and Hughes Abriel

  20. 双相障碍临床研究现状与趋势%Current status and future trends in clinical research of bipolar disorder

    Institute of Scientific and Technical Information of China (English)

    方贻儒; 汪作为

    2011-01-01

    Compared to patients with depressive disorders, those with bipolar disorders have a more complex clinical presentation and course, a greater risk for treatment non-response, a poorer prognosis and an increased risk of suicide. The reported prevalence of the full spectrum of bipolar disorders is 6% but the rates of recognition and treatment around the world are very low, particularly in China. Clinicians need to become more familiar with the “soft”signs of bipolar spectrum disorders including hypomania, and they need to be better at discriminating bipolar depression from unipolar depression, at identifying patients with other primary disorders who have comorbid bipolar disorders, and at providing the maintenance treatment needed to prevent relapse in patients with bipolar disorders. Clinical research about bipolar spectrum disorders needs to effectively integrate psychological and biological approaches.%与抑郁障碍相比,双相障碍的临床表现和病程更复杂,治疗更困难,预后更差,自杀风险更大.据报道,双相谱系障碍的患病率为6%,但是在世界范围内尤其是在中国,对这类疾病的识别率和治疗率很低.临床医生需要更熟悉"软双相"的症状,更准确地鉴别双相抑郁与单相抑郁,更准确地区分出共病双相障碍的其他精神障碍,并为预防双相障碍的复发提供更有效的维持治疗.对双相谱系障碍的临床研究需要有效地整合心理治疗和生物治疗.

  1. Measuring pacemaker dose: A clinical perspective

    Energy Technology Data Exchange (ETDEWEB)

    Studenski, Matthew T., E-mail: matthew.studenski@jeffersonhospital.org [Department of Radiation Oncology at the Jefferson Medical College and Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA (United States); Xiao Ying; Harrison, Amy S. [Department of Radiation Oncology at the Jefferson Medical College and Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA (United States)

    2012-07-01

    Recently in our clinic, we have seen an increased number of patients presenting with pacemakers and defibrillators. Precautions are taken to develop a treatment plan that minimizes the dose to the pacemaker because of the adverse effects of radiation on the electronics. Here we analyze different dosimeters to determine which is the most accurate in measuring pacemaker or defibrillator dose while at the same time not requiring a significant investment in time to maintain an efficient workflow in the clinic. The dosimeters analyzed here were ion chambers, diodes, metal-oxide-semiconductor field effect transistor (MOSFETs), and optically stimulated luminescence (OSL) dosimeters. A simple phantom was used to quantify the angular and energy dependence of each dosimeter. Next, 8 patients plans were delivered to a Rando phantom with all the dosimeters located where the pacemaker would be, and the measurements were compared with the predicted dose. A cone beam computed tomography (CBCT) image was obtained to determine the dosimeter response in the kilovoltage energy range. In terms of the angular and energy dependence of the dosimeters, the ion chamber and diode were the most stable. For the clinical cases, all the dosimeters match relatively well with the predicted dose, although the ideal dosimeter to use is case dependent. The dosimeters, especially the MOSFETS, tend to be less accurate for the plans, with many lateral beams. Because of their efficiency, we recommend using a MOSFET or a diode to measure the dose. If a discrepancy is observed between the measured and expected dose (especially when the pacemaker to field edge is <10 cm), we recommend analyzing the treatment plan to see whether there are many lateral beams. Follow-up with another dosimeter rather than repeating multiple times with the same type of dosimeter. All dosimeters should be placed after the CBCT has been acquired.

  2. Pacemakers and implantable cardioverter defibrillators - general and anesthetic considerations

    Directory of Open Access Journals (Sweden)

    Amy G. Rapsang

    2014-06-01

    Full Text Available A pacemaking system consists of an impulse generator and lead or leads to carry the electrical impulse to the patient's heart. Pacemaker and implantable cardioverter defibrillator codes were made to describe the type of pacemaker or implantable cardioverter defibrillator implanted. Indications for pacing and implantable cardioverter defibrillator implantation were given by the American College of Cardiologists. Certain pacemakers have magnet-operated reed switches incorporated; however, magnet application can have serious adverse effects; hence, devices should be considered programmable unless known otherwise. When a device patient undergoes any procedure (with or without anesthesia, special precautions have to be observed including a focused history/physical examination, interrogation of pacemaker before and after the procedure, emergency drugs/temporary pacing and defibrillation, reprogramming of pacemaker and disabling certain pacemaker functions if required, monitoring of electrolyte and metabolic disturbance and avoiding certain drugs and equipments that can interfere with pacemaker function. If unanticipated device interactions are found, consider discontinuation of the procedure until the source of interference can be eliminated or managed and all corrective measures should be taken to ensure proper pacemaker function should be done. Post procedure, the cardiac rate and rhythm should be monitored continuously and emergency drugs and equipments should be kept ready and consultation with a cardiologist or a pacemaker-implantable cardioverter defibrillator service may be necessary.

  3. Excitation model of pacemaker cardiomyocytes of cardiac conduction system

    Science.gov (United States)

    Grigoriev, M.; Babich, L.

    2015-11-01

    Myocardium includes typical and atypical cardiomyocytes - pacemakers, which form the cardiac conduction system. Excitation from the atrioventricular node in normal conditions is possible only in one direction. Retrograde direction of pulses is impossible. The most important prerequisite for the work of cardiomyocytes is the anatomical integrity of the conduction system. Changes in contractile force of the cardiomyocytes, which appear periodically, are due to two mechanisms of self-regulation - heterometric and homeometric. Graphic course of the excitation pulse propagation along the heart muscle more accurately reveals the understanding of the arrhythmia mechanism. These models have the ability to visualize the essence of excitation dynamics. However, they do not have the proper forecasting function for result estimation. Integrative mathematical model enables further investigation of general laws of the myocardium active behavior, allows for determination of the violation mechanism of electrical and contractile function of cardiomyocytes. Currently, there is no full understanding of the topography of pacemakers and ionic mechanisms. There is a need for the development of direction of mathematical modeling and comparative studies of the electrophysiological arrangement of cells of atrioventricular connection and ventricular conduction system.

  4. Influence of D-net (European GSM-Standard) cellular phones on pacemaker function in 50 patients with permanent pacemakers.

    Science.gov (United States)

    Wilke, A; Grimm, W; Funck, R; Maisch, B

    1996-10-01

    The widespread use of cellular phones in the last years has prompted some recent studies to suggest an interference of pacemaker function by cellular phone usage. To determine the risk of pacemaker patients using D-net cellular phones, we tested 50 patients with permanent pacemakers after routine pacemaker check by short phone calls using a cellular phone (Ericsson, D-net, frequency 890-915 MHz, digital information coding, equivalent to the European Groupe Systemes Mobiles standard). A six-channel surface ECG was continuously recorded from each patient to detect any interactions between pacemakers and cellular phones. Phone calls were repeated during the following pacemaker settings: (1) preexisting setting; (2) minimum ventricular rate of 90 beats/min and preexisting sensitivity; and (3) minimum ventricular rate of 90 beats/min and maximum sensitivity without T wave oversensing. Only 2 (4%) of 50 patients repeatedly showed intermittent pacemaker inhibition during calls with the cellular phone. Both pacemakers had unipolar sensing. Therefore, although interactions between cellular phone use and pacemaker function appear to be rare in our study, pacemaker dependent patients in particular should avoid the use of cellular phones.

  5. Genetics of bipolar disorder

    Directory of Open Access Journals (Sweden)

    Kerner B

    2014-02-01

    Full Text Available Berit Kerner Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA Abstract: Bipolar disorder is a common, complex genetic disorder, but the mode of transmission remains to be discovered. Many researchers assume that common genomic variants carry some risk for manifesting the disease. The research community has celebrated the first genome-wide significant associations between common single nucleotide polymorphisms (SNPs and bipolar disorder. Currently, attempts are under way to translate these findings into clinical practice, genetic counseling, and predictive testing. However, some experts remain cautious. After all, common variants explain only a very small percentage of the genetic risk, and functional consequences of the discovered SNPs are inconclusive. Furthermore, the associated SNPs are not disease specific, and the majority of individuals with a “risk” allele are healthy. On the other hand, population-based genome-wide studies in psychiatric disorders have rediscovered rare structural variants and mutations in genes, which were previously known to cause genetic syndromes and monogenic Mendelian disorders. In many Mendelian syndromes, psychiatric symptoms are prevalent. Although these conditions do not fit the classic description of any specific psychiatric disorder, they often show nonspecific psychiatric symptoms that cross diagnostic boundaries, including intellectual disability, behavioral abnormalities, mood disorders, anxiety disorders, attention deficit, impulse control deficit, and psychosis. Although testing for chromosomal disorders and monogenic Mendelian disorders is well established, testing for common variants is still controversial. The standard concept of genetic testing includes at least three broad criteria that need to be fulfilled before new genetic tests should be introduced: analytical validity, clinical validity, and clinical utility. These criteria are

  6. Neutron absorbed dose in a pacemaker CMOS

    Energy Technology Data Exchange (ETDEWEB)

    Borja H, C. G.; Guzman G, K. A.; Valero L, C.; Banuelos F, A.; Hernandez D, V. M.; Vega C, H. R. [Universidad Autonoma de Zacatecas, Unidad Academica de Estudios Nucleares, Cipres No. 10, Fracc. La Penuela, 98068 Zacatecas (Mexico); Paredes G, L., E-mail: fermineutron@yahoo.com [ININ, Carretera Mexico-Toluca s/n, 52750 Ocoyoacac, Estado de Mexico (Mexico)

    2012-06-15

    The neutron spectrum and the absorbed dose in a Complementary Metal Oxide Semiconductor (CMOS), has been estimated using Monte Carlo methods. Eventually a person with a pacemaker becomes an oncology patient that must be treated in a linear accelerator. Pacemaker has integrated circuits as CMOS that are sensitive to intense and pulsed radiation fields. Above 7 MV therapeutic beam is contaminated with photoneutrons that could damage the CMOS. Here, the neutron spectrum and the absorbed dose in a CMOS cell was calculated, also the spectra were calculated in two point-like detectors in the room. Neutron spectrum in the CMOS cell shows a small peak between 0.1 to 1 MeV and a larger peak in the thermal region, joined by epithermal neutrons, same features were observed in the point-like detectors. The absorbed dose in the CMOS was 1.522 x 10{sup -17} Gy per neutron emitted by the source. (Author)

  7. Limit Cycle Oscillations in Pacemaker Cells

    CERN Document Server

    Endresen, L P; Endresen, Lars Petter; Skarland, Nils

    1999-01-01

    In recent decades, several mathematical models describing the pacemaker activity of the rabbit sinoatrial node have been developed. We demonstrate that it is not possible to establish the existence, uniqueness, and stability of a limit cycle oscillation in those models. Instead we observe an infinite number of limit cycles. We then display numerical results from a new model, with a limit cycle that can be reached from many different initial conditions.

  8. [Bipolar patients, structured psychotherapeutic treatment and approaches].

    Science.gov (United States)

    Bonvalot, Thierry; Mazouni, Rabbah; Rivallan, Armel; Lassignardie, Hélène

    2010-01-01

    The current development of structured psychotherapy has brought gradual improvements to the treatment provided to bipolar patients. This psychotherapy may be either carried out individually or in a group. In this context, psychotherapeutic meditation seems beneficial.

  9. Staging Bipolar Disorder.

    OpenAIRE

    Vieta i Pascual, Eduard, 1963-; Reinares, M.; Rosa, A. R.

    2011-01-01

    The purpose of this study was to analyze the evidence supporting a staging model for bipolar disorder. The authors conducted an extensive Medline and Pubmed search of the published literature using a variety of search terms (staging, bipolar disorder, early intervention) to find relevant articles, which were reviewed in detail. Only recently specific proposals have been made to apply clinical staging to bipolar disorder. The staging model in bipolar disorder suggests a progression from prodro...

  10. Pacemakers handshake synchronization mechanism of mammalian respiratory rhythmogenesis

    OpenAIRE

    Wittmeier, Steffen; Song, Gang; Duffin, James; Poon, Chi-Sang

    2008-01-01

    Inspiratory and expiratory rhythms in mammals are thought to be generated by pacemaker-like neurons in 2 discrete brainstem regions: pre-Bötzinger complex (preBötC) and parafacial respiratory group (pFRG). How these putative pacemakers or pacemaker networks may interact to set the overall respiratory rhythm in synchrony remains unclear. Here, we show that a pacemakers 2-way “handshake” process comprising pFRG excitation of the preBötC, followed by reverse inhibition and postinhibitory rebound...

  11. Overview of patient care issues and treatment in bipolar spectrum and bipolar II disorder.

    Science.gov (United States)

    Calabrese, Joseph R

    2008-06-01

    Recent studies have reported lifetime prevalence estimates of 1.0% for bipolar I disorder, 1.1% for bipolar II disorder, and 2.4% to 4.7% for subthreshold bipolar disorder, illustrating the need for consensus definitions of bipolar spectrum disorders. These definitions will aid researchers in studying viable treatments options, as well as help clinicians in the differential diagnosis of patients. Broader definitions of bipolar spectrum disorders would also allow clinicians to more accurately diagnose patients, rather than placing them in the catchall category of bipolar disorder not otherwise specified. Bipolar symptoms that are currently labeled as subthreshold symptoms are becoming increasingly recognized as having relevant clinical implications. Despite diagnostic controversy, screening for the presence of mania in patients who present with depressive symptoms is a critical step in the appropriate treatment of bipolar spectrum disorders. Identifying the early onset of bipolar symptoms as manifested in prodromal disorders such as childhood major depressive disorder and attention-deficit/hyperactivity disorder is also important for possible early intervention and improved outcomes.

  12. Cardiorespiratory Mechanical Simulator for In Vitro Testing of Impedance Minute Ventilation Sensors in Cardiac Pacemakers.

    Science.gov (United States)

    Marcelli, Emanuela; Cercenelli, Laura

    2016-01-01

    We developed a cardiorespiratory mechanical simulator (CRMS), a system able to reproduce both the cardiac and respiratory movements, intended to be used for in vitro testing of impedance minute ventilation (iMV) sensors in cardiac pacemakers. The simulator consists of two actuators anchored to a human thorax model and a software interface to control the actuators and to acquire/process impedance signals. The actuators can be driven separately or simultaneously to reproduce the cardiac longitudinal shortening at a programmable heart rate and the diaphragm displacement at a programmable respiratory rate (RR). A standard bipolar pacing lead moving with the actuators and a pacemaker case fixed to the thorax model have been used to measure impedance (Z) variations during the simulated cardiorespiratory movements. The software is able to discriminate the low-frequency component because of respiration (Z(R)) from the high-frequency ripple because of cardiac effect (Z(C)). Impedance minute ventilation is continuously calculated from Z(R) and RR. From preliminary tests, the CRMS proved to be a reliable simulator for in vitro evaluation of iMV sensors. Respiration impedance recordings collected during cardiorespiratory movements reproduced by the CRMS were comparable in morphology and amplitude with in vivo assessments of transthoracic impedance variations. PMID:26501915

  13. Recurrent syncope in a hypertensive subject with vascular cognitive impairment and permanent pacemaker

    Directory of Open Access Journals (Sweden)

    Alberto Mazza

    2012-09-01

    Full Text Available Syncope following permanent pacemaker (PM implantation is a nightmare for electrophysiologists. We describe a case of daily recurrent syncope in an 84-year-old man having a dual-chamber pacemaker implanted for complete atrio-ventricular block occurred 4 years before the admission to our department. He had a history of arterial hypertension, parossistic atrial fibrillation, chronic obstructive pulmonary disease, stage-III chronic renal failure, mild vascular cognitive impairment and glaucoma. The initial work-up including electrocardiogram (ECG, repeated PM inter- rogations, Holter electrocardiogram, blood pressure measurement in orthostatic position, complete blood count, serum glycaemia, electrolytes and thyroid function tests showed normal findings. Syncope occurred in lying position and during 90° left clockwise neck rotation and was associated to pallor, sweating, tonic-clonic seizures and transient self-limited loss of consciousness lasting a few seconds. Electroencephalogram was normal. During continuous ECG monitoring, the right rotation of the head determined a ventricular asystolic pause lasting 9 seconds associated with loss of consciousness. Restoration of sinus rhythm was observed after bringing back the head in axis. The PM interrogation, performed during pacing failure, recorded low impedance of bipolar ventricular lead, suggesting a damage in lead insulation. It is likely that lead movements during clockwise neck rotation produced an intermittent short circuit that prevented sufficient energy delivery to the myocardium with a consequence of sudden loss of capture.

  14. Cardiorespiratory Mechanical Simulator for In Vitro Testing of Impedance Minute Ventilation Sensors in Cardiac Pacemakers.

    Science.gov (United States)

    Marcelli, Emanuela; Cercenelli, Laura

    2016-01-01

    We developed a cardiorespiratory mechanical simulator (CRMS), a system able to reproduce both the cardiac and respiratory movements, intended to be used for in vitro testing of impedance minute ventilation (iMV) sensors in cardiac pacemakers. The simulator consists of two actuators anchored to a human thorax model and a software interface to control the actuators and to acquire/process impedance signals. The actuators can be driven separately or simultaneously to reproduce the cardiac longitudinal shortening at a programmable heart rate and the diaphragm displacement at a programmable respiratory rate (RR). A standard bipolar pacing lead moving with the actuators and a pacemaker case fixed to the thorax model have been used to measure impedance (Z) variations during the simulated cardiorespiratory movements. The software is able to discriminate the low-frequency component because of respiration (Z(R)) from the high-frequency ripple because of cardiac effect (Z(C)). Impedance minute ventilation is continuously calculated from Z(R) and RR. From preliminary tests, the CRMS proved to be a reliable simulator for in vitro evaluation of iMV sensors. Respiration impedance recordings collected during cardiorespiratory movements reproduced by the CRMS were comparable in morphology and amplitude with in vivo assessments of transthoracic impedance variations.

  15. A NEW METHOD FOR DIAGRAMMING PACEMAKER/HEART INTERACTION

    Institute of Scientific and Technical Information of China (English)

    1999-01-01

    Advancements in technology have enhanced the performance of pacemakers but made the interaction between the pacemaker and the heart becoming increasingly complex, and its is difficult to interpret the paced ECGs (PGCGs). This paper introduces a brief method to interpret PECGs, which illustrate the timing intervals graphically and avoid using symbols and strings.

  16. The Drosophila melanogaster circadian pacemaker circuit

    Indian Academy of Sciences (India)

    Vasu Sheeba

    2008-12-01

    As an experimental model system, the fruit fly Drosophila melanogaster has been seminal in shaping our understanding of the circadian clockwork. The wealth of genetic tools at our disposal over the past four decades has enabled discovery of the genetic and molecular bases of circadian rhythmicity. More recently, detailed investigation leading to the anatomical, neurochemical and electrophysiological characterization of the various neuronal subgroups that comprise the circadian machinery has revealed pathways through which these neurons come together to act as a neuronal circuit. Thus the D. melanogaster circadian pacemaker circuit presents a relatively simple and attractive model for the study of neuronal circuits and their functions.

  17. A Formal Verification Methodology for DDD Mode Pacemaker Control Programs

    Directory of Open Access Journals (Sweden)

    Sana Shuja

    2015-01-01

    Full Text Available Pacemakers are safety-critical devices whose faulty behaviors can cause harm or even death. Often these faulty behaviors are caused due to bugs in programs used for digital control of pacemakers. We present a formal verification methodology that can be used to check the correctness of object code programs that implement the safety-critical control functions of DDD mode pacemakers. Our methodology is based on the theory of Well-Founded Equivalence Bisimulation (WEB refinement, where both formal specifications and implementation are treated as transition systems. We develop a simple and general formal specification for DDD mode pacemakers. We also develop correctness proof obligations that can be applied to validate object code programs used for pacemaker control. Using our methodology, we were able to verify a control program with millions of transitions against the simple specification with only 10 transitions. Our method also found several bugs during the verification process.

  18. Pacemaker implantation complication rates in elderly and young patients

    Directory of Open Access Journals (Sweden)

    Özcan KS

    2013-08-01

    Full Text Available Kazim Serhan Özcan, Damirbek Osmonov, Servet Altay, Cevdet Dönmez, Ersin Yildirim, Ceyhan Türkkan, Baris Güngör, Ahmet Ekmekçi, Ahmet Taha Alper, Kadir Gürkan, İzzet ErdinlerDepartment of Cardiology, Siyami Ersek Cardiovascular and Thoracic Surgery Center, Istanbul, TurkeyAims: To evaluate the complication rate differences between elderly and younger patients who receive a permanent pacemaker implantation.Methods: We reviewed all cases admitted to our institution between January 2008 and June 2009 with symptomatic bradyarrhythmia for whom a permanent pacemaker was implanted. Beginning in June 2009, we prospectively collected data from all patients with the same diagnosis and procedure. The frequency of complications due to the pacemaker implantation procedure was evaluated and compared between young (<70 years old and elderly (≥70 years old patients.Results: Among 574 patients with a permanent pacemaker, 259 patients (45.1% were below and 315 patients (54.9% were above or at 70 years of age. There were 240 (92.7% and 19 (7.3% dual-chamber pacemaker (DDD and single-chamber pacemaker (VVI implanted patients in the younger group, and 291 (76.8% and 73 (23.2% DDD and VVI pacemaker implanted patients in the elderly group, respectively. The complication rate was 39 (15.1% out of 259 young patients and 24 (7.6% out of 315 elderly patients. Postprocedural complications were statistically lower in the elderly patients than in younger patients (P = 0.005.Conclusion: A pacemaker implantation performed by an experienced operator is a safe procedure for patients of advanced age. The patients who are above 70 years old may have less complication rates than the younger patients.Keywords: complications of pacemaker implantation, elderly patients, permanent pacemaker

  19. Self-powered cardiac pacemaker enabled by flexible single crystalline PMN-PT piezoelectric energy harvester.

    Science.gov (United States)

    Hwang, Geon-Tae; Park, Hyewon; Lee, Jeong-Ho; Oh, SeKwon; Park, Kwi-Il; Byun, Myunghwan; Park, Hyelim; Ahn, Gun; Jeong, Chang Kyu; No, Kwangsoo; Kwon, HyukSang; Lee, Sang-Goo; Joung, Boyoung; Lee, Keon Jae

    2014-07-23

    A flexible single-crystalline PMN-PT piezoelectric energy harvester is demonstrated to achieve a self-powered artificial cardiac pacemaker. The energy-harvesting device generates a short-circuit current of 0.223 mA and an open-circuit voltage of 8.2 V, which are enough not only to meet the standard for charging commercial batteries but also for stimulating the heart without an external power source.

  20. Self-powered cardiac pacemaker enabled by flexible single crystalline PMN-PT piezoelectric energy harvester.

    Science.gov (United States)

    Hwang, Geon-Tae; Park, Hyewon; Lee, Jeong-Ho; Oh, SeKwon; Park, Kwi-Il; Byun, Myunghwan; Park, Hyelim; Ahn, Gun; Jeong, Chang Kyu; No, Kwangsoo; Kwon, HyukSang; Lee, Sang-Goo; Joung, Boyoung; Lee, Keon Jae

    2014-07-23

    A flexible single-crystalline PMN-PT piezoelectric energy harvester is demonstrated to achieve a self-powered artificial cardiac pacemaker. The energy-harvesting device generates a short-circuit current of 0.223 mA and an open-circuit voltage of 8.2 V, which are enough not only to meet the standard for charging commercial batteries but also for stimulating the heart without an external power source. PMID:24740465

  1. Neuroimaging in Bipolar Disorder

    Directory of Open Access Journals (Sweden)

    Kemal Kara

    2013-03-01

    Full Text Available Bipolar disorder is characterized by recurrent attacks, significantly disrupts the functionality of a chronic mental disorder. Although there is growing number of studies on the neurobiological basis of the disorder, the pathophysiology has not yet been clearly understood. Structural and functional imaging techniques present a better understanding of the etiology of bipolar disorder and has contributed significantly to the development of the diagnostic approach. Recent developments in brain imaging modalities have let us learn more about the underlying abnormalities in neural systems of bipolar patients. Identification of objective biomarkers would help to determine the pathophysiology of bipolar disorder, a disorder which causes significant deterioration in neurocognitive and emotional areas.

  2. Enhanced charge trapping in bipolar spacer oxides during low-dose-rate irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Fleetwood, D.M.; Reber, R.A. Jr.; Winokur, P.S. [Sandia National Labs., Albuquerque, NM (United States); Kosier, S.L.; Schrimpf, R.D. [Arizona Univ., Tucson, AZ (United States). Dept. of Electrical and Computer Engineering; Nowlin, R.N. [Air Force Phillips Laboratory, Albuquerque, NM (United States); Pease, R.L. [RLP Research, Inc., Albuquerque, NM (United States); DeLaus, M. [Analog Devices, Wilmington, MA (United States)

    1994-03-01

    Thermally-stimulated-current and capacitance-voltage measurements reveal enhanced hole trapping in bipolar spacer-oxide capacitors irradiated at 0 V at low dose rates. Possible mechanisms and implications for bipolar low-rate response are discussed.

  3. Design and Implementation of programmable Cardiac Pacemaker Using VHDL

    Directory of Open Access Journals (Sweden)

    Omkar Dwivedi

    2015-05-01

    Full Text Available Pacemaker design has evolved very rapidly over the last several years. There has been a great deal of work in enhancing the programmability of pacemakers, to enable them to be programmed to work with different selected operating parameters, and indeed to work in different modes. In Taiwan, about 70%of cardiac pacemakerpatients are paced only from the ventricle with some pacing parameter programmability. This paper goal is to design a cardiac pacemaker with various NBG modes. A state machine approach has been followed to achieve the desired purpose. The pacemaker system is divide into three main sections i.e. controlling unit, sensing unit and pulse generator. In this paper we mainly concentrate on controlling unit and pulse generator. It has been developed using VHDL coding and implemented in hardware using FPGA. In a simple pacemaker process i.e. single chamber or dual chamber pacemaker, first an input signal or an event is detected in heart through leads. When the input signal is detected a timer generates a delay for approximately 0.8 sec. It is the time between two consecutive heartbeats, thus giving us 72 heartbeats per minute. Once the generated delay expires, sensing unit again start detecting a new event. If any event is detected we repeat the process of detection and waiting. If no event is detected we need to provide an electrical pulse to the heart and then repeat the whole process of detection and waiting. The code has been optimized and modified for different pacemaker modes.

  4. Broadening the diagnosis of bipolar disorder: benefits vs. risks

    OpenAIRE

    Strakowski, Stephen M.; Fleck, David E.; MAJ, MARIO

    2011-01-01

    There is considerable debate over whether bipolar and related disorders that share common signs and symptoms, but are currently defined as distinct clinical entities in DSM-IV and ICD-10, may be better characterized as falling within a more broadly defined “bipolar spectrum”. With a spectrum view in mind, the possibility of broadening the diagnosis of bipolar disorder has been proposed. This paper discusses some of the rationale for an expanded diagnostic scheme from both cl...

  5. Routine chest radiography after permanent pacemaker implantation: Is it necessary?

    Directory of Open Access Journals (Sweden)

    Edwards N

    2005-01-01

    Full Text Available Background and Aims: Chest radiographs (CXRs are performed routinely after permanent pacemaker implantation to identify pacemaker lead position and exclude pneumothorax. We assessed the clinical value and need for this procedure. Design: Retrospective analysis of pacemaker data and CXRs following permanent pacemaker insertion between December 2002 and February 2004. Materials and Methods: Post-procedural CXRs were available in 125/126 consecutive patients after either first endocardial pacemaker implantation or insertion of at least one new lead. Subclavian vein puncture was used for venous access in all cases. CXRs were examined to establish the incidence of pneumothorax and assess pacing lead positions. The clinical records were examined in all patients who had subsequent CXRs or a further pacemaker procedure to identify the indication for these and to establish whether CXR had influenced patient management. Results: In total, 192 post-procedural CXRs were performed, either postero-anterior (PA and/or lateral views. Ventricular and/or atrial pacing lead contour and electrode position was considered radiographically appropriate in 86% CXRs. Fourteen per cent of post-procedural radiographs were considered to have radiologically sub-optimal pacemaker lead positioning. None of the patients with these "abnormal" radiographs experienced subsequent pacemaker complications or had further radiographs recorded at a later date. Later repeat CXRs were performed in 16 patients (13% but only 3 patients (2% had pacing abnormalities as the primary indication. All three had satisfactory pacing lead position on initial post-implantation and later radiographs, but required further procedures for lead re-positioning. Iatrogenic pneumothorax occurred in one patient (incidence 0.8% in our series. CXR confirmed the clinical diagnosis and allowed an assessment of size to guide treatment. Conclusion: Routine CXR after permanent pacemaker insertion is not necessary in

  6. Of pacemakers and statistics: the actuarial method extended.

    Science.gov (United States)

    Dussel, J; Wolbarst, A B; Scott-Millar, R N; Obel, I W

    1980-01-01

    Pacemakers cease functioning because of either natural battery exhaustion (nbe) or component failure (cf). A study of four series of pacemakers shows that a simple extension of the actuarial method, so as to incorporate Normal statistics, makes possible a quantitative differentiation between the two modes of failure. This involves the separation of the overall failure probability density function PDF(t) into constituent parts pdfnbe(t) and pdfcf(t). The approach should allow a meaningful comparison of the characteristics of different pacemaker types. PMID:6160497

  7. Spontaneous electrical activity of guinea-pig sinoatrial cells under modulation of two different pacemaker mechanisms

    Directory of Open Access Journals (Sweden)

    Francesca Cacciani

    2014-01-01

    Full Text Available The main cellular determinants of cardiac automaticity are the hyperpolarization-activated cationic current If, and the electrogenic Na+/Ca2+ exchanger which generates an inward current after each action potential (AP. Our goal was to evaluate their relative role in pacemaking, by means of application of Ivabradine (IVA (specific If blocker and Ryanodine (RYA (known to abolish calcium transient on enzimatically isolated guinea-pig pacemaker cells. Spontaneous APs were recorded in patch-clamp whole cell configuration at 36°C from 7 cells perfused with the following sequence of solutions: physiological normal tyrode (NT, IVA 3 mM, NT and RYA 3 mM. Cycle length (CL, ms and diastolic depolarization rate (DDR, V/s were also calculated. Both blockers displayed similar effects, increasing CL (by 27 and 30%, respectively, and decreasing DDR (by 34 and 42% with respect to NT exposure. These results suggest that both mechanisms are involved into pacemaking mechanism at a similar degree.

  8. Neutron absorbed dose in a pacemaker CMOS

    Energy Technology Data Exchange (ETDEWEB)

    Borja H, C. G.; Guzman G, K. A.; Valero L, C. Y.; Banuelos F, A.; Hernandez D, V. M.; Vega C, H. R. [Universidad Autonoma de Zacatecas, Unidad Academica de Estudios Nucleares, Calle Cipres No. 10, Fracc. La Penuela, 98068 Zacatecas (Mexico); Paredes G, L., E-mail: candy_borja@hotmail.com [ININ, Carretera Mexico-Toluca s/n, 52750 Ocoyoacac, Estado de Mexico (Mexico)

    2011-11-15

    The absorbed dose due to neutrons by a Complementary Metal Oxide Semiconductor (CMOS) has been estimated using Monte Carlo methods. Eventually a person with a pacemaker becomes a patient that must be treated by radiotherapy with a linear accelerator; the pacemaker has integrated circuits as CMOS that are sensitive to intense and pulsed radiation fields. When the Linac is working in Bremsstrahlung mode an undesirable neutron field is produced due to photoneutron reactions; these neutrons could damage the CMOS putting the patient at risk during the radiotherapy treatment. In order to estimate the neutron dose in the CMOS a Monte Carlo calculation was carried out where a full radiotherapy vault room was modeled with a W-made spherical shell in whose center was located the source term of photoneutrons produced by a Linac head operating in Bremsstrahlung mode at 18 MV. In the calculations a phantom made of tissue equivalent was modeled while a beam of photoneutrons was applied on the phantom prostatic region using a field of 10 x 10 cm{sup 2}. During simulation neutrons were isotropically transported from the Linac head to the phantom chest, here a 1 {theta} x 1 cm{sup 2} cylinder made of polystyrene was modeled as the CMOS, where the neutron spectrum and the absorbed dose were estimated. Main damages to CMOS are by protons produced during neutron collisions protective cover made of H-rich materials, here the neutron spectrum that reach the CMOS was calculated showing a small peak around 0.1 MeV and a larger peak in the thermal region, both connected through epithermal neutrons. (Author)

  9. Modeling of single-event upset in bipolar integrated circuits

    Science.gov (United States)

    Zoutendyk, J. A.

    1983-01-01

    The results of work done on the quantitative characterization of single-event upset (SEU) in bipolar random-access memories (RAMs) have been obtained through computer simulation of SEU in RAM cells that contain circuit models for bipolar transistors. The models include current generators that emulate the charge collected from ion tracks. The computer simulation results are compared with test data obtained from a RAM in a bipolar microprocessor chip. This methodology is applicable to other bipolar integrated circuit constructions in addition to RAM cells.

  10. Optimising the management of bipolar disorder.

    Science.gov (United States)

    MsAbda Mahmood; Ebmeler, Klaus R

    2015-05-01

    NICE recommends that when adults present in primary care with depression, they should be asked about previous periods of overactivity or disinhibited behaviour. If this behaviour lasted for four or more days referral for a specialist mental health assessment should be considered. Although depressive episodes are not necessary for a diagnosis of bipolar disorder, they are common and dominate the lifetime pattern of the condition: 50% of the time is spent in a euthymic (well) state, 38% in a depressed and 12% in a manic state. If there have only been depressive symptoms, it is not possible to exclude bipolar disorder. A diagnosis of bipolar disorder is supported by diagnostic criteria and usually confirmed by a psychiatrist. If the GP suspects mania or severe depression, or if patients are a danger to themselves or others, an urgent referral should be made for a specialist mental health assessment. If a manic episode has been present during the history the diagnosis is bipolar I disorder, while a hypomanic episode is indicative of bipolar disorder. The patient's care plan should include current health status, social situation, social support, co-ordination arrangements with secondary care, details of early warning signs, and the patient's preferred course of action in the event of a clinical relapse. Physical health checks should focus on cardiovascular disease, diabetes, obesity and respiratory disease given the heightened risk for these illnesses in bipolar disorder. PMID:27254890

  11. Sleep Apnea May Raise Heart Risks in People with Pacemakers

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_158688.html Sleep Apnea May Raise Heart Risks in People With ... 2016 (HealthDay News) -- People with heart pacemakers and sleep apnea are at much greater risk for a ...

  12. New Approaches to Biological Pacemakers: Links to Sinoatrial Node Development.

    Science.gov (United States)

    Vedantham, Vasanth

    2015-12-01

    Irreversible degeneration of the cardiac conduction system is a common disease that can cause activity intolerance, fainting, and death. While electronic pacemakers provide effective treatment, alternative approaches are needed when long-term indwelling hardware is undesirable. Biological pacemakers comprise electrically active cells that functionally integrate with the heart. Recent findings on cardiac pacemaker cells (PCs) within the sinoatrial node (SAN), along with developments in stem cell technology, have opened a new era in biological pacing. Recent experiments that have derived PC-like cells from non-PCs have brought the field closer than ever before to biological pacemakers that can faithfully recapitulate SAN activity. In this review, I discuss these approaches in the context of SAN biology and address the potential for clinical translation. PMID:26611337

  13. Cardiovascular magnetic resonance with an MR compatible pacemaker

    OpenAIRE

    Bhandiwad Anita R; Cummings Kristopher W; Crowley Michael; Woodard Pamela K

    2013-01-01

    Abstract Magnetic resonance imaging (MRI) within FDA guidelines for the MRI-conditional pacemaker precludes placing the heart at the center of the magnet’s bore. This in effect appears to preclude cardiovascular MR. In this manuscript, we describe a protocol for cardiovascular MR of patients with a Revo pacemaker system while operating within FDA guidelines, and the first US case of cardiovascular MR in a patient with a Revo MRI-conditional pacing system despite position constraints.

  14. Bounding the total-dose response of modern bipolar transistors

    Energy Technology Data Exchange (ETDEWEB)

    Kosier, S.L.; Wei, A.; Schrimpf, R.D. [Arizona Univ., Tucson, AZ (United States). Dept. of Electrical and Computer Engineering; Combs, W.E. [Naval Surface Warfare Center-Crane, Crane, IN (United States); Fleetwood, D.M. [Sandia National Labs., Albuquerque, NM (United States); DeLaus, M. [Analog Devices, Inc., Wilmington, MA (United States); Pease, R.L. [RLP Research, Albuquerque, NM (United States)

    1994-03-01

    The base current in modern bipolar transistors saturates at large total doses once a critical oxide charge is reached. The saturated value of base current is dose-rate independent. Testing implications are discussed.

  15. Characteristics of Gintonin-Mediated Membrane Depolarization of Pacemaker Activity in Cultured Interstitial Cells of Cajal

    Directory of Open Access Journals (Sweden)

    Byung Joo Kim

    2014-08-01

    Full Text Available Background/Aims: Ginseng regulates gastrointestinal (GI motor activity but the underlying components and molecular mechanisms are unknown. We investigated the effect of gintonin, a novel ginseng-derived G protein-coupled lysophosphatidic acid (LPA receptor ligand, on the pacemaker activity of the interstitial cells of Cajal (ICC in murine small intestine and GI motility. Materials and Methods: Enzymatic digestion was used to dissociate ICC from mouse small intestines. The whole-cell patch-clamp configuration was used to record pacemaker potentials and currents from cultured ICC in the absence or presence of gintonin. In vivo effects of gintonin on gastrointestinal (GI motility were investigated by measuring the intestinal transit rate (ITR of Evans blue in normal and streptozotocin (STZ-induced diabetic mice. Results: We investigated the effects of gintonin on pacemaker potentials and currents in cultured ICC from mouse small intestine. Gintonin caused membrane depolarization in current clamp mode but this action was blocked by Ki16425, an LPA1/3 receptor antagonist, and by the addition of GDPβS, a GTP-binding protein inhibitor, into the ICC. To study the gintonin signaling pathway, we examined the effects of U-73122, an active PLC inhibitor, and chelerythrine and calphostin, which inhibit PKC. All inhibitors blocked gintonin actions on pacemaker potentials, but not completely. Gintonin-mediated depolarization was lower in Ca2+-free than in Ca2+-containing external solutions and was blocked by thapsigargin. We found that, in ICC, gintonin also activated Ca2+-activated Cl- channels (TMEM16A, ANO1, but not TRPM7 channels. In vivo, gintonin (10-100 mg/kg, p.o. not only significantly increased the ITR in normal mice but also ameliorated STZ-induced diabetic GI motility retardation in a dose-dependent manner. Conclusions: Gintonin-mediated membrane depolarization of pacemaker activity and ANO1 activation are coupled to the stimulation of GI

  16. The Ebers-Moll model for magnetic bipolar transistors

    OpenAIRE

    Fabian, J.; Zutic, I.

    2004-01-01

    The equivalent electrical circuit of the Ebers-Moll type is introduced for magnetic bipolar transistors. In addition to conventional diodes and current sources, the new circuit comprises two novel elements due to spin-charge coupling. A classification scheme of the operating modes of magnetic bipolar transistors in the low bias regime is presented.

  17. Characteristics of the Cholecystokinin-Induced Depolarization of Pacemaking Activity in Cultured Interstitial Cells of Cajal from Murine Small Intestine

    Directory of Open Access Journals (Sweden)

    Jae Hwa Lee

    2013-04-01

    Full Text Available Background/Aims: In this study, we studied the effects of cholecystokinin (CCK on pacemaker potentials in cultured interstitial cells of Cajal (ICCs from mouse small intestine using the whole cell patch clamp technique. Methods: ICCs are pacemaker cells that exhibit periodic spontaneous depolarization, which is responsible for the production of slow waves in gastrointestinal smooth muscle, and generate periodic pacemaker potentials in current-clamp mode. Results: Exposure to CCK (100 nM-5 µM decreased the amplitudes of pacemaker potentials and depolarized resting membrane potentials. To identify the type of CCK receptors involved in ICCs, we examined the effects of CCK agonists and found that the addition of CCK1 agonist (A-71323, 1 µM depolarized resting membrane potentials, whereas exposure to CCK2 agonist (gastrin , 1 µM had no effect on pacemaker potentials. To confirm these results, we examined the effects of CCK antagonists and found that pretreatment with CCK1 antagonist (SR 27897, 1 µM blocked CCK-induced effects. However, pretreatment with CCK2 antagonist (LY 225910, 1 µM did not. Furthermore, intracellular GDPβS suppressed CCK-induced effects. To investigate the involvements of phospholipase C (PLC, protein kinase C (PKC, and protein kinase A (PKA in the effects of CCK in cultured ICCs, we used U-73122 (an active PLC inhibitor, chelerythrine (a PKC inhibitor, SQ-22536 (an inhibitor of adenylate cyclase, or mPKAI (an inhibitor of myristoylated PKA. All inhibitors blocked the CCK-mediated effects on pacemaker potentials. In addition, we found that transient receptor potential classical 5 (TRPC5 channel was involved in CCK-activated currents in cultured ICCs. Conclusion: These results suggest that the CCK induced depolarization of pacemaking activity occurs in a G-protein-, PLC-, PKC-, and PKA-dependent manner via CCK1 receptor and TRPC5 channel is a candidate for CCK-activated currents in cultured ICCs in murine small intestine

  18. Bipolar effects in unipolar junctionless transistors

    Science.gov (United States)

    Parihar, Mukta Singh; Ghosh, Dipankar; Armstrong, G. Alastair; Yu, Ran; Razavi, Pedram; Kranti, Abhinav

    2012-08-01

    In this work, we analyze hysteresis and bipolar effects in unipolar junctionless transistors. A change in subthreshold drain current by 5 orders of magnitude is demonstrated at a drain voltage of 2.25 V in silicon junctionless transistor. Contrary to the conventional theory, increasing gate oxide thickness results in (i) a reduction of subthreshold slope (S-slope) and (ii) an increase in drain current, due to bipolar effects. The high sensitivity to film thickness in junctionless devices will be most crucial factor in achieving steep transition from ON to OFF state.

  19. 三种诊断定义对抑郁发作患者中双相障碍的识别效能%Recognition potency of three diagnostic definitions of bipolar disorder in patients with current depressive episode

    Institute of Scientific and Technical Information of China (English)

    朱玥; 马燕桃; 魏镜; 于欣

    2011-01-01

    目的:比较不同诊断定义对当前抑郁发作患者中双相障碍(BD)的识别效能,并考察有助提高BD识别的临床指标.方法:对符合精神障碍诊断与统计手册第4版(DSM-Ⅳ)抑郁发作诊断标准的成年患者共95例,实施盲法、横断面筛查.由两位主治以上水平的精神科医生依据疾病和有关健康问题的国际统计分类第10次修订本心境障碍诊断标准做出临床已知诊断,并以此为参照标准,评价DSM-Ⅳ,双极性及轻躁狂症状清单(HCL-32)三种诊断定义对BD(包括双相Ⅰ型及Ⅱ型)的识别效能;并比较双极性定义筛查BD阳性及阴性患者的临床特征.结果:临床已知诊断中BD比例为21%,DSM-Ⅳ、双极性及HCL-32对目前抑郁发作患者中BD的识别率分别为8%、48%及61%.三种诊断定义对BD的筛检灵敏度分别为30%、85%及85%,筛检特异度分别为97%、63%及41%,准确度(粗一致率)分别为83%、67%及51%.抑郁患者若伴有不典型抑郁、企图自杀≥2次及既往情感发作≥4次等特征时,双极性定义诊断BD的机率增加.结论:抑郁发作患者中存在相对高比例的BD.双极性定义具有较好的诊断灵敏度,兼有中等特异度及准确度,有助提高BD的识别率.%Objective: To compare recognition potency of three diagnostic definitions for bipolar disorder (BD) in patients with current depressive episode, and to explore possible clinical indicators of BD.Methods: A total of 95 adult patients with current depressive episode who met the diagnostic criteria for depression episode in Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-Ⅳ) were recruited.Clinical diagnosis was made by two qualified psychiatrists according to the International statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) and was regarded as reference standard with comparison.The BD recognition potency of the DSM- Ⅳ, the bipolarity criteria and the 32-item

  20. Mood self-assessment in bipolar disorder: a comparison between patients in mania, depression, and euthymia

    OpenAIRE

    Rafael de Assis da Silva; Mograbi, Daniel C.; Luciana Angélica Silva Silveira; Ana Letícia Santos Nunes; Fernanda Demôro Novis; Paola Anaquim Cavaco; Landeira-Fernandez, J.; Elie Cheniaux

    2013-01-01

    BACKGROUND: Some studies indicate that mood self-assessment is more severely impaired in patients with bipolar disorder in a manic episode than in depression. OBJECTIVES: To investigate variations in mood self-assessment in relation to current affective state in a group of individuals with bipolar disorder. METHODS: A total of 165 patients with a diagnosis of bipolar disorder type I or type II had their affective state assessed using the Clinical Global Impressions Scale for use in bipolar il...

  1. Types of Bipolar Disorder

    Science.gov (United States)

    ... improve the lives of people who have mood disorders. The Power of Peers DBSA envisions wellness for people who live with depression and bipolar disorder. Because DBSA was created for and is led ...

  2. Management of radiation therapy patients with cardiac defibrillator or pacemaker.

    Science.gov (United States)

    Salerno, Francesca; Gomellini, Sara; Caruso, Cristina; Barbara, Raffaele; Musio, Daniela; Coppi, Tamara; Cardinale, Mario; Tombolini, Vincenzo; de Paula, Ugo

    2016-06-01

    The increasing growth of population with cardiac implantable electronic devices (CIEDs) such as Pacemaker (PM) and Implantable Cardiac Defibrillators (ICD), requires particular attention in management of patients needing radiation treatment. This paper updates and summarizes some recommendations from different international guidelines. Ionizing radiation and/or electromagnetic interferences could cause device failure. Current approaches to treatment in patients who have these devices vary among radiation oncology centres. We refer to the German Society of Radiation Oncology and Cardiology guidelines (ed. 2015); to the Society of Cardiology Australia and New Zealand Statement (ed. 2015); to the guidelines in force in the Netherlands (ed. 2012) and to the Italian Association of Radiation Oncology recommendations (ed. 2013) as reported in the guidelines for the treatment of breast cancer in patients with CIED. Although there is not a clear cut-off point, risk of device failure increases with increasing doses. Cumulative dose and pacing dependency have been combined to categorize patients into low-, medium- and high-risk groups. Measures to secure patient safety are described for each category. The use of energy ≤6MV is preferable and it's strongly recommended not to exceed a total dose of 2 Gy to the PM and 1 Gy for ICD. Given the dangers of device malfunction, radiation oncology departments should adopt all the measures designed to minimize the risk to patients. For this reason, a close collaboration between cardiologist, radiotherapist and physicist is necessary.

  3. Nonphotic entrainment of the human circadian pacemaker

    Science.gov (United States)

    Klerman, E. B.; Rimmer, D. W.; Dijk, D. J.; Kronauer, R. E.; Rizzo, J. F. 3rd; Czeisler, C. A.

    1998-01-01

    In organisms as diverse as single-celled algae and humans, light is the primary stimulus mediating entrainment of the circadian biological clock. Reports that some totally blind individuals appear entrained to the 24-h day have suggested that nonphotic stimuli may also be effective circadian synchronizers in humans, although the nonphotic stimuli are probably comparatively weak synchronizers, because the circadian rhythms of many totally blind individuals "free run" even when they maintain a 24-h activity-rest schedule. To investigate entrainment by nonphotic synchronizers, we studied the endogenous circadian melatonin and core body temperature rhythms of 15 totally blind subjects who lacked conscious light perception and exhibited no suppression of plasma melatonin in response to ocular bright-light exposure. Nine of these fifteen blind individuals were able to maintain synchronization to the 24-h day, albeit often at an atypical phase angle of entrainment. Nonphotic stimuli also synchronized the endogenous circadian rhythms of a totally blind individual to a non-24-h schedule while living in constant near darkness. We conclude that nonphotic stimuli can entrain the human circadian pacemaker in some individuals lacking ocular circadian photoreception.

  4. Dual chamber pacemaker in the treatment of paroxysmal atrial fibrillation

    Directory of Open Access Journals (Sweden)

    Rađen Goran

    2005-01-01

    Full Text Available Background. Atrial fibrillation is the most frequent cardiac dysrhythmia. The aim of this study was to show the role and the efficacy of a dual chamber pacemaker with the algorithm of atrial dynamic overdrive, in the suppression of paroxysmal atrial fibrillation. Case report. A woman with a classical bradycardia-tachycardia syndrome, and frequent attacks of atrial fibrillation, underwent the implantation of a single chamber permanent pacemaker (VVI. Pacemaker successfully treated the episodes of symptomatic bradycardia, but the patient had frequent attacks of atrial fibrillation, despite the use of different antiarrhythmic drugs, which she did not tolerate well. The decision was made to reimplant a permanent dual chamber pacemaker with the algorithm of atrial dynamic overdrive. The pacemaker was programmed to the basic rate of 75/min, while rate at rest was 55/min. In addition, sotalol was administered. After three months, the patient became asymptomatic with only 4 short − term episodes of atrial fibrillation, and a high level of atrial pacing (99%. Conclusion. In selected patients with bradycardia−tachycardia syndrome, atrial-based pacing seemed to be very effective in reducing the incidence of paroxysmal atrial fibrillation.

  5. Surgical Removal of a Giant Vegetation on Permanent Endocavitary Pacemaker Wire and Lead

    Institute of Scientific and Technical Information of China (English)

    Guo-tao Ma; Qi Miao; Chao-ji Zhang; Li-hua Cao

    2011-01-01

    PACEMAKER lead infections are rare.There are only about 0.4%-1.1% of the patients who have been implanted permanent pacemakers suffering from serious infections which lead to endocarditis.1 Generally,removal of the infected pacemaker wire and lead,long-term anti-infection therapy,and implantation of a new pacemaker to another anatomic site are accepted approaches for these patients.

  6. Bipolar Affective Disorder and Migraine

    Directory of Open Access Journals (Sweden)

    Birk Engmann

    2012-01-01

    Full Text Available This paper consists of a case history and an overview of the relationship, aetiology, and treatment of comorbid bipolar disorder migraine patients. A MEDLINE literature search was used. Terms for the search were bipolar disorder bipolar depression, mania, migraine, mood stabilizer. Bipolar disorder and migraine cooccur at a relatively high rate. Bipolar II patients seem to have a higher risk of comorbid migraine than bipolar I patients have. The literature on the common roots of migraine and bipolar disorder, including both genetic and neuropathological approaches, is broadly discussed. Moreover, bipolar disorder and migraine are often combined with a variety of other affective disorders, and, furthermore, behavioural factors also play a role in the origin and course of the diseases. Approach to treatment options is also difficult. Several papers point out possible remedies, for example, valproate, topiramate, which acts on both diseases, but no first-choice treatments have been agreed upon yet.

  7. SYNCHRONIZATION OF TWO COUPLED HINDMARSH-ROSE NEURONS BY A PACEMAKER

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    This paper considers the synchronization of two coupled Hindmarsh-Rose neurons by a pacemaker.Based on the stability theory of differential equations,the complete synchronization of this pacemaker neuron model is reached.Moreover,we also show that pacemaker can enhance or induce synchronization.Numerical simulations are given to illustrate the main results.

  8. Pacemaker patients' perception of unsafe activities: a survey

    Directory of Open Access Journals (Sweden)

    Shafquat Azam

    2008-11-01

    Full Text Available Abstract Background Cardiac pacing is a recognized and widely used treatment for patients presenting with bradycardia. Physicians expect patients to return to normal activities almost immediately post implantation. However, patients themselves may perceive interference to pacemaker function by various routine activities and devices, and hence continue to lead restricted, disabled lives. The aim of this study is to determine if routine activities are perceived by pacemaker patients to interfere with their device function. Methods A descriptive cross sectional survey was carried out on consecutive patients at the pacemaker clinic at a public hospital in Karachi, Pakistan. A 47-question tool was developed and tested. Patients' perceptions of safety of performing various routine activities, along with socio-demographic data were recorded. Results The final sample included 93 adult patients (45% males. 41% were illiterate. 77.4% recalled receiving counselling at implantation, predominantly from the implanting physician and house staff. A considerable proportion of patients considered many routine activities unsafe including driving automobiles (28%, passing through metal detectors (31%, bending over (37%, and sleeping on the side of the pacemaker (30%. Also considered unsafe were operation of household appliances- TV/VCR (television/video cassette recorders (53%, irons (55% and electrical wall switches (56%. For nearly all variables neither literacy nor history of counselling improved incorrect perceptions. Conclusion This study shows that our pacemaker patients perceive many routine activities as unsafe, potentially leading to disabling life style modifications. The tremendous investment in pacemaker technology to improve patient performance is not going to pay dividends if patients continue to remain disabled due to incorrect perceptions. Further studies are required to determine the reasons for these misperceptions, and to determine if these

  9. [Electromagnetic interference of electrical dental equipment with cardiac pacemakers].

    Science.gov (United States)

    Brand, H S; van der Hoeff, E V; Schrama, T A M; Entjes, M L; van Nieuw, Amerongen A

    2007-09-01

    Eight different electrical dental appliances were tested at different intervals for their ability to interfere with the function of a contemporary cardiac pacemaker. The normal atrial and ventricular pacing was inhibited by an ultrasonic bath cleaner at a distance of less than 15 cm. In contrast, a dental chair, an electrosurgical unit, an ultrasonic tooth scaler, 2 handpieces, and 2 amalgamators failed to produce electromagnetic interference at the minimum distance of 2.5 cm. In conclusion, the results suggest that normal clinical use of dental electrical equipment does not have any significant effect on the cardiac pacemaker tested. PMID:17937372

  10. Permanent internal pacemaker safety in air medical transport.

    Science.gov (United States)

    Gordon, R S; O'Dell, K B

    1991-02-01

    Helicopter and fixed-wing air medical transportation provides an important role in the management of critically-ill patients. As the use of cardiac pacemakers continues to grow, knowledge of their expanding capabilities and sophistication is important. The environments of our "airborne intensive care units" are subject to many sources of electromagnetic and vibrational interference. Although pacemaker shielding mechanisms have become quite elaborate, further studies are needed to define their reliability in modern aircraft. Further, the possible effects of electromagnetic and vibrational interference upon inflight reprogramming require further study. PMID:10109075

  11. Bipolar battery construction

    Science.gov (United States)

    Rippel, Wally E. (Inventor); Edwards, Dean B. (Inventor)

    1981-01-01

    A lightweight, bipolar battery construction for lead acid batteries in which a plurality of thin, rigid, biplates each comprise a graphite fiber thermoplastic composition in conductive relation to lead stripes plated on opposite flat surfaces of the plates, and wherein a plurality of nonconductive thermoplastic separator plates support resilient yieldable porous glass mats in which active material is carried, the biplates and separator plates with active material being contained and maintained in stacked assembly by axial compression of the stacked assembly. A method of assembling such a bipolar battery construction.

  12. Corrosion test cell for bipolar plates

    Science.gov (United States)

    Weisbrod, Kirk R.

    2002-01-01

    A corrosion test cell for evaluating corrosion resistance in fuel cell bipolar plates is described. The cell has a transparent or translucent cell body having a pair of identical cell body members that seal against opposite sides of a bipolar plate. The cell includes an anode chamber and an cathode chamber, each on opposite sides of the plate. Each chamber contains a pair of mesh platinum current collectors and a catalyst layer pressed between current collectors and the plate. Each chamber is filled with an electrolyte solution that is replenished with fluid from a much larger electrolyte reservoir. The cell includes gas inlets to each chamber for hydrogen gas and air. As the gases flow into a chamber, they pass along the platinum mesh, through the catalyst layer, and to the bipolar plate. The gas exits the chamber through passageways that provide fluid communication between the anode and cathode chambers and the reservoir, and exits the test cell through an exit port in the reservoir. The flow of gas into the cell produces a constant flow of fresh electrolyte into each chamber. Openings in each cell body is member allow electrodes to enter the cell body and contact the electrolyte in the reservoir therein. During operation, while hydrogen gas is passed into one chamber and air into the other chamber, the cell resistance is measured, which is used to evaluate the corrosion properties of the bipolar plate.

  13. Pacemaker optimization guided by echocardiography in cardiac resynchronization therapy

    Directory of Open Access Journals (Sweden)

    Trifunović Danijela

    2009-01-01

    Full Text Available Introduction. Cardiac resynchronization therapy (CRT or biventricular pacing is a contemporary treatment in the management of advanced heart failure. Echocardiography plays an evolving and important role in patient selection for CRT, follow-up of acute and chronic CRT effects and optimization of device settings after biventricular pacemaker implantation. In this paper we illustrate usefulness of echocardiography for successful AV and VV timing optimization in patients with CRT. A review of up-to-date literature concerning rationale for AV and VV delay optimization, echocardiographic protocols and current recommendations for AV and VV optimization after CRT are also presented. Outline of Cases. The first case is of successful AV delay optimization guided by echocardiography in a patient with dilated cardiomyopathy treated with CRT is presented. Pulsed blood flow Doppler was used to detect mitral inflow while programming different duration of AV delay. The AV delay with optimal transmittal flow was established. The optimal mitral flow was the one with clearly defined E and A waves and maximal velocity time integral (VTI of the mitral flow. Improvement in clinical status and reverse left ventricle remodelling with improvement of ejection fraction was registered in our patient after a month. The second case presents a patient with heart failure caused by dilated cardiomyopathy; six months after CRT implantation the patient was still NYHA class III and with a significantly depressed left ventricular ejection fraction. Optimization of VV interval guided by echocardiography was undertaken measuring VTI of the left ventricular outflow tract (LVOT during programming of different VV intervals. The optimal VV interval was determined using a maximal LVOT VTI. A month after VV optimization our patient showed improvement in LV ejection fraction. Conclusion. Optimal management of patients treated with CRT integrate both clinical and echocardiographic follow

  14. Hardware-in-the-loop simulation and energy optimization of cardiac pacemakers.

    Science.gov (United States)

    Barker, Chris; Kwiatkowska, Marta; Mereacre, Alexandru; Paoletti, Nicola; Patane, Andrea

    2015-01-01

    Implantable cardiac pacemakers are medical devices that can monitor and correct abnormal heart rhythms. To provide the necessary safety assurance for pacemaker software, both testing and verification of the code, as well as testing the entire pacemaker hardware in the loop, is necessary. In this paper, we present a hardware testbed that enables detailed hardware-in-the-loop simulation and energy optimisation of pacemaker algorithms with respect to a heart model. Both the heart and the pacemaker models are encoded in Simulink/Stateflow™ and translated into executable code, with the pacemaker executed directly on the microcontroller. We evaluate the usefulness of the testbed by developing a parameter synthesis algorithm which optimises the timing parameters based on power measurements acquired in real-time. The experiments performed on real measurements successfully demonstrate that the testbed is capable of energy minimisation in real-time and obtains safe pacemaker timing parameters.

  15. Hardware-in-the-loop simulation and energy optimization of cardiac pacemakers.

    Science.gov (United States)

    Barker, Chris; Kwiatkowska, Marta; Mereacre, Alexandru; Paoletti, Nicola; Patane, Andrea

    2015-08-01

    Implantable cardiac pacemakers are medical devices that can monitor and correct abnormal heart rhythms. To provide the necessary safety assurance for pacemaker software, both testing and verification of the code, as well as testing the entire pacemaker hardware in the loop, is necessary. In this paper, we present a hardware testbed that enables detailed hardware-in-the-loop simulation and energy optimisation of pacemaker algorithms with respect to a heart model. Both the heart and the pacemaker models are encoded in Simulink/Stateflow™ and translated into executable code, with the pacemaker executed directly on the microcontroller. We evaluate the usefulness of the testbed by developing a parameter synthesis algorithm which optimises the timing parameters based on power measurements acquired in real-time. The experiments performed on real measurements successfully demonstrate that the testbed is capable of energy minimisation in real-time and obtains safe pacemaker timing parameters. PMID:26737950

  16. Pacemaker dislocation - Truly ectopic activation necessitating surgical treatment

    NARCIS (Netherlands)

    de Kroon, TL; Witsenburg, M; Bogerts, AJJC

    2002-01-01

    Intra-abdominal migration of a generator from an epicardial pacemaker system is a rare but potentially life-threatening complication. We report on a case of a 2-year-old child in whom the generator silently migrated from the sheath of the rectus abdominis muscle in the upper abdominal wall down into

  17. Pacemaker Related Infective Endocarditis from Staphylococcus Lugdunensis: A Case Report

    Directory of Open Access Journals (Sweden)

    Michael Ward

    2013-01-01

    Full Text Available Staphylococcus lugdunensis is a common skin flora not typically associated with infection. There are, however, several cases reported in the literature of Staphylococcus lugdunensis as a causative bacterium of various infections. This paper reports an additional case of pacemaker associated endocarditis with Staphylococcus lugdunensis as the causative bacterium.

  18. Differentially timed extracellular signals synchronize pacemaker neuron clocks.

    Directory of Open Access Journals (Sweden)

    Ben Collins

    2014-09-01

    Full Text Available Synchronized neuronal activity is vital for complex processes like behavior. Circadian pacemaker neurons offer an unusual opportunity to study synchrony as their molecular clocks oscillate in phase over an extended timeframe (24 h. To identify where, when, and how synchronizing signals are perceived, we first studied the minimal clock neural circuit in Drosophila larvae, manipulating either the four master pacemaker neurons (LNvs or two dorsal clock neurons (DN1s. Unexpectedly, we found that the PDF Receptor (PdfR is required in both LNvs and DN1s to maintain synchronized LNv clocks. We also found that glutamate is a second synchronizing signal that is released from DN1s and perceived in LNvs via the metabotropic glutamate receptor (mGluRA. Because simultaneously reducing Pdfr and mGluRA expression in LNvs severely dampened Timeless clock protein oscillations, we conclude that the master pacemaker LNvs require extracellular signals to function normally. These two synchronizing signals are released at opposite times of day and drive cAMP oscillations in LNvs. Finally we found that PdfR and mGluRA also help synchronize Timeless oscillations in adult s-LNvs. We propose that differentially timed signals that drive cAMP oscillations and synchronize pacemaker neurons in circadian neural circuits will be conserved across species.

  19. Can Brain 'Pacemaker' Improve Lives of Head Trauma Patients?

    Science.gov (United States)

    ... 161109.html Can Brain 'Pacemaker' Improve Lives of Head Trauma Patients? Deep brain stimulation appears to boost function and quality of life, small study finds To use the sharing ... that's implanted from the head, under the skin, through the neck and shoulders ...

  20. Cardiac electronic pacemakers and biological Pacemakers%心脏电子起搏器时代与生物起搏替代的前沿话题

    Institute of Scientific and Technical Information of China (English)

    周亚峰; 杨向军

    2008-01-01

    流的超极化激活环核苷酸门控通道基因被认为是最有可能实现生物起搏的.结论:基因治疗和细胞治疗必将成为改善生物"起搏"功能最理想的方法,以超极化激活环核苷酸门控通道基因和细胞为主的生物起搏在缓慢性心律失常治疗中必将占有一席之地.%BACKGROUND: The implantation of electronic devices has become the preferred treatment tor symptomatic bradyarrhythmias.However,there are many shortcomings in electronic pacemakers.The usage of molecular biology principle to develop biological pacemaker has become a topic of discussion in research.When sinoatrial node is lnhlblted,pacemaker effect runs by transfecting hyperpolarization-activated cyclic nucleotide-gated(HCN)channel gene of If current,overexprcssing HCN,and increasing inward current in diastolic phase of the heart.Construction of biological pacemakefs by gene therapy and cell therapy may become an optimal substitute of electronic pacemakers in the near future.OBJECTIVE:To sum up the research advancement in application of HCN channel gene to the development of biological pacemaker.RETRIEVAL STRATEGY:The relevant articles published between January 1979 and June 2007 were searched for in Pubmed database by researcher of this article with the key words of"hyperpolarization-activated cyclic nucleotide-gated chartnel,biological pacemaker"in English.157 articles were selected and reviewed by the inclusive cntena of:① articles closely related with the application of HCN to the development of biological pacemaker;②the late articles and articles in anthority journals in the same field.Exclusive criterion:repetitive studies.LITERATURE EVALUATION:The main sources of literatures were randomized clinical trial(RCT)on biological pacemaker by HCN.Among 36 selected articles,10 were reviews,and others were elementary expenInental studles.DATA SYNTHESIS:①Of all four HCN isoforms,HCNI,HCN2,and HCN4 are the main isoforms in the heart.HCN3 only

  1. Clinical assessment of bipolar depression: validity, factor structure and psychometric properties of the Korean version of the Bipolar Depression Rating Scale (BDRS)

    OpenAIRE

    Jung, Young-Eun; Kim, Moon-Doo; Bahk, Won-Myong; Woo, Young Sup; Lee, Jonghun; Jang, Sae-Heon; Won, Seunghee; Min, Kyung Joon; Chung, Sangkeun; Kwon, Young-Joon; Jon, Duk-In; Lee, Kwanghun; Yoon, Bo-Hyun

    2016-01-01

    Background The Bipolar Depression Rating Scale (BDRS) is a scale for assessment of the clinical characteristics of bipolar depression. The primary aims of this study were to describe the development of the Korean version of the BDRS (K-BDRS) and to establish more firmly its psychometric properties in terms of reliability and validity. Methods The study included 141 patients (62 male and 79 female) who had been diagnosed with bipolar disorder, were currently experiencing symptoms of depression...

  2. Abordagens psicoterápicas no transtorno bipolar Psychoterapeutic approach in bipolar disorder

    Directory of Open Access Journals (Sweden)

    Paulo Knapp

    2005-01-01

    Full Text Available Embora o tratamento farmacológico seja essencial para o tratamento do transtorno bipolar, apenas 40% de todos os pacientes que aderem às medicações permanecem assintomáticos durante o período de seguimento, o que tem levado ao desenvolvimento de intervenções psicoterápicas associadas. O objetivo deste artigo é examinar as evidências atuais da eficácia de intervenções psicoterápicas no tratamento do transtorno bipolar. Foi realizada uma pesquisa bibliográfica por meio do MedLine, PsychoINFO, Lilacs e Cochrane Data Bank, até o ano de 2004, em que foram procurados artigos originais e revisões sobre as abordagens psicoterápicas utilizadas no tratamento do transtorno bipolar. Há várias abordagens que podem se mostrar úteis no tratamento do transtorno bipolar. A psicoeducação e a terapia cognitivo-comportamental apresentam as evidências mais consistentes e são as técnicas mais amplamente estudadas. As intervenções envolvendo familiares e a terapia interpessoal e de ritmo social se mostram tratamentos eficazes em determinadas situações. Há alguns estudos empregando a terapia psicodinâmica no transtorno bipolar, mas são estudos com limitações metodológicas. Apesar de haver evidências demonstrando a eficácia de determinadas abordagens psicoterápicas no transtorno bipolar, ainda é necessária a realização de estudos posteriores que comprovem tais dados e que desenvolvam tratamentos baseados em modelos etiológicos e que identifiquem tratamentos específicos para as diferentes fases e tipos de transtorno bipolar.Although pharmacological treatment is essential for treating bipolar disorder, less than half of all medication compliant patients are non-symptomatic during follow-up, which has led to developments of adjunctive psychosocial interventions. This paper examines the current evidence for effectiveness of psychotherapeutic interventions in the treatment of bipolar disorder. Searches were undertaken through Med

  3. Electrostatic Changes Observed with Narrow Bipolar Pulses

    Science.gov (United States)

    Karunarathne, S.; Marshall, T. C.; Stolzenburg, M.; Karunarathna, N.

    2015-12-01

    Narrow bipolar pulses (NBPs) or compact intracloud discharges are impulsive discharges that are considered to be the strongest natural emitters in the HF radio band; they usually occur at high altitudes in some thunderstorms. In the summer of 2011, we collected E-change data with wideband flat-plate antennas (0.16 Hz - 2.5 MHz) at ten stations covering an area of nearly 70 km x 100 km in and around Kennedy Space Center, Florida, USA. On one thunderstorm day, 14 August 2011, we detected 226 positive NBPs, and some observations of these pulses were published in Karunarathne et al. [2015, JGR-atmospheres]. Of these 226 NBPs, 50 (22.1 %) occurred within 10 km horizontally of at least one sensor. All of these closer sensors show electrostatic changes associated with corresponding NBPs, with a net electrostatic change in the main bipolar pulse and with a slower electrostatic change after the bipolar pulse that seems similar to short continuing current immediately after some cloud-to-ground return strokes. Although NBPs have been considered as short duration pulses (10 - 20 microseconds), the electrostatic changes after the main bipolar pulse ranged from 0.7 ms to 34 ms and associated charge moments were calculated. The total duration of the electrostatic E-change was strongly dependent on the distance to the sensors. In this presentation, we will present data for these electrostatic changes, some statistics, and physical background and reasoning for the electrostatic changes.

  4. Perturbed reward processing in pediatric bipolar disorder: an antisaccade study.

    Science.gov (United States)

    Mueller, Sven C; Ng, Pamela; Temple, Veronica; Hardin, Michael G; Pine, Daniel S; Leibenluft, Ellen; Ernst, Monique

    2010-12-01

    Pediatric bipolar disorder is a severe and impairing illness. Characterizing the impact of pediatric bipolar disorder on cognitive function might aid in understanding the phenomenology of the disorder. While previous studies of pediatric bipolar disorder have reported deficits in cognitive control and reward behavior, little is understood about how affective processes influence behavioral control. Relative to prior studies using manual-response paradigms, eye movement tasks provide a more precise assessment of reward sensitivity and cognitive and motor control. The current study compares 20 youths with bipolar disorder (mean age = 13.9 years ± 2.22) and 23 healthy subjects (mean age = 13.8 years ± 2.49) on a mixed pro-antisaccade task with monetary incentives. On both types of saccades, participants were presented with three types of incentives: those where subjects can win money, lose money, or neither win nor lose money. Impaired reward processing was found in youths with bipolar disorder relative to controls, particularly on antisaccades. This difference was reflected in lower error rates during incentive trials in the control but not in the bipolar disorder group. By comparison, no group differences were found on prosaccade trials. The results provide further evidence for deficits in cognitive and reward processing in bipolar disorder. PMID:20080923

  5. Impulsivity and risk taking in bipolar disorder and schizophrenia.

    Science.gov (United States)

    Reddy, L Felice; Lee, Junghee; Davis, Michael C; Altshuler, Lori; Glahn, David C; Miklowitz, David J; Green, Michael F

    2014-01-01

    Impulsive risk taking contributes to deleterious outcomes among clinical populations. Indeed, pathological impulsivity and risk taking are common in patients with serious mental illness, and have severe clinical repercussions including novelty seeking, response disinhibition, aggression, and substance abuse. Thus, the current study seeks to examine self-reported impulsivity (Barratt Impulsivity Scale) and performance-based behavioral risk taking (Balloon Analogue Risk Task) in bipolar disorder and schizophrenia. Participants included 68 individuals with bipolar disorder, 38 with schizophrenia, and 36 healthy controls. Self-reported impulsivity was elevated in the bipolar group compared with schizophrenia patients and healthy controls, who did not differ from each other. On the risk-taking task, schizophrenia patients were significantly more risk averse than the bipolar patients and controls. Aside from the diagnostic group differences, there was a significant effect of antipsychotic (AP) medication within the bipolar group: bipolar patients taking AP medications were more risk averse than those not taking AP medications. This difference in risk taking because of AP medications was not explained by history of psychosis. Similarly, the differences in risk taking between schizophrenia and bipolar disorder were not fully explained by AP effects. Implications for clinical practice and future research are discussed. PMID:23963117

  6. Broadening the diagnosis of bipolar disorder: benefits vs. risks

    Science.gov (United States)

    STRAKOWSKI, STEPHEN M.; FLECK, DAVID E.; MAJ, MARIO

    2011-01-01

    There is considerable debate over whether bipolar and related disorders that share common signs and symptoms, but are currently defined as distinct clinical entities in DSM-IV and ICD-10, may be better characterized as falling within a more broadly defined “bipolar spectrum”. With a spectrum view in mind, the possibility of broadening the diagnosis of bipolar disorder has been proposed. This paper discusses some of the rationale for an expanded diagnostic scheme from both clinical and research perspectives in light of potential drawbacks. The ultimate goal of broadening the diagnosis of bipolar disorder is to help identify a common etiopathogenesis for these conditions to better guide treatment. To help achieve this goal, bipolar researchers have increasingly expanded their patient populations to identify objective biological or endophenotypic markers that transcend phenomenological observation. Although this approach has and will likely continue to produce beneficial results, the upcoming DSM-IV and ICD-10 revisions will place increasing scrutiny on psychiatry’s diagnostic classification systems and pressure to re-evaluate our conceptions of bipolar disorder. However, until research findings can provide consistent and converging evidence as to the validity of a broader diagnostic conception, clinical expansion to a dimensional bipolar spectrum should be considered with caution. PMID:21991268

  7. BIPOLAR DISORDER IN ADULTS

    Directory of Open Access Journals (Sweden)

    Yadav Jaya

    2013-06-01

    Full Text Available Bipolar disorder is a chronic illness, which may require life-long treatment. Patients will spend 3-5 times more days in the depressed episode then in the manic phase. Due to this variability in episodes, polypharmacy is used quite frequently in practice, though the evidence to do this remains quite limited. Many positive and negative outcomes can occur from this practice. Bipolar disorder is the 6th leading cause of disability in the developed world among those between the ages 15 and 44 years age groups. Serotonin is one of the neurotransmitter in the brain, and one of that strongly affects the person mood. Clozapine (clozaril, olanzapine (zyperexa, risperidone (Risperdal, and ziprasidone (zeldox and the clozapine may be helpful as mood stabilizer for people who do not respond to lithium and anticonvulsant.

  8. Epilepsy and bipolar disorder.

    Science.gov (United States)

    Knott, Sarah; Forty, Liz; Craddock, Nick; Thomas, Rhys H

    2015-11-01

    It is well recognized that mood disorders and epilepsy commonly co-occur. Despite this, our knowledge regarding the relationship between epilepsy and bipolar disorder is limited. Several shared features between the two disorders, such as their episodic nature and potential to run a chronic course, and the efficacy of some antiepileptic medications in the prophylaxis of both disorders, are often cited as evidence of possible shared underlying pathophysiology. The present paper aims to review the bidirectional associations between epilepsy and bipolar disorder, with a focus on epidemiological links, evidence for shared etiology, and the impact of these disorders on both the individual and wider society. Better recognition and understanding of these two complex disorders, along with an integrated clinical approach, are crucial for improved evaluation and management of comorbid epilepsy and mood disorders.

  9. Life expectancy in bipolar disorder

    DEFF Research Database (Denmark)

    Kessing, Lars Vedel; Vradi, Eleni; Andersen, Per Kragh

    2015-01-01

    OBJECTIVE: Life expectancy in patients with bipolar disorder has been reported to be decreased by 11 to 20 years. These calculations are based on data for individuals at the age of 15 years. However, this may be misleading for patients with bipolar disorder in general as most patients have a later...... onset of illness. The aim of the present study was to calculate the remaining life expectancy for patients of different ages with a diagnosis of bipolar disorder. METHODS: Using nationwide registers of all inpatient and outpatient contacts to all psychiatric hospitals in Denmark from 1970 to 2012 we...... remaining life expectancy in bipolar disorder and that of the general population decreased with age, indicating that patients with bipolar disorder start losing life-years during early and mid-adulthood. CONCLUSIONS: Life expectancy in bipolar disorder is decreased substantially, but less so than previously...

  10. Bipolar Disorder and Cancer

    OpenAIRE

    Sermin Kesebir; Arzu Bayrak

    2012-01-01

    Prevalence studies and studies on causation relations have shown that the relation between psychiatric disorders and chronic physical diseases is neglected. For heterogeneous diseases an increasing number of susceptibility variants are being defined. Alzheimer disease, bipolar disorder, breast and prostate cancer, coronary artery disease, Chron's disease, systemic lupus eritematosus, type 1 and type 2 diabetes mellitus are mentioned together with epigenetic concept. In acrocentric zone of chr...

  11. Treatment of bipolar disorder

    OpenAIRE

    Geddes, John R.; Miklowitz, David J.

    2013-01-01

    We review recent developments in the acute and long-term treatment of bipolar disorder and identify promising future routes to therapeutic innovation. Overall, advances in drug treatment remain quite modest. Antipsychotic drugs are effective in the acute treatment of mania; their efficacy in the treatment of depression is variable with the clearest evidence for quetiapine. Despite their widespread use, considerable uncertainty and controversy remains about the use of antidepressant drugs in t...

  12. Pacemaker potentials for the periodic burst discharge in the heart ganglion of a stomatopod, Squilla oratoria.

    Science.gov (United States)

    Watanabe, A; Obara, S; Akiyama, T

    1967-03-01

    From somata of the pacemaker neurons in the Squilla heart ganglion, pacemaker potentials for the spontaneous periodic burst discharge are recorded with intracellular electrodes. The electrical activity is composed of slow potentials and superimposed spikes, and is divided into four types, which are: (a) "mammalian heart" type, (b) "slow generator" type, (c) "slow grower" type, and (d) "slow deficient" type. Since axons which are far from the somata do not produce slow potentials, the soma and dendrites must be where the slow potentials are generated. Hyperpolarization impedes generation of the slow potential, showing that it is an electrically excitable response. Membrane impedance increases on depolarization. Brief hyperpolarizing current can abolish the plateau but brief tetanic inhibitory fiber stimulation is more effective for the abolition. A single stimulus to the axon evokes the slow potential when the stimulus is applied some time after a previous burst. Repetitive stimuli to the axon are more effective in eliciting the slow potential, but the depolarization is not maintained on continuous stimulation. Synchronization of the slow potential among neurons is achieved by: (a) the electrotonic connections, with periodic change in resistance of the soma membrane, (b) active spread of the slow potential, and (c) synchronization through spikes. PMID:6034506

  13. Prophylactic treatment in bipolar disorder

    OpenAIRE

    Eroğlu, Meliha Zengin; Özpoyraz, Nurgül; Tamam, Lut

    2014-01-01

    Objective: The aim of this study was to determine the prophylactic treatment response and its relationship between clinical variables among the bipolar disorder patient group followed up in the Bipolar Disorder Unit of Psychiatry Department of Cukurova University Faculty of Medicine. Methods: One hundred patients, in euthymic period, diagnosed as bipolar disorder, were included in this study. “Affective Disorders Patient Registry Form” developed by our unit, SCID-I, Young Mani Rating Scale...

  14. Mathematical models of bipolar disorder

    OpenAIRE

    Daugherty, D; Roque-Urrea, T; Urrea-Roque, J; DE TROYER, J; Wirkus, S; Porter, M. A.

    2009-01-01

    We use limit cycle oscillators to model bipolar II disorder, which is characterized by alternating hypomanic and depressive episodes and afflicts about 1% of the United States adult population. We consider two non-linear oscillator models of a single bipolar patient. In both frameworks, we begin with an untreated individual and examine the mathematical effects and resulting biological consequences of treatment. We also briefly consider the dynamics of interacting bipolar II individuals using ...

  15. The Genetics of Bipolar Disorder

    OpenAIRE

    Jennifer H Barnett; Smoller, Jordan W.

    2009-01-01

    Bipolar disorder is a mood disorder characterized by impairing episodes of mania and depression. Twin studies have established that bipolar disorder is among the most heritable of medical disorders and efforts to identify specific susceptibility genes have intensified over the past two decades. The search for genes influencing bipolar disorder has been complicated by a paucity of animal models, limited understanding of pathogenesis, and the genetic and phenotypic complexity of the syndrome. L...

  16. Mathematical Models of Bipolar Disorder

    OpenAIRE

    Daugherty, Darryl; Roque-Urrea, Tairi; Urrea-Roque, John; Snyder, Jessica; Wirkus, Stephen; Mason A. Porter

    2003-01-01

    We use limit cycle oscillators to model Bipolar II disorder, which is characterized by alternating hypomanic and depressive episodes and afflicts about one percent of the United States adult population. We consider two nonlinear oscillator models of a single bipolar patient. In both frameworks, we begin with an untreated individual and examine the mathematical effects and resulting biological consequences of treatment. We also briefly consider the dynamics of interacting bipolar II individual...

  17. Childhood trauma in bipolar disorder

    OpenAIRE

    Watson, S; Gallagher, P.; Dougall, D.; R Porter; Moncrieff, J.; Ferrier, I. N.; Young, A. H.

    2014-01-01

    Objective: There has been little investigation of early trauma in bipolar disorder despite evidence that stress impacts on the course of this illness. We aimed to compare the rates of childhood trauma in adults with bipolar disorder to a healthy control group, and to investigate the impact of childhood trauma on the clinical course of bipolar disorder. Methods: Retrospective assessment of childhood trauma was conducted using the Childhood Trauma Questionnaire (CTQ) in 60 outpatients with bipo...

  18. Bipolar Disorder in Children and Teens

    Science.gov (United States)

    ... is in crisis. What do I do? Share Bipolar Disorder in Children and Teens Download PDF Download ePub ... brochure will give you more information. What is bipolar disorder? Bipolar disorder is a serious brain illness. It ...

  19. Bipolar Disorder and Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Sermin Kesebir

    2010-04-01

    Full Text Available Comorbid endocrine and cardiovascular situations with bipolar disorder usually result from the bipolar disorder itself or as a consequence of its treatment. With habits and lifestyle, genetic tendency and side effects, this situation is becoming more striking. Subpopulations of bipolar disorders patients should be considered at high risk for diabetes mellitus. The prevalence of diabetes mellitus in bipolar disorder may be three times greater than in the general population. Comorbidity of diabetes causes a pathophysiological overlapping in the neurobiological webs of bipolar cases. Signal mechanisms of glycocorticoid/insulin and immunoinflammatory effector systems are junction points that point out the pathophysiology between bipolar disorder and general medical cases susceptible to stress. Glycogen synthetase kinase (GSK-3 is a serine/treonine kinase and inhibits the transport of glucose stimulated by insulin. It is affected in diabetes, cancer, inflammation, Alzheimer disease and bipolar disorder. Hypoglycemic effect of lithium occurs via inhibiting glycogen synthetase kinase. When comorbid with diabetes, the other disease -for example bipolar disorder, especially during its acute manic episodes-, causes a serious situation that presents its influences for a lifetime. Choosing pharmacological treatment and treatment adherence are another important interrelated areas. The aim of this article is to discuss and review the etiological, clinical and therapeutic properties of diabetes mellitus and bipolar disorder comorbidity.

  20. Partial Rodent Genetic Models for Bipolar Disorder

    OpenAIRE

    Chen, Guang; Henter, Ioline D.; Manji, Husseini K

    2011-01-01

    Bipolar disorder (BPD) is a complex clinical phenomenon. This episodic illness comprises at least four features/components: depression, mania, vulnerability to mood swings in euthymic BPD patients, and spontaneous cyclicity in at least some BPD patients. Currently, there is no rodent genetic model capable of encompassing the whole phenotype of BPD exists; however, recent genetic-behavioral studies have delineated partial models for some components of BPD, namely, depression, mania, and vulner...

  1. Bipolar Outflows and the Evolution of Stars

    OpenAIRE

    Frank, Adam

    1998-01-01

    Hypersonic bipolar outflows are a ubiquitous phenomena associated with both young and highly evolved stars. Observations of Planetary Nebulae, the nebulae surrounding Luminous Blue Variables such as $\\eta$ Carinae, Wolf Rayet bubbles, the circumstellar environment of SN 1987A and Young Stellar Objects all revealed high velocity outflows with a wide range of shapes. In this paper I review the current state of our theoretical understanding of these outflows. Beginning with Planetary Nebulae con...

  2. Secure pacemaker fixation critical for prevention of Twiddler's syndrome.

    Science.gov (United States)

    Zimmerman, Sarah A; Bright, Janice M

    2004-05-01

    A two year old, female spayed border collie presented three weeks after permanent pacemaker implantation for weakness, lethargy and collapse. Electrocardiogram documented complete (3(rd) degree) atrioventricular (AV) block, the absence of pacing and a ventricular escape rhythm. Thoracic radiographs revealed retraction and dislodgement of the passive fixation lead from the right ventricular apex. During a procedure to reposition the lead, it was noted that lead retraction had resulted from rotation of the generator with twisting and entanglement of the lead on itself and around the generator, a complication recognized in human patients as "Twiddlers syndrome". The pacemaker lead was removed, a new lead securely placed at the right ventricular apex, and the generator was secured into a revised subcutaneous pocket. Pacing was re-established and the Twiddler's syndrome has not reoccurred. PMID:19083303

  3. Transient apical dyskinesia with a pacemaker: Electrocardiographic features.

    Science.gov (United States)

    Núñez-Gil, Iván J; Feltes, Gisela I; Mejía-Rentería, Hernán D; Biagioni, Corina; De Agustín, J Alberto; Vivas, David; Fernández-Ortiz, Antonio

    2015-04-01

    Transient apical dyskinesia syndromes present features similar to acute coronary syndromes, but with normal coronary arteries and rapid complete resolution of wall motion alterations. We report the case of a 73-year-old woman who was admitted to hospital because of typical chest pain at rest after her brother's death. She had had a pacemaker implanted in 2001. Troponin levels were elevated and apical hypokinesia was shown by ventriculography and echocardiography, with normal coronary arteries. Evolving ECG alterations were observed in spite of the continued pacing rhythm. All these alterations were fully resolved after discharge. This case shows that, even in the presence of a pacemaker, evolving ECG alterations can be observed in Takotsubo syndrome. PMID:25840647

  4. Pregnancy in sick sinus syndrome with pacemaker - two cases.

    Science.gov (United States)

    Parveen, T; Begum, F; Akhter, N; Sharmin, F

    2013-04-01

    Sick sinus syndrome is a generalized abnormality of cardiac impulse formation that may be caused by extrinsic causes or by intrinsic disease of the sinus node making it unable to perform pace making function. It can be manifested for the first time in pregnancy. First case was diagnosed as sick sinus syndrome at 8 weeks of gestation having Mobitz type I heart block (Wenckebach block), and needed temporary pacemaker during caesarean section. Second case was diagnosed at 24 weeks of gestation having complete heart block and needed permanent pacemaker at 38 weeks of gestation due to exaggeration of the symptoms. Both the cases were dealt successfully by caesarean section under general anesthesia in close collaboration with cardiologists and anesthesiologists.

  5. Temporary transvenous pacemaker placement in the Emergency Department.

    Science.gov (United States)

    Harrigan, Richard A; Chan, Theodore C; Moonblatt, Steven; Vilke, Gary M; Ufberg, Jacob W

    2007-01-01

    Emergency Department placement of a temporary transvenous cardiac pacemaker offers potential life-saving benefits, as the device can definitively control heart rate, ensure effective myocardial contractility, and provide adequate cardiac output in select circumstances. The procedure begins with establishment of central venous access, usually by a right internal jugular or left subclavian vein approach, although the femoral vein is an acceptable alternative, especially in patients who are more likely to bleed should vascular access become complicated. The indications for the procedure, as well as the equipment needed, are reviewed. Both blind and ECG-guided techniques of insertion are described. Methods of verification of pacemaker placement and function are discussed, as are the early complications of the procedure. PMID:17239740

  6. Prevalence and correlates of eating disorder co-morbidity in patients with bipolar disorder1

    OpenAIRE

    Wildes, Jennifer E.; Marcus, Marsha D.; Fagiolini, Andrea

    2008-01-01

    This study was designed to document eating disorder symptoms in a well-defined sample of patients with bipolar disorder and to evaluate the relationship of current loss of control over eating (LOC) to demographic and clinical features hypothesized to characterize bipolar patients at risk for disordered eating. Eighty-one patients enrolled in the Bipolar Disorder Center for Pennsylvanians provided demographic information and completed the Structured Clinical Interview for DSM-IV Axis I Disorde...

  7. Clinicohemodynamic and roentgenologic correlations in patients with artificial pacemakers

    International Nuclear Information System (INIS)

    The clinical pattern, central hemodynamics and roentgenologic data are studied in 34 patients with artificial cardiac pacemaker (ACP) to solve the problem on adequate medicamental therapy of heart failure (HF). Heart sizes and the state of a pulmonary image are estimated roentgenologically. Two types of cardiac-vessel system reactions on physical load: adequate and nonadequate - are detected. Implantation of ACP in patients with the nonadequate reaction does not lead to total liquidation of HF

  8. Plethyzmography in assessment of hemodynamic results of pacemaker functions programming

    Science.gov (United States)

    Wojciechowski, Dariusz; Sionek, Piotr; Peczalski, Kazimierz; Janusek, Dariusz

    2011-01-01

    The paper presents potential role of plethyzmography in optimization of heart hemodynamic function during pacemaker programming. The assessment of optimal stroke volume in patients, with implanted dual chamber pacemaker (DDD), by plethyzmography was a goal of the study. The data were collected during pacing rhythm. 20 patients (8 female and 12 male, average 77.4+/-4.6 years) with dual chamber pacemaker (DDD) and with pacing rhythm during routine pacemaker control and study tests were incorporated in the study group. Hemodynamic parameters were assessed during modification of atrio-ventricular delay (AVD) for pacing rhythm of 70 bpm and 90 bpm. The time of atrioventricular was programmed with 20 ms steps within range 100-200 ms and data were recorded with two minutes delay between two consecutive measurements. Stroke volume (SV) and cardiac output (CO) were calculated from plethyzmographic signal by using Beatscope software (TNO Holand). Highest SV calculated for given pacing rhythm was named optimal stroke volume (OSV) and consequently highest cardiac output was named maximal cardiac output (MCO). The time of atrio-ventricular delay for OSV was named optimal atrioventricular delay (OAVD). The results have showed: mean values of OAVD for 70 bpm - 152+/-33 ms and for 90 bpm -149+/-35 ms, shortening of the mean OAVD time caused by increase of pacing rate from 70 bpm to 90 bpm what resulted in statistically significant decrease of OSV with not statistically significant increase of MCO. The analysis of consecutive patients revealed three types of response to increase of pacing rhythm: 1. typical-shortening of OAVD, 2. neutral-no change of OAVD and 3.atypical-lengthening of OAVD.

  9. Persistently Active, Pacemaker-Like Neurons in Neocortex

    OpenAIRE

    Le Bon-Jego, Morgane; Yuste, Rafael

    2007-01-01

    The neocortex is spontaneously active, however, the origin of this self-generated, patterned activity remains unknown. To detect potential “pacemaker cells,” we use calcium imaging to directly identify neurons that discharge action potentials in the absence of synaptic transmissionin slices from juvenile mouse visual cortex. We characterize 60 of these neurons electrophysiologically and morphologically, finding that they belong to two classes of cells: one class composed of pyramidal neurons ...

  10. Persistently active, pacemaker-like neurons in neocortex

    OpenAIRE

    Morgane Le Bon-Jego; Rafael Yuste

    2007-01-01

    The neocortex is spontaneously active, however, the origin of this self-generated, patterned activity remains unknown. To detect potential pacemaker cells, we use calcium imaging to directly identify neurons that discharge action potentials in the absence of synaptic transmissionin slices from juvenile mouse visual cortex. We characterize 60 of these neurons electrophysiologically and morphologically, finding that they belong to two classes of cells: one class composed of pyramidal neurons...

  11. Percutaneously Inject able Fetal Pacemaker: Electrodes, Mechanical Design and Implantation*

    OpenAIRE

    Zhou, Li; Chmait, Ramen; Bar-Cohen, Yaniv; Peck, Raymond A.; Gerald E. Loeb

    2012-01-01

    We are developing a self-contained cardiac pacemaker with a small, cylindrical shape (~3×20mm) that permits it to be implanted percutaneously into a fetus to treat complete heart block and consequent hydrops fetalis, which is otherwise fatal. The device uses off-the-shelf components including a rechargeable lithium cell and a highly efficient relaxation oscillator encapsulated in epoxy and glass. A corkscrew electrode made from activated iridium can be screwed into the myocardium, followed by...

  12. Neuronal Coding of pacemaker neurons - A random dynamical systems approach

    OpenAIRE

    de Jaeger, T

    2009-01-01

    The behaviour of neurons under the influence of periodic external input has been modelled very successfully by circle maps. The aim of this note is to extend certain aspects of this analysis to a much more general class of forcing processes. We apply results on the fibred rotation number of randomly forced circle maps to show the uniqueness of the asymptotic firing frequency of ergodically forced pacemaker neurons. The details of the analysis are carried out for the forced leaky integrate-and...

  13. Physiological effects of light on the human circadian pacemaker

    Science.gov (United States)

    Shanahan, T. L.; Czeisler, C. A.

    2000-01-01

    The physiology of the human circadian pacemaker and its influence and on the daily organization of sleep, endocrine and behavioral processes is an emerging interest in science and medicine. Understanding the development, organization and fundamental properties underlying the circadian timing system may provide insight for the application of circadian principles to the practice of clinical medicine, both diagnostically (interpretation of certain clinical tests are dependent on time of day) and therapeutically (certain pharmacological responses vary with the time of day). The light-dark cycle is the most powerful external influence acting upon the human circadian pacemaker. It has been shown that timed exposure to light can both synchronize and reset the phase of the circadian pacemaker in a predictable manner. The emergence of detectable circadian rhythmicity in the neonatal period is under investigation (as described elsewhere in this issue). Therefore, the pattern of light exposure provided in the neonatal intensive care setting has implications. One recent study identified differences in both amount of sleep time and weight gain in infants maintained in a neonatal intensive care environment that controlled the light-dark cycle. Unfortunately, neither circadian phase nor the time of day has been considered in most clinical investigations. Further studies with knowledge of principles characterizing the human circadian timing system, which governs a wide array of physiological processes, are required to integrate these findings with the practice of clinical medicine.

  14. Permanent and temporary pacemaker implantation after orthotopic heart transplantation

    Directory of Open Access Journals (Sweden)

    Bacal Fernando

    2000-01-01

    Full Text Available PURPOSE:To determine the indication for and incidence and evolution of temporary and permanent pacemaker implantation in cardiac transplant recipients. METHODS: A retrospective review of 114 patients who underwent orthotopic heart transplantation InCor (Heart Institute USP BR between March 1985 and May 1993. We studied the incidence of and indication for temporary pacing, the relationship between pacing and rejection, the need for pemanent pacing and the clinical follow-up. RESULTS: Fourteen of 114 (12%heart transplant recipients required temporary pacing and 4 of 114 (3.5% patients required permanent pacing. The indication for temporary pacing was sinus node dysfunction in 11 patients (78.5% and atrioventricular (AV block in 3 patients (21.4%. The indication for permanent pacemaker implantation was sinus node dysfunction in 3 patients (75% and atrioventricular (AV block in 1 patient (25%. We observed rejection in 3 patients (21.4% who required temporary pacing and in 2 patients (50% who required permanent pacing. The previous use of amiodarone was observed in 10 patients (71.4% with temporary pacing. Seven of the 14 patients (50% died during follow-up. CONCLUSION: Sinus node dysfunction was the principal indication for temporary and permanent pacemaker implantation in cardiac transplant recipients. The need for pacing was related to worse prognosis after cardiac transplantation.

  15. Isolating neural correlates of the pacemaker for food anticipation.

    Directory of Open Access Journals (Sweden)

    Ian David Blum

    Full Text Available Mice fed a single daily meal at intervals within the circadian range exhibit food anticipatory activity. Previous investigations strongly suggest that this behaviour is regulated by a circadian pacemaker entrained to the timing of fasting/refeeding. The neural correlate(s of this pacemaker, the food entrainable oscillator (FEO, whether found in a neural network or a single locus, remain unknown. This study used a canonical property of circadian pacemakers, the ability to continue oscillating after removal of the entraining stimulus, to isolate activation within the neural correlates of food entrainable oscillator from all other mechanisms driving food anticipatory activity. It was hypothesized that continued anticipatory activation of central nuclei, after restricted feeding and a return to ad libitum feeding, would elucidate a neural representation of the signaling circuits responsible for the timekeeping component of the food entrainable oscillator. Animals were entrained to a temporally constrained meal then placed back on ad libitum feeding for several days until food anticipatory activity was abolished. Activation of nuclei throughout the brain was quantified using stereological analysis of c-FOS expressing cells and compared against both ad libitum fed and food entrained controls. Several hypothalamic and brainstem nuclei remained activated at the previous time of food anticipation, implicating them in the timekeeping mechanism necessary to track previous meal presentation. This study also provides a proof of concept for an experimental paradigm useful to further investigate the anatomical and molecular substrates of the FEO.

  16. Percutaneous Extraction of Transvenous Permanent Pacemaker/Defibrillator Leads

    Directory of Open Access Journals (Sweden)

    Stylianos Paraskevaidis

    2014-01-01

    Full Text Available Background. Widespread use of cardiovascular implantable electronic devices has inevitably increased the need for lead revision/replacement. We report our experience in percutaneous extraction of transvenous permanent pacemaker/defibrillator leads. Methods. Thirty-six patients admitted to our centre from September 2005 through October 2012 for percutaneous lead extraction were included. Lead removal was attempted using Spectranetics traction-type system (Spectranetics Corp., Colorado, CO, USA and VascoExtor countertraction-type system (Vascomed GmbH, Weil am Rhein, Germany. Results. Lead extraction was attempted in 59 leads from 36 patients (27 men, mean ± SD age 61±5 years, with permanent pacemaker (n=25, defibrillator (n=8, or cardiac resynchronisation therapy (n=3 with a mean ± SD implant duration of 50±23 months. The indications for lead removal included pocket infection (n=23, endocarditis (n=2, and ventricular (n=10 and atrial lead dysfunction (n=1. Traction device was used for 33 leads and countertraction device for 26 leads. Mean ± SD fluoroscopy time was 4±2 minutes/lead for leads implanted 48 months (n=21, P=0.03. Complete procedural success rate was 91.7% and clinical procedural success rate was 100%, while lead procedural success rate was 95%. Conclusions. In conclusion, percutaneous extraction of transvenous permanent pacemaker/defibrillator leads using dedicated removal tools is both feasible and safe.

  17. Psychosocial aspects and mental health in children after permanent pacemaker implantation

    DEFF Research Database (Denmark)

    Andersen, C; Hørder, K; Kristensen, L;

    1994-01-01

    -14). Generally the psychological condition was strained in 7 families, in which psychiatric and social therapy had been necessary. The children's intelligence was within normal ranges, average IQ being 110 (range 80-135). The children had abnormal body image related to the pacemaker. Adults virtually incorporate...... the pacemaker in their body image without disturbance, but children who are forming their body image and identity, are influenced by having a pacemaker. This may give psychosocial implication....

  18. The psychosocial context of bipolar disorder: environmental, cognitive, and developmental risk factors.

    Science.gov (United States)

    Alloy, Lauren B; Abramson, Lyn Y; Urosevic, Snezana; Walshaw, Patricia D; Nusslock, Robin; Neeren, Amy M

    2005-12-01

    In this article, we review empirical research on the role of individuals' current environmental contexts, cognitive styles, and developmental histories as risk factors for the onset, course, and expression of bipolar spectrum disorders. Our review is focused on the following over arching question: Do psychosocial factors truly contribute risk to the onset, course, or expression of bipolar disorders? As a secondary issue, we also address whether the psychosocial risks for bipolar disorders are similar to those for unipolar depression. We begin by discussing the methodological requirements for demonstrating a psychosocial risk factor and the challenges posed by bipolar spectrum disorders for psychosocial risk research. Next, we review the extant studies on the role of recent life events and supportive and non-supportive social interactions (current environment) in bipolar disorders, as well as psychosocial treatments designed to remediate these current environmental factors. We then review the role of cognitive styles featured as vulnerabilities in theories of unipolar depression as risk factors for bipolar disorder alone and in combination with life events, including studies of cognitive-behavioral therapies for bipolar disorder. Finally, we review studies of parenting and maltreatment histories in bipolar disorders. We conclude with an assessment of the state of the psychosocial risk factors literature in bipolar disorder with regard to our guiding questions.

  19. Involvement of MAPKs and PLC Pathways in Modulation of Pacemaking Activity by So-Cheong-Ryong-Tang in Interstitial Cells of Cajal from Murine Small Intestine

    Directory of Open Access Journals (Sweden)

    Min Woo Hwang

    2013-01-01

    Full Text Available Purpose. Interstitial cells of Cajal (ICCs are the pacemaker cells that generate slow waves in the gastrointestinal (GI tract. We have aimed to investigate the effects of Socheongryong-Tang (SCRT in ICCs from mouse’s small intestine. Methods. The whole-cell patch-clamp configuration was used to record membrane potentials from cultured ICCs. Intracellular Ca2+ ([Ca2+]i increase was studied in cultured ICCs using fura-2 AM. Results. ICCs generated pacemaker potentials in mouse’s small intestine. SCRT produced membrane depolarization in current clamp mode. Y25130 (5-HT3 receptor antagonist and RS39604 (5-HT4 receptor antagonist blocked SCRT-induced membrane depolarizations, whereas SB269970 (5-HT7 receptor antagonist did not. When GDP-β-S (1 mM was in the pipette solution, SCRT did not induce the membrane depolarizations. [Ca2+]i analysis showed that SCRT increased [Ca2+]i. In the presence of PD98059 (p42/44 MAPK inhibitor, SCRT did not produce membrane depolarizations. In addition, SB203580 (p38 MAPK inhibitor and JNK inhibitors blocked the depolarizations by SCRT in pacemaker potentials. Furthermore, the membrane depolarizations by SCRT were not inhibited by U-73122, an active phospholipase C (PLC inhibitor, but by U-73343, an inactive PLC inhibitor. Conclusion. These results suggest that SCRT might affect GI motility by the modulation of pacemaker activity through MAPKs and PLC pathways in the ICCs.

  20. Modulation of Pacemaker Potentials by Pyungwi-San in Interstitial Cells of Cajal from Murine Small Intestine - Pyungwi-San and Interstitial Cells of Cajal -

    Directory of Open Access Journals (Sweden)

    Kim Jung Nam

    2013-03-01

    Full Text Available Objective: Pyungwi-san (PWS plays a role in a number of physiologic and pharmacologic functions in many organs. Interstitial cells of Cajal (ICCs are pacemaker cells that generate slow waves in the gastrointestinal (GI tract. We aimed to investigate the beneficial effects of PWS in mouse small-intestinal ICCs. Methods: Enzymatic digestion was used to dissociate ICCs from the small intestine of a mouse. The wholecell patch-clamp configuration was used to record membrane potentials from the cultured ICCs. Results: ICCs generated pacemaker potentials in the GI tract. PWS produced membrane depolarization in the current clamp mode. Pretreatment with a Ca2+-free solution and a thapsigargin, a Ca2+-ATPase, inhibitor in the endoplasmic reticulum, eliminated the generation of pacemaker potentials. However, only when the thapsigargin was applied in a bath solution, the membrane depolarization was not produced by PWS. Furthermore, the membrane depolarizations due to PWS were inhibited not by U-73122, an active phospholipase C inhibitor, but by chelerythrine and calphostin C, protein kinase C inhibitors. Conclusions: These results suggest that PWS might affect GI motility by modulating the pacemaker activity in the ICCs.

  1. Subjective consequences of permanent pacemaker therapy in patients under the age of retirement

    DEFF Research Database (Denmark)

    Mickley, H; Petersen, J; Nielsen, B L

    1989-01-01

    people (98.6%) agreed to participate. The mean pacing period (range) was 33.8 (11-72) months. Surgical intervention was required in 14 patients (19.4%) during follow-up. Regarding all symptoms 67 patients (93.1%) perceived benefit from the pacemaker. The effectiveness of cardiac pacing was most...... or a sensation of "impulses"/palpitations. To the majority (49 patients or 68.1%) pacemaker treatment did not influence quality of sexual activity. Six patients (8.3%) perceived an improvement, whereas a corresponding number felt deterioration in sexual activity following pacemaker implantation. Pacemaker...

  2. Interference of implanted cardiac pacemakers with TASER X26 dart mode application.

    Science.gov (United States)

    Leitgeb, Norbert; Niedermayr, Florian; Neubauer, Robert

    2012-06-01

    The prevalence of pacemaker patients among the general population and of conducted energy devices for law enforcement and self-defence is increasing. Consequently, the question on whether cardiac pacemaker patients are at particular risk becomes increasingly important, in particular, as the widespread use of such devices is planned in Europe. The risk of pacemaker patients has been investigated by numerical simulation at detailed anatomical models of patients with cardiac pacemakers implanted in left pectoral, right pectoral, and abdominal positions, with the monopolar electrode placed at the ventricular apex. The induced cardiac pacemaker interference voltages have been assessed for distant application of TASER X26 devices with dart electrodes propelled towards a subject. It could be shown that interference voltages are highest in abdominal pacemaker implantation, while they are about 20% lower in left or right pectoral sites. They remain below the immunity threshold level as defined by safety standards of implanted cardiac pacemakers and of implanted cardioverter defibrillators to prevent persisting malfunction or damage. However, induced voltages are high enough to be sensed by the pacemaker and to capture pacemaker function in case of hits at thorax and abdomen, frontal as well as dorsal. PMID:22691428

  3. Multiple photoreceptor systems control the swim pacemaker activity in box jellyfish

    DEFF Research Database (Denmark)

    Garm, Anders Lydik; Mori, S.

    2009-01-01

    Like all other cnidarian medusae, box jellyfish propel themselves through the water by contracting their bell-shaped body in discrete swim pulses. These pulses are controlled by a swim pacemaker system situated in their sensory structures, the rhopalia. Each medusa has four rhopalia each...... with a similar set of six eyes of four morphologically different types. We have examined how each of the four eye types influences the swim pacemaker. Multiple photoreceptor systems, three of the four eye types, plus the rhopalial neuropil, affect the swim pacemaker. The lower lens eye inhibits the pacemaker...

  4. Scientific attitudes towards bipolar disorders

    Directory of Open Access Journals (Sweden)

    Mohammad-Hossein Biglu

    2014-02-01

    Full Text Available Introduction: Bipolar disorder is a psychiatric condition that is also called manic-depressive disease. It causes unusual changes in mood, energy, activity levels, and the ability to carry out day-to-day tasks. In the present study, 3 sets of data were considered and analyzed: first, all papers categorized under Bipolar Disorders in Science Citation Index Expanded (SCI-E database through 2001-2011; second, papers published by the international journal of Bipolar Disorders indexed in SCI-E during a period of 11 years; and third, all papers distributed by the international journal of Bipolar Disorders indexed in MEDLINE during the period of study. Methods: The SCI-E database was used to extract all papers indexed with the topic of Bipolar Disorders as well as all papers published by The International Journal of Bipolar Disorders. Extraction of data from MEDLINE was restricted to the journals name from setting menu. The Science of Science Tool was used to map the co-authorship network of papers published by The International Journal of Bipolar Disorders through 2009-2011. Results: Analysis of data showed that the majority of publications in the subject area of bipolar disorders indexed in SCI-E were published by The International Journal of Bipolar Disorders. Although journal articles consisted of 59% of the total publication type in SCI-E, 65% of publications distributed by The Journal of Bipolar Disorders were in the form of meetingabstracts. Journal articles consisted of only 23% of the total publications. USA was the leading country regarding sharing data in the field of bipolar disorders followed by England, Canada, and Germany. Conclusion: The editorial policy of The International Journal of Bipolar Disorders has been focused on new themes and new ways of researching in the subject area of bipolar disorder. Regarding the selection of papers for indexing, the SCI-E database selects data more comprehensively than MEDLINE. The number of papers

  5. Long-term Treatment in Bipolar Disorder

    Directory of Open Access Journals (Sweden)

    Meliha Zengin Eroglu

    2010-08-01

    Full Text Available Although the importance of long-term prophylactic treatment is certain in bipolar disorder, there is stil debate on how to which patients and evaluate the treatment response. Efficacious long-term treatment can reduce morbidity and mortality significantly and improve quality of life of bipolar patients. The concept of ideal response should also be defined very clearly in order to discuss the difficulties of measuring the effectiveness of the prophylactic treatment. The aims of this paper are to determine whether our currently methods and criteria are valid, reliable and sensitive evaluating the efficacy of the treatment response and to briefly inform the clinicians about the drugs used in pharmacologic prophylaxis in accordance with relevant data.

  6. Bipolar zinc/oxygen battery development

    Energy Technology Data Exchange (ETDEWEB)

    Mueller, S. [Paul Scherrer Inst. (PSI), Villigen (Switzerland); Schlatter, C. [Swiss Federal Inst. of Technology, Lausanne (Switzerland)

    1997-06-01

    A bipolar electrically rechargeable Zn/O{sub 2} battery has been developed. Reticulated copper foam served as substrate for the zinc deposit on the anodic side, and La{sub 0.6}Ca{sub 0.4}CoO{sub 3}-catalyzed bifunctional oxygen electrodes were used on the cathodic side of the cells. The 100 cm{sup 2} unit cell had an open circuit voltage of 1,4 V(O{sub 2}) in moderately alkaline electrolyte. The open circuit voltage and the peak power measured for a stack containing seven cells were ca. 10V and 90W, respectively. The current-potential behaviour was determined as a function of the number of bipolar cells, and the maximum discharge capacity was determined at different discharge rates. (author) 4 figs., 1 ref.

  7. Structure improvement and electrochemical studies of bipolar nickel metal hydride batteries for hybrid electric vehicles

    Institute of Scientific and Technical Information of China (English)

    DENG Chao; SHI Peng-fei

    2006-01-01

    Nickel metal hydride battery in bipolar design offers some advantages for its application as a power storage system for electric and hybrid vehicles. This paper deals with the structure design and electrochemical studies of bipolar Ni/MH batteries for hybrid vehicles. An improvement is applied in bipolar battery design,and such bipolar Ni/MH batteries with 5 sub-cells have been assembled and investigated. Testing results show that bipolar batteries with improved structure have better compression tolerance and cycle performance than conventional ones. In addition, the improved bipolar batteries display excellent large current discharge ability and high power density. As simulating working conditions for hybrid vehicles, the batteries show good stability during pulse cycles, which verifies the possibility of being used as a power storage device on hybrid vehicles.

  8. The Treatment of Adult Bipolar Disorder with Aripiprazole: A Systematic Review.

    Science.gov (United States)

    Muneer, Ather

    2016-01-01

    Bipolar disorder is characterized by exacerbations of opposite mood polarity, ranging from manic to major depressive episodes. In the current nosological system of the Diagnostic and Statistical Manual - 5(th) edition (DSM-5), it is conceptualized as a spectrum disorder consisting of bipolar disorder type I, bipolar disorder type II, cyclothymic disorder, and bipolar disorder not otherwise specified. Treatment of all phases of this disorder is primarily with mood stabilizers, but many patients either show resistance to the conventional mood stabilizing medications or are intolerant to their side-effects. In this setting, second-generation antipsychotics have gained prominence as many bipolar subjects who are otherwise treatment refractory show response to these agents. Aripiprazole is a novel antipsychotic initially approved for the treatment of schizophrenia but soon found to be effective in bipolar disorder. This drug is well studied, as randomized controlled trials have been conducted in various phases of bipolar disorders. Aripiprazole exhibits the pharmacodynamic properties of partial agonism, functional selectivity, and serotonin-dopamine activity modulation - the new exemplars in the treatment of major psychiatric disorders. It is the first among a new series of psychotropic medications, which now also include brexpiprazole and cariprazine. The current review summarizes the data from controlled trials regarding the efficacy and safety of aripiprazole in adult bipolar patients. On the basis of this evidence, aripiprazole is found to be efficacious in the treatment and prophylaxis of manic and mixed episodes but has no effectiveness in acute and recurrent bipolar depression. PMID:27190727

  9. Computer modeling of electrical and thermal performance during bipolar pulsed radiofrequency for pain relief

    Energy Technology Data Exchange (ETDEWEB)

    Pérez, Juan J. [Instituto de Investigación Interuniversitario en Bioingeniería y Tecnología Orientada al Ser Humano, Universitat Politècnica de València, Valencia 46022 (Spain); Pérez-Cajaraville, Juan J. [Pain Unit and Department of Anesthesia and Critical Care, Clínica Universidad de Navarra, University of Navarra, Pamplona 31008 (Spain); Muñoz, Víctor [Neurotherm Spain, Barcelona 08303 (Spain); Berjano, Enrique, E-mail: eberjano@eln.upv.es [Biomedical Synergy, Electronic Engineering Department, Universitat Politècnica de València 46022 (Spain)

    2014-07-15

    Purpose: Pulsed RF (PRF) is a nonablative technique for treating neuropathic pain. Bipolar PRF application is currently aimed at creating a “strip lesion” to connect the electrode tips; however, the electrical and thermal performance during bipolar PRF is currently unknown. The objective of this paper was to study the temperature and electric field distributions during bipolar PRF. Methods: The authors developed computer models to study temperature and electric field distributions during bipolar PRF and to assess the possible ablative thermal effect caused by the accumulated temperature spikes, along with any possible electroporation effects caused by the electrical field. The authors also modeled the bipolar ablative mode, known as bipolar Continuous Radiofrequency (CRF), in order to compare both techniques. Results: There were important differences between CRF and PRF in terms of electrical and thermal performance. In bipolar CRF: (1) the initial temperature of the tissue impacts on temperature progress and hence on the thermal lesion dimension; and (2) at 37 °C, 6-min of bipolar CRF creates a strip thermal lesion between the electrodes when these are separated by a distance of up to 20 mm. In bipolar PRF: (1) an interelectrode distance shorter than 5 mm produces thermal damage (i.e., ablative effect) in the intervening tissue after 6 min of bipolar RF; and (2) the possible electroporation effect (electric fields higher than 150 kV m{sup −1}) would be exclusively circumscribed to a very small zone of tissue around the electrode tip. Conclusions: The results suggest that (1) the clinical parameters considered to be suitable for bipolar CRF should not necessarily be considered valid for bipolar PRF, and vice versa; and (2) the ablative effect of the CRF mode is mainly due to its much greater level of delivered energy than is the case in PRF, and therefore at same applied energy levels, CRF, and PRF are expected to result in same outcomes in terms of

  10. Design of an exterior-chargeable implanted artificial cardiac pacemaker%体外充电植入式人工心脏起搏器的设计

    Institute of Scientific and Technical Information of China (English)

    温志浩; 陈海军

    2011-01-01

    背景:人工心脏起搏器长期植入人体,使用寿命至关重要,目前尚没有可充电的植入式人工心脏起搏器问世.目的:探讨植入式人工心脏起搏器体外充电技术,以期降低人工心脏起搏器寿命对电池能量的依赖.方法:利用某种对人体无创、无害的介质,把体外能量隔离传输给植入体内的接收转换装置,进而对人工心脏起搏器可充电电池的能量给予补充,以延长使用寿命.结果与结论:试制了可充电人工心脏起搏器实验样机,完成了一期动物实验,同时以超声波为能量传输载体进行了隔离无创充电试验,对相关技术做了探讨.%BACKGROUND: An artificial cardiac pacemaker has to be implanted into human body for a long time, so its life-span is very important. The cell energy is an important factor, especially in energy-consuming implanted artificial cardiac pacemaker.Currently, an exterior-chargeable implanted artificial cardiac pacemaker has not been invented.OBJECTIVE: To study on the exterior-chargeable technology, reduce artificial cardiac pacemaker's dependence on the cell energy, hoping to solve the technology problem of tremble-removing implanted artificial cardiac pacemaker.METHODS: The author proposed to use a certain medium, which is woundless and harmless to human body, transfers exterior energy to the receiver implanted into human body, providing the chargeable cell with energy, thus prolong pacemaker's life-span.RESU LTS AND CONCLUSION: The author trial-manufactured a chargeable artificial cardiac pacemaker, carried experiments on animals, using ultrasonic transferring energy. Thus, the author made further study on concerned technology.

  11. Options for pharmacological treatment of refractory bipolar depression.

    Science.gov (United States)

    Tondo, Leonardo; Vázquez, Gustavo H; Baldessarini, Ross J

    2014-02-01

    Bipolar disorders of types I and II, even when treated by currently standard options, show a marked excess of depressive morbidity. Treated, type I patients in mid-course or from the onset of illness are ill, overall, 50 % of weeks of follow-up, and 75 % of that unresolved morbidity is depressive. Currently widely held impressions are that bipolar depression typically is poorly responsive to antidepressants, that treatment-resistant depression (TRD) is characteristic of the disorder, and that risk of mania with antidepressant treatment is very high. However, none of these views is supported consistently by available research. TRD may be more prevalent in bipolar than unipolar mood disorders. Relatively intense research attention is directed toward characteristics and treatments of TRD in unipolar depression, but studies of bipolar TRD are uncommon. We found only five controlled trials, plus 10 uncontrolled trials, providing data on a total of 13 drug treatments, all of which involved one or two trials, in 87 % as add-ons to complex, uncontrolled regimens. In two controlled trials, ketamine was superior to placebo but it is short-acting and not orally active; pramipexole was weakly superior to placebo in one controlled trial; three other drugs failed to outperform controls. Other pharmacotherapies are inadequately evaluated and nonpharmacological options are virtually untested in bipolar TRD. The available research supports the view that antidepressants may be effective in bipolar depression provided that currently agitated patients are excluded, that risk of mania with antidepressants is only moderately greater than risk of spontaneous mania, and that bipolar TRD is not necessarily resistant to all treatments. PMID:24425269

  12. The Bipolar Interactive Psychoeducation (BIPED study: trial design and protocol

    Directory of Open Access Journals (Sweden)

    Jones Ian

    2009-08-01

    Full Text Available Abstract Background Bipolar disorders affect between 3–5% of the population and are associated with considerable lifelong impairment. Since much of the morbidity associated with bipolar disorder is caused by recurrent depressive symptoms, which are often only poorly responsive to antidepressants, there is a need to develop alternative, non-pharmacological interventions. Psychoeducational interventions have emerged as promising long-term therapeutic options for bipolar disorder. Methods/design The study is an exploratory, individually randomised controlled trial. The intervention known as 'Beating Bipolar' is a psychoeducational programme which is delivered via a novel web-based system. We will recruit 100 patients with a diagnosis of DSM-IV bipolar disorder (including type I and type II currently in clinical remission. The primary outcome is quality of life. This will be compared for those patients who have participated in the psychoeducational programme with those who received treatment as usual. Quality of life will be assessed immediately following the intervention as well as 10 months after randomisation. Secondary outcomes include current depressive and manic symptoms, number of episodes of depression and mania/hypomania experienced during the follow-up period, global functioning, functional impairment and insight. An assessment of costs and a process evaluation will also be conducted which will explore the feasibility and acceptability of the intervention as well as potential barriers to effectiveness. Discussion Bipolar disorder is common, under-recognised and often poorly managed. It is a chronic, life-long, relapsing condition which has an enormous impact on the individual and the economy. This trial will be the first to explore the effectiveness of a novel web-based psychoeducational intervention for patients with bipolar disorder which has potential to be easily rolled out to patients. Trial registration Current Controlled Trials

  13. Electrical Injury-Induced Complete Atrioventricular Block: Is Permanent Pacemaker Required?

    Directory of Open Access Journals (Sweden)

    Osman Beton

    2015-01-01

    Full Text Available A considerable percentage of electrical injuries occur as a result of work activities. Electrical injury can lead to various cardiovascular disorders: acute myocardial necrosis, myocardial ischemia, heart failure, arrhythmias, hemorrhagic pericarditis, acute hypertension with peripheral vasospasm, and anomalous, nonspecific ECG alterations. Ventricular fibrillation is the most common arrhythmia resulting from electrical injury and is the leading cause of death in electrical (especially low voltage alternating current injury cases. Asystole, premature ventricular contractions, ventricular tachycardia, conduction disorders (various degrees of heart blocks, bundle-brunch blocks, supraventricular tachycardia, and atrial fibrillation are the other arrhythmic complications of electrical injury. Complete atrioventricular block has rarely been reported and permanent pacemaker was required for the treatment in some of these cases. Herein, we present a case of reversible complete atrioventricular block due to low voltage electrical injury in a young electrical technician.

  14. Electrical Injury-Induced Complete Atrioventricular Block: Is Permanent Pacemaker Required?

    Science.gov (United States)

    Beton, Osman; Efe, Tolga Han; Kaya, Hakki; Bilgin, Murat; Dinc Asarcikli, Lale; Yilmaz, Mehmet Birhan

    2015-01-01

    A considerable percentage of electrical injuries occur as a result of work activities. Electrical injury can lead to various cardiovascular disorders: acute myocardial necrosis, myocardial ischemia, heart failure, arrhythmias, hemorrhagic pericarditis, acute hypertension with peripheral vasospasm, and anomalous, nonspecific ECG alterations. Ventricular fibrillation is the most common arrhythmia resulting from electrical injury and is the leading cause of death in electrical (especially low voltage alternating current) injury cases. Asystole, premature ventricular contractions, ventricular tachycardia, conduction disorders (various degrees of heart blocks, bundle-brunch blocks), supraventricular tachycardia, and atrial fibrillation are the other arrhythmic complications of electrical injury. Complete atrioventricular block has rarely been reported and permanent pacemaker was required for the treatment in some of these cases. Herein, we present a case of reversible complete atrioventricular block due to low voltage electrical injury in a young electrical technician. PMID:26839721

  15. Parasitic bipolar amplification in a single event transient and its temperature dependence

    Institute of Scientific and Technical Information of China (English)

    Liu Zheng; Chen Shu-Ming; Chen Jian-Jun; Qin Jun-Rui; Liu Rong-Rong

    2012-01-01

    Using three-dimensional technology computer-aided design (TCAD) simulation,parasitic bipolar amplification in a single event transient (SET) current of a single transistor and its temperature dependence are studied.We quantify the contributions of different current components in a SET current pulse,and it is found that the proportion of parasitic bipolar amplification in total collected charge is about 30% in both 130-nm and 90-nm technologies.The temperature dependence of parasitic bipolar amplification and the mechanism of the SET pulse are also investigated and quantified.The results show that the proportion of charge induced by parasitic bipolar increases with rising temperature,which illustrates that the parasitic bipolar amplification plays an important role in the charge collection of a single transistor.

  16. Tritium separation from light and heavy water by bipolar electrolysis

    International Nuclear Information System (INIS)

    Use of bipolar electrolysis with countercurrent electrolyte flow to separate hydrogen isotopes was investigated for the removal of tritium from light water effluents or from heavy water moderator. Deuterium-tritium and protium-tritium separation factors occurring on a Pd-25% Ag bipolar electrode were measured to be 2.05 to 2.16 and 11.6 to 12.4 respectively, at current densities between 0.21 and 0.50 A cm-2, and at 35 to 900C. Current densities up to 0.3 A cm-2 have been achieved in continuous operation, at 80 to 900C, without significant gas formation on the bipolar electrodes. From the measured overvoltage at the bipolar electrodes and the electrolyte conductivity the power consumption per stage was calculated to be 3.0 kwh/kg H2O at 0.2 A cm-2 and 5.0 kwh/kg H2O at 0.5 A cm-2 current density, compared to 6.4 and 8.0 kwh/kg H2O for normal electrolysis. A mathematical model derived for hydrogen isotope separation by bipolar electrolysis, i.e., for a square cascade, accurately describes the results for protium-tritium separation in two laboratory scale, multistage experiments with countercurrent electrolyte flow; the measured tiritum concentration gradient through the cascade agreed with the calculated values

  17. Potentiating action of propofol at GABAA receptors of retinal bipolar cells

    DEFF Research Database (Denmark)

    Yue, Lan; Xie, An; Bruzik, Karol S;

    2011-01-01

    specific retinal neurons. The authors investigated the action of propofol on GABA-elicited membrane current responses of retinal bipolar cells, which have both GABA(A) and GABA(C) receptors. Methods. Single, enzymatically dissociated bipolar cells obtained from rat retina were treated with propofol...

  18. Transdiagnostic Treatment of Bipolar Disorder and Comorbid Anxiety with the Unified Protocol: A Clinical Replication Series

    Science.gov (United States)

    Ellard, Kristen K.; Deckersbach, Thilo; Sylvia, Louisa G.; Nierenberg, Andrew A.; Barlow, David H.

    2012-01-01

    Bipolar disorder (BD) is a chronic, debilitating disorder with recurrent manic and depressive episodes. More than 75% of bipolar patients have a current or lifetime diagnosis of a comorbid anxiety disorder. Comorbid anxiety in BD is associated with greater illness severity, greater functional impairment, and poorer illness-related outcomes.…

  19. Asenapine for bipolar disorder

    Directory of Open Access Journals (Sweden)

    Scheidemantel T

    2015-12-01

    Full Text Available Thomas Scheidemantel,1 Irina Korobkova,2 Soham Rej,3,4 Martha Sajatovic1,2 1University Hospitals Case Medical Center, 2Case Western Reserve University School of Medicine, Cleveland, OH, USA; 3Department of Psychiatry, University of Toronto, Toronto, ON, 4Geri PARTy Research Group, Jewish General Hospital, Montreal, QC, Canada Abstract: Asenapine (Saphris® is an atypical antipsychotic drug which has been approved by the US Food and Drug Administration for the treatment of schizophrenia in adults, as well as the treatment of acute manic or mixed episodes of bipolar I in both adult and pediatric populations. Asenapine is a tetracyclic drug with antidopaminergic and antiserotonergic activity with a unique sublingual route of administration. In this review, we examine and summarize the available literature on the safety, efficacy, and tolerability of asenapine in the treatment of bipolar disorder (BD. Data from randomized, double-blind trials comparing asenapine to placebo or olanzapine in the treatment of acute manic or mixed episodes showed asenapine to be an effective monotherapy treatment in clinical settings; asenapine outperformed placebo and showed noninferior performance to olanzapine based on improvement in the Young Mania Rating Scale scores. There are limited data available on the use of asenapine in the treatment of depressive symptoms of BD, or in the maintenance phase of BD. The available data are inconclusive, suggesting the need for more robust data from prospective trials in these clinical domains. The most commonly reported adverse effect associated with use of asenapine is somnolence. However, the somnolence associated with asenapine use did not cause significant rates of discontinuation. While asenapine was associated with weight gain when compared to placebo, it appeared to be modest when compared to other atypical antipsychotics, and its propensity to cause increases in hemoglobin A1c or serum lipid levels appeared to be

  20. Twiddler-syndrom er en årsag til pacemaker elektrode displacering

    DEFF Research Database (Denmark)

    Grønbech, Keea Treu; Hansen, Michael Gilså

    2013-01-01

    Twiddler's syndrome is a rare cause of pacemaker electrode displacement. The displacement is caused by the patient's manipulation with the pacemaker, so the electrode is retracted. We describe a case of a 79-year-old overweight woman with a known psychiatric anamnesis, who was admitted twice...

  1. A forced desynchrony study of circadian pacemaker characteristics in seasonal affective disorder

    NARCIS (Netherlands)

    Koorengevel, Kathelijne M.; Beersma, Domien G.M.; den Boer, Johan; Hoofdakker, Rutger H. van den

    2002-01-01

    The circadian pacemaker is an endogenous clock that regulates oscillations in most physiological and psychological processes with a near 24-h period. In many species, this pacemaker triggers seasonal changes in behavior. The seasonality of symptoms and the efficacy of light therapy suggest involveme

  2. Anti-inflammatory agents in the treatment of bipolar depression

    DEFF Research Database (Denmark)

    Rosenblat, Joshua D; Kakar, Ron; Berk, Michael;

    2016-01-01

    OBJECTIVE: Inflammation has been implicated in the risk, pathophysiology, and progression of mood disorders and, as such, has become a target of interest in the treatment of bipolar disorder (BD). Therefore, the objective of the current qualitative and quantitative review was to determine...... or significant treatment-emergent adverse events were reported. CONCLUSIONS: Overall, a moderate antidepressant effect was observed for adjunctive anti-inflammatory agents compared with conventional therapy alone in the treatment of bipolar depression. The small number of studies, diversity of agents, and small...... sample sizes limited interpretation of the current analysis....

  3. Risk factors for suicide among children and youths with bipolar spectrum and early bipolar disorder.

    Directory of Open Access Journals (Sweden)

    Aleksandra Rajewska-Rager

    2015-06-01

    the overview of recent years literature available in PubMed/MEDLINE database, including the following search criteria: early onset bipolar disorder, bipolar disorder in children and young people, the spectrum of bipolar disorder, and suicidal ideation, suicidal intent, suicide.

  4. Multiple photoreceptor systems control the swim pacemaker activity in box jellyfish.

    Science.gov (United States)

    Garm, A; Mori, S

    2009-12-01

    Like all other cnidarian medusae, box jellyfish propel themselves through the water by contracting their bell-shaped body in discrete swim pulses. These pulses are controlled by a swim pacemaker system situated in their sensory structures, the rhopalia. Each medusa has four rhopalia each with a similar set of six eyes of four morphologically different types. We have examined how each of the four eye types influences the swim pacemaker. Multiple photoreceptor systems, three of the four eye types, plus the rhopalial neuropil, affect the swim pacemaker. The lower lens eye inhibits the pacemaker when stimulated and provokes a strong increase in the pacemaker frequency upon light-off. The upper lens eye, the pit eyes and the rhopalial neuropil all have close to the opposite effect. When these responses are compared with all-eye stimulations it is seen that some advanced integration must take place. PMID:19946073

  5. A brief review of exercise, bipolar disorder, and mechanistic pathways

    Science.gov (United States)

    Thomson, Daniel; Turner, Alyna; Lauder, Sue; Gigler, Margaret E.; Berk, Lesley; Singh, Ajeet B.; Pasco, Julie A.; Berk, Michael; Sylvia, Louisa

    2015-01-01

    Despite evidence that exercise has been found to be effective in the treatment of depression, it is unclear whether these data can be extrapolated to bipolar disorder. Available evidence for bipolar disorder is scant, with no existing randomized controlled trials having tested the impact of exercise on depressive, manic or hypomanic symptomatology. Although exercise is often recommended in bipolar disorder, this is based on extrapolation from the unipolar literature, theory and clinical expertise and not empirical evidence. In addition, there are currently no available empirical data on program variables, with practical implications on frequency, intensity and type of exercise derived from unipolar depression studies. The aim of the current paper is to explore the relationship between exercise and bipolar disorder and potential mechanistic pathways. Given the high rate of medical co-morbidities experienced by people with bipolar disorder, it is possible that exercise is a potentially useful and important intervention with regard to general health benefits; however, further research is required to elucidate the impact of exercise on mood symptomology. PMID:25788889

  6. Sleep Disturbances in Bipolar Disorder

    OpenAIRE

    Cátia Alves Moreira; Pedro Afonso

    2015-01-01

    Background: Bipolar disorder, characterized by episodes of mania, hypomania and depression is associated with sleep disturbances and circadian rhythm disruption. These changes have significant impact on quality of life and in the disease prognosis. Aims: Review of the main sleep disturbances observed in the bipolar disorder, their clinical impact and the hypothetical pathophysiological mechanisms involved. Methods: We conducted a non-systematic review of the literature in English through rese...

  7. : Genetic heterogeneity of bipolar disorder

    OpenAIRE

    Mathieu, Flavie; Dizier, Marie-Hélène; Etain, Bruno; Jamain, Stéphane; Rietschel, Marcella; Maier, Wolfgang; Albus, Margot; Mckeon, Patrick; Roche, Siobhan; Blackwood, Douglas; Muir, Walter,; Henry, Chantal; Malafosse, Alain; Preisig, Martin; Ferrero, François

    2010-01-01

    Bipolar disorder has a genetic component, but the mode of inheritance remains unclear. A previous genome scan conducted in 70 European families led to detect eight regions linked to bipolar disease. Here, we present an investigation of whether the phenotypic heterogeneity of the disorder corresponds to genetic heterogeneity in these regions using additional markers and an extended sample of families. The MLS statistic was used for linkage analyses. The predivided sample test and the maximum l...

  8. Bipolar spectrum disorders. New perspectives.

    OpenAIRE

    Piver, Andre; Yatham, Lakshmi N.; Raymond W. Lam

    2002-01-01

    OBJECTIVE: To review new perspectives on diagnosis, clinical features, epidemiology, and treatment of bipolar II and related disorders. QUALITY OF EVIDENCE: Articles were identified by searching MEDLINE and ClinPSYCH from January 1994 to August 2001 using the key words bipolar disorder, type II or 2; hypomania; spectrum; or variants. Reference lists from articles were reviewed. Overall, the quality of evidence was not high; we found no randomized controlled trials that specifically addressed ...

  9. Threat sensitivity in bipolar disorder.

    Science.gov (United States)

    Muhtadie, Luma; Johnson, Sheri L

    2015-02-01

    Life stress is a major predictor of the course of bipolar disorder. Few studies have used laboratory paradigms to examine stress reactivity in bipolar disorder, and none have assessed autonomic reactivity to laboratory stressors. In the present investigation we sought to address this gap in the literature. Participants, 27 diagnosed with bipolar I disorder and 24 controls with no history of mood disorder, were asked to complete a complex working memory task presented as "a test of general intelligence." Self-reported emotions were assessed at baseline and after participants were given task instructions; autonomic physiology was assessed at baseline and continuously during the stressor task. Compared to controls, individuals with bipolar disorder reported greater increases in pretask anxiety from baseline and showed greater cardiovascular threat reactivity during the task. Group differences in cardiovascular threat reactivity were significantly correlated with comorbid anxiety in the bipolar group. Our results suggest that a multimethod approach to assessing stress reactivity-including the use of physiological parameters that differentiate between maladaptive and adaptive profiles of stress responding-can yield valuable information regarding stress sensitivity and its associations with negative affectivity in bipolar disorder. (PsycINFO Database Record (c) 2015 APA, all rights reserved). PMID:25688436

  10. [Psychoeducation and interpersonal and social rhythm therapy for bipolar disorder].

    Science.gov (United States)

    Mizushima, Hiroko

    2011-01-01

    In treating bipolar disorder, specific psychotherapies in adjunct to pharmacotherapy have been shown to be effective in preventing new episodes and treating depressive episodes. Among those, interpersonal and social rhythm therapy (IPSRT) developed by Frank, amalgamation of interpersonal psychotherapy (IPT) with behavioral therapy focused on social rhythm has been shown to be an efficacious adjunct to mediation in preventing new episodes in bipolar I patients and in treating depression in bipolar I arid II disorder. IPSRT has also been shown to enhance total functioning, relationship functioning and life satisfaction among patients with bipolar disorder, even after pretreatment functioning and concurrent depression were covaried. IPSRT was designed to directly address the major pathways to recurrence in bipolar disorder, namely medication nonadherence, stressful life events, and disruptions in social rhythms. IPT, originated by Klerman et al., is a strategic time-limited psychotherapy focused on one or two of four current interpersonal problem areas (ie, grief, interpersonal role disputes, role transitions, and interpersonal dificits). In IPSRT, the fifth problem area "grief for the lost healthy self" has been added in order to promote acceptance of the diagnosis and the need for life-long treatment. Social rhythm therapy is a behavioral approach aiming at increasing regularity of social rhythms using the Social Rhythm Metric (SRM), a chart to record daily social activities including how stimulating they were, developed from observation that disruptions in social rhythms often trigger affective episodes in patients with bipolar disorder. IPSRT also appears to be a promising intervention for a subset of individuals with bipolar II depression as monotherapy for the acute treatment.

  11. Animal models of recurrent or bipolar depression.

    Science.gov (United States)

    Kato, T; Kasahara, T; Kubota-Sakashita, M; Kato, T M; Nakajima, K

    2016-05-01

    Animal models of mental disorders should ideally have construct, face, and predictive validity, but current animal models do not always satisfy these validity criteria. Additionally, animal models of depression rely mainly on stress-induced behavioral changes. These stress-induced models have limited validity, because stress is not a risk factor specific to depression, and the models do not recapitulate the recurrent and spontaneous nature of depressive episodes. Although animal models exhibiting recurrent depressive episodes or bipolar depression have not yet been established, several researchers are trying to generate such animals by modeling clinical risk factors as well as by manipulating a specific neural circuit using emerging techniques. PMID:26265551

  12. [Dementia and bipolar disorder on the borderline of old age].

    Science.gov (United States)

    Kontis, D; Theochari, I; Tsalta, E

    2013-01-01

    efficacy of anticonvulsants and antipsychotics is superior during acute bipolar episodes in elderly individuals, although both drug categories have been associated with important adverse effects. Current data suggest that the best option during the maintenance phase of the elderly bipolar disorder is the continuation of agents which have been shown effective in the management of acute episodes. The appropriate treatment of cognitive symptoms in elderly bipolar patients has not been thoroughly investigated. In addition, the therapeutic value of psychotropics except cholinesterase inhibitors and memantine in dementia is still controversial, due to their association with side effects. Recent studies which have focused on the role of lithium in dementia could help clarify the relationship of dementia and elderly bipolar disorder. Although there are promising findings with respect to the value of lithium treatment in the prevention of dementia, the existing clinical studies do not support any beneficial effect of lithium administration on enhancing cognitive functioning of people with dementia. The specific role of lithium in dementia and the preventive value of interventions against vascular risk factors in both disorders remain to be evaluated in future prospective studies.

  13. Cognitive functions in the euthymic patients with bipolar disorder

    International Nuclear Information System (INIS)

    Recent studies have focused on the nature of dysfunction in bipolar patients. The purpose of the current study was to investigate cognitive performance of individuals with bipolar disorder compared to healthy control subjects during a well-established euthymic period. The sample consisted of 27 bipolar euthymic patients and 21 control subjects. Verbal and visual memory performance, attention, executive functions and psychological functions were evaluated for each participant. Bipolar patients showed significant attentional deficit and executive dysfunction and also poor performance on verbal and visual memory tasks compared to the controls. Illness duration and lifetime total episode number and previous episode with psychotic features was associated with worsened performance on attention, executive and memory tasks. Psychological functioning was not associated with cognitive deficit. The present study showed persistent cognitive impairment on inhibitory control and selective attention as well as poor performance on verbal and visual memory tests in a group of bipolar euthymic patients. The impaired neuropsychological performance was associated with psychotic features. Attentional dysfunction seemed to be a trait abnormality for the sample studied. (author)

  14. Management of bipolar depression with Lamotrigine: an antiepileptic mood stabilizer

    Directory of Open Access Journals (Sweden)

    Kedar S Prabhavalkar

    2015-10-01

    Full Text Available The efficacy of lamotrigine in the treatment of focal epilepsies have already been reported in several case reports and open studies, which is thought to act by inhibiting glutamate release through voltage-sensitive sodium channels blockade and neuronal membrane stabilization. However, recent findings have also illustrated the importance of lamotrigine in alleviating the depressive symptoms of bipolar disorder, without causing mood destabilization or precipitating mania. Currently, no mood stabilizers are available having equal efficacy in the treatment of both mania and depression, two of which forms the extreme sides of the bipolar disorder. Lamotrigine, a well established anticonvulsant has received regulatory approval for the treatment and prevention of bipolar depression in more than 30 countries worldwide. Lamotrigine, acts through several molecular targets and overcomes the major limitation of other conventional antidepressants by stabilizing mood from ‘below baseline’ thereby preventing switches to mania or episode acceleration, thus being effective for bipolar I disorder. Recent studies have also suggested that these observations could also be extended to patients with bipolar II disorder. Thus, lamotrigine may supposedly fulfill the unmet requirement for an effective depression mood stabilizer.

  15. Basic Principles of Interpersonal Social Rhythm Therapy in Bipolar Disorder

    Directory of Open Access Journals (Sweden)

    Gokben Hizli Sayar

    2014-08-01

    Full Text Available Interpersonal Social Rhythm Therapy is a psychotherapy modality that helps the patient recognize the relationship between disruptions in social rhythms and the onset of previous episodes of psychiatric disorders. It uses psychoeducation and behavioral techniques to maintain social rhythm and sleep/wake regularity. It is closely related to and ldquo;social zeitgeber theory and rdquo; that emphasizes the importance that social rhythm regularity may play in synchronization of circadian rhythms in individuals with or at risk for bipolar spectrum disorders. Interpersonal and social rhythm therapy have been shown to stabilize social rhythms and enhance course and outcome in bipolar disorder. This review focuses on the theoretical principles and the basic steps of interpersonal and social rhythm therapy as a psychotherapy approach in bipolar disorder. PubMed, Scopus, Google Scholar databases were searched without temporal restriction. Search terms included interpersonal social rhythm therapy, bipolar, mood disorders. Abstracts were reviewed for relevance, and randomized controlled trials of interpersonal and social rhythm therapy in bipolar disorder selected. These researches also summarized on the final part of this review. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2014; 6(4.000: 438-446

  16. PEM fuel cell bipolar plate material requirements for transportation applications

    Energy Technology Data Exchange (ETDEWEB)

    Borup, R.L.; Stroh, K.R.; Vanderborgh, N.E. [Los Alamos National Lab., NM (United States)] [and others

    1996-04-01

    Cost effective bipolar plates are currently under development to help make proton exchange membrane (PEM) fuel cells commercially viable. Bipolar plates separate individual cells of the fuel cell stack, and thus must supply strength, be electrically conductive, provide for thermal control of the fuel stack, be a non-porous materials separating hydrogen and oxygen feed streams, be corrosion resistant, provide gas distribution for the feed streams and meet fuel stack cost targets. Candidate materials include conductive polymers and metal plates with corrosion resistant coatings. Possible metals include aluminium, titanium, iron/stainless steel and nickel.

  17. Observation of negative differential transconductance in tunneling emitter bipolar transistors

    Science.gov (United States)

    van Veenhuizen, Marc J.; Locatelli, Nicolas; Moodera, Jagadeesh; Chang, Joonyeon

    2009-08-01

    We report on measurement of negative differential transconductance (NDTC) of iron (Fe)/magnesium-oxide (MgO)/silicon tunneling emitter NPN bipolar transistors. Device simulations reveal that the NDTC is a consequence of an inversion layer at the tunneling-oxide/P-silicon interface for low base voltages. Electrons travel laterally through the inversion layer into the base and give rise to an increase in collector current. The NDTC results from the recombination of those electrons at the interface between emitter and base contact which is dependent on the base voltage. For larger base voltages, the inversion layer disappears marking the onset of normal bipolar transistor behavior.

  18. The Role of Family Functioning in Bipolar Disorder in Families

    Science.gov (United States)

    Du Rocher Schudlich, Tina D.; Youngstrom, Eric A.; Calabrese, Joseph R.; Findling, Robert L.

    2008-01-01

    Investigated the association between family functioning and conflict and their links with mood disorder in parents and with children's risk for bipolar disorder. Participants were 272 families with a child between the ages of 5-17 years. Parents' history of psychiatric diagnoses and children's current diagnoses were obtained via semi-structured…

  19. Bipolar Transistors Can Detect Charge in Electrostatic Experiments

    Science.gov (United States)

    Dvorak, L.

    2012-01-01

    A simple charge indicator with bipolar transistors is described that can be used in various electrostatic experiments. Its behaviour enables us to elucidate links between 'static electricity' and electric currents. In addition it allows us to relate the sign of static charges to the sign of the terminals of an ordinary battery. (Contains 7 figures…

  20. Conductivity-limiting bipolar thermal conductivity in semiconductors.

    Science.gov (United States)

    Wang, Shanyu; Yang, Jiong; Toll, Trevor; Yang, Jihui; Zhang, Wenqing; Tang, Xinfeng

    2015-01-01

    Intriguing experimental results raised the question about the fundamental mechanisms governing the electron-hole coupling induced bipolar thermal conduction in semiconductors. Our combined theoretical analysis and experimental measurements show that in semiconductors bipolar thermal transport is in general a "conductivity-limiting" phenomenon, and it is thus controlled by the carrier mobility ratio and by the minority carrier partial electrical conductivity for the intrinsic and extrinsic cases, respectively. Our numerical method quantifies the role of electronic band structure and carrier scattering mechanisms. We have successfully demonstrated bipolar thermal conductivity reduction in doped semiconductors via electronic band structure modulation and/or preferential minority carrier scatterings. We expect this study to be beneficial to the current interests in optimizing thermoelectric properties of narrow gap semiconductors. PMID:25970560

  1. Peripheral blood brain-derived neurotrophic factor in bipolar disorder

    DEFF Research Database (Denmark)

    Munkholm, K; Vinberg, M; Kessing, L V

    2016-01-01

    Peripheral blood brain-derived neurotrophic factor (BDNF) has been proposed as a potential biomarker related to disease activity and neuroprogression in bipolar disorder, speculated to mirror alterations in brain expression of BDNF. The research area is rapidly evolving; however, recent...... investigations have yielded conflicting results with substantial variation in outcomes, highlighting the need to critically assess the state of current evidence. The aims of the study were to investigate differences in peripheral blood BDNF concentrations between bipolar disorder patients and healthy control...... subjects and between affective states in bipolar disorder patients, including assessment of the effect of treatment of acute episodes on BDNF levels. A systematic review of English language studies without considering publication status was conducted in PubMed (January 1950-November 2014), Embase (1974...

  2. Ventricular oversensing of atrial electrical activity that inhibits VVI pacemaker and causes syncope

    Directory of Open Access Journals (Sweden)

    Elibet Chávez González

    2015-10-01

    Full Text Available Far-field oversensing of atrial electrical activity caused by a VVI pacemaker is a rare phenomenon; however, it may have serious clinical consequences. It has several causes and its timely identification may avoid a possible ventricular asystole. This article reports the case of a 72-year-old male who had a Biotronik Axios SR pacemaker implanted, in VVIR mode, six years ago, due to blocked atrial fibrillation. He suffered syncope due to pacemaker inhibition caused by ventricular oversensing of atrial electrical activity.

  3. Targeting astrocytes in bipolar disorder.

    Science.gov (United States)

    Peng, Liang; Li, Baoman; Verkhratsky, Alexei

    2016-06-01

    Astrocytes are homeostatic cells of the central nervous system, which are critical for development and maintenance of synaptic transmission and hence of synaptically connected neuronal ensembles. Astrocytic densities are reduced in bipolar disorder, and therefore deficient astroglial function may contribute to overall disbalance in neurotransmission and to pathological evolution. Classical anti-bipolar drugs (lithium salts, valproic acid and carbamazepine) affect expression of astroglial genes and modify astroglial signalling and homeostatic cascades. Many effects of both antidepressant and anti-bipolar drugs are exerted through regulation of glutamate homeostasis and glutamatergic transmission, through K(+) buffering, through regulation of calcium-dependent phospholipase A2 (that controls metabolism of arachidonic acid) or through Ca(2+) homeostatic and signalling pathways. Sometimes anti-depressant and anti-bipolar drugs exert opposite effects, and some effects on gene expression in drug treated animals are opposite in neurones vs. astrocytes. Changes in the intracellular pH induced by anti-bipolar drugs affect uptake of myo-inositol and thereby signalling via inositoltrisphosphate (InsP3), this being in accord with one of the main theories of mechanism of action for these drugs. PMID:27015045

  4. Enhancement of Spontaneous Activity by HCN4 Overexpression in Mouse Embryonic Stem Cell-Derived Cardiomyocytes - A Possible Biological Pacemaker.

    Directory of Open Access Journals (Sweden)

    Yukihiro Saito

    Full Text Available Establishment of a biological pacemaker is expected to solve the persisting problems of a mechanical pacemaker including the problems of battery life and electromagnetic interference. Enhancement of the funny current (If flowing through hyperpolarization-activated cyclic nucleotide-gated (HCN channels and attenuation of the inward rectifier K+ current (IK1 flowing through inward rectifier potassium (Kir channels are essential for generation of a biological pacemaker. Therefore, we generated HCN4-overexpressing mouse embryonic stem cells (mESCs and induced cardiomyocytes that originally show poor IK1 currents, and we investigated whether the HCN4-overexpressing mESC-derived cardiomyocytes (mESC-CMs function as a biological pacemaker in vitro.The rabbit Hcn4 gene was transfected into mESCs, and stable clones were selected. mESC-CMs were generated via embryoid bodies and purified under serum/glucose-free and lactate-supplemented conditions. Approximately 90% of the purified cells were troponin I-positive by immunostaining. In mESC-CMs, expression level of the Kcnj2 gene encoding Kir2.1, which is essential for generation of IK1 currents that are responsible for stabilizing the resting membrane potential, was lower than that in an adult mouse ventricle. HCN4-overexpressing mESC-CMs expressed about a 3-times higher level of the Hcn4 gene than did non-overexpressing mESC-CMs. Expression of the Cacna1h gene, which encodes T-type calcium channel and generates diastolic depolarization in the sinoatrial node, was also confirmed. Additionally, genes required for impulse conduction including Connexin40, Connexin43, and Connexin45 genes, which encode connexins forming gap junctions, and the Scn5a gene, which encodes sodium channels, are expressed in the cells. HCN4-overexpressing mESC-CMs showed significantly larger If currents and more rapid spontaneous beating than did non-overexpressing mESC-CMs. The beating rate of HCN4-overexpressing mESC-CMs responded

  5. Imunologia do transtorno bipolar Immunology of bipolar disorder

    OpenAIRE

    Izabela Guimarães Barbosa; Rodrigo Barreto Huguet; Fernando Silva Neves; Moisés Evandro Bauer; Antônio Lúcio Teixeira

    2009-01-01

    OBJETIVO: Pesquisas recentes têm implicado fatores imunes na patogênese de diversos transtornos neuropsiquiátricos. O objetivo do presente trabalho é revisar os trabalhos que investigaram a associação entre transtorno bipolar e alterações em parâmetros imunes. MÉTODOS: Artigos que incluíam as palavras-chave: "bipolar disorder", "mania", "immunology", "cytokines", "chemokines", "interleukins", "interferon" e "tumor necrosis factor" foram selecionados em uma revisão sistemática da literatura. A...

  6. A new acquisition method with pacemaker resetting of coronary multidetector-row computed tomography for reduction of radiation dose in patients with pacemaker

    International Nuclear Information System (INIS)

    We proposed a new acquisition method of coronary multidetector-row CT (MDCT) achieved by pacing rate resetting and/or propranolol or verapamil injection in patients with a pacemaker. Coronary MDCT was undertaken in 57 patients with a pacemaker (DDD: 51, VVI: 6) and in 2975 patients with sinus rhythm as control using Aquilion 64 (Toshiba). Pacing rate was reset to 60 beats per minute (bpm) in DDD, and spontaneous beats were suppressed by propranolol injection. Pacing rate was reset to 70 bpm in atrial fibrillation with VVI, and spontaneous beats were suppressed by verapamil injection. Coronary MDCT was undertaken using as high a beam pitch (BP) as possible. When spontaneous beats were not suppressed, we selected the optimal gantry speed and BP to get the highest temporal resolution. Image quality makes no significant difference between pacemaker and sinus rhythm. When spontaneous beats were completely suppressed (all pacing), mean radiation dose and acquisition time, respectively, decreased by 33.0% and 35.2% in DDD compared with the method recommended by Heart Navi (by Toshiba), and they decreased by 38.1% and 25.9%, respectively, in VVI compared with the method recommended by Heart Navi. We could not estimate coronary stenosis in the proximal right coronary artery by lead artifacts in 30% of DDD pacemakers. In conclusion, the new method is useful for not only reducing radiation dose and acquisition time, but also for maintaining image quality in patients with a pacemaker. (author)

  7. Mathematical models of bipolar disorder

    Science.gov (United States)

    Daugherty, Darryl; Roque-Urrea, Tairi; Urrea-Roque, John; Troyer, Jessica; Wirkus, Stephen; Porter, Mason A.

    2009-07-01

    We use limit cycle oscillators to model bipolar II disorder, which is characterized by alternating hypomanic and depressive episodes and afflicts about 1% of the United States adult population. We consider two non-linear oscillator models of a single bipolar patient. In both frameworks, we begin with an untreated individual and examine the mathematical effects and resulting biological consequences of treatment. We also briefly consider the dynamics of interacting bipolar II individuals using weakly-coupled, weakly-damped harmonic oscillators. We discuss how the proposed models can be used as a framework for refined models that incorporate additional biological data. We conclude with a discussion of possible generalizations of our work, as there are several biologically-motivated extensions that can be readily incorporated into the series of models presented here.

  8. Polyphosphonium-based ion bipolar junction transistors.

    Science.gov (United States)

    Gabrielsson, Erik O; Tybrandt, Klas; Berggren, Magnus

    2014-11-01

    Advancements in the field of electronics during the past few decades have inspired the use of transistors in a diversity of research fields, including biology and medicine. However, signals in living organisms are not only carried by electrons but also through fluxes of ions and biomolecules. Thus, in order to implement the transistor functionality to control biological signals, devices that can modulate currents of ions and biomolecules, i.e., ionic transistors and diodes, are needed. One successful approach for modulation of ionic currents is to use oppositely charged ion-selective membranes to form so called ion bipolar junction transistors (IBJTs). Unfortunately, overall IBJT device performance has been hindered due to the typical low mobility of ions, large geometries of the ion bipolar junction materials, and the possibility of electric field enhanced (EFE) water dissociation in the junction. Here, we introduce a novel polyphosphonium-based anion-selective material into npn-type IBJTs. The new material does not show EFE water dissociation and therefore allows for a reduction of junction length down to 2 μm, which significantly improves the switching performance of the ion transistor to 2 s. The presented improvement in speed as well the simplified design will be useful for future development of advanced iontronic circuits employing IBJTs, for example, addressable drug-delivery devices. PMID:25553192

  9. Differences in the ICD-10 diagnostic subtype of depression in bipolar disorder compared to recurrent depressive disorder

    DEFF Research Database (Denmark)

    Jensen, H.M.; Christensen, E.M.; Kessing, Lars Vedel

    2008-01-01

    Background: The aim of the study was to investigate whether patients with bipolar depression and patients with recurrent depressive disorder present with different subtypes of depressive episode as according to ICD-10. Sampling and Methods: All patients who got a diagnosis of bipolar affective......: Totally, 389 patients got a diagnosis of bipolar disorder, current episode of depression, and 5.391 patients got a diagnosis of recurrent depressive disorder, current episode of depression, at first contact. Compared with patients with a diagnosis of recurrent depressive disorder, patients with bipolar...... for patients with bipolar disorder, current episode of depression, compared with patients with a current depression as part of a recurrent depressive disorder (HR = 1.50, 95% CI = 1.20-1.86). Conclusions: The results consistently indicate that a depressive episode is severer and/or more often associated...

  10. A novel non invasive measurement of hemodynamic parameters: Comparison of single-chamber ventricular and dual-chamber pacemaker

    Directory of Open Access Journals (Sweden)

    Ingrid M. Pardede

    2008-03-01

    Full Text Available We carried out a cross sectional study to analyze hemodynamic parameters of single-chamber ventricular pacemaker compared with dual-chamber pacemaker by using thoracic electrical bioimpedance monitoring method (Physio Flow™ - a novel simple non-invasive measurement. A total of 48 consecutive outpatients comprised of 27 single chamber pacemaker and 21 dual chamber were analyzed. We measured cardiac parameters: heart rate, stroke volume index, cardiac output index, estimated ejection fraction, end diastolic volume, early diastolic function ratio, thoracic fluid index, and systemic parameters: left cardiac work index and systemic vascular resistance index. Baseline characteristic and pacemaker indication were similar in both groups. Cardiac parameters assessment revealed no significant difference between single-chamber pacemaker and dual-chamber pacemaker in heart rate, stroke volume index, cardiac index, estimated ejection fraction, end-diastolic volume, thoracic fluid index. There was significantly higher early diastolic function ratio in single-chamber pacemaker compared to dual-chamber pacemaker: 92% (10.2-187.7% vs. 100.6% (48.7-403.2%; p=0.006. Systemic parameters assessment revealed significantly higher left cardiac work index in single-chamber group than dual-chamber group 4.9 kg.m/m² (2.8-7.6 kg.m/m² vs. 4.3 kg.m/m² (2.9-7.2 kg.m/m²; p=0.004. There was no significant difference on systemic vascular resistance in single-chamber compared to dual-chamber pacemaker. Single-chamber ventricular pacemaker provides similar stroke volume, cardiac output and left cardiac work, compared to dual-chamber pacemaker. A non-invasive hemodynamic measurement using thoracic electrical bioimpedance is feasible for permanent pacemaker outpatients. (Med J Indones 2008; 17: 25-32Keywords: Permanent pacemaker, single chamber, dual chamber, thoracic electrical bioimpedance, hemodynamic parameter

  11. Influence of ionizing radiation on the probability of failure of long-term pacemakers

    Energy Technology Data Exchange (ETDEWEB)

    Eger, H.; Hesse, W.; Otte, K.B.; Rauh, G.; Salewski, D.; Stopp, G. (Zentralklinik fuer Herz- und Lungenkrankheiten, Bad Berka (German Democratic Republic); VEB Transformatoren- und Roentgenwerk ' Hermann Matern' Dresden (German Democratic Republic); Martin-Luther-Universitaet Halle-Wittenberg, Halle (German Democratic Republic). Radiologische Klinik; Staatliches Amt fuer Atomsicherheit und Strahlenschutz, Berlin (German Democratic Republic))

    1982-11-01

    The functional disturbances observed during the exposure of cardiac pacemakers with a CMOS switching circle U 115 are described qualitatively for different types of radiation. Based on the maximum sensitivity of the U 115 within the X-ray range, the correlation for this range between dose of exposure and parameter changes is established. As is demonstrated such changes is established. As is demonstrated such changes are not clinically relevant as long as the dose of 5,16 x 10/sup -2/ C/kg is not exceeded. Proceeding from the accumulated dose to which the U 115 is exposed during various diagnostic radiographic procedures it is shown that such procedures do not result in functional disturbances of the pacemaker. Recommendations are given for radiotherapeutic measures as to pacemaker patients, which should be realized in close co-operation between the pacemaker centre concerned and an authorized hospital.

  12. Magnetic Resonance Imaging in a Patient with a Dual Chamber Pacemaker

    Directory of Open Access Journals (Sweden)

    Lynne Martina Millar

    2010-01-01

    Full Text Available Having a pacemaker has been seen an absolute contraindication to having an MRI scan. This has become increasingly difficult in clinical practice as insertion of pacemakers and implantable cardiac defibrillators is at an all time high. Here we outline a case where a 71-year-old male patient with a permanent pacemaker needed to have an MRI scan to ascertain the aetiology of his condition and help guide further management. Given this clinical dilemma, an emergency clinical ethics consultation was arranged. As a result the patient underwent an MRI scan safely under controlled conditions with a consultant cardiologist and radiologist present. The results of the MRI scan were then able to tailor further treatment. This case highlights that in certain conditions an MRI can be performed in patients with permanent pacemakers and outlines the role of clinical ethics committees in complex medical decision making.

  13. Social support and bipolar disorder

    OpenAIRE

    Paula Mendonça Studart; Severino Bezerra Filho; Ana Beatriz Didier Studart; Amanda Galvão-de Almeida; Ângela Miranda-Scippa

    2015-01-01

    Background Bipolar disorder is a chronic condition that affects the functioning of its carriers in many different ways, even when treated properly. Therefore, it’s also important to identify the psychosocial aspects that could contribute to an improvement of this population’s quality of life.Objective Carry out a literature review on the role of social support in cases of bipolar disorder.Method A research on the following online databases PubMed, Lilacs and SciELO was conducted by using the ...

  14. Bipolar lead acid battery development

    Science.gov (United States)

    Eskra, Michael; Vidas, Robin; Miles, Ronald; Halpert, Gerald; Attia, Alan; Perrone, David

    1991-01-01

    A modular bipolar battery configuration is under development at Johnson Control, Inc. (JCI) and the Jet Propulsion Laboratory (JPL). The battery design, incorporating proven lead acid electrochemistry, yields a rechargeable, high-power source that is light weight and compact. This configuration offers advantages in power capability, weight, and volume over conventional monopolar batteries and other battery chemistries. The lead acid bipolar battery operates in a sealed, maintenance-free mode allowing for maximum application flexibility. It is ideal for high-voltage and high-power applications.

  15. Bipolar dislocation of the clavicle

    Directory of Open Access Journals (Sweden)

    Wei Jiang

    2012-01-01

    Full Text Available Bipolar dislocation of the clavicle at acromioclavicular and sternoclavicular joint is an uncommon traumatic injury. The conservative treatments adopted in the past is associated with redislocation dysfunction and deformity. A 41 years old lady with bipolar dislocation of right shoulder is treated surgically by open reduction and internal fixation by oblique T-plate at sternoclavicular joint and Kirschner wire stabilization at acromioclavicular joint. The patient showed satisfactory recovery with full range of motion of the right shoulder and normal muscular strength. The case reported in view of rarity and at 2 years followup.

  16. Bipolar dislocation of the clavicle.

    Science.gov (United States)

    Jiang, Wei; Gao, Shu-Guang; Li, Yu-Sheng; Lei, Guang-Hua

    2012-11-01

    Bipolar dislocation of the clavicle at acromioclavicular and sternoclavicular joint is an uncommon traumatic injury. The conservative treatments adopted in the past is associated with redislocation dysfunction and deformity. A 41 years old lady with bipolar dislocation of right shoulder is treated surgically by open reduction and internal fixation by oblique T-plate at sternoclavicular joint and Kirschner wire stabilization at acromioclavicular joint. The patient showed satisfactory recovery with full range of motion of the right shoulder and normal muscular strength. The case reported in view of rarity and at 2 years followup. PMID:23325981

  17. Refractory bipolar disorder and neuroprogression.

    Science.gov (United States)

    da Costa, Sabrina C; Passos, Ives C; Lowri, Caroline; Soares, Jair C; Kapczinski, Flavio

    2016-10-01

    Immune activation and failure of physiologic compensatory mechanisms over time have been implicated in the pathophysiology of illness progression in bipolar disorder. Recent evidence suggests that such changes are important contributors to neuroprogression and may mediate the cross-sensitization of episode recurrence, trauma exposure and substance use. The present review aims to discuss the potential factors related to bipolar disorder refractoriness and neuroprogression. In addition, we will discuss the possible impacts of early therapeutic interventions as well as the alternative approaches in late stages of the disorder. PMID:26368941

  18. Sikkerhed af magnetisk resonans-skanning hos patienter med pacemaker og implanterbar defibrillator

    DEFF Research Database (Denmark)

    Al-Sabagh, Kifah Hekmat; Christensen, Britta Ege; Thøgersen, Anna Margrethe;

    2010-01-01

    INTRODUCTION: The presence of a cardiac implantable device is ICD considered an absolute contraindication to magnetic resonance imaging (MRI). The purpose of this study was to evaluate the safety of performing MRI in patients with cardiac pacemakers and ICDs that had a compelling clinical need fo...... pacemakers with an acceptable risk-benefit ratio, while MRI of patients with ICDs must still be considered an experimental procedure. Udgivelsesdato: 2010-Jun...

  19. Cardiovascular magnetic resonance in cardiac sarcoidosis with MR conditional pacemaker in situ

    OpenAIRE

    Hausenloy Derek; Harkness Allan; Plant Gordon T; Holdright Diana R; Quarta Giovanni; Hyare Harpreet; Moon James C

    2011-01-01

    Abstract Cardiovascular implantable electronic devices represent important limitations to magnetic resonance imaging (MRI). Recently, MRI-conditional dual chamber pacemakers and leads have become available. We describe a case of a patient with neuro-sarcoidosis presenting with diplopia and hydrocephalus requiring an MRI-conditional programmable ventriculo-peritoneal shunt, who developed complete heart block. In view of the ongoing need for neuro-imaging, MRI-conditional dual chamber pacemaker...

  20. SU-E-I-42: Normalized Embryo/fetus Doses for Fluoroscopically Guided Pacemaker Implantation Procedures Calculated Using a Monte Carlo Technique

    Energy Technology Data Exchange (ETDEWEB)

    Damilakis, J; Stratakis, J; Solomou, G [University of Crete, Heraklion (Greece)

    2014-06-01

    Purpose: It is well known that pacemaker implantation is sometimes needed in pregnant patients with symptomatic bradycardia. To our knowledge, there is no reported experience regarding radiation doses to the unborn child resulting from fluoroscopy during pacemaker implantation. The purpose of the current study was to develop a method for estimating embryo/fetus dose from fluoroscopically guided pacemaker implantation procedures performed on pregnant patients during all trimesters of gestation. Methods: The Monte Carlo N-Particle (MCNP) radiation transport code was employed in this study. Three mathematical anthropomorphic phantoms representing the average pregnant patient at the first, second and third trimesters of gestation were generated using Bodybuilder software (White Rock science, White Rock, NM). The normalized embryo/fetus dose from the posteroanterior (PA), the 30° left-anterior oblique (LAO) and the 30° right-anterior oblique (RAO) projections were calculated for a wide range of kVp (50–120 kVp) and total filtration values (2.5–9.0 mm Al). Results: The results consist of radiation doses normalized to a) entrance skin dose (ESD) and b) dose area product (DAP) so that the dose to the unborn child from any fluoroscopic technique and x-ray device used can be calculated. ESD normalized doses ranged from 0.008 (PA, first trimester) to 2.519 μGy/mGy (RAO, third trimester). DAP normalized doses ranged from 0.051 (PA, first trimester) to 12.852 μGy/Gycm2 (RAO, third trimester). Conclusion: Embryo/fetus doses from fluoroscopically guided pacemaker implantation procedures performed on pregnant patients during all stages of gestation can be estimated using the method developed in this study. This study was supported by the Greek Ministry of Education and Religious Affairs, General Secretariat for Research and Technology, Operational Program ‘Education and Lifelong Learning’, ARISTIA (Research project: CONCERT)

  1. SU-E-I-42: Normalized Embryo/fetus Doses for Fluoroscopically Guided Pacemaker Implantation Procedures Calculated Using a Monte Carlo Technique

    International Nuclear Information System (INIS)

    Purpose: It is well known that pacemaker implantation is sometimes needed in pregnant patients with symptomatic bradycardia. To our knowledge, there is no reported experience regarding radiation doses to the unborn child resulting from fluoroscopy during pacemaker implantation. The purpose of the current study was to develop a method for estimating embryo/fetus dose from fluoroscopically guided pacemaker implantation procedures performed on pregnant patients during all trimesters of gestation. Methods: The Monte Carlo N-Particle (MCNP) radiation transport code was employed in this study. Three mathematical anthropomorphic phantoms representing the average pregnant patient at the first, second and third trimesters of gestation were generated using Bodybuilder software (White Rock science, White Rock, NM). The normalized embryo/fetus dose from the posteroanterior (PA), the 30° left-anterior oblique (LAO) and the 30° right-anterior oblique (RAO) projections were calculated for a wide range of kVp (50–120 kVp) and total filtration values (2.5–9.0 mm Al). Results: The results consist of radiation doses normalized to a) entrance skin dose (ESD) and b) dose area product (DAP) so that the dose to the unborn child from any fluoroscopic technique and x-ray device used can be calculated. ESD normalized doses ranged from 0.008 (PA, first trimester) to 2.519 μGy/mGy (RAO, third trimester). DAP normalized doses ranged from 0.051 (PA, first trimester) to 12.852 μGy/Gycm2 (RAO, third trimester). Conclusion: Embryo/fetus doses from fluoroscopically guided pacemaker implantation procedures performed on pregnant patients during all stages of gestation can be estimated using the method developed in this study. This study was supported by the Greek Ministry of Education and Religious Affairs, General Secretariat for Research and Technology, Operational Program ‘Education and Lifelong Learning’, ARISTIA (Research project: CONCERT)

  2. Late life bipolar disorder evolving into frontotemporal dementia mimic

    Directory of Open Access Journals (Sweden)

    Dols A

    2016-09-01

    Full Text Available Annemiek Dols,1 Welmoed Krudop,2 Christiane Möller,2 Kenneth Shulman,3 Martha Sajatovic,4 Yolande AL Pijnenburg2 1Department of Old Age Psychiatry, GGZInGeest, 2Alzheimer Centre and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Centre, Amsterdam, the Netherlands; 3Department of Geriatric Psychiatry, Sunnybrook Health Science Centre, Faculty of Medicine, University of Toronto, Toronto, Canada; 4Department of Psychiatry and Neurology, Case Western Reserve University School of Medicine, University Hospitals Case Medical Center, Cleveland, OH, USA Objectives: Although bipolar disorder has been understood classically as a cyclic disease with full recovery between mood episodes, in the last decade, evidence has accumulated supporting progressive features. The clinical picture of advanced or end-stage bipolar disorder is heterogeneous with possible deficits in cognition and behavior, as illustrated by our case series.Cases: From our neuropsychiatric outpatient clinic, we describe four cases with bipolar disorder gradually developing a clinical syndrome, including apathy, disinhibition, loss of empathy, stereotypical behavior, and compulsiveness, fulfilling the criteria for possible behavioral variant frontotemporal dementia. All cases were diagnosed with bipolar 1 disorder at least 10 years before the onset of the current symptoms, which were not due to recent mood episodes or switches of medication. In all cases, 3–7 years of follow-up yielded no progression. Repeated neuroimaging was within normal limits. Cerebrospinal fluid biomarker studies were not supportive of underlying neurodegenerative pathology. C9orf72 mutation status was negative in all cases.Conclusion: Symptoms fitting the criteria for possible behavioral variant frontotemporal dementia may be present in end-stage of bipolar disorder. An alternative neurodegenerative nature seems unlikely based on repeated normal neuroimaging and the absence of clinical

  3. Preparation and Performance of Bipolar Membranes with Liquid Ion-Exchange Medium

    Institute of Scientific and Technical Information of China (English)

    苏静; 余立新; 郝继华

    2003-01-01

    The current density is rather low in solid bipolar membranes, because the water transfer rate is relatively slow across solid bipolar membranes made of solid ion-exchange materials. This paper describes the use of polymer solutions, such as phosphatic poly(vinyl alcohol) solution, poly(acrylic acid) solution and poly(vinyl alcohol) solutions with dispersed cation/anion-exchange resin particles to prepare bipolar membranes. The 0.1 mol/L NaOH and the 0.05 mol/L H2SO4 were used to test the performance of the bipolar membranes. For a fixed liquid layer thickness, both the current density and the selectivity increase with the concentration increase of a polyelectrolyte solution. The maximum current density measured in the experiment was 1497 A/m2 with a selectivity of 96.8%.

  4. Sleep disturbances in pediatric bipolar disorder: A comparison between Bipolar I and Bipolar NOS

    Directory of Open Access Journals (Sweden)

    Argelinda eBaroni

    2012-03-01

    Full Text Available Introduction: The diagnosis of Bipolar Disorder (BD in youths has been controversial, especially for the subtype BD Not Otherwise Specified (BD-NOS. In spite of growing evidence that sleep is a core feature of BD, few studies characterize and compare sleep disturbances in youth with BD type I (BD-I and BD-NOS. Sleep disturbances are frequently reported in clinical descriptions of children and adolescents with BD, however the reporting of the frequency and characteristics of sleep symptoms in youth with BD NOS and BD I during episodes remain poor. This study compares symptom of sleep disturbance as occurring in manic and depressive episodes in BD I and BD NOS youth using KSADS-PL interview data. The study also addresses whether symptoms of sleep disturbance vary in different age groups. Material and Methods: The sample consisted of 70 children and adolescent outpatients at an urban specialty clinic (42M/28F, 10.8±3.6 years old including 24 BP-I and 46 BP-NOS assessed using K-SADS-PL-parent interview. Results: Sleep disturbances including insomnia and decreased need for sleep were reported by 84.3% of the sample. Enuresis was diagnosed in 27% of sample. There were no significant differences in frequency of sleep symptoms between BD-I and BD-NOS. Regardless of BD subtype, current functioning was negatively correlated with decreased need for sleep but not insomnia, and regardless of BD subtype. Conclusion: The majority of youth with BD presents with sleep symptoms during mood episodes. BD NOS presents with the same proportion of sleep symptoms as BD I in our sample.

  5. Radiotherapy in patients with pacemakers and implantable cardioverter defibrillators: a literature review.

    Science.gov (United States)

    Zaremba, Tomas; Jakobsen, Annette Ross; Søgaard, Mette; Thøgersen, Anna Margrethe; Riahi, Sam

    2016-04-01

    An increasing number of patients with implantable cardiac rhythm devices undergo radiotherapy (RT) for cancer and are thereby exposed to the risk of device failure. Current safety recommendations seem to have limitations by not accounting for the risk of pacemakers and implantable cardioverter defibrillators malfunctioning at low radiation doses. Besides scant knowledge about optimal safety measures, only little is known about the exact prevalence of patients with devices undergoing RT. In this review, we provide a short overview of the principles of RT and present the current evidence on the predictors and mechanisms of device malfunctions during RT. We also summarize practical recommendations from recent publications and from the industry. Strongly associated with beam energy of photon RT, device malfunctions occur at ∼3% of RT courses, posing a substantial issue in clinical practice. Malfunctions described in the literature typically consist of transient software disturbances and only seldom manifest as a permanent damage of the device. Through close cooperation between cardiologists and oncologists, a tailored individualized approach might be necessary in this patient group in waiting time for updated international guidelines in the field. PMID:26041870

  6. Service irradiation centers as pacemakers for the industrial use of radiation processing of polymers

    International Nuclear Information System (INIS)

    BGS Beta-Gamma-Service was founded in 1981 to make radiation processing economically feasible for many more products and thus accessible to every company, independent of its size and its consumption of irradiation capacity; and to provide at the same time, the necessary expertise in a special technical discipline which does not exist in most of the polymer processing companies. I the present report, the example of BGS illustrate how service irradiation centers can assume the role of pacemakers in the field of radiation processing. Today, the service offer of BGS is based on four different irradiation facilities. In the sequence of increasing penetration of the generated radiation, these are: a 560 kV/20 mA electron accelerator, operating from 300 kV upwards; a 3 MV electron accelerator, with maximum beam power and current of 100 kW and 50 mA, respectively, operating from 1.5 MV upwards; a 4.5 MV electron accelerator, with maximum beam power and current of 150 kW and 50 mA, respectively, operating from 2.5 MV upwards; and a Co-60 gamma facility of a palet type, with a maximum loading of 3.5 MCi in two source plaques. The total market value of the products BGS is refining or finishing at present is estimated in the range of 100 million DM per annum. (Nogami, K.)

  7. Electromagnetic immunity of implantable pacemakers exposed to wi-fi devices.

    Science.gov (United States)

    Mattei, Eugenio; Censi, Federica; Triventi, Michele; Calcagnini, Giovanni

    2014-10-01

    The purpose of this study is to evaluate the potential for electromagnetic interference (EMI) and to assess the immunity level of implantable pacemakers (PM) when exposed to the radiofrequency (RF) field generated by Wi-Fi devices. Ten PM from five manufacturers, representative of what today is implanted in patients, have been tested in vitro and exposed to the signal generated by a Wi-Fi transmitter. An exposure setup that reproduces the actual IEEE 802.11b/g protocol has been designed and used during the tests. The system is able to amplify the Wi-Fi signal and transmits at power levels higher than those allowed by current international regulation. Such approach allows one to obtain, in case of no EMI, a safety margin for PM exposed to Wi-Fi signals, which otherwise cannot be derived if using commercial Wi-Fi equipment. The results of this study mitigate concerns about using Wi-Fi devices close to PM: none of the PM tested exhibit any degradation of their performance, even when exposed to RF field levels five times higher than those allowed by current international regulation (20 W EIRP). In conclusion, Wi-Fi devices do not pose risks of EMI to implantable PM. The immunity level of modern PM is much higher than the transmitting power of RF devices operating at 2.4 GHz.

  8. Sleep Disturbances in Bipolar Disorder

    Directory of Open Access Journals (Sweden)

    Cátia Alves Moreira

    2015-11-01

    Full Text Available Background: Bipolar disorder, characterized by episodes of mania, hypomania and depression is associated with sleep disturbances and circadian rhythm disruption. These changes have significant impact on quality of life and in the disease prognosis. Aims: Review of the main sleep disturbances observed in the bipolar disorder, their clinical impact and the hypothetical pathophysiological mechanisms involved. Methods: We conducted a non-systematic review of the literature in English through research in PubMed with the keywords “sleep disturbance”, “bipolar disorder”, “polysomnography”. Results and Conclusions: Complaints about sleep pattern changes may occur during any phase of the disease. These in clude frequent night-time awakenings, poor sleep quality, reduction of the total sleeping time and decreased latency and increased density of REM sleep. The treatment of the sleep disturbances observed in bipolar disorder should be considered a priority, since it prevents symptoms recurrence and facilitate the socio-professional integration, thus providing greater success in patient’s rehabilitation and quality of life.

  9. SUTURELESS THYROIDECTOMY WITH BIPOLAR DIATHERMY

    Directory of Open Access Journals (Sweden)

    Ravi Kumar

    2016-05-01

    Full Text Available The thyroid gland is one of the most vascular organs in the body and surgical resection mandates meticulous surgical technique and haemostasis. The rate of complications of thyroid surgeries were very high earlier but with the advent of ligasure, harmonic scalpel and bipolar surgical diathermy complications have reduced. In this study, we have used bipolar surgical diathermy. MATERIALS 116 patients with thyroid swelling attending surgical OPD in Vydehi Institute of Medical Sciences and Research Centre during the period of 2011-2015 were included in the study. Proper preoperative workup was done and sutureless thyroidectomy surgeries were done using bipolar surgical diathermy. Patients were reviewed for any complications following thyroidectomy like haemorrhage, hypocalcaemia and recurrent laryngeal nerve palsy. RESULTS Out of 116 patients who underwent sutureless thyroidectomy none of them had any primary, secondary or reactionary haemorrhage, one patient who underwent total thyroidectomy for follicular carcinoma had transient hypocalcaemia. CONCLUSION Sutureless thyroidectomy is a very good surgical practice with bipolar surgical diathermy and it permits low postoperative complications and cost effectiveness.

  10. Corrosion resistant metallic bipolar plate

    Science.gov (United States)

    Brady, Michael P.; Schneibel, Joachim H.; Pint, Bruce A.; Maziasz, Philip J.

    2007-05-01

    A corrosion resistant, electrically conductive component such as a bipolar plate for a PEM fuel cell includes 20 55% Cr, balance base metal such as Ni, Fe, or Co, the component having thereon a substantially external, continuous layer of chromium nitride.

  11. [Cognitive deficits in bipolar disorder].

    Science.gov (United States)

    Sachs, Gabriele; Schaffer, Markus; Winklbaur, Bernadette

    2007-01-01

    Bipolar disorders are often associated with cognitive deficits which have an influence on social functioning and the course of the illness. These deficits have an impact on occupational ability and social integration. To date, specific cognitive domains have been found which characterize bipolar affective disorders. However, there is evidence of stable and lasting cognitive impairment in all phases of the disorder, including the remission phase, in the following domains: sustained attention, memory and executive functions (e.g. cognitive flexibility and problem solving). Although their cognitive deficits are comparable the deficits in patients with schizophrenia are more severe than those with bipolar disorder. Recent brain imaging findings indicate structural and functional abnormalities in the cortical and limbic networks of the brain in patients with bipolar disorder compared to healthy controls. Mood stabilizer and atypical antipsychotics may reduce cognitive deficits in certain domains (e.g. executive functions and word fluency) and may have a positive effect on quality of life and social functioning. PMID:17640495

  12. Social support and bipolar disorder

    Directory of Open Access Journals (Sweden)

    Paula Mendonça Studart

    2015-08-01

    Full Text Available Background Bipolar disorder is a chronic condition that affects the functioning of its carriers in many different ways, even when treated properly. Therefore, it’s also important to identify the psychosocial aspects that could contribute to an improvement of this population’s quality of life.Objective Carry out a literature review on the role of social support in cases of bipolar disorder.Method A research on the following online databases PubMed, Lilacs and SciELO was conducted by using the keywords “social support” or “social networks” and “mood disorders” or “bipolar disorder” or “affective disorder,” with no defined timeline.Results Only 13 studies concerning the topic of social support and BD were found in the search for related articles. Generally speaking, the results show low rates of social support for BD patients.Discussion Despite the growing interest in the overall functioning of patients with bipolar disorder, studies on social support are still rare. Besides, the existing studies on the subject use different methodologies, making it difficult to establish data comparisons.

  13. A linkage study of bipolar disorder

    Energy Technology Data Exchange (ETDEWEB)

    Kelsoe, J.R. [Univ. of California, San Diego (United States); Sadovnick, A.D.; Remick, R.A. [Univ. of British Columbia, Vancouver (Canada)] [and others

    1994-09-01

    We are currently surveying the genome with polymorphic DNA markers in search of loci linked to bipolar disorder (manic-depressive illness) in three populations: 20 families (175 subjects) from the general North American population from San Diego (UCSD) and Vancouver (UBC); 3 Icelandic families (55 subjects); and an Old Order Amish pedigree 110 (118 subjects). Over 50 markers on chromosomes 1, 2, 5, 11, 17, 18, 20 and 21 have been examined. All markers have been tested in the Amish and Icelandic families, and a portion of them in the UCSD/UBC families, which we have only recently begun genotyping. The following candidate genes have been examined: {beta}-TSH, dopamine transporter (HDAT), {beta}2 adrenergic receptor (ADRB2), glucocorticoid type II receptor (GRL), D2 dopamine receptor, serotonin transporter (HSERT), and G{alpha}s G protein subunit (GNAS1). Linkage analysis was conducted using an autosomal dominant model with age-dependent reduced penetrance. Subjects with bipolar, schizoaffective, or recurrent major depressive disorders were considered affected. No significant evidence for linkage was obtained. Mildly positive lods ranging between 1.1 and 1.6 were obtained for three loci: D11S29, HDAT, and GRL.

  14. Characterization and influence of cardiac background sodium current in the atrioventricular node

    OpenAIRE

    Cheng, Hongwei; Li, Jue; James, Andrew F.; Inada, Shin; Choisy, Stéphanie C.M.; Orchard, Clive H.; Zhang, Henggui; Boyett, Mark R.; Hancox, Jules C.

    2016-01-01

    Background inward sodium current (IB,Na) that influences cardiac pacemaking has been comparatively under-investigated. The aim of this study was to determine for the first time the properties and role of IB,Na in cells from the heart's secondary pacemaker, the atrioventricular node (AVN). Myocytes were isolated from the AVN of adult male rabbits and mice using mechanical and enzymatic dispersion. Background current was measured using whole-cell patch clamp and monovalent ion substitution with...

  15. Adverse Effects in the Pharmacologic Management of Bipolar Disorder During Pregnancy.

    Science.gov (United States)

    Hogan, Charlotte S; Freeman, Marlene P

    2016-09-01

    Management of bipolar disorder during pregnancy often involves medications with potential adverse effects, including risks to the mother and fetus. Although some specifics are known, many medications continue to have incompletely characterized reproductive safety profiles. Women with bipolar disorder who are planning pregnancy face challenging decisions about their treatment; careful risk-benefit discussions are necessary. With the goal of further informing these discussions, this article reviews the data currently available regarding medication safety in the management of bipolar disorder during pregnancy, with specific attention to lithium, valproic acid, lamotrigine, carbamazepine, and antipsychotic medications. PMID:27514299

  16. Use of an active fixation lead and a subpectoral pacemaker pocket may not avoid Twiddler′s syndrome

    Directory of Open Access Journals (Sweden)

    Floris E A Udink ten Cate

    2012-01-01

    Full Text Available Manipulation of a pacemaker with consequent malfunction of the device has been called Twiddler′s syndrome. Use of active-fixation leads and subpectoral pacemaker pockets has been considered to help in avoiding this problem. We describe a child in whom twiddling was not prevented despite implantation of a lumenless atrial lead and insertion of the pacemaker generator in a subpectoral pocket.

  17. A novel non invasive measurement of hemodynamic parameters: Comparison of single-chamber ventricular and dual-chamber pacemaker

    OpenAIRE

    Ingrid M. Pardede; Yoga Yuniadi

    2008-01-01

    We carried out a cross sectional study to analyze hemodynamic parameters of single-chamber ventricular pacemaker compared with dual-chamber pacemaker by using thoracic electrical bioimpedance monitoring method (Physio Flow™) - a novel simple non-invasive measurement. A total of 48 consecutive outpatients comprised of 27 single chamber pacemaker and 21 dual chamber were analyzed. We measured cardiac parameters: heart rate, stroke volume index, cardiac output index, estimated ejection fraction,...

  18. Responsabilidade penal no transtorno bipolar Penal responsibility in bipolar disorder

    Directory of Open Access Journals (Sweden)

    Alexandre Martins Valença

    2010-01-01

    Full Text Available Os autores relatam o caso de uma mulher que cometeu delito de assalto e foi avaliada em perícia psiquiátrica para análise da responsabilidade penal. Conclui-se que ela apresentava doença mental, na forma de transtorno bipolar, daí ser inimputável. A avaliação da responsabilidade penal é de extrema importância, para que se possam aplicar medidas de segurança ou sanções penais e correcionais adequadas a cada caso.The authors report a case of a woman who committed the crime of assault and was evaluated in penal imputability exam to assess criminal responsibility. It was concluded that she had a mental illness, bipolar disorder, being inimputable. The evaluation of penal responsibility is extremely important, in order to apply adequate involuntary commitment or correctional and penal sanctions to each case.

  19. Ziprasidone in the treatment of mania in bipolar disorder

    Directory of Open Access Journals (Sweden)

    Stephen E Nicolson

    2007-01-01

    Full Text Available Stephen E Nicolson1, Charles B Nemeroff21From the Department of Psychiatry, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA; 2From the Department of Psychiatry and Behavioral Sciences, Emory University, School of Medicine, Atlanta, GA, USAAbstract: Ziprasidone is an atypical antipsychotic with a unique receptor-binding profile. Currently, ziprasidone is approved by the US Food and Drug Administration for the acute treatment of psychosis in schizophrenia and mania in bipolar disorder. When compared to certain other atypical antipsychotics, ziprasidone appears to have a relatively benign side effect profile, especially as regards metabolic effects eg, weight gain, serum lipid elevations and glucose dysregulation. Taken together, these data suggest that ziprasidone may be a first line treatment for patients with bipolar mania. However, ziprasidone is a relatively new medication for which adverse events after long-term use and/or in vulnerable patient populations must be studied. Unstudied areas of particular importance include the efficacy and safety of ziprasidone in the treatment of bipolar depression and relapse prevention of mania as, well as in the subpopulations of pregnant women, the elderly and pediatric patients. The emergence of mania in patients taking ziprasidone is another topic for further study.Keywords: antipsychotic, bipolar disorder, mania, mood disorder, neuroleptic, ziprasidone

  20. Treatment of bipolar disorder: a complex treatment for a multi-faceted disorder

    OpenAIRE

    Fresno David; Oral Timucin; Magiria Stamatia; Valenti Marc; Siamouli Melina; Vieta Eduard; Fountoulakis Konstantinos N; Giannakopoulos Panteleimon; Kaprinis George S

    2007-01-01

    Abstract Background Manic-depression or bipolar disorder (BD) is a multi-faceted illness with an inevitably complex treatment. Methods This article summarizes the current status of our knowledge and practice of its treatment. Results It is widely accepted that lithium is moderately useful during all phases of bipolar illness and it might possess a specific effectiveness on suicidal prevention. Both first and second generation antipsychotics are widely used and the FDA has approved olanzapine,...

  1. Bipolar Disorder: Clinical Perspectives and Implications with Cognitive Dysfunction and Dementia

    OpenAIRE

    Lopes, R; Fernandes, L

    2012-01-01

    Introduction. Cognitive dysfunction as a core feature in the course of bipolar affective disorder (BPD) is a current subject of debate and represents an important source of psychosocial and functional burden. Objectives. To stand out the connection and clinical implications between cognitive dysfunction, dementia, and BPD. Methods. A nonsystematic review of all English language PubMed articles published between 1995 and 2011 using the terms “bipolar disorder,” “cognitive dysfunction,” and “de...

  2. Employment Of IGBT-Transistors For Bipolar Impulsed Micro-Arc Oxidation

    OpenAIRE

    Krainyukov Alexander; Kutev Valery

    2015-01-01

    The paper is devoted to the use of insulated gate bipolar transistors (IGBT) for the micro-arc oxidation (MAO) process. The technical requirements to the current switches of power supplies for the pulsed bipolar MAO technology have been developed. The research installation for investigating the IGBT commutation processes during the pulse anode-cathode oxidation has been constructed. The experiments have been performed with its help in order to estimate the possibility of using half-bridge IGB...

  3. The International Society for Bipolar Disorders (ISBD) Task Force Report on Antidepressant Use in Bipolar Disorders

    NARCIS (Netherlands)

    Pacchiarotti, Isabella; Bond, David J.; Baldessarini, Ross J.; Nolen, Willem A.; Grunze, Heinz; Licht, Rasmus W.; Post, Robert M.; Berk, Michael; Goodwin, Guy M.; Sachs, Gary S.; Tondo, Leonardo; Findling, Robert L.; Youngstrom, Eric A.; Tohen, Mauricio; Undurraga, Juan; Gonzalez-Pinto, Ana; Goldberg, Joseph F.; Yildiz, Aysegul; Altshuler, Lori L.; Calabrese, Joseph R.; Mitchell, Philip B.; Thase, Michael E.; Koukopoulos, Athanasios; Colom, Francesc; Frye, Mark A.; Malhi, Gin S.; Fountoulakis, Konstantinos N.; Vazquez, Gustavo; Perlis, Roy H.; Ketter, Terence A.; Cassidy, Frederick; Akiskal, Hagop; Azorin, Jean-Michel; Valenti, Marc; Mazzei, Diego Hidalgo; Lafer, Beny; Kato, Tadafumi; Mazzarini, Lorenzo; Martinez-Aran, Anabel; Parker, Gordon; Souery, Daniel; Ozerdem, Aysegul; McElroy, Susan L.; Girardi, Paolo; Bauer, Michael; Yatham, Lakshmi N.; Zarate, Carlos A.; Nierenberg, Andrew A.; Birmaher, Boris; Kanba, Shigenobu; El-Mallakh, Rif S.; Serretti, Alessandro; Rihmer, Zoltan; Young, Allan H.; Kotzalidis, Georgios D.; MacQueen, Glenda M.; Bowden, Charles L.; Ghaemi, S. Nassir; Lopez-Jaramillo, Carlos; Rybakowski, Janusz; Ha, Kyooseob; Perugi, Giulio; Kasper, Siegfried; Amsterdam, Jay D.; Hirschfeld, Robert M.; Kapczinski, Flavio; Vieta, Eduard

    2013-01-01

    Objective: The risk-benefit profile of antidepressant medications in bipolar disorder is controversial. When conclusive evidence is lacking, expert consensus can guide treatment decisions. The International Society for Bipolar Disorders (ISBD) convened a task force to seek consensus recommendations

  4. Study on ionizing radiation effects of bipolar transistor with BPSG films

    International Nuclear Information System (INIS)

    Background: Because of the damage induced by ionizing radiation, bipolar transistors in integrated voltage regulator could induce the current gain degradation and increase leakage current. This will bring serious problems to electronic system. Purpose: In order to ensure the reliability of the device work in the radiation environments, the device irradiation reinforcement technology is used. Methods: The characteristics of 60Co γ irradiation and annealing at different temperatures in bipolar transistors and voltage regulators (JW117) with different passive films for SiO2+BPSG+SiO2 and SiO2+SiN have been investigated. Results: The devices with BPSG film enhanced radiation tolerance significantly. Because BPSG films have better absorption for Na+ in SiO2 layer, the surface recombination rate of base region in a bipolar transistor and the excess base current have been reduced. It may be the main reason for BJT with BPSG film having a good radiation hardness. And annealing experiments at different temperatures after irradiation ensure the reliability of the devices with BPSG films. Conclusions: A method of improving the ionizing irradiation hardness of bipolar transistors is proposed. As well as the linear integrated circuits which containing bipolar transistors, an experimental basis for the anti-ionizing radiation effects of bipolar transistors is provided. (authors)

  5. Unrecognized bipolar disorder in patients with a diagnosis of unipolar depression%诊断为单相抑郁症者中未识别的双相障碍

    Institute of Scientific and Technical Information of China (English)

    David L.DUNNER

    2011-01-01

    @@ The diagnosis of bipolar rather than unipolar depression is currently a clinicaI diagnosis which cannot be validated by specific biological measures,such as laboratory tests.Certainly the characteristics of bipolar depression frequently differ from unipolar major depression in that patients with bipolar depression generally have an earlier age of onset and more frequent episodes than individuals with unipolar major depression[1]Some,but not all,studies support an increase in suicidal behaviors among bipolar as compared with unipolar major depression[2],and"atypical features"such as hypersomnia and hyperphagia also may be found more frequently among individuals with bipolar depression.Furthermore family histories of subjects with bipolar disorders more frequently reveal relatives with bipolar disorder.In contrast,relatives of patients with unipolar depression's family history generally reflects major depression but not bipolar disorder[3].

  6. Internet use by patients with bipolar disorder

    DEFF Research Database (Denmark)

    Bauer, Rita; Conell, Jörn; Glenn, Tasha;

    2016-01-01

    There is considerable international interest in online education of patients with bipolar disorder, yet little understanding of how patients use the Internet and other sources to seek information. 1171 patients with a diagnosis of bipolar disorder in 17 countries completed a paper-based, anonymous...... on bipolar disorder or 63% of the total sample. More years of education in relation to the country mean, and feeling very confident about managing life decreased the odds of seeking information on bipolar disorder online, while having attended support groups increased the odds. Patients who looked online...... for information on bipolar disorder consulted medical professionals plus a mean of 2.3 other information sources such as books, physician handouts, and others with bipolar disorder. Patients not using the Internet consulted medical professionals plus a mean of 1.6 other information sources. The percentage...

  7. Bipolar disorder: staging and neuroprogression

    OpenAIRE

    Rodrigues, Aline André; Rosa, Adriana R.; Kunz, Maurício; Ascoli, Bruna; Kapczinski, Flávio

    2014-01-01

    In bipolar disorder illness progression has been associated with a higher number of mood episodes and hospitalizations, poorer response to treatment, and more severe cognitive and functional impairment. This supports the notion of the use of staging models in this illness. The value of staging models has long been recognized in many medical and malignant conditions. Staging models rely on the fact that different interventions may suit different stages of the disorder, and that better outcomes...

  8. Neurocognitive function in bipolar disorder: a comparison between bipolar I and II disorder and matched controls

    OpenAIRE

    Pålsson, Erik; Figueras, Clara; Johansson, Anette GM; Ekman, Carl-Johan; Hultman, Björn; Östlind, Josefin; Landén, Mikael

    2013-01-01

    Background Cognitive deficits have been documented in patients with bipolar disorder. Further, it has been suggested that the degree and type of cognitive impairment differ between bipolar I and bipolar II disorder, but data is conflicting and remains inconclusive. This study aimed to clarify the suggested differences in cognitive impairment between patients with bipolar I and II disorder in a relatively large, clinically stable sample while controlling for potential confounders. Methods 67 p...

  9. Permanent transvenous pacemaker implantation in a patient with Cor triatriatum dextrum

    Institute of Scientific and Technical Information of China (English)

    Kun; Xiang; George; V; Moukarbel; Blair; Grubb

    2015-01-01

    Cor triatriatum dextrum is an extremely rare congenital heart abnormality in which the right atrium is separatedinto two chambers by a persistent fibrous membrane. A transvenous approach to place a dual-chamber pacemaker in such patients is technically challenging. We report the first case of a transvenous permanent pacemaker placement in a patient with cor triatriatum dextrum. An 87-year-old woman was diagnosed with paroxysmal atrial fibrillation. She was accidentally found to have cor triatriatum dextrum during the transesophageal echocardiography(TEE) prior to cardioversion. Later during her hospital stay, it was indicated to place a permanant pacemaker due to high grade atrioventricular block. After thorough reviewing TEE imagings, a transvenous catheter-based approach was decided feasible. Patient successfully received a dual chamber pacemaker through left subclavian venous approach. Furthermore in our case, using specially designed pacemaker leads and cautious intra-procedural maneuvering under fluoroscopic guidance ensured procedural success. In summary, a thorough pre-operative evaluation with transesophageal echocardiography is critical for the planning and eventual success of the transvenous placement of rightsided leads.

  10. Pre-ejection period by radial artery tonometry supplements echo doppler findings during biventricular pacemaker optimization

    Directory of Open Access Journals (Sweden)

    Qamruddin Salima

    2011-07-01

    Full Text Available Abstract Background Biventricular (Biv pacemaker echo optimization has been shown to improve cardiac output however is not routinely used due to its complexity. We investigated the role of a simple method involving computerized pre-ejection time (PEP assessment by radial artery tonometry in guiding Biv pacemaker optimization. Methods Blinded echo and radial artery tonometry were performed simultaneously in 37 patients, age 69.1 ± 12.8 years, left ventricular (LV ejection fraction (EF 33 ± 10%, during Biv pacemaker optimization. Effect of optimization on echo derived velocity time integral (VTI, ejection time (ET, myocardial performance index (MPI, radial artery tonometry derived PEP and echo-radial artery tonometry derived PEP/VTI and PEP/ET indices was evaluated. Results Significant improvement post optimization was achieved in LV ET (286.9 ± 37.3 to 299 ± 34.6 ms, p Conclusion An acute shortening of PEP by radial artery tonometry occurs post Biv pacemaker optimization and correlates with improvement in hemodynamics by echo Doppler and may provide a cost-efficient approach to assist with Biv pacemaker echo optimization.

  11. Metabolic syndrome in bipolar disorders

    Directory of Open Access Journals (Sweden)

    Sandeep Grover

    2012-01-01

    Full Text Available To review the data with respect to prevalence and risk factors of metabolic syndrome (MetS in bipolar disorder patients. Electronic searches were done in PUBMED, Google Scholar and Science direct. From 2004 to June 2011, 34 articles were found which reported on the prevalence of MetS. The sample size of these studies varied from 15 to 822 patients, and the rates of MetS vary widely from 16.7% to 67% across different studies. None of the sociodemographic variable has emerged as a consistent risk factor for MetS. Among the clinical variables longer duration of illness, bipolar disorder- I, with greater number of lifetime depressive and manic episodes, and with more severe and difficult-to-treat index affective episode, with depression at onset and during acute episodes, lower in severity of mania during the index episode, later age of onset at first manic episode, later age at first treatment for the first treatment for both phases, less healthy diet as rated by patients themselves, absence of physical activity and family history of diabetes mellitus have been reported as clinical risk factors of MetS. Data suggests that metabolic syndrome is fairly prevalent in bipolar disorder patients.

  12. Bipolar Experiences and Self-Identity

    OpenAIRE

    Bedford, Rosie

    2012-01-01

    Background: Bipolar II disorder has a prevalence rate of approximately 0.4% in adults and 1.5% in adolescents, with the onset typically around 18 years old (Merikangas & Lamers, 2012). As the age of onset is during adolescent years the impact on identity is of special interest. Although the profound impact bipolar has on an individual’s sense of self has surfaced as a predominant theme in the bipolar literature, there remains a dearth of research directly addressing this impact. ...

  13. Major Ups and Downs: Bipolar Disorder Brings Extreme Mood Swings

    Science.gov (United States)

    ... our exit disclaimer . Subscribe Major Ups and Downs Bipolar Disorder Brings Extreme Mood Swings Most people feel happy ... Strike Out Stroke Wise Choices Links Dealing with Bipolar Disorder If you have bipolar disorder, get treatment and ...

  14. Course of Subthreshold Bipolar Disorder in Youth: Diagnostic Progression from Bipolar Disorder Not Otherwise Specified

    Science.gov (United States)

    Axelson, David A.; Birmaher, Boris; Strober, Michael A.; Goldstein, Benjamin I.; Ha, Wonho; Gill, Mary Kay; Goldstein, Tina R.; Yen, Shirley; Hower, Heather; Hunt, Jeffrey I.; Liao, Fangzi; Iyengar, Satish; Dickstein, Daniel; Kim, Eunice; Ryan, Neal D.; Frankel, Erica; Keller, Martin B.

    2011-01-01

    Objective: To determine the rate of diagnostic conversion from an operationalized diagnosis of bipolar disorder not otherwise specified (BP-NOS) to bipolar I disorder (BP-I) or bipolar II disorder (BP-II) in youth over prospective follow-up and to identify factors associated with conversion. Method: Subjects were 140 children and adolescents…

  15. GABAergic neuroactive steroids: a new frontier in bipolar disorders?

    Directory of Open Access Journals (Sweden)

    Carta Mauro Giovanni

    2012-12-01

    Full Text Available Abstract Neurosteroids are synthesized in the brain and modulate brain excitability. There is increasing evidence of their sedative, anesthetic and antiseizure properties, as well as their influence on mood. Currently neurosteroids are classified as pregnane neurosteroids (allopregnanolone and allotetrahydrodeoxycorticosterone, androstane neurosteroids (androstanediol and etiocholanone or sulfated neurosteroids (pregnenolone sulfate and dehydroepiandrosterone sulfate. Both preclinical and clinical findings indicate that progesterone derivative neurosteroids such as allopregnanolone and allotetrahydrodeoxycorticosterone play a role in mood disorders. Clozapine and olanzapine, which were shown to be effective in stabilizing bipolar disorder, elevate pregnenolone levels in rat hippocampus, cerebral cortex, and serum. In lithium-treated mice, the blood levels of allopregnanolone and pregnenolone were elevated compared to control levels. Women diagnosed with bipolar disorder typically show symptomatic exacerbation in relation to the menstrual cycle, and show vulnerability to the onset or recurrence of mood disorders immediately after giving birth, when the levels of neurosteroid derivatives of progesterone drop. Whereas in women who had recovered from bipolar disorder, the plasma concentration of allopregnanolone was elevated compared to either healthy controls or women with major depressive disorder during the premenstrual period. During depressive episodes, blood level of allopregnanolone is low. Treatment with fluoxetine tends to stabilize the levels of neurosteroids in depression. These findings converge to suggest that these steroids have significant mood-stabilizing effect. This hypothesis is consistent with the observation that a number of anticonvulsants are effective therapies for bipolar disorder, a finding also consistent with the antiseizure properties of neurosteroids. Further exploration of action of neuroactive steroids is likely to

  16. [Oxidative stress in bipolar affective disorder].

    Science.gov (United States)

    Reininghaus, E Z; Zelzer, S; Reininghaus, B; Lackner, N; Birner, A; Bengesser, S A; Fellendorf, F T; Kapfhammer, H-P; Mangge, H

    2014-09-01

    The results of mortality studies have indicated that medical conditions, such as cardiovascular disease, obesity and diabetes are the most important causes of mortality among patients with bipolar disorder. The reasons for the increased incidence and mortality are not fully understood. Oxidative stress and an inadequate antioxidative system might be one missing link and could also help to further elucidate the pathophysiological basis of bipolar disorder. This article provides a comprehensive review of oxidative stress in general and about the existing data for bipolar disorder. In addition information is given about possible therapeutic strategies to reduce oxidative stress and the use in bipolar disorder. PMID:24441847

  17. TBX18 gene induces adipose-derived stem cells to differentiate into pacemaker-like cells in the myocardial microenvironment

    Science.gov (United States)

    Yang, Mei; Zhang, Ge-Ge; Wang, Teng; Wang, Xi; Tang, Yan-Hong; Huang, He; Barajas-Martinez, Hector; Hu, Dan; Huang, Cong-Xin

    2016-01-01

    T-box 18 (TBX18) plays a crucial role in the formation and development of the head of the sinoatrial node. The objective of this study was to induce adipose-derived stem cells (ADSCs) to produce pacemaker-like cells by transfection with the TBX18 gene. A recombinant adenovirus vector carrying the human TBX18 gene was constructed to transfect ADSCs. The ADSCs transfected with TBX18 were considered the TBX18-ADSCs. The control group was the GFP-ADSCs. The transfected cells were co-cultured with neonatal rat ventricular cardiomyocytes (NRVMs). The results showed that the mRNA expression of TBX18 in TBX18-ADSCs was significantly higher than in the control group after 48 h and 7 days. After 7 days of co-culturing with NRVMs, there was no significant difference in the expression of the myocardial marker cardiac troponin I (cTnI) between the two groups. RT-qPCR and western blot analysis showed that the expression of HCN4 was higher in the TBX18-ADSCs than in the GFP-ADSCs. The If current was detected using the whole cell patch clamp technique and was blocked by the specific blocker CsCl. Human induced pluripotent stem cell-derived cardiomyocytes (hiPSCMs) showed approximately twice the current density compared with the ADSCs. Our study indicated that the TBX18 gene induces ADSCs to differentiate into pacemaker-like cells in the cardiac microenvironment. Although further experiments are required in order to assess safety and efficacy prior to implementation in clinical practice, this technique may provide new avenues for the clinical therapy of bradycardia. PMID:27632938

  18. Doping To Reduce Base Resistances Of Bipolar Transistors

    Science.gov (United States)

    Lin, True-Lon

    1991-01-01

    Modified doping profile proposed to reduce base resistance of bipolar transistors. A p/p+ base-doping profile reduces base resistance without reducing current gain. Proposed low/high base-doping profile realized by such low-temperature deposition techniques as molecular-beam epitaxy, ultra-high-vacuum chemical-vapor deposition, and limited-reaction epitaxy. Produces desired doping profiles without excessive diffusion of dopant.

  19. Innovative approaches to bipolar disorder and its treatment

    OpenAIRE

    Harrison, Paul J.; Cipriani, Andrea; Harmer, Catherine J.; Nobre, Anna C.; Saunders, Kate; Goodwin, Guy M.; Geddes, John R.

    2016-01-01

    All psychiatric disorders have suffered from a dearth of truly novel pharmacological interventions. In bipolar disorder, lithium remains a mainstay of treatment, six decades since its effects were serendipitously discovered. The lack of progress reflects several factors, including ignorance of the disorder's pathophysiology and the complexities of the clinical phenotype. After reviewing the current status, we discuss some ways forward. First, we highlight the need for a richer characterizatio...

  20. [The computer assisted pacemaker clinic at the regional hospital of Udine (author's transl)].

    Science.gov (United States)

    Feruglio, G A; Lestuzzi, L; Carminati, D

    1978-01-01

    For a close follow-up of large groups of pacemaker patients and for evaluation of long term pacing on a reliable statistical basis, many pacemaker centers in the world are now using computer systems. A patient data system with structured display records, designed to give complete, comprehensive and surveyable information and which are immediately retrievable 24 hours a day, on display or printed sets, seems to offer an ideal solution. The pacemaker clinic at the Regional Hospital of Udine has adopted this type of system. The clinic in linked to a live, on-line patient data system (G/3, Informatica Friuli-Venezia Giulia). The input and retrieval of information are made through a conventional keyboard. The input formats have fixed headings with coded alternatives and a limited space for comments in free text. The computer edits the coded information to surveyable reviews. Searches can be made on coded information and data of interest.

  1. Dynamic Breast Magnetic Resonance Imaging without Complications in a Patient with Dual-Chamber Demand Pacemaker

    Energy Technology Data Exchange (ETDEWEB)

    Sardanelli, F.; Lupo, P.; Esseridou, A.; Fausto, A.; Quarenghi, M. [Policlinico San Donato, San Donato Milanese, Milan (Italy). Depts. of Radiology, Arrhythmia and Electrophysiology Center

    2006-02-15

    Mammography and ultrasound indicated a cancer of the right breast in a 77-year-old woman with a dual-chamber demand pacemaker. The patient was not pacemaker-dependent. She underwent breast 1.5T magnetic resonance imaging (MRI) (dynamic gradient echo sequence with Gd-DOTA 0.1 mmol/kg). Before the patient entered the MR room, the configuration of the device was changed (the response to magnet was switched from asynchronous to off and the rate-responsive algorithm was disabled). No relevant modifications of heart rhythm or rate were observed during the MR examination. No symptom was reported. Immediately after the examination, the pacemaker interrogation showed neither program changes nor alert warnings. MRI detected a bifocal cancer in the right breast which allowed tailored breast-conserving treatment to be initiated. Histopathology confirmed a bifocal invasive ductal carcinoma.

  2. [Verification of irradiation conditions of X-rays that influence implantable cardiac pacemakers].

    Science.gov (United States)

    Umezawa, Naoki; Hirose, Minoru; Shinbo, Toshihiro

    2008-07-20

    Originally, it was thought that X-rays did not influence implantable cardiac pacemakers. In general, radiological technologists did not take proper care of these devises at the time of X-Ray examinations. However, 11 cases in which pacemakers malfunctioned (for example partial electrical reset) during CT examinations have been reported in recent years. At the time, we tended to attribute such problems to the peculiarities of multi-detector CT (MDCT). However, on logical grounds this explanation seemed weak. To better explain the problem, we attempted various tests in which pacemakers were exposed to CT and X-ray photography equipment. We analyzed some ECG results to clarify the matter and took measurements to examine these problems. PMID:18719296

  3. Risk of pacemaker implantation subsequent to radiotherapy for early-stage breast cancer in Denmark, 1982-2005

    DEFF Research Database (Denmark)

    Rehammar, Jens Christian; Videbaek, L.; Brock Johansen, J.;

    2015-01-01

    . Objectives: The aim of this study was to examine the risk of severe conduction abnormalities evaluated by implantation of a pacemaker, subsequent to breast cancer radiotherapy. Methods: From the database of the Danish Breast Cancer Collaborative Group, we identified women treated with radiotherapy for early......-stage breast cancer in Denmark from 1982 to 2005. By record linkage to the Danish Pacemaker and ICD Registry information was retrieved on pacemaker implants subsequent to radiotherapy. Rate ratios (RR) of pacemaker implantation for left versus right sided breast cancer were calculated. Results: Among 18......,308 women treated with radiotherapy for early-stage breast cancer, 179 women had a pacemaker implanted subsequent to radiotherapy, 90 in 9,315 left sided and 89 in 8,993 right sided breast cancers. The unadjusted RR was 1.02 (0.76-1.36 95% CI, p=0.91) and the RR adjusted for year, age and time since...

  4. Bipolar depression: the importance of being on remission Depressão bipolar: a importância da remissão

    OpenAIRE

    Fernando Kratz Gazalle; Ana Cristina Andreazza; Pedro Curi Hallal; Márcia Kauer-Sant'Anna; Keila Maria Ceresér; Soares, Jair C; Aida Santin; Flávio Kapczinski

    2006-01-01

    OBJECTIVE: The aim of the present study is to compare quality of life among currently depressed, subsyndromal and remitted patients with bipolar disorder (BD) and to assess whether the level of depression correlates with the scores of quality of life in BD patients. METHOD: Sixty bipolar outpatients diagnosed using the Structured Clinical Interview for DSM-IV who met criteria for diagnosis of BD type I, II or not otherwise specified (BD-NOS), and who were not currently on a manic or mixed epi...

  5. Application of bipolar electrodialysis on recovery of free lactic acid after simultaneous saccharification and fermentation of cassava starch.

    Science.gov (United States)

    Timbuntam, Walaiporn; Sriroth, Klanarong; Piyachomkwan, Kuakoon; Tokiwa, Yutaka

    2008-10-01

    The efficiency of bipolar electrodialysis (BED) for the recovery of lactic acid from fermentation broth was evaluated. Three systems of BED (bipolar-anion, bipolar-cation and bipolar-anion-cation) at fixed voltage (20 V) were compared using a model solution of ammonium lactate (100 g l(-1)). Results showed that bipolar-anion (BED-anion) was the most beneficial in terms of lactate flux, current efficiency, energy consumption and recovery ratio. Consequently, BED-anion was used to purify lactic acid from fermentation broth which had been pre-treated with mono-polar electrodialysis (MED). The final lactic acid concentration and lactate flux obtained were 144 g l(-1) and 393 g m(-2) h(-1), respectively. Using the two-step process (MED and BED-anion) the concentration of fermentation broth was increased by 33% and the total energy consumption was 2.76 kW h kg(-1).

  6. [Superior vena cava syndrome after pacemaker implantation. Increased risk with DDD-systems? Case report].

    Science.gov (United States)

    Minale, C; Splittgerber, F H; Niehage, D

    1992-04-01

    Superior vena cava syndrome due to transvenous pacing leads is a rare event. Local infection as well as multiple leads are important predisposing factors. The case of a patient with superior caval syndrome after multiple complicated permanent pacemaker insertions is presented. Medical treatment was unsuccessful. At operation a fibrous narrowing of the vena cava superior was found. The two leads (DDD-pacemaker) were left in place. A Goretex patch was used for enlargement of the anterior wall of the vein. Postoperatively, the patient remained free of symptoms and the vein was patent angiographically. In case of failure of medical management surgical correction should be attempted without delay. PMID:1604927

  7. Reduction of atrial fibrillation in remotely monitored pacemaker patients: results from a Chinese multicentre registry

    Institute of Scientific and Technical Information of China (English)

    CHEN Ke-ping; DAI Yan; HUA Wei; YANG Jie-fu; LI Kang; LIANG Zhao-guang; SHEN Fa-rong

    2013-01-01

    Background Many recipients of implantable cardiac electronic devices have atrial fibrillation (AF) occurrences after device implantation,even if there is no previous history of AF,and some of the episodes are asymptomatic.The purpose of this study was to evaluate trends in AF burden following early AF detection in patients treated with pacemakers equipped with automatic,daily Home Monitoring function.Methods Between February 2009 and December 2010,the registry recruited 701 pacemaker patients (628 dual-chamber,73 biventricular devices) at 97 clinical centers in China.Daily Home Monitoring data transmissions were analyzed to screen for the AF burden.In-office follow-ups were scheduled for 3 and 6 months after implantation.Upon first AF (i.e.,mode-switch) detection in a patient,screening of AF burden by Home Monitoring was extended for the next 180 days.Results At least one episode of AF was observed in 22.9% of patients with dual-chamber pacemakers and in 28.8% of patients with biventricular pacemakers.The first AF detection in a patient occurred,on average,about 2 months before scheduled follow-up visits.In both pacemaker groups,mean AF burden decreased significantly (P<0.05) over 180 days following first AF detection:from 12.0% to 2.5% in dual-chamber and from 12.2% to 0.5% in biventricular pacemaker recipients.The number of patients with an AF burden >10% per month was significantly reduced over 6 months of implantation in both dual chamber (38 patients in the first month vs.21 patients in month 6,P<0.05) and biventricular (7 patients in the first month vs.0 patient in months 4-6,P<0.05) pacemaker recipients.Conclusions Automatic,daily Home Monitoring of patients treated with cardiac pacemakers allows early detection of AF,and there is a gradual and significant decrease in AF burden.

  8. Toward complementary ionic circuits: the npn ion bipolar junction transistor.

    Science.gov (United States)

    Tybrandt, Klas; Gabrielsson, Erik O; Berggren, Magnus

    2011-07-01

    Many biomolecules are charged and may therefore be transported with ionic currents. As a step toward addressable ionic delivery circuits, we report on the development of a npn ion bipolar junction transistor (npn-IBJT) as an active control element of anionic currents in general, and specifically, demonstrate actively modulated delivery of the neurotransmitter glutamic acid. The functional materials of this transistor are ion exchange layers and conjugated polymers. The npn-IBJT shows stable transistor characteristics over extensive time of operation and ion current switch times below 10 s. Our results promise complementary chemical circuits similar to the electronic equivalence, which has proven invaluable in conventional electronic applications. PMID:21598973

  9. Management of radiation oncology patients with a pacemaker or ICD: A new comprehensive practical guideline in The Netherlands

    International Nuclear Information System (INIS)

    Current clinical guidelines for the management of radiotherapy patients having either a pacemaker or implantable cardioverter defibrillator (both CIEDs: Cardiac Implantable Electronic Devices) do not cover modern radiotherapy techniques and do not take the patient’s perspective into account. Available data on the frequency and cause of CIED failure during radiation therapy are limited and do not converge. The Dutch Society of Radiotherapy and Oncology (NVRO) initiated a multidisciplinary task group consisting of clinical physicists, cardiologists, radiation oncologists, pacemaker and ICD technologists to develop evidence based consensus guidelines for the management of CIED patients. CIED patients receiving radiotherapy should be categorised based on the chance of device failure and the clinical consequences in case of failure. Although there is no clear cut-off point nor a clear linear relationship, in general, chances of device failure increase with increasing doses. Clinical consequences of device failures like loss of pacing, carry the most risks in pacing dependent patients. Cumulative dose and pacing dependency have been combined to categorise patients into low, medium and high risk groups. Patients receiving a dose of less than 2 Gy to their CIED are categorised as low risk, unless pacing dependent since then they are medium risk. Between 2 and 10 Gy, all patients are categorised as medium risk, while above 10 Gy every patient is categorised as high risk. Measures to secure patient safety are described for each category. This guideline for the management of CIED patients receiving radiotherapy takes into account modern radiotherapy techniques, CIED technology, the patients’ perspective and the practical aspects necessary for the safe management of these patients. The guideline is implemented in The Netherlands in 2012 and is expected to find clinical acceptance outside The Netherlands as well

  10. Transient Stuttering in Catatonic Bipolar Patients

    Directory of Open Access Journals (Sweden)

    Anthony B. Joseph

    1991-01-01

    Full Text Available Two cases of transient stuttering occurring in association with catatonia and bipolar disorder are described. Affective decompensation has been associated with lateralized cerebral dysfunction, and it is hypothesized that in some bipolar catatonic patients a concomitant disorder of the lateralization of language function may lead to a variety of clinical presentations including aphasia, mutism, and stuttering.

  11. Bipolar Disorder and Cognitive Therapy: A Commentary

    Science.gov (United States)

    Riskind, John H.

    2005-01-01

    This article comments on the three articles (Leahy, 2005; Newman, 2005; and Reilly-Harrington & Knauz, 2005) that deal with the applications of cognitive therapy to treatment of bipolar disorder. They focus on the uses of cognitive therapy in treating three important facets of the special problems of bipolar patients: rapid cycling, severe…

  12. Developmental staging models in bipolar disorder

    OpenAIRE

    Passos, Ives C; Jansen, Karen; Kapczinski, Flavio

    2015-01-01

    The previous contribution of Duffy and colleagues suggests that a chain of behavioral events starting during childhood precedes the development of full-blown bipolar disorder. In this vein, the recent contribution of Keown-Stoneman and colleagues brings a new perspective to the study of prodromal symptoms of bipolar disorder.

  13. Modeling "Soft" Errors in Bipolar Integrated Circuits

    Science.gov (United States)

    Zoutendyk, J.; Benumof, R.; Vonroos, O.

    1985-01-01

    Mathematical models represent single-event upset in bipolar memory chips. Physics of single-event upset in integrated circuits discussed in theoretical paper. Pair of companion reports present mathematical models to predict critical charges for producing single-event upset in bipolar randomaccess memory (RAM) chips.

  14. Swimming in Deep Water: Childhood Bipolar Disorder

    Science.gov (United States)

    Senokossoff, Gwyn W.; Stoddard, Kim

    2009-01-01

    The authors focused on one parent's struggles in finding a diagnosis and intervention for a child who had bipolar disorder. The authors explain the process of identification, diagnosis, and intervention of a child who had bipolar disorder. In addition to the personal story, the authors provide information on the disorder and outline strategies…

  15. Bipolar disorder diagnosis: challenges and future directions.

    Science.gov (United States)

    Phillips, Mary L; Kupfer, David J

    2013-05-11

    Bipolar disorder refers to a group of affective disorders, which together are characterised by depressive and manic or hypomanic episodes. These disorders include: bipolar disorder type I (depressive and manic episodes: this disorder can be diagnosed on the basis of one manic episode); bipolar disorder type II (depressive and hypomanic episodes); cyclothymic disorder (hypomanic and depressive symptoms that do not meet criteria for depressive episodes); and bipolar disorder not otherwise specified (depressive and hypomanic-like symptoms that do not meet the diagnostic criteria for any of the aforementioned disorders). Bipolar disorder type II is especially difficult to diagnose accurately because of the difficulty in differentiation of this disorder from recurrent unipolar depression (recurrent depressive episodes) in depressed patients. The identification of objective biomarkers that represent pathophysiologic processes that differ between bipolar disorder and unipolar depression can both inform bipolar disorder diagnosis and provide biological targets for the development of new and personalised treatments. Neuroimaging studies could help the identification of biomarkers that differentiate bipolar disorder from unipolar depression, but the problem in detection of a clear boundary between these disorders suggests that they might be better represented as a continuum of affective disorders. Innovative combinations of neuroimaging and pattern recognition approaches can identify individual patterns of neural structure and function that accurately ascertain where a patient might lie on a behavioural scale. Ultimately, an integrative approach, with several biological measurements using different scales, could yield patterns of biomarkers (biosignatures) to help identify biological targets for personalised and new treatments for all affective disorders. PMID:23663952

  16. Diagnostic stability in pediatric bipolar disorder

    DEFF Research Database (Denmark)

    Vedel Kessing, Lars; Vradi, Eleni; Andersen, Per Kragh

    2015-01-01

    BACKGROUND: The diagnostic stability of pediatric bipolar disorder has not been investigated previously. The aim was to investigate the diagnostic stability of the ICD-10 diagnosis of pediatric mania/bipolar disorder.METHODS: All patients below 19 years of age who got a diagnosis of mania/bipolar...... disorder at least once in a period from 1994 to 2012 at psychiatric inpatient or outpatient contact in Denmark were identified in a nationwide register.RESULTS: Totally, 354 children and adolescents got a diagnosis of mania/bipolar disorder at least once; a minority, 144 patients (40.7%) got the diagnosis...... at the first contact whereas the remaining patients (210; 59.3%) got the diagnosis at later contacts before age 19. For the latter patients, the median time elapsed from first treatment contact with the psychiatric service system to the first diagnosis with a manic episode/bipolar disorder was nearly 1 year...

  17. Thyroid Functions and Bipolar Affective Disorder

    Directory of Open Access Journals (Sweden)

    Subho Chakrabarti

    2011-01-01

    Full Text Available Accumulating evidence suggests that hypothalamo-pituitary-thyroid (HPT axis dysfunction is relevant to the pathophysiology and clinical course of bipolar affective disorder. Hypothyroidism, either overt or more commonly subclinical, appears to the commonest abnormality found in bipolar disorder. The prevalence of thyroid dysfunction is also likely to be greater among patients with rapid cycling and other refractory forms of the disorder. Lithium-treatment has potent antithyroid effects and can induce hypothyroidism or exacerbate a preexisting hypothyroid state. Even minor perturbations of the HPT axis may affect the outcome of bipolar disorder, necessitating careful monitoring of thyroid functions of patients on treatment. Supplementation with high dose thyroxine can be considered in some patients with treatment-refractory bipolar disorder. Neurotransmitter, neuroimaging, and genetic studies have begun to provide clues, which could lead to an improved understanding of the thyroid-bipolar disorder connection, and more optimal ways of managing this potentially disabling condition.

  18. Could Harmonic Scalpel (Ultracision®) be considered the best device in surgical treatment of vulvar cancer of patients with implanted pace-maker? Proposal and rationale

    Science.gov (United States)

    Gizzo, Salvatore; Andrisani, Alessandra; Ancona, Emanuele; Quaranta, Michela; Vitagliano, Amerigo; Noventa, Marco; Nardelli, Giovanni Battista; Ambrosini, Guido

    2015-01-01

    Vulvar cancer (VC) represents about 4% of gynecologic malignancies, its incidence increases with age and peak incidence is found between 70-79 years. In cases of locally advanced disease surgery is often required and radical vulvectomy, with or without mono-bilateral inguino-femoral lymphadenectomy, is standard management. Various devices have been implemented in gynecological surgery in an attempt to minimize or avoid frequent intra/postoperative complications linked to energy use, unfortunately the majority of these devices require monopolar or bipolar energy. Ultracision® represents a unique surgical device capable of performing both cutting and coagulation at different intensities without use of electric energy. The use of Ultracision® in the radical treatment of VC has advantages both in terms of intraoperative and postoperative complications responsible for the reduction of surgical time and blood loss, complete tissue removal according to oncological criteria, diminished desensitization of peripheral areas and reduction of wound complications. These advantages have been widely demonstrated and contribute to making Ultracision® a cost-effective option in the routine treatment of patients affected by vulvar cancer especially when considering its safety in cardiopathic patients with implanted pacemaker. If the impressive results achieved in radical vulvar surgery will be confirmed, scalpel use could be proposed as routine for surgery of the routinely in surgical approach of vulvar and perineal area, in both benign and malignant disease. PMID:26309660

  19. Modeling and Simulation of Photoelectronic Lambda Bipolar Transistor

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    Based on the region model of lambda bipolar transistor (LBT), a dividing region theory model of PLBT is set up,simulated and verified. Firstly, the principal operations of different kinds of photoelectronic lambda bipolar transistor (PLBT) are characterized by a simple circuit model.Through mathematical analysis of the equivalent circuit, the typical characteristics curve is divided into positive resistance, peak, negative resistance and cutoff regions. Secondly, by analyzing and simulating this model, the ratio of MOSFET width to channel length, threshold voltage and common emitter gain are discovered as the main structure parameters that determine the characteristic curves of PLBT. And peak region width, peak current value, negative resistance value and valley voltage value of PLBT can be changed conveniently according to the actual demands by modifying these parameters. Finally comparisons of the characteristics of the fabricated devices and the simulation results are made, which show that the analytical results are in agreement with the observed devices characteristics.

  20. Dynamic thermoelectricity in uniform bipolar semiconductor

    Science.gov (United States)

    Volovichev, I. N.

    2016-07-01

    The theory of the dynamic thermoelectric effect has been developed. The effect lies in an electric current flowing in a closed circuit that consists of a uniform bipolar semiconductor, in which a non-uniform temperature distribution in the form of the traveling wave is created. The calculations are performed for the one-dimensional model in the quasi-neutrality approximation. It was shown that the direct thermoelectric current prevails, despite the periodicity of the thermal excitation, the circuit homogeneity and the lack of rectifier properties of the semiconductor system. Several physical reasons underlining the dynamic thermoelectric effect are found. One of them is similar to the Dember photoelectric effect, its contribution to the current flowing is determined by the difference in the electron and hole mobilities, and is completely independent of the carrier Seebeck coefficients. The dependence of the thermoelectric short circuit current magnitude on the semiconductor parameters, as well as on the temperature wave amplitude, length and velocity is studied. It is shown that the magnitude of the thermoelectric current is proportional to the square of the temperature wave amplitude. The dependence of the thermoelectric short circuit current on the temperature wave length and velocity is the nonmonotonic function. The optimum values for the temperature wave length and velocity, at which the dynamic thermoelectric effect is the greatest, have been deduced. It is found that the thermoelectric short circuit current changes its direction with decreasing the temperature wave length under certain conditions. The prospects for the possible applications of the dynamic thermoelectric effect are also discussed.

  1. Bipolar electrochemistry: from materials science to motion and beyond.

    Science.gov (United States)

    Loget, Gabriel; Zigah, Dodzi; Bouffier, Laurent; Sojic, Neso; Kuhn, Alexander

    2013-11-19

    Bipolar electrochemistry, a phenomenon which generates an asymmetric reactivity on the surface of conductive objects in a wireless manner, is an important concept for many purposes, from analysis to materials science as well as for the generation of motion. Chemists have known the basic concept for a long time, but it has recently attracted additional attention, especially in the context of micro- and nanoscience. In this Account, we introduce the fundamentals of bipolar electrochemistry and illustrate its recent applications, with a particular focus on the fields of materials science and dynamic systems. Janus particles, named after the Roman god depicted with two faces, are currently in the heart of many original investigations. These objects exhibit different physicochemical properties on two opposite sides. This makes them a unique class of materials, showing interesting features. They have received increasing attention from the materials science community, since they can be used for a large variety of applications, ranging from sensing to photosplitting of water. So far the great majority of methods developed for the generation of Janus particles breaks the symmetry by using interfaces or surfaces. The consequence is often a low time-space yield, which limits their large scale production. In this context, chemists have successfully used bipolar electrodeposition to break the symmetry. This provides a single-step technique for the bulk production of Janus particles with a high control over the deposit structure and morphology, as well as a significantly improved yield. In this context, researchers have used the bipolar electrodeposition of molecular layers, metals, semiconductors, and insulators at one or both reactive poles of bipolar electrodes to generate a wide range of Janus particles with different size, composition and shape. In using bipolar electrochemistry as a driving force for generating motion, its intrinsic asymmetric reactivity is again the

  2. Clinical features, comorbidity, and cognitive impairment in elderly bipolar patients

    Directory of Open Access Journals (Sweden)

    Rise IV

    2016-05-01

    Full Text Available Ida Vikan Rise,1 Josep Maria Haro,2–4 Bjørn Gjervan,5,61Department of Psychiatry, Sorlandet Hospital, Arendal, Norway; 2Research Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; 3Faculty of Medicine, Universitat de Barcelona, Barcelona, Spain; 4CIBERSAM (Centro de Investigación Biomédica En Red de Salud Mental, Madrid, Spain; 5Department of Psychiatry, North-Trondelag Hospital Trust, Levanger, Norway; 6Department of Medicine, Institute of Neuromedicine, Norwegian University of Science and Technology, Trondheim, NorwayIntroduction: Data specific to late-life bipolar disorder (BD are limited. Current research is sparse and present guidelines are not adapted to this group of patients.Objectives: We present a literature review on clinical characteristics, comorbidities, and cognitive impairment in patients with late-life BD. This review discusses common comorbidities that affect BD elders and how aging might affect cognition and treatment.Methods: Eligible studies were identified in MedLine by the Medical Subject Headings terms “bipolar disorder” and “aged”. We only included original research reports published in English between 2012 and 2015.Results: From 414 articles extracted, 16 studies were included in the review. Cardiovascular and respiratory conditions, type II diabetes, and endocrinological abnormalities were observed as highly prevalent. BD is associated with a high suicide risk. Bipolar elderly had an increased risk of dementia and performed worse on cognitive screening tests compared to age-matched controls across different levels of cognition. Despite high rates of medical comorbidity among bipolar elderly, a systematic under-recognition and undertreatment of cardiovascular disease have been suggested.Conclusion: There was a high burden of physical comorbidities and cognitive impairment in late-life BD. Bipolar elderly might be under-recorded and undertreated in primary medical care, indicating that

  3. 阳性症状为主型精神分裂症和伴有精神病性症状双相障碍患者MMPI对照研究%A study on the difference of MMPI between schizophrenia with positive symptoms and bipolar disorder, current episode manic or depression with psychotic symptoms

    Institute of Scientific and Technical Information of China (English)

    钟舒明; 刘滔; 廖潇潇; 贾艳滨

    2014-01-01

    Objective To investigate the differences of personality characteristics between schizophrenia with positive symptoms and bipolar disorder, current episode manic or depression with psychotic symptoms by MMPI, which can provide clues to their differential diagnosis. Methods Twenty-four schizophrenia patients with positive symptoms and thirty-seven bipolar disorder patients, current episode manic or depression with psychotic symptoms were enrolled in this study. Subjects were tested personality with MMPI software, and then calculated the scores of ten clinical scales. All data analyses were performed using SPSS for Windows software, version 13.0, to find the differences between the two groups. Results The male schizophrenia with positive symptoms patients' social introversion(Si) score was significantly higher than female schizophrenia patients(t=2.186, P=0.040). There was no significant difference between the genders in bipolar disorder patients. No significant differences of the clinical scales were found between the two patient groups(P>0.05), however, the scores of psychopathic deviate, paranoia, schizophrenia and hypomania in schizophrenia patients with positive symptoms were higher than the T score of China norm, as well as the score of paranoia in bipolar disorder patients. Conclusions Personality characteristics changes exist in both schizophrenia with positive symptoms and bipolar disorder patients when compared with China norm, there is no significant difference between the two patient groups, social introversion in schizophrenia patients with positive symptoms may have gender differences.%目的:探讨阳性症状为主型精神分裂症和伴有精神病性症状的躁狂或抑郁的双相障碍患者的个性特征,为其鉴别诊断提供线索。方法采用MMPI测试软件,评估24例精神分裂症阳性症状为主型患者(精神分裂症组)和37例伴有精神病性症状的躁狂或抑郁的双相障碍患者(双相障碍组)人格

  4. Tilt-table testing of patients with pacemaker and recurrent syncope

    DEFF Research Database (Denmark)

    Haarmark, Christian; Kanters, Jørgen K; Mehlsen, Jesper

    2016-01-01

    The diagnosis of recurrent syncope in patients with pacemakers (PM) is quite challenging and the etiology of syncope is often multifactorial. To portray the mechanism of syncope in PM patients, we report the results of head-up tilt table testing (HUT) in a series of patients with PM, originally...

  5. Precise Estimation of Cellular Radio Electromagnetic Field in Elevators and EMI Impact on Implantable Cardiac Pacemakers

    Science.gov (United States)

    Harris, Louis-Ray; Hikage, Takashi; Nojima, Toshio

    The purpose of this paper is to investigate the possible impact of cellular phones' signals on implantable cardiac pacemakers in elevators. This is achieved by carrying out precise numerical simulations based on the Finite-Difference-Time-Domain method to examine the electromagnetic fields in elevator models. In order to examine the realistic and complicated situations where humans are present in the elevator, we apply the realistic homogeneous human phantom and cellular radios operating in the frequency bands 800MHz, 1.5GHz and 2GHz. These computed results of field strength inside the elevator are compared with a certain reference level determined from the experimentally obtained maximum interference distance of implantable cardiac pacemakers. This enables us to carry out a quantitative evaluation of the EMI risk to pacemakers by cellular radio transmission. The results show that for the case when up to 5 mobile radio users are present in the elevator model used, there is no likelihood of pacemaker malfunction for the frequency bands 800MHz, 1.5GHz and 2GHz.

  6. Reevaluation of the indications for permanent pacemaker implantation after transcatheter aortic valve implantation

    DEFF Research Database (Denmark)

    Bjerre Thygesen, Julie; Loh, Poay Huan; Cholteesupachai, Jiranut;

    2014-01-01

    AIMS: Conduction abnormalities (CA) requiring permanent pacemaker (PPM) are a well-known complication after transcatheter aortic valve implantation (TAVI). This study aimed to determine the incidence of TAVI-related PPM and reevaluate the indications for PPM after the periprocedural period. METHO...

  7. Potential additional indicators for pacemaker requirement in isolated congenital atrioventricular block.

    NARCIS (Netherlands)

    Breur, J.M.; Udink ten Cate, F.E.; Kapusta, L.; Boramanand, N.; Cohen, M.I.; Crosson, J.E.; Lubbers, L.J.; Friedman, A.H.; Brenner, J.I.; Vetter, V.L.; Meijboom, E.J.

    2006-01-01

    Low heart rate is the predominantly used indication for pacemaker intervention in patients with isolated congenital atrioventricular block (CAVB). The aim of this study was to compare the difference in heart rates recorded with ECG and Holter monitoring between paced (PM) and nonpaced (NPM) patients

  8. Potential additional indicators for pacemaker requirement in isolated congenital atrioventricular block

    NARCIS (Netherlands)

    J.M.P.J. Breur; F.E.A.U. ten Cate; L. Kapusta; N. Boramanand; M.I. Cohen; J.E. Crosson; L.J. Lubbers; A.H. Friedman; J.I. Brenner; V.L. Vetter; E.J. Meijboom

    2006-01-01

    Low heart rate is the predominantly used indication for pacemaker intervention in patients with isolated congenital atrioventricular block (CAVB). The aim of this study was to compare the difference in heart rates recorded with ECG and Holter monitoring between paced (PM) and nonpaced (NPM) patients

  9. Swim pacemakers in box jellyfish are modulated by the visual input

    DEFF Research Database (Denmark)

    Garm, Anders Lydik; Bielecki, Jan

    2008-01-01

    A major part of the cubozoan central nervous system is situated in the eye-bearing rhopalia. One of the neuronal output channels from the rhopalia carries a swim pacemaker signal, which has a one-to-one relation with the swim contractions of the bell shaped body. Given the advanced visual system...

  10. Transcription factor ISL1 is essential for pacemaker development and function.

    Science.gov (United States)

    Liang, Xingqun; Zhang, Qingquan; Cattaneo, Paola; Zhuang, Shaowei; Gong, Xiaohui; Spann, Nathanael J; Jiang, Cizhong; Cao, Xinkai; Zhao, Xiaodong; Zhang, Xiaoli; Bu, Lei; Wang, Gang; Chen, H S Vincent; Zhuang, Tao; Yan, Jie; Geng, Peng; Luo, Lina; Banerjee, Indroneal; Chen, Yihan; Glass, Christopher K; Zambon, Alexander C; Chen, Ju; Sun, Yunfu; Evans, Sylvia M

    2015-08-01

    The sinoatrial node (SAN) maintains a rhythmic heartbeat; therefore, a better understanding of factors that drive SAN development and function is crucial to generation of potential therapies, such as biological pacemakers, for sinus arrhythmias. Here, we determined that the LIM homeodomain transcription factor ISL1 plays a key role in survival, proliferation, and function of pacemaker cells throughout development. Analysis of several Isl1 mutant mouse lines, including animals harboring an SAN-specific Isl1 deletion, revealed that ISL1 within SAN is a requirement for early embryonic viability. RNA-sequencing (RNA-seq) analyses of FACS-purified cells from ISL1-deficient SANs revealed that a number of genes critical for SAN function, including those encoding transcription factors and ion channels, were downstream of ISL1. Chromatin immunoprecipitation assays performed with anti-ISL1 antibodies and chromatin extracts from FACS-purified SAN cells demonstrated that ISL1 directly binds genomic regions within several genes required for normal pacemaker function, including subunits of the L-type calcium channel, Ank2, and Tbx3. Other genes implicated in abnormal heart rhythm in humans were also direct ISL1 targets. Together, our results demonstrate that ISL1 regulates approximately one-third of SAN-specific genes, indicate that a combination of ISL1 and other SAN transcription factors could be utilized to generate pacemaker cells, and suggest ISL1 mutations may underlie sick sinus syndrome.

  11. Influence of Continuous Nursing on the Psychological State and Coping Style of Patients Undergoing Pacemaker Implantation

    Directory of Open Access Journals (Sweden)

    Xin LIU

    2015-10-01

    Full Text Available Background: Patients undergoing pacemaker implantation often experience anxiety and fear. As such, studies have focused on the mechanisms that relieve the negative emotions caused by the intervention. Continuous nursing is a safe and effective nursing mode. In this study, continuous nursing intervention was provided for elderly patients undergo-ing pacemaker implantation and an empirical investigation was performed to determine the effects of their negative emotion and disease-coping ability.Methods: Overall, 114 (68 males and 46 females elderly patients who were undergoing pacemaker implantation from Harbin City (China, were enrolled in the study. The patients were divided into two groups, namely, the control group and the intervention group, based on different nursing methods. Routine nursing was applied to the control group; continuous nursing support was provided for the intervention group from January 2014 to January 2015. The nursing results of the two groups were compared. These results were also evaluated using self-rating depression scale, self-rating anxiety scale, and trait coping style questionnaire.Result: The effects of depression and anxiety intervention were significant in the intervention group (P<0.05. Com-pared with the control group, the intervention group did not significantly differ. The coping style of the intervention group elicited significant effects. Compared with the control group, the intervention group was significantly different (P < 0.05.Conclusion: Continuous nursing can relieve the negative emotion and improve the negative coping style of patients undergoing pacemaker implantation.

  12. Sikkerhed af magnetisk resonans-skanning hos patienter med pacemaker og implanterbar defibrillator

    DEFF Research Database (Denmark)

    Al-Sabagh, Kifah Hekmat; Christensen, Britta Ege; Thøgersen, Anna Margrethe;

    2010-01-01

    INTRODUCTION: The presence of a cardiac implantable device is ICD considered an absolute contraindication to magnetic resonance imaging (MRI). The purpose of this study was to evaluate the safety of performing MRI in patients with cardiac pacemakers and ICDs that had a compelling clinical need fo...

  13. Swim pacemakers in box jellyfish are modulated by the visual input.

    Science.gov (United States)

    Garm, A; Bielecki, J

    2008-07-01

    A major part of the cubozoan central nervous system is situated in the eye-bearing rhopalia. One of the neuronal output channels from the rhopalia carries a swim pacemaker signal, which has a one-to-one relation with the swim contractions of the bell shaped body. Given the advanced visual system of box jellyfish and that the pacemaker signal originates in the vicinity of these eyes, it seems logical to assume that the pacemakers are modified by the visual input. Here, the firing frequency and distribution of inter-signal intervals (ISIs) of single pacemakers are examined in the Caribbean box jellyfish, Tripedalia cystophora. It is shown that the absolute ambient light intensity, if kept constant, has no influence on the signal, but if the intensity changes, it has a major impact on both frequency and ISIs. If the intensity suddenly drops there is an increase in firing frequency, and the ISIs become more homogeneously distributed. A rise in intensity, on the other hand, produces a steep decline in the frequency and makes the ISIs highly variable. These electrophysiological data are correlated with behavioral observations from the natural habitat of the medusae. PMID:18446348

  14. Hyperpolarization-activated cation and T-type calcium ion channel expression in porcine and human renal pacemaker tissues.

    Science.gov (United States)

    Hurtado, Romulo; Smith, Carl S

    2016-05-01

    Renal pacemaker activity triggers peristaltic upper urinary tract contractions that propel waste from the kidney to the bladder, a process prone to congenital defects that are the leading cause of pediatric kidney failure. Recently, studies have discovered that hyperpolarization-activated cation (HCN) and T-type calcium (TTC) channel conductances underlie murine renal pacemaker activity, setting the origin and frequency and coordinating upper urinary tract peristalsis. Here, we determined whether this ion channel expression is conserved in the porcine and human urinary tracts, which share a distinct multicalyceal anatomy with multiple pacemaker sites. Double chromagenic immunohistochemistry revealed that HCN isoform 3 is highly expressed at the porcine minor calyces, the renal pacemaker tissues, whereas the kidney and urinary tract smooth muscle lacked this HCN expression. Immunofluorescent staining demonstrated that HCN(+) cells are integrated within the porcine calyx smooth muscle, and that they co-express TTC channel isoform Cav3.2. In humans, the anatomic structure of the minor calyx pacemaker was assayed via hematoxylin and eosin analyses, and enabled the visualization of the calyx smooth muscle surrounding adjacent papillae. Strikingly, immunofluorescence revealed that HCN3(+) /Cav3.2(+) cells are also localized to the human minor calyx smooth muscle. Collectively, these data have elucidated a conserved molecular signature of HCN and TTC channel expression in porcine and human calyx pacemaker tissues. These findings provide evidence for the mechanisms that can drive renal pacemaker activity in the multi-calyceal urinary tract, and potential causes of obstructive uropathies. PMID:26805464

  15. Correlation analysis of the relationship between B-type natriuretic peptide and selected echocardiographic parameters in patients with permanent pacemakers

    Directory of Open Access Journals (Sweden)

    Janusz Sielski

    2016-01-01

    Full Text Available Introduction: The present study was undertaken to evaluate the practical value of BNP measurements and echocardiographic left ventricular volume index in patients with permanent pacemakers because there are no such reports in the literature. Aim of the research: The aim of the study was to reveal multiple correlations between BNP levels and selected echocardiographic parameters of the left atrium in patients with permanent pacemakers. In the literature there are reports on the significance of BNP values and left atrial size in patients with permanent pacemakers. The results of the present study appear to be of value in the outpatient assessment of these patients. Material and methods: We analysed a group of 117 patients with permanent pacemakers (AAI/R 21 patients, DDD/R 59 patients, VVI/R 37 patients and 48 healthy volunteers serving as the control group. BNP measurements were performed on venous blood samples using Triage meters. The Simpson method and the ellipse method were used to assess the left atrium on echocardiography. Results: There was a significant correlation between BNP and maximum left atrial volume, minimum left atrial volume, and left atrial volume index in patients with AAI/R, DDD/R, and VVI/R pacemakers at 3 and 6 months after the implantation. Conclusions : In patients after implantation of permanent pacemakers there are correlations between BNP values and echocardiographic left atrial parameters, especially in patients with DDD/R pacemakers. Left atrial function improves in patients with DDD/R pacemakers. Pacemaker check-up should be extended to include BNP measurements and echocardiographic assessment of the left atrium.

  16. Valproate, bipolar disorder and polycystic ovarian syndrome

    Directory of Open Access Journals (Sweden)

    Okanović Milana

    2016-01-01

    Full Text Available Introduction. Polycystic ovarian syndrome is a syndrome of ovarian dysfunction with the principal features of hyperandrogenism and polycystic ovary morphology. A large number of studies conducted on this topic have suggested a possible role of anticonvulsants, particularly valproate, in the pathogenesis or risk factors associated with polycystic ovarian syndrome. Bipolar treatment guidelines from Canada and the United States of America recommend valproate as the first line strategy in the acute treatment of bipolar disorder. Discussion. Most persons with bipolar disorder require maintenance treatment. Long-term administration of valproate in women with bipolar disorder or epilepsy is believed to result in the increased risk of hyperandro­genism, menstrual abnormalities and polycystic ovaries. Valproate may also increase the risk of infertility and other associated symptoms of polycystic ovarian syndrome. Therefore, particular caution is indicated in the use of valproate in women of reproductive age. Conclusion. The treatment of the female patients with bipolar disorder presents various challenges for the clinician. Every woman of reproductive age needs to know the risk and benefits of her pharmacologic treatment options. Bipolar disorder should be considered chronic disorder, whose development is largely affected by hormonal changes and reproductive cycle in women. These issues should be researched more thoroughly in order to opt for the most appropriate treatment in women with bipolar disorder.

  17. Tratamento do transtorno bipolar: eutimia Bipolar disorder treatment: euthymia

    Directory of Open Access Journals (Sweden)

    Fábio Gomes de Matos e Souza

    2005-01-01

    Full Text Available O transtorno bipolar é um quadro complexo caracterizado por episódios de depressão, mania ou hipomania e fases assintomáticas. O tratamento visa ao controle de episódios agudos e prevenção de novos episódios. O tratamento farmacológico iniciou-se com o lítio. Até o momento, o lítio permanece como o tratamento com mais evidências favoráveis na fase de manutenção. Outros tratamentos demonstram eficácia nessa fase, como o valproato, a carbamazepina e os antipsicóticos atípicos. Dos antipsicóticos atípicos o mais estudado nesta fase do tratamento é a olanzapina. Mais estudos prospectivos são necessários para confirmar a ação profilática de novos agentes.Bipolar disorder is a complex disorder characterized by depression episodes, mania or hypomania and asymptomatic phases. The treatment aims at the control of acute episodes and prevention of new episodes. The pharmacological treatment was inaugurated with lithium. Until the moment, lithium remains as the treatment with more favorable evidences in the maintenance phase. Other treatments demonstrate efficacy in this phase, as valproate, carbamazepine and atypical antipsychotics. Of the atypical antipsychotics, the most studied in this phase of treatment is olanzapine. More prospective studies are necessary to confirm prophylactic action of new agents.

  18. Lower switch rate in depressed patients with bipolar II than bipolar I disorder treated adjunctively with second-generation antidepressants

    NARCIS (Netherlands)

    Altshuler, LL; Suppes, T; Nolen, WA; Leverich, G; Keck, PE; Frye, MA; Kupka, R; McElroy, SL; Grunze, H; Kitchen, CMR; Post, R; Black, D.O.

    2006-01-01

    Objectives: The authors compared the switch rate into hypomania/mania in depressed patients treated with second-generation antidepressants who had either bipolar I or bipolar II disorder. Method: In a 10-week trial, 184 outpatients with bipolar depression (134 with bipolar I disorder, 48 with bipola

  19. Performance evaluation and characterization of metallic bipolar plates in a proton exchange membrane (PEM) fuel cell

    Science.gov (United States)

    Hung, Yue

    Bipolar plate and membrane electrode assembly (MEA) are the two most repeated components of a proton exchange membrane (PEM) fuel cell stack. Bipolar plates comprise more than 60% of the weight and account for 30% of the total cost of a fuel cell stack. The bipolar plates perform as current conductors between cells, provide conduits for reactant gases, facilitate water and thermal management through the cell, and constitute the backbone of a power stack. In addition, bipolar plates must have excellent corrosion resistance to withstand the highly corrosive environment inside the fuel cell, and they must maintain low interfacial contact resistance throughout the operation to achieve optimum power density output. Currently, commercial bipolar plates are made of graphite composites because of their relatively low interfacial contact resistance (ICR) and high corrosion resistance. However, graphite composite's manufacturability, permeability, and durability for shock and vibration are unfavorable in comparison to metals. Therefore, metals have been considered as a replacement material for graphite composite bipolar plates. Since bipolar plates must possess the combined advantages of both metals and graphite composites in the fuel cell technology, various methods and techniques are being developed to combat metallic corrosion and eliminate the passive layer formed on the metal surface that causes unacceptable power reduction and possible fouling of the catalyst and the electrolyte. The main objective of this study was to explore the possibility of producing efficient, cost-effective and durable metallic bipolar plates that were capable of functioning in the highly corrosive fuel cell environment. Bulk materials such as Poco graphite, graphite composite, SS310, SS316, incoloy 800, titanium carbide and zirconium carbide were investigated as potential bipolar plate materials. In this work, different alloys and compositions of chromium carbide coatings on aluminum and SS316

  20. Ziprasidone in the treatment of mania in bipolar disorder.

    Science.gov (United States)

    Nicolson, Stephen E; Nemeroff, Charles B

    2007-12-01

    Ziprasidone is an atypical antipsychotic with a unique receptor-binding profile. Currently, ziprasidone is approved by the US Food and Drug Administration for the acute treatment of psychosis in schizophrenia and mania in bipolar disorder. When compared to certain other atypical antipsychotics, ziprasidone appears to have a relatively benign side effect profile, especially as regards metabolic effects eg, weight gain, serum lipid elevations and glucose dysregulation. Taken together, these data suggest that ziprasidone may be a first line treatment for patients with bipolar mania. However, ziprasidone is a relatively new medication for which adverse events after long-term use and/or in vulnerable patient populations must be studied. Unstudied areas of particular importance include the efficacy and safety of ziprasidone in the treatment of bipolar depression and relapse prevention of mania as, well as in the subpopulations of pregnant women, the elderly and pediatric patients. The emergence of mania in patients taking ziprasidone is another topic for further study. PMID:19300617

  1. Vacuum interface flashover with bipolar electric fields

    International Nuclear Information System (INIS)

    High energy, compact, particle accelerators require accelerating cavities that have large gradients and operate with high efficiency. The bipolar electric fields necessary in these efficient accelerating cavities place severe requirements on the insulator-vacuum interface. A new interface has been designed and 50 gv/cm bipolar flashover field achieved for a waveform train that lasted 1 μs. This paper discusses the design of this vacuum interface and the evaluation of various materials that led to achieving bipolar flashover fields 50% greater than the authors had previously obtained

  2. Modeling Low-Dose-Rate Effects in Irradiated Bipolar-Base Oxides

    Energy Technology Data Exchange (ETDEWEB)

    Cirba, C.R.; Fleetwood, D.M.; Graves, R.J.; Michez, A.; Milanowski, R.J.; Saigne, F.; Schrimpf, R.D.; Witczak, S.C.

    1998-10-26

    A physical model is developed to quantify the contribution of oxide-trapped charge to enhanced low-dose-rate gain degradation in bipolar junction transistors. Multiple-trapping simulations show that space charge limited transport is partially responsible for low-dose-rate enhancement. At low dose rates, more holes are trapped near the silicon-oxide interface than at high dose rates, resulting in larger midgap voltage shifts at lower dose rates. The additional trapped charge near the interface may cause an exponential increase in excess base current, and a resultant decrease in current gain for some NPN bipolar technologies.

  3. Comorbidade com transtornos de ansiedade em transtorno bipolar Anxiety disorders comorbidity in bipolar disorder

    Directory of Open Access Journals (Sweden)

    Cilly Klüger Issler

    2004-10-01

    Full Text Available Comorbidade elevada de transtornos de ansiedade em bipolares é freqüentemente relatada em estudos epidemiológicos e clínicos. A associação tem implicações importantes no diagnóstico, evolução clínica, tratamento e prognóstico do transtorno bipolar, que são apresentadas nesta revisão.High comorbidity between bipolar and anxiety disorders is frequently described in epidemiological and clinical studies. This association has important implications for diagnoses, clinical outcome, therapeutic intervention and prognoses of bipolar disorder that are presented in this review.

  4. Bipolar disorder and neurophysiologic mechanisms

    Directory of Open Access Journals (Sweden)

    Simon M McCrea

    2008-11-01

    Full Text Available Simon M McCreaDepartments of Neurology and Neuroophthalmology, University of British Columbia, 2550 Willow Street, Vancouver, British Columbia, Canada V5Z 3N9Abstract: Recent studies have suggested that some variants of bipolar disorder (BD may be due to hyperconnectivity between orbitofrontal (OFC and temporal pole (TP structures in the dominant hemisphere. Some initial MRI studies noticed that there were corpus callosum abnormalities within specific regional areas and it was hypothesized that developmentally this could result in functional or effective connectivity changes within the orbitofrontal-basal ganglia-thalamocortical circuits. Recent diffusion tensor imaging (DTI white matter fiber tractography studies may well be superior to region of interest (ROI DTI in understanding BD. A “ventral semantic stream” has been discovered connecting the TP and OFC through the uncinate and inferior longitudinal fasciculi and the elusive TP is known to be involved in theory of mind and complex narrative understanding tasks. The OFC is involved in abstract valuation in goal and sub-goal structures and the TP may be critical in binding semantic memory with person–emotion linkages associated with narrative. BD patients have relative attenuation of performance on visuoconstructional praxis consistent with an atypical localization of cognitive functions. Multiple lines of evidence suggest that some BD alleles are being selected for which could explain the enhanced creativity in higher-ability probands. Associations between ROI’s that are not normally connected could explain the higher incidence of artistic aptitude, writing ability, and scientific achievements among some mood disorder subjects.Keywords: bipolar disorder, diffusion tensor imaging, white matter tractography, inferior longitudinal fasciculus, inferior fronto-occipital fasciculus, uncinate fasciculus, mood dysphoria, creativity, ventral semantic stream, writing ability, artistic aptitude

  5. Are rates of pediatric bipolar disorder increasing?

    DEFF Research Database (Denmark)

    Kessing, Lars Vedel; Vradi, Eleni; Andersen, Per Kragh

    2014-01-01

    Studies from the USA suggest that rates of pediatric bipolar disorder have increased since the mid-90s, but no study outside the USA has been published on the rates of pediatric bipolar disorder. Further, it is unclear whether an increase in rates reflects a true increase in the illness or more...... diagnostic attention. Using nationwide registers of all inpatients and outpatients contacts to all psychiatric hospitals in Denmark, we investigated (1) gender-specific rates of incident pediatric mania/bipolar disorder during a period from 1995 to 2012, (2) whether age and other characteristics...... for pediatric mania/bipolar disorder changed during the calendar period (1995 to 2003 versus 2004 to 2012), and (3) whether the diagnosis is more often made at first psychiatric contact in recent time compared to earlier according to gender. Totally, 346 patients got a main diagnosis of a manic episode (F30...

  6. White matter microstructure alterations in bipolar disorder

    Science.gov (United States)

    Bellani, Marcella; Perlini, Cinzia; Ferro, Adele; Cerruti, Stefania; Rambaldelli, Gianluca; Isola, Miriam; Cerini, Roberto; Dusi, Nicola; Andreone, Nicola; Balestrieri, Matteo; Mucelli, Roberto Pozzi; Tansella, Michele; Brambilla, Paolo

    2012-01-01

    Summary Genetic, neuropathological and magnetic resonance imaging findings support the presence of diffuse white matter cytoarchitectural disruption in bipolar disorder. In this study, diffusion-weighted imaging (DWI) was applied to study cortical white matter microstructure organisation in 24 patients with DSM-IV bipolar disorder and 35 matched normal controls. DWI images were obtained using a 1.5 Tesla scanner and apparent diffusion coefficient (ADC) values were determined over regions of interest placed, bilaterally, in the frontal, temporal, parietal, and occipital white matter. Significantly increased ADC values were found in bipolar patients with respect to normal controls in the right temporal lobe, left parietal lobe and bilateral occipital lobes. ADC values did not associate significantly with age or with clinical variables (p>0.05). Diffuse cortical white matter alterations on DWI in bipolar disorder denote widespread disruption of white matter integrity and may be due to altered myelination and/or axonal integrity. PMID:22687164

  7. PEMFC Performance with Metal Bipolar Plates Depending on the Channel Dimension

    Directory of Open Access Journals (Sweden)

    Kwon Kuikam

    2016-01-01

    Full Text Available Bipolar plates of a proton exchange membrane fuel cell (PEMFC play an important role in removing liquid phase water as a by-product in order to facilitate the reaction between fuel and oxygen. A great amount of effort has been made to improve the performance of a fuel cell such as maximum current density or maximum power, by improving water removability of a bipolar plate. Most of the studies, however, are conducted numerically because of the complexity of analysing gas and liquid and the poor manufacturability of graphite bipolar plates. In this proceeding, we demonstrate that the performance of a PEMFC with metal bipolar plates can be enhanced by reducing the dimension of the channel. Bipolar plates were machined with stainless steel (type 316L to have three different channel size (1000 μm, 500 μm and 300 μm and the performance of each assembled cells were tested. As a result, the maximum power density and the maximum current density increased by 25%.

  8. O transtorno bipolar na mulher Bipolar disorder in women

    Directory of Open Access Journals (Sweden)

    Alexandro de Borja Gonçalves Guerra

    2005-01-01

    Full Text Available Diferenças sexuais, descritas em vários transtornos psiquiátricos, também parecem estar presentes no transtorno afetivo bipolar (TAB. A prevalência do TAB tipo I se distribui igualmente entre mulheres e homens. Mulheres parecem estar sujeitas a um risco maior de ciclagem rápida e mania mista, condições que fariam do TAB um transtorno com curso mais prejudicial no sexo feminino. Uma diátese depressiva mais marcante, uso excessivo de antidepressivos e diferenças hormonais surgem como hipóteses para explicar essas diferenças fenomenológicas, apesar das quais, mulheres e homens parecem responder igualmente ao tratamento medicamentoso. A indicação de anticonvulsivantes como primeira escolha em mulheres é controversa, a não ser para o tratamento da mania mista e, talvez, da ciclagem rápida. O tratamento do TAB na gravidez deve levar em conta tanto os riscos de exposição aos medicamentos quanto à doença materna. A profilaxia do TAB no puerpério está fortemente indicada em decorrência do grande risco de recorrência da doença nesse período. Embora, de modo geral, as medicações psicotrópicas estejam contra-indicadas durante a amamentação, entre os estabilizadores do humor, a carbamazepina e o valproato são mais seguros do que o lítio. Mais estudos são necessários para a confirmação das diferenças de curso do TAB entre mulheres e homens e a investigação de possíveis diferenças na efetividade dos tratamentos.Gender differences, described in several psychiatric disorders, seem to be also present in bipolar disorder (BD. The prevalence of bipolar I disorder is equally distributed between women and men. Women seem to be at higher risk for rapid cycling and mixed mania, conditions that could make BD a disorder with a more severe course in the female sex. A marked depressive diathesis among women, greatest use of antidepressants and hormonal differences have been mentioned as hypotheses to explain these

  9. Current Controlled Current Differencing Buffered Amplifier: Implementation and Applications

    Directory of Open Access Journals (Sweden)

    Sudhanshu Maheshwari

    2004-01-01

    Full Text Available A new four terminal current-controlled active element is introduced, where parasitic resistances at two current input ports are controlled leading to the definition of current-controlled current differencing buffered amplifier. Bipolar implementation and as application current-mode band-pass filter circuits are proposed. Simulation results using real device parameters are included, which show device bandwidth of 35 MHz, low total harmonic distortions, and tuning over a wide current range.

  10. Joint Effects: A Pilot Investigation of the Impact of Bipolar Disorder and Marijuana Use on Cognitive Function and Mood.

    Directory of Open Access Journals (Sweden)

    Kelly A Sagar

    Full Text Available Marijuana is the most widely used illicit substance in those diagnosed with bipolar I disorder. However, there is conflicting evidence as to whether marijuana may alleviate or exacerbate mood symptomatology. As bipolar disorder and marijuana use are individually associated with cognitive impairment, it also remains unclear whether there is an additive effect on cognition when bipolar patients use marijuana. The current study aimed to determine the impact of marijuana on mood in bipolar patients and to examine whether marijuana confers an additional negative impact on cognitive function. Twelve patients with bipolar disorder who smoke marijuana (MJBP, 18 bipolar patients who do not smoke (BP, 23 marijuana smokers without other Axis 1 pathology (MJ, and 21 healthy controls (HC completed a neuropsychological battery. Further, using ecological momentary assessment, participants rated their mood three times daily as well as after each instance of marijuana use over a four-week period. Results revealed that although the MJ, BP, and MJBP groups each exhibited some degree of cognitive impairment relative to HCs, no significant differences between the BP and MJBP groups were apparent, providing no evidence of an additive negative impact of BPD and MJ use on cognition. Additionally, ecological momentary assessment analyses indicated alleviation of mood symptoms in the MJBP group after marijuana use; MJBP participants experienced a substantial decrease in a composite measure of mood symptoms. Findings suggest that for some bipolar patients, marijuana may result in partial alleviation of clinical symptoms. Moreover, this improvement is not at the expense of additional cognitive impairment.

  11. Bipolar Saline TURP for Large Prostate Glands

    OpenAIRE

    Finley, David S.; Shawn Beck; Szabo, Richard J.

    2007-01-01

    The objective of this study was to evaluate the feasibility of bipolar transurethral resection of the prostate ( TURP) in patients with very large prostate glands and significant comorbidities. Four patients with prostate glands > 160 cc on preoperative volume measurement and ASA class three or higher underwent bipolar TURP with the Gyrus PlasmaKinetic system. Preoperative, operative, and postoperative parameters were studied. The results showed an average ASA class 3.25 (range: 3-4). The ave...

  12. Bipolar Harmonic encoding of CMB correlation patterns

    OpenAIRE

    Joshi, Nidhi; Jhingan, Sanjay; Souradeep, Tarun; Hajian, Amir

    2009-01-01

    Deviations from statistical isotropy can be modeled in various ways, for instance, anisotropic cosmological models (Bianchi models), compact topologies and presence of primordial magnetic field. Signature of anisotropy manifests itself in CMB correlation patterns. Here we explore the symmetries of the correlation function and its implications on the observable measures constructed within the Bipolar harmonic formalism for these variety of models. Different quantifiers within the Bipolar harmo...

  13. Integrating Bipolar Disorder Management in Primary Care

    OpenAIRE

    Kilbourne, Amy M.; Goodrich, David E.; O’Donnell, Allison N.; Miller, Christopher J.

    2012-01-01

    There is growing realization that persons with bipolar disorder may exclusively be seen in primary (general medical) care settings, notably because of limited access to mental health care and stigma in seeking mental health treatment. At least two clinical practice guidelines for bipolar disorder recommend collaborative chronic care models (CCMs) to help integrate mental health care to better manage this illness. CCMs, which include provider guideline support, self-management support, care ma...

  14. Homocysteine and cognitive functions in bipolar depression

    OpenAIRE

    Agnieszka Permoda-Osip; Jacek Kisielewski; Jolanta Dorszewska; Janusz Rybakowski

    2014-01-01

    Objectives The aim of the study was to evaluate a relationship between concentrations of hoocysteine (HCY), vitamin B12 and folic acid and disturbances of cognitive functions during acute episode of bipolar depression. Methods 116 patients were studied (93 women, 23 men), aged 20-78 (mean 51±13) years during acute episode of bipolar depression. Depression was evaluated by the 17-item Hamilton’s Depression Rating Scale (HDRS). The following tests measuring cognitive functions were ap...

  15. Differential loss and preservation of glutamate receptor function in bipolar cells in the rd10 mouse model of retinitis pigmentosa

    OpenAIRE

    Puthussery, Theresa; Gayet-Primo, Jacqueline; Pandey, Shilpi; Duvoisin, Robert M; Taylor, W. Rowland

    2009-01-01

    Photoreceptor degenerations can trigger morphological alterations in second-order neurons, however, the functional implications of such changes are not well known. We conducted a longitudinal study, using whole-cell patch-clamp, immunohistochemistry and electron microscopy to correlate physiological with anatomical changes in bipolar cells of the rd10 mouse - a model of autosomal recessive retinitis pigmentosa. Rod bipolar cells (RBCs) showed progressive changes in mGluR6-induced currents wit...

  16. Clinical response of quetiapine in rapid cycling manic bipolar patients and lactate level changes in proton magnetic resonance spectroscopy

    OpenAIRE

    Dajung J Kim; Lyoo, In Kyoon; Yoon, Sujung J; Choi, Taeyoung; Lee, Byungchol; Kim, Jieun E.; Lee, Joonsun S.; Renshaw, Perry F.

    2007-01-01

    The aim of the current study was to evaluate the relationship between quetiapine’s effect on the improvement of mood symptoms in bipolar patients and brain metabolite level changes as measured by proton magnetic resonance spectroscopy (1H-MRS). Rapid cycling bipolar patients in the manic state were recruited and treated with quetiapine for 12 weeks. Clinical assessment was performed using the Young Mania Rating Scale (YMRS), the 17-item Hamilton Depression Rating Scale (HDRS) and the Clinical...

  17. Clozapine as add-on medication in the maintenance treatment of bipolar and schizoaffective disorders - A case series

    OpenAIRE

    Hummel, B.; Dittmann, Sandra; Forsthoff, A.; Matzner, N.; AMANN, B.; GRUNZE, HEINZ

    2002-01-01

    Atypical neuroleptics are increasingly used in the treatment of bipolar and schizoaffective disorders. Currently, numerous controlled short-term studies are available for clozapine, olanzapine, risperidone or quetiapine, but long-term data are still missing. Three patients (2 with bipolar disorder, 1 with schizoaffective disorder) are described who showed a marked reduction of affective symptomatology after clozapine had been added to mood stabilizer pretreatment. The patients were seen once ...

  18. Pacemaking through Ca2+ stores interacting as coupled oscillators via membrane depolarization.

    Science.gov (United States)

    Imtiaz, Mohammad S; Zhao, Jun; Hosaka, Kayoko; von der Weid, Pierre-Yves; Crowe, Melissa; van Helden, Dirk F

    2007-06-01

    This study presents an investigation of pacemaker mechanisms underlying lymphatic vasomotion. We tested the hypothesis that active inositol 1,4,5-trisphosphate receptor (IP(3)R)-operated Ca(2+) stores interact as coupled oscillators to produce near-synchronous Ca(2+) release events and associated pacemaker potentials, this driving action potentials and constrictions of lymphatic smooth muscle. Application of endothelin 1 (ET-1), an agonist known to enhance synthesis of IP(3), to quiescent lymphatic smooth muscle syncytia first enhanced spontaneous Ca(2+) transients and/or intracellular Ca(2+) waves. Larger near-synchronous Ca(2+) transients then occurred leading to global synchronous Ca(2+) transients associated with action potentials and resultant vasomotion. In contrast, blockade of L-type Ca(2+) channels with nifedipine prevented ET-1 from inducing near-synchronous Ca(2+) transients and resultant action potentials, leaving only asynchronous Ca(2+) transients and local Ca(2+) waves. These data were well simulated by a model of lymphatic smooth muscle with: 1), oscillatory Ca(2+) release from IP(3)R-operated Ca(2+) stores, which causes depolarization; 2), L-type Ca(2+) channels; and 3), gap junctions between cells. Stimulation of the stores caused global pacemaker activity through coupled oscillator-based entrainment of the stores. Membrane potential changes and positive feedback by L-type Ca(2+) channels to produce more store activity were fundamental to this process providing long-range electrochemical coupling between the Ca(2+) store oscillators. We conclude that lymphatic pacemaking is mediated by coupled oscillator-based interactions between active Ca(2+) stores. These are weakly coupled by inter- and intracellular diffusion of store activators and strongly coupled by membrane potential. Ca(2+) store-based pacemaking is predicted for cellular systems where: 1), oscillatory Ca(2+) release induces depolarization; 2), membrane depolarization provides positive

  19. Valuing happiness is associated with bipolar disorder.

    Science.gov (United States)

    Ford, Brett Q; Mauss, Iris B; Gruber, June

    2015-04-01

    Although people who experience happiness tend to have better psychological health, people who value happiness to an extreme tend to have worse psychological health, including more depression. We propose that the extreme valuing of happiness may be a general risk factor for mood disturbances, both depressive and manic. To test this hypothesis, we examined the relationship between the extreme valuing of happiness and risk for, diagnosis of, and illness course for bipolar disorder (BD). Supporting our hypothesis, the extreme valuing of happiness was associated with a measure of increased risk for developing BD (Studies 1 and 2), increased likelihood of past diagnosis of BD (Studies 2 and 3), and worse prospective illness course in BD (Study 3), even when controlling for current mood symptoms (Studies 1-3). These findings indicate that the extreme valuing of happiness is associated with and even predicts BD. Taken together with previous evidence, these findings suggest that the extreme valuing of happiness is a general risk factor for mood disturbances. More broadly, what emotions people strive to feel may play a critical role in psychological health.

  20. Advanced insulated gate bipolar transistor gate drive

    Science.gov (United States)

    Short, James Evans; West, Shawn Michael; Fabean, Robert J.

    2009-08-04

    A gate drive for an insulated gate bipolar transistor (IGBT) includes a control and protection module coupled to a collector terminal of the IGBT, an optical communications module coupled to the control and protection module, a power supply module coupled to the control and protection module and an output power stage module with inputs coupled to the power supply module and the control and protection module, and outputs coupled to a gate terminal and an emitter terminal of the IGBT. The optical communications module is configured to send control signals to the control and protection module. The power supply module is configured to distribute inputted power to the control and protection module. The control and protection module outputs on/off, soft turn-off and/or soft turn-on signals to the output power stage module, which, in turn, supplies a current based on the signal(s) from the control and protection module for charging or discharging an input capacitance of the IGBT.

  1. The role of sleep in bipolar disorder

    Directory of Open Access Journals (Sweden)

    Gold AK

    2016-06-01

    Full Text Available Alexandra K Gold,1 Louisa G Sylvia,1,2 1Department of Psychiatry, Massachusetts General Hospital, 2Harvard Medical School, Boston, MA, USA Abstract: Bipolar disorder is a serious mental illness characterized by alternating periods of elevated and depressed mood. Sleep disturbances in bipolar disorder are present during all stages of the condition and exert a negative impact on overall course, quality of life, and treatment outcomes. We examine the partnership between circadian system (process C functioning and sleep–wake homeostasis (process S on optimal sleep functioning and explore the role of disruptions in both systems on sleep disturbances in bipolar disorder. A convergence of evidence suggests that sleep problems in bipolar disorder result from dysregulation across both process C and process S systems. Biomarkers of depressive episodes include heightened fragmentation of rapid eye movement (REM sleep, reduced REM latency, increased REM density, and a greater percentage of awakenings, while biomarkers of manic episodes include reduced REM latency, greater percentage of stage I sleep, increased REM density, discontinuous sleep patterns, shortened total sleep time, and a greater time awake in bed. These findings highlight the importance of targeting novel treatments for sleep disturbance in bipolar disorder. Keywords: bipolar disorder, circadian rhythms, sleep–wake homeostasis

  2. Rumination in bipolar disorder: evidence for an unquiet mind

    Directory of Open Access Journals (Sweden)

    Ghaznavi Sharmin

    2012-01-01

    Full Text Available Abstract Depression in bipolar disorder has long been thought to be a state characterized by mental inactivity. However, recent research demonstrates that patients with bipolar disorder engage in rumination, a form of self-focused repetitive cognitive activity, in depressed as well as in manic states. While rumination has long been associated with depressed states in major depressive disorder, the finding that patients with bipolar disorder ruminate in manic states is unique to bipolar disorder and challenges explanations put forward for why people ruminate. We review the research on rumination in bipolar disorder and propose that rumination in bipolar disorder, in both manic and depressed states, reflects executive dysfunction. We also review the neurobiology of bipolar disorder and recent neuroimaging studies of rumination, which is consistent with our hypothesis that the tendency to ruminate reflects executive dysfunction in bipolar disorder. Finally, we relate the neurobiology of rumination to the neurobiology of emotion regulation, which is disrupted in bipolar disorder.

  3. Improved quality of life after treatment of prolonged asystole during breath holding spells with a cardiac pacemaker

    Directory of Open Access Journals (Sweden)

    Bruno Kolterer

    2015-01-01

    Conclusion: Cardiac pacing using appropriate pacemaker settings seems effective in the prevention of LOC and reduction of the frequency of BHS. Our results imply a reduction of subjective stress levels of patients and parents as well as an increased quality of everyday life. After all, randomized controlled trials of the influence of cardiac pacemaker implantation on subjective stress levels in patients with BHS are needed.

  4. A premature low-birth-weight infant with congenital complete atrioventricular block and myocarditis successfully treated by staged pacemaker implantation.

    Science.gov (United States)

    Fujioka, Tao; Nii, Masaki; Tanaka, Yasuhiko

    2016-06-01

    Congenital complete atrioventricular block is a known lethal condition. Although antenatal diagnosis and the technical advances of pacemaker treatment have reduced its mortality, treatment of premature babies with significant myocardial damage remains a challenge. In this paper, we report the case of a premature low-birth-weight infant with congenital complete atrioventricular block and extremely low ventricular rate, fetal hydrops, and myocarditis who was successfully treated with staged permanent pacemaker implantation. PMID:27071550

  5. Transtorno bipolar de início tardio: uma variedade orgânica do transtorno de humor? Bipolar disorder with late onset: an organic variety of mood disorder?

    Directory of Open Access Journals (Sweden)

    Osvaldo P Almeida

    2004-10-01

    Full Text Available Transtorno bipolar (TB é comumente associado à fase final da adolescência ou idade adulta jovem, embora em uma proporção substancial dos pacientes a doença comece em fases mais tardias da vida. Os resultados de várias investigações clínicas sugerem que casos de transtorno bipolar com início tardio têm, mais freqüentemente, uma "causa orgânica" e que isso justificaria a subdivisão do transtorno bipolar entre "início precoce" e "início tardio". Este artigo revê a literatura sobre a hipótese orgânica do transtorno bipolar de início tardio e conclui que essa subdivisão é artificial e carece de suporte clínico e epidemiológico.Bipolar disorder (BD is commonly associated with late adolescence or early adulthood, although a substantial proportion of patients develops the condition in later life. The results of early clinical investigations suggested that cases of bipolar disorder with onset in later life were more often associated with 'organic causes', and could potentially justify the distinction between early and late onset bipolar disorder. This paper reviews currently available evidence in support of the organic hypothesis for late onset bipolar disorder. It concludes that the split of bipolar disorder according to age at onset is artificial, and lacks clinical significance and epidemiological support.

  6. Women with bipolar disorder and pregnancy: factors influencing their decision-making

    Science.gov (United States)

    Jones, Ian R.; Howard, Louise M.

    2016-01-01

    Background Women with bipolar disorder are at increased risk of having a severe episode of illness associated with childbirth. Aims To explore the factors that influence the decision-making of women with bipolar disorder regarding pregnancy and childbirth. Method Qualitative study with a purposive sample of women with bipolar disorder considering pregnancy, or currently or previously pregnant, supplemented by data from an online forum. Data were analysed using thematic analysis. Results Twenty-one women with bipolar disorder from an NHS organisation were interviewed, and data were used from 50 women’s comments via the online forum of the UK’s national bipolar charity. The centrality of motherhood, social and economic contextual factors, stigma and fear were major themes. Within these themes, new findings included women considering an elective Caesarian section in an attempt to avoid the deleterious effects of a long labour and loss of sleep, or trying to avoid the risks of pregnancy altogether by means of adoption or surrogacy. Conclusions This study highlights the information needs of women with bipolar disorder, both pre-conception and when childbearing, and the need for improved training for all health professionals working with women with bipolar disorder of childbearing age to reduce stigmatising attitudes and increase knowledge of the evidence base on treatment in the perinatal period. Declaration of interest None. Copyright and usage © The Royal College of Psychiatrists 2016. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) license. PMID:27703792

  7. [Clinical relevance of antidepressant-induced activation syndrome: from a perspective of bipolar spectrum disorder].

    Science.gov (United States)

    Tanaka, Teruaki; Inoue, Takeshi; Suzuki, Katsuji; Kitaichi, Yuji; Masui, Takuya; Denda, Kenzo; Koyama, Tsukasa

    2007-01-01

    Recent concerns have been raised regarding whether antidepressants, especially selective serotonin reuptake inhibitors (SSRIs) might increase suicidal tendencies and intense debate-rages over the pros and cons of their use. Although systematic reviews and population-based studies have been conducted, a consensus on this association remains to be established. Subsequently, the concept of so-called 'activation syndrome' associated with antidepressants has been accepted without its adequate verification. In the present report, we present our experience of seven cases considered of having 'activation syndrome' brought on by antidepressants, and examine its clinical relevance to bipolar spectrum disorder (Ghaemi, et al., 2001) both symptomatologically and diagnostically. Five patients, diagnosed as having major depressive disorder according to the diagnostic manual (DSM-IV), met the criteria of bipolar spectrum disorder and suffered from activation syndrome following the administration of SSRIs, mainly paroxetine. Similarly, hypomania developed in all five cases with depression; the diagnostic criteria of a hypomanic episode were not met. In the remaining two patients, who were both diagnosed with bipolar disorder, one showed irritability and insomnia through imipramine use, and the another developed a hypomanic and/or a mixed state after the co-administration of fluvoxamine and trazodone. From the results of our examination, 'bipolarity', which is the pivotal factor of bipolar spectrum, might exist behind the phenomenon recognized as activation syndrome, and be revealed by antidepressant treatment, just like manic switching. Moreover, the various problems encountered in the current practice of treating mood disorders, including unipolar-bipolar dichotomy, manic switching by antidepressants, and narrow criteria for a mixed episode, were pointed out a new through this concept of activation syndrome. Actually, the understanding of activation syndrome clinically leads to

  8. Temporal order of bipolar cell genesis in the neural retina

    Directory of Open Access Journals (Sweden)

    Chen C-M Amy

    2008-01-01

    Full Text Available Abstract Background Retinal bipolar cells comprise a diverse group of neurons. Cone bipolar cells and rod bipolar cells are so named for their connections with cone and rod photoreceptors, respectively. Morphological criteria have been established that distinguish nine types of cone bipolar cells and one type of rod bipolar cell in mouse and rat. While anatomical and physiological aspects of bipolar types have been actively studied, little is known about the sequence of events that leads to bipolar cell type specification and the potential relationship this process may have with synapse formation in the outer plexiform layer. In this study, we have examined the birth order of rod and cone bipolar cells in the developing mouse and rat in vivo. Results Using retroviral lineage analysis with the histochemical marker alkaline phosphatase, the percentage of cone and rod bipolar cells born on postnatal day 0 (P0, P4, and P6 were determined, based upon the well characterized morphology of these cells in the adult rat retina. In this in vivo experiment, we have demonstrated that cone bipolar genesis clearly precedes rod bipolar genesis. In addition, in the postnatal mouse retina, using a combination of tritiated-thymidine birthdating and immunohistochemistry to distinguish bipolar types, we have similarly found that cone bipolar genesis precedes rod bipolar genesis. The tritiated-thymidine birthdating studies also included quantification of the birth of all postnatally generated retinal cell types in the mouse. Conclusion Using two independent in vivo methodologies in rat and mouse retina, we have demonstrated that there are distinct waves of genesis of the two major bipolar cell types, with cone bipolar genesis preceding rod bipolar genesis. These waves of bipolar genesis correspond to the order of genesis of the presynaptic photoreceptor cell types.

  9. Study on incidence of pulmonary embolism in patients with cardiac pacemakers using lung perfusion mapping and ventilation scanning

    International Nuclear Information System (INIS)

    We investigated pulmonary perfusion mapping and ventilation scanning employing 99mTC-MMA and 81mKr-Gas in patients with DDD and VVI cardiac pacemaker implantation. In 51 cases among 175 patients we observed some defects which matched the results from lung perfusion scanning in the pulmonary segments and sub-segments. These were diagnosed as pulmonary embolism after the possibility of other pulmonary diseases was rejected. The incidence rate of pulmonary embolism in patients with VVI (Ventricular pacing/sensing, inhibited type) pacemakers was 47 out of 138, or 34.1%, especially for those who received a pulmonary scanning examination whithin 6 months after pacemaker implantation. In contrast, those who were examined after 6 months had lower rates as well as chronological factors. The incidence rate of pulmonary embolism in 37 patients with DDD (Double chamber pacing/sensing, double modes of response) pacemakers was 10.8%, considerably lower than that for patients with VVI pacemakers. Therefore, one main factor of pulmonary embolism in patients with pacemakers could be the non-physiological phase of the contractions of both atria and ventricles. Other factors, such as the presence of foreign bodies in the endocardium, aging, and hypertension, could also promote pulmonary embolism. (author)

  10. Prevalence of sleep-disordered breathing in elderly patients with cardiac pacemaker: a case-control study

    Institute of Scientific and Technical Information of China (English)

    Haiyun WU; Shiwen WANG; Jianping JIA; Wenli ZHANG; Qiang XU

    2005-01-01

    Objective To investigate the prevalence of sleep-disordered breathing in elderly patients with permanent cardiac pacemaker implantation due to bradyarrhythmias, and the relationship between pacing mode and patients' sleep apnea-hypopnea index.Methods Forty-four elderly patients (>60 years) with cardiac pacemaker and their 44 controls matched for gender, age, body mass index and cardiovascular morbidity were studied using polysomnography or portable sleep monitoring device. Results Prevalence of sleep-disordered breathing (apnea-hypopnea index ≥5/h) was 44.7% and the mean apnea-hypopnea index was 8.2 ±4.1/h in the cardiac pacemaker group, which were significantly higher than those in control subjects (25% and 4.6±2.4/h, respectively, P<0.01 and P<0.05). The mean apnea-hypopnea index of patients with DDD or AAI pacemaker was significantly lower than that of patients with VVI pacemaker. Conclusions Sleep-disordered breathing was more common in patients who had their cardiac pacemaker implanted due to bradyarrhythmias than in their matched controls. Compared with VVI pacing, DDD or AAI pacing may be more beneficial to patients with bradyarrhythmias and sleep-disordered breathing.

  11. Next Generation Bipolar Plates for Automotive PEM Fuel Cells

    Energy Technology Data Exchange (ETDEWEB)

    Adrianowycz, Orest; Norley, Julian; Stuart, David J; Flaherty, David; Wayne, Ryan; ; Williams, Warren; Tietze, Roger; Nguyen, Yen-Loan H; Zawodzinski, Tom; Pietrasz, Patrick

    2010-04-15

    The results of a successful U.S. Department of Energy (DoE) funded two-year $2.9 MM program lead by GrafTech International Inc. (GrafTech) are reported and summarized. The program goal was to develop the next generation of high temperature proton exchange membrane (PEM) fuel cell bipolar plates for use in transportation fuel cell applications operating at temperatures up to 120 °C. The bipolar plate composite developed during the program is based on GrafTech’s GRAFCELL resin impregnated flexible graphite technology and makes use of a high temperature Huntsman Advanced Materials resin system which extends the upper use temperature of the composite to the DoE target. High temperature performance of the new composite is achieved with the added benefit of improvements in strength, modulus, and dimensional stability over the incumbent resin systems. Other physical properties, including thermal and electrical conductivity of the new composite are identical to or not adversely affected by the new resin system. Using the new bipolar plate composite system, machined plates were fabricated and tested in high temperature single-cell fuel cells operating at 120 °C for over 1100 hours by Case Western Reserve University. Final verification of performance was done on embossed full-size plates which were fabricated and glued into bipolar plates by GrafTech. Stack testing was done on a 10-cell full-sized stack under a simulated drive cycle protocol by Ballard Power Systems. Freeze-thaw performance was conducted by Ballard on a separate 5-cell stack and shown to be within specification. A third stack was assembled and shipped to Argonne National Laboratory for independent performance verification. Manufacturing cost estimate for the production of the new bipolar plate composite at current and high volume production scenarios was performed by Directed Technologies Inc. (DTI). The production cost estimates were consistent with previous DoE cost estimates performed by DTI for the

  12. Terapia comportamental cognitiva para pessoas com transtorno bipolar Cognitive behavioral therapy for bipolar disorders

    OpenAIRE

    Francisco Lotufo Neto

    2004-01-01

    Descrição dos objetivos e principais técnicas da terapia comportamental cognitiva usadas para a psicoterapia das pessoas com transtorno bipolar.Objectives and main techniques of cognitive behavior therapy for the treatment of bipolar disorder patients are described.

  13. Terapia comportamental cognitiva para pessoas com transtorno bipolar Cognitive behavioral therapy for bipolar disorders

    Directory of Open Access Journals (Sweden)

    Francisco Lotufo Neto

    2004-10-01

    Full Text Available Descrição dos objetivos e principais técnicas da terapia comportamental cognitiva usadas para a psicoterapia das pessoas com transtorno bipolar.Objectives and main techniques of cognitive behavior therapy for the treatment of bipolar disorder patients are described.

  14. Subcortical Gray Matter Volume Abnormalities in Healthy Bipolar Offspring: Potential Neuroanatomical Risk Marker for Bipolar Disorder?

    Science.gov (United States)

    Ladouceur, Cecile D.; Almeida, Jorge R. C.; Birmaher, Boris; Axelson, David A.; Nau, Sharon; Kalas, Catherine; Monk, Kelly; Kupfer, David J.; Phillips, Mary L.

    2008-01-01

    A study is conducted to examine the extent to which bipolar disorder (BD) is associated with gray matter volume abnormalities in brain regions in healthy bipolar offspring relative to age-matched controls. Results show increased gray matter volume in the parahippocampus/hippocampus in healthy offspring at genetic risk for BD.

  15. What psychotherapists should know about pharmacotherapies for bipolar disorder.

    Science.gov (United States)

    Goldberg, Joseph F

    2007-05-01

    This article provides a practice-friendly overview of current psychotropic agents used for the treatment of bipolar disorder. The author reviews definitions and concepts about mood stabilization according to the evidence base, in turn profiling a "clinical niche" for lithium, anticonvulsant drugs, atypical antipsychotics, and antidepressants. Results from randomized clinical trials are summarized to help clinicians individualize treatment decisions and tailor them to real-world patients. Recognition and management of common adverse effects are discussed alongside risk-benefit strategies to guide optimal treatment that balances clinical efficacy with drug safety and tolerability. PMID:17417812

  16. Pacemakers and implantable cardioverter defibrillators, unknown to chest radiography: Review, complications and systematic reading

    Energy Technology Data Exchange (ETDEWEB)

    Alandete Germán, Salvador Pascual, E-mail: salaiger@gmail.com; Isarria Vidal, Santiago, E-mail: isarria@comv.es; Domingo Montañana, María Luisa, E-mail: domingo.luimon@gmail.com; De la vía Oraá, Esperanza, E-mail: esviao82@gmail.com; Vilar Samper, José, E-mail: vilarsamper@gmail.com

    2015-03-15

    Highlights: •Radiologists have an important function in the evaluation of these devices. •We revise their radiological appearances and possible complications. •The knowledge in normal aspects and complications is important for radiologist. •To ensure an accurate reading of the chest x-ray, we present a systematic approach. -- Abstract: Chest X-ray is the imaging technique of choice for an initial study of pacemakers and implantable cardio-defibrillators (ICD). Radiologists have an important role in the evaluation of its initial placement and in the assessment during its follow-up. For this reason, it is necessary to know not only the different existing devices and its components but also the reasons of malfunction or possible complications. The purpose of this article is to do a systematic review of the different types of pacemakers and ICD. We review their usual radiological appearances, the possible complications which might take place and its causes of malfunctioning.

  17. Persistent wandering atrial pacemaker after epinephrine overdosing – a case report

    Directory of Open Access Journals (Sweden)

    Aburawi Elhadi H

    2013-01-01

    Full Text Available Abstract Background Long-term complications of sympathomimetic drug overdosing have not been adequately investigated in infants and young children. Despite reports discouraging their use in children, these formulations are frequently administered for “cold-like symptoms”. Their frequent adverse events are different forms of arrhythmias, including multifocal atrial tachycardia. Case presentation A 3-year-old toddler developed multifocal atrial tachycardia following an iatrogenic overdose of epinephrine accidentally administered intravenously. His ECG showed wandering atrial pacemaker (p-waves with different origins and configurations that persisted for at least one year. This event demonstrated the sensitivity of young children to the sympathomimetic drugs, especially overdosing. Conclusions Health care providers and parents should be warned of toxicities associated with sympathomimetic drug overdosing. Future studies are needed to determine whether wandering atrial pacemaker is a potential long-term complication of high-dose sympathomimetics.

  18. Pacemakers and implantable cardioverter defibrillators, unknown to chest radiography: Review, complications and systematic reading

    International Nuclear Information System (INIS)

    Highlights: •Radiologists have an important function in the evaluation of these devices. •We revise their radiological appearances and possible complications. •The knowledge in normal aspects and complications is important for radiologist. •To ensure an accurate reading of the chest x-ray, we present a systematic approach. -- Abstract: Chest X-ray is the imaging technique of choice for an initial study of pacemakers and implantable cardio-defibrillators (ICD). Radiologists have an important role in the evaluation of its initial placement and in the assessment during its follow-up. For this reason, it is necessary to know not only the different existing devices and its components but also the reasons of malfunction or possible complications. The purpose of this article is to do a systematic review of the different types of pacemakers and ICD. We review their usual radiological appearances, the possible complications which might take place and its causes of malfunctioning

  19. A Cross-sectional, comparative study of insight in schizophrenia and bipolar patients in remission

    Directory of Open Access Journals (Sweden)

    Arul Saravanan Ramachandran

    2016-01-01

    Full Text Available Aims: To study insight correlates in schizophrenia and bipolar mood disorder in remission among out-patients attending the Psychiatry Department of a Tertiary Care Hospital. Settings and Design: In a cross-sectional, naturalistic study, adult patients with schizophrenia and bipolar mood disorder in remission (n = 80; schizophrenia-40, mania-20, bipolar depression-20 were compared on insight measures and clinical correlates. Materials and Methods: Scale to Assess the Unawareness of Mental Disorders (SUMD was used as the main tool to assess current and past measures of insight. Hogan's Drug Attitude Inventory was used to assess the drug attitude and compliance. Positive and Negative Symptom Scale for Schizophrenia, Young's Mania Rating Scale, and HAMD were used to rate psychopathology. Clinical Global Improvement was used as a screening tool for remission. Statistical Analysis: For comparison of the three clinical groups, analysis of variance and Chi-square test were used. In the post-hoc analysis, the Ryan-Einot-Gabriel-Welsch test was used to find the group difference. Results: About 40% in the schizophrenia group were unaware of their mental illness as against none in the bipolar group. The awareness of mental disorder for the current period, the awareness of the achieved effects of medications, and the awareness of social consequence was better in the bipolar group. The drug attitude (compliant positive attitude increased as the SUMD item scale decreased or in other words, as the insight improved. Conclusions: Insight, both current and retrospect, showed significant differences between the schizophrenia and bipolar patients. Insight is significantly correlated with the observed compliance and drug attitude of the patient groups.

  20. Processamento cognitivo "Teoria da Mente" no transtorno bipolar Cognitive "Theory of Mind" processing in bipolar disorder

    Directory of Open Access Journals (Sweden)

    Hélio Anderson Tonelli

    2009-12-01

    Full Text Available OBJETIVO: O transtorno afetivo bipolar está associado ao comprometimento funcional persistente. Apesar de muitas pesquisas demonstrarem que bipolares podem apresentar déficits cognitivos, um número menor de trabalhos avaliou o papel de prejuízos no processamento cognitivo social, a Teoria da Mente (relacionado à capacidade de inferir estados mentais, no aparecimento de sintomas e complicações sociais em bipolares. O objetivo deste trabalho é o de revisar sistemática e criticamente a literatura sobre possíveis alterações do processamento Teoria da Mente no transtorno afetivo bipolar. MÉTODO: Foi realizada uma busca na base de dados Medline por trabalhos publicados em língua inglesa, alemã, espanhola ou portuguesa nos últimos 20 anos, utilizando a frase de busca "Bipolar Disorder"[Mesh] AND "Theory of Mind". Foram procurados por estudos clínicos envolvendo indivíduos bipolares e que empregaram uma ou mais tarefas cognitivas desenvolvidas para a avaliação de habilidades Teoria da Mente. Foram excluídos os relatos de caso e cartas ao editor. A busca inicial resultou em cinco artigos, sendo selecionados quatro. Outros quatro foram também selecionados a partir da leitura dos artigos acima. DISCUSSÃO: Os artigos selecionados avaliaram populações de bipolares adultos e pediátricos, incluindo indivíduos eutímicos, maníacos e deprimidos. A maioria dos trabalhos avaliados sugere que existam prejuízos no processamento Teoria da Mente em portadores de transtorno afetivo bipolar e que estes podem estar por trás dos sintomas e dos déficits funcionais do transtorno afetivo bipolar. CONCLUSÃO: Pesquisas futuras a respeito do tema em questão poderão esclarecer muito acerca do papel das alterações sociocognitivas no surgimento dos sintomas do transtorno afetivo bipolar, bem como ajudar no desenvolvimento de estratégias preventivas e terapêuticas do mesmo.OBJECTIVE: Bipolar disorder is associated to persistent functional

  1. Involvement of Adherence and Adhesion Staphylococcus epidermidis Genes in Pacemaker Lead-Associated Infections

    OpenAIRE

    Klug, Didier; Wallet, Frédéric; Kacet, Salem; Courcol, René J.

    2003-01-01

    We explored three genes of attachment (fbe and atlE) and adhesion (ica) in 27 and 10 Staphylococcus epidermidis strains involved in pacemaker-related infections (PMI) and intravascular-catheter-related infections (IVCI), respectively, and in 25 saprophytic strains. The detection rates of fbe and atlE were identical in PMI and IVCI strains, but ica detection rates were identical in PMI and saprophytic strains.

  2. High ventricular lead impedance of a DDD pacemaker after cranial magnetic resonance imaging.

    Science.gov (United States)

    Baser, Kazim; Guray, Umit; Durukan, Mine; Demirkan, Burcu

    2012-09-01

    Management of electromagnetic interference in the form of magnetic resonance imaging (MRI) in patients with pacemakers (PMs) may be challenging. Serious consequences, especially in PM-dependent patients, may be encountered. Changes in device programming, asynchronous pacing, heating of the lead tip(s), and increased thresholds or even device dislocation may be experienced. We report of a patient with a DDD PM who underwent an emergent MRI, after which there was an increase in ventricular impedance as well as increased cardiac biomarkers.

  3. Treatment of pacemaker-induced superior vena cava syndrome by balloon angioplasty and stenting.

    LENUS (Irish Health Repository)

    Klop, B

    2011-01-01

    Superior vena cava (SVC) syndrome is a rare but serious complication after pacemaker implantation. This report describes three cases of SVC syndrome treated with venoplasty and venous stenting, with an average follow-up of 30.7 (±3.1) months. These cases illustrate that the definitive diagnosis, and the extent and location of venous obstruction, can only be determined by venography.

  4. Defect in Lung Perfusion and Ventilation Scanning of Patients with Permanent Transvenous Implantable Pacemaker

    OpenAIRE

    Matsuura, Yuichiro; Tamura, Mutsuo; Yamashina, Hideki; Higo, Masanori; Fujii, Takanori; Shimamoto, Hiroyuki; Kinoshita, Hirofumi

    1984-01-01

    Lung perfusion and ventilation scanning with 99mTc-MAA and 81mKr-Gass were studied in 138 patients with permanent transvenous implantable pacemaker. There were observed segmental or subsegmental defects in lung perfusion and ventilation scanning which were considered to be probably lung embolism of 47 cases. The incidence of lung embolism was high during the first postoperative 6 months, and it also increased progressively with aging. The patient with ischemic heart disease or va...

  5. Traveling waves and dynamical formation of autonomous pacemakers in a bistable medium with periodic boundary conditions

    Science.gov (United States)

    Shepelev, Igor A.; Vadivasova, Tatiana E.; Postnov, Dmitry E.

    2015-03-01

    The problem of spatiotemporal pattern formation in the wall of arterial vesselsmay be reduced to 1D or 2D models of nonlinear active medium. We address this problem using the discrete array of non-oscillating (bistable) active units. We show how the specific choice of initial conditions in a 1D model with periodic boundary conditions triggers the self-sustained behaviour. We reveal the core of observed effects being the dynamical formation of localized (few-element size) autonomous pacemakers.

  6. Light therapy in the treatment of patients with bipolar depression: A meta-analytic study.

    Science.gov (United States)

    Tseng, Ping-Tao; Chen, Yen-Wen; Tu, Kun-Yu; Chung, Weilun; Wang, Hung-Yu; Wu, Ching-Kuan; Lin, Pao-Yen

    2016-06-01

    Light therapy (LT) has been widely used in the treatment of seasonal affective disorder. Recently some evidence indicated that LT may play a role in bipolar depression, either as monotherapy or in combination with total sleep deprivation (TSD). However, the studies examining the treatment effect of LT in bipolar depression resulted in inconsistent findings. To clarify the role of LT in the disorder, we conducted a meta-analysis to compare the efficacy of LT in the treatment of bipolar depression. The results of individual studies were synthesized by a random effects model. Nine studies including 489 patients with bipolar depression were included in this current meta-analysis. We found that disease severity was significantly decreased after LT, in both with and without TSD, and with concomitant medication (pdepression. However, the detailed mechanism of LT still remains elusive. Further well-designed controlled trials are required to investigate the optimal intensity and frequency of LT in the treatment of bipolar depression. PMID:26993616

  7. Dysregulation of the NF-κB pathway as a potential inducer of bipolar disorder.

    Science.gov (United States)

    Elhaik, Eran; Zandi, Peter

    2015-11-01

    A century of investigations enhanced our understanding of bipolar disorder although it remains a complex multifactorial disorder with a mostly unknown pathophysiology and etiology. The role of the immune system in this disorder is one of the most controversial topics in genetic psychiatry. Though inflammation has been consistently reported in bipolar patients, it remains unclear how the immunologic process influences the disorder. One of the core components of the immune system is the NF-κB pathway, which plays an essential role in the development of innate and adaptive immunity. Remarkably, the NF-κB pathway received only little attention in bipolar studies, as opposed to studies of related psychiatric disorders where immune dysregulation has been proposed to explain the neurodegeneration in patient conditions. If immune dysregulation can also explains the neurodegeneration in bipolar disorder, it will underscore the role of the immune system in the chronicity and pathophysiology of the disorder and may promote personalized therapeutic strategies. This is the first review to summarize the current knowledge of the pathophysiological functions of NF-κB in bipolar disorder.

  8. Mood self-assessment in bipolar disorder: a comparison between patients in mania, depression, and euthymia

    Directory of Open Access Journals (Sweden)

    Rafael de Assis da Silva

    2013-01-01

    Full Text Available BACKGROUND: Some studies indicate that mood self-assessment is more severely impaired in patients with bipolar disorder in a manic episode than in depression. OBJECTIVES: To investigate variations in mood self-assessment in relation to current affective state in a group of individuals with bipolar disorder. METHODS: A total of 165 patients with a diagnosis of bipolar disorder type I or type II had their affective state assessed using the Clinical Global Impressions Scale for use in bipolar illness (CGI-BP, the Positive and Negative Syndrome Scale (PANSS, and the Global Assessment of Functioning (GAF. In addition, participants completed a self-report visual analog mood scale (VAMS. Patients were divided into three groups (euthymia, mania, and depression and compared with regard to VAMS results. RESULTS: Manic patients rated their mood similarly to patients in euthymia in 14 out of 16 items in the VAMS. By contrast, depressed patients rated only two items similarly to euthymic patients. CONCLUSION: Patients with bipolar disorder in mania, but not those in depression, poorly evaluate their affective state, reinforcing the occurrence of insight impairment in the manic syndrome.

  9. Staging Models in Bipolar Disorder: A Systematic Review of the Literature.

    Science.gov (United States)

    Muneer, Ather

    2016-05-31

    Bipolar disorder is manifested as severe dysregulation of mood with recurrent manic and major depressive episodes. It is associated with psychiatric and medical comorbidities, inadequate response to currently available pharmacological agents and a progressively deteriorating course in many patients. The index episode is often depressive in nature, while the first manic or hypomanic episode may occur several years later in the course of the disorder causing delay in diagnosis and use of inappropriate treatment strategies. Staging has been used to great advantage in other branches of medicine like cardiology and oncology. There is growing realization that major mental disorders are fundamentally progressive, with simpler treatment requirements and better prognosis during initial stages of the illness. Defining these conditions into clinically applicable stages not only helps in better understanding the trajectory of a particular disorder, but also assists in management. Patients with a chronic, recalcitrant condition like bipolar disorder are likely to greatly benefit from this approach. If the illness is correctly identified early in its course, proper treatment can be instigated arresting progression to latter phases which are associated with myriad complications in the biopsychosocial realm. With these considerations, a search of the MEDLINE data base was conducted to seek out literature pertaining to staging models in bipolar disorder. A thorough scrutiny of the existing research work revealed that a number of investigators have endeavored to stage define bipolar disorder. This paper outlines staging proposals for bipolar disorder which have the greatest supporting evidence in the literature. PMID:27121423

  10. A novel electrode-bipolar plate assembly for vanadium redox flow battery applications

    Science.gov (United States)

    Qian, Peng; Zhang, Huamin; Chen, Jian; Wen, Yuehua; Luo, Qingtao; Liu, Zonghao; You, Dongjiang; Yi, Baolian

    A novel electrode-bipolar plate assembly has been developed and evaluated for application in the vanadium redox flow battery (VRB). It is composed of three parts: a graphite felt (electrode), an adhesive conducting layer (ACL) and a flexible graphite plate (bipolar plate). The ACL connects the electrode with the bipolar plate to an assembly. By the evaluations of cost, resistivity, surface morphology, electrolyte permeation and single cell performance, this novel assembly demonstrates its applicability in VRB as evident in the following outcomes: (1) lowers the cost and area resistivity to about 10% and 40% of the conventional setups, respectively; (2) improves electrical conductivity to 4.97 mΩ cm as compared to over 100 mΩ cm of the carbon-plastic composite bipolar plate; (3) attains zero electrolyte permeation; and (4) achieves a higher energy efficiency of 81% at a charge/discharge current density of 40 mA cm -2 when employed in a VRB single cell, which is 73% for the conventional setup. All these indicate that the novel electrode-bipolar plate assembly is a promising candidate for VRB applications.

  11. Nitric Oxide Modulates the Temporal Properties of the Glutamate Response in Type 4 OFF Bipolar Cells

    Science.gov (United States)

    Vielma, Alex H.; Agurto, Adolfo; Valdés, Joaquín; Palacios, Adrián G.; Schmachtenberg, Oliver

    2014-01-01

    Nitric oxide (NO) is involved in retinal signal processing, but its cellular actions are only partly understood. An established source of retinal NO are NOACs, a group of nNOS-expressing amacrine cells which signal onto bipolar, other amacrine and ganglion cells in the inner plexiform layer. Here, we report that NO regulates glutamate responses in morphologically and electrophysiologically identified type 4 OFF cone bipolar cells through activation of the soluble guanylyl cyclase-cGMP-PKG pathway. The glutamate response of these cells consists of two components, a fast phasic current sensitive to kainate receptor agonists, and a secondary component with slow kinetics, inhibited by AMPA receptor antagonists. NO shortened the duration of the AMPA receptor-dependent component of the glutamate response, while the kainate receptor-dependent component remained unchanged. Application of 8-Br-cGMP mimicked this effect, while inhibition of soluble guanylate cyclase or protein kinase G prevented it, supporting a mechanism involving a cGMP signaling pathway. Notably, perfusion with a NOS-inhibitor prolonged the duration of the glutamate response, while the NO precursor L-arginine shortened it, in agreement with a modulation by endogenous NO. Furthermore, NO accelerated the response recovery during repeated stimulation of type 4 cone bipolar cells, suggesting that the temporal response properties of this OFF bipolar cell type are regulated by NO. These results reveal a novel cellular mechanism of NO signaling in the retina, and represent the first functional evidence of NO modulating OFF cone bipolar cells. PMID:25463389

  12. Re-use of explanted DDD pacemakers as VDD- clinical utility and cost effectiveness.

    Science.gov (United States)

    Namboodiri, K K N; Sharma, Y P; Bali, H K; Grover, A

    2004-01-01

    Re-use of DDD pulse generators explanted from patients died of unrelated causes is associated with an additional cost of two transvenous leads if implanted as DDD itself, and high rate of infection according to some studies. We studied the clinical and economical aspects of reutilization of explanted DDD pacemakers programmed to VDD mode. Out of 28 patients who received VDD pacemaker during the period, October 2000- September 2001 in the Department of Cardiology, PGIMER, Chandigarh, 5 poor patients were implanted with explanted DDD pulse generators programmed to VDD mode. Each implantation was planned and carried out according to a standard protocol. The age ranged from 45 to 75 (mean-61) years. The indications for pacing were complete heart block (4) and second degree AV block (1). The clinical profile, costs and complications, if any were noted and followed up at regular intervals. The results were compared with patients who received new DDD pulse generators during this period. The additional cost for the atrial lead was not required in these patients. None of these patients had any local site infection. Compared to the two-lead system, the single lead system provided more rapid implantation and minimized complications associated with placement of an atrial lead. The explanted DDD pacemaker can be safely reused as VDD mode with same efficacy in selected patient population. This is associated with lower cost and complications compared to reimplantation as DDD itself.

  13. [Competitive pacing in a patient with DDD pacemaker and bigeminal ventricular extrasystoles].

    Science.gov (United States)

    Carbone, Vincenzo; Candelmo, Fiore; Todaro, Chiara; Oreto, Giuseppe

    2008-11-01

    The ECG recorded from a patient with DDD pacemaker showed variable responses of the pacing system to bigeminal ventricular extrasystoles, dependent on the coupling interval of premature beats. For relatively short coupling intervals, the premature spontaneous event was detected by the pacemaker, inhibiting both atrial and ventricular output, and resulting in a relatively long pacing pause. In slightly less premature end-diastolic extrasystoles, in contrast, the pacing system delivered an atrial spike that was superimposed upon the spontaneous premature QRS complex (pseudo-pseudofusion); under these circumstances, the atrial spike was followed, at the end of the programmed atrioventricular interval, by a ventricular spike falling on the extrasystolic T wave apex (competitive ventricular pacing). This phenomenon, however, did not express a sensing malfunction, but was due to post-atrial ventricular blanking (PAVB), a short period initiated by the atrial spike during which ventricular sensing is temporarily disabled, so that no signal can be detected. Finally, whenever premature end-diastolic impulses occurred after PAVB, during the brief interval defined ventricular safety pacing, the spontaneous event was sensed, being followed by an earlier-than-expected ventricular spike, whose prematurity was aimed at avoiding the occurrence of an artificial impulse upon the T wave of extrasystole. In conclusion, despite several not sensed ventricular extrasystoles and competitive pacing, no sensing malfunction was present. This case demonstrates how complex can be the electrocardiographic analysis of a DDD pacemaker, owing to the many complicating phenomena related to this pacing mechanism.

  14. Employment Of IGBT-Transistors For Bipolar Impulsed Micro-Arc Oxidation

    Directory of Open Access Journals (Sweden)

    Krainyukov Alexander

    2015-09-01

    Full Text Available The paper is devoted to the use of insulated gate bipolar transistors (IGBT for the micro-arc oxidation (MAO process. The technical requirements to the current switches of power supplies for the pulsed bipolar MAO technology have been developed. The research installation for investigating the IGBT commutation processes during the pulse anode-cathode oxidation has been constructed. The experiments have been performed with its help in order to estimate the possibility of using half-bridge IGBT-modules with different drivers. The research results of the commutation processes investigation for different IGBT half- bridge modules are presented.

  15. Big data for bipolar disorder.

    Science.gov (United States)

    Monteith, Scott; Glenn, Tasha; Geddes, John; Whybrow, Peter C; Bauer, Michael

    2016-12-01

    The delivery of psychiatric care is changing with a new emphasis on integrated care, preventative measures, population health, and the biological basis of disease. Fundamental to this transformation are big data and advances in the ability to analyze these data. The impact of big data on the routine treatment of bipolar disorder today and in the near future is discussed, with examples that relate to health policy, the discovery of new associations, and the study of rare events. The primary sources of big data today are electronic medical records (EMR), claims, and registry data from providers and payers. In the near future, data created by patients from active monitoring, passive monitoring of Internet and smartphone activities, and from sensors may be integrated with the EMR. Diverse data sources from outside of medicine, such as government financial data, will be linked for research. Over the long term, genetic and imaging data will be integrated with the EMR, and there will be more emphasis on predictive models. Many technical challenges remain when analyzing big data that relates to size, heterogeneity, complexity, and unstructured text data in the EMR. Human judgement and subject matter expertise are critical parts of big data analysis, and the active participation of psychiatrists is needed throughout the analytical process.

  16. Big data for bipolar disorder.

    Science.gov (United States)

    Monteith, Scott; Glenn, Tasha; Geddes, John; Whybrow, Peter C; Bauer, Michael

    2016-12-01

    The delivery of psychiatric care is changing with a new emphasis on integrated care, preventative measures, population health, and the biological basis of disease. Fundamental to this transformation are big data and advances in the ability to analyze these data. The impact of big data on the routine treatment of bipolar disorder today and in the near future is discussed, with examples that relate to health policy, the discovery of new associations, and the study of rare events. The primary sources of big data today are electronic medical records (EMR), claims, and registry data from providers and payers. In the near future, data created by patients from active monitoring, passive monitoring of Internet and smartphone activities, and from sensors may be integrated with the EMR. Diverse data sources from outside of medicine, such as government financial data, will be linked for research. Over the long term, genetic and imaging data will be integrated with the EMR, and there will be more emphasis on predictive models. Many technical challenges remain when analyzing big data that relates to size, heterogeneity, complexity, and unstructured text data in the EMR. Human judgement and subject matter expertise are critical parts of big data analysis, and the active participation of psychiatrists is needed throughout the analytical process. PMID:27068058

  17. Electrical characterization of commercial NPN bipolar junction transistors under neutron and gamma irradiation

    Directory of Open Access Journals (Sweden)

    OO Myo Min

    2014-01-01

    Full Text Available Electronics components such as bipolar junction transistors, diodes, etc. which are used in deep space mission are required to be tolerant to extensive exposure to energetic neutrons and ionizing radiation. This paper examines neutron radiation with pneumatic transfer system of TRIGA Mark-II reactor at the Malaysian Nuclear Agency. The effects of the gamma radiation from Co-60 on silicon NPN bipolar junction transistors is also be examined. Analyses on irradiated transistors were performed in terms of the electrical characteristics such as current gain, collector current and base current. Experimental results showed that the current gain on the devices degraded significantly after neutron and gamma radiations. Neutron radiation can cause displacement damage in the bulk layer of the transistor structure and gamma radiation can induce ionizing damage in the oxide layer of emitter-base depletion layer. The current gain degradation is believed to be governed by the increasing recombination current in the base-emitter depletion region.

  18. Low frequency magnetic emissions and resulting induced voltages in a pacemaker by iPod portable music players

    Science.gov (United States)

    Bassen, Howard

    2008-01-01

    Background Recently, malfunctioning of a cardiac pacemaker electromagnetic, caused by electromagnetic interference (EMI) by fields emitted by personal portable music players was highly publicized around the world. A clinical study of one patient was performed and two types of interference were observed when the clinicians placed a pacemaker programming head and an iPod were placed adjacent to the patient's implanted pacemaker. The authors concluded that "Warning labels may be needed to avoid close contact between pacemakers and iPods". We performed an in-vitro study to evaluate these claims of EMI and present our findings of no-effects" in this paper. Methods We performed in-vitro evaluations of the low frequency magnetic field emissions from various models of the Apple Inc. iPod music player. We measured magnetic field emissions with a 3-coil sensor (diameter of 3.5 cm) placed within 1 cm of the surface of the player. Highly localized fields were observed (only existing in a one square cm area). We also measured the voltages induced inside an 'instrumented-can' pacemaker with two standard unipolar leads. Each iPod was placed in the air, 2.7 cm above the pacemaker case. The pacemaker case and leads were placed in a saline filled torso simulator per pacemaker electromagnetic compatibility standard ANSI/AAMI PC69:2000. Voltages inside the can were measured. Results Emissions were strongest (≈ 0.2 μT pp) near a few localized points on the cases of the two iPods with hard drives. Emissions consisted of 100 kHz sinusoidal signal with lower frequency (20 msec wide) pulsed amplitude modulation. Voltages induced in the iPods were below the noise level of our instruments (0.5 mV pp in the 0 – 1 kHz band or 2 mV pp in the 0 – 5 MHz bandwidth. Conclusion Our measurements of the magnitude and the spatial distribution of low frequency magnetic flux density emissions by 4 different models of iPod portable music players. Levels of less than 0.2 μT exist very close (1 cm

  19. Low frequency magnetic emissions and resulting induced voltages in a pacemaker by iPod portable music players

    Directory of Open Access Journals (Sweden)

    Bassen Howard

    2008-02-01

    Full Text Available Abstract Background Recently, malfunctioning of a cardiac pacemaker electromagnetic, caused by electromagnetic interference (EMI by fields emitted by personal portable music players was highly publicized around the world. A clinical study of one patient was performed and two types of interference were observed when the clinicians placed a pacemaker programming head and an iPod were placed adjacent to the patient's implanted pacemaker. The authors concluded that "Warning labels may be needed to avoid close contact between pacemakers and iPods". We performed an in-vitro study to evaluate these claims of EMI and present our findings of no-effects" in this paper. Methods We performed in-vitro evaluations of the low frequency magnetic field emissions from various models of the Apple Inc. iPod music player. We measured magnetic field emissions with a 3-coil sensor (diameter of 3.5 cm placed within 1 cm of the surface of the player. Highly localized fields were observed (only existing in a one square cm area. We also measured the voltages induced inside an 'instrumented-can' pacemaker with two standard unipolar leads. Each iPod was placed in the air, 2.7 cm above the pacemaker case. The pacemaker case and leads were placed in a saline filled torso simulator per pacemaker electromagnetic compatibility standard ANSI/AAMI PC69:2000. Voltages inside the can were measured. Results Emissions were strongest (≈ 0.2 μT pp near a few localized points on the cases of the two iPods with hard drives. Emissions consisted of 100 kHz sinusoidal signal with lower frequency (20 msec wide pulsed amplitude modulation. Voltages induced in the iPods were below the noise level of our instruments (0.5 mV pp in the 0 – 1 kHz band or 2 mV pp in the 0 – 5 MHz bandwidth. Conclusion Our measurements of the magnitude and the spatial distribution of low frequency magnetic flux density emissions by 4 different models of iPod portable music players. Levels of less than 0.2

  20. Cross-Species Studies on the Mechanisms Underlying Abnormal Behavior in Bipolar Disorder: A Dopaminergic Focus

    NARCIS (Netherlands)

    van Enkhuizen, J.

    2014-01-01

    Bipolar disorder (BD) is a severe neuropsychiatric disorder, affecting approximately 2% of the worldwide population. It is characterized by euphoric states of mania and opposite mood states of depression, which are devastating to the patients’ quality of life. Current treatment options are poor and

  1. Subclinical psychotic experiences and bipolar spectrum features in depression: association with outcome of psychotherapy

    NARCIS (Netherlands)

    J.T.W. Wigman; J. van Os; L. Abidi; M.J.H. Huibers; J. Roelofs; A. Arntz; I. Kelleher; F.P.M.L. Peeters

    2013-01-01

    Background: Subthreshold psychotic and bipolar experiences are common in major depressive disorder (MDD). However, it is unknown if effectiveness of psychotherapy is altered in depressed patients who display such features compared with those without. The current paper aimed to investigate the impact

  2. Subclinical psychotic experiences and bipolar spectrum features in depression : association with outcome of psychotherapy

    NARCIS (Netherlands)

    Wigman, J. T. W.; van Os, J.; Abidi, L.; Huibers, M. J. H.; Roelofs, J.; Arntz, A.; Kelleher, I.; Peeters, F. P. M. L.

    2014-01-01

    Background Subthreshold psychotic and bipolar experiences are common in major depressive disorder (MDD). However, it is unknown if effectiveness of psychotherapy is altered in depressed patients who display such features compared with those without. The current paper aimed to investigate the impact

  3. Characterization testing of a 40 Ahr bipolar nickel hydrogen battery

    Science.gov (United States)

    Brewer, Jeffrey C.; Manzo, Michelle A.; Gahn, Randall F.

    1989-01-01

    In a continuing effort to develop NiH2 bipolar technology to a point where it can be used efficiently in space flight, testing of a second 40 Ahr, 10-cell bipolar battery has begun. This battery has undergone extensive characterization testing to determine the effects of such operating parameters as charge and discharge rates, temperature, and pressure. The fundamental design of this actively cooled bipolar battery is the same as the first battery. Most of the individual components, however, are from different manufacturers. Different testing procedures as well as certain unique battery characteristics make it difficult to directly compare the two sets of results. In general, the performance of this battery throughout characterization produced expected results. The main differences seen between the first and second batteries occurred during the high-rate discharge portion of the test matrix. The first battery also had poor high-rate discharge results, although better than those of the second battery. Minor changes were made to the battery frame design used for the first battery in an attempt to allow better gas access to the reaction sites for the second build and hopefully improve performance. The changes, however, did not improve the performance of the second battery and could have possibly contributed to the poorer performance that was observed. There are other component differences that could have contributed to the poorer performance of the second battery. The H2 electrode in the second battery was constructed with a Goretex backing which could have limited the high-rate current flow. The gas screen in the second battery had a larger mesh which again could have limited the high-rate current flow. Small scale 2 x 2 batteries are being tested to evaluate the effects of the component variations.

  4. A Review of Metallic Bipolar Plates for Proton Exchange Membrane Fuel Cells: Materials and Fabrication Methods

    Directory of Open Access Journals (Sweden)

    Shahram Karimi

    2012-01-01

    Full Text Available The proton exchange membrane fuel cell offers an exceptional potential for a clean, efficient, and reliable power source. The bipolar plate is a key component in this device, as it connects each cell electrically, supplies reactant gases to both anode and cathode, and removes reaction products from the cell. Bipolar plates have been fabricated primarily from high-density graphite, but in recent years, much attention has been paid to developing cost-effective and feasible alternative materials. Two different classes of materials have attracted attention: metals and composites. This paper offers a comprehensive review of the current research being carried out on metallic bipolar plates, covering materials and fabrication methods.

  5. Bipolarly stacked electrolyser for energy and space efficient fabrication of supercapacitor electrodes

    Science.gov (United States)

    Liu, Xiaojuan; Wu, Tao; Dai, Zengxin; Tao, Keran; Shi, Yong; Peng, Chuang; Zhou, Xiaohang; Chen, George Z.

    2016-03-01

    Stacked electrolysers with titanium bipolar plates are constructed for electrodeposition of polypyrrole electrodes for supercapacitors. The cathode side of the bipolar Ti plates are pre-coated with activated carbon. In this new design, half electrolysis occurs which significantly lowers the deposition voltage. The deposited electrodes are tested in a symmetrical unit cell supercapacitor and an asymmetrical supercapacitor stack. Both devices show excellent energy storage performances and the capacitance values are very close to the design value, suggesting a very high current efficiency during the electrodeposition. The electrolyser stack offers multi-fold benefits for preparation of conducting polymer electrodes, i.e. low energy consumption, facile control of the electrode capacitance and simultaneous preparation of a number of identical electrodes. Therefore, the stacked bipolar electrolyser is a technology advance that offers an engineering solution for mass production of electrodeposited conducting polymer electrodes for supercapacitors.

  6. Coronal Pseudo-Streamer and Bipolar Streamer Observed by SOHO/UVCS in March 2008

    CERN Document Server

    Abbo, Lucia; Riley, Pete; Wang, Yi-Ming

    2015-01-01

    The last solar minimum is characterized by several peculiar aspects and by the presence of a complex magnetic topology with two different kinds of coronal streamers: pseudo-streamers and bipolar streamers. Pseudo-streamers or unipolar streamer are coronal structures which separate coronal holes of the same polarity, without a current sheet in the outer corona; unlike bipolar streamer that separate coronal holes of opposite magnetic polarity. In this study, two examples of these structures have been identified in the period of Carrington rotation 2067, by applying a potential-field source-surface extrapolation of the photospheric field measurements. We present a spectroscopic analysis of a pseudo-streamer and a bipolar streamer observed in the period 12-17 March 2008 at high spectral and spatial resolution by the Ultraviolet Coronagraph Spectrometer (UVCS; Kohl et al., 1995) onboard Solar and Heliospheric Observatory (SOHO). The solar wind plasma parameters, such as kinetic temperature, electron density and ou...

  7. Effect of bipolar electrode material on the reclamation of urban wastewater by an integrated electrodisinfection/electrocoagulation process.

    Science.gov (United States)

    Llanos, Javier; Cotillas, Salvador; Cañizares, Pablo; Rodrigo, Manuel A

    2014-04-15

    This work presents an integrated electrodisinfection/electrocoagulation (ED-EC) process for urban wastewater reuse that employs iron bipolar electrodes. Boron doped diamond (BDD) was used as the anode and stainless steel (SS) as the cathode. A perforated iron plate was introduced between the anode and cathode to function as a bipolar electrode. This ED-EC combined cell makes it possible to conduct the simultaneous removal of microbiological content and elimination of turbidity from urban wastewater. The results show that current densities greater than or equal to 6.70 A m(-2) enable complete disinfection of the effluent and the removal of more than 90% of its initial turbidity. Hypochlorite and chloramines formed during the ED-EC process were found to be the main compounds responsible for the disinfection process. Furthermore, a cell configuration of cathode (inlet)-anode (outlet) improves the process performance by enhancing turbidity removal. Finally, the influence of the bipolar electrode material (iron or aluminium) was assessed. The results indicate that the efficiency of the electrodisinfection process depends mainly on the anodic material and is not influenced by the material of the bipolar electrode. In contrast, the removal of turbidity is more efficient when using iron as a bipolar electrode, especially at low current densities, due to the formation of a passive layer on the aluminium that hinders the dissolution of the bipolar electrode. PMID:24531029

  8. Ca2+-Clock-Dependent Pacemaking in the Sinus Node Is Impaired in Mice with a Cardiac Specific Reduction in SERCA2 Abundance

    Science.gov (United States)

    Logantha, Sunil Jit R. J.; Stokke, Mathis K.; Atkinson, Andrew J.; Kharche, Sanjay R.; Parveen, Sajida; Saeed, Yawer; Sjaastad, Ivar; Sejersted, Ole M.; Dobrzynski, Halina

    2016-01-01

    Background: The sarcoplasmic reticulum Ca2+-ATPase (SERCA2) pump is an important component of the Ca2+-clock pacemaker mechanism that provides robustness and flexibility to sinus node pacemaking. We have developed transgenic mice with reduced cardiac SERCA2 abundance (Serca2 KO) as a model for investigating SERCA2's role in sinus node pacemaking. Methods and Results: In Serca2 KO mice, ventricular SERCA2a protein content measured by Western blotting was 75% (P 70% reduction in SERCA2 activity. Conclusions: Serca2 KO mice show a disrupted Ca2+-clock-dependent pacemaker mechanism contributing to impaired sinus node and atrioventricular node function. PMID:27313537

  9. Bipolar batteries based on Ebonex ® technology

    Science.gov (United States)

    Loyns, A. C.; Hill, A.; Ellis, K. G.; Partington, T. J.; Hill, J. M.

    Continuing work by Atraverda on the production of a composite-laminate form of the Ebonex ® material, that can be cheaply formulated and manufactured to form substrate plates for bipolar lead-acid batteries, is described. Ebonex ® is the registered trade name of a range of titanium suboxide ceramic materials, typically Ti 4O 7 and Ti 5O 9, which combine electrical conductivity with high corrosion and oxidation resistance. Details of the structure of the composite, battery construction techniques and methods for filling and forming of batteries are discussed. In addition, lifetime and performance data obtained by Atraverda from laboratory bipolar lead-acid batteries and cells are presented. Battery production techniques for both conventional monopolar and bipolar batteries are reviewed. The findings indicate that substantial time and cost savings may be realised in the manufacture of bipolar batteries in comparison to conventional designs. This is due to the fewer processing steps required and more efficient formation. The results indicate that the use of Ebonex ® composite material as a bipolar substrate will provide lightweight and durable high-voltage lead-acid batteries suitable for a wide range of applications including advanced automotive, stationary power and portable equipment.

  10. The role of sleep in bipolar disorder.

    Science.gov (United States)

    Gold, Alexandra K; Sylvia, Louisa G

    2016-01-01

    Bipolar disorder is a serious mental illness characterized by alternating periods of elevated and depressed mood. Sleep disturbances in bipolar disorder are present during all stages of the condition and exert a negative impact on overall course, quality of life, and treatment outcomes. We examine the partnership between circadian system (process C) functioning and sleep-wake homeostasis (process S) on optimal sleep functioning and explore the role of disruptions in both systems on sleep disturbances in bipolar disorder. A convergence of evidence suggests that sleep problems in bipolar disorder result from dysregulation across both process C and process S systems. Biomarkers of depressive episodes include heightened fragmentation of rapid eye movement (REM) sleep, reduced REM latency, increased REM density, and a greater percentage of awakenings, while biomarkers of manic episodes include reduced REM latency, greater percentage of stage I sleep, increased REM density, discontinuous sleep patterns, shortened total sleep time, and a greater time awake in bed. These findings highlight the importance of targeting novel treatments for sleep disturbance in bipolar disorder. PMID:27418862

  11. QUALITY OF LIFE IN BIPOLAR DISORDER

    Directory of Open Access Journals (Sweden)

    Nieznańska, Anna

    2014-12-01

    Full Text Available Background: Among the consequences of bipolar disorder there i s a decreased quality of life, including the deterioration of patients’ social functioning. Material: The paper contains an analysis of 24 major publica tions from the years 2009 to 2014, including 17 related to the assessment of quality of life and 7 articles on the bipolar patients’ social functioning. Results: There were selected 8 factors which are related with the assessment of the quality of life of persons with a diagnosis of bipolar disorder: the presence of depressive symptoms, substance use, sleep deficit, religious activity and social support, internalized stigma, suicide attempts in the past, the perception of emotions and impulsivity. It was defined that social functioning of bipolar patients is dependent on the emotional state of patients, and in particular the presence of depressive symptoms. It is dependent also on patients’ cognitive performance and internalized stigma. Conclusions: Assistance in mastering the first symptoms of a depressive phase can help bipolar patients in their smooth social functioning and quality of life. Taking into account the implementation of appropriate therapy with cognitive exercise and which is aimed at reducing internalized stigma, may contribute to improving the quality of life and improve the patients’ social functioning.

  12. The role of sleep in bipolar disorder

    Science.gov (United States)

    Gold, Alexandra K; Sylvia, Louisa G

    2016-01-01

    Bipolar disorder is a serious mental illness characterized by alternating periods of elevated and depressed mood. Sleep disturbances in bipolar disorder are present during all stages of the condition and exert a negative impact on overall course, quality of life, and treatment outcomes. We examine the partnership between circadian system (process C) functioning and sleep–wake homeostasis (process S) on optimal sleep functioning and explore the role of disruptions in both systems on sleep disturbances in bipolar disorder. A convergence of evidence suggests that sleep problems in bipolar disorder result from dysregulation across both process C and process S systems. Biomarkers of depressive episodes include heightened fragmentation of rapid eye movement (REM) sleep, reduced REM latency, increased REM density, and a greater percentage of awakenings, while biomarkers of manic episodes include reduced REM latency, greater percentage of stage I sleep, increased REM density, discontinuous sleep patterns, shortened total sleep time, and a greater time awake in bed. These findings highlight the importance of targeting novel treatments for sleep disturbance in bipolar disorder. PMID:27418862

  13. [Pseudocholinesterase activity in type 1 bipolar patients].

    Science.gov (United States)

    Ezzaher, Asma; Haj Mouhamed, Dhouha; Mechri, Anwar; Neffati, Fadoua; Douki, Wahiba; Gaha, Lotfi; Najjar, Mohamed Fadhel

    2012-01-01

    This study aims to investigate the variation of pseudocholinesterase activity (BuChE) in bipolar patients and to explore its relation to the clinical and therapeutic characteristics of this disease. Our study included 105 patients with bipolar disorder and 100 control subjects aged 38.7 ± 12.2 and 36.4 ± 15.7 y, respectively. BuChE was determined by kinetic methods on Cobas Integra 400 plus™. Compared with controls, patients had a significantly higher pseudocholinesterase activity. Moreover, this increase was significantly associated (p = 0.001) with bipolar disorder with sensibility of 58% and specificity of 62% at threshold of 7392 IU/L. There was no significant change in pseudocholinesterase activity in relation to illness episodes and treatment, whereas the lowest values of this activity were seen in euthymic patients and those taking psychotics. Therefore, this activity is a real interest in the biological monitoring of patients as a risk factor for neurodegenerative diseases associated with bipolar disorder. But it would be most useful to evaluate their interest as a predictor of bipolar disorder in patients at risk. PMID:22294139

  14. Cytokines in bipolar disorder vs. healthy control subjects

    DEFF Research Database (Denmark)

    Munkholm, Klaus; Braüner, Julie Vestergaard; Kessing, Lars Vedel;

    2013-01-01

    Bipolar disorder may be associated with peripheral immune system dysfunction; however, results in individual studies are conflicting. Our aim was to systematically review evidence of peripheral cytokine alterations in bipolar disorder integrating findings from various affective states....

  15. Assessment of subjective and objective cognitive function in bipolar disorder

    DEFF Research Database (Denmark)

    Demant, Kirsa M; Vinberg, Maj; Kessing, Lars V;

    2015-01-01

    Cognitive dysfunction is prevalent in bipolar disorder (BD). However, the evidence regarding the association between subjective cognitive complaints, objective cognitive performance and psychosocial function is sparse and inconsistent. Seventy seven patients with bipolar disorder who presented...

  16. Application of Bipolar Fuzzy Sets in Graph Structures

    Directory of Open Access Journals (Sweden)

    Muhammad Akram

    2016-01-01

    Full Text Available A graph structure is a useful tool in solving the combinatorial problems in different areas of computer science and computational intelligence systems. In this paper, we apply the concept of bipolar fuzzy sets to graph structures. We introduce certain notions, including bipolar fuzzy graph structure (BFGS, strong bipolar fuzzy graph structure, bipolar fuzzy Ni-cycle, bipolar fuzzy Ni-tree, bipolar fuzzy Ni-cut vertex, and bipolar fuzzy Ni-bridge, and illustrate these notions by several examples. We study ϕ-complement, self-complement, strong self-complement, and totally strong self-complement in bipolar fuzzy graph structures, and we investigate some of their interesting properties.

  17. Anticonvulsant Drugs for Nerve Pain, Bipolar Disorder and Fibromyalgia

    Science.gov (United States)

    Anticonvulsant Drugs for Nerve Pain, Bipolar Disorder &Fibromyalgia: Choosing What’sRight for You What are anticonvulsant drugs? Anticonvulsants are drugs used to treat seizures. They are also used to treat bipolar ...

  18. Lithium Beats Newer Meds for Bipolar Disorder, Study Finds

    Science.gov (United States)

    ... for Treatment and Research of Bipolar Disorder at Zucker Hillside Hospital in Glen Oaks, N.Y., and ... Center for Treatment and Research of Bipolar Disorder, Zucker Hillside Hospital, Glen Oaks, N.Y.; May 11, ...

  19. Kids with Bipolar Disorder More Likely to Abuse Drugs, Alcohol

    Science.gov (United States)

    ... html Kids With Bipolar Disorder More Likely to Abuse Drugs, Alcohol: Study And those who also have conduct disorder ... with bipolar disorder, the risk that they will abuse alcohol and drugs may increase as they get older, ...

  20. Immune activation by casein dietary antigens in bipolar disorder

    NARCIS (Netherlands)

    Severance, E.G.; Dupont, D.; Dickerson, F.B.; Stallings, C.R.; Origoni, A.E.; Krivogorsky, B.; Yang, S.; Haasnoot, W.; Yolken, R.H.

    2010-01-01

    Objectives: Inflammation and other immune processes are increasingly linked to psychiatric diseases. Antigenic triggers specific to bipolar disorder are not yet defined. We tested whether antibodies to bovine milk caseins were associated with bipolar disorder, and whether patients recognized differe

  1. A minimum thermodynamic model for the bipolar seesaw

    DEFF Research Database (Denmark)

    Stocker, Thomas F.; Johnsen, Sigfus Johann

    2003-01-01

    Bipolar seesaw, synchronization of Antarctic and Greenland ice cores, Dansgaard-Oeschger events, north-south connection......Bipolar seesaw, synchronization of Antarctic and Greenland ice cores, Dansgaard-Oeschger events, north-south connection...

  2. Differences between Depression Episodes of Bipolar Disorder I and II

    Directory of Open Access Journals (Sweden)

    Leman Inanc

    2013-09-01

    Full Text Available In 1975 Fieve and Dunner made the distinction between hypomania and mania as hypomania does not usually cause social and occupational impair-ment and hospitalization is not needed, moreover patients do not experience psychosis. Bipolar disorder type I is defined by the presence of manic and depressive episodes and differs from Bipolar disorder type II characterized with hipomanic and depressive episodes. Bipolar disorder type I and II do not differ in their depressive episodes. It is still point of contention whether bipolar type II is a variant of bipolar disorder type I or is positioned on the spectrum between bipolar type I and unipolar disorder. Even there are some similarities in characteristics of depressive episodes and outcome features of different bipolar disorder subtypes, there are differences that can be useful in differential diagnosis and treatment. This paper aims to focus on those differences between bipolar disorder type I and II.

  3. SU-D-18C-06: Initial Experience with Implementing MRI Safety Guidelines for Patients with Pacemakers - Medical Physicist Perspective

    Energy Technology Data Exchange (ETDEWEB)

    James, J; Place, V; Panda, A [Mayo Clinic, Scottsdale, AZ (United States); Edmonson, H [Mayo Clinic College of Medicine, Rochester, MN (United States); Felmlee, J [Mayo Clinic, Rochester, MN (United States); Pooley, R [Mayo Clinic, Jacksonville, FL (United States)

    2014-06-01

    Purpose: Several institutions have developed MRI guidelines for patients with MR-unsafe or MR-conditional pacemakers. Here we highlight the role of a medical physicist in implementing these guidelines for non-pacemaker dependent patients. Guidelines: Implementing these guidelines requires involvement from several medical specialties and a strong collaboration with the site MRI supervisor to develop a structured workflow. A medical physicist is required to be present during the scan to supervise the MR scanning and to maintain a safety checklist that ensures: 1) uninterrupted patient communication with the technologist, 2) continuous patient physiologic monitoring (e.g. blood pressure and electrocardiography) by a trained nurse, 3) redundant patient vitals monitoring (e.g. pulse oximetry) due to the possibility of in vivo electrocardiography reading fluctuations during image acquisition. A radiologist is strongly recommended to be available to review the images before patients are discharged from the scanner. Pacemaker MRI should be restricted to 1.5T field strength. The MRI sequences should be optimized by the physicist with regards to: a) SAR: limited to <1.5 W/Kg for MR-unsafe pacemakers in normal operating mode, b) RF exposure time: <30 min, c) Coils: use T/R coils but not restricted to such, d) Artifacts: further optimization of sequences whenever image quality is compromised due to the pacemaker. In particular, cardiac, breast and left-shoulder MRIs are most susceptible to these artifacts. Possible strategies to lower the SAR include: a) BW reduction, 2) echo-train-length reduction, 3) increase TR, 4) decrease number of averages, 5) decrease flip angle, 6) reduce slices and/or a combination of all the options. Conclusion: A medical physicist in collaboration with the MR supervisor plays an important role in the supervision/implementation of safe MR scanning of pacemaker patients. Developing and establishing a workflow has enabled our institution to scan over

  4. Immunocytochemical Evidence that Monkey Rod Bipolar Cells Use GABA

    OpenAIRE

    Lassová, Luisa; Fina, Marie; Sulaiman, Pyroja; Vard, Noga

    2010-01-01

    Certain bipolar cells in most species immunostain for GABA or its synthesizing enzyme, GAD. However it is unknown whether they actually release GABA, and if so, from which cellular compartment, and by what release mechanism. We investigated these questions in monkey retina where rod bipolar cells immunostain for GABA. We found that rod bipolar cells immunostain for one isoform of GAD, GAD65, in their somas, dendrites, and axon terminals. Near the fovea, the somatic stain of rod bipolar cells ...

  5. Experience of Subjective Symptoms in Euthymic Patients with Bipolar Disorder

    OpenAIRE

    Joe, Soohyun; Joo,YeonHo; Kim, Seongyoon

    2008-01-01

    Bipolar patients often experience subjective symptoms even if they do not have active psychotic symptoms in their euthymic state. Most studies about subjective symptoms are conducted in schizophrenia, and there are few studies involving bipolar patients. We examined the nature of the subjective symptoms of bipolar patients in their euthymic state, and we also compared it to that of schizophrenia and normal control. Thirty bipolar patients, 25 patients with schizophrenia, and 21 normal control...

  6. A Review of MR Spectroscopy Studies of Pediatric Bipolar Disorder

    OpenAIRE

    Kondo, D.G.; Hellem, T.L.; Shi, X.-F.; Sung, Y.H.; Prescot, A.P.; Kim, T.S.; Huber, R.S.; Forrest, L.N.; Renshaw, P.F.

    2014-01-01

    Pediatric bipolar disorder is a severe mental illness whose pathophysiology is poorly understood and for which there is an urgent need for improved diagnosis and treatment. MR spectroscopy is a neuroimaging method capable of in vivo measurement of neurochemicals relevant to bipolar disorder neurobiology. MR spectroscopy studies of adult bipolar disorder provide consistent evidence for alterations in the glutamate system and mitochondrial function. In bipolar disorder, these 2 phenomena may be...

  7. Rumination in bipolar disorder: evidence for an unquiet mind

    OpenAIRE

    Ghaznavi Sharmin; Deckersbach Thilo

    2012-01-01

    Abstract Depression in bipolar disorder has long been thought to be a state characterized by mental inactivity. However, recent research demonstrates that patients with bipolar disorder engage in rumination, a form of self-focused repetitive cognitive activity, in depressed as well as in manic states. While rumination has long been associated with depressed states in major depressive disorder, the finding that patients with bipolar disorder ruminate in manic states is unique to bipolar disord...

  8. New non-linear photovoltaic effect in uniform bipolar semiconductor

    Energy Technology Data Exchange (ETDEWEB)

    Volovichev, I. [A. Usikov Institute for Radiophysics and Electronics, National Academy of Sciences of Ukraine, 12 Ac. Proscura St., Kharkov 61085 (Ukraine)

    2014-11-21

    A linear theory of the new non-linear photovoltaic effect in the closed circuit consisting of a non-uniformly illuminated uniform bipolar semiconductor with neutral impurities is developed. The non-uniform photo-excitation of impurities results in the position-dependant current carrier mobility that breaks the semiconductor homogeneity and induces the photo-electromotive force (emf). As both the electron (or hole) mobility gradient and the current carrier generation rate depend on the light intensity, the photo-emf and the short-circuit current prove to be non-linear functions of the incident light intensity at an arbitrarily low illumination. The influence of the sample size on the photovoltaic effect magnitude is studied. Physical relations and distinctions between the considered effect and the Dember and bulk photovoltaic effects are also discussed.

  9. Paired structures and bipolar knowledge representation

    DEFF Research Database (Denmark)

    Montero, Javier; Bustince, Humberto; Franco, Camilo;

    In this strictly positional paper we propose a general approach to bipolar knowledge representation, where the meaning of concepts can be modelled by examining their decomposition into opposite and neutral categories. In particular, it is the semantic relationship between the opposite categories...... and at the same time the type of neutrality rising in between opposites. Based on this first level of bipolar knowledge representation, paired structures in fact offer the means to characterize a specific bipolar valuation scale depending on the meaning of the concept that has to be verified. In this sense...... which suggests the emergence of a paired structure and its associated type of neutrality, being there three general types of neutral categories, namely indeterminacy, ambivalence and conflict. Hence, the key issue consists in identifying the semantic opposition characterizing the meaning of concepts...

  10. Plain carbon steel bipolar plates for PEMFC

    Institute of Scientific and Technical Information of China (English)

    WANG Jianli; SUN Juncai; TIAN Rujin; XU Jing

    2006-01-01

    Bipolar plates are a multifunctional component of PEMFC. Comparing with the machined graphite and stainless steels, the plain carbon steel is a very cheap commercial metal material. In this paper, the possibility of applying the plain carbon steels in the bipolar plate for PEMFC was exploited. In order to improve the corrosion resistance of the low carbon steel in the PEMFCs' environments,two surface modification processes was developed and then the electrochemical performances and interfacial contact resistance (ICR) of the surface modified plate of plain carbon steel were investigated. The results show that the surface modified steel plates have good corrosion resistance and relatively low contact resistance, and it may be a candidate material as bipolar plate of PEMFC.

  11. A radiation hard bipolar monolithic front-end readout

    CERN Document Server

    Baschirotto, A; Cappelluti, I; Castello, R; Cermesoni, M; Gola, A; Pessina, G; Pistolesi, E; Rancoita, P G; Seidman, A

    1999-01-01

    A fast bipolar monolithic charge sensitive preamplifier (CSP), implemented in the monolithic 2 mu m BiCMOS technology (called HF2CMOS) was designed and built in a quad monolithic chip. Studies of radiation effects in the CSP $9 performance, from non-irradiated and up to neutron irradiation of 5.3*10/sup 14/ n/cm/sup 2/, have confirmed that the use of bipolar npn transistors is suitable for the radiation level of the future LHC collider environment. The CSP $9 presents a new circuit solution for obtaining adequate slew rate performances which results in an integral linearity better than 0.8554330n 5 V at 20 ns of shaping time, regardless of the bias current selected for the CSP. This way $9 the bias current of the CSP can be set for optimizing the power dissipation with respect to series and parallel noise, especially useful when the CSP is put in a radiation environment. A prototype test with a novel monolithic 20 ns $9 time constant RC-CR shaper, capable to sum up four inputs has been also realized, featurin...

  12. Family Functioning and the Course of Adolescent Bipolar Disorder

    Science.gov (United States)

    Sullivan, Aimee E.; Judd, Charles M.; Axelson, David A.; Miklowitz, David J.

    2012-01-01

    The symptoms of bipolar disorder affect and are affected by the functioning of family environments. Little is known, however, about the stability of family functioning among youth with bipolar disorder as they cycle in and out of mood episodes. This study examined family functioning and its relationship to symptoms of adolescent bipolar disorder,…

  13. Processamento cognitivo "Teoria da Mente" no transtorno bipolar Cognitive "Theory of Mind" processing in bipolar disorder

    OpenAIRE

    Hélio Anderson Tonelli

    2009-01-01

    OBJETIVO: O transtorno afetivo bipolar está associado ao comprometimento funcional persistente. Apesar de muitas pesquisas demonstrarem que bipolares podem apresentar déficits cognitivos, um número menor de trabalhos avaliou o papel de prejuízos no processamento cognitivo social, a Teoria da Mente (relacionado à capacidade de inferir estados mentais), no aparecimento de sintomas e complicações sociais em bipolares. O objetivo deste trabalho é o de revisar sistemática e criticamente a literatu...

  14. Transtorno bipolar do humor e gênero Bipolar affective disorder and gender

    OpenAIRE

    Rodrigo da Silva Dias; Florence Kerr-Corrêa; Ricardo Cezar Torresan; Carlos Henrique R. dos Santos

    2006-01-01

    Embora o transtorno bipolar (TB) ocorra quase igualmente em ambos os sexos, a fenomenologia e o curso da doença diferem no homem e na mulher. No entanto, há evidências de que mulheres bipolares, mais que os homens, apresentariam início mais tardio (em especial na quinta década de vida), ciclagem rápida, mais episódios depressivos, mais mania disfórica que eufórica, estados mistos e evolução do tipo bipolar II, ainda que os achados nem sempre sejam consistentes. Embora o risco de comorbidades ...

  15. Circadian Phase Preference in Pediatric Bipolar Disorder

    Directory of Open Access Journals (Sweden)

    Kerri L. Kim

    2014-03-01

    Full Text Available Pediatric bipolar disorder (BD rates have notably increased over the past three decades. Given the significant morbidity and mortality associated with BD, efforts are needed to identify factors useful in earlier detection to help address this serious public health concern. Sleep is particularly important to consider given the sequelae of disrupted sleep on normative functioning and that sleep is included in diagnostic criteria for both Major Depressive and Manic Episodes. Here, we examine one component of sleep—i.e., circadian phase preference with the behavioral construct of morningness/eveningness (M/E. In comparing 30 BD and 45 typically developing control (TDC participants, ages 7–17 years, on the Morningness-Eveningness Scale for Children (MESC, no between-group differences emerged. Similar results were found when comparing three groups (BD−ADHD; BD+ADHD; TDC. Consistent with data available on circadian phase preference in adults with BD, however, we found that BD adolescents, ages 13 years and older, endorsed significantly greater eveningness compared to their TDC peers. While the current findings are limited by reliance on subjective report and the high-rate of comorbid ADHD among the BD group, this finding that BD teens demonstrate an exaggerated shift towards eveningness than would be developmentally expected is important. Future studies should compare the circadian rhythms across the lifespan for individuals diagnosed with BD, as well as identify the point at which BD youth part ways with their healthy peers in terms of phase preference. In addition, given our BD sample was overall euthymic, it may be that M/E is more state vs. trait specific in latency age youth. Further work would benefit from assessing circadian functioning using a combination of rating forms and laboratory-based measures. Improved understanding of sleep in BD may identify behavioral targets for inclusion in prevention and intervention protocols.

  16. Radiotherapy in patients with pacemakers and implantable cardioverter defibrillators

    DEFF Research Database (Denmark)

    Zaremba, Tomas; Jakobsen, Annette Ross; Søgaard, Mette;

    2016-01-01

    defibrillators malfunctioning at low radiation doses. Besides scant knowledge about optimal safety measures, only little is known about the exact prevalence of patients with devices undergoing RT. In this review, we provide a short overview of the principles of RT and present the current evidence on the...

  17. Climatic factors and bipolar affective disorder

    DEFF Research Database (Denmark)

    Christensen, Ellen Margrethe; Larsen, Jens Knud; Gjerris, Annette;

    2008-01-01

    . A group of patients with at least three previous hospitalizations for bipolar disorder was examined every 3 months for up to 3 years. At each examination an evaluation of the affective phase was made according to the Hamilton Depression Scale (HAM-D(17)), and the Bech-Rafaelsen Mania Rating Scale (MAS......). In the same period, daily recordings from the Danish Meteorological Institute were received. We found no correlations between onset of bipolar episodes [defined as MAS score of 11 or more (mania) and as HAM-D(17) score of 12 or more (depression)] and any meteorological parameters. We found a statistical...

  18. [Bipolar disorders and self-stigma].

    Science.gov (United States)

    Richard-Lepouriel, H

    2015-09-16

    Despite wide media coverage in recent years, the stigmatization of people with bipolar disorder still exists. Bipolar people also have their own tendency to self-stigmatize that is to integrate their beliefs, prejudices and stigmatizing behaviors. The consequences are important: shame, guilt, withdrawal and renunciation to lead one's own life according to personal values increasing therefore the risk of mood relapses. Self-stigma is rarely assessed in clinical practice and few strategies have been designed to face them efficiently. Recognizing self-stigmatizing beliefs and challenging them are the first steps of this vast endeavour. PMID:26591079

  19. Rumination in bipolar disorder: a systematic review

    OpenAIRE

    Érico de M. Silveira Jr.; Marcia Kauer-Sant'Anna

    2015-01-01

    Objective:To conduct a systematic review of the literature about the symptom of rumination in bipolar disorder (BD).Methods:We searched the MEDLINE (PubMed), ISI Web of Knowledge, PsycINFO, and SciELO databases using the descriptors “rumination” and “bipolar disorder” and no time limits. This strategy yielded 105 references, of which 74 were selected. Inclusion criteria were studies involving patients with BD and the use of at least one validated scale for the assessment of rumination. Review...

  20. Effects of thallium on membrane currents at diastolic potentials in canine cardiac Purkinje strands.

    Science.gov (United States)

    Cohen, I S; Mulrine, N K

    1986-01-01

    A two-micro-electrode voltage-clamp technique was used to record membrane currents from canine cardiac Purkinje strands during hyperpolarizing steps to potentials between -70 and -150 mV in Tyrode solutions containing K+ and/or Tl+. Complete replacement of external K+ by equimolar Tl+ increases the instantaneous inwardly rectifying current. The inwardly rectifying region of the instantaneous I-V relation is shifted to more positive potentials and its slope is increased. The diastolic time-dependent current is reduced or reversed. Partial substitution of equimolar Tl+ for K+ reduces the diastolic time-dependent current. The instantaneous I-V relation is shifted inward for molar fractions of Tl+ (YTl) greater than 0.5, and is slightly more inward or unchanged for YTl less than or equal to 0.5. Addition of small amounts of Tl+ shifts the instantaneous I-V relation inward and reduces the diastolic time-dependent current. Addition of Tl+ in solutions containing Ba2+ to block the background inward rectifier has no effect on the instantaneous I-V relation; the diastolic time-dependent (pace-maker) current is reduced. Block of the pace-maker current by Tl+ is largely independent of potential in Ba2+ Tyrode solution. Since Tl+ has opposite effects on the pace-maker current and the inward rectifier, these findings support other evidence that the pace-maker current is not part of the background inward rectifier.

  1. Three times more days depressed than manic or hypomanic in both bipolar I and bipolar II disorder

    NARCIS (Netherlands)

    Kupka, Ralph W.; Altshuler, Lori L.; Nolen, Willem A.; Suppes, Trisha; Luckenbaugh, David A.; Leverich, Gabriele S.; Frye, Mark A.; Keck, Paul E.; McElroy, Susan L.; Grunze, Heinz; Post, Robert M.

    2007-01-01

    Objectives: To assess the proportion of time spent in mania, depression and euthymia in a large cohort of bipolar subjects studied longitudinally, and to investigate depression/mania ratios in patients with bipolar I versus bipolar II disorder. Methods: Clinician-adjusted self-ratings of mood were c

  2. A report on older-age bipolar disorder from the International Society for Bipolar Disorders Task Force

    DEFF Research Database (Denmark)

    Sajatovic, Martha; Strejilevich, Sergio A; Gildengers, Ariel G;

    2015-01-01

    OBJECTIVES: In the coming generation, older adults with bipolar disorder (BD) will increase in absolute numbers as well as proportion of the general population. This is the first report of the International Society for Bipolar Disorder (ISBD) Task Force on Older-Age Bipolar Disorder (OABD). METHO...

  3. The effectiveness of rigid pericardial endoscopy for minimally invasive minor surgeries: cell transplantation, epicardial pacemaker lead implantation, and epicardial ablation

    Directory of Open Access Journals (Sweden)

    Kimura Takehiro

    2012-11-01

    Full Text Available Abstract Background The efficacy and safety of rigid pericardial endoscopy as the promising minimally invasive approach to the pericardial space was evaluated. Techniques for cell transplantation, epicardial pacemaker lead implantation, and epicardial ablation were developed. Methods Two swine and 5 canines were studied to evaluate the safety and efficacy of rigid pericardial endoscopy. After a double pericardiocentesis, a transurethral rigid endoscope was inserted into the pericardial space. The technique to obtain a clear visual field was examined, and acute complications such as hemodynamic changes and the effects on intra-pericardial pressure were evaluated. Using custom-made needles, pacemaker leads, and forceps, the applications for cell transplantation, epicardial pacemaker lead implantation, and epicardial ablation were also evaluated. Results The use of air, the detention of a stiff guide wire in the pericardial space, and the stretching of the pericardium with the rigid endoscope were all useful to obtain a clear visual field. A side-lying position also aided observation of the posterior side of the heart. As a cell transplantation methodology, we developed an ultrasonography-guided needle, which allows for the safe visualization of transplantation without major complications. Pacemaker leads were safely and properly implanted, which provides a better outcome for cardiac resynchronizing therapy. Furthermore, the success of clear visualization of the pulmonary veins enabled us to perform epicardial ablation. Conclusions Rigid pericardial endoscopy holds promise as a safe method for minimally invasive cell transplantation, epicardial pacemaker lead implantation, and epicardial ablation by allowing clear visualization of the pericardial space.

  4. Role of sinoatrial node architecture in maintaining a balanced source-sink relationship and synchronous cardiac pacemaking

    Directory of Open Access Journals (Sweden)

    Sathya D Unudurthi

    2014-11-01

    Full Text Available Normal heart rhythm (sinus rhythm depends on regular activity of the sinoatrial node (SAN, a heterogeneous collection of specialized myocytes in the right atrium. SAN cells, in general, possess a unique electrophysiological profile that promotes spontaneous electrical activity (automaticity. However, while automaticity is required for normal pacemaking, it is not necessarily sufficient. Less appreciated is the importance of the elaborate structure of the SAN complex for proper pacemaker function. Here, we review the important structural features of the SAN with a focus on how these elements help manage a precarious balance between electrical charge generated by the SAN (source and the charge needed to excite the surrounding atrial tissue (sink. We also discuss how compromised source-sink balance due, for example to fibrosis, may promote SAN dysfunction, characterized by slow and/or asynchronous pacemaker activity and even failure, in the setting of cardiovascular disease (e.g. heart failure, atrial fibrillation. Finally, we discuss implications of the source-sink balance in the SAN complex for cell and gene therapies aimed at creating a biological pacemaker as replacement or bridge to conventional electronic pacemakers.

  5. BIPOLAR DISORDER AND METABOLIC SYNDROME: COMORBIDITY OR SIDE EFFECTS OF TREATMENT OF BIPOLAR DISORDER

    OpenAIRE

    Babić, Dragan; Maslov, Boris; Nikolić, Katica; Martinac, Marko; Uzun, Suzana; Kozumplik, Oliver

    2010-01-01

    Objective: There is evidence that people with mental disorders are more likely to suffer from metabolic syndrome. In the last decades there has been an increase in interest for researching metabolic syndrome in psychiatric patients and plenty of evidence about their association. However, investigations on the prevalence of metabolic syndrome in patients with bipolar disorder are still surprisingly rare. The aim of this paper is to analyze comorbidity of bipolar disorder and metabolic syndrome...

  6. Commentary on N. Ghaemi's “Hippocratic Psychopharmacology of Bipolar Disorder” Maintenance Treatment in Bipolar Disorder

    OpenAIRE

    Tohen, Mauricio; Lin, Daniel

    2006-01-01

    Bipolar disorder is a chronic recurring condition that is associated with high mortality and severe functional and psychosocial impairments. Treatment strategies that prolong recovery from a mood episode and delay relapse into a new mood episode are essential for long-term improvements in outcomes. Maintenance treatments for bipolar disorder should be evaluated on the strength of the empirical evidence and with the recognition that some treatments may be more effective in preventing relapse i...

  7. Clinical variables and implications of the personality on the outcome of bipolar illness: a pilot study

    OpenAIRE

    Casas-Barquero, Nieves; García-López, Olga; Fernández-Argüelles, Pedro; Camacho-Laraña, Manuel

    2007-01-01

    Outcome in bipolar patients is affected by comorbidity. Comorbid personality disorders are frequent and may complicate the course of bipolar illness. This pilot study examined a series of 40 euthymic bipolar patients (DSM-IV criteria) (bipolar I disorder 31, bipolar II disorder 9) to assess the effect of clinical variables and the influence of comorbid personality on the clinical course of bipolar illness. Bipolar patients with a diagnosis of comorbid personality disorder (n = 30) were compar...

  8. Delineating ADHD and bipolar disorder:A comparison of clinical profiles in adult women

    OpenAIRE

    Kitsune, Glenn L; Kuntsi, Jonna; Costello, Helen; Frangou, Sophia; Hosang, Georgina M.; McLoughlin, Gráinne; Asherson, Philip

    2016-01-01

    OBJECTIVE: Overlapping symptoms can make the diagnostic differentiation of attention-deficit/hyperactivity disorder (ADHD) and bipolar disorder (BD) challenging in adults using current clinical assessments. This study sought to determine if current clinical measures delineate ADHD from BD in adults, comparing relative levels of ADHD, BD and emotional lability (EL) symptoms. METHODS: Sixty adult women with ADHD, BD or controls were compared on self-report and interview measures for ADHD sy...

  9. Genetic utility of broadly defined bipolar schizoaffective disorder as a diagnostic concept

    OpenAIRE

    Hamshere, M. L.; Green, E K; Jones, I. R.; Jones, L.; Moskvina, V; Kirov, G.; Grozeva, D; Nikolov, I; Vukcevic, D; Caesar, S.; Gordon-Smith, K; Fraser, C; Russell, E; Breen, G.; D. St Clair

    2009-01-01

    Background Psychiatric phenotypes are currently defined according to sets of descriptive criteria. Although many of these phenotypes are heritable, it would be useful to know whether any of the various diagnostic categories in current use identify cases that are particularly helpful for biological–genetic research. Aims To use genome-wide genetic association data to explore the relative genetic utility of seven different descriptive operational diagnostic categories relevant to bipolar illnes...

  10. Heritability of cognitive functions in families with bipolar disorder.

    Science.gov (United States)

    Antila, Mervi; Tuulio-Henriksson, Annamari; Kieseppä, Tuula; Soronen, Pia; Palo, Outi M; Paunio, Tiina; Haukka, Jari; Partonen, Timo; Lönnqvist, Jouko

    2007-09-01

    Bipolar disorder is highly heritable. Cognitive dysfunctions often observed in bipolar patients and their unaffected relatives implicate that these impairments may be associated with genetic predisposition to bipolar disorder and thus fulfill the criteria of a valid endophenotype for the disorder. However, the most fundamental criterion, their heritability, has not been directly studied in any bipolar population. This population-based study estimated the heritability of cognitive functions in bipolar disorder. A comprehensive neuropsychological test battery and the Structured Clinical Interview for DSM-IV were administered to a population-based sample of 110 individuals from 52 families with bipolar disorder. Heritability of cognitive functions as assessed with neuropsychological test scores were estimated using the Solar package. Significant additive heritabilities were found in verbal ability, executive functioning, and psychomotor processing speed. Genetic contribution was low to verbal learning functions. High heritability, in executive functioning and psychomotor processing speed suggest that these may be valid endophenotypic traits for genetic studies of bipolar disorder.

  11. Cognitive enhancement treatments for bipolar disorder

    DEFF Research Database (Denmark)

    Miskowiak, Kamilla W; Carvalho, André F; Vieta, Eduard;

    2016-01-01

    Cognitive dysfunction is an emerging treatment target in bipolar disorder (BD). Several trials have assessed the efficacy of novel pharmacological and psychological treatments on cognition in BD but the findings are contradictory and unclear. A systematic search following the PRISMA guidelines...

  12. Bias in emerging biomarkers for bipolar disorder

    DEFF Research Database (Denmark)

    Carvalho, A F; Köhler, C A; Fernandes, B S;

    2016-01-01

    BACKGROUND: To date no comprehensive evaluation has appraised the likelihood of bias or the strength of the evidence of peripheral biomarkers for bipolar disorder (BD). Here we performed an umbrella review of meta-analyses of peripheral non-genetic biomarkers for BD. METHOD: The Pubmed...

  13. Designing Mobile Health Technology for Bipolar Disorder

    DEFF Research Database (Denmark)

    Bardram, JE; Frost, Mads; Szántó, Károly;

    2013-01-01

    An increasing number of pervasive healthcare systems are being designed, that allow people to monitor and get feedback on their health and wellness. To address the challenges of self-management of mental illnesses, we have developed the MONARCA system - a personal monitoring system for bipolar...

  14. Oxide bipolar electronics: materials, devices and circuits

    Science.gov (United States)

    Grundmann, Marius; Klüpfel, Fabian; Karsthof, Robert; Schlupp, Peter; Schein, Friedrich-Leonhard; Splith, Daniel; Yang, Chang; Bitter, Sofie; von Wenckstern, Holger

    2016-06-01

    We present the history of, and the latest progress in, the field of bipolar oxide thin film devices. As such we consider primarily pn-junctions in which at least one of the materials is a metal oxide semiconductor. A wide range of n-type and p-type oxides has been explored for the formation of such bipolar diodes. Since most oxide semiconductors are unipolar, challenges and opportunities exist with regard to the formation of heterojunction diodes and band lineups. Recently, various approaches have led to devices with high rectification, namely p-type ZnCo2O4 and NiO on n-type ZnO and amorphous zinc-tin-oxide. Subsequent bipolar devices and applications such as photodetectors, solar cells, junction field-effect transistors and integrated circuits like inverters and ring oscillators are discussed. The tremendous progress shows that bipolar oxide electronics has evolved from the exploration of various materials and heterostructures to the demonstration of functioning integrated circuits. Therefore a viable, facile and high performance technology is ready for further exploitation and performance optimization.

  15. Homocysteine and cognitive functions in bipolar depression

    Directory of Open Access Journals (Sweden)

    Agnieszka Permoda-Osip

    2014-12-01

    The results obtained show higher HCY concentration in considerable proportion of patients with bipolar depression, especially in men. They also confirm a connect between high homocysteine concentration and worse performance in some neuropsychological tests. Such relationship was more marked in men.

  16. Unraveling Psychomotor Slowing in Bipolar Disorde

    NARCIS (Netherlands)

    Morsel, A.M.; Temmerman, A.; Sabbe, B.G.C.; Hulstijn, W.; Morrens, M.

    2015-01-01

    Background/Aims: In addition to affective and cognitive symptomatology, psychomotor deficits are known to be present in bipolar disorder (BD). Psychomotor functioning includes all of the processes necessary for completing a movement, from planning to initiation and execution. While these psychomotor

  17. Bipolar disorder: from genes to behavior pathways

    OpenAIRE

    Martinowich, Keri; Schloesser, Robert J; Manji, Husseini K

    2009-01-01

    Bipolar disorder (BPD) is a devastating illness that is characterized by recurrent episodes of mania and depression. In addition to these cyclic episodes, individuals with BPD exhibit changes in psychovegetative function, cognitive performance, and general health and well being. In this article we draw from neuroimaging findings in humans, postmortem data, and human genetic and pharmacological studies as well as ...

  18. Mechanism on bipolar distribution of Permian brachiopods

    Institute of Scientific and Technical Information of China (English)

    Chengwen WANG; Songmei ZHANG

    2008-01-01

    By reasearch on geographic distribution, nine genera in bipolar distribution are selected from Permian brachiopods. These taxa originated from middle-high latitude areas in the boreal realm, of which five genera were derived from Late Carboniferous, and other four genera originated from Permian. They were all in bipolar distribution during some different stages in Permian. Specific diversity for each genus was high in the boreal realm, whereas in the Gondwana realm was very low. Perdurability was long in the boreal realm, and short in the Gondwana realm. It was the time when these nine genera came to their maximum diversity that these genera appeared in the Gondwana and formed bipolar distribution; while they also migrated to the low latitude from high latitude. This shows very close relationship between several main cooling events in Permian and the migration of genera from the boreal realm to the Gondwana realm through the Tethys. Therefore, the cooling events might be the main drive which caused these cold-water-type brachiopods migrated to the Gondwana realm and being bipolar distribution. In this process, the planula tolerance to warm water would be another important factor.

  19. Vacuum interface flashover with bipolar electric fields

    Energy Technology Data Exchange (ETDEWEB)

    Tucker, W.K.; Anderson, R.A.; Hasti, D.E.; Jones, E.E.; Bennett, L.F.

    1985-05-01

    High energy, compact, particle accelerators require accelerating cavities that have large gradients and operate with high efficiency. The bipolar electric fields required in these efficient accelerating cavities place severe requirements on the vacuum interface. Experimentally, we have found that the bipolar flashover field varies as t/sup -1/2/ for times out to 300 ns and then remains essentially constant at 33 kV/cm for longer duration waveforms, whereas materials subjected to unipolar electric fields follow a t/sup -1/6/ relationship. Furthermore, specific accelerating cavities offer enhancements that may be employed to achieve highly uniform electric fields across the vacuum interface. Using these results and the results of a previously developed theory of unipolar flashover, a new interface has been designed and 50 kV/cm bipolar flashover field achieved for a waveform train that lasted 1 ..mu..s. This paper will discuss the design of this vacuum interface and the evaluation of various materials that led to achieving bipolar flashover fields 50% greater than we had previously obtained for long duration waveforms. 10 refs., 6 figs.

  20. Vacuum interface flashover with bipolar electric fields

    International Nuclear Information System (INIS)

    High energy, compact, particle accelerators require accelerating cavities that have large gradients and operate with high efficiency. The bipolar electric fields required in these efficient accelerating cavities place severe requirements on the vacuum interface. Experimentally, we have found that the bipolar flashover field varies as t/sup -1/2/ for times out to 300 ns and then remains essentially constant at 33 kV/cm for longer duration waveforms, whereas materials subjected to unipolar electric fields follow a t/sup -1/6/ relationship. Furthermore, specific accelerating cavities offer enhancements that may be employed to achieve highly uniform electric fields across the vacuum interface. Using these results and the results of a previously developed theory of unipolar flashover, a new interface has been designed and 50 kV/cm bipolar flashover field achieved for a waveform train that lasted 1 μs. This paper will discuss the design of this vacuum interface and the evaluation of various materials that led to achieving bipolar flashover fields 50% greater than we had previously obtained for long duration waveforms. 10 refs., 6 figs

  1. Bipolar disorder: Evidence for a major locus

    Energy Technology Data Exchange (ETDEWEB)

    Spence, M.A.; Flodman, P.L. [Univ. of California, Irvine, CA (United States); Sadovnick, A.D.; Ameli, H. [Univ. of British Columbia, Vancouver (Canada)] [and others

    1995-10-09

    Complex segregation analyses were conducted on families of bipolar I and bipolar II probands to delineate the mode of inheritance. The probands were ascertained from consecutive referrals to the Mood Disorder Service, University Hospital, University of British Columbia and diagnosed by DSM-III-R and Research Diagnostic Criteria. Data were available on over 1,500 first-degree relatives of the 186 Caucasian probands. The purpose of the analyses was to determine if, after correcting for age and birth cohort, there was evidence for a single major locus. Five models were fit to the data using the statistical package SAGE: (1) dominant, (2) recessive, (3) arbitrary mendelian inheritance, (4) environmental, and (5) no major effects. A single dominant, mendelian major locus was the best fitting of these models for the sample of bipolar I and II probands when only bipolar relatives were defined as affected (polygenic inheritance could not be tested). Adding recurrent major depression to the diagnosis {open_quotes}affected{close_quotes} for relatives reduced the evidence for a major locus effect. Our findings support the undertaking of linkage studies and are consistent with the analyses of the National Institutes of Mental Health (NIMH) Collaborative Study data by Rice et al. and Blangero and Elston. 39 refs., 4 tabs.

  2. Genética do transtorno bipolar Genetics of bipolar disorder

    Directory of Open Access Journals (Sweden)

    Leandro Michelon

    2004-10-01

    mapping suggest novel genes whose mutations may be responsible for BD. Due to the complexity of the transmission pattern for BD and its phenotypic heterogeneity many difficulties have emerged to exactly define bipolar susceptibility genes. There is currently only preliminary results of genes associated with BD. However, the increasing understanding of gene expression regulation by epigenetic mechanisms and the dimensional approach to mental disorders can give directions for further research in psychiatric genetics.

  3. Lmo mutants reveal a novel role for circadian pacemaker neurons in cocaine-induced behaviors.

    Directory of Open Access Journals (Sweden)

    Linus T-Y Tsai

    2004-12-01

    Full Text Available Drosophila has been developed recently as a model system to investigate the molecular and neural mechanisms underlying responses to drugs of abuse. Genetic screens for mutants with altered drug-induced behaviors thus provide an unbiased approach to define novel molecules involved in the process. We identified mutations in the Drosophila LIM-only (LMO gene, encoding a regulator of LIM-homeodomain proteins, in a genetic screen for mutants with altered cocaine sensitivity. Reduced Lmo function increases behavioral responses to cocaine, while Lmo overexpression causes the opposite effect, reduced cocaine responsiveness. Expression of Lmo in the principal Drosophila circadian pacemaker cells, the PDF-expressing ventral lateral neurons (LN(vs, is sufficient to confer normal cocaine sensitivity. Consistent with a role for Lmo in LN(vfunction,Lmomutants also show defects in circadian rhythms of behavior. However, the role for LN(vs in modulating cocaine responses is separable from their role as pacemaker neurons: ablation or functional silencing of the LN(vs reduces cocaine sensitivity, while loss of the principal circadian neurotransmitter PDF has no effect. Together, these results reveal a novel role for Lmo in modulating acute cocaine sensitivity and circadian locomotor rhythmicity, and add to growing evidence that these behaviors are regulated by shared molecular mechanisms. The finding that the degree of cocaine responsiveness is controlled by the Drosophila pacemaker neurons provides a neuroanatomical basis for this overlap. We propose that Lmo controls the responsiveness of LN(vs to cocaine, which in turn regulate the flies' behavioral sensitivity to the drug.

  4. Beam Profile Disturbances from Implantable Pacemakers or Implantable Cardioverter-Defibrillator Interactions

    Energy Technology Data Exchange (ETDEWEB)

    Gossman, Michael S., E-mail: mgossman@tsrcc.com [Tri-State Regional Cancer Center, Medical Physics Section, Ashland, KY (United States); Comprehensive Heart and Vascular Associates, Heart and Vascular Center, Ashland, KY (United States); Medtronic, Inc., External Research Program, Mounds View, MN (United States); Nagra, Bipinpreet; Graves-Calhoun, Alison; Wilkinson, Jeffrey [Tri-State Regional Cancer Center, Medical Physics Section, Ashland, KY (United States); Comprehensive Heart and Vascular Associates, Heart and Vascular Center, Ashland, KY (United States); Medtronic, Inc., External Research Program, Mounds View, MN (United States)

    2011-01-01

    The medical community is advocating for progressive improvement in the design of implantable cardioverter-defibrillators and implantable pacemakers to accommodate elevations in dose limitation criteria. With advancement already made for magnetic resonance imaging compatibility in some, a greater need is present to inform the radiation oncologist and medical physicist regarding treatment planning beam profile changes when such devices are in the field of a therapeutic radiation beam. Treatment plan modeling was conducted to simulate effects induced by Medtronic, Inc.-manufactured devices on therapeutic radiation beams. As a continuation of grant-supported research, we show that radial and transverse open beam profiles of a medical accelerator were altered when compared with profiles resulting when implantable pacemakers and cardioverter-defibrillators are placed directly in the beam. Results are markedly different between the 2 devices in the axial plane and the sagittal planes. Vast differences are also presented for the therapeutic beams at 6-MV and 18-MV x-ray energies. Maximum changes in percentage depth dose are observed for the implantable cardioverter-defibrillator as 9.3% at 6 MV and 10.1% at 18 MV, with worst distance to agreement of isodose lines at 2.3 cm and 1.3 cm, respectively. For the implantable pacemaker, the maximum changes in percentage depth dose were observed as 10.7% at 6 MV and 6.9% at 18 MV, with worst distance to agreement of isodose lines at 2.5 cm and 1.9 cm, respectively. No differences were discernible for the defibrillation leads and the pacing lead.

  5. Global Bifurcation Structure and Variability of Pacemaker Rhythm in a Detailed Model of Cardiac Sinoatrial Node Cells

    Science.gov (United States)

    Pan, Zhenxing; Doi, Shinji

    As a cardiac pacemaker, sinoatrial node spontaneously generates periodic electrical signals (action potentials) in its cells. The action potential generation is deeply related to various ion channels in cell membranes, and the abnormalities of ion channels cause sinus arrhythmia. We use the Zhang model of sinoatrial node cells to investigate the relation between pacemaker rhythm (frequency of action potential generation) and ion channels. The Zhang model is described by the Hodgkin-Huxley-type nonlinear ordinary differential equations, and its parameter values vary between periphery and center cells of sinoatrial node. We analyze the bifurcation structure of the Zhang model, and investigate the variability of pacemaker rhythm and its sensitivity on ion channel conductance changes for both periphery and center cells. Moreover, these results are compared with the previous results of another sinoatrial node cell model: Yanagihara-Noma-Irisawa model.

  6. Risk factors for an anxiety disorder comorbidity among Thai patients with bipolar disorder: results from the Thai Bipolar Disorder Registry

    Directory of Open Access Journals (Sweden)

    Paholpak S

    2014-05-01

    Full Text Available Suchat Paholpak,1 Ronnachai Kongsakon,2 Wasana Pattanakumjorn,3 Roongsang Kanokvut,4 Wiroj Wongsuriyadech,5 Manit Srisurapanont6 On behalf of the Thai Bipolar Disorder Registry Study Group1Department of Psychiatry, Faculty of Medicine, Khon Kaen University, Khon Kaen, 2Department of Psychiatry, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, 3Department of Psychiatry, Ratchaburi Hospital, Ratchaburi, 4Department of Psychiatry, Buddhachinaraj Hospital, Phitsanulok, 5Department of Psychiatry, Udonthani Hospital, Udonthani, 6Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand Background: The aim of the study was to determine in a clinical setting the risk factors for current anxiety disorder (AD comorbidity among Thai patients with bipolar disorder (BD, being treated under the Thai Bipolar Disorder Registry Project (TBDR. Methods: The TBDR was a multisite naturalistic study conducted at 24 psychiatric units (ie, at university, provincial mental, and government general hospitals between February 2009 and January 2011. Participants were in- or out-patients over 18 years of age who were diagnosed with BD according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Instruments used in this study included the Thai Mini International Neuropsychiatric Interview version 5; Thai Montgomery–Åsberg Depression Rating Scale (MADRS; Thai Young Mania Rating Scale; Clinical Global Impression of Bipolar Disorder-Severity (CGI-BP-S, CGI-BP-S-mania, CGI-BP-S-depression, and CGI-BP-S-overall BP illness; and the Thai SF-36 quality of life questionnaire. Results: Among the 424 BD patients, 404 (95.3% had BD type I. The respective mean ± standard deviation of age of onset of mood disturbance, first diagnosis of BD, and first treatment of BD was 32.0±11.9, 36.1±12.2, and 36.2±12.2 years. The duration of illness was 10.7±9.0 years. Fifty-three (12.5% of the 424 participants had

  7. Bipolar resistive switching and charge transport in silicon oxide memristor

    International Nuclear Information System (INIS)

    Graphical abstract: - Highlights: • Si-based thin-film memristor structure was fabricated by magnetron sputtering. • We study bipolar resistive switching and charge transport mechanisms. • Resistive switching parameters are determined by a balance between redox reactions. - Abstract: Reproducible bipolar resistive switching has been studied in SiOx-based thin-film memristor structures deposited by magnetron sputtering technique on the TiN/Ti metalized SiO2/Si substrates. It is established that, after electroforming, the structure can be switched between the quasi-ohmic low-resistance state related to silicon chains (conducting filaments) and the high-resistance state with semiconductor-like hopping mechanism of charge transport through the defects in silicon oxide. The switching parameters are determined by a balance between the reduction and oxidation processes that, in turn, are driven by the value and polarity of voltage bias, current, temperature and device environment. The results can be used for the development of silicon-based nonvolatile memory and memristive systems as a key component of future electronics

  8. Bipolar resistive switching and charge transport in silicon oxide memristor

    Energy Technology Data Exchange (ETDEWEB)

    Mikhaylov, Alexey N., E-mail: mian@nifti.unn.ru [Lobachevsky State University of Nizhni Novgorod, 23/3 Gagarin Prospect, Nizhni Novgorod 603950 (Russian Federation); Belov, Alexey I.; Guseinov, Davud V.; Korolev, Dmitry S.; Antonov, Ivan N.; Efimovykh, Denis V.; Tikhov, Stanislav V.; Kasatkin, Alexander P.; Gorshkov, Oleg N.; Tetelbaum, David I.; Bobrov, Alexander I.; Malekhonova, Natalia V.; Pavlov, Dmitry A. [Lobachevsky State University of Nizhni Novgorod, 23/3 Gagarin Prospect, Nizhni Novgorod 603950 (Russian Federation); Gryaznov, Evgeny G. [Lobachevsky State University of Nizhni Novgorod, 23/3 Gagarin Prospect, Nizhni Novgorod 603950 (Russian Federation); Sedakov Scientific-Research Institute, GSP-486, Nizhny Novgorod 603950 (Russian Federation); Yatmanov, Alexander P. [Sedakov Scientific-Research Institute, GSP-486, Nizhny Novgorod 603950 (Russian Federation)

    2015-04-15

    Graphical abstract: - Highlights: • Si-based thin-film memristor structure was fabricated by magnetron sputtering. • We study bipolar resistive switching and charge transport mechanisms. • Resistive switching parameters are determined by a balance between redox reactions. - Abstract: Reproducible bipolar resistive switching has been studied in SiO{sub x}-based thin-film memristor structures deposited by magnetron sputtering technique on the TiN/Ti metalized SiO{sub 2}/Si substrates. It is established that, after electroforming, the structure can be switched between the quasi-ohmic low-resistance state related to silicon chains (conducting filaments) and the high-resistance state with semiconductor-like hopping mechanism of charge transport through the defects in silicon oxide. The switching parameters are determined by a balance between the reduction and oxidation processes that, in turn, are driven by the value and polarity of voltage bias, current, temperature and device environment. The results can be used for the development of silicon-based nonvolatile memory and memristive systems as a key component of future electronics.

  9. Genetically engineered cardiac pacemaker: Stem cells transfected with HCN2 gene and myocytes—A model

    Science.gov (United States)

    Kanani, S.; Pumir, A.; Krinsky, V.

    2008-01-01

    One of the successfully tested methods to design genetically engineered cardiac pacemaker cells consists in transfecting a human mesenchymal stem cell (hMSC) with a HCN2 gene and connecting it to a myocyte. We develop and study a mathematical model, describing a myocyte connected to a hMSC transfected with a HCN2 gene. The cardiac action potential is described both with the simple Beeler Reuter model, as well as with the elaborate dynamic Luo Rudy model. The HCN2 channel is described by fitting electrophysiological records, in the spirit of Hodgkin Huxley. The model shows that oscillations can occur in a pair myocyte-stem cell, that was not observed in the experiments yet. The model predicted that: (1) HCN pacemaker channels can induce oscillations only if the number of expressed I channels is low enough. At too high an expression level of I channels, oscillations cannot be induced, no matter how many pacemaker channels are expressed. (2) At low expression levels of I channels, a large domain of values in the parameter space (n, N) exists, where oscillations should be observed. We denote N the number of expressed pacemaker channels in the stem cell, and n the number of gap junction channels coupling the stem cell and the myocyte. (3) The expression levels of I channels observed in ventricular myocytes, both in the Beeler Reuter and in the dynamic Luo Rudy models are too high to allow to observe oscillations. With expression levels below ˜1/4 of the original value, oscillations can be observed. The main consequence of this work is that in order to obtain oscillations in an experiment with a myocyte-stem cell pair, increasing the values of n, N is unlikely to be helpful, unless the expression level of I has been reduced enough. The model also allows us to explore levels of gene expression not yet achieved in experiments, and could be useful to plan new experiments, aimed at improving the robustness of the oscillations.

  10. Apical Ballooning Syndrome (Takotsubo Cardiomyopathy after Permanent Dual-Chamber Pacemaker Implantation

    Directory of Open Access Journals (Sweden)

    Armando Gardini

    2012-01-01

    Full Text Available Apical ballooning syndrome, also called takotsubo cardiomyopathy, has been recently reported. It may mimic acute myocardial infarction and is typically observed in postmenopausal women after stressful events. A 75-year-old female after permanent dual chamber pacemaker implant complained of chest pain with repolarization alterations suggesting acute myocardial ischemia. Echocardiography showed a left ventricle with akinesia of the apical portions and reduced global systolic function. The patient was treated with antithrombotic agents and intravenous nitrates. No coronary lesions were found at angiography. At ventriculography, a typical takotsubo-like shape of the left ventricle was observed. The clinical and echocardiographic picture normalized at discharge.

  11. Medical treatment of a pacemaker endocarditis due to Candida albicans and to Candida glabrata.

    Science.gov (United States)

    Roger, P M; Boissy, C; Gari-Toussaint, M; Foucher, R; Mondain, V; Vandenbos, F; le Fichoux, Y; Michiels, J F; Dellamonica, P

    2000-09-01

    We describe a case of pacemaker infection due to two fungal species: Candida albicans and C. glabrata. Transthoracic echocardiography showed a large vegetation on the intraventricular wires. Because of severe underlying diseases, surgery was believed to be contraindicated. The patient was treated using high dose of fluconazole, resulting in clinical improvement and negative blood cultures. However, 2 months later, the patient underwent a fatal stroke. At autopsy, a large vegetation was found only all along the wires. Postmortem culture of the infected material was positive for both C. albicans and C. glabrata. PMID:11023765

  12. Pacemaker implantation in a patient with brugada and sick sinus syndrome

    DEFF Research Database (Denmark)

    Risgaard, Bjarke; Bundgaard, Henning; Jabbari, Reza;

    2013-01-01

    with loss-of-function mutations in SCN5A. In this case-report we present a 75-year old woman referred to our outpatient clinic for inherited cardiac diseases for a familial clinical work-up. Since childhood she had suffered from dizziness, absence seizures, and countless Syncope's. In 2004 sick sinus...... syndrome was suspected and she was treated with implantation of a pacemaker (PM) at another institution. An inherited cardiac disease was one day suddenly suspected, as the patient had a 61-year old brother who was diagnosed with symptomatic BrS, and treated with an implantable cardioverter defibrillator...

  13. Unmet needs of bipolar disorder patients

    Directory of Open Access Journals (Sweden)

    Hajda M

    2016-06-01

    Full Text Available Miroslav Hajda,1 Jan Prasko,1 Klara Latalova,1 Radovan Hruby,2 Marie Ociskova,1 Michaela Holubova,1,3 Dana Kamaradova,1 Barbora Mainerova1 1Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University Olomouc, University Hospital Olomouc, Olomouc, Czech Republic; 2Outpatient Psychiatric Department, Martin, Slovak Republic; 3Department of Psychiatry, Regional Hospital Liberec, Liberec, Czech Republic Background: Bipolar disorder (BD is a serious mental illness with adverse impact on the lives of the patients and their caregivers. BD is associated with many limitations in personal and interpersonal functioning and restricts the patients’ ability to use their potential capabilities fully. Bipolar patients long to live meaningful lives, but this goal is hard to achieve for those with poor insight. With progress and humanization of society, the issue of patients’ needs became an important topic. The objective of the paper is to provide the up-to-date data on the unmet needs of BD patients and their caregivers. Methods: A systematic computerized examination of MEDLINE publications from 1970 to 2015, via the keywords “bipolar disorder”, “mania”, “bipolar depression”, and “unmet needs”, was performed. Results: Patients’ needs may differ in various stages of the disorder and may have different origin and goals. Thus, we divided them into five groups relating to their nature: those connected with symptoms, treatment, quality of life, family, and pharmacotherapy. We suggested several implications of these needs for pharmacotherapy and psychotherapy. Conclusion: Trying to follow patients’ needs may be a crucial point in the treatment of BD patients. However, many needs remain unmet due to both medical and social factors. Keywords: bipolar disorder, unmet needs, stigma, treatment, medication, quality of life, family, psychotherapy

  14. Bipolar depression: the importance of being on remission Depressão bipolar: a importância da remissão

    Directory of Open Access Journals (Sweden)

    Fernando Kratz Gazalle

    2006-06-01

    Full Text Available OBJECTIVE: The aim of the present study is to compare quality of life among currently depressed, subsyndromal and remitted patients with bipolar disorder (BD and to assess whether the level of depression correlates with the scores of quality of life in BD patients. METHOD: Sixty bipolar outpatients diagnosed using the Structured Clinical Interview for DSM-IV who met criteria for diagnosis of BD type I, II or not otherwise specified (BD-NOS, and who were not currently on a manic or mixed episode were included. The main variables of interest were quality of life (QOL assessed using the 26-item World Health Organization QOL instrument (WHOQOL-BREF and depression assessed using the 17-item Hamilton Depression Rating Scale (HDRS. RESULTS: A linear trend test showed a dose response association between patients' current mood state and all domains of quality of life. Higher quality of life scores were found among remitted patients, followed by subsyndromal patients; depressed patients presented lower scores of quality of life, except for the social domain. The four domains of the WHOQOL scale correlated negatively with the HDRS. CONCLUSIONS: Our findings suggest that bipolar depression and residual symptoms of depression are negatively correlated with QOL in BD patients.OBJETIVO: O objetivo deste estudo é o de comparar a qualidade de vida entre pacientes com transtorno bipolar que estão atualmente deprimidos, com depressão subsindrômica e com remissão de sintomas, e avaliar se o nível de depressão tem correlação com os escores de qualidade de vida em pacientes com transtorno bipolar. MÉTODO: Sessenta pacientes bipolares tratados ambulatorialmente, diagnosticados pela Entrevista Clínica Estruturada do DSM-IV, que preencheram critérios diagnósticos de transtorno bipolar tipo I, tipo II ou sem outra especificação (TB-SOE, e que não estavam atualmente em um episódio maníaco ou misto foram incluídos. As principais variáveis de interesse

  15. Lurasidone for the treatment of bipolar depression: an evidence-based review

    Directory of Open Access Journals (Sweden)

    Franklin R

    2015-08-01

    Full Text Available Rachel Franklin,1 Sam Zorowitz,1 Andrew K Corse,1 Alik S Widge,2 Thilo Deckersbach1 1Division of Neurotherapeutics, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, 2Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Cambridge, MA, USA Abstract: Bipolar disorder (BD is a debilitating and difficult-to-treat psychiatric disease that presents a serious burden to patients’ lives as well as health care systems around the world. The essential diagnostic criterion for BD is episodes of mania or hypomania; however, the patients report that the majority of their time is spent in a depressive phase. Current treatment options for this component of BD have yet to achieve satisfactory remission rates. Lurasidone is a drug in the benzisothiazole class approved by the US Food and Drug Administration in June 2013 for the acute treatment of bipolar depression. Its pharmacological profile features high-affinity antagonism at D2, 5-HT2A, and 5-HT7 receptors; moderate-affinity antagonism at α2C-adrenergic receptors; low- to very low-affinity antagonism at α1A-adrenergic, α2A-adrenergic, H1, M1, and 5-HT2C receptors; and high-affinity partial agonism at 5-HT1A. Preliminary findings from two recent double-blinded clinical trials suggest that lurasidone is efficacious in treating bipolar I depression, with clinical effects manifesting as early as the first 2–3 weeks of treatment (as measured by the Montgomery–Åsberg Depression Rating Scale and Clinical Global Impressions Scale for use in bipolar illness. Its therapeutic benefit appears to be comparable to the current US Food and Drug Administration-indicated treatments: quetiapine and olanzapine–fluoxetine, according to a measure of effect size known as number needed to treat. These studies reported relatively limited extrapyramidal and metabolic side effects as a result of treatment with lurasidone, with the most common side

  16. Tertiapin-Q removes a large and rapidly acting component of vagal slowing of the guinea-pig cardiac pacemaker.

    Science.gov (United States)

    Bolter, Chris P; Turner, Michael J

    2009-10-01

    The participation of acetylcholine-activated potassium current (I(K,ACh)) and hyperpolarization-activated pacemaker current (I(f)) in vagal bradycardia were examined using vagally-innervated preparations of guinea-pig atria. Preparations were maintained in Krebs-Henseleit solution (36 degrees C). Before treatment, trains of vagal stimuli (10 s at 2, 5 and 10 Hz) produced graded bradycardias displaying rapid onset and offset. Tertiapin-Q (300 nM), which blocks I(K,ACh), had no effect on baseline atrial rate. In tertiapin-Q, vagal bradycardia displayed a gradual onset and offset, with a peak response ~50% of that recorded in control conditions. Cumulative addition of 1 mM ZD7288 (blocker of I(f)) caused atrial rate to fall by ~60%, but had no further effect on the amplitude of the vagal bradycardia, while response onset and offset became slightly faster. From these observations, we argue that (i) vagal bradycardia was attributable primarily to activation of I(K,ACh), (ii) vagal modulation of I(f) had a minor influence on the rate of onset and offset of bradycardia, and (iii) removal of the influence of I(K,ACh) unmasked a slow response, of undetermined origin, to vagal stimulation. In a separate set of experiments we compared the effects of 1 mM Ba(2+) and 300 nM tertiapin-Q on vagal bradycardia. Ba(2+) reduced baseline atrial rate and the response to vagal stimulation. Subsequent cumulative addition of tertiapin-Q had no additional effect on baseline atrial rate, but caused further reduction in the amplitude of vagal bradycardia, suggesting that 1 mM Ba(2+) did not achieve a complete block of I(K,ACh) in this preparation. PMID:19481505

  17. [An indication for a permanent pacemaker : digitialis therapy for cardiac failure with disturbed atrioventricular conduction (author's transl)].

    Science.gov (United States)

    Letac, B; Hubscher, C; Toussaint, C; Cazor, J L

    1978-09-01

    In twenty patients with advanced heart disease with severe cardiac failure and the presence of conduction disturbances before digitalis therapy, but in whom such disturbances were worsened or revealed by the treatment, it was necessary to insert a permanent pacemaker in order to make effective long term digitalisation possible without the risk of excessive bradycardia or pauses due to worsening of atrioventricular block. Six patients died within a period of 9 days to 34 months after insertion of the pacemaker, two were lost from sight, and the other 12 were followed-up regularly for an average period of 20 months, their condition remaining stationary and, in general, satisfactory. PMID:704314

  18. Symptomatic sick sinus syndrome requiring permanent pacemaker implantation in a patient uwith mirror image dextrocardia with situs inversus and infertility.

    Science.gov (United States)

    Kahali, Dhiman; Mandal, Saroj; Mandal, Debasmita; Ghose, Arijit; Kanjilal, Souvik

    2013-01-01

    Situs inversus with dextrocardia is a congenital condition in which the heart is a mirror image of the anatomically normal heart on the right side. A patient presented with the sick sinus syndrome accompanying mirror image dextrocardia which was associated with double superior vena cava and a left sided inferior vena cava A permanent transvenous demand pacemaker was inserted because of repeated episodes of dizziness and a single episode of syncope with ECG showing bradycardia with junctional escape rhythm. Precise knowledge of the venous system and the location of the apex of the right ventricle were necessary prior to permanent pacemaker implantation. Without such knowledge pacing may be technically challenging.

  19. Pheochromocytoma-induced atrial tachycardia leading to cardiogenic shock and cardiac arrest: resolution with atrioventricular node ablation and pacemaker placement.

    Science.gov (United States)

    Shawa, Hassan; Bajaj, Mandeep; Cunningham, Glenn R

    2014-12-01

    Pheochromocytoma should be considered in young patients who have acute cardiac decompensation, even if they have no history of hypertension. Atrioventricular node ablation and pacemaker placement should be considered for stabilizing pheochromocytoma patients with cardiogenic shock due to atrial tachyarrhythmias. A 38-year-old black woman presented with cardiogenic shock (left ventricular ejection fraction, cardiogenic shock and cardiac arrest unresolved by the placement of 2 different ventricular assist devices, but that was completely reversed by radiofrequency ablation of the atrioventricular node and the placement of a temporary pacemaker. We present the patient's clinical, laboratory, and imaging findings, and we review the relevant literature.

  20. Berberine induces pacemaker potential inhibition via cGMP-dependent ATP-sensitive K+ channels by stimulating mu/delta opioid receptors in cultured interstitial cells of Cajal from mouse small intestine.

    Science.gov (United States)

    Kim, Hyun Jung; Kim, Hyungwoo; Jung, Myeong Ho; Kwon, Young Kyu; Kim, Byung Joo

    2016-10-01

    Berberine is traditionally used to treat gastrointestinal (GI) motility disorders. The interstitial cells of Cajal (ICCs) are the pacemaker cells of the gastrointestinal tract, which are responsible for the production of gut movements. The present study aimed to investigate the effects of berberine on pacemaker potentials (PPs) in cultured ICC clusters from the mouse small intestine, and sought to identify the receptors involved and the underlying mechanisms of action. All experiments were performed on cultured ICCs, and a whole‑cell patch‑clamp configuration was used to record PPs from ICC clusters (current clamp mode). Under current clamp mode, berberine was shown to decrease the amplitude and frequency of PPs. However, these effects were suppressed by treatment with glibenclamide, a specific ATP‑sensitive K+ channel blocker. Nor‑binaltorphimine dihydrochloride (a kappa opioid receptor antagonist) did not suppress berberine‑induced PP inhibition, whereas ICI 174,864 (a delta opioid receptor antagonist) and CTOP (a mu opioid receptor antagonist) did suppress the inhibitory effects of berberine. Pretreatment with SQ‑22536 (an adenylate cyclase inhibitor) or with KT‑5720 (a protein kinase A inhibitor) did not suppress the effects of berberine; however, pretreatment with 1H‑[1,2,4] oxadiazolo [4,3‑a] quinoxalin‑1‑one (a guanylate cyclase inhibitor) or KT‑5823 [a protein kinase G (PKG) inhibitor] did. In addition, berberine stimulated cyclic guanosine monophosphate (cGMP) production in ICCs. These observations indicate that berberine may inhibit the pacemaker activity of ICC clusters via ATP‑sensitive K+ channels and the cGMP‑PKG‑dependent pathway by stimulating mu and delta opioid receptors. Therefore, berberine may provide a basis for the development of novel agents for the treatment of GI motility dysfunction. PMID:27601272