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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 depolarizing current. Platelet activation may ensue, resulting in aggregation, release reaction, and contraction. In contrast, a unipolar pacemaker system will not depolarize blood, but transmit current directly into the myocardium, and the current afterward passes through other tissues before...

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

    Science.gov (United States)

    Zhang, Yue; Wang, Kuanquan; 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 (I K1). 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

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

    OpenAIRE

    Yue Zhang; Kuanquan Wang; Qince Li; Henggui Zhang

    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 biopa...

  5. 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.

  6. Current Propagation in Narrow Bipolar Pulses

    Science.gov (United States)

    Watson, S. S.; Marshall, T. C.

    2005-12-01

    We model the observed electric fields of a particular narrow bipolar pulse (NBP) published in Eack [2004]. We assume an exponential growth of current carriers due to a runaway breakdown avalanche and show that this leads to a corresponding increase in current. With specific input values for discharge altitude, length, current, and propagation velocity, the model does a good job of reproducing the observed near and far electric field. The ability of the model to reproduce the observed electric fields is an indication that our assumptions concerning the runaway avalanche may be correct, and this indication is further strengthened by the inability of the simple transmission line model to reproduce simultaneously both the near and far electric fields. Eack, K. B. (2004), Electrical characteristics of narrow bipolar events, Geophys. Res. Lett., 31, L20102, doi:10.1029/2004/GL021117.

  7. "Caged calcium" in Aplysia pacemaker neurons. Characterization of calcium-activated potassium and nonspecific cation currents

    OpenAIRE

    1989-01-01

    We have studied calcium-activated potassium current, IK(Ca), and calcium-activated nonspecific cation current, INS(Ca), in Aplysia bursting pacemaker neurons, using photolysis of a calcium chelator (nitr-5 or nitr-7) to release "caged calcium" intracellularly. A computer model of nitr photolysis, multiple buffer equilibration, and active calcium extrusion was developed to predict volume-average and front-surface calcium concentration transients. Changes in arsenazo III absorbance were used to...

  8. Madagascar: A pacemaker for the Agulhas Current system?

    Science.gov (United States)

    Penven, P.; Lutjeharms, J. R. E.; Florenchie, P.

    2006-09-01

    Western boundary currents are driven by zonally integrated wind-stress curl over the width of subtropical basins. This cross-basin integration is interrupted in the South Indian Ocean where Madagascar presents a formidable barrier. Nevertheless, a western boundary current has been thought to exist in the Mozambique Channel, the Mozambique Current. Recent observations have however shown that no such current exists and that the flow in the channel instead consists of a train of eddies. Is this western boundary anomaly due to the presence of Madagascar? We have used a primitive equations model to investigate the flow in the South West Indian Ocean as if there were no Madagascar. We show that a normal, continuous western boundary current is then formed that constitutes a continuum with the Agulhas Current. The presence of Madagascar is shown to affect the frequency of inter-ocean exchange events south of Africa.

  9. 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

  10. 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

  11. 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...

  12. Cardiac Pacemakers

    International Nuclear Information System (INIS)

    A complete survey of physiological biophysical,clinical and engineering aspects of cardiac facing,including the history and an assessment of possible future developments.Among the topics studied are: pacemakers, energy search, heart stimulating with pacemakers ,mathematical aspects of the electric cardio stimulation chronic, pacemaker implants,proceeding,treatment and control

  13. 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

  14. High current and voltage effects in heterojunction bipolar transistor collectors

    International Nuclear Information System (INIS)

    The influence of temperature on speed and power applications is important in heterojunction bipolar transistors with the need for high current drive capability, high cutoff frequency and high voltage handling capability. At high current density, the onset of the Kirk effect is often the main power constraint in the bipolar transistor. An analytical model that accurately describes the physics behind the parasitic electron barrier formation in double heterojunction bipolar transistors in the Si/SiGe, GalnP/GaAs and InP/GaAsSb materials systems at the onset of the Kirk effect is presented. A new lateral current spreading effect due to the electron barrier dependence on collector current density is also discussed. The electron saturation velocity in Ga0.52In0.48P has also been measured as a function of temperature, utilising the Kirk effect in double heterojunction bipolar transistors. An AIGaAs base was used to eliminate the conduction band spike and measurements were carefully performed using pulse biasing to minimise device self-heating. Voltage drops across the base and collector series resistances were also taken into account. The measured room temperature saturation velocity of 5.0 x 106 cm/s decreased rapidly to 2.9 x 106 cm/s at 200 deg C. These results are particularly important for the prediction of frequency performance of Ga0.52In0.48P/(Al)GaAs/Ga0.52In0.48P DHBTs. Avalanche multiplication and hence impact ionisation coefficients for In0.53Ga0.47As have been determined from photomultiplication measurements over the temperature range of 20 - 400 K for a series of p-i-n/n-i-p diodes. Negative temperature dependence is observed in both the electron and hole multiplication of In0.53Ga0.47As at electric fields over 200 kV/cm, contrary to the temperature dependence of collector multiplication previously observed in InP/In0.53Ga0.47As heterojunction bipolar transistors. The results also showed that the breakdown voltage for In0.53Ga0.47As is comparable to GaAs at

  15. 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.)

  16. Low cost bipolar current collector-separator for electrochemical cells

    International Nuclear Information System (INIS)

    A bipolar current collecting, cell separating element for electrochemical cells for conducting current from the anode electrode of one cell unit to cathode electrode of the adjacent cell unit comprises: (A) a pressure mold aggregate of electrically conductive carbon/graphite particles and thermoplastic fluorocarbon polymer resin particles in a weight ratio of 2.5:1 to 16:1 whereby said molded aggregated has a bulk resistivity which is less than 4x10-3 ohm/inch, (B) said molded aggregate having a fluid imprevious main body, at least one recessed chamber on one side of said main body and a plurality of spaced, conductive projections extending from the base of said chamber for contacting and permitting current flow between the electrode of adjacent cell unit, and (C) means communicating with said recessed chambers to permit introduction and removal of fluids

  17. 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℃.

  18. Current and Emerging Therapies for the Management of Bipolar Disorders

    OpenAIRE

    El-Mallakh, Rif S; Elmaadawi, Ahmed Z.; Yonglin Gao; Kavita Lohano; R. Jeannie Roberts

    2011-01-01

    Bipolar disorder is a complex condition to treat because agents that may be effective for a specific phase may not be effective for other phases, or may even worsen the overall course of the illness. Over the last decade there has been an increase in research activity in the treatment of bipolar illness. There are now several agents that are well established for the treatment of acute mania (lithium, divalproex, carbamazepine, nearly all antipsychotics), acute bipolar depression (lamotrigine,...

  19. 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

  20. Trends in Cardiac Pacemaker Batteries

    Directory of Open Access Journals (Sweden)

    Venkateswara Sarma Mallela

    2004-10-01

    Full Text Available Batteries used in Implantable cardiac pacemakers-present unique challenges to their developers and manufacturers in terms of high levels of safety and reliability. In addition, the batteries must have longevity to avoid frequent replacements. Technological advances in leads/electrodes have reduced energy requirements by two orders of magnitude. Micro-electronics advances sharply reduce internal current drain concurrently decreasing size and increasing functionality, reliability, and longevity. It is reported that about 600,000 pacemakers are implanted each year worldwide and the total number of people with various types of implanted pacemaker has already crossed 3 million. A cardiac pacemaker uses half of its battery power for cardiac stimulation and the other half for housekeeping tasks such as monitoring and data logging. The first implanted cardiac pacemaker used nickel-cadmium rechargeable battery, later on zinc-mercury battery was developed and used which lasted for over 2 years. Lithium iodine battery invented and used by Wilson Greatbatch and his team in 1972 made the real impact to implantable cardiac pacemakers. This battery lasts for about 10 years and even today is the power source for many manufacturers of cardiac pacemakers. This paper briefly reviews various developments of battery technologies since the inception of cardiac pacemaker and presents the alternative to lithium iodine battery for the near future.

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

    International Nuclear Information System (INIS)

    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°C and 20% in −55°C–25°C. (condensed matter: electronic structure, electrical, magnetic, and optical properties)

  2. 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.

  3. [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

  4. A current-controlled PWM bipolar power supply for a magnet load

    International Nuclear Information System (INIS)

    The Advanced Photon Source, at Argonne National Laboratory will produce the world's brightest x-ray beams when it is complete. A number of correction magnets are used to maintain proper beam position. Basically, two different types of bipolar power supplies are used for all the correction magnets: one requires dc correction only, and the other requires dc and ac correction. Normally linear-mode power amplifiers would be used for the bipolar power supplies. However, linear-mode power amplifiers dissipate a substantial amount of power as heat, resulting in poor efficiency for their large size. In addition, most commercial bipolar power supplies are linear-mode and available for lower power levels. Therefore, for higher power levels it was necessary to design a bipolar power supply that uses switch-mode power conversion. This paper describes a control technique for a pulse-width-modulatcd bipolar power supply, which can deliver a controlled current, dc plus ac to a correction magnet. A design example of a 150A bipolar power supply is presented

  5. Current Suicide Ideation and Prior Suicide Attempts of Bipolar Patients as Influences on Caregiver Burden

    Science.gov (United States)

    Chessick, Cheryl A.; Perlick, Deborah A.; Miklowitz, David J.; Kaczynski, Richard; Allen, Michael H.; Morris, Chad D.; Marangell, Lauren B.

    2007-01-01

    We examined whether caregivers of bipolar patients reporting current suicidal ideation and/or a history of a suicide attempt reported higher levels of burden and/or poorer health compared to caregivers of patients without these suicidality indices. In a cross-sectional design, caregivers (N = 480) associated with (a) patients with current suicidal…

  6. 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 ...

  7. 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

  8. 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.

  9. 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 ...

  10. A migrating pacemaker

    OpenAIRE

    Gale, C.; Mulley, G.

    2005-01-01

    A deceased 79 year old man with a permanent cardiac pacemaker was due to be cremated, but the pacemaker generator was not detectable by palpation. A hand held metal detector to locate the device so that it could be extracted before cremation.

  11. 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

  12. High stability bipolar current power supply for a variable pole-gap dipole magnet

    International Nuclear Information System (INIS)

    A bipolar current power supply of rating 15 A, 50 V is built for demonstrating experiments on the measurement of magnetic field quality of a variable pole-gap dipole magnet to the trainees of RRCAT training school. Essentially, the ±100 ppm stability power supply has been built in two stages consisting of: 1) a pre-regulator based on half-bridge switch-mode power supply, and 2) a four-quadrant switch-mode power converter. In this paper, critical design issues relating to switching ripple and choice of topology, freewheeling magnet energy, wide load current variation, handling of step current references, current and voltage control loop designs, protection for over-voltages generated during operation of MOSFET bridge due to repetitive step change in DC-link current, and mounting of components and devices are discussed. Results obtained from the power supply are given at the end. (author)

  13. 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

  14. 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.

  15. 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

  16. 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. PMID:26148458

  17. 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.

  18. 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.

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

    Science.gov (United States)

    Wu, Shuxiang; Li, Shuwei

    2015-08-01

    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.

  20. A new current regulator for the APS storage ring correction magnet bipolar switching mode converters

    International Nuclear Information System (INIS)

    The correction magnets in the Advanced Photon Source's storage ring are powered by PWM-controlled bipolar switching-mode converters. These converters are designed to operate at up to ±150 A. The original control circuit used a polarity detection circuit with a hysteresis to determine which IGBT was needed to regulate the current with a given polarity. Only the required IGBT was switched with PWM pulses while others were held on or off continuously. The overall IGBT switching losses were minimized by the design. The shortcoming of the design was that the converter's output was unstable near zero current because of the hysteresis. To improve the stability, a new current regulator using a different PWM method has been developed to eliminate the requirement of the polarity detection. With the new design, converters can operate smoothly in the full range of ±150 A. The new design also meets tighter specs in terms of the ripple current and dynamic response. This paper describes the design of the new regulator and the test results.

  1. 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 ...

  2. 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

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

    OpenAIRE

    Lemke Leyman; Rudi De Raedt; Koster, Ernst H.W.

    2009-01-01

    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 paci...

  4. 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...

  5. 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...

  6. Management of Bipolar Depression

    OpenAIRE

    Jae Seung Chang; Kyooseob Ha

    2011-01-01

    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 di...

  7. 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...

  8. 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

  9. 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...

  10. 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

  11. 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.)

  12. Defibrillator/monitor/pacemakers.

    Science.gov (United States)

    2003-05-01

    Defibrillator/monitors allow operators to assess and monitor a patient's ECG and, when necessary, deliver a defibrillating shock to the heart. When integral noninvasive pacing is added, the device is called a defibrillator/monitor/pacemaker. In this Evaluation, we present our findings for two newly evaluated models, the Welch Allyn PIC 50 and the Zoll M Series CCT, and we summarize our findings for the previously evaluated models that are still on the market. We rate the models for the following applications: general crash-cart use, in-hospital transport use, and emergency medical service (EMS) use. PMID:12827940

  13. 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.

  14. 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.

  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. 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...

  18. 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.

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

    International Nuclear Information System (INIS)

    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 (electron 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.

  20. 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.

  1. 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)

  2. Improving Treatment Adherence in Bipolar Disorder: A Review of Current Psychosocial Treatment Efficacy and Recommendations for Future Treatment Development

    Science.gov (United States)

    Gaudiano, Brandon A.; Weinstock, Lauren M.; Miller, Ivan W.

    2008-01-01

    Treatment adherence is a frequent problem in bipolar disorder, with research showing that more than 60% of bipolar patients are at least partially nonadherent to medications. Treatment nonadherence is consistently predictive of a number of negative outcomes in bipolar samples, and the discontinuation of mood stabilizers places these patients at…

  3. 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

  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. Potential mechanisms of action of lithium in bipolar disorder. Current understanding.

    Science.gov (United States)

    Malhi, Gin S; Tanious, Michelle; Das, Pritha; Coulston, Carissa M; Berk, Michael

    2013-02-01

    Lithium has been used for over half a century for the treatment of bipolar disorder as the archetypal mood stabilizer, and has a wealth of empirical evidence supporting its efficacy in this role. Despite this, the specific mechanisms by which lithium exerts its mood-stabilizing effects are not well understood. Given the inherently complex nature of the pathophysiology of bipolar disorder, this paper aims to capture what is known about the actions of lithium ranging from macroscopic changes in mood, cognition and brain structure, to its effects at the microscopic level on neurotransmission and intracellular and molecular pathways. A comprehensive literature search of databases including MEDLINE, EMBASE and PsycINFO was conducted using relevant keywords and the findings from the literature were then reviewed and synthesized. Numerous studies report that lithium is effective in the treatment of acute mania and for the long-term maintenance of mood and prophylaxis; in comparison, evidence for its efficacy in depression is modest. However, lithium possesses unique anti-suicidal properties that set it apart from other agents. With respect to cognition, studies suggest that lithium may reduce cognitive decline in patients; however, these findings require further investigation using both neuropsychological and functional neuroimaging probes. Interestingly, lithium appears to preserve or increase the volume of brain structures involved in emotional regulation such as the prefrontal cortex, hippocampus and amygdala, possibly reflecting its neuroprotective effects. At a neuronal level, lithium reduces excitatory (dopamine and glutamate) but increases inhibitory (GABA) neurotransmission; however, these broad effects are underpinned by complex neurotransmitter systems that strive to achieve homeostasis by way of compensatory changes. For example, at an intracellular and molecular level, lithium targets second-messenger systems that further modulate neurotransmission. For

  6. 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...

  7. 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. ...

  8. 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...

  9. Design of the Pacemaker REmote Follow-up Evaluation and Review (PREFER trial to assess the clinical value of the remote pacemaker interrogation in the management of pacemaker patients

    Directory of Open Access Journals (Sweden)

    Johnson W Ben

    2008-04-01

    Full Text Available Abstract Background Although pacemakers are primarily used for the treatment of bradycardia, diagnostic data available in current pacemakers allow them to be also used as sophisticated, continuous monitoring devices. Easy access to these stored data may assist clinicians in making diagnostic and therapeutic decisions sooner, thus avoiding potential long-term sequelae due to untreated clinical disorders. Internet-based remote device interrogation systems provide clinicians with frequent and complete access to stored data in pacemakers. In addition to monitoring device function, remote monitors may be a helpful tool in assisting physicians in the management of common arrhythmia disorders. Methods The Pacemaker REmote Follow-up Evaluation and Review (PREFER trial is a prospective, randomized, parallel, unblinded, multicenter, open label clinical trial to determine the utility of remote pacemaker interrogation in the earlier diagnosis of clinically actionable events compared to the existing practice of transtelephonic monitoring. There have been 980 patients enrolled and randomized to receive pacemaker follow up with either remote interrogation using the Medtronic CareLink® Network (CareLink versus the conventional method of transtelephonic monitoring (TTM in addition to periodic in-person interrogation and programming evaluations. The purpose of this manuscript is to describe the design of the PREFER trial. The results, to be presented separately, will characterize the number of clinically actionable events as a result of pacemaker follow-up using remote interrogation instead of TTM. Trial registration ClinicalTrials.gov: NCT00294645.

  10. 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 ...

  11. 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.

  12. Bipolar Disorder

    Science.gov (United States)

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

  13. Bipolar Disorder

    Science.gov (United States)

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

  14. 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 ...

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

    International Nuclear Information System (INIS)

    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 SiO2/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

  16. Bipolar semicopulas

    Czech Academy of Sciences Publication Activity Database

    Greco, S.; Mesiar, Radko; Rindone, F.

    Linz: Univesitatsdirektion, JKU Linz, Austria, 2013. s. 63-65. [Linz Seminar on Fuzzy Set Theory /34./. 26.02.2013-02.03.2013, Linz] R&D Projects: GA ČR GAP402/11/0378 Keywords : bipolar integral * bipolar semicopula * bipolar aggregation Subject RIV: BA - General Mathematics http://library.utia.cas.cz/separaty/2013/E/mesiar-0422906.pdf

  17. 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.

  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. Simulation of electron and ion bipolar flow in high current diode with magnetic insulation

    International Nuclear Information System (INIS)

    Numerical simulation of the formation of the collector ion flow in a magnetically insulated ion diode (MID) with a hollow cylindrical and cone-shaped cathode was studied. Such cathodes are often used for the production of tubular high current microsecond electron beams. The ions, emitted by the collector and born as a result of ionization of the residual gas by the electron beam, are focused into the cathode plasma region. This effect can adversely influence the diode operation

  20. High Current Multi-finger InGaAs/InP Double Heterojunction Bipolar Transistor with the Maximum Oscillation Frequency 253 GHz

    International Nuclear Information System (INIS)

    A four-finger InGaAs/InP double heterojunction bipolar transistor is designed and fabricated successfully by using planarization technology. The emitter area of each finger is 1 × 15μm2. The breakdown voltage is more than 7 V, the maximum collector current could be more than 100 mA. The current gain cutoff frequency is as high as 155 GHz and the maximum oscillation frequency reaches 253 GHz. The heterostructure bipolar transistor can offer more than 70mW class-A maximum output power at W band and the maximum power density can be as high as 1.2W/mm. (cross-disciplinary physics and related areas of science and technology)

  1. Pacemakers and implantable cardioverter defibrillators.

    Science.gov (United States)

    Allen, M

    2006-09-01

    An increasing number of patients are now treated cardiac pacemakers and implantable cardioverter defibrillators and the technology of these is constantly changing. It is vital to have a good understanding of how they function and what the real risks are. Understanding how the device should work when functioning normally, and the possible effects of electromagnetic interference, is paramount to their safe management in the peri-operative period. Knowing when a device should be disabled or reprogrammed requires careful consideration. Information from the patient's pacemaker clinic should be sought whenever possible and can be invaluable. In addition, the Medicines Healthcare products Regulatory Agency have published the first set of UK guidelines on the management of implantable devices in the presence of surgical diathermy and this will undoubtedly provide a firm foundation on which anaesthetists can base much of their practice. PMID:16922756

  2. Prefronto–cerebellar transcranial direct current stimulation improves visuospatial memory, executive functions, and neurological soft signs in patients with euthymic bipolar disorder

    OpenAIRE

    Minichino, Amedeo; Bersani, Francesco Saverio; Bernabei, Laura; Spagnoli, Francesco; Vergnani, Lucilla; Corrado, Alessandra; Taddei, Ines; Biondi, Massimo; Delle Chiaie, Roberto

    2015-01-01

    Objective The aim of the study was to improve neuropsychological functioning of euthymic patients with bipolar disorder (BD) using transcranial direct current stimulation (tDCS) applied to cerebellar and prefrontal cortices. Methods Twenty-five BD outpatients underwent prefrontal (anodal) and cerebellar (cathodal) tDCS for 3 consecutive weeks. All participants were assessed through the Rey Complex Figure Test delay and copy and the Neurological Examination Scale at baseline and after therapy ...

  3. Circadian Pacemaker – Temperature Compensation

    OpenAIRE

    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 changes, but with an opposing and counterbalancing effect on the periodicity of the clock system. As a result of temperature compensation, the increase in reaction velocity for every 10° rise in tempera...

  4. 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...

  5. 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.

  6. The “Funny” Current (If Inhibition by Ivabradine at Membrane Potentials Encompassing Spontaneous Depolarization in Pacemaker Cells

    Directory of Open Access Journals (Sweden)

    Yael Yaniv

    2012-07-01

    Full Text Available Recent clinical trials have shown that ivabradine (IVA, a drug that inhibits the funny current (If in isolated sinoatrial nodal cells (SANC, decreases heart rate and reduces morbidity and mortality in patients with cardiovascular diseases. While IVA inhibits If, this effect has been reported at essentially unphysiological voltages, i.e., those more negative than the spontaneous diastolic depolarization (DD between action potentials (APs. We tested the relative potency of IVA to block If over a wide range of membrane potentials, including those that encompass DD governing to the SANC spontaneous firing rate. A clinically relevant IVA concentration of 3 μM to single, isolated rabbit SANC slowed the spontaneous AP firing rate by 15%. During voltage clamp the maximal If was 18 ± 3 pA/pF (at −120 mV and the maximal If reduction by IVA was 60 ± 8% observed at −92 ± 4 mV. At the maximal diastolic depolarization (~−60 mV If amplitude was only −2.9 ± 0.4 pA/pF, and was reduced by only 41 ± 6% by IVA. Thus, If amplitude and its inhibition by IVA at physiologically relevant membrane potentials are substantially less than that at unphysiological (hyperpolarized membrane potentials. This novel finding more accurately describes how IVA affects SANC function and is of direct relevance to numerical modeling of SANC automaticity.

  7. 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.

  8. 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.

  9. 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.

  10. Pacemaker lead design masquerading as lead fracture

    OpenAIRE

    Madhu Gangadhara; Charles Peebles; James Gnanapragasam

    2015-01-01

    Performing chest X-ray is an important annual investigation to check pacemaker lead integrity during follow-up of patients with pacemakers. Understanding lead design is vital to the correct interpretation of X-rays to prevent inappropriate interventions for patients as highlighted in this case.

  11. Bipolar Disorder.

    Science.gov (United States)

    Spearing, Melissa

    Bipolar disorder, a brain disorder that causes unusual shifts in a person's mood, affects approximately one percent of the population. It commonly occurs in late adolescence and is often unrecognized. The diagnosis of bipolar disorder is made on the basis of symptoms, course of illness, and when possible, family history. Thoughts of suicide are…

  12. 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.

  13. 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.

  14. 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 ( ...

  15. 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

  16. 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.

  17. 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

    International Nuclear Information System (INIS)

    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/dm2 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/dm2) exhibited the coating prepared at 10 A/dm2 and 10 min possessing the best corrosion resistance (Icorr = 9.360 × 10−8 A/cm2). The contact resistance of Cr–C plated at coating current density of 10 A/dm2 was the lowest (16.54 mΩ cm2 at 150 N cm−2), which showed great potential of application. The single cell test with Cr–C coated SS304 prepared at coating current density of 10 A/dm2 as BPPs showed the highest current density (about 791.532 mA/cm2) and power density (about 270.150 mW/cm2). - 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

  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

    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 ...

  20. Lightweight bipolar storage battery

    Science.gov (United States)

    Rowlette, John J. (Inventor)

    1992-01-01

    An apparatus [10] is disclosed for a lightweight bipolar battery of the end-plate cell stack design. Current flow through a bipolar cell stack [12] is collected by a pair of copper end-plates [16a,16b] and transferred edgewise out of the battery by a pair of lightweight, low resistance copper terminals [28a,28b]. The copper terminals parallel the surface of a corresponding copper end-plate [16a,16b] to maximize battery throughput. The bipolar cell stack [12], copper end-plates [16a,16b] and copper terminals [28a,28b] are rigidly sandwiched between a pair of nonconductive rigid end-plates [20] having a lightweight fiber honeycomb core which eliminates distortion of individual plates within the bipolar cell stack due to internal pressures. Insulating foam [30] is injected into the fiber honeycomb core to reduce heat transfer into and out of the bipolar cell stack and to maintain uniform cell performance. A sealed battery enclosure [ 22] exposes a pair of terminal ends [26a,26b] for connection with an external circuit.

  1. 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

  2. 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

  3. Synchronization of Coupled Neurons Controlled by a Pacemaker

    International Nuclear Information System (INIS)

    We investigate synchronization of Hindmarsh—Rose neurons with gap junctions under the control of a pacemaker. In a ring Hindmarsh—Rose neuronal network, the coupled neurons with the pacemaker can occur in synchronization more easily than those without the pacemaker. Furthermore, the pacemaker can induce phase synchronization or nearly-complete synchronization of nonidentical neurons. This synchronization can occur more easily when time delay is considered. Theses results can be helpful to understand the activities of the real neuronal system. (general)

  4. Experimental observation of the behaviour of cogenerated dusty plasma using a bipolar pulsed direct current power supply

    International Nuclear Information System (INIS)

    We have experimentally observed the behaviour of cogenerated dusts in unmagnetized plasma produced using a bipolar pulsed dc power supply. In this experiment, the dust particles have been generated through sputtering of graphite cathode and were stratified between two electrodes. This stratification of dust clouds has obtained at a typical range of plasma parameters, namely, 650 V (peak-to-peak) with 0.2 mbar pressure. In above condition, we detected the Taylor-like instability at the interface of two dusty clouds with different densities. A very less dust density (void like) region inside the lesser dust density portion is also noted. Again, it has been observed that a self excited dust density wave propagates towards the higher density dust fluid inside the system as well as a stationary band structure of thin multiple layers of dust particles when we apply a higher voltage (750 V peak-to-peak). The wavelength, phase velocity, and frequency of the excited wave have also been estimated.

  5. 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

  6. Measurement and analysis EMC parameters of implantable pacemaker

    OpenAIRE

    Penhaker, Marek; Hájovský, Radovan; Korpas, David

    2011-01-01

    This paper deals with problematic of Electromagnetic Compatibility of Implantable Pacemaker. The ambient electromagnetic field can negatively influence the pacemaker functionality and also the wireless communication between its programmer and device. Electromagnetic compatibility parameters are tested by direct induction of interference signal to the inputs of cardiac pacemaker according to technical specification. The experimental tests were also made by generating of interference radio freq...

  7. 21 CFR 870.1750 - External programmable pacemaker pulse generator.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false External programmable pacemaker pulse generator... External programmable pacemaker pulse generator. (a) Identification. An external programmable pacemaker pulse generators is a device that can be programmed to produce one or more pulses at...

  8. 21 CFR 870.3600 - External pacemaker pulse generator.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false External pacemaker pulse generator. 870.3600... pacemaker pulse generator. (a) Identification. An external pacemaker pulse generator is a device that has a power supply and electronic circuits that produce a periodic electrical pulse to stimulate the...

  9. 21 CFR 870.3610 - Implantable pacemaker pulse generator.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Implantable pacemaker pulse generator. 870.3610... pacemaker pulse generator. (a) Identification. An implantable pacemaker pulse generator is a device that has a power supply and electronic circuits that produce a periodic electrical pulse to stimulate...

  10. 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

  11. Nuclear-powered pacemaker fuel cladding study

    International Nuclear Information System (INIS)

    The fabrication of fuel capsules with refractory metal and alloy clads used in nuclear-powered cardiac pacemakers precludes the expedient dissolution of the clad in inorganic acid solutions. An experiment to measure penetration rates of acids on commonly used fuel pellet clads indicated that it is not impossible, but that it would be very difficult to dissolve the multiple cladding. This work was performed because of a suggestion that a 238PuO2-powered pacemaker could be transformed into a terrorism weapon

  12. On Bipolar Soft Sets

    OpenAIRE

    Shabir, Muhammad; Naz, Munazza

    2013-01-01

    We have studied the concept of bipolarity of information in the soft sets. We have defined bipolar soft sets and basic operations of union, intersection and complementation for bipolar soft sets. Examples of bipolar soft sets and an application of bipolar soft sets in a decision making problem with general algorithms have also been presented at the end.

  13. 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

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

    International Nuclear Information System (INIS)

    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. (paper)

  15. Analysis of Cumulative Dose to Implanted Pacemaker According to Various IMRT Delivery Methods: Optimal Dose Delivery Versus Dose Reduction Strategy

    International Nuclear Information System (INIS)

    Cancer patients with implanted cardiac pacemaker occasionally require radiotherapy. Pacemaker may be damaged or malfunction during radiotherapy due to ionizing radiation or electromagnetic interference. Although radiotherapy should be planned to keep the dose to pacemaker as low as possible not to malfunction ideally, current radiation treatment planning (RTP) system does not accurately calculate deposited dose to adjacent field border or area beyond irradiated fields. In terms of beam delivery techniques using multiple intensity modulated fields, dosimetric effect of scattered radiation in high energy photon beams is required to be detailed analyzed based on measurement data. The aim of this study is to evaluate dose discrepancies of pacemaker in a RTP system as compared to measured doses. We also designed dose reduction strategy limited value of 2 Gy for radiation treatment patients with cardiac implanted pacemaker. Total accumulated dose of 145 cGy based on in-vivo dosimetry was satisfied with the recommendation criteria to prevent malfunction of pacemaker in SS technique. However, the 2 mm lead shielder enabled the scattered doses to reduce up to 60% and 40% in the patient and the phantom, respectively. The SS technique with the lead shielding could reduce the accumulated scattered doses less than 100 cGy. Calculated and measured doses were not greatly affected by the beam delivery techniques. In-vivo and measured doses on pacemaker position showed critical dose discrepancies reaching up to 4 times as compared to planned doses in RTP. The current SS technique could deliver lower scattered doses than recommendation criteria, but use of 2 mm lead shielder contributed to reduce scattered doses by 60%. The tertiary lead shielder can be useful to prevent malfunction or electrical damage of implanted pacemakers during radiotherapy. It is required to estimate more accurate scattered doses of the patient or medical device in RTP to design proper dose reduction strategy.

  16. Cayley Bipolar Fuzzy Graphs

    OpenAIRE

    Alshehri, Noura O.; Muhammad Akram

    2013-01-01

    We introduce the concept of Cayley bipolar fuzzy graphs and investigate some of their properties. We present some interesting properties of bipolar fuzzy graphs in terms of algebraic structures. We also discuss connectedness in Cayley bipolar fuzzy graphs.

  17. 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.

  18. 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

  19. 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

  20. Risperidone in the treatment of bipolar mania

    OpenAIRE

    Sajatovic, Martha; Subramoniam, Madhusoodanan; Fuller, Matthew A

    2006-01-01

    Atypical antipsychotic medications have assumed growing importance for the treatment of bipolar disorder, an illness that affects approximately 1.2%–3.7% of the general population in a given year. Current practice guidelines for the treatment of bipolar mania support the use of atypical antipsychotic medications as monotherapy or as a component of polytherapy, and in clinical settings the use of atypical antipsychotics to treat bipolar disorder is widespread. Risperidone is an atypical antips...

  1. 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...

  2. Distinctions between bipolar and unipolar depression

    OpenAIRE

    Cuellar, Amy K.; Johnson, Sheri L.; Winters, Ray

    2005-01-01

    This is a review of the studies comparing unipolar and bipolar depression, with focus on the course, symptomatology, neurobiology, and psychosocial literatures. These are reviewed with one question in mind: does the evidence support diagnosing bipolar and unipolar depressions as the same disorder or different? The current nomenclature of bipolar and unipolar disorders has resulted in research that compares these disorders as a whole, without considering depression separately from mania within...

  3. 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

  4. 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.

  5. Measuring pacemaker dose: A clinical perspective

    International Nuclear Information System (INIS)

    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.

  6. Validation of the Chinese version of the "Mood Disorder Questionnaire" for screening bipolar disorder among patients with a current depressive episode

    Directory of Open Access Journals (Sweden)

    Gan Zhaoyu

    2012-01-01

    Full Text Available Abstract Background The Mood Disorder Questionnaire (MDQ is a well-recognized screening tool for bipolar disorder, but its Chinese version needs further validation. This study aims to measure the accuracy of the Chinese version of the MDQ as a screening instrument for bipolar disorder (BPD in a group of patients with a current major depressive episode. Methods 142 consecutive patients with an initial DSM-IV-TR diagnosis of a major depressive episode were screened for BPD using the Chinese translation of the MDQ and followed up for one year. The final diagnosis, determined by a special committee consisting of three trained senior psychiatrists, was used as a 'gold standard' and ROC was plotted to evaluate the performance of the MDQ. The optimal cut-off was chosen by maximizing the Younden's index. Results Of the 142 patients, 122 (85.9% finished the one year follow-up. On the basis of a semi-structured clinical interview 48.4% (59/122 received a diagnosis of unipolar depression (UPD, 36.9% (45/122 BPDII and 14.8% (18/122 BPDI. At the end of the one year follow-up,9 moved from UPD to BPD, 2 from BPDII to UPD, 1 from BPDII to BPDI, the overall rate of initial misdiagnosis was 16.4%. MDQ showed a good accuracy for BPD: the optimal cut-off was 4, with a sensitivity of 0.72 and a specificity of 0.73. When BPDII and BPDI were calculated independently, the optimal cut-off for BPDII was 4, with a sensitivity of 0.70 and a specificity of 0.73; while the optimal cut-off for BPDI was 5, with a sensitivity of 0.67 and a specificity of 0.86. Conclusions Our results show that the Chinese version of MDQ is a valid tool for screening BPD in a group of patients with current depressive episode on the Chinese mainland.

  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. 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.

  9. 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

    2014-01-01

    Aalborg University Hospital pacemakers are tested when implanted, 3 months later and then two years after the implantation. It is tested by a nurse specialist who also is interested in the patient’s general health status and well being. Patient expectations are unknown. Cheng et al (2002) have found 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 of this...... man) before the 3 month visit and one (4 women, 1 man) after the 3 month visit. The interview was transcribed ad verbatim and analyzed inspired by Ricouers three text comprising levels: naïve reading, structural analysis and critical interpretation and discussion. Results Both interviews showed the...

  10. 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

    Aalborg University Hospital pacemakers are tested when implanted, 3 months later and then two years after the implantation. It is tested by a nurse specialist who also is interested in the patient’s general health status and well being. Patient expectations are unknown. Cheng et al (2002) have found 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 of this...... man) before the 3 month visit and one (4 women, 1 man) after the 3 month visit. The interview was transcribed ad verbatim and analyzed inspired by Ricouers three text comprising levels: naïve reading, structural analysis and critical interpretation and discussion. Results Both interviews showed the...

  11. 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.

  12. Prefronto–cerebellar transcranial direct current stimulation improves visuospatial memory, executive functions, and neurological soft signs in patients with euthymic bipolar disorder

    Directory of Open Access Journals (Sweden)

    Minichino A

    2015-08-01

    Full Text Available Amedeo Minichino, Francesco Saverio Bersani, Laura Bernabei, Francesco Spagnoli, Lucilla Vergnani, Alessandra Corrado, Ines Taddei, Massimo Biondi, Roberto Delle Chiaie Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy Objective: The aim of the study was to improve neuropsychological functioning of euthymic patients with bipolar disorder (BD using transcranial direct current stimulation (tDCS applied to cerebellar and prefrontal cortices.Methods: Twenty-five BD outpatients underwent prefrontal (anodal and cerebellar (cathodal tDCS for 3 consecutive weeks. All participants were assessed through the Rey Complex Figure Test delay and copy and the Neurological Examination Scale at baseline and after therapy with tDCS.Results: After tDCS treatment, patients showed significant improvements in visuospatial memory tasks. Patients with worse baseline cognitive performances also showed a significant improvement in executive functioning tasks. Neurological Examination Scale total score and motor coordination subscale significantly improved.Conclusion: Prefrontal-excitatory and cerebellar-inhibitory stimulations in euthymic BD patients may lead to better neurocognitive performances. This improvement could result from the modulation of prefronto–thalamic–cerebellar circuit activity pattern, which can be disrupted in BD. Keywords: cerebellum, dorsolateral prefrontal cortex, neuropsychology, cognition 

  13. Current-voltage characteristic for bipolar p-n junction devices with drift fields, including correlation between carrier lifetimes and shallow-impurity concentration

    International Nuclear Information System (INIS)

    We present general analytic solutions for static current-voltage characteristics of quasineutral regions of nonilluminated semiconductor bipolar devices under the following assumptions: (a) the quasineutral region has a graded shallow-level impurity concentration producing a constant built-in electric (drift) field; (b) minority carriers injected into this region stay at concentrations low enough to avoid violation of low-injection conditions; (c) the minority-carrier lifetime of this region depends on position in accordance with a power-law dependence on the shallow-level donor concentration, a dependence that is consistent with the longest minority-carrier lifetimes measured and with the physical chemistry of divacancy-donor reactions at high temperatures. The solutions presented are apparently the first that include assumption (c). Modified Bessel functions of the first and second kind appear in these solutions. From a pheonomenological standpoint, the solutions may account for defect centers associated with vacancy complexes and, in part, for the gettering observed in highly doped n-type Si. Design implications for transistors, diodes, and solar cells are discussed quantitatively for a thin drift-field Si p/n(x) junction solar cell

  14. Filament Geometry Induced Bipolar, Complementary, and Unipolar Resistive Switching under the Same Set Current Compliance in Pt/SiOx/TiN

    Science.gov (United States)

    Lim, Dong-Hyeok; Kim, Ga-Yeon; Song, Jin-Ho; Jeong, Kwang-Sik; Ko, Dae-Hong; Cho, Mann-Ho

    2015-10-01

    The decidedly unusual co-occurrence of bipolar, complementary, and unipolar resistive switching (BRS, CRS, and URS, respectively) behavior under the same high set current compliance (set-CC) is discussed on the basis of filament geometry in a Pt/SiOx/TiN stack. Set-CC-dependent scaling behavior with relations Ireset ~ R0-α and Vreset ~ R0-β differentiates BRS under low set-CC from other switching behaviors under high set-CC due to a low α and β involving a narrow filamentary path. Because such co-occurrence is observed only in the case of a high α and β involving a wide filamentary path, such a path can be classified into three different geometries according to switching behavior in detail. From the cyclic switching and a model simulation, we conclude that the reset of BRS originates from a narrower filamentary path near the top electrode than that of CRS due to the randomness of field-driven migration even under the same set-CC. Also, we conclude that URS originates from much narrower inversed conical filamentary path. Therefore, filament-geometry-dependent electric field and/or thermal effects can precisely describe the entire switching behaviors in this experiment.

  15. 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 o...

  16. 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.

  17. 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

  18. 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

  19. 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.

  20. Discrete bipolar universal integrals

    OpenAIRE

    Greco, Salvatore; Mesiar, Radko; Rindone, Fabio

    2014-01-01

    The concept of universal integral, recently proposed, generalizes the Choquet, Shilkret and Sugeno integrals. Those integrals admit a discrete bipolar formulation, useful in those situations where the underlying scale is bipolar. In this paper we propose the concept of discrete bipolar universal integral, in order to provide a common framework for bipolar discrete integrals, including as special cases the discrete Choquet, Shilkret and Sugeno bipolar integrals. Moreover we provide two differe...

  1. Electrical coupling between bipolar cells in carp retina

    OpenAIRE

    Kujiraoka, Toru; Saito, Takehiko

    1986-01-01

    Intracellular recordings were made simultaneously from pairs of neighboring bipolar cells by advancing two independent microelectrodes into retinas of carp (Cyprinus carpio). Bipolar cells were identified by their response properties and in several samples were verified by intracellular injection of Lucifer yellow. Current of either polarity injected into one member of the bipolar cell pair elicited a signconserving, sustained potential change in the other bipolar cell without any significant...

  2. 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.

  3. 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

  4. 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...

  5. Quetiapine monotherapy for bipolar depression

    Directory of Open Access Journals (Sweden)

    Michael E Thase

    2008-03-01

    Full Text Available Michael E ThaseDepartments of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA, USA; the Philadelphia Veterans Affairs Medical Center, Philadelphia, PA, USA; and the University of Pittsburgh Medical Center, Pittsburgh, PA, USAAbstract: Bipolar depression is more common, disabling, and difficult-to-treat than the manic and hypomanic phases that define bipolar disorder. Unlike the treatment of so-called “unipolar” depressions, antidepressants generally are not indicated as monotherapies for bipolar depressions and recent studies suggest that - even when used in combination with traditional mood stabilizers – antidepressants may have questionable value for bipolar depression. The current practice is that mood stabilizers are initiated first as monotherapies; however, the antidepressant efficacy of lithium and valproate is modest at best. Within this context the role of atypical antipsychotics is being evaluated. The combination of olanzapine and the antidepressant fluoxetine was the first treatment to receive regulatory approval in the US specifically for bipolar I depression. Quetiapine was the second medication to be approved for this indication, largely as the result of two pivotal trials known by the acronyms of BOLDER (BipOLar DEpRession I and II. Both studies demonstrated that two doses of quetiapine (300 mg and 600 mg given once daily at bedtime were significantly more effective than placebo, with no increased risk of patients switching into mania. Pooling the two studies, quetiapine was effective for both bipolar I and bipolar II depressions and for patients with (and without a history of rapid cycling. The two doses were comparably effective in both studies. Although the efficacy of quetiapine monotherapy has been established, much additional research is necessary. Further studies are needed to more fully investigate dose-response relationships and comparing quetiapine monotherapy to other mood stabilizers

  6. [Antipsychotics in bipolar disorders].

    Science.gov (United States)

    Vacheron-Trystram, M-N; Braitman, A; Cheref, S; Auffray, L

    2004-01-01

    This article is a review of the various treatments that are currently available, in particular in France, for the treatment of bipolar disorders. This article specifically addresses the use of novel antipsychotic agents as alternative therapy to a lithium therapy and/or the use of conventional antipsychotics. The prevalence of bipolar disorder over a lifetime is around 1% of the general population. Bipolar disorder consists of alternating depressive and manic episodes. It mainly affects younger subjects, and is often associated with alcohol and drug addictions. There are two main subtypes of bipolar disorder. According to the DSM IV-R, type 1 of bipolar disorder is characterised when at least one manic episode (or a mixed episode) has been diagnosed. Type 2 of bipolar disorder is related to patients enduring recurrent depressive episodes but no manic episode. Type 2 affects women more frequently as opposed to type 1 affecting individuals of both sexes. Manic-depressive disorder (or cyclo-thymic disorder) appears in relation to patients who has never suffered manic episode, mixed episode or severe depressive episode but have undergone numerous periods with some symptoms of depression and hypomanic symptoms over a two-year period during which any asymptomatic periods last no longer than two months. The average age of the person going through a first episode (often a depressive one) is 20 years-old. Untreated bipolar patients may endure more than ten manic or depressive episodes. Finally, in relation to 10 to 20% of patients, the bipolar disorder will turn into a fast cycle form, either spontaneously or as a result of certain medical treatments. Psychiatrists are now able to initiate various treating strategies which are most likely to be effective as a result of the identification of clinical subtypes of the bipolar disorder. Lithium therapy has been effectively and acutely used for patients with pure or elated mania and its prophylaxis. However, lithium medication

  7. Prefrontocerebellar transcranial direct current stimulation increases amplitude and decreases latency of P3b component in patients with euthymic bipolar disorder

    Directory of Open Access Journals (Sweden)

    Bersani FS

    2015-11-01

    Full Text Available Francesco Saverio Bersani, Amedeo Minichino, Francesco Fattapposta, Laura Bernabei, Francesco Spagnoli, Daniela Mannarelli, Marta Francesconi, Caterina Pauletti, Alessandra Corrado, Lucilla Vergnani, Ines Taddei, Massimo Biondi, Roberto Delle Chiaie Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy Introduction: Neurocognitive impairments have been observed in patients with bipolar disorder (BD even during the euthymic phase of the disease, potentially representing trait-associated rather than state-associated characteristics of the disorder. In the present study, we used transcranial direct current stimulation (tDCS applied to cerebellar and prefrontal cortices to improve the neurophysiological performances of patients with euthymic BD.Methods: Twenty-five outpatients with BD underwent open-label prefrontocerebellar tDCS for 3 consecutive weeks. Neurophysiological performances were assessed through the examination of the P3b and P3a subcomponents of P300 event-related potential at baseline and after stimulation.Results: Compared to baseline, P3b component after tDCS showed significantly higher amplitude and shorter latency (latency: Fz P=0.02, Cz P=0.03, and Pz P=0.04; amplitude: Fz P=0.24, Cz P=0.02, and Pz P=0.35.Conclusion: In our sample of patients with euthymic BD, concomitant prefrontoexcitatory and cerebellar-inhibitory modulations led to improved brain information processing stream. This improvement may at least partially result from neuroplastic modulation of prefrontocerebellar circuitry activity. Keywords: mood disorders, tDCS, cerebellum, P300, dorsolateral prefrontal cortex, event-related potentials

  8. Shengmaisan Regulates Pacemaker Potentials in Interstitial Cells of Cajal in Mice

    Directory of Open Access Journals (Sweden)

    Kim Byung Joo

    2013-12-01

    Full Text Available Objectives: Shengmaisan (SMS is a traditional Chinese medicine prescription widely used for the treatment of diverse organs in Korea. The interstitial cells of Cajal (ICCs are pacemaker cells that play an important role in the generation of coordinated gastrointestinal (GI motility. We have aimed to investigate the effects of SMS in the ICCs in the mouse small intestine. Methods: To dissociate the ICCs, we used enzymatic digestions from the small intestine in a mouse. After that, the ICCs were identified immunologically by using the anti-c-kit antibody. In the ICCs, the electrophysiological whole-cell patch-clamp configuration was used to record pacemaker potentials in the cultured ICCs. Results: The ICCs generated pacemaker potentials in the mouse small intestine. SMS produced membrane depolarization with concentration-dependent manners in the current clamp mode. Pretreatment with a Ca2+ free solution and thapsigargin, a Ca2+-ATPase inhibitor in the endoplasmic reticulum, stopped the generation of the pacemaker potentials. In the case of Ca2+-free solutions, SMS induced membrane depolarizations. However, when thapsigargin in a bath solution was applied, the membrane depolarization was not produced by SMS. The membrane depolarizations produced by SMS were inhibited by U-73122, an active phospholipase C (PLC inhibitors. Furthermore, chelerythrine and calphostin C, a protein kinase C (PKC inhibitors had no effects on SMS-induced membrane depolarizations. Conclusions: These results suggest that SMS might affect GI motility by modulating the pacemaker activity through an internal Ca2+- and PLC-dependent and PKC-independent pathway in the ICCs.

  9. Generalized bipolar product and sum

    OpenAIRE

    Greco, Salvatore; Mesiar, Radko; Rindone, Fabio

    2016-01-01

    Aggregation functions on [0, 1] with annihilator 0 can be seen as a generalized product on [0, 1]. We study the generalized product on the bipolar scale [−1, 1], stressing the axiomatic point of view ( compare also [9]). Based on newly introduced bipolar properties, such as the bipolar increasingness, bipolar unit element, bipolar idempotent element, several kinds of generalized bipolar product are introduced and studied. A special stress is put on bipolar semicopulas, bipolar quasi-copulas a...

  10. 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.

  11. 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

  12. 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

  13. 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.

  14. Runaway pacemaker: a still existing complication and therapeutic guidelines

    DEFF Research Database (Denmark)

    Mickley, H; Andersen, C; Nielsen, L H

    1989-01-01

    (rate 240-260 beats/min) was documented. One patient died. Runaway pacemakers must be exchanged as soon as possible. Until this can be accomplished, different emergency maneuvers should be tried. As documented in the cases presented, placing a magnet over the pacemaker may result in a lower, more...

  15. Prefrontocerebellar transcranial direct current stimulation increases amplitude and decreases latency of P3b component in patients with euthymic bipolar disorder

    OpenAIRE

    Bersani FS; Minichino A; Fattapposta F; Bernabei L; Spagnoli F; Mannarelli D; Francesconi M; Pauletti C; Corrado A; Vergnani L; Taddei I; Biondi M; Delle Chiaie R

    2015-01-01

    Francesco Saverio Bersani, Amedeo Minichino, Francesco Fattapposta, Laura Bernabei, Francesco Spagnoli, Daniela Mannarelli, Marta Francesconi, Caterina Pauletti, Alessandra Corrado, Lucilla Vergnani, Ines Taddei, Massimo Biondi, Roberto Delle Chiaie Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy Introduction: Neurocognitive impairments have been observed in patients with bipolar disorder (BD) even during the euthymic phase of the disease, potentially repres...

  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. Help With Bipolar Disorders

    Science.gov (United States)

    ... a Psychiatrist Patients & Families All Topics Help With Bipolar Disorders Curated and updated for the community by APA Topic Information Bipolar disorders are brain disorders that cause changes in a ...

  18. 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...

  19. Bipolar Fuzzy Integrals

    OpenAIRE

    Greco, Salvatore; Rindone, Fabio

    2012-01-01

    In decision analysis and especially in multiple criteria decision analysis, several non additive integrals have been introduced in the last sixty years. Among them, we remember the Choquet integral, the Shilkret integral and the Sugeno integral. Recently, the bipolar Choquet integral has been proposed for the case in which the underlying scale is bipolar. In this paper we propose the bipolar Shilkret integral and the bipolar Sugeno integral. Moreover, we provide an axiomatic characterization ...

  20. Percutaneous extraction of inadvertently placed left-sided pacemaker leads with complete cerebral embolic protection.

    Science.gov (United States)

    Bahadorani, John N; Schricker, Amir A; Pretorius, Victor G; Birgersdotter-Green, Ulrika; Dominguez, Arturo; Mahmud, Ehtisham

    2015-10-01

    Lead wire malposition is a known, but rare complication of permanent pacemaker or defibrillator implantation. The actual incidence and prevalence is unknown and management options for inadvertent left ventricular lead malposition have not been uniform. Current recommendations include systemic anticoagulation with warfarin or surgical lead removal with circulatory arrest for compelling clinical scenarios. Percutaneous left-sided lead extraction is contraindicated due to the potentially increased risk of thromboembolic complications associated with this procedure. To our knowledge, this is the first report of percutaneous extraction of inadvertently placed left ventricular and left atrial endocardial pacemaker leads with flow-preserving complete cerebral embolic protection. We also review the current literature regarding the incidence, management, and percutaneous extraction of left-sided cardiac leads. PMID:25581608

  1. Irregular Bipolar Fuzzy Graphs

    OpenAIRE

    Samanta, Sovan; Pal, Madhumangal

    2012-01-01

    In this paper, we define irregular bipolar fuzzy graphs and its various classifications. Size of regular bipolar fuzzy graphs is derived. The relation between highly and neighbourly irregular bipolar fuzzy graphs are established. Some basic theorems related to the stated graphs have also been presented.

  2. 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

  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. Family Environment and Suicidal Ideation Among Bipolar Youth

    OpenAIRE

    Goldstein, Tina R; Birmaher, Boris; Axelson, David; Goldstein, Benjamin I.; Gill, Mary Kay; Esposito-Smythers, Christianne; Ryan, Neal D.; Strober, Michael A.; Hunt, Jeffrey; Keller, Martin

    2009-01-01

    The objective of this study was to examine the association between family environment and suicidal ideation among youth with bipolar disorder. Subjects included 446 bipolar (BP) youth (age 7–17) enrolled in the Course and Outcome of Bipolar Youth study. Current suicidal ideation, family functioning and family stress were assessed at intake. BP youth with current suicidal ideation reported more conflict with their mother and less family adaptability. Ideators endorsed more stressful family eve...

  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. 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 ...

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

    Science.gov (United States)

    ... nlm.nih.gov/medlineplus/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 ...

  10. Family Environment and Suicidal Ideation Among Bipolar Youth

    Science.gov (United States)

    Goldstein, Tina R.; Birmaher, Boris; Axelson, David; Goldstein, Benjamin I.; Gill, Mary Kay; Esposito-Smythers, Christianne; Ryan, Neal D.; Strober, Michael A.; Hunt, Jeffrey; Keller, Martin

    2010-01-01

    The objective of this study was to examine the association between family environment and suicidal ideation among youth with bipolar disorder. Subjects included 446 bipolar (BP) youth (age 7–17) enrolled in the Course and Outcome of Bipolar Youth study. Current suicidal ideation, family functioning and family stress were assessed at intake. BP youth with current suicidal ideation reported more conflict with their mother and less family adaptability. Ideators endorsed more stressful family events over the prior year and higher rates of specific familial stressors. Clinicians treating bipolar youth should consider family stress when conducting suicide risk assessment. Treatment goals may include enhancing family communication and addressing issues of loss. PMID:19813115

  11. Performance Analysis in Pacemaker Electrode and Study Effect Electric Resistance

    OpenAIRE

    S. Iman Zonoori , Elaheh Nikkhah Bahrami; Zahra Bahrami; Shahin Rezvani Abravani

    2014-01-01

    — In recent years, there has been an increasing use pacemaker electrode that is placed inside the heart and helps the patient’s heart to keep a normal rhythm. In this paper, performance of pacemaker electrode and electric resistance are investigated. These structures are modelled and numerically tested by using Finite Element Method (FEM) by using Comsol Multiphysics. The created virtual models using 3D simulation and computation software proved that used shiel...

  12. Delayed lead perforation: a rare cause of pacemaker dysfunction.

    Science.gov (United States)

    dos Santos, Luís Ferreira; Costa, Filipa; Correia, Emanuel; Rodrigues, Bruno; Moreira, Davide; Correia, Hugo; Nunes, Luís; Pipa, João; Costa, António; de Carvalho, Lopes; Cabral, Costa; Ribeiro, Nuno; de Olival, Ramos; Santos, Oliveira

    2011-06-01

    A 65-year-old woman with a dual-chamber pacemaker implanted in 2006 for symptomatic carotid sinus hypersensitivity was incidentally found to have loss of ventricular capture on routine pacemaker interrogation. A chest X-ray raised the suspicion of perforation and migration of the right ventricular lead, confirmed by three-dimensional echocardiogram and CT scan. On the basis of this case, we review myocardial lead perforation, including predisposing factors, pathophysiological mechanisms, diagnostic approach and therapeutic options. PMID:21874925

  13. Venous obstruction in permanent pacemaker patients: an isotopic study

    International Nuclear Information System (INIS)

    Isotope venography was used to study the venous circulation proximal to the superior vena cava in two groups of pacemaker patients, one with a single endocavitary electrode and the other with multiple pacing catheters. A control group of patients without pacemakers was also studied. Numerous abnormalities were found, especially in the group with multiple electrodes. These findings suggest that venous obstruction is a common complication of endocardial pacing

  14. Venous obstruction in permanent pacemaker patients: an isotopic study

    Energy Technology Data Exchange (ETDEWEB)

    Pauletti, M.; Di Ricco, G.; Solfanelli, S.; Marini, C.; Contini, C.; Giuntini, C.

    1981-01-01

    Isotope venography was used to study the venous circulation proximal to the superior vena cava in two groups of pacemaker patients, one with a single endocavitary electrode and the other with multiple pacing catheters. A control group of patients without pacemakers was also studied. Numerous abnormalities were found, especially in the group with multiple electrodes. These findings suggest that venous obstruction is a common complication of endocardial pacing.

  15. 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.

  16. Radiation therapy in patients with cardiac pacemakers or implantable cardioverter defibrillators. Interdisciplinary safety recommendations

    International Nuclear Information System (INIS)

    Background: With increasing numbers of implanted pacemakers and implantable cardioverter defibrillators (ICD) and a rising incidence of malignant tumors, there is a growing probability of radiation-mediated device dysfunction. The only guidelines for the management of patients with cardiac pacemakers in the case of radiation therapy were published in 1994 and have not been updated since then. Based on the current evidence and modern device technology, the present paper aims to develop contemporary and interdisciplinary safety recommendations for the minimization of patient risk. Methods and results: A systematic literature research was carried out including the most relevant medical electronic databases. The search yielded 147 articles published between 1994 and 2012 of which 45 met the selection criteria and of these studies 34 presented primary data (9 in vitro and 25 in vivo studies). The impact of ionizing radiation varied significantly between implanted devices and ranged from no functional changes to complete loss of function. Important device dysfunctions included changes in sensing capability, altered pacing pulses or rate, changed or disabled tachyarrhythmia ICD therapies, early battery depletion and loss of telemetry. Modern pacemakers and ICDs are more sensitive to radiation than older models. Potentially life-threatening complications were observed after exposure of the pulse generator to comparatively low radiation doses (0.11 Gy). Conclusions: Practical recommendations for patient management and safety are presented that can be readily adopted by any institution carrying out radiation therapy. (orig.)

  17. Costs of Bipolar Disorder

    OpenAIRE

    Leah S. Kleinman; Ana Lowin; Emuella Flood; Gian Gandhi; Eric Edgell; Revicki, Dennis A

    2003-01-01

    Bipolar disorder is a chronic affective disorder that causes significant economic burden to patients, families and society. It has a lifetime prevalence of approximately 1.3%. Bipolar disorder is characterised by recurrent mania or hypomania and depressive episodes that cause impairments in functioning and health-related quality of life. Patients require acute and maintenance therapy delivered via inpatient and outpatient treatment. Patients with bipolar disorder often have contact with the s...

  18. Treatment Resistant Bipolar Disorder

    OpenAIRE

    Elvan Ozalp; Ersin Hatice Karslioglu

    2015-01-01

    Many patients diagnosed with bipolar disorder respond incompletely or unsatisfactorily to available treatments. Defining refractoriness in bipolar disorder is a complex issue and should concern and include either every phase and pole or the disorder as a whole. There are only limited and sometimes confusing data on the treatment of refractory bipolar patients. The objective of this paper was to review the evidence for treatment options in treatment resistant patients on depressive, manic atta...

  19. Bipolar Affective Disorder and Migraine

    OpenAIRE

    Birk Engmann

    2012-01-01

    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 ...

  20. 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...

  1. The development of lurasidone for bipolar depression.

    Science.gov (United States)

    Loebel, Antony; Xu, Jane; Hsu, Jay; Cucchiaro, Josephine; Pikalov, Andrei

    2015-11-01

    Bipolar disorder is a chronic, recurrent illness that ranks among the top 10 causes of disability in the developed world. As the illness progresses, major depressive episodes increasingly predominate. However, few treatment options are available that have demonstrated efficacy in the treatment of bipolar depression, either as monotherapy or adjunctive therapy in combination with mood stabilizers. Lurasidone is an atypical antipsychotic drug that was initially developed for the treatment of schizophrenia. Since no previous atypical antipsychotic development program had proceeded directly from work on schizophrenia to bipolar depression, the decision to focus on this indication represented an innovation in central nervous system drug development and was designed to address a clinically significant unmet need. The current review summarizes key results of a clinical development program undertaken to characterize the efficacy and safety of lurasidone in patients diagnosed with bipolar depression. Lurasidone is currently the only treatment for bipolar depression approved in the United States as both a monotherapy and an adjunctive therapy with lithium or valproate. The approval of lurasidone expands available treatment options for patients with bipolar depression and provides a therapy with an overall favorable risk-benefit profile. PMID:26771990

  2. 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.

  3. 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.

  4. Properties of Bipolar Fuzzy Hypergraphs

    OpenAIRE

    Akram, M.; Dudek, W. A.; Sarwar, S.

    2013-01-01

    In this article, we apply the concept of bipolar fuzzy sets to hypergraphs and investigate some properties of bipolar fuzzy hypergraphs. We introduce the notion of $A-$ tempered bipolar fuzzy hypergraphs and present some of their properties. We also present application examples of bipolar fuzzy hypergraphs.

  5. Surveillance and follow-up of patients with implanted cardiac pacemaker by telephone transmission.

    Science.gov (United States)

    Sakurai, T; Tokutsu, S; Nishimura, O; Tagami, Y; Takimoto, M; Ohta, H; Yamaoka, Y; Okada, K; Suzuki, Y; Yokoi, H; Enomoto, K; Okada, N; Tanaka, H; Murakami, K

    1978-11-01

    A follow-up study on pacemaker function in 15 patients with implanted cardiac pacemaker has been performed by telephone transmission. The transmitting set consisting of electrocardiograph, pacemaker pulse modulator and acoustic coupler was manipulated by the patients themselves. ECG, pacemaker pulse, and pulse rate were simultaneously transmitted through 1 channel to the receiver in our clinic. Of 56 patients with pacemaker, 15 patients were surveyed by telephone transmission. In these patients battery exhaustion was detected in 3, competition in 2, and lead fracture in 1. The fact that surveillance and follow-up of the patients with implanted cardiac pacemaker could be carried out by telephone transmission as well as by clinic visitation tells us that the telephone transmission is a useful method and plays an important role in a pacemaker clinic. Moreover our study established its further usefulness in the patient's preference due to difficulties in travelling to the pacemaker clinic and in reducing patient's anxiety. PMID:750667

  6. 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.

  7. Towards the Emulation of the Cardiac Conduction System for Pacemaker Testing

    OpenAIRE

    Yip, Eugene; Andalam, Sidharta; Roop, Partha S.; Malik, Avinash; Trew, Mark; Ai, Weiwei; Patel, Nitish

    2016-01-01

    The heart is a vital organ that relies on the orchestrated propagation of electrical stimuli to coordinate each heart beat. Abnormalities in the heart's electrical behaviour can be managed with a cardiac pacemaker. Recently, the closed-loop testing of pacemakers with an emulation (real-time simulation) of the heart has been proposed. An emulated heart would provide realistic reactions to the pacemaker as if it were a real heart. This enables developers to interrogate their pacemaker design wi...

  8. 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.

  9. 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

  10. 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...

  11. 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.

  12. 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

  13. Bipolar Ag-Zn battery

    Science.gov (United States)

    Giltner, L. John

    1994-02-01

    The silver-zinc (AgZn) battery system has been unique in its ability to safely satisfy high power demand applications with low mass and volume. However, a new generation of defense, aerospace, and commercial applications will impose even higher power demands. These new power demands can be satisfied by the development of a bipolar battery design. In this configuration the power consuming, interelectrode current conductors are eliminated while the current is then conducted via the large cross-section electrode substrate. Negative and positive active materials are applied to opposite sides of a solid silver foil substrate. In addition to reducing the weight and volume required for a specified power level, the output voltage performance is also improved as follows. Reduced weight through: elimination of the plastic cell container; elimination of plate leads and intercell connector; and elimination of internal plate current collector. Increased voltage through: elimination of resistance of current collector; elimination of resistance of plate lead; and elimination of resistance of intercell connector. EPI worked previously on development of a secondary bipolar silver zinc battery. This development demonstrated the electrical capability of the system and manufacturing techniques. One difficulty with this development was mechanical problems with the seals. However, recent improvements in plastics and adhesives should eliminate the major problem of maintaining a seal around the periphery of the bipolar module. The seal problem is not as significant for a primary battery application or for a requirement for only a few discharge cycles. A second difficulty encountered was with activation (introducing electrolyte into the cell) and with venting gas from the cell without loss of electrolyte. During previous work, the following projections for energy density were made from test data for a high power system which demonstrated in excess of 50 discharge/charge cycles. Projected

  14. Experimental evidence of a chaotic region in a neural pacemaker

    International Nuclear Information System (INIS)

    In this Letter, we report the finding of period-adding scenarios with chaos in firing patterns, observed in biological experiments on a neural pacemaker, with fixed extra-cellular potassium concentration at different levels and taken extra-cellular calcium concentration as the bifurcation parameter. The experimental bifurcations in the two-dimensional parameter space demonstrate the existence of a chaotic region interwoven with the periodic region thereby forming a period-adding sequence with chaos. The behavior of the pacemaker in this region is qualitatively similar to that of the Hindmarsh–Rose neuron model in a well-known comb-shaped chaotic region in two-dimensional parameter spaces.

  15. 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

  16. [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

  17. 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 ...

  18. Bipolar membrane characterization

    Czech Academy of Sciences Publication Activity Database

    Richau, K.; Kůdela, Vlastimil

    Enschede : Twente University Press, 2001 - (Kemperman, A.), s. 112-147 ISBN 903651523 R&D Projects: GA MŠk ME 079 Keywords : bipolar membranes * water dissociation * methods for characterisation Subject RIV: CD - Macromolecular Chemistry

  19. 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

  20. 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.

  1. 238Pu sources for cardiac pacemakers. II. Control

    International Nuclear Information System (INIS)

    The method and the apparatus used for thermal (power) and radioactive control of radioisotopic sources for pacemakers are briefly described. The cybernetic system is also presented, which assumes almost automatically the monitoring of control, mechanical and electronic works, data processing, the measurements and computations, and the works related to quality control

  2. 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.

  3. [Psychotherapeutic interventions in bipolar disorder: a review].

    Science.gov (United States)

    Hausmann, Armand; Hörtnagl, Christine; Müller, Markus; Waack, Julie; Walpath, Michaela; Conca, Andreas

    2007-01-01

    The treatment of bipolar disorders is a demanding task involving patients, therapists and relatives. As bipolar disorders are associated to multiple psychosocial disturbances, the management of a bipolar disease should focus on psychosocial interventions. Despite an exploding literature on this topic, psychopharmacological interventions applied as a monotherapy have shown unsatisfactory outcomes. In order to enhance outcome, psychotherapy, such as cognitive behavioural therapy (CBT), psychoeducation, a modified form of interpersonal psychotherapy (IPSRT) or family focussed psychotherapy (FFT) were investigated. When used in conjunction with pharmacotherapy, these interventions may prolong time to relapse, reduce symptom severity, and increase medication adherence. These combinations are currently considered being the golden standard in the treatment of bipolar disorders. Psychotherapeutic interventions as an add-on strategy exert better effects when patients are euthymic at entry. Prevention of manic episodes seems to be more successful as compared to the prevention of depressive episodes. There are currently no hints for a method specific efficacy. Efficacy of psychoeducation seems to be rather short lived. Currently not yet evaluated booster-sessions might help. More data are needed in order to identify patients with a putative good response to psychotherapeutic interventions. PMID:17640496

  4. 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.

  5. The bipolar universal integral

    Czech Academy of Sciences Publication Activity Database

    Greco, S.; Mesiar, Radko; Rindone, F.

    Heidelberg: Springer, 2012 - (Greco, S.; Bouchon-Meunier, B.; Coletti, G.; Fedrizzi, M.; Matarazzo, B.; Yager, R.), s. 360-369. (Communications in Computer and Information Science. 299). ISBN 978-3-642-31717-0. ISSN 1865-0929. [IPMU 2012 /14./. Catania (IT), 09.07.2012-13.07.2012] R&D Projects: GA ČR GAP402/11/0378 Institutional support: RVO:67985556 Keywords : bipolar integral * Choquet integral * universal integral Subject RIV: BA - General Mathematics http://library.utia.cas.cz/separaty/2012/E/mesiar-the%20bipolar%20universal%20integral.pdf

  6. 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

  7. Bipolar bozukluklarda intihar

    OpenAIRE

    SAYIL, Işık

    1997-01-01

    Makalede bipolar bozukluklarda intihar olgusuuygulamadan gelen deneyimler doğrultusundagözden geçirilmiştir. İntihar girişimlerinde ilk yardımtartışılmış ve acil serviste kriz ekibinin çalışmasıanlatılmıştır.

  8. Discrete bipolar universal integrals

    Czech Academy of Sciences Publication Activity Database

    Greco, S.; Mesiar, Radko; Rindone, F.

    2014-01-01

    Roč. 252, č. 1 (2014), s. 55-65. ISSN 0165-0114 R&D Projects: GA ČR GAP402/11/0378 Institutional support: RVO:67985556 Keywords : bipolar integral * universal integral * Choquet integral Subject RIV: BA - General Mathematics Impact factor: 1.986, year: 2014 http://library.utia.cas.cz/separaty/2014/E/mesiar-0432224.pdf

  9. 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

  10. 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

  11. 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

  12. Differential Association of the COMT Val158Met Polymorphism with Clinical Phenotypes in Schizophrenia and Bipolar Disorder

    OpenAIRE

    Goghari, Vina M; Sponheim, Scott R.

    2008-01-01

    Schizophrenia and bipolar disorder, although diagnostically separate, likely share elements of their genetic etiology. This study assessed whether COMT Val158Met polymorphism has shared or specific associations with clinical phenotypes evident in schizophrenia and bipolar disorder. Schizophrenia and bipolar patients completed a clinical assessment encompassing premorbid functioning and current and lifetime symptomatology. Multivariate analyses yielded a three-way interaction of diagnosis, COM...

  13. 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...

  14. Conceptual design of GaN betavoltaic battery using in cardiac pacemaker

    International Nuclear Information System (INIS)

    Introduction: Pacemaker is an electronic biomedical device which stimulates and regulates or amplify the human heartbeat by delivering weak electrical pulses to the cardiac muscle at regular intervals when its natural regulating mechanisms break down. Developments in design and implementation of power source in adjacent to advances in electronic circuitry is an important aspect in optimization of pacemakers. For instance, many implant patients continue to outlive their batteries and require costly and risky replacement surgery. So such device needs to have high energy density power source and maintain a stable current and voltage for a long period of time to avoid frequent replacements. In addition, the size is also an important consideration for implantable batteries. Betavoltaic batteries are being researched as a suitable source for these applications. Also, these batteries have vast application in which the replacement of batteries is highly inconvenient, such as in oil and mining industries, which often place sensors in dangerous or hard-to-reach locations. The purpose of the present investigation is determination of the optimal parameters of low energy GaN betavoltaic battery in artificial cardiac pacemakers using MCNP code which have higher efficiency than those available with previous devices, especially thermoelectric converters (∼15%). Material and Methods: In this design, two p-n diode structures from GaN semiconductor were used to collect the charge from a layer of 63Ni as a source which is centered between the two p-n junctions. MCNP simulation results have been used to determine the amount of electron current from interaction of beta particles in p-n junctions. Results and Discussion: Calculation results indicate that the short circuit current, open circuit voltage and efficiency of a single device are 1.1 μA/cm2, 2.7 volt and 25%, respectively. Also, it's concluded that with suitable arrangement of these single devices, one could construct a

  15. 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...

  16. 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

  17. 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...

  18. 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.

  19. Cardiac Output Measurement in Patients with an Implanted Pacemaker

    Czech Academy of Sciences Publication Activity Database

    Vondra, Vlastimil; Halámek, Josef; Viščor, Ivo; Jurák, Pavel; Novák, M.

    Danvers : Institute of Electrical and Electronics Engineers, Inc., 2007, s. 916-918. ISBN 978-1-4244-0787-3. ISSN 1557-170X. [Annual International Conference of the IEEE Engineering in Medicine and Biology Society /29./. Lyon (FR), 23.08.2007-26.08.2007] R&D Projects: GA ČR GA102/06/0136 Institutional research plan: CEZ:AV0Z20650511 Keywords : cardiac output measurement * implanted pacemaker Subject RIV: FA - Cardiovascular Diseases incl. Cardiotharic Surgery

  20. 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 ...

  1. 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...

  2. [When do you implant a pacemaker in myotonic dystrophy?].

    Science.gov (United States)

    Babuty, Dominique; Lallemand, Bénédicte; Laurent, Valérie; Clémenty, Nicolas; Pierre, Bertrand; Fauchier, Laurent; Raynaud, Martine; Pellieux, Sybille

    2011-01-01

    Myotonic dystrophy is the most frequent adult form of hereditary muscular dystrophy caused by a mutation on the DMPK gene. Myotonic dystrophy leads to multiple systemic complications related to weakness, respiratory failure, cardiac arrhythmias and cardiac conduction disturbances. Age of death is earlier in myotonic dystrophy patients than in general population with a high frequency of sudden death. Several mechanisms are involved in sudden death: atrio-ventricular block, severe ventricular arrhythmias or non-cardiac mechanism. The high degree of atrio-ventricular block is a well-recognized indication of pacemaker implantation but the prophylactic implantation of pacemaker should be considered to prevent sudden death in asymptomatic myotonic dystrophy patients. A careful clinical evaluation needs to be done for the identification of patients at high risk of sudden death. The resting ECG and SA ECG are non-invasive tools useful to select the patients who need an electrophysiologic study. In presence of prolonged HV interval more than or equal to 70 ms one can discuss the implantation of a prophylactic pacemaker. The choice of an implantable cardiac defibrillator is preferred in presence of spontaneous ventricular tachycardia or an alteration of the left ventricular ejection fraction. PMID:21549556

  3. 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.

  4. 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.

  5. Effects of Lubiprostone on Pacemaker Activity of Interstitial Cells of Cajal from the Mouse Colon

    OpenAIRE

    Jiao, Han-Yi; Kim, Dong Hyun; Ki, Jung Suk; Ryu, Kwon Ho; Choi, Seok; Jun, Jae Yeoul

    2014-01-01

    Lubiprostone is a chloride (Cl-) channel activator derived from prostaglandin E1 and used for managing constipation. In addition, lubiprostone affects the activity of gastrointestinal smooth muscles. Interstitial cells of Cajal (ICCs) are pacemaker cells that generate slow-wave activity in smooth muscles. We studied the effects of lubiprostone on the pacemaker potentials of colonic ICCs. We used the whole-cell patch-clamp technique to determine the pacemaker activity in cultured colonic ICCs ...

  6. Cardiac magnetic resonance imaging of a patient with an magnetic resonance imaging conditional permanent pacemaker

    OpenAIRE

    Chris B. Pepper; Mohan Sivananthan; Artis, Nigel J.; Hogarth, Andrew J.

    2011-01-01

    Cardiac Magnetic Resonance Imaging (MRI) is increasingly used as the optimum modality for cardiac imaging. An aging population and rising numbers of patients with permanent pacemakers means many such individuals may require cardiac MRI scanning in the future. Whilst the presence of a permanent pacemaker is historically regarded as a contra-indication to MRI scanning, pacemaker systems have been developed to limit any associated risks. No reports have been published regarding the use of such d...

  7. Gold-coated pacemaker implantation for a patient with type IV allergy to titanium

    Science.gov (United States)

    Kypta, Alexander; Blessberger, Hermann; Lichtenauer, Michael; Lambert, Thomas; Kammler, Juergen; Steinwender, Clemens

    2016-01-01

    A 65-year-old man was scheduled for pacemaker implantation for symptomatic sick-sinus-syndrome (SSS). He suffered from multiple drug-allergies and allergies to several metals like quicksilver and titanium. Gold-coated pacemaker generators and polyurethane leads are effective in avoiding allergic reactions to pacing system components. Therefore, we decided to implant a custom-made gold-coated DDDR-pacemaker generator and polyurethane leads.

  8. Haemophilus parainfluenzae bacteremia associated with a pacemaker wire localized by gallium scan

    International Nuclear Information System (INIS)

    A young woman with a history of sick sinus syndrome and placement of a permanent pacemaker 6 months before admission had fever and Haemophilus parainfluenzae bacteremia. A gallium scan localized the infection to the site of the pacemaker wire. Echocardiograms were negative for any vegetations. The patient responded to cefotaxime and trimethoprim-sulfamethoxazole therapy. We believe that this is the first case of H. parainfluenzae bacteremia associated with a pacemaker wire and localized by gallium scan

  9. YINYANG BIPOLAR LATTICES AND L-SETS FOR BIPOLAR KNOWLEDGE FUSION, VISUALIZATION, AND DECISION

    OpenAIRE

    WEN-RAN ZHANG

    2005-01-01

    YinYang bipolar sets, bipolar lattice, bipolar L-crisp sets, and Bipolar L-fuzzy sets are presented for bipolar information/knowledge fusion, visualization, and decision. First, a bipolar lattice B is defined as a 4-tuple (B, ⊕, &, ⊗) in which every pair of elements has a bipolar lub (blub ⊕), a bipolar glb (bglb &), and a cross-pole glb (cglb ⊗). A bipolar L-set (crisp or fuzzy) B = (B-, B+) in X to a bipolar lattice BL is defined as a bipolar equilibrium function or mapping B : X ⇒ BL. A st...

  10. 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.

  11. 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.

  12. 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

  13. Reuse Of Pacemakers In Ghana And Nigeria: Medical, Legal, Cultural And Ethical Perspectives.

    Science.gov (United States)

    Ochasi, Aloysius; Clark, Peter

    2015-12-01

    According to the World Health Organization (WHO) cardiovascular disease (CVD) is the leading cause of death globally. Over 80% of CVD deaths take place in low- and middle-income countries (LMICs). It is estimated that 1 million to 2 million people worldwide die each year due to lack of access to an implantable cardiac defibrillator (ICD) or a pacemaker. Despite the medical, legal, cultural and ethical controversies surrounding the pacemaker reutilization, studies done so far on the reuse of postmortem pacemakers show it to be safe and effective with an infection rate of 1.97% and device malfunction rate of 0.68%. Pacemaker reutilization can be effectively and safely done and does not pose significant additional risk to the recipient. Heart patients with reused pacemakers have an improved quality of life compared to those without pacemakers. The thesis of this paper is that pacemaker reutilization is a life-saving initiative in LMICs of Nigeria and Ghana. It is cost effective; consistent with the principles of beneficence, nonmaleficence, and justice with a commitment to stewardship of resources and the Common Good. Used pacemakers with adequate battery life can be properly sterilized for use by patients in LMICs who cannot afford the cost of a new pacemaker. PMID:24720369

  14. 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

  15. 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.

  16. 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.

  17. 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...

  18. 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...

  19. 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...

  20. 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.

  1. 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 ...

  2. 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...

  3. 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 ...

  4. 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...

  5. 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...

  6. 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...

  7. Scientific attitudes towards bipolar disorders

    OpenAIRE

    Mohammad-Hossein Biglu; Sahar Biglu

    2014-01-01

    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 d...

  8. Pediatrik Bipolar Bozuklukta Epidemiyoloji

    OpenAIRE

    Caner Mutlu; Neslim Guvendeger Doksat; Ayten Erdogan

    2015-01-01

    Çocuk ve ergenlerde bipolar bozukluk tanısı giderek artış göstermektedir. Çocuk ve ergen popülasyonunda intihar girişiminde bulunanların önemli bir oranının bipolar bozukluğu olanlarda ortaya çıkıyor olması, bu hastalığın tanı ve tedavisini daha da önemli kılmaktadır. Özellikle ergenlik dönemi öncesi örneklemlerde açık tanı ölçütlerinin olmaması ve değerlendirmelerin belirtilere dayanılarak yapılmasından dolayı yanlış biçimde bipolar bozukluk tanısı konduğu ve yaygınlık oranlarının oldu-ğunda...

  9. 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.

  10. 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

  11. 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.

  12. 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...

  13. 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...

  14. Effects of Transient Receptor Potential Channel Blockers on Pacemaker Activity in Interstitial Cells of Cajal from Mouse Small Intestine

    OpenAIRE

    Kim, Byung Joo; Nam, Joo Hyun; Kim, Seon Jeong

    2011-01-01

    The interstitial cells of Cajal (ICCs) are pacemakers in the gastrointestinal tract and transient receptor potential melastatin type 7 (TRPM7) is a candidate for pacemaker channels. The effect of the 5-lipoxygenase (5-LOX) inhibitors NDGA, AA861, MK886 and zileuton on pacemaking activity of ICCs was examined using the whole cell patch clamp technique. NDGA and AA861 decreased the amplitude of pacemaker potentials in ICC clusters, but the resting membrane potentials displayed little change, re...

  15. 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...

  16. 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...

  17. Pacemaker and radiotherapy in breast cancer: is targeted intraoperative radiotherapy the answer in this setting?

    International Nuclear Information System (INIS)

    We present the case of an 83 year old woman with a cardiac pacemaker located close in distance to a subsequently diagnosed invasive ductal carcinoma of the left breast. Short range intraoperative radiotherapy was given following wide local excision and sentinel node biopsy. The challenges of using ionising radiation with pacemakers is also discussed

  18. Involvement of mitochondrial Na+–Ca2+ exchange in intestinal pacemaking activity

    OpenAIRE

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

    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.

  19. I-123 metaiodobenzylguanidine cardiac scintigraphy in patients with an implanted permanent pacemaker

    International Nuclear Information System (INIS)

    Tl scintigraphic abnormalities have been reported in patients with an implanted permanent pacemaker, but little is known about the MIBG scintigraphic findings in such patients. This study was performed to assess the MIBG scintigraphic findings in patients with an implanted permanent pacemaker, and to test the hypothesis that imaging characteristics of MIBG scintigraphy differ according to its mode. Twelve patients (4 men and 8 women, mean age: 72.4±9.5 years), who had undergone the implantation of a permanent pacemaker for bradyarrhythmias, underwent MIBG scintigraphy. The patients were divided into VVI pacemaker and DDD pacemaker groups. The tomograms were divided into nine segments and the MIBG defect in each segment scored on a scale ranging from 0 (normal uptake) to 3 (no uptake). Total MIBG defect scores were generated by summing the scores for the nine segments in each patient. MIBG scintigraphic abnormalities were found in ten of the twelve patients. The six patients with the VVI pacemaker manifested MIBG scintigraphic abnormalities. These MIBG scintigraphic abnormalities were observed in all segments, particularly in the posterior segments. The mean total defect score of the VVI group was higher than that of the DDD group (14.8±9.8 vs 3.0±3.5, respectively p<0.05). Therefore, we conclude that despite several limitations of the study, MIBG scintigraphic abnormalities occur in patients with implanted permanent pacemakers, and that such abnormalities are more prominent with the VVI than DDD pacemaker. (author)

  20. Electrical stimulation of primary neonatal rat ventricular cardiomyocytes using pacemakers.

    Science.gov (United States)

    Martherus, Ruben S R M; Zeijlemaker, Volkert A; Ayoubi, Torik A Y

    2010-01-01

    The study of gene regulation in cardiac myocytes requires a reliable in vitro model. However, monolayer cultures used for this purpose are typically not exposed to electrical stimulation, though this has been shown to strongly affect cardiomyocyte gene expression. Based on pacemakers for clinical use, we developed an easy-to-use portable system that allows the user to perform electro-stimulation of cardiomyocyte cultures in standard tissue incubators without the need for bulky equipment. In addition, we present a refined protocol for culturing high-purity cardiomyocyte cultures with excellent contractile properties for a wide variety of applications. PMID:20078430

  1. 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

  2. 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.

  3. 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.

  4. Optical orientation in bipolar spintronic devices

    International Nuclear Information System (INIS)

    Optical orientation is a highly efficient tool for the generation of nonequilibrium spin polarization in semiconductors. Combined with spin-polarized transport it offers new functionalities for conventional electronic devices, such as pn junction bipolar diodes or transistors. In nominally nonmagnetic junctions optical orientation can provide a source for spin capacitance—the bias-dependent nonequilibrium spin accumulation—or for spin-polarized current in bipolar spin-polarized solar cells. In magnetic junctions, the nonequilibrium spin polarization generated by spin orientation in the proximity of an equilibrium magnetization gives rise to the spin-voltaic effect (a realization of the Silsbee–Johnson coupling), enabling efficient control of electrical properties such as the I–V characteristics of the junctions by magnetic and optical fields. This paper reviews the main results of investigations of spin-polarized and magnetic pn junctions, from spin capacitance to the spin-voltaic effect

  5. 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.

  6. DsRNA as a stimulator of cell pacemaker activity

    International Nuclear Information System (INIS)

    The authors study the action of double-stranded RNAs (dsRNA) on the characteristics of neuron pacemaker activity which permits prediction of the character of action of dsRNA on the pacemaker activity of cells and organs, and takes the investigators closer to an understanding of the membrane mechanisms underlying the action of dsRNA on the cell. The methods for isolating and fractionating dsRNA from yeasts and the intracellular recording of the electrical activity of the snail giant neuron have been described by the authors earlier. The authors determined the dependence of Ca2+ entry upon dsRNA concentration using the isotope 45Ca. Preweighed ganglia were incubated five each for an hour in 2 ml Ringer's solution containing dsRNA and 5 microliters 45CaCl2 of 12.5 mCi activity. After incubation, the ganglia were rinsed three times for 8 min each time in normal Ringers solution. The washed ganglia were dissolved for one day in KOH. The amount of isotope entering was counted using Brav's scintillator and an RGT counter tuned to the 45Ca isotope. The physiological saline used for the isolated ganglion contained 85 mmole NaCl, 4 mmole KCl, 8 mmole CaCl2, 10 mmole MgCl2, 10 mmole Tris-HCl, and 5 mmole glucose

  7. 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

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

    Science.gov (United States)

    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 – 5th 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.

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

    International Nuclear Information System (INIS)

    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−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 thermal

  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. Bipolar pulse forming line

    Science.gov (United States)

    Rhodes, Mark A.

    2008-10-21

    A bipolar pulse forming transmission line module for linear induction accelerators having first, second, third, fourth, and fifth planar conductors which form an interleaved stack with dielectric layers between the conductors. Each conductor has a first end, and a second end adjacent an acceleration axis. The first and second planar conductors are connected to each other at the second ends, the fourth and fifth planar conductors are connected to each other at the second ends, and the first and fifth planar conductors are connected to each other at the first ends via a shorting plate adjacent the first ends. The third planar conductor is electrically connectable to a high voltage source, and an internal switch functions to short a high voltage from the first end of the third planar conductor to the first end of the fourth planar conductor to produce a bipolar pulse at the acceleration axis with a zero net time integral. Improved access to the switch is enabled by an aperture through the shorting plate and the proximity of the aperture to the switch.

  14. Complement and Isomorphism on Bipolar Fuzzy Graphs

    Directory of Open Access Journals (Sweden)

    Ali Asghar Talebi

    2014-12-01

    Full Text Available In this paper, we discuss some properties of the self complement and self weak complement bipolar fuzzy graphs, and get a sufficient condition for a bipolar fuzzy graph to be the self weak complement bipolar fuzzy graph. Also we investigate relations between operations union, join, and complement on bipolar fuzzy graphs.

  15. Complement and Isomorphism on Bipolar Fuzzy Graphs

    OpenAIRE

    Ali Asghar Talebi; Hossein Rashmanlou

    2014-01-01

    In this paper, we discuss some properties of the self complement and self weak complement bipolar fuzzy graphs, and get a sufficient condition for a bipolar fuzzy graph to be the self weak complement bipolar fuzzy graph. Also we investigate relations between operations union, join, and complement on bipolar fuzzy graphs.

  16. 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.

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

    International Nuclear Information System (INIS)

    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

  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. 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...

  20. 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

  1. False positive defects on exercise myocardial perfusion tomography in patients with a right ventricular pacemaker

    International Nuclear Information System (INIS)

    It is known that the specificity of exercise perfusion scintigraphy is decrease in patients with a left bundle block. Patients with a permanent ventricular pacemaker have a similar conduction abnormality that may also potentially result in similar false positive perfusion defects. Aim: To identify the presence or absence of abnormalities on myocardial perfusion in patients with permanent ventricular pacemaker during the exercise and without coronary artery disease. Material and Methods: We include twelve patients (mean age +/- SD: 73 +/- 12 year) in prospective form with ventricular pacemaker indication. All had a narrow QRS on the rest electrocardiogram and none had history of typical chest pain or myocardial infarction. All the patients had an exercise myocardial perfusion tomography with technetium 99m methoxyisonitrile, before the pacemaker placing. Ten with normal stress perfusion were subject to another exercise SPECT after a week, at least. They had the same load and heart rate up to the maximum exercise as in the previous study, but with pacemaker rhythm during the maximum exercise, The different studies before and after pacemaker placing were compared by semiquantitative analysis. Results: Seven out of ten normal patients before pacemaker placing had perfusion defects (70%) on the second study after pacemaker placing. The location of the defects were: two apical (28%), one inferior (14%), and four apical and inferior (57%). Conclusion: In patients without coronary artery disease the continuous pacemaker during the exercise has a high incidence of false positive perfusion defects in single photon emission computed tomography. Most of false positive defects were localized to the apical and inferior territories

  2. Burden of Illness in Bipolar Depression

    OpenAIRE

    Manning, J. Sloan

    2005-01-01

    Bipolar depression is the underrecognized and unappreciated phase of bipolar disorder. Nevertheless, bipolar depression is responsible for much of the morbidity and mortality associated with the disorder. Depressive symptoms are far more prevalent than hypomanic or manic symptoms in bipolar patients, and they are associated with a heavier burden of illness, including reduced functioning, increased risk of suicidal acts, and high economic costs. Because most patients with bipolar disorder pres...

  3. 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....

  4. CaV1.3 as pacemaker channels in adrenal chromaffin cells: specific role on exo- and endocytosis?

    Science.gov (United States)

    Comunanza, Valentina; Marcantoni, Andrea; Vandael, David H; Mahapatra, Satyajit; Gavello, Daniela; Carabelli, Valentina; Carbone, Emilio

    2010-01-01

    Voltage-gated L-type calcium channels (LTCCs) are expressed in adrenal chromaffin cells. Besides shaping the action potential (AP), LTCCs are involved in the excitation-secretion coupling controlling catecholamine release and in Ca (2+) -dependent vesicle retrieval. Of the two LTCCs expressed in chromaffin cells (CaV1.2 and CaV1.3), CaV1.3 possesses the prerequisites for pacemaking spontaneously firing cells: low-threshold, steep voltage-dependence of activation and slow inactivation. By using CaV1 .3 (-/-) KO mice and the AP-clamp it has been possible to resolve the time course of CaV1.3 pacemaker currents, which is similar to that regulating substantia nigra dopaminergic neurons. In mouse chromaffin cells CaV1.3 is coupled to fast-inactivating BK channels within membrane nanodomains and controls AP repolarization. The ability to carry subthreshold Ca (2+) currents and activate BK channels confers to CaV1.3 the unique feature of driving Ca (2+) loading during long interspike intervals and, possibly, to control the Ca (2+) -dependent exocytosis and endocytosis processes that regulate catecholamine secretion and vesicle recycling. PMID:21084859

  5. 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

  6. Sphingosine and FTY720 Modulate Pacemaking Activity in Interstitial Cells of Cajal from Mouse Small Intestine

    OpenAIRE

    Nam, Joo Hyun; Kim, Woo Kyung; Kim, Byung Joo

    2013-01-01

    Interstitial cells of Cajal (ICCs) are the pacemakers of the gastrointestinal tract, and transient receptor potential melastatin type 7 (TRPM7) and Ca2+ activated Cl− channels (ANO1) are candidate the generators of pacemaker potentials in ICCs. The effects of D-erythro-sphingosine (SPH) and structural analogues of SPH, that is, N,N-dimethyl-Derythro-sphingosine (N,N-DMS), FTY720, and FTY720-P on the pacemaking activities of ICCs were examined using the whole cell patch clamp technique. SPH, N...

  7. 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.

  8. 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

  9. 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)

  10. Development of a Woven-Grid Quasi-Bipolar Battery

    Science.gov (United States)

    Tokumaru, P.; Rippel, W.; Zambrano, T.

    1998-01-01

    This report describes an analytical and experimental investigation of AeroVironment's Quasi-Bipolar battery concept. The modelling/battery design part of the study demonstrates that there is a trade-off between thermal and specified electrical performance. Even so, quasi-bipolar batteries can be designed, with ten times better thermal uniformity, that meet or exceed current state-of-the-art hybrid-electric vehicle battery pack performance, even using the same active materials. The thermal uniformity, power, and energy for these quasi-bipolar battery packs is projected to be very good. The experimental part of the investigation demonstrates the concept of the quasi-bipolar plate applied to a lead foil current collector wrapping around two sides of an inexpensive plastic film core. Approximately 50 quasi-biplate samples were fabricated using a hot laminating press. Hot lamination with "texture" between the plastic and lead shows some promise as a low cost method for fabricating the plates. Five of these plates were assembled into two cells plus one two-cell battery. Data from these test cells were compared with existing data for similar true bipolar batteries. The positive side of the plates exhibited corrosion where not protected by the active material.

  11. 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

  12. Quetiapine monotherapy for bipolar depression

    OpenAIRE

    THASE, MICHAEL E.

    2008-01-01

    Michael E ThaseDepartments of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA, USA; the Philadelphia Veterans Affairs Medical Center, Philadelphia, PA, USA; and the University of Pittsburgh Medical Center, Pittsburgh, PA, USAAbstract: Bipolar depression is more common, disabling, and difficult-to-treat than the manic and hypomanic phases that define bipolar disorder. Unlike the treatment of so-called “unipolar” depressions, antidepressants gener...

  13. 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...

  14. : 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...

  15. 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 ...

  16. 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

  17. 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

  18. 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.

  19. [Optimalization of rate adaptation using Holter functions in DDD/R pacemakers].

    Science.gov (United States)

    Novotný, T; Dvorák, R; Kozák, M; Vlasínová, J

    1998-06-01

    Introduction of the pacing rate adaptation according to the momentary metabolic needs added other programmable parametres which demand physician's attention during the initial postimplantation programmation and also in follow-up of pacemaker patients. The parametres setting is strictly individual with a need of feedback control. In some devices it is enabled by Holter functions as a part of pacemaker software. These methods were used to set the rate adaptive parametres in the group of 23 patients with implanted DDD/R pacemaker. The walking stress test was used. Model follow-up situations are presented in 3 case reports. Using Holter functions enables the physician to put patient's subjective complains in relation with actual heart rate--this is used to optimize the parametres of rate adaptation. The authors consider the Holter functions a necessary part of rate adaptive pacemaker software. PMID:9820057

  20. 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.

  1. Flyback Topology TEM Bipolar Pulse Transmitter

    Directory of Open Access Journals (Sweden)

    Guo-fu Wang

    2013-09-01

    Full Text Available In the fields of transient electromagnetic (TEM geophysical exploration, it is necessary to create a bipolar pulse current source with decline edge of high linearity, short turn-off time and high stability. In order to improve detection equipment’s practicality, it’s urgently needed to miniaturize and improve the reliability of the detection equipment. In this paper, a clamp and prompt drop bipolar pulse current circuit based on Flyback topology is represented, which can accelerate the decline of load current by clamping the coil load with fixed high voltage in the period of current declining. Also, because of this circuit’s low power consumption and significantly improvement of the transmitter’s energy utilization, chassis’s cooling equipment can be greatly reduced and it’s easier to miniaturize the transmitter. To start with, the principle of this circuit is represented. Then, the method is given to select the optimal values of circuit’s components. Finally, the results of simulation proves the proposed circuit meeting the requirements much better than those reported, with shorter turn-off time, higher linearity, less energy consumption. In general, this circuit has been successfully applied to a new type of detection equipment.

  2. A model of cardiac tissue as a conductive system with interacting pacemakers and refractory time

    OpenAIRE

    Loskutov, Alexander; Rybalko, Sergei; Zhuchkova, Ekaterina

    2002-01-01

    A model of the heart tissue as a conductive system with two interacting pacemakers and a refractory time, is proposed. In the parametric space of the model the phase locking areas are investigated in detail. Obtained results allow us to predict the behaviour of excitable systems with two pacemakers depending on the type and intensity of their interaction and the initial phase. Comparison of the described phenomena with intrinsic pathologies of cardiac rhythms is presented.

  3. 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...

  4. 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...

  5. Cancer patients with cardiac pacemakers needing radiation treatment: A systematic review

    OpenAIRE

    Anusheel Munshi; Jai Prakash Agarwal; Kailash Chander Pandey

    2013-01-01

    With improving average life expectancy of individuals in most countries, there has been increase in the incidence of cardiovascular diseases and cancers. Radiation oncologists therefore are likely to encounter an increasing number of cancer patients with in situ cardiac pacemaker devices needing radiation treatments. Pacemaker technology has advanced rapidly in recent years. As a result, the potential interactions of these devices with radiation therapy have changed since American Association...

  6. Designing a Computer-Assisted Clinic to Cope with the Evolution of Pacemaker Technology

    OpenAIRE

    Pfeil, Catherine N.; Keltz, Paul D.; Gertz, Edward W.; Okawachi, Melanie H.

    1983-01-01

    A computer-assisted program for follow-up monitoring of implanted cardiac pacemakers has been in operation at the San Francisco Veterans Administration Medical Center since 1977. It was originally created at a time when the technology of pacemakers was stable and only a few parameters could be measured or telemetered. Two recent developments have necessitated a major reassessment of this project as a well as redesign of the entire computer infrastructure: the advent of multi-programmable and ...

  7. Development of bipolar pulse accelerator for high-purity intense pulsed ion beam

    International Nuclear Information System (INIS)

    In order to improve the purity of the intense pulsed ion beam, a new type of a pulsed ion beam accelerator named “bipolar pulse accelerator” has been proposed. A double coaxial type bipolar pulse generator was developed as the power supply of the bipolar pulse accelerator. By applying the bipolar pulse with voltage of about ±100 kV and pulse duration of about 70 ns to the drift tube of the bipolar pulse accelerator, the ion beam was successfully accelerated from the grounded anode to the drift tube in the 1st gap by the negative pulse of the bipolar pulse and the pulsed ion beam with current density of 40 A/cm2 and pulse duration of 30 ns was obtained at 50 mm downstream from the anode surface. In addition, part of the ion beam was again accelerated toward the grounded cathode in the 2nd gap by the positive pulse of the bipolar pulse. The pulsed ion beam with the peak ion current density of 2 A/cm2 and the beam pulse duration of 30 ns was obtained at 25 mm downstream from the cathode surface, which suggests the bipolar pulse acceleration. (author)

  8. 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)

  9. 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)

  10. 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

  11. 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.)

  12. 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

  13. 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

  14. Neuroleptic-induced deficit syndrome in bipolar disorder with psychosis.

    Science.gov (United States)

    Ueda, Satoshi; Sakayori, Takeshi; Omori, Ataru; Fukuta, Hajime; Kobayashi, Takashi; Ishizaka, Kousuke; Saijo, Tomoyuki; Okubo, Yoshiro

    2016-01-01

    Neuroleptics can induce not only physical adverse effects but also mental effects that produce deficit status in thought, affect, cognition, and behavior. This condition is known as neuroleptic-induced deficit syndrome (NIDS), which includes apathy, lack of initiative, anhedonia, indifference, blunted affect, and reduced insight into disease. Although this old concept now appears almost forgotten, neuroleptics, whether typical or atypical, can make depression or bipolar disorder resemble other more refractory conditions, readily leading to mistaken diagnosis and inappropriate treatment. The authors describe three cases of NIDS superimposed on depressive phase in bipolar disorder with psychosis, where the attending psychiatrist's failure to recognize NIDS prevented patients from receiving effective treatment and achieving remission. All cases achieved remission after reduction of neuroleptics and intensive therapy, including electroconvulsive therapy, for bipolar depression. The concept of NIDS was originally introduced for schizophrenia, and it has rarely been highlighted in other diseases. In recent years, however, atypical antipsychotics are being more often administered to patients with bipolar disorder. Psychiatrists, therefore, should also remember and exercise caution regarding NIDS in the pharmacotherapy of bipolar disorder with and without psychosis. The authors believe that the concept of NIDS needs to be reappraised in current psychiatry. PMID:26893564

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

    Science.gov (United States)

    Rise, Ida Vikan; Haro, Josep Maria; Gjervan, Bjørn

    2016-01-01

    Introduction 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 this group needs an adapted clinical assessment and specific clinical guidelines need to be established.

  16. 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)

  17. 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.

  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. Bipolar disorder: how far are we from a rigorous definition and effective management?

    Science.gov (United States)

    Emilien, Gérard; Septien, Lucia; Brisard, Claudine; Corruble, Emmanuelle; Bourin, Michel

    2007-06-30

    Bipolar disorder is a pathological disturbance of mood, characterized by waxing and waning manic, depressive and, sometimes distinctly mixed states. A diagnosis of bipolar disorder can only be made with certainty when the manic syndrome declares itself. Most individuals who are diagnosed with this disorder will experience both poles of the illness recurrently, but depressive episodes are the commonest cause of morbidity and, indeed, of death by suicide. Twin, adoption and epidemiological studies suggest a strongly genetic aetiology. It is a genetically and phenotypically complex disorder. Thus, the genes contributing are likely to be numerous and of small effect. Individuals with bipolar disorder also display deficits on a range of neuropsychological tasks in both the acute and euthymic phases of illness and correlations between number of affective episodes experienced and task performance are commonly reported. Current self-report and observer-rated scales are optimized for unipolar depression and hence limited in their ability to accurately assess bipolar depression. The development of a specific depression rating scale will improve the assessment of bipolar depression in both research and clinical settings. It will improve the development of better treatments and interventions. Guidelines support the use of antidepressants for bipolar depression. With regard to the adverse effects of antidepressants for bipolar depression, double-blind, placebo-controlled data suggest that antidepressant monotherapy or the addition of a tricyclic antidepressant may worsen the course of bipolar disorder. Importantly, adjunctive psychotherapies add significantly (both statistically and clinically) to the efficacy of pharmacological treatment regimens. The successful management of bipolar disorder clearly demands improved recognition of bipolar disorder and effective long-term treatment for bipolar depression as well as mania. PMID:17459551

  1. 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

  2. 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...

  3. 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.

  4. The possible roles of hyperpolarization-activated cyclic nucleotide channels in regulating pacemaker activity in colonic interstitial cells of Cajal

    OpenAIRE

    Shahi, Pawan Kumar; Choi, Seok; Zuo, Dong Chuan; Kim, Man Yoo; Park, Chan Guk; Kim, Young Dae; Lee, Jun; Park, Kyu Joo; So, Insuk; Jun, Jae Yeoul

    2013-01-01

    Background Hyperpolarization-activated cyclic nucleotide (HCN) channels are pacemaker channels that regulate heart rate and neuronal rhythm in spontaneously active cardiac and neuronal cells. Interstitial cells of Cajal (ICCs) are also spontaneously active pacemaker cells in the gastrointestinal tract. Here, we investigated the existence of HCN channel and its role on pacemaker activity in colonic ICCs. Methods We performed whole-cell patch clamp, RT-PCR, and Ca2+-imaging in cultured ICCs fro...

  5. 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,...

  6. Is metabolic rate a universal 'pacemaker' for biological processes?

    Science.gov (United States)

    Glazier, Douglas S

    2015-05-01

    A common, long-held belief is that metabolic rate drives the rates of various biological, ecological and evolutionary processes. Although this metabolic pacemaker view (as assumed by the recent, influential 'metabolic theory of ecology') may be true in at least some situations (e.g. those involving moderate temperature effects or physiological processes closely linked to metabolism, such as heartbeat and breathing rate), it suffers from several major limitations, including: (i) it is supported chiefly by indirect, correlational evidence (e.g. similarities between the body-size and temperature scaling of metabolic rate and that of other biological processes, which are not always observed) - direct, mechanistic or experimental support is scarce and much needed; (ii) it is contradicted by abundant evidence showing that various intrinsic and extrinsic factors (e.g. hormonal action and temperature changes) can dissociate the rates of metabolism, growth, development and other biological processes; (iii) there are many examples where metabolic rate appears to respond to, rather than drive the rates of various other biological processes (e.g. ontogenetic growth, food intake and locomotor activity); (iv) there are additional examples where metabolic rate appears to be unrelated to the rate of a biological process (e.g. ageing, circadian rhythms, and molecular evolution); and (v) the theoretical foundation for the metabolic pacemaker view focuses only on the energetic control of biological processes, while ignoring the importance of informational control, as mediated by various genetic, cellular, and neuroendocrine regulatory systems. I argue that a comprehensive understanding of the pace of life must include how biological activities depend on both energy and information and their environmentally sensitive interaction. This conclusion is supported by extensive evidence showing that hormones and other regulatory factors and signalling systems coordinate the processes of

  7. 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

  8. 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...

  9. 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...

  10. Ectopic jejunal pacemakers and gastric emptying after Roux gastrectomy: Effect of intestinal pacing

    International Nuclear Information System (INIS)

    The aims of this study were to determine whether ectopic pacemakers are present after meals in the Roux limbs of dogs after vagotomy and Roux gastrectomy, whether these pacemakers slow gastric emptying of liquids or solids, and whether abolishing the pacemakers with electric pacing might speed any slow emptying that occurs. In six dogs that underwent vagotomy and Roux gastrectomy and in four dogs that underwent vagotomy and Billroth gastrectomy (controls), myoelectric activity of the Roux limb or duodenum was measured during gastric emptying of a 500 kcal mixed meal of 99mTc-labeled cooked egg and 111In-labeled milk. Roux dogs were tested with and without pacing of the Roux limb. Roux dogs showed ectopic pacemaker in the Roux limb that drove the pacesetter potentials of the limb in a reverse, or orad, direction during 57% of the postprandial recordings. Billroth dogs had no ectopic pacemakers (p less than 0.05). Liquids emptied more slowly in Roux dogs (half-life (t1/2) = 121 +/- 15 minutes) than in Billroth dogs (t1/2 = 43 +/- 9 minutes; p less than 0.05), but solids emptied similarly in both groups of dogs (t1/2 approximately 8 hours). Pacing the Roux limb abolished the ectopic pacemakers, restored the slow emptying of liquids to the more rapid rate found in the Billroth dogs (t1/2: paced Roux, 72 +/- 15 minutes; Billroth, 43 +/- 9 minutes; p greater than 0.05) and did not change emptying of solids. The conclusion was that ectopic pacemakers present in the Roux limb after vagotomy and Roux gastrectomy drove the limb in a reverse direction and slowed emptying of liquids after the operation. The defect was corrected by pacing the Roux limb in a forward direction

  11. 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.

  12. Pre-clinical evaluation of a minimally invasive laryngeal pacemaker system in mini-pig.

    Science.gov (United States)

    Foerster, Gerhard; Arnold, Dirk; Bischoff, Sabine; Boltze, Karsten; Scholle, Hans-Christoph; Schubert, Harald; Mueller, Andreas H

    2016-01-01

    Microlaryngoscopic enlargement techniques have been the standard treatment for bilateral vocal fold paralysis (BVFP) for decades. Laryngeal pacing is a promising alternative treatment based on the electrostimulation of the posterior cricoarytenoid (PCA) muscle. This paper reports on the results of a pre-clinical study aiming to evaluate this method. Eight Göttingen mini-pigs were implanted with a laryngeal pacemaker (LP) implant prototype and with two LP electrodes, one in each PCA muscle. The 6-week follow-up included endoscopic stimulation controls in general anaesthesia and radiographic controls of electrode integrity and position stability. Stimulation parameters for optimal glottal opening were evaluated via videolaryngoscopy. Histopathology was performed upon conclusion of the study. 7/8 (87.5 %) animals were successfully implanted with the LP implant prototype and two LP electrodes. In general, stimulation was effectively delivered and correlated with the expected PCA muscle activation. 2/14 (14.3 %) electrodes dislocated and 1/14 (7.1 %) electrode tip broke. The LP system used in this experiment to induce vocal fold abduction by means of selective functional electrical stimulation of the PCA showed promising results. It may be a valid alternative to the current golden standard for BVFP treatment. Clinical studies are needed to confirm the medical relevance of the LP. PMID:26264908

  13. Anticoagulation Management in Patients with Pacemaker-Detected Atrial Fibrillation

    Science.gov (United States)

    Poposka, Lidija; Boskov, Vladimir; Risteski, Dejan; Taleski, Jane; Georgievska-Ismail, Ljubica

    2016-01-01

    INTRODUCTION: In patients with an implanted pacemaker, asymptomatic atrial fibrillation (AF) is associated with an increased risk of thrombo-embolic complications. There is still no consensus which duration of episodes of atrial fibrillation should be taken as an indicator for inclusion of oral anticoagulation therapy (OAC). MATERIAL AND METHODS: A total of 104 patients who had no AF episodes in the past and have an indication for permanent pacing were included in the study. RESULTS: During an average follow-up of 18 months, 33 of the patients developed episodes of AF. Inclusion of OAC was performed in 17 patients, in whom AF was recorded, although in all patients CHA2DS2-VASc score was ≥ 1. The inclusion of OAC showed a statistically significant correlation with increasing duration of episodes of AF (r = 0.502, p = 0.003). During the follow-up period none of the patients developed thrombo-embolic complication. CONCLUSION: Considering that our group of patients had no thrombo-embolic events, we could conclude that dividing the AF episodes in less than 1% in 24 hours and longer than 1% within 24 hours could be an indicator for decision-making to include OAK if the CHA2DS2-VASc score is ≥ 1. PMID:27335594

  14. 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 ...

  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. 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%.

  19. Neuroleptic-induced deficit syndrome in bipolar disorder with psychosis

    Directory of Open Access Journals (Sweden)

    Ueda S

    2016-02-01

    Full Text Available Satoshi Ueda,1 Takeshi Sakayori,1 Ataru Omori,2 Hajime Fukuta,3 Takashi Kobayashi,3 Kousuke Ishizaka,1 Tomoyuki Saijo,4 Yoshiro Okubo1 1Department of Neuropsychiatry, Nippon Medical School, Tokyo, Japan; 2Tamachuo Hospital, Tokyo, Japan; 3Kurumegaoka Hospital, Tokyo, Japan; 4Saijo Clinic, Tokyo, Japan Abstract: Neuroleptics can induce not only physical adverse effects but also mental effects that produce deficit status in thought, affect, cognition, and behavior. This condition is known as neuroleptic-induced deficit syndrome (NIDS, which includes apathy, lack of initiative, anhedonia, indifference, blunted affect, and reduced insight into disease. Although this old concept now appears almost forgotten, neuroleptics, whether typical or atypical, can make depression or bipolar disorder resemble other more refractory conditions, readily leading to mistaken diagnosis and inappropriate treatment. The authors describe three cases of NIDS superimposed on depressive phase in bipolar disorder with psychosis, where the attending psychiatrist’s failure to recognize NIDS prevented patients from receiving effective treatment and achieving remission. All cases achieved remission after reduction of neuroleptics and intensive therapy, including electroconvulsive therapy, for bipolar depression. The concept of NIDS was originally introduced for schizophrenia, and it has rarely been highlighted in other diseases. In recent years, however, atypical antipsychotics are being more often administered to patients with bipolar disorder. Psychiatrists, therefore, should also remember and exercise caution regarding NIDS in the pharmacotherapy of bipolar disorder with and without psychosis. The authors believe that the concept of NIDS needs to be reappraised in current psychiatry. Keywords: neuroleptic-induced deficit syndrome (NIDS, bipolar disorder, psychosis, atypical antipsychotics, electroconvulsive therapy

  20. Loss of Cav1.3 channels reveals the critical role of L-type and BK channel coupling in pacemaking mouse adrenal chromaffin cells.

    Science.gov (United States)

    Marcantoni, Andrea; Vandael, David H F; Mahapatra, Satyajit; Carabelli, Valentina; Sinnegger-Brauns, Martina J; Striessnig, Joerg; Carbone, Emilio

    2010-01-13

    We studied wild-type (WT) and Cav1.3(-/-) mouse chromaffin cells (MCCs) with the aim to determine the isoform of L-type Ca(2+) channel (LTCC) and BK channels that underlie the pacemaker current controlling spontaneous firing. Most WT-MCCs (80%) were spontaneously active (1.5 Hz) and highly sensitive to nifedipine and BayK-8644 (1,4-dihydro-2,6-dimethyl-5-nitro-4-[2-(trifluoromethyl)phenyl]-3-pyridinecarboxylic acid, methyl ester). Nifedipine blocked the firing, whereas BayK-8644 increased threefold the firing rate. The two dihydropyridines and the BK channel blocker paxilline altered the shape of action potentials (APs), suggesting close coupling of LTCCs to BK channels. WT-MCCs expressed equal fractions of functionally active Cav1.2 and Cav1.3 channels. Cav1.3 channel deficiency decreased the number of normally firing MCCs (30%; 2.0 Hz), suggesting a critical role of these channels on firing, which derived from their slow inactivation rate, sizeable activation at subthreshold potentials, and close coupling to fast inactivating BK channels as determined by using EGTA and BAPTA Ca(2+) buffering. By means of the action potential clamp, in TTX-treated WT-MCCs, we found that the interpulse pacemaker current was always net inward and dominated by LTCCs. Fast inactivating and non-inactivating BK currents sustained mainly the afterhyperpolarization of the short APs (2-3 ms) and only partially the pacemaker current during the long interspike (300-500 ms). Deletion of Cav1.3 channels reduced drastically the inward Ca(2+) current and the corresponding Ca(2+)-activated BK current during spikes. Our data highlight the role of Cav1.3, and to a minor degree of Cav1.2, as subthreshold pacemaker channels in MCCs and open new interesting features about their role in the control of firing and catecholamine secretion at rest and during sustained stimulations matching acute stress. PMID:20071512

  1. Epidemiologia do transtorno bipolar Epidemiology of bipolar disorders

    Directory of Open Access Journals (Sweden)

    Maurício Silva de Lima

    2005-01-01

    Full Text Available A formulação de políticas em saúde mental depende essencialmente de informações a respeito da freqüência e distribuição dos transtornos mentais. Nas últimas duas décadas, pesquisas de base populacional em epidemiologia psiquiátrica têm sido conduzidas, gerando informações detalhadas sobre freqüência, fatores de risco, incapacidade social e utilização de serviços de saúde. Neste artigo, dados sobre a epidemiologia do transtorno bipolar (TB são discutidos, a partir de resultados de recentes pesquisas populacionais: o estudo da Área de Captação Epidemiológica do Instituto Nacional de Saúde Mental dos Estados Unidos (ECA-NIMH, a Pesquisa Nacional de Comorbidade (NCS, a Pesquisa de Morbidade Psiquiátrica na Grã-Bretanha (OPCS, o Estudo Brasileiro Multicêntrico de Morbidade Psiquiátrica e os estudos longitudinais conduzidos por Angst, em Zurique. As estimativas de prevalências de transtorno bipolar são relativamente baixas, independentemente do lugar onde a pesquisa foi conduzida, do tipo de instrumento diagnóstico usado e dos períodos de tempo para os quais a prevalência se aplica. A partir da introdução do conceito de espectro bipolar, ampliando as fronteiras diagnósticas do TB, as estimativas de prevalências encontradas são substancialmente mais altas. Tais estimativas, entretanto, ainda carecem de validação em estudos populacionais. O transtorno afetivo bipolar é igualmente prevalente entre homens e mulheres, sendo mais freqüente entre solteiros ou separados. Indivíduos acometidos têm maiores taxas de desemprego e estão mais sujeitos a utilizarem serviços médicos e serem hospitalizados. O custo e a eficácia dos tratamentos do TB devem ser balanceados com o alto custo individual e social associados à enfermidade.Information about the epidemiology of bipolar disorders is essential for providing a framework for the formulation of effective mental health policy. In the last two decades, population

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

    Directory of Open Access Journals (Sweden)

    ArgelindaBaroni

    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.

  3. 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.

  4. Echocardiography-guided Radiofrequency Catheter Ablation of Atrioventricular Node and VVI Pacemaker Implantation

    Directory of Open Access Journals (Sweden)

    T Guo

    2014-05-01

    Full Text Available Objective: This study is to evaluate the feasibility and safety of intracardiac radiofrequency catheter ablation (RFCA of the atrioventricular node (AVN and pacemaker implantation using transthoracic echocardiography. Methods: Eleven patients – six males and five females (mean age 66 years – with persistent or permanent atrial fibrillation/atrial flutter received RFCA of AVN and VVI pacemaker implantation (paces and senses the ventricle and is inhibited if it senses ventricular activity. Under transthoracic echocardiography, the electrode catheters were positioned intracardiac, and target ablation was performed, with the permanent pacemaking catheter in the left subclavian vein and the ablation catheter in the right femoral vein. The multi-view imaging and dynamic observation applied during the stable AV dissociation were successful. Results: Atrioventricular node ablation and permanent pacemaker implantation in 11 patients were completed successfully without X-ray exposure. The operation success rate was 100%. All patients recovered well within the follow-up period. Conclusions: Radiofrequency catheter ablation of AVN and VVI pacemaker implantation under transthoracic echocardiography guidance is a safe, easy and feasible approach. This procedure could be an important supplemental measure to catheter ablation of arrhythmia under routine X-ray fluoroscopy.

  5. Application of Bipolar Fuzzy Sets in Graph Structures

    OpenAIRE

    Muhammad Akram; Rabia Akmal

    2016-01-01

    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 examp...

  6. 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.

  7. 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.

  8. [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

  9. 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.

  10. 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.

  11. 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

  12. 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

    During a 5-year period, 81 patients ages 20 to 60 years old had implantation of a permanent cardiac pacemaker at the University Hospital, Odense. At follow-up, during 1985, the 73 survivors received a semi-structured questionnaire regarding subjective consequences of pacemaker therapy, and 72...... 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...... pronounced in subjects suffering from syncope and/or dizziness. Eight patients (11.1%) perceived anxiety most frequently due to fear of pacing failure. Physical complaints were present in 17 patients (23.6%), and the discomfort was mainly due to the size of generator, pain/tenderness from the scar or a...

  13. [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

  14. Pacemaker reuse for patients in resource poor countries: is something always better than nothing?

    Science.gov (United States)

    VanArtsdalen, Jamie; Goold, Susan Dorr; Kirkpatrick, James N; Goldman, Ed; Eagle, Kim; Crawford, Thomas

    2012-01-01

    Cardiovascular disease is the most common cause of death across the globe. Large disparities in access to cardiovascular care exist in the world. An estimated one million people die each year due to lack of access to life saving pacemaker therapy. We discuss the concept of justice in health and health care as it relates to the use of refurbished pacemakers in patients in low- and middle- income countries, where financial circumstances severely limit access to brand new devices. Egalitarianism, utilitarianism, and justice as fairness are examined, as they relate to provision of re-processed pacemakers. This practice, since it holds promise to improve human functioning and capabilities, can be morally justified with some conditions: transparency, further research in is its safety and efficacy, and its impact on other needs and priorities in those countries. PMID:23217434

  15. Experimental Evaluation of SAR around an Implanted Cardiac Pacemaker Caused by Mobile Radio Terminal

    Science.gov (United States)

    Endo, Yuta; Saito, Kazuyuki; Watanabe, Soichi; Takahashi, Masaharu; Ito, Koichi

    Although the effect of electromagnetic interference on an implanted cardiac pacemaker due to a nearby mobile phone has been investigated, there have been few studies on the enhancement of the specific absorption rate (SAR) around an implanted cardiac pacemaker due to a nearby mobile phone. In this study, the SAR distribution around a pacemaker model embedded in a parallelepiped torso phantom when a mobile phone was nearby was numerically calculated and experimentally measured. The results of both investigations showed a characteristic SAR distribution. The system presented can be used to estimate the effects of electromagnetic interference on implanted electric circuits and thus could lead to the development of guidelines for the safe use of mobile radio terminals near people with medical implants.

  16. Reuse of Explanted Pacemakers: An Option for Economically Underprivileged Patients in Developing Countries

    Directory of Open Access Journals (Sweden)

    Johnson Francis

    2007-10-01

    Full Text Available Permanent pacemaker implantation is an established mode of life saving therapy for patients with symptomatic bradycardia. As the human population is aging world-over, the need for pacemakers are also increasing. Reviewing the results of the 2001 World Survey on Cardiac Pacing and Implantable Cardioverter Defibrillators (Table 1, it is evident that not all patients who require pacemakers are receiving them, particularly in the Asia-Pacific region. The largest implanting country per head of population is Germany, although the largest numbers implanted are in the United States of America. In contrast, the countries of Asia have much smaller numbers with Myanmar having less than one implant per million population per year1.

  17. Autaptic pacemaker mediated propagation of weak rhythmic activity across small-world neuronal networks

    Science.gov (United States)

    Yilmaz, Ergin; Baysal, Veli; Ozer, Mahmut; Perc, Matjaž

    2016-02-01

    We study the effects of an autapse, which is mathematically described as a self-feedback loop, on the propagation of weak, localized pacemaker activity across a Newman-Watts small-world network consisting of stochastic Hodgkin-Huxley neurons. We consider that only the pacemaker neuron, which is stimulated by a subthreshold periodic signal, has an electrical autapse that is characterized by a coupling strength and a delay time. We focus on the impact of the coupling strength, the network structure, the properties of the weak periodic stimulus, and the properties of the autapse on the transmission of localized pacemaker activity. Obtained results indicate the existence of optimal channel noise intensity for the propagation of the localized rhythm. Under optimal conditions, the autapse can significantly improve the propagation of pacemaker activity, but only for a specific range of the autaptic coupling strength. Moreover, the autaptic delay time has to be equal to the intrinsic oscillation period of the Hodgkin-Huxley neuron or its integer multiples. We analyze the inter-spike interval histogram and show that the autapse enhances or suppresses the propagation of the localized rhythm by increasing or decreasing the phase locking between the spiking of the pacemaker neuron and the weak periodic signal. In particular, when the autaptic delay time is equal to the intrinsic period of oscillations an optimal phase locking takes place, resulting in a dominant time scale of the spiking activity. We also investigate the effects of the network structure and the coupling strength on the propagation of pacemaker activity. We find that there exist an optimal coupling strength and an optimal network structure that together warrant an optimal propagation of the localized rhythm.

  18. A new bipolar RRAM selector based on anti-parallel connected diodes for crossbar applications

    International Nuclear Information System (INIS)

    Crossbar arrays are the most promising application of a resistive random access memory (RRAM) device for achieving high density memory. However, cross-talk interference in the crossbar array limits the increase in the integration density. In this paper, the combination of two anti-parallel connected diodes and a bipolar RRAM cell is proposed to suppress the sneak current in a crossbar array with anti-parallel connected diodes as the selector for the bipolar RRAM. By using the anti-parallel connected diodes as a selector, the sneak current can be effectively suppressed and the high density crossbar array of more than 1 Mb can be realized as estimated by the 1/2V read voltage scheme. These results indicate that anti-parallel connected diodes can be used as a bipolar selector and have great potential for high density bipolar RRAM crossbar array applications. (papers)

  19. Mood Disorders in Family Practice: Beyond Unipolarity to Bipolarity

    OpenAIRE

    Manning, J. Sloan; Ahmed, Saeeduddin; McGuire, Hillary C.; Hay, Donald P.

    2002-01-01

    Primary care physicians increasingly have treated depressive disorders over the last decade. Unrecognized bipolar disorder, sometimes misdiagnosed as unipolar depression, may lead to treatment resistance or nonresponse. We describe differences between unipolar and bipolar disorders, focusing on recognition, diagnosis, and treatment of bipolar spectrum disorders such as bipolar I, bipolar II, antidepressant-induced mania, and cyclothymia. Broadening the understanding of these different disorde...

  20. Nicotine dependence and psychosis in Bipolar disorder and Schizoaffective disorder, Bipolar type.

    Science.gov (United States)

    Estrada, Elena; Hartz, Sarah M; Tran, Jeffrey; Hilty, Donald M; Sklar, Pamela; Smoller, Jordan W; Pato, Michele T; Pato, Carlos N

    2016-06-01

    Patients with Bipolar disorder smoke more than the general population. Smoking negatively impacts mortality and clinical course in Bipolar disorder patients. Prior studies have shown contradictory results regarding the impact of psychosis on smoking behavior in Bipolar disorder. We analyzed a large sample of Bipolar disorder and Schizoaffective disorder, Bipolar Type patients and predicted those with a history of psychosis would be more likely to be nicotine dependent. Data from subjects and controls were collected from the Genomic Psychiatry Cohort (GPC). Subjects were diagnosed with Bipolar disorder without psychosis (N = 610), Bipolar disorder with psychosis (N = 1544). Participants were classified with or without nicotine dependence. Diagnostic groups were compared to controls (N = 10065) using logistic regression. Among smokers (N = 6157), those with Bipolar disorder had an increased risk of nicotine dependence (OR = 2.5; P Bipolar disorder with psychosis were more likely to be dependent than Bipolar disorder patients without psychosis (OR = 1.3; P = 0.03). Schizoaffective disorder, Bipolar Type patients had more risk of nicotine dependence when compared to Bipolar disorder patients with or without psychosis (OR = 1.2; P = 0.02). Bipolar disorder patients experiencing more severity of psychosis have more risk of nicotine dependence. © 2015 Wiley Periodicals, Inc. PMID:26467098

  1. [Comorbidity of eating disorders and bipolar affective disorders].

    Science.gov (United States)

    Kamińska, Katarzyna; Rybakowski, Filip

    2006-01-01

    Eating disorders--anorexia nervosa, bulimia nervosa and eating disorders not otherwise specified (EDNOS) occur usually in young females. The significant pathogenic differences between patients who only restrict food, and patients with binge eating and compensatory behaviours, such as vomiting and purging were described. The prevalence of bipolar affective disorders--especially bipolar II and bipolar spectrum disorders (BS) may reach 5% in the general population. About half of the depressive episodes are associated with a "mild" bipolar disorder, and such a diagnosis is suggested by impulsivity and mood-instability. Previously, majority of research on the comorbidity between eating and affective disorders focused on depressive symptomatology, however difficulties in the reliable assessment of hypomania may obfuscate the estimation of the co-occurrence of eating disorders with BS. Epidemiological studies suggest the association between BS and eating disorders with binge episodes (bulimia nervosa, anorexia- bulimic type and EDNOS with binge episodes). Co-occurrence of such disorders with depressive symptoms probably suggests the diagnosis of BS, not recurrent depression. Bulimic behaviours, impulsivity and affective disorders might be related to the impairment of the serotonergic neurotransmission, which may result from the genetic vulnerability and early life trauma. Currently, the first-line pharmacological treatment of co-occurring eating disorders with binge episodes and BS are selective serotonin reuptake inhibitors. However in some cases, the use of mood-stabilising agents as monotherapy or in combination with serotonergic drugs may be helpful. PMID:17037812

  2. 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

  3. 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,...

  4. Psychopharmacological Treatment Status in Outpatients with Bipolar Disorder: A Clinical Survey in Germany

    OpenAIRE

    Quante, Arnim; Zeugmann, Sara; Regen, Francesca; Engelhardt, Annette; Anghelescu, Ion-George

    2010-01-01

    Objective The objective of this epidemiological study was to evaluate the current treatment status as well as the acceptance of medication and satisfaction with life in outpatients with bipolar disorder in Germany. Methods Data for this cross-sectional epidemiologic survey was collected between February 15th, 2006 and May 31st, 2006. Three hundreds six bipolar euthymic outpatients under routine treatment conditions were included in the study. Forty one practicing psychiatrists used a clinical...

  5. On the Role of Goal Dysregulation in the Treatment of Bipolar Disorder

    OpenAIRE

    Miklowitz, David J.; Johnson, Sheri L.

    2009-01-01

    Nusslock, Abramson, Harmon-Jones, Alloy, and Coan (this issue) propose that current psychosocial treatments for bipolar disorder be supplemented with interventions focused on altering goal dysregulation pathways. While innovations to existing treatment manuals are always welcome, there are several reasons why this suggestion may require further consideration. We highlight issues pertaining to the status of cognitive-behavioral therapy for bipolar disorder, the distinction between education an...

  6. Stressful life events predict delayed functional recovery following treatment for mania in bipolar disorder

    OpenAIRE

    Yan-Meier, Leslie; Eberhart, Nicole K.; Hammen, Constance L.; Gitlin, Michael; Sokolski, Kenneth; Altshuler, Lori

    2011-01-01

    Identifying predictors of functional recovery in bipolar disorder is critical to treatment efforts to help patients re-establish premorbid levels of role adjustment following an acute manic episode. The current study examined the role of stressful life events as potential obstacles to recovery of functioning in various roles. 65 patients with bipolar I disorder participated in a longitudinal study of functional recovery following clinical recovery from a manic episode. Stressful life events w...

  7. 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...

  8. 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...

  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. 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].

  11. 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)

  12. [Psychopharmacological treatment of bipolar disease].

    Science.gov (United States)

    Licht, Rasmus W; Vestergaard, Per

    2002-05-01

    This paper gives an update on the psychopharmacological treatment of bipolar disorder. The antimanic efficacy of lithium is well documented. The same applies to valproate, which is also efficacious in mixed mania. Conventional antipsychotics act fast in mania and do not require blood tests, but they have considerable neurological side effects. The newer antipsychotics, olanzapine, risperidone, and ziprasidone, have also been shown to have antimanic efficacy. Clozapine is extremely effective, also when other treatment fails. For the treatment of bipolar depression, lithium, lamotrigine, and antidepressants all seem to work, but antidepressants may sometimes precipitate mania or worsen the course of illness. For prophylaxis, lithium is still to be considered the first drug of choice. However, for several reasons, for instance treatment failure or side effects, long-term treatment with antiepileptics may often be necessary. Among the antiepileptics, carbamazepine, valproate, and lamotrigine are the best studied. PMID:12025705

  13. Unsplit bipolar pulse forming line

    Science.gov (United States)

    Rhodes, Mark A.

    2011-05-24

    A bipolar pulse forming transmission line module and system for linear induction accelerators having first, second, third, and fourth planar conductors which form a sequentially arranged interleaved stack having opposing first and second ends, with dielectric layers between the conductors. The first and second planar conductors are connected to each other at the first end, and the first and fourth planar conductors are connected to each other at the second end via a shorting plate. The third planar conductor is electrically connectable to a high voltage source, and an internal switch functions to short at the first end a high voltage from the third planar conductor to the fourth planar conductor to produce a bipolar pulse at the acceleration axis with a zero net time integral. Improved access to the switch is enabled by an aperture through the shorting plate and the proximity of the aperture to the switch.

  14. Prepubertal bipolar disorder: available pharmacological treatment options.

    Science.gov (United States)

    Masi, Gabriele

    2005-04-01

    Awareness of bipolar spectrum disorders in children is rapidly increasing, with a more precise definition of their clinical subtypes and early signs. Paediatric bipolar disorder can lead to an important impairment in scholastic, familial and social functioning, and to a higher risk for substance abuse and suicide. In the context of a multimodal approach, the core treatment of early-onset bipolar disorder is pharmacological. This review focuses on the empirical evidence for pharmacotherapy in paediatric bipolar disorder. Mood stabilizers, including lithium, and older and newer anticonvulsivants will be considered, in mono- or polypharmacy. Atypical antipsychotics will be considered in more severe and/or treatment-resistant manic or mixed episodes. Finally, the prophylaxis of intercritical phases and the management of specific challenging conditions, such as bipolar depression and attention deficit hyperactivity disorder, with bipolar comorbidity, will be reviewed. PMID:15934881

  15. 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...

  16. 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...

  17. 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

  18. 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 ...

  19. Cognitive Behavioral Therapy in Bipolar Disorder

    OpenAIRE

    Zeynep Mackali; Ahmet Tosun

    2011-01-01

    Bipolar disorder is an early-onset, chronic disorder. It impairs occupational, social, and family functioning, which makes learning to adapt living with the disorder and its treatment critically important. Therefore, it has now become common knowledge that psychosocial interventions are also necessary in the treatment of bipolar disorder adjunctive to pharmacotherapy. Thus, whichever psychosocial interventions are more effective in bipolar disorder is a crucial research question. In this arti...

  20. Adolescent Bipolar Disorder: A Clinical Vignette

    OpenAIRE

    Rodgers, Melissa J.; Zylstra, Robert G.; McKay, Julia B.; Solomon, A. Lee; Choby, Beth A.

    2010-01-01

    Adolescence is a vulnerable developmental phase marked by physical, psychological, and social changes that rapidly expose young people to a wide range of new stressors. When differentiating between bipolar disorder and teenage “acting out,” a careful history is important. Adolescent bipolar disorder is a psychiatric illness characterized by fluctuating episodes of mood elevation and depression that is frequently neither recognized nor formally diagnosed. Adolescents with bipolar disorder ofte...

  1. 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. ...

  2. Pharmaceutical treatment of acute bipolar depression

    OpenAIRE

    Fountoulakis, Konstantinos N

    2010-01-01

    The treatment of bipolar depression is one of the most challenging fields in contemporary psychiatry. The best data concern the antipsychotics quetiapine and the olanzapine-fluoxetine combination. However, the usefulness of antidepressants in bipolar depression remains controversial; positive data are available for fluoxetine but negative results have been published for paroxetine. Accumulated knowledge so far suggests that bipolar patients need continuous administration of an antimanic agent...

  3. The common bipolar phenotype in young people

    OpenAIRE

    Rock, Philippa L; Chandler, Rebecca A.; Harmer, Catherine J.; Rogers, Robert D.; Goodwin, Guy M.

    2013-01-01

    Background Mood elevation is common in adolescents and young adults. The aim of this study was to investigate the prevalence of a bipolar diagnosis and co-morbidity in individuals identified by online screening for experience of (hypo)manic symptoms in order to better define the common bipolar phenotype in young people. Methods Survey data regarding experience of (hypo)manic symptoms and occurrence of co-morbidities were analysed for 106 students satisfying criteria for probable bipolar syndr...

  4. 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…

  5. Strong attachment of circadian pacemaker neurons on modified ultrananocrystalline diamond surfaces.

    Science.gov (United States)

    Voss, Alexandra; Wei, HongYing; Zhang, Yi; Turner, Stuart; Ceccone, Giacomo; Reithmaier, Johann Peter; Stengl, Monika; Popov, Cyril

    2016-07-01

    Diamond is a promising material for a number of bio-applications, including the fabrication of platforms for attachment and investigation of neurons and of neuroprostheses, such as retinal implants. In the current work ultrananocrystalline diamond (UNCD) films were deposited by microwave plasma chemical vapor deposition, modified by UV/O3 treatment or NH3 plasma, and comprehensively characterized with respect to their bulk and surface properties, such as crystallinity, topography, composition and chemical bonding nature. The interactions of insect circadian pacemaker neurons with UNCD surfaces with H-, O- and NH2-terminations were investigated with respect to cell density and viability. The fast and strong attachment achieved without application of adhesion proteins allowed for advantageous modification of dispersion protocols for the preparation of primary cell cultures. Centrifugation steps, which are employed for pelletizing dispersed cells to separate them from dispersing enzymes, easily damage neurons. Now centrifugation can be avoided since dispersed neurons quickly and strongly attach to the UNCD surfaces. Enzyme solutions can be easily washed off without losing many of the dispersed cells. No adverse effects on the cell viability and physiological responses were observed as revealed by calcium imaging. Furthermore, the enhanced attachment of the neurons, especially on the modified UNCD surfaces, was especially advantageous for the immunocytochemical procedures with the cell cultures. The cell losses during washing steps were significantly reduced by one order of magnitude in comparison to controls. In addition, the integration of a titanium grid structure under the UNCD films allowed for individual assignment of physiologically characterized neurons to immunocytochemically stained cells. Thus, employing UNCD surfaces free of foreign proteins improves cell culture protocols and immunocytochemistry with cultured cells. The fast and strong attachment of

  6. L-type calcium channels in adrenal chromaffin cells: role in pace-making and secretion.

    Science.gov (United States)

    Marcantoni, A; Baldelli, P; Hernandez-Guijo, J M; Comunanza, V; Carabelli, V; Carbone, E

    2007-01-01

    Voltage-gated L-type (Cav1.2 and Cav1.3) channels are widely expressed in cardiovascular tissues and represent the critical drug-target for the treatment of several cardiovascular diseases. The two isoforms are also abundantly expressed in neuronal and neuroendocrine tissues. In the brain, Cav1.2 and Cav1.3 channels control synaptic plasticity, somatic activity, neuronal differentiation and brain aging. In neuroendocrine cells, they are involved in the genesis of action potential generation, bursting activity and hormone secretion. Recent studies have shown that Cav1.2 and Cav1.3 are also expressed in chromaffin cells but their functional role has not yet been identified despite that L-type channels possess interesting characteristics, which confer them an important role in the control of catecholamine secretion during action potentials stimulation. In intact rat adrenal glands L-type channels are responsible for adrenaline and noradrenaline release following splanchnic nerve stimulation or nicotinic receptor activation. L-type channels can be either up- or down-modulated by membrane autoreceptors following distinct second messenger pathways. L-type channels are tightly coupled to BK channels and activate at relatively low-voltages. In this way they contribute to the action potential hyperpolarization and to the pace-maker current controlling action potential firings. L-type channels are shown also to regulate the fast secretion of the immediate readily releasable pool of vesicles with the same Ca(2+)-efficiency of other voltage-gated Ca(2+) channels. In mouse adrenal slices, repeated action potential-like stimulations drive L-type channels to a state of enhanced stimulus-secretion efficiency regulated by beta-adrenergic receptors. Here we will review all these novel findings and discuss the possible implication for a specific role of L-type channels in the control of chromaffin cells activity. PMID:17561252

  7. 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...

  8. 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.

  9. Early-Onset Bipolar Spectrum Disorders: Diagnostic Issues

    OpenAIRE

    Danner, Stephanie; Fristad, Mary A.; Arnold, L. Eugene; Youngstrom, Eric A.; Birmaher, Boris; Horwitz, Sarah M.; Demeter, Christine; Findling, Robert L; Kowatch, Robert A

    2009-01-01

    Since the mid 1990s, early-onset bipolar spectrum disorders (BPSDs) have received increased attention in both the popular press and scholarly press. Rates of diagnosis of BPSD in children and adolescents have increased in inpatient, outpatient, and primary care settings. BPSDs remain difficult to diagnose, particularly in youth. The current diagnostic system makes few modifications to accommodate children and adolescents. Researchers in this area have developed specific BPSD definitions that ...

  10. Management of bipolar depression with lamotrigine: an antiepileptic mood stabilizer

    OpenAIRE

    Prabhavalkar, Kedar S.; Poovanpallil, Nimmy B.; Bhatt, Lokesh K.

    2015-01-01

    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 st...

  11. 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; Franzen, Olaf; Søndergård, Lars

    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...

  12. 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.

  13. 76 FR 44872 - Effective Date of Requirement for Premarket Approval for an Implantable Pacemaker Pulse Generator

    Science.gov (United States)

    2011-07-27

    .... Improper Sensing Electromagnetic interference with pacemaker electronics, loose connections, or sensing... HUMAN SERVICES Food and Drug Administration 21 CFR Part 870 Effective Date of Requirement for Premarket... medical devices intended for human use. Section 513 of the FD&C Act (21 U.S.C. 360c) established...

  14. 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.

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

    DEFF Research Database (Denmark)

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

    1994-01-01

    , and they were given a child-psychiatric evaluation consisting of a semi-structured and a child-psychiatric interview. The psychological interview used intelligence tests and the Draw-A-Person test as well as the Rorschach test. The patients had had their pacemakers during an average of 6.7 years...

  16. 76 FR 64223 - Cardiovascular Devices; Reclassification of External Pacemaker Pulse Generator Devices

    Science.gov (United States)

    2011-10-17

    ... premarket approval for external pacemaker pulse generator devices (52 FR 17732, May 11, 1987). In 2009, FDA... rule (44 FR 13284, March 9, 1979 and 44 FR 13372, March 9, 1979), the Cardiovascular Devices Panel..., 2009 (74 FR 16214, April 9, 2009). In response to that order, FDA received reclassification...

  17. 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...

  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...

  19. 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

  20. 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.

  1. 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...

  2. Infection and twiddler syndrome in a dog with addison's disease, complete heart block, and wandering artificial pacemakers

    International Nuclear Information System (INIS)

    Third degree heart block developed in an obese, 10-year-old Labrador retriever with adrenocortical failure. A permanent transthoracic pacemaker was fitted, but the pulse generator migrated 2 years later, to the ventral part of the flank, where an abscess formed. A new pacemaker was fitted, but also migrated and rotated and a syndrome analogous to Twiddler's syndrome in man developed. After a further 2 years the second pacemaker was located, encapsulated within the right pleural cavity. Culture of the brownish exudate around the pulse generator yielded Pseudomonas sp

  3. Poorer sustained attention in bipolar I than bipolar II disorder

    Directory of Open Access Journals (Sweden)

    Chen Shih-Heng

    2010-02-01

    Full Text Available Abstract Background Nearly all information processing during cognitive processing takes place during periods of sustained attention. Sustained attention deficit is among the most commonly reported impairments in bipolar disorder (BP. The majority of previous studies have only focused on bipolar I disorder (BP I, owing to underdiagnosis or misdiagnosis of bipolar II disorder (BP II. With the refinement of the bipolar spectrum paradigm, the goal of this study was to compare the sustained attention of interepisode patients with BP I to those with BP II. Methods In all, 51 interepisode BP patients (22 with BP I and 29 with BP II and 20 healthy controls participated in this study. The severity of psychiatric symptoms was assessed by the 17-item Hamilton Depression Rating Scale and the Young Mania Rating Scale. All participants undertook Conners' Continuous Performance Test II (CPT-II to evaluate sustained attention. Results After controlling for the severity of symptoms, age and years of education, BP I patients had a significantly longer reaction times (F(2,68 = 7.648, P = 0.001, worse detectability (d' values (F(2,68 = 6.313, P = 0.003 and more commission errors (F(2,68 = 6.182, P = 0.004 than BP II patients and healthy controls. BP II patients and controls scored significantly higher than BP I patients for d' (F = 6.313, P = 0.003. No significant difference was found among the three groups in omission errors and no significant correlations were observed between CPT-II performance and clinical characteristics in the three groups. Conclusions These findings suggested that impairments in sustained attention might be more representative of BP I than BP II after controlling for the severity of symptoms, age, years of education and reaction time on the attentional test. A longitudinal follow-up study design with a larger sample size might be needed to provide more information on chronological sustained attention deficit in BP patients, and to illustrate

  4. Progression along the Bipolar Spectrum: A Longitudinal Study of Predictors of Conversion from Bipolar Spectrum Conditions to Bipolar I and II Disorders

    OpenAIRE

    Alloy, Lauren B.; Urošević, Snežana; Abramson, Lyn Y.; Jager-Hyman, Shari; Nusslock, Robin; Whitehouse, Wayne G.; Hogan, Michael

    2011-01-01

    Little longitudinal research has examined progression to more severe bipolar disorders in individuals with “soft” bipolar spectrum conditions. We examine rates and predictors of progression to bipolar I and II diagnoses in a non-patient sample of college-age participants (n = 201) with high General Behavior Inventory scores and childhood or adolescent onset of “soft” bipolar spectrum disorders followed longitudinally for 4.5 years from the Longitudinal Investigation of Bipolar Spectrum (LIBS)...

  5. 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.

  6. 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.

  7. 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…

  8. Bipolar states of electrons in clusters

    International Nuclear Information System (INIS)

    Conditions are found under which the production of a bipolar state in a cluster consisting of polar molecules is possible. In (H2O)n cluster the bipolar state is possible under n ≥ 630, and in (NH3)n one - under n ≥ 2015. 4 refs

  9. 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…

  10. 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

  11. Bipolar Disorder in School-Age Children

    Science.gov (United States)

    Olson, Patricia M.; Pacheco, Mary Rae

    2005-01-01

    This article examines the individual components of bipolar disorder in children and the behaviors that can escalate as a result of misdiagnosis and treatment. The brain/behavior relationship in bipolar disorders can be affected by genetics, developmental failure, or environmental influences, which can cause an onset of dramatic mood swings and…

  12. White matter microstructure alterations in bipolar disorder

    OpenAIRE

    Bellani, M; Perlini, C.; Ferro, A.; Cerruti, S.; G. Rambaldelli; Isola, M.; CERINI, R.; N. Dusi; N. Andreone; Balestrieri, M.; R. Pozzi Mucelli; Tansella, M; Brambilla, P

    2012-01-01

    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.

  13. Study on the ELDRS of bipolar linear operational amplifier

    International Nuclear Information System (INIS)

    Bipolar linear devices laboratory irradiation testing results are significantly different from the actual in flight exposure to the radiation. In this paper the total dose irradiation of operational amplifiers, and analysis upon the total dose response of these bipolar circuits under the different test conditions were investigated in the same experiment. Total dose tests of bipolar linear operational amplifiers show susceptible to dose rate, bias and room temperature annealing during exposure. The critical sensitive parameters of operational amplifier are input bias current, input offset current, input offset voltage, and open loop gain, which exhibits both bias and dose rate dependence. With calculating the change of each electrical parameter (Δpara) for each sample at 300 Gy radiation level, it has been found that ratio of the Δpara at low dose rate to the Δpara at high dose rate exceeds 2.46 times for any of the parameters. So these parts are considered to be ELDRS susceptible. After room temperature annealing, the main parameters have time dependence effect at low dose rate and without time dependent effect at high dose rate. (authors)

  14. 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.

  15. 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.

  16. Management of Bipolar II Disorder

    OpenAIRE

    Michael M.C Wong

    2011-01-01

    Bipolar II disorder (BP II) disorder was recognized as a distinct subtype in the DSM-IV classification. DSM-IV criteria for BP II require the presence or history of one or more major depressive episode, plus at least one hypomanic episode, which, by definition, must last for at least 4 days. Various studies found distinct patterns of symptoms and familial inheritance for BP II disorder. BP II is commonly underdiagnosed or misdiagnosed. Making an early and accurate diagnosis of BP II is utmost...

  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. 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...

  19. 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

  20. 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.

  1. Involvement of Na+-leak Channel in Substance P-induced Depolarization of Pacemaking Activity in Interstitial Cells of Cajal

    OpenAIRE

    Kim, Byung Joo; Chang, In Youb; Choi, Seok; Jun, Jae Yeoul; Jeon, Ju-Hong; Xu, Wen-Xie; Kwon, Young Kyu; Ren, Dejian; So, Insuk

    2012-01-01

    Interstitial cells of Cajal (ICCs) are the pacemaking cells in the gastrointestinal muscles that generate the rhythmic oscillations in membrane potential known as slow waves. ICCs also mediate or transduce inputs from the enteric nervous system. Substance P (SubP) is a member of the family of mammalian tachykinin peptides that are predominantly released by enteric neurons. This study assessed the relationship of Na+-leak channel (NALCN) in the SubP-induced depolarization in pacemaking activit...

  2. 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

  3. Hierarchical Micro- and Nanostructured Superhydrophobic Surfaces to Reduce Fibrous Encapsulation of Pacemaker Leads : Nanotechnology in Practical Applications

    OpenAIRE

    Carlsson, Louise

    2008-01-01

    The purpose of this master’s thesis was to, by the use of nanotechnology, improve material properties of the biomedical polymer Optim™, used as the insulation of pacemaker leads. Improved material properties are required to reduce the extent of fibrous encapsulation of the leads. Today, laser ablation is used to be able to remove the pacemaker lead because of the fibrous tissue, which can cause the lead to adhere to vascular structures. Consequently, the laser ablation results in risks of dam...

  4. ANAESTHETIC MANAGEMENT OF ELDERLY PATIENT WITH PERMANENT PACEMAKER FOR EXCISION OF SUSPECTED ADRENAL MASS – A CHALLENGING CASE

    Directory of Open Access Journals (Sweden)

    Ketaki

    2014-01-01

    Full Text Available Pacemakers and the underlying pathophysiologies leading to their implantation present challenges to the anesthetist 1 . Patients with an implanted cardiac pulse generator often have significant co - morbid disease in addition to their cardiac rhythm disturbance. Our ability to care for these patients requires attention to both their medical , psychological and surgical problems. We present the case of a 60 year old man with a permanent pacemaker posted for excision of a suspected adrenal mass.

  5. Design and development of bipolar 4-quadrant switch-mode power converter for superconducting magnets

    International Nuclear Information System (INIS)

    A uniform zero crossing magnetic field in a magnet can be achieved by using bipolar power converter with four quadrant operation. A high current bipolar switch-mode power converter (rated ±27 Vmax, ±7V flat top, ±300A, 100 ppm) has been designed and developed indigenously at VECC Kolkata. Four quadrants operation is accomplished by using power IGBTs in an H-bridge configuration with switching frequency around 20 kHz. The switch-mode power converter is used because of high dynamic response, low output ripple, high efficiency and low input current harmonics. In this paper, circuit topology, function of system components and key system specifications of high current bipolar switch mode power converter is discussed. (author)

  6. 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

  7. 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)

  8. 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.

  9. Dye sensitized solar cells based on novel bipolar spiro compounds

    Energy Technology Data Exchange (ETDEWEB)

    Salbeck, Josef [Macromolecular Chemistry and Molecular Materials (mmCmm), Department of Science and Center for Interdisciplinary Nanostructure Science and Technology (CINSaT), University of Kassel, Heinrich-Plett-Strasse 40, 34109 Kassel (Germany)

    2007-07-01

    We report dye sensitized solar cells (DSSC) based on novel bipolar spiro compounds containing perylene and diphenylamino moiety. The corresponding compound has high extinction coefficient ({proportional_to}10{sup 5} M{sup -1}cm{sup -1}) and, therefore, is a potential compound for DSSCs applications. After an ultraviolet treatment of the device, the short circuit current density increases from 0.04 mA cm{sup -2} to 0.10 mA cm{sup -2} especially with t-butyl ammonium ion containing cell. In contrast, no noticeable change in current density in device containing lithium ion has been observed.

  10. 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

  11. 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.

  12. 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

  13. 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.

  14. 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.

  15. Brief Report: A Family Risk Study Exploring Bipolar Spectrum Problems and Cognitive Biases in Adolescent Children of Bipolar Parents

    Science.gov (United States)

    Espie, Jonathan; Jones, Steven H.; Vance, Yvonne H.; Tai, Sara J.

    2012-01-01

    Children of parents with bipolar disorder are at increased risk of bipolar spectrum diagnoses. This cross-sectional study explores cognitive factors in the prediction of vulnerability to bipolar disorder. Adolescents at high-risk (with a parent with bipolar disorder; n = 23) and age and gender matched adolescents (n = 24) were recruited. Parent…

  16. 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

  17. 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

  18. Single rotating stars and the formation of bipolar planetary nebula

    Energy Technology Data Exchange (ETDEWEB)

    García-Segura, G. [Instituto de Astronomía, Universidad Nacional Autónoma de Mexico, Km. 103 Carr. Tijuana-Ensenada, 22860 Ensenada, B. C. (Mexico); Villaver, E. [Departamento de Física Teórica, Universidad Autónoma de Madrid, Cantoblanco, E-28049 Madrid (Spain); Langer, N. [Argelander-Institut für Astronomie, Universität Bonn, D-53121 Bonn (Germany); Yoon, S.-C. [Astronomy Program, Department of Physics and Astronomy, Seoul National University, Seoul, 151-747 (Korea, Republic of); Manchado, A., E-mail: ggs@astrosen.unam.mx [Instituto de Astrofísica de Canarias, Via Láctea s/n, E-38200 La Laguna, Tenerife (Spain)

    2014-03-10

    We have computed new stellar evolution models that include the effects of rotation and magnetic torques under different hypotheses. The goal is to test whether a single star can sustain the rotational velocities needed in the envelope for magnetohydrodynamical(MHD) simulations to shape bipolar planetary nebulae (PNe) when high mass-loss rates take place. Stellar evolution models with main sequence masses of 2.5 and 5 M {sub ☉} and initial rotational velocities of 250 km s{sup –1} have been followed through the PNe formation phase. We find that stellar cores have to be spun down using magnetic torques in order to reproduce the rotation rates observed for white dwarfs. During the asymptotic giant branch phase and beyond, the magnetic braking of the core has a practically null effect on increasing the rotational velocity of the envelope since the stellar angular momentum is efficiently removed by the wind. We have also tested the best possible case scenarios in rather non-physical contexts to give enough angular momentum to the envelope. We find that we cannot get the envelope of a single star to rotate at the speeds needed for MHD simulations to form bipolar PNe. We conclude that single stellar rotators are unlikely to be the progenitors of bipolar PNe under the current MHD model paradigm.

  19. Single rotating stars and the formation of bipolar planetary nebula

    International Nuclear Information System (INIS)

    We have computed new stellar evolution models that include the effects of rotation and magnetic torques under different hypotheses. The goal is to test whether a single star can sustain the rotational velocities needed in the envelope for magnetohydrodynamical(MHD) simulations to shape bipolar planetary nebulae (PNe) when high mass-loss rates take place. Stellar evolution models with main sequence masses of 2.5 and 5 M ☉ and initial rotational velocities of 250 km s–1 have been followed through the PNe formation phase. We find that stellar cores have to be spun down using magnetic torques in order to reproduce the rotation rates observed for white dwarfs. During the asymptotic giant branch phase and beyond, the magnetic braking of the core has a practically null effect on increasing the rotational velocity of the envelope since the stellar angular momentum is efficiently removed by the wind. We have also tested the best possible case scenarios in rather non-physical contexts to give enough angular momentum to the envelope. We find that we cannot get the envelope of a single star to rotate at the speeds needed for MHD simulations to form bipolar PNe. We conclude that single stellar rotators are unlikely to be the progenitors of bipolar PNe under the current MHD model paradigm.

  20. Timing of human sleep: recovery process gated by a circadian pacemaker

    OpenAIRE

    DAAN, S; BEERSMA, DGM; BORBELY, AA

    1984-01-01

    A model for the timing of human sleep is presented, It is based on a sleep-regulating variable (S)-possibly, but not necessarily, associated with a neurochemical substance-which increases during wakefulness and decreases during sleep. Sleep onset is triggered when S approaches an upper threshold (H); awakening occurs when S reaches a lower threshold (L). The thresholds show a circadian rhythm controlled by a single circadian pacemaker. Time constants of the S process were derived from rates o...

  1. 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.

  2. 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.

  3. Shengmaisan Regulates Pacemaker Potentials in Interstitial Cells of Cajal in Mice

    OpenAIRE

    Kim Byung Joo

    2013-01-01

    Objectives: Shengmaisan (SMS) is a traditional Chinese medicine prescription widely used for the treatment of diverse organs in Korea. The interstitial cells of Cajal (ICCs) are pacemaker cells that play an important role in the generation of coordinated gastrointestinal (GI) motility. We have aimed to investigate the effects of SMS in the ICCs in the mouse small intestine. Methods: To dissociate the ICCs, we used enzymatic digestions from the small intestine in a mouse. After that, the ICCs ...

  4. 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.

  5. 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...

  6. High Altitude and Intracardiac Devices(Pacemaker and Intracardiac Defibrillator andCardiac Resynchronisation Therapy)

    OpenAIRE

    Gürsoy, Mustafa Ozan; Yıldız, Banu Şahin; Yıldız, Mustafa

    2013-01-01

    Cardiovascular system responds to high altitude short after exposure. Hypoxia induces increase in heart rate, myocardial contractility, and cardiac output. This may have clinical implications in patients with underlying heart disease such as coronary artery disease, heart failure and rhythm disorders. Past studies have showed that patients may experience altitude-induced arrhythmias. However, there are conflicting data for patients with cardiac devices such as permanent pacemaker, intracardia...

  7. ESPECTRA: Searching the Bipolar Spectrum in Eating Disorder patients

    Directory of Open Access Journals (Sweden)

    Moreno Ricardo A

    2011-04-01

    Full Text Available Abstract Background Bipolar Disorder (BD is a chronic, recurrent and highly prevalent illness. Despite the need for correct diagnosis to allow proper treatment, studies have shown that reaching a diagnosis can take up to ten years due to the lack of recognition of the broader presentations of BD. Frequent comorbidities with other psychiatric disorders are a major cause of misdiagnosis and warrant thorough evaluation. Methods/Design ESPECTRA (Occurrence of Bipolar Spectrum Disorders in Eating Disorder Patients is a single-site cross-sectional study involving a comparison group, designed to evaluate the prevalence of bipolar spectrum in an eating disorder sample. Women aged 18-45 years will be evaluated using the SCID-P and Zurich criteria for diagnosis and the HAM-D, YOUNG, SCI-MOODS, HCL-32, BIS-11, BSQ, WHOQoL and EAS instruments for rating symptoms and measuring clinical correlates. Discussion The classificatory systems in psychiatry are based on categorical models that have been criticized for simplifying the diagnosis and leading to an increase in comorbidities. Some dimensional approaches have been proposed aimed at improving the validity and reliability of psychiatric disorder assessments, especially in conditions with high rates of comorbidity such as BD and Eating Disorder (ED. The Bipolar Spectrum (BS remains under-recognized in clinical practice and its definition is not well established in current diagnostic guidelines. Broader evaluation of psychiatric disorders combining categorical and dimensional views could contribute to a more realistic understanding of comorbidities and help toward establishing a prognosis.

  8. 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...... 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...

  9. 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

  10. Ionizing radiations simulation on bipolar components

    International Nuclear Information System (INIS)

    This thesis presents the ionizing radiation effects on bipolar components and more specially their behavior facing the total dose. The first part is devoted to the radiation environments with a special attention to the spatial environments and new emergent environments. The specificities of bipolar components are then presented and their behavior facing the interactions. The physical mechanisms bound to the dose rate are also discussed. The second part presents a physical analysis of degradations induced by the cumulated dosimetry on bipolar components and simulation with the ATLAS code. The third part exposes an electric empirical simulation induced by the cumulated dose in static conditions. (A.L.B.)

  11. Measurement of neutron doses from the models 9000 and 9090 cardiac pacemakers

    International Nuclear Information System (INIS)

    Dose distribution in various points within the body of a patient implanted with a cardiac pacemaker must be known in order to assess long-term risks for patients. Absorbed doses due to neutrons were computed by means of a method based on the use of the TRIPOLI code initially developed for reactor neutronic calculations. For this purpose, the human trunk was assimilated to an elliptical cylinder as proposed by Snyder et al. The results were compared with those obtained in other laboratories: data for surface doses for the pacemaker 9000 and the phantom are in good agreement with the results of Battelle Pacific Northwest Laboratory; contact doses for both models 9000 and 9090 are much similar to the results obtained using PLESCH's formula. The results show that absorbed doses at the level of the various organs, i.e. at fairly large distances, are little modified as a function of the pacemaker size, the source geometry remaining the same. However, contact doses may vary by a large factor (about 2) on account of the variation of distances to the source

  12. Sexual interactions influence the molecular oscillations in DN1 pacemaker neurons in Drosophila melanogaster.

    Science.gov (United States)

    Hanafusa, Shiho; Kawaguchi, Tomoaki; Umezaki, Yujiro; Tomioka, Kenji; Yoshii, Taishi

    2013-01-01

    Circadian rhythms can synchronize to environmental time cues, such as light, temperature, humidity, and food availability. Previous studies have suggested that these rhythms can also be entrained by social interactions. Here, we used Drosophila melanogaster as a model to study the influence of socio-sexual interactions on the circadian clock in behavior and pacemaker neurons. If two flies of opposite sex were paired and kept in a small space, the daily activity patterns of the two flies were clearly different from the sum of the activity of single male and female flies. Compared with single flies, paired flies were more active in the night and morning, were more active during females' active phase, and were less active during males' active phase. These behavioral phenotypes are related to courtship behavior, but not to the circadian clock. Nevertheless, in male-female pairs of flies with clocks at different speeds (wild-type and per (S) flies), clock protein cycling in the DN1 pacemaker neurons in the male brain were slightly influenced by their partners. These results suggest that sexual interactions between male-female couples can serve as a weak zeitgeber for the DN1 pacemaker neurons, but the effect is not sufficient to alter rhythms of behavioral activity. PMID:24367668

  13. 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.

  14. 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

  15. 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

  16. Antidepressant chronotherapeutics for bipolar depression.

    Science.gov (United States)

    Benedetti, Francesco

    2012-12-01

    Chronotherapeutics refers to treatments based on the principles of circadian rhythm organization and sleep physiology, which control the exposure to environmental stimuli that act on biological rhythms, in order to achieve therapeutic effects in the treatment of psychiatric conditions. It includes manipulations of the sleep-wake cycle such as sleep deprivation and sleep phase advance, and controlled exposure to light and dark. The antidepressant effects of chronotherapeutics are evident in difficult-to-treat conditions such as bipolar depression, which has been associated with extremely low success rates of antidepressant drugs in naturalistic settings and with stable antidepressant response to chronotherapeutics in more than half of the patients. Recent advances in the study of the effects of chronotherapeutics on neurotransmitter systems, and on the biological clock machinery, allow us to pinpoint its mechanism of action and to transform it from a neglected or "orphan" treatment to a powerful clinical instrument in everyday psychiatric practice. PMID:23393416

  17. 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

  18. 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%.

  19. Characteristics of pulsed heavy ion beam generated in bipolar pulse accelerator

    International Nuclear Information System (INIS)

    We have developed a new type of a pulsed ion beam accelerator named 'bipolar pulse accelerator' for improvement of the purity of the intense pulsed ion beam. The system utilizes a magnetically insulated accelerate on gap and was operated with the bipolar pulse. A coaxial gas puff plasma gun was used as an ion source, which was placed inside of the grounded anode. Source plasma (nitrogen) of current density of ≈30 A/cm2 and pulse duration of ≈1.0 μs was injected into the acceleration gap. When the bipolar pulse of -114 kV, 70 ns (1st pulse) and 85 kV, 62 ns (2nd pulse) was applied to the drift tube, the ions were successfully accelerated from the grounded anode to the drift tube in the 1st gap by the negative pulse of the bipolar pulse. The pulsed ion beam with current density of 60 A/cm2 and pulse duration of ≈50 ns was obtained at 48 mm downstream from the anode surface. The energy spectrum of the ion beam was evaluated by a magnetic energy spectrometer. The ion energy was in reasonable good agreement with the acceleration voltage, i.e., 1st pulse (negative pulse) voltage of the bipolar pulse. (author)

  20. 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.

  1. Ni-based amorphous alloy-coating for bipolar plate of PEM fuel cell by electrochemical plating

    International Nuclear Information System (INIS)

    In this study, the Ni-Cr-P amorphous alloy-coated bipolar plates were produced by electro-plating on the Cu base plates with a flow field. The power generation tests of a single fuel cell with those Ni-Cr-P bipolar plates were conducted at 353 K. It was found that the single fuel cell with those Ni-Cr-P bipolar plates showed excellent I-V performance as well as that with the carbon graphite bipolar plates. It was also found that the single cell with those Ni-Cr-P bipolar plates showed better I-V performance than that with the Ni-P amorphous alloy-coated bipolar plates. Furthermore, the long-time operation test was conducted for 440 h with those Ni-Cr-P bipolar plates at the constant current density of 200 mA·cm−2. As a result, it was found that the cell voltage gradually decreased at the beginning of the measurement before 300 h and then the voltage was kept constant after 300 h.

  2. Cognitive dysfunction in bipolar disorder and schizophrenia

    DEFF Research Database (Denmark)

    Bortolato, Beatrice; Miskowiak, Kamilla W; Köhler, Cristiano A;

    2015-01-01

    Cognitive impairment is a core feature of schizophrenia (SZ) and bipolar disorder (BD). A neurocognitive profile characterized by widespread cognitive deficits across multiple domains in the context of substantial intellectual impairment, which appears to antedate illness onset, is a replicated...

  3. 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...... survey. 81% of the patients used the Internet, a percentage similar to the general public. Older age, less education, and challenges in country telecommunications infrastructure and demographics decreased the odds of using the Internet. About 78% of the Internet users looked online for information...... 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...

  4. 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

  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) or...

  6. Undiagnosed Bipolar Disorders in Patients with Major Depressive Episode: Iran's part of a Multicenter Cross-Sectional Study

    OpenAIRE

    Seyed Ali Ahmadi Abhari; Majid Sadeghi; Seyed Mehdi Samimi Ardestani; Yousef Semnani; Gholamreza Mirsepassi; Seyed Saeed Sadr; Atefe Kamaloo; Morvarid Ahadi; Behin Pourmirza; Elham Mir

    2013-01-01

    Objective: Bipolar spectrum disorders may often go undiagnosed or unrecognized. The aim of this study was to determine the proportion of bipolar disorder symptoms in Iranian patients with a major depressive episode.Methods: 313 patients with a current DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders 4th ed. Text rev.) diagnosed with a major depressive episode entered this cross-sectional study. Thirty two items revised Hypomania/ mania Symptoms Checklist (HCL-32) was used to d...

  7. Assessment of Response to Lithium Maintenance Treatment in Bipolar Disorder: A Consortium on Lithium Genetics (ConLiGen) Report

    OpenAIRE

    Manchia, Mirko; Adli, Mazda; Akula, Nirmala; Ardau, Raffaella; Aubry, Jean-Michel; Backlund, Lena; Banzato, Claudio Em; Bernhard T. Baune; Bellivier, Frank; Bengesser, Susanne; Biernacka, Joanna M; Brichant-Petitjean, Clara; Bui, Elise; Calkin, Cynthia V.; Cheng, Andrew Tai Ann

    2013-01-01

    Objective: The assessment of response to lithium maintenance treatment in bipolar disorder (BD) is complicated by variable length of treatment, unpredictable clinical course, and often inconsistent compliance. Prospective and retrospective methods of assessment of lithium response have been proposed in the literature. In this study we report the key phenotypic measures of the “Retrospective Criteria of Long-Term Treatment Response in Research Subjects with Bipolar Disorder” scale currently us...

  8. 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...

  9. 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...

  10. 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 ...

  11. 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

  12. SU-D-18C-06: Initial Experience with Implementing MRI Safety Guidelines for Patients with Pacemakers - Medical Physicist Perspective

    International Nuclear Information System (INIS)

    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

  13. 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

  14. 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...

  15. 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...

  16. Long-term Treatment in Bipolar Disorder

    OpenAIRE

    Meliha Zengin Eroglu; Nurgul Ozpoyraz

    2010-01-01

    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 ...

  17. QUALITY OF LIFE IN BIPOLAR DISORDER

    OpenAIRE

    Nieznańska, Anna; Baron, Urszula; Jaracz, Krystyna

    2014-01-01

    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 w...

  18. Behavioral Treatment of Insomnia in Bipolar Disorder

    OpenAIRE

    Kaplan, Katherine A; Harvey, Allison G.

    2013-01-01

    Sleep disturbance is common in bipolar disorder. Stimulus control and sleep restriction are powerful, clinically useful behavioral interventions for insomnia, typically delivered as part of cognitive-behavioral therapy for insomnia (CBT-I). Both involve short-term sleep deprivation. The potential for manic or hypomanic symptoms to emerge after sleep deprivation in bipolar disorder raises questions about the appropriateness of these methods for treating insomnia. In a series of patients with b...

  19. A Review of Bipolar Disorder in Adults

    OpenAIRE

    Hilty, Donald M; Leamon, Martin H.; Lim, Russell F.; Kelly, Rosemary H.; Hales, Robert E.

    2006-01-01

    Objective: This article reviews the epidemiology, etiology, assessment, and management of bipolar disorder. Special attention is paid to factors that complicate treatment, including nonadherence, comorbid disorders, mixed mania, and depression. Methods: A Medline search was conducted from January of 1990 through December of 2005 using key terms of bipolar disorder, diagnosis, and treatment. Papers selected for further review included those published in English in peer-reviewed journals, with ...

  20. 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...

  1. Bipolar cautery forceps: An economical version

    OpenAIRE

    Appukuttan Aswin; Jagadeesh S

    2007-01-01

    Context: Bipolar cautery forceps are an expensive instrument and especially in Government Medical colleges and Government Hospitals, getting a pair is a very tedious and prolonged task due to official reasons. Aims: To make a cheap and easily obtainable bipolar cautery forceps. Settings and Design: The reason for innovation was that the cautery forceps in the department were out of order and we were not getting replacements. Materials and Methods: Made from condemned and damaged forcep...

  2. 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...

  3. Bipolar spectrum: Relevant psychological and biological factors

    OpenAIRE

    Terao, Takeshi

    2012-01-01

    The bipolar spectrum is a concept which bridges bipolar I disorder and unipolar depression. As Kraepelin described, there may be continuity across mood disorders. If this is the case, why should we discriminate for drug choice For example, it is generally accepted that mood stabilizers should be used for the bipolar spectrum, whereas antidepressants are for unipolar depression. If these disorders are diagnostically continuous, it is possible that the same drug could be effective in treating b...

  4. 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

  5. Bipolar II compared with bipolar I disorder: baseline characteristics and treatment response to quetiapine in a pooled analysis of five placebo-controlled clinical trials of acute bipolar depression

    OpenAIRE

    Datto, Catherine; Pottorf, William J.; Feeley, Louisa; LaPorte, Scott; Liss, Charlie

    2016-01-01

    Background Bipolar I and II represent the most common and severe subtypes of bipolar disorder. Although bipolar I disorder is relatively well studied, the clinical characteristics and response to treatment of patients with bipolar II disorder are less well understood. Methods To compare the severity and burden of illness of patients with bipolar II versus bipolar I disorder, baseline demographic, clinical, and quality of life data were examined in 1900 patients with bipolar I and 973 patients...

  6. Bipolar Conductance Switching of Single Anthradithiophene Molecules.

    Science.gov (United States)

    Borca, Bogdana; Schendel, Verena; Pétuya, Rémi; Pentegov, Ivan; Michnowicz, Tomasz; Kraft, Ulrike; Klauk, Hagen; Arnau, Andrés; Wahl, Peter; Schlickum, Uta; Kern, Klaus

    2015-12-22

    Single molecular switches are basic device elements in organic electronics. The pentacene analogue anthradithiophene (ADT) shows a fully reversible binary switching between different adsorption conformations on a metallic surface accompanied by a charge transfer. These transitions are activated locally in single molecules in a low-temperature scanning tunneling microscope . The switching induces changes between bistable orbital structures and energy level alignment at the interface. The most stable geometry, the "off" state, which all molecules adopt upon evaporation, corresponds to a short adsorption distance at which the electronic interactions of the acene rings bend the central part of the molecule toward the surface accompanied by a significant charge transfer from the metallic surface to the ADT molecules. This leads to a shift of the lowest unoccupied molecular orbital down to the Fermi level (EF). In the "on" state the molecule has a flat geometry at a larger distance from the surface; consequently the interaction is weaker, resulting in a negligible charge transfer with an orbital structure resembling the highest occupied molecular orbital when imaged close to EF. The potential barrier between these two states can be overcome reversibly by injecting charge carriers locally into individual molecules. Voltage-controlled current traces show a hysteresis characteristic of a bipolar switching behavior. The interpretation is supported by first-principles calculations. PMID:26580569

  7. New perspectives on coping in bipolar disorder

    Directory of Open Access Journals (Sweden)

    Rodrigo Grassi-Oliveira

    2010-01-01

    Full Text Available Bipolar disorder (BD is a prevalent and highly disabling psychiatric condition. Despite the widely acknowledged importance of psychosocial interventions that involve a complex cognitive, behavioral, and biological process to help patients cope better with their illness, few studies have systematically evaluated coping in BD. Therefore, our objective was to examine recent developments in current research on coping in BD. Several studies have documented a strong association between BD and numerous neuroanatomical and neuropsychological abnormalities, particularly multiple episodes and longer durations of the disorder. The most marked effects of BD encompass brain areas involved in executive function, which may affect the mechanisms underlying an adequate selection of coping strategies. Thus, the ability of individuals to reduce their own stress burden is impaired, increasing vulnerability to stressful life events and negatively affecting the course of BD. Psychosocial interventions that focus on BD should be evaluated for their ability to improve coping abilities, and research on BD should consider neuropsychological impairment and cognitive-behavioral strategies for coping with stress.

  8. Thought Suppression in Patients With Bipolar Disorder

    Science.gov (United States)

    Miklowitz, David J.; Alatiq, Yousra; Geddes, John R.; Goodwin, Guy M.; Williams, J. Mark G.

    2010-01-01

    Suppression of negative thoughts has been observed under experimental conditions among patients with major depressive disorder (MDD) but has never been examined among patients with bipolar disorder (BD). Patients with BD (n = 36), patients with MDD (n = 20), and healthy controls (n = 20) completed a task that required unscrambling 6-word strings into 5-word sentences, leaving out 1 word. The extra word allowed the sentences to be completed in a negative, neutral, or “hyperpositive” (manic/goal-oriented) way. Participants completed the sentences under conditions of cognitive load (rehearsing a 6-digit number), reward (a bell tone), load and reward, or neither load nor reward. We hypothesized that patients with BD would engage in more active suppression of negative and hyperpositive thoughts than would controls, as revealed by their unscrambling more word strings into negative or hyperpositive sentences. Under conditions of load or reward and in the absence of either load or reward, patients with BD unscrambled more negative sentences than did controls. Under conditions of reward, patients with BD unscrambled more negative sentences than did patients with MDD. Patients with BD also reported more use of negative thought suppression than did controls. These group differences in negative biases were no longer significant when current mood states were controlled. Finally, the groups did not differ in the proportion of hyperpositive sentence completions in any condition. Thought suppression may provide a critical locus for psychological interventions in BD. PMID:20455608

  9. 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.

  10. 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.

  11. 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

  12. Attention and psychomotor functioning in bipolar depression.

    Science.gov (United States)

    Burdick, Katherine E; Gunawardane, Nisali; Goldberg, Joseph F; Halperin, Jeffrey M; Garno, Jessica L; Malhotra, Anil K

    2009-04-30

    The objective of this study was to assess psychomotor functioning and attention in individuals with bipolar disorder during the depressed phase of illness. Measures of attention and psychomotor functioning were administered to a sample of 24 bipolar I and II patients and a matched sample of healthy controls. Relative to the healthy controls, the bipolar sample demonstrated evidence of psychomotor slowing and revealed deficits on measures of effortful attention, yet demonstrated comparable performance on measures of automatic attention. In the bipolar sample, we detected significant correlations among measures of psychomotor functioning and some aspects of attention and a strong relationship between the severity of depression and psychomotor functioning, but no direct relationship between attention deficits and depressive symptomatology. These results suggest an attentional impairment during the depressed phase of bipolar disorder that may be specific to effortful processing, while automatic processes remain relatively intact. Associations among indices of attention deficits and psychomotor slowing may be indicative of similarities in the underlying neurobiology of these frequently co-occurring symptom domains in depressed individuals with bipolar disorder. PMID:19272656

  13. [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

  14. 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.

  15. 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...

  16. 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

  17. Tourette syndrome and bipolar disorder: Unique problems with pediatric comorbidity

    Directory of Open Access Journals (Sweden)

    Anjana Rao Kavoor

    2015-01-01

    Full Text Available Tourette syndrome and bipolar disorder are frequent comorbidities in pediatric age group. They provide a clinician with certain unique challenges. While on one hand the tics mask manifestation of affective symptomatology, the latter makes it difficult to elicit tics with certainty. Data suggest that they might share genetic and neurobiological basis and this is currently an area of extensive research. These clinical and biological overlaps provide grey areas in our understanding, which not only complicates the diagnosis, but also poses problems with management.

  18. 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

  19. 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.

  20. 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.