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Sample records for eocanthecona furcellata wolff

  1. A Comparison of Infectivity between Polyhedra of the Spodoptera litura Multiple Nucleopolyhedrovirus Before and After Passage Through the Gut of the Stink Bug, Eocanthecona furcellata

    OpenAIRE

    Gupta, R. K.; Gani, Mudasir; Jasrotia, P.; Srivastava, K.; Kaul, V.

    2014-01-01

    Infectivity of polyhedra of Spodoptera litura multiple nucleopolyhedrovirus before and after passage through the gut of the predatory stink bug, Eocanthecona furcellata Wolff (Hemiptera: Pentatomidae) was compared through field bioassay studies. Three sets of E. furcellata were used for bioassays and these were allowed to feed on a single meal of five third instar Oriental leaf worm, Spodoptera litura (Fabricius) (Lepidoptera: Noctuidae), that were infected with polyhedra before passage, afte...

  2. Linking Life Table and Predation Rate for Biological Control: A Comparative Study of Eocanthecona furcellata (Hemiptera: Pentatomidae) Fed on Spodoptera litura (Lepidoptera: Noctuidae) and Plutella xylostella (Lepidoptera: Plutellidae).

    Science.gov (United States)

    Tuan, Shu-Jen; Yeh, Chih-Chun; Atlihan, Remzi; Chi, Hsin

    2016-02-01

    To better understand the predator-prey relationship and to compare predation rates, we studied the life table and predation rate of the predator Eocanthecona furcellata Wolff (Hemiptera: Pentatomidae) when reared on two major crucifer pests, Spodoptera litura (F.) (Lepidoptera: Noctuidae) and Plutella xylostella L. (Lepidoptera: Plutellidae). The net reproductive rate, intrinsic rate of increase, finite rate, and net predation rates of E. furcellata reared on P. xylostella were 292.4 offspring, 0.1389 d(-1), 1.1490 d(-1), and 644.1 third instars of P. xylostella, respectively. These values are significantly higher than those reared on S. litura, i.e., 272.3 offspring, 0.1220 d(-1), 1.1298 d(-1), and 863.1 third instars of S. litura. To evaluate the predation potential of E. furcellata fed on P. xylostella and S. litura, we combined both the growth rate and predation rate to calculate the finite predation rate (ω); our results showed that E. furcellata is an effective predator of both S. litura (ω = 1.6029) and P. xylostella (ω = 1.4277). © The Authors 2015. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  3. A comparison of infectivity between polyhedra of the Spodoptera litura multiple nucleopolyhedrovirus before and after passage through the gut of the stink bug, Eocanthecona furcellata.

    Science.gov (United States)

    Gupta, R K; Gani, Mudasir; Jasrotia, P; Srivastava, K; Kaul, V

    2014-01-01

    Infectivity of polyhedra of Spodoptera litura multiple nucleopolyhedrovirus before and after passage through the gut of the predatory stink bug, Eocanthecona furcellata Wolff (Hemiptera: Pentatomidae) was compared through field bioassay studies. Three sets of E. furcellata were used for bioassays and these were allowed to feed on a single meal of five third instar Oriental leaf worm, Spodoptera litura (Fabricius) (Lepidoptera: Noctuidae), that were infected with polyhedra before passage, after passage, and healthy (control) larvae 1 day prior to the trial. The predators were subsequently released on cabbage plants that were infested with 100 healthy S. litura larvae. The median lethal dose (LD50) and survival time (ST50) values before and after passage through the gut were not significantly different. Additional mortality due to virus infection increased 13- 17% before and after treatments but within these treatments the mortality did not vary significantly. It was concluded that E. furcellata disseminated the virus through their feces into the ecosystem and infectivity of the SpltMNPV was not altered after passage through the gut of the predator. This is an open access paper. We use the Creative Commons Attribution 3.0 license that permits unrestricted use, provided that the paper is properly attributed.

  4. Wolff-Parkinson-White Syndrome and Accessory Pathways

    Science.gov (United States)

    ... the American Heart Association Cardiology Patient Page Wolff-Parkinson-White Syndrome and Accessory Pathways James Kulig , Bruce ... rate, which can be dangerous. What is Wolff-Parkinson-White Syndrome? Wolff-Parkinson-White syndrome (WPW) is ...

  5. Overset Wolff-Parkinson-White-syndrom

    DEFF Research Database (Denmark)

    Nielsen, Trine Skov; Dalager, Søren; Larsen, Maiken Kudahl

    2010-01-01

    An autopsy in a 28-year-old man did not explain the cause of sudden unexpected death. However, a history of episodes with tachycardia and dizziness and a reassessed previous electrocardiogram exhibiting ventricular pre-excitation was consistent with Wolff-Parkinson-White (WPW) syndrome. In this p......An autopsy in a 28-year-old man did not explain the cause of sudden unexpected death. However, a history of episodes with tachycardia and dizziness and a reassessed previous electrocardiogram exhibiting ventricular pre-excitation was consistent with Wolff-Parkinson-White (WPW) syndrome...

  6. Overset Wolff-Parkinson-White-syndrom

    DEFF Research Database (Denmark)

    Nielsen, Trine Skov; Dalager, Søren; Larsen, Maiken Kudahl

    2010-01-01

    An autopsy in a 28-year-old man did not explain the cause of sudden unexpected death. However, a history of episodes with tachycardia and dizziness and a reassessed previous electrocardiogram exhibiting ventricular pre-excitation was consistent with Wolff-Parkinson-White (WPW) syndrome...

  7. Wolff-Parkinson-White syndrome in infants.

    Science.gov (United States)

    Hermosura, Tisha; Bradshaw, Wanda T

    2010-01-01

    Wolff-Parkinson-White (WPW) syndrome is a ventricular preexcitation that presents as supraventricular tachycardia. Health care professionals can attain optimal results in caring for infants with WPW syndrome by understanding both its pathophysiology and proper management to prevent and treat complications associated with it. This article reviews the prevalence, pathophysiology, clinical manifestations, diagnostic modalities, assessment, and management of WPW syndrome.

  8. The Wolff rearrangement in radical cations

    International Nuclear Information System (INIS)

    Ohashi, Mamoru; Tsujimoto, Kazuo; Shida, Yasuo; Yamada, Yasuji.

    1975-01-01

    The mass spectrometric behavior of 1-phenyl-4,5,6,7-tetrahydrobenzotriazole and its seven membered analog is described. The principal fragmentation process of the molecular ions is loss of nitrogen. It was concluded from the results of deuterium labeling and accurate mass measurements that the subsequent fragmentation of the M-N 2 ions proceeds via isomerization to the ring-contracted ketenimine ions by the Wolff rearrangement, in sharp contrast to the case of 1-phenylbenzotriazole. (auth.)

  9. Responding to Robert Wolff's In Defense of Anarchism Emmanuel ...

    African Journals Online (AJOL)

    ANDCORPgh changing the world

    issues the “command” functions merely as the occasion for my ... Wolff begins with the fundamental assumption in moral philosophy that ..... by selfish political leaders (cited by Reiman himself) that the business of politics is power. .... Wolff after Reiman), William Edmundson (1998) considers the anarchist objection to.

  10. The Ultrafast Wolff Rearrangement in the Gas Phase

    Science.gov (United States)

    Steinbacher, Andreas; Roeding, Sebastian; Brixner, Tobias; Nuernberger, Patrick

    The Wolff rearrangement of gas-phase 5-diazo Meldrum's acid is disclosed with femtosecond ion spectroscopy. Distinct differences are found for 267 nm and 200 nm excitation, the latter leading to even two ultrafast rearrangement reactions.

  11. Wolff-Parkinson-White Syndrome: Electrocardiogram

    Directory of Open Access Journals (Sweden)

    Brianna Miner

    2016-09-01

    Full Text Available History of present illness: A 26-year-old male with no significant past medical history presented to the emergency department with palpitations. The patient experienced these symptoms five times before in his life, but they had self-resolved with squatting or raising his arms. He denied chest pain, shortness of breath, dizziness, syncope, or pre-syncope symptoms. He denied any recent illnesses, cough, chest pain, drug use, or infections. Significant findings: The initial EKG showed wide complex, irregular tachycardia > 200 bpm (EKG 1. Given the possibility of Wolff-Parkinson-White (WPW, procainamide was given to the patient. The patient’s heart rate responded and decreased to 120-140 bpm with narrowing of the QRS complex. A repeat EKG showed narrow complex tachycardia without P waves approximately 120 bpm (EKG 2. Once the procainamide infusion was complete, the patient had converted to sinus rhythm with a delta wave now apparent, consistent with WPW (EKG 3. Discussion: Wolff-Parkinson-White syndrome is a combination of the presence of a certain congenital accessory pathway (Bundle of Kent and episodes of tachyarrhythmia.1 The incidence is less than one percent of the general population,2 but it is associated with the risk of sudden cardiac death, making the diagnosis imperative. When examining a wide-based tachycardia, it is important to consider WPW when choosing medications for rate control or chemical cardioversion. The first EKG shows an example of atrial fibrillation with WPW. While procainamide blocks the accessory pathway, other drugs such as beta blockers and calcium channel blockers can inhibit the AV node resulting in increased use of the accessory pathway. This can worsen the tachyarrhythmia and potentially lead to ventricular fibrillation, ventricular tachycardia, or asystole.

  12. Who's afraid of the big bad Wolff?: "Wolff's law" and bone functional adaptation.

    Science.gov (United States)

    Ruff, Christopher; Holt, Brigitte; Trinkaus, Erik

    2006-04-01

    "Wolff's law" is a concept that has sometimes been misrepresented, and frequently misunderstood, in the anthropological literature. Although it was originally formulated in a strict mathematical sense that has since been discredited, the more general concept of "bone functional adaptation" to mechanical loading (a designation that should probably replace "Wolff's law") is supported by much experimental and observational data. Objections raised to earlier studies of bone functional adaptation have largely been addressed by more recent and better-controlled studies. While the bone morphological response to mechanical strains is reduced in adults relative to juveniles, claims that adult morphology reflects only juvenile loadings are greatly exaggerated. Similarly, while there are important genetic influences on bone development and on the nature of bone's response to mechanical loading, variations in loadings themselves are equally if not more important in determining variations in morphology, especially in comparisons between closely related individuals or species. The correspondence between bone strain patterns and bone structure is variable, depending on skeletal location and the general mechanical environment (e.g., distal vs. proximal limb elements, cursorial vs. noncursorial animals), so that mechanical/behavioral inferences based on structure alone should be limited to corresponding skeletal regions and animals with similar basic mechanical designs. Within such comparisons, traditional geometric parameters (such as second moments of area and section moduli) still give the best available estimates of in vivo mechanical competence. Thus, when employed with appropriate caution, these features may be used to reconstruct mechanical loadings and behavioral differences within and between past populations. Copyright 2006 Wiley-Liss, Inc.

  13. Wolff-Parkinson-White Syndrome Mimics a Conduction Disease

    Directory of Open Access Journals (Sweden)

    S. Marrakchi

    2014-01-01

    Full Text Available Background. It is important to recognise Wolff-Parkinson-White (WPW syndrome in electrocardiograms (ECG, as it may mimic ischaemic heart disease, ventricular hypertrophy, and bundle branch block. Recognising WPW syndrome allows for risk stratification, the identification of associated conditions, and the institution of appropriate management. Objective. The present case showed that electrophysiological study is indicated in patients with abnormal ECG and syncope. Case Report. A 40-year-old man with Wolff-Parkinson-White syndrome was presented to emergency with syncope. A baseline ECG was a complete right branch block and posterior left hemiblock. He was admitted to the cardiac care unit for pacemaker implantation. The atypical figure of complete right branch block and posterior left hemiblock was thought to be a “false positive” of conduction abnormality. But the long anterograde refractory period of the both accessory pathway and atrioventricular conduction may cause difficulty in diagnosing Wolff-Parkinson-White syndrome, Conclusion. A Wolff-Parkinson-White Syndrome may mimic a conduction disease. No reliable algorithm exists for making an ECG diagnosis of a preexcitation syndrome with conduction disorders. This can lead to diagnostic and therapeutic dilemmas in the context of syncope.

  14. Wolff-Parkinson-white syndrome mimics a conduction disease.

    Science.gov (United States)

    Marrakchi, S; Kammoun, I; Kachboura, S

    2014-01-01

    Background. It is important to recognise Wolff-Parkinson-White (WPW) syndrome in electrocardiograms (ECG), as it may mimic ischaemic heart disease, ventricular hypertrophy, and bundle branch block. Recognising WPW syndrome allows for risk stratification, the identification of associated conditions, and the institution of appropriate management. Objective. The present case showed that electrophysiological study is indicated in patients with abnormal ECG and syncope. Case Report. A 40-year-old man with Wolff-Parkinson-White syndrome was presented to emergency with syncope. A baseline ECG was a complete right branch block and posterior left hemiblock. He was admitted to the cardiac care unit for pacemaker implantation. The atypical figure of complete right branch block and posterior left hemiblock was thought to be a "false positive" of conduction abnormality. But the long anterograde refractory period of the both accessory pathway and atrioventricular conduction may cause difficulty in diagnosing Wolff-Parkinson-White syndrome, Conclusion. A Wolff-Parkinson-White Syndrome may mimic a conduction disease. No reliable algorithm exists for making an ECG diagnosis of a preexcitation syndrome with conduction disorders. This can lead to diagnostic and therapeutic dilemmas in the context of syncope.

  15. Caring for the Student with Wolff-Parkinson-White Syndrome

    Science.gov (United States)

    Prenni, Patricia G.

    2009-01-01

    Wolff-Parkinson-White syndrome is a cardiac condition in which an extra electrical pathway within the heart causes an abnormal increase in heart rate. It affects one to three people of every 1,000 people worldwide, occurring more often in males. Diagnosis usually occurs during young adulthood, so it is important for school nurses to be familiar…

  16. Genetics Home Reference: Wolff-Parkinson-White syndrome

    Science.gov (United States)

    ... Davis AM, Drago F, Janousek J, Klein GJ, Law IH, Morady FJ, Paul T, Perry JC, Sanatani S, Tanel RE. PACES/HRS expert consensus statement on the management of the asymptomatic young patient with a Wolff-Parkinson-White (WPW, ventricular preexcitation) electrocardiographic pattern: developed in ...

  17. Surgical cure ofthe Wolff-Parkinson-White syndrome a comparison ...

    African Journals Online (AJOL)

    Surgical cure ofthe Wolff-Parkinson-White syndrome a comparison oftwo techniques. u. o. VON OPPELL, R. N. SCOTT MILLAR, D. A. MILNE. TABLE!. Characteristics of WPW patients referred for surgical ablation of their aberrant atrioventricular pathways. Patient population and methods. We' retrospectively reviewed 19 ...

  18. Anaesthetic management of Wolff-Parkinson-White syndrome for hysterectomy

    Directory of Open Access Journals (Sweden)

    Sandeep Sahu

    2011-01-01

    Full Text Available Wolff-Parkinson-White syndrome (WPW is an uncommon cardiac disorder having an aberrant pathway between atria and ventricles. We are reporting a known case of WPW syndrome for hysterectomy under combined spinal epidural anaesthesia. Management of the present case is an important pearl to revisit management of WPW syndrome. The perioperative management should be tailored according to the nature of surgery and the clinical presentation of the patient.

  19. Relevance of collagen piezoelectricity to "Wolff's Law": a critical review.

    Science.gov (United States)

    Ahn, Andrew C; Grodzinsky, Alan J

    2009-09-01

    According to "Wolff's Law", bone is deposited and reinforced at areas of greatest stress. From a clinical perspective, this "law" is supported by the strong association between bone density and physical activity. From a mechanistic standpoint, however, the law presents a challenge to scientists seeking to understand how osteocytes and osteoblasts sense the mechanical load. In the 1960s, collagen piezoelectricity was invoked as a potential mechanism by which osteocytes could detect areas of greater stress but piezoelectricity diminished in importance as more compelling mechanisms, such as streaming potential, were identified. In addition, accumulating evidence for the role of fluid-related shear stress in osteocyte's mechanosensory function has made piezoelectricity seemingly more obsolete in bone physiology. This review critically evaluates the role of collagen piezoelectricity (if any) in Wolff's Law--specifically, the evidence regarding its involvement in strain-generated potentials, existing alternate mechanisms, the present understanding of bone mechanosensation, and whether piezoelectricity serves an influential role within the context of this newly proposed mechanism. In addition to reviewing the literature, this review generates several hypotheses and proposes future research to fully address the relevance of piezoelectricity in bone physiology.

  20. Wolff-Parkinson-White syndrome: lessons learnt and lessons remaining.

    Science.gov (United States)

    Benson, D Woodrow; Cohen, Mitchell I

    2017-01-01

    The Wolff-Parkinson-White pattern refers to the electrocardiographic appearance in sinus rhythm, wherein an accessory atrioventricular pathway abbreviates the P-R interval and causes a slurring of the QRS upslope - the "delta wave". It may be asymptomatic or it may be associated with orthodromic reciprocating tachycardia; however, rarely, even in children, it is associated with sudden death due to ventricular fibrillation resulting from a rapid response by the accessory pathway to atrial fibrillation, which itself seems to result from orthodromic reciprocating tachycardia. Historically, patients at risk for sudden death were characterised by the presence of symptoms and a shortest pre- excited R-R interval during induced atrial fibrillation Wolff-Parkinson-White pattern and availability of catheter ablation, there has been a need to identify risk among asymptomatic patients. Recent guidelines recommend invasive evaluation for such patients where pre-excitation clearly does not disappear during exercise testing. This strategy has a high negative predictive value only. The accuracy of this approach is under continued investigation, especially in light of other considerations: Patients having intermittent pre-excitation, once thought to be at minimal risk may not be, and the role of isoproterenol in risk assessment.

  1. Characterisation of three-dimensional mapping in Wolff-Parkinson-White syndrome with septal aneurysmal dyskinesis.

    Science.gov (United States)

    Okada, Seigo; Muneuchi, Jun; Origuchi, Hideki

    2018-01-01

    A 21-year-old man with Wolff-Parkinson-White syndrome and aneurysmal septal dyskinesis underwent radiofrequency catheter ablation of the accessory pathways. Before radiofrequency catheter ablation, the activation wavefront arose from the aneurysmal septum, whereas the propagation of the left ventricle was normalised after radiofrequency catheter ablation. These findings demonstrate the importance of the electro-mechanical interaction in patients with Wolff-Parkinson-White syndrome and ventricular dysfunction.

  2. How to maintain the oral health of a child with Wolff-Parkinson-White syndrome: a case report.

    Science.gov (United States)

    Petroniatis, Tsampikos; Ortu, Eleonora; Marchili, Nicola; Giannoni, Mario; Marzo, Giuseppe; Monaco, Annalisa

    2014-09-30

    Wolff-Parkinson-White syndrome is one of the most important disorders of the heart conduction system. It is caused by the presence of an abnormal accessory electrical conduction pathway between the atria and the ventricles. In the present report, we describe the correct oral health management of a 12-year-old Caucasian girl with Wolff-Parkinson-White syndrome. We successfully undertook the dental care of a girl with Wolff-Parkinson-White syndrome, which we describe here.

  3. Wolff-Parkinson-White syndrome: Implications for an anaesthesiologist

    Directory of Open Access Journals (Sweden)

    Vinaya Udaybhaskar

    2017-01-01

    Full Text Available Wolff-Parkinson-White (WPW syndrome is an electrical conduction abnormality of the heart that can induce potentially fatal arrhythmias at intermittent intervals. The induction and maintenance of general anaesthesia for a patient with WPW syndrome are risky due to the triggering capability of arrhythmias by various drugs and instrumentation. We hereby present the case of a 28-year-old male with previous cardiac illness, admitted for neurosurgical procedure, with drug-controlled WPW syndrome. The pre-operative optimisation, intraoperative scrutiny and vigil, along with readiness of standby medications and defibrillator made the ingress and egress from general anaesthesia uneventful. Thus, the potential dangers of WPW syndrome can be circumvented with watchful preparedness and meticulous monitoring.

  4. Asymptomatic Wolff-Parkinson-White Syndrome: Incidental EKG

    Directory of Open Access Journals (Sweden)

    Samer Assaf

    2017-07-01

    Full Text Available History of present illness: A 38-year-old male presents to the emergency department for a minor trauma evaluation after falling off a bicycle at a moderate rate of speed. The patient was not wearing a helmet when he hit his head with unknown loss of consciousness. Focused assessment with sonography for trauma (FAST exam and head computed tomography (CT were negative. Routine electrocardiogram (ECG showed sinus rhythm with pre-excitation indicative of Wolff-Parkinson-White Syndrome (WPW. The patient confirmed a previous diagnosis of WPW, but had not previously followed up with a cardiologist. Significant findings: The ECG shows slurred up-stroking of the QRS complexes characteristic of a delta wave. The PR interval is normal; however, the QT interval is greater than 110ms. Discussion: Wolff-Parkinson-White Syndrome (WPW is a frequently encountered macro-reentrant arrhythmia characterized by a shortened PR interval less than 120ms, prolonged QRS greater than 120ms with an up-stroking QRS complex (delta wave, and occasional ST abnormalities.1 The incidence is reported to be 0.9%-3% of the general population and most diagnoses are made on routine EKGs.2,3 WPW is thought to be caused by abnormalities of conduction through the accessory pathway, also known as the Bundle of Kent, causing premature excitation of the ventricles. The complications from WPW are supraventricular tachycardia, atrial arrhythmias, and ventricular fibrillation leading to sudden cardiac death.3 Approximately 40-50% of patients who die from sudden cardiac arrest associated with WPW were previously asymptomatic.4 Unfortunately, it is agreed that approximately 50% of patients with WPW are asymptomatic and unaware of their diagnosis.5 The definitive treatment for WPW is radiofrequency catheter ablation (RFCA. However, it comes with a low risk of complications including arrhythmias and death.6 For asymptomatic WPW, children are at the highest risk for ventricular arrhythmias while

  5. Medical image of the week: Wolff-Parkinson-White syndrome

    Directory of Open Access Journals (Sweden)

    Van Hook C

    2017-04-01

    Full Text Available No abstract available. Article truncated at 150 words. A 38-year-old man developed sustained rapid heart rate while rock climbing. The patient reported that he had experienced rare bouts of self-limited palpitations in the past. Blood pressure on arrival to the emergency department was 112/ 65 mm Hg. The patient’s initial EKG demonstrated a regular, narrow complex supraventricular tachycardia, with a rate of 232 (Figure 1. Intravenous adenosine was administered with no change in his rate or rhythm. The patient then received amiodarone by intravenous bolus, with subsequent conversion to sinus rhythm (Figure 2. Wolff-Parkinson-White (WPW syndrome is a congenital cardiac condition present in approximately 0.15% of the general population. WPW is characterized by the abnormal presence of conduction tissue that creates an accessory atrioventricular pathway and thus potentiates reentrant tachycardia (1. The classic resting EKG findings in WPW are: a shortened PR interval (less than 0.12 seconds, an indistinct initial upslope of the QRS complex (known as the …

  6. The use of echocardiography in Wolff-Parkinson-White syndrome.

    Science.gov (United States)

    Cai, Qiangjun; Shuraih, Mossaab; Nagueh, Sherif F

    2012-04-01

    Endocardial mapping and radiofrequency catheter ablation are well established modalities for the diagnosis and treatment of patients with Wolff-Parkinson-White (WPW) syndrome associated with tachyarrhythmias. However, the electrophysiologic techniques are invasive, require radiation exposure, and lack spatial resolution of cardiac structures. A variety of echocardiographic techniques have been investigated as a non-invasive alternative for accessory pathway localization. Conventional M-mode echocardiography can detect the fine premature wall motion abnormalities associated with WPW syndrome. However, it is unable to identify the exact site of accessory pathway with sufficient accuracy. 2D, 2D-guided M-mode, and 2D phase analysis techniques are limited by image quality and endocardial border definition. Various modalities of tissue Doppler echocardiography significantly increase the accuracy of left-sided accessory pathway localization to 80-90% even in patients with poor acoustic window. However, right-sided pathways remain a diagnostic challenge. Strain echocardiography by speckle tracking has recently been evaluated and appears promising. Different cardiac abnormalities have been detected by echocardiography in WPW patients. Patients with WPW syndrome and tachyarrhythmias have impaired systolic and diastolic function which improves after radiofrequency ablation. Echocardiography is useful in identifying patient with accessory pathway-associated left ventricular dyssynchrony and dysfunction who may benefit from ablation therapy. Transesophageal and intracardiac echocardiography have been used to guide ablation procedure. Ablation-related complications detected by routine echocardiography are infrequent, rarely clinically relevant, and of limited value.

  7. Molecular Pathogenesis of Familial Wolff-Parkinson-White Syndrome.

    Science.gov (United States)

    Licht, Miyamotoa

    2018-01-01

    Familial Wolff-Parkinson-White (WPW) syndrome is an autosomal dominant inherited disease and consists of a small percentage of WPW syndrome which exhibits ventricular pre-excitation by development of accessory atrioventricular pathway. A series of mutations in PRKAG2 gene encoding gamma2 subunit of 5'AMP-activated protein kinase (AMPK) has been identified as the cause of familial WPW syndrome. AMPK is one of the most important metabolic regulators of carbohydrates and lipids in many types of tissues including cardiac and skeletal muscles. Patients and animals with the mutation in PRKAG2 gene exhibit aberrant atrioventricular conduction associated with cardiac glycogen overload. Recent studies have revealed "novel" significance of canonical pathways leading to glycogen synthesis and provided us profound insights into molecular mechanism of the regulation of glycogen metabolism by AMPK. This review focuses on the molecular basis of the pathogenesis of cardiac abnormality due to PRKAG2 mutation and will provide current overviews of the mechanism of glycogen regulation by AMPK. J. Med. Invest. 65:1-8, February, 2018.

  8. Electrophysiological evaluation of Wolff-Parkinson-White Syndrome

    Science.gov (United States)

    Brembilla-Perrot, Beatrice

    2002-01-01

    Sudden death might complicate the follow-up of symptomatic patients with the Wolff-Parkinson-White syndrome (WPW) and might be the first event in patients with asymptomatic WPW. The risk of sudden death is increased in some clinical situations. Generally, the noninvasive studies are unable to predict the risk of sudden death correctly . The electrophysiological study is the best means to detect the risk of sudden death and to evaluate the nature of symptoms. Methods used to define the prognosis of WPW are well-defined. At first the maximal rate of conduction through the accessory pathway is evaluated; programmed atrial stimulation using 1 and 2 extrastimuli delivered at different cycle lengths is then used to determine the accessory pathway refractory period and to induce a supraventricular tachycardia. These methods should be performed in the control state and repeated in adrenergic situations either during exercise test or more simply during a perfusion of small doses of isoproterenol. The induction of an atrial fibrillation with rapid conduction through the accessory pathway (> 240/min in control state, > 300/min after isoproterenol) is the sign of a form of WPW at risk of sudden death. PMID:16951730

  9. Electrophysiological evaluation of Wolff-Parkinson-White Syndrome

    Directory of Open Access Journals (Sweden)

    Béatrice Brembilla-Perrot

    2002-10-01

    Full Text Available Sudden death might complicate the follow-up of symptomatic patients with the Wolff-Parkinson-White syndrome (WPW and might be the first event in patients with asymptomatic WPW. The risk of sudden death is increased in some clinical situations. Generally, the noninvasive studies are unable to predict the risk of sudden death correctly . The electrophysiological study is the best means to detect the risk of sudden death and to evaluate the nature of symptoms. Methods used to define the prognosis of WPW are well-defined. At first the maximal rate of conduction through the accessory pathway is evaluated; programmed atrial stimulation using 1 and 2 extrastimuli delivered at different cycle lengths is then used to determine the accessory pathway refractory period and to induce a supraventricular tachycardia. These methods should be performed in the control state and repeated in adrenergic situations either during exercise test or more simply during a perfusion of small doses of isoproterenol. The induction of an atrial fibrillation with rapid conduction through the accessory pathway (> 240/min in control state, > 300/min after isoproterenol is the sign of a form of WPW at risk of sudden death.

  10. Phase analysis in patients with Wolff-Parkinson-White syndrome

    International Nuclear Information System (INIS)

    Nakajima, Kenichi; Bunko, Hisashi; Tada, Akira; Taki, Junichi; Tonami, Norihisa

    1983-01-01

    Twenty-five patients with Wolff-Parkinson-White (WPW) syndrome who underwent surgical division of the accessory conduction pathway (ACP) were studied by gated blood pool studies and phase analyses. All of 11 patients with right cardiac type (R-type) had abnormal initial phase in the right ventricle (RV), while 10 out of 14 patients with left cardiac type (L-type) had initial phase in the left ventricle (LV). However, in 4 L-type patients, there were no significant differences in the initiation of both ventricular contractions. In 10 patients who had radionuclide studies before and after surgical division of the ACP, the ventricular contraction patterns were apparently changed and the abnormal wall motions induced by the presence of ACPs disappeared. These observations indicate that the abnormal initial contraction is associated with pre-excitation of WPW syndrome. Sensitivities to identify the side of preexcitation were 100% (11/11) for R-type and 71% (10/14) for L-type. However, regarding the detection of the precise site of ACP, the agreement was 48% (12/25). Therefore, as a method of preoperative study, it seemed difficult to identify the precise localization of the ACP by phase analysis alone. Phase analysis provided interesting informations and was useful for evaluating patients with WPW syndrome before and after surgery. (author)

  11. La systématique de l’esprit pratique chez Wolff, Kant, Fichte et Hegel

    OpenAIRE

    Siep, Ludwig

    2011-01-01

    En dépit des grands bouleversements systématiques dans la philosophie allemande du xviiie siècle, la continuité est étonnante, de Wolff à Hegel, pour ce qui concerne le contenu des doctrines sur la raison pratique. Une comparaison de ces doctrines chez Wolff, Kant, Fichte et Hegel peut révéler l’intention et les raisons pour lesquelles chacun de ces auteurs modifia la systématique des différentes facultés. À partir de Kant, autonomie et liberté deviennent les concepts directeurs permettant de...

  12. Wolff-Michael Roth's passibility: at the limits of the constructivist metaphor: a book review

    Science.gov (United States)

    Brendel, Michelle

    2014-12-01

    Wolff-Michael Roth deconstructs the preeminent role conceded to constructivism in Science Education and demonstrates how we learn and know through pain, suffering, love or passion. This review explores his book "Passibility: At the Limits of the Constructivist Metaphor" through the eyes of an outsider to the world of science education.

  13. Alternating Wolff-Parkinson-White syndrome associated with attack of angina

    International Nuclear Information System (INIS)

    Mangiafico, R.A.; Petralito, A.; Grimaldi, D.R.

    1990-01-01

    In a patient with Wolff-Parkinson-White syndrome and an inferior-posterior bypass tract, transient restoration of normal conduction occurred during an attack of angina. The ECG pattern of inferior posterior ischemia was present when the conduction was normal. Thallium scintigraphy showed a reversible posterolateral perfusion defect. The possible mechanisms for production of intermittent preexcitation are discussed

  14. Role of atrial fibrillation and atrioventricular conduction (including Wolff-Parkinson-White Syndrome) in sudden death

    NARCIS (Netherlands)

    Meijler, F.L.; Tweel, I. van der; Herbschleb, J.N.; Hauer, R.N.W.; Robles de Medina, E.O.

    A short refractory period of the accessory pathway is considered a major threat for sudden death in patients with Wolff-Parkinson-White syndrome and atrial fibrillation. RR interval and QRS signal analysis together with signal analysis of a bipolar high right atrial electrogram were obtained in six

  15. Alternating Wolff-Parkinson-White syndrome associated with attack of angina

    Energy Technology Data Exchange (ETDEWEB)

    Mangiafico, R.A.; Petralito, A.; Grimaldi, D.R. (Univ. of Catania (Italy))

    1990-07-01

    In a patient with Wolff-Parkinson-White syndrome and an inferior-posterior bypass tract, transient restoration of normal conduction occurred during an attack of angina. The ECG pattern of inferior posterior ischemia was present when the conduction was normal. Thallium scintigraphy showed a reversible posterolateral perfusion defect. The possible mechanisms for production of intermittent preexcitation are discussed.

  16. Normalization of reverse redistribution of thallium-201 with procainamide pretreatment in Wolff-Parkinson-White syndrome

    International Nuclear Information System (INIS)

    Nii, T.; Nakashima, Y.; Nomoto, J.; Hiroki, T.; Ohshima, F.; Arakawa, K.

    1991-01-01

    Stress thallium-201 myocardial perfusion imaging was performed in a patient with Wolff-Parkinson-White syndrome. Reverse redistribution phenomenon was observed in the absence of coronary artery disease. This seems to be the first report of normalization of this phenomenon in association with reversion of accessory pathway to normal atrioventricular conduction after pretreatment with procainamide

  17. Sudden death in a young competitive athlete with Wolff-Parkinson-White syndrome

    NARCIS (Netherlands)

    Wiedermann, C. J.; Becker, A. E.; Hopferwieser, T.; Mühlberger, V.; Knapp, E.

    1987-01-01

    The case history is documented of a young competitive athlete known to have the electrocardiographic pattern of the Wolff-Parkinson-White syndrome, but considered asymptomatic. On that basis competitive sport was not proscribed. In retrospect, he had experienced occasional tachycardias which were of

  18. SAFETY OF AMIODARONE USAGE IN PATIENTS WITH WOLFF-PARKINSON-WHITE SYNDROME AND ATRIAL FIBRILLATION

    Directory of Open Access Journals (Sweden)

    D. A. Kuzhel

    2010-01-01

    Full Text Available Amiodarone is one of the basic antiarrhytmic drugs for atrial fibrillation treatment. However application of amiodarone in patients with atrial fibrillation and Wolff-Parkinson-White syndrome can induce ventricular fibrillation. Amiodarone usage in these patients should be accompanied by readiness for performance of resuscitation. This is confirmed by clinical case presentation.

  19. Normalization of reverse redistribution of thallium-201 with procainamide pretreatment in Wolff-Parkinson-White syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Nii, T.; Nakashima, Y.; Nomoto, J.; Hiroki, T.; Ohshima, F.; Arakawa, K. (Fukuoka Univ. School of Medicine (Japan))

    1991-03-01

    Stress thallium-201 myocardial perfusion imaging was performed in a patient with Wolff-Parkinson-White syndrome. Reverse redistribution phenomenon was observed in the absence of coronary artery disease. This seems to be the first report of normalization of this phenomenon in association with reversion of accessory pathway to normal atrioventricular conduction after pretreatment with procainamide.

  20. Atrial flutter with 1:1 conduction in undiagnosed Wolff-Parkinson-White syndrome.

    Science.gov (United States)

    Nelson, Jessie G; Zhu, Dennis W

    2014-05-01

    Atrial flutter with 1:1 atrioventricular conduction via an accessory pathway is an uncommon presentation of Wolff-Parkinson-White syndrome not previously reported in the emergency medicine literature. Wolff-Parkinson-White syndrome, a form of ventricular preexcitation sometimes initially seen and diagnosed in the emergency department (ED), can present with varied tachydysrhythmias for which certain treatments are contraindicated. For instance, atrial fibrillation with preexcited conduction needs specific consideration of medication choice to avoid potential degeneration into ventricular fibrillation. We describe an adult female presenting with a very rapid, regular wide complex tachycardia successfully cardioverted in the ED followed by a normal electrocardiogram (ECG). Electrophysiology study confirmed atrial flutter with 1:1 conduction and revealed an accessory pathway consistent with Wolff-Parkinson-White syndrome, despite lack of ECG findings of preexcitation during sinus rhythm. Why should an emergency physician be aware of this? Ventricular tachycardia must be the first consideration in patients with regular wide complex tachycardia. However, clinicians should consider atrial flutter with 1:1 conduction related to an accessory pathway when treating patients with the triad of very rapid rate (>250 beats/min), wide QRS complex, and regular rhythm, especially when considering pharmacologic treatment. Emergency physicians also should be aware of electrocardiographically concealed accessory pathways, and that lack of delta waves does not rule out preexcitation syndromes such as Wolff-Parkinson-White syndrome. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. Wolff-Parkinson-White Syndrome in a Term Infant Presenting With Cardiopulmonary Arrest.

    Science.gov (United States)

    Hoeffler, Christina D; Krenek, Michele E; Brand, M Colleen

    2016-02-01

    Wolff-Parkinson-White syndrome is a congenital abnormality of the cardiac conduction system caused by the presence of an abnormal accessory electrical pathway between the atria and the ventricles. This can result in intermittent tachyarrhythmias such as supraventricular tachycardia. In rare occasions, sudden death may occur from atrial fibrillation with rapid ventricular conduction. Supraventricular tachycardia typically has a sudden onset and offset, classified as a paroxysmal arrhythmia. Because of the variable occurrence, Wolff-Parkinson-White syndrome may go undiagnosed in the immediate newborn period. To highlight arrhythmia as a possible cause of sudden decompensation in infants. The clinical presentation of this infant is complex and a number of potential diagnoses were considered. Preexcitation on electrocardiogram resulted in the diagnosis of Wolff-Parkinson-White syndrome. Nurses caring for infants should be alert to tachycardia and irregularities of the heart rate, including those in the prenatal history, and should report them for evaluation. While all parents should be taught to watch for signs of illness, parents of infants with Wolff-Parkinson-White have additional learning needs, including recognizing early signs and symptoms of heart failure.

  2. Wolff-Parkinson-White syndrome with cleft lip and palate: A rare, previously unreported association

    Directory of Open Access Journals (Sweden)

    K Kannan

    2008-01-01

    Full Text Available Wolff-Parkinson-White syndrome, also called Pre Excitation Syndrome, is characterized by an extra pathway that conducts the electrical impulses from the atria to the ventricles without the normal delay. We are reporting a case of WPW syndrome with a cleft lip and palate, which is a rare association and previously unreported in literature.

  3. Subjectivity and Cultural Adjustment in Mathematics Education: A Response to Wolff-Michael Roth

    Science.gov (United States)

    Brown, Tony

    2012-01-01

    In this volume, Wolff-Michael Roth provides a critical but partial reading of Tony Brown's book "Mathematics Education and Subjectivity". The reading contrasts Brown's approach with Roth's own conception of subjectivity as derived from the work of Vygotsky, in which Roth aims to "reunite" psychology and sociology. Brown's book, however, focuses on…

  4. Structural features of flower trichomes in drug eyebright (Euphrasia stricta D. Wolff EX J. F. Lehm.

    Directory of Open Access Journals (Sweden)

    Weronika Haratym

    2014-01-01

    Full Text Available Euphrasia stricta D. Wolff ex J. F. Lehm. (Orobanchaceae is a representative of plants that are widely used in folk medicine, phytomedicine, and homeopathy. The medicinal raw material derived from the drug eyebright is applied primarily in treatment of ophthalmic diseases. The investigations of trichomes in drug eyebright (Euphrasia stricta D. Wolff ex J. F. Lehm were conducted in 2010–2011. Using light microscopy and scanning electron microscopy, their location and morphological and anatomical features were identified. Three types of non-glandular trichomes were found: short unicellular, long 1–2 celled, and long 2-celled with wall ornamentation. Additionally, 7 types of glandular trichomes were found; these included: unicellular clavate, 2–3-celled clavate, capitate with a unicellular head and a 3-cel- led stalk, capitate with a unicellular head and a 2-celled stalk, capitate with a 2-celled head, conical papillae, and ribbon-like trichomes with wall thickening.

  5. Lymphocutaneous Sporotrichosis Treated with Potassium Iodide with Development of Subclinical Hypothyroidism: Wolff-Chaikoff Effect?

    Science.gov (United States)

    Arora, Pooja; Raihan, M; Kubba, Asha; Gautam, Ram K

    2017-01-01

    Sporotrichosis is a subcutaneous mycotic infection caused by Sporothrix schenckii that is acquired by traumatic implantation. The diagnosis is established by demonstration of fungal elements on histopathology and culture. Potassium iodide, azole antifungals, and terbinafine are the treatment options available. In this article, we report a 60-year-old female with lymphocutaneous sporotrichosis that responded well to potassium iodide. However, subclinical hypothyroidism (Wolff-Chaikoff effect) was encountered as a side effect of therapy which was managed with thyroxine replacement. Knowledge about the Wolff-Chaikoff effect (WCE) is important for the dermatologist and reinforces the need for screening and monitoring of thyroid stimulating hormone (TSH) in patients where long duration therapy is being planned.

  6. Multiple Cardiac Rhabdomyomas, Wolff-Parkinson-White Syndrome, and Tuberous Sclerosis: An Infrequent Combination

    Science.gov (United States)

    Castilla Cabanes, Elena; Lacambra Blasco, Isaac

    2014-01-01

    Cardiac rhabdomyomas are benign cardiac tumours and are often associated with tuberous sclerosis. They are often asymptomatic with spontaneus regresion but can cause heart failure, arrhythmias, and obstruction. There have also been a few isolated reports of Wolff-Parkinson-White syndrome occurring in association with tuberous sclerosis and the great majority has been detected in patients with concomitant rhabdomyomas. We report a 12-day-old infant girl with tuberous sclerosis who presented with intraparietal and intracavitary rhabdomyomas with a Wolff-Parkinson-White syndrome (WPW). She represents one of the few published cases of WPW syndrome and tuberous sclerosis and particularly interesting because of intramural rhabdomyomas regression with persistent intracavitary rhabdomyomas after two years of followup. PMID:25328743

  7. Multiple Cardiac Rhabdomyomas, Wolff-Parkinson-White Syndrome, and Tuberous Sclerosis: An Infrequent Combination

    Directory of Open Access Journals (Sweden)

    Elena Castilla Cabanes

    2014-01-01

    Full Text Available Cardiac rhabdomyomas are benign cardiac tumours and are often associated with tuberous sclerosis. They are often asymptomatic with spontaneus regresion but can cause heart failure, arrhythmias, and obstruction. There have also been a few isolated reports of Wolff-Parkinson-White syndrome occurring in association with tuberous sclerosis and the great majority has been detected in patients with concomitant rhabdomyomas. We report a 12-day-old infant girl with tuberous sclerosis who presented with intraparietal and intracavitary rhabdomyomas with a Wolff-Parkinson-White syndrome (WPW. She represents one of the few published cases of WPW syndrome and tuberous sclerosis and particularly interesting because of intramural rhabdomyomas regression with persistent intracavitary rhabdomyomas after two years of followup.

  8. Hypertrophic cardiomyopathy and Wolff-Parkinson-White Syndrome with complete auriculoventricular block. A strange association

    International Nuclear Information System (INIS)

    Vallejo, Franco J; Montana, Paula A; Vesga, Carlos; Miranda Antonio; Citelli Jose E; Negrete Alberto; Gil, Efrain

    2007-01-01

    A 22 years old male patient is admitted for a syncope episode. An electrocardiogram shows a Wolff-Parkinson-White pattern and signs of auricular overload with left ventricular hypertrophy and complete auriculoventricular block. The transthoracic echocardiogram is compatible with non-obstructive hypertrophic cardiomyopathy. An electrophysiological study is carried out, finding pre-excitation through an accessory way and infra-His auriculoventricular block. An ablation is performed and a bicameral pacemaker is implanted

  9. Wolff-Parkinson-White syndrome: a single exercise stress test might be misleading.

    Science.gov (United States)

    Salavitabar, Arash; Silver, Eric S; Liberman, Leonardo

    2017-05-01

    Risk stratification of patients with Wolff-Parkinson-White syndrome for sudden death is a complex process, particularly in understanding the utility of the repeat exercise stress test. We report a case of an 18-year-old patient who was found to have a high-risk pathway by both invasive and exercise stress testing after an initial exercise stress test showing beat-to-beat loss of pre-excitation.

  10. Syndrome and Phenomenon of Wolff — Parkinson — White in Children (Literature Review

    Directory of Open Access Journals (Sweden)

    N.V. Nagornaya

    2013-03-01

    Full Text Available The article deals with the data on the history of the discovery and study of the phenomenon and syndrome Wolff — Parkinson — White (WPW. The features of the anatomy and electrophysiology of additional ways, mechanisms of attacks of atrioventricular reentrant tachycardia in WPW syndrome are considered. The role of the standard ECG, methods for topical analysis of additional atrioventricular connections and non-invasive electrophysiological studies in the diagnosis of this disease is shown.

  11. Noninvasive risk stratification for sudden death in asymptomatic patients with Wolff-Parkinson-White syndrome.

    Science.gov (United States)

    Novella, John; DeBiasi, Ralph M; Coplan, Neil L; Suri, Ranji; Keller, Seth

    2014-01-01

    Sudden cardiac death (SCD) as the first clinical manifestation of Wolff-Parkinson-White (WPW) syndrome is a well-documented, although rare occurrence. The incidence of SCD in patients with WPW ranges from 0% to 0.39% annually. Controversy exists regarding risk stratification for patients with preexcitation on surface electrocardiogram (ECG), particularly in those who are asymptomatic. This article focuses on the role of risk stratification using exercise and pharmacologic testing in patients with WPW pattern on ECG.

  12. Malignant vasovagal syndrome in two patients with Wolff-Parkinson-White syndrome

    Science.gov (United States)

    Gandhi, N M; Bennett, D H

    2004-01-01

    The presence of Wolff-Parkinson-White (WPW) syndrome in patients presenting with syncope suggests that tachyarrhythmia may be the cause. However, the symptoms require careful evaluation. Two young patients presented with syncope and were found to have WPW syndrome on their ECG. In both patients symptoms were suggestive of vasovagal syncope. During tilt testing, both the patients developed their typical symptoms with a fall in blood pressure and heart rate confirming the diagnosis of malignant vasovagal syndrome. PMID:15020537

  13. Prophylactic accessory-pathway ablation in asymptomatic patients with a Wolff-Parkinson-White electrocardiographic pattern.

    Science.gov (United States)

    Ozenc, S; Iscen, S; Kibrisli, E; Tok, D; Parlak, A; Altinel, O; Altinel, S

    2014-01-01

    The optimal approach is controversial in asymptomatic patients who are coincidentally found to have evidence of an accessory pathway (AP) on an ECG. The risk of sudden cardiac death (SCD) is low, and the risk of developing symptoms also appears to be low, although a wide range of incidences have been reported. In our trial, we tested the hypothesis that if prophylactic accessory-pathway ablation performed at the time of the initial electrophysiological testing would improve the long-term outcome in asymptomatic patients with a Wolff-Parkinson-White electrocardiographic pattern. Recruitment of patients began on February 1, 2004, and ended on February 5, 2009. All 110 asymptomatic patients were hospitalized and underwent electrophysiological testing the same day to assess the inducibility of atrioventricular reciprocating tachycardia. The anterograde effective refractory period of the accessory pathway was defined as the longest coupling interval at which anterograde block in the bypass tract was observed. For the statistical analysis, the statistical software SPSS version 15.0 for Windows (SPSS Inc., Chicago, IL, USA). Of 110 asymptomatic patients with a Wolff-Parkinson-White electrocardiographic pattern, 80 patients were ablated. Ablation group consisted of these patients. Control group consisted of remaining 30 and were divided into two groups according to the anterograde effective refractory period of the accessory pathway. There was no significant difference between three groups in terms of arrhythmic events (p: 0.58). Asymptomatic patients with the Wolff-Parkinson-White syndrome do not require prophylactic ablation, since they remain asymptomatic for many years.

  14. Natural history of Wolff-Parkinson-White syndrome diagnosed in childhood.

    Science.gov (United States)

    Cain, Nicole; Irving, Claire; Webber, Steven; Beerman, Lee; Arora, Gaurav

    2013-10-01

    Wolff-Parkinson-White (WPW) syndrome carries a risk for symptomatic arrhythmias and sudden death. The aim of this study was to examine the natural history of patients with Wolff-Parkinson-White syndrome diagnosed in childhood followed longitudinally at a single institution. The study population consisted of 446 patients. The median age of diagnosis was 7 years, and 61% were male. Associated heart disease was present in 40 patients (9%). Modes of presentation included supraventricular tachycardia (38%), palpitations (22%), chest pain (5%), syncope (4%), atrial fibrillation (0.4%), sudden death (0.2%), and incidental findings (26%); data were unavailable in 4%. During the study period, a total of 243 patients (54%) had supraventricular tachycardia, and 7 patients (1.6%) had atrial fibrillation. Of patients who presented at ≤3 months of age, 35% had resolution of manifest preexcitation compared with 5.8% who presented at >3 months of age (p Wolff-Parkinson-White syndrome diagnosed in childhood, 64% had symptoms at presentation, and an additional 20% developed symptoms during follow-up. There were 6 sudden deaths (1.3%), with an overall incidence of 1.1 per 1,000 patient-years in patients with structurally normal hearts and 27 per 1,000 patient-years in patients with associated heart disease. Copyright © 2013 Elsevier Inc. All rights reserved.

  15. Spinal Anaesthesia is Safe in a Patient with Wolff-Parkinson-White Syndrome Undergoing Evacuation of Molar Pregnancy.

    Science.gov (United States)

    Deviseti, Pravalika; Pujari, Vinayak S

    2016-02-01

    Wolff-Parkinson-White (WPW) syndrome is an uncommon cardiac condition where there is an abnormal band of atrial tissue connecting atria and ventricles which can electrically bypass atrioventricular node. The anaesthetic management in these patients is challenging as life threatening complications can occur perioperatively like paroxysmal supraventricular tachycardia and atrial fibrillation. Also, regional anaesthetic technique like subarachnoid block is a safe and cost effective alternative to general anaesthesia as it avoids polypharmacy. We report the successful anaesthetic management of Wolff Parkinson White syndrome in a primi with hydatiform mole posted for suction and evacuation.

  16. Wolff-Parkinson-White syndrome concomitant with idiopathic ventricular fibrillation associated with inferior early repolarization.

    Science.gov (United States)

    Takahashi, Naohiko; Shinohara, Tetsuji; Hara, Masahide; Saikawa, Tetsunori

    2012-01-01

    We encountered a 39-year-old man with documented ventricular fibrillation (VF). His ECGs showed intermittent Wolff-Parkinson-White (WPW) syndrome pattern. During electrophysiological study, no ventricular preexcitation was observed. An accessory pathway located at the posterior mitral annulus was identified, and successfully eliminated by radiofrequency catheter ablation. VF was not induced. His ECGs in the absence of delta waves demonstrated early repolarization in the inferior leads. This case raises the possibility that patients with manifest WPW syndrome may have an arrhythmogenic substrate associated with early repolarization, and the characteristic J waves can be masked by the presence of ventricular preexcitation.

  17. Coexistent Brugada Syndrome and Wolff-Parkinson-White Syndrome: What is the Optimal Management?

    Directory of Open Access Journals (Sweden)

    Abhishek Jaiswal, MBBS

    2013-09-01

    Full Text Available Coexistent Brugada syndrome and Wolff-Parkinson-White (WPW syndrome is rare, and as such poses management challenges. The overlap of symptoms attributable to each condition, the timing of ventricular stimulation after accessory pathway ablation and the predictive value of programmed stimulation in Brugada syndrome are controversial. We describe a case of coexistent Brugada syndrome and WPW syndrome in a symptomatic young adult. We discuss our treatment approach and the existing literature along with the challenges in management of such cases.

  18. Accuracy of algorithms to predict accessory pathway location in children with Wolff-Parkinson-White syndrome.

    Science.gov (United States)

    Wren, Christopher; Vogel, Melanie; Lord, Stephen; Abrams, Dominic; Bourke, John; Rees, Philip; Rosenthal, Eric

    2012-02-01

    The aim of this study was to examine the accuracy in predicting pathway location in children with Wolff-Parkinson-White syndrome for each of seven published algorithms. ECGs from 100 consecutive children with Wolff-Parkinson-White syndrome undergoing electrophysiological study were analysed by six investigators using seven published algorithms, six of which had been developed in adult patients. Accuracy and concordance of predictions were adjusted for the number of pathway locations. Accessory pathways were left-sided in 49, septal in 20 and right-sided in 31 children. Overall accuracy of prediction was 30-49% for the exact location and 61-68% including adjacent locations. Concordance between investigators varied between 41% and 86%. No algorithm was better at predicting septal pathways (accuracy 5-35%, improving to 40-78% including adjacent locations), but one was significantly worse. Predictive accuracy was 24-53% for the exact location of right-sided pathways (50-71% including adjacent locations) and 32-55% for the exact location of left-sided pathways (58-73% including adjacent locations). All algorithms were less accurate in our hands than in other authors' own assessment. None performed well in identifying midseptal or right anteroseptal accessory pathway locations.

  19. Patient with Wolff-Parkinson-White syndrome with intermittent pre-excitation under subarachnoid block for urological surgery

    Directory of Open Access Journals (Sweden)

    Rakesh Garg

    2011-01-01

    Full Text Available Wolff-Parkinson-White (WPW syndrome is one of the pre-excitation syndromes in which activation of an accessory atrioventricular (AV conduction pathway leads to bypass the AV node and cause earlier ventricular activation than the normal pathway. We report a patient with intermittent WPW syndrome who repeatedly manifested pre-excitation after subarachnoid block.

  20. Wolff-Parkinson-White Syndrome and Rheumatic Mitral Stenosis: an Uncommon Coincidence that can Cause Severe Hemodynamic Disturbance

    Directory of Open Access Journals (Sweden)

    Ahmet Taha Alper

    2008-11-01

    Full Text Available The combination of rheumatic mitral stenosis and Wolff-Parkinson-White syndrome is a rare situation. In this case, we are reporting an 72-year-old man presenting with multi-organ failure due to the this combination and successfully treated with radiofrequency ablation during preexcitated atrial fibrillation.

  1. Patient with Wolff-Parkinson-White syndrome with intermittent pre-excitation under subarachnoid block for urological surgery

    Science.gov (United States)

    Garg, Rakesh; Sinha, Renu; Nishad, PK

    2011-01-01

    Wolff-Parkinson-White (WPW) syndrome is one of the pre-excitation syndromes in which activation of an accessory atrioventricular (AV) conduction pathway leads to bypass the AV node and cause earlier ventricular activation than the normal pathway. We report a patient with intermittent WPW syndrome who repeatedly manifested pre-excitation after subarachnoid block. PMID:21712875

  2. Digital 3D reconstruction of two parahissian accessory bundles in a case of Wolff-Parkinson White syndrome

    NARCIS (Netherlands)

    Steffen, C.; Schaepman, M.E.; Hardmeier, T.; Schweitzer, W.

    2004-01-01

    Three-dimensional reconstruction of digitized histological serial sections of the cardiac conduction system yielded two accessory pathways in a case of a 24-day-old male infant who died after a short period of illness with ECG findings of Wolff-Parkinson-White syndrome. In infants, the differential

  3. Probable association of tachyarrhythmia with nebulized albuterol in a child with previously subclinical wolff Parkinson white syndrome

    NARCIS (Netherlands)

    Kroesen, M.; Maseland, M.; Smal, J.; Reimer, A.; van Setten, P.

    2012-01-01

    We present the case of a 2-year-old asthmatic boy with atrioventricular (AV)-reentry tachycardia following albuterol inhalation, who was later diagnosed with Wolff-Parkinson-White (WPW) syndrome. The Naranjo adverse drug reaction probability scale score for this adverse event was 7, indicating that

  4. Wolff-Parkinson-White Syndrome and Rheumatic Mitral Stenosis: an Uncommon Coincidence that can Cause Severe Hemodynamic Disturbance

    Science.gov (United States)

    Alper, Ahmet Taha; Hasdemir, Hakan; Akyol, Ahmet

    2008-01-01

    The combination of rheumatic mitral stenosis and Wolff-Parkinson-White syndrome is a rare situation. In this case, we are reporting an 72-year-old man presenting with multi-organ failure due to the this combination and successfully treated with radiofrequency ablation during preexcitated atrial fibrillation. PMID:18982140

  5. Op zoek naar de tropenstijl, Leven en werk van prof. ir. C.P. Wolff Schoemaker, Indisch architect

    NARCIS (Netherlands)

    Dullemen, C.J. van

    2008-01-01

    This thesis is about the life and work of Charles Prosper Wolff Schoemaker. He was born on Java in 1882 and died on the same island in May 1949. For his secondary school education and study at the KMA (Royal Military Academy), Charles was sent to the Netherlands. In 1905 he returned to the Dutch

  6. Quantum control of the photoinduced Wolff rearrangement of diazonaphthoquinone in the condensed phase

    Energy Technology Data Exchange (ETDEWEB)

    Wolpert, Daniel; Gerber, Gustav; Brixner, Tobias [Physikalisches Institut, Universitaet Wuerzburg, Am Hubland, 97074 Wuerzburg (Germany); Schade, Marco; Langhojer, Florian [Institut fuer Physikalische Chemie, Universitaet Wuerzburg, Am Hubland, 97074 Wuerzburg (Germany)], E-mail: brixner@phys-chemie.uni-wuerzburg.de

    2008-04-14

    A shaped UV pump-MIR probe setup is employed for quantum control of the photoinduced Wolff rearrangement reaction of diazonaphthoquinone (DNQ) dissolved in methanol, yielding a ketene photoproduct. Time-resolved vibrational spectroscopy is a well-suited tool to monitor a photoreaction in the liquid phase as the narrow vibrational lines allow the observation of structural changes. Especially in the mid-infrared region, marker modes originating from different photoproducts can be identified unambiguously providing suitable feedback signals for open-loop or closed-loop control schemes. We report an experiment where the initiation of a complicated structural change of a molecule, involving bond cleavage and rearrangement, in the liquid phase can be controlled and mechanistic insight is obtained. Single-parameter scans show that the molecule is sensitive to intrapulse dumping during the excitation. Adaptive optimizations lead to pulse structures which can be understood consistently with this dumping mechanism.

  7. [Evaluation of the radiofrequency ablation effectiveness in patients with the Wolff-Parkinson-White syndrome].

    Science.gov (United States)

    Ushakov, I B; Ardashev, A V; Ardashev, V N; Voronkov, Iu I; Sharoĭko, M V; Akimova, O S

    2012-01-01

    A one-year prospective study involved 22 patients with the Wolff-Parkinson-White syndrome (WPW) and 20 healthy people. Means age of patients was 34.3 +/- 16.3 years. All 22 patients were successfully treated with radiofrequency ablation (RFA) of additional pathways. RFA effectiveness was evaluated with the help of clinical questionnaire, data of ECG, EchoCG, heart rate variability (HRV), frequency response and nonlinear dynamics. Cardiac rhythm disturbances were verified using Holter monitoring applied to all patients. Positive clinical effect was achieved in all the WPW patients, as RFA arrested cardiac arrhythmias completely. Holter monitoring did not register cardiac disturbances which points to high RFA effectiveness in WPW patients. HRV, frequency response and nonlinear dynamics reassumed their normal patterns.

  8. Electroconvulsive therapy-induced Wolff-Parkinson-White syndrome: a case report.

    Science.gov (United States)

    Enomoto, Shingo; Yoshino, Aihide; Takase, Bonpei; Kuwahara, Tatsuro; Tatsuzawa, Yasutaka; Nomura, Soichiro

    2013-01-01

    Wolff-Parkinson-White (WPW) syndrome is characterized by premature ventricular excitation due to the presence of an abnormal accessory pathway. Electrocardiography (ECG) of patients with WPW syndrome portrays a short PR interval and a wide QRS interval with a delta wave. Herein, we report the case of a patient with schizophrenia who developed a wide QRS interval with a delta wave immediately following electroconvulsive therapy (ECT). Initially, the delta wave disappeared within 2 days after ECT. However, the duration of the delta wave increased exponentially to 4 months when ECT was repeated. Although the patient's cardiocirculatory dynamics remained normal, we continued to monitor her ECG until the delta wave disappeared because WPW syndrome can lead to serious arrhythmia. Copyright © 2013 Elsevier Inc. All rights reserved.

  9. Anaesthetic management of a case of Wolff-Parkinson-White syndrome

    Directory of Open Access Journals (Sweden)

    Savitri D Kabade

    2011-01-01

    Full Text Available We report a case of fibroid uterus with Wolff-Parkinson-White (WPW syndrome in a 48-year-old female, posted for elective hysterectomy. Patient gave history of short recurrent episodes of palpitation and electrocardiograph confirmed the diagnosis of WPW syndrome. The anaesthetic management of these patients is challenging as they are known to develop life threatening tachyarrhythmia like paroxysmal supra-ventricular tachycardia (PSVT and atrial fibrillation (AF. Epidural anaesthesia is preferred compared to general anaesthesia to avoid polypharmacy, noxious stimuli of laryngoscopy and intubation. To deal with perioperative complications like PSVT and AF, anti-arrhythmic drugs like adenosine, beta blockers and defibrillator should be kept ready. Perioperative monitoring is essential as patients can develop complications.

  10. Sugammadex Use in a Patient with Wolff-Parkinson-White (WPW) Syndrome.

    Science.gov (United States)

    Şahin, Sevtap Hekimoğlu; Öztekin, İlhan; Kuzucuoğlu, Aytuna; Aslanoğlu, Ayça

    2015-07-01

    Wolff-Parkinson-White (WPW) syndrome is a disease associated with episodes of supraventricular tachycardia and ventricular pre-excitation or atrial fibrillation. WPW is characterized by an aberrant electrical conduction pathway between atria and ventricles. The major anesthetic problem connected with WPW syndrome is the risk of tachyarrhythmias due to accessory pathway. Therefore, it has been proposed that the aim of anesthetic management should be the avoidance of tachyarrhythmia and sympathetic stimulation. Sugammadex was administered as a neuromuscular reversal agent in this case. To our knowledge, this is the first case report of sugammadex use in a patient with WPW. This report presents a case of general anesthesia management in a patient with WPW syndrome. We think that it is appropriate to use sugammadex to reverse rocuronium for the prevention of sudden hemodynamic changes in patients with WPW who underwent general anesthesia.

  11. Toxic adenoma of the thyroid gland and Wolff-Parkinson-White syndrome

    Science.gov (United States)

    Naço, M; Çeliku, E; Llukaçaj, A; Shehaj, J; Kameniku, R

    2009-01-01

    We report the case of a 17-year-old girl with toxic adenoma scheduled for surgery right lobectomy and isthmectomy of thyroid gland. During the examination before surgery, patient was diagnosed for the first time as having with Wolff – Parkinson – White (WPW) syndrome. In the operating room, after the induction of anesthesia, the electrocardiogram showed wide QRS complex tachycardia with a rate of 180 beats/min, which was diagnosed as paroxysmal supraventricular tachycardia. The patient was treated immediately with antiarrhythmic drugs: adenosine iv three times (at doses of 6 mg, 12mg, 12mg bolus) and esmolol iv twice (at doses 28.5 mg). This approach resulted in disappearance of the delta wave and tachycardia for the whole surgery period. In this case report we discuss the role of induction of anesthesia and presence of toxic adenoma in a patient with WPW. PMID:19561784

  12. Depression masquerading as chest pain in a patient with Wolff Parkinson White syndrome

    Science.gov (United States)

    Madabushi, Rajashree; Agarwal, Anil; Gautam, Sujeet K S; Khuba, Sandeep

    2016-01-01

    Wolff Parkinson White (WPW) syndrome is a condition in which there is an aberrant conduction pathway between the atria and ventricles, resulting in tachycardia. A 42-year-old patient, who was treated for WPW syndrome previously, presented with chronic somatic pain. With her cardiac condition in mind, she was thoroughly worked up for a recurrence of disease. As part of routine screening of all patients at our pain clinic, she was found to have severe depression as per the Patient Health Questionnaire–9 (PHQ–9) criteria. After ruling out sinister causes, she was treated for depression using oral Duloxetine and counselling. This led to resolution of symptoms, and improved her mood and functional capability. This case highlights the use of psychological screening tools and diligent examination in scenarios as confusing as the one presented here. Addressing the psychological aspects of pain and adopting a holistic approach are as important as treatment of the primary pathology. PMID:27738505

  13. Effect of atrial pacing on phase analysis in patients with the Wolff-Parkinson-White syndrome

    International Nuclear Information System (INIS)

    Magosaki, Nobuhisa; Hiroe, Michiaki; Kasanuki, Hiroshi; Ohnishi, Satoshi; Tanaka, Etsuko; Horie, Toshinobu; Kusakabe, Kiyoko; Kondo, Mizuka; Hirosawa, Koshichiro

    1984-01-01

    Phase analysis of ECG-gated radionuclide ventriculography was performed during sinus rhythm and atrial pacing for 11 patients with the Wolff-Parkinson-White (WPW) syndrome. During sinus rhythm, phase analysis demonstrated abnormal early-emptying segments reflecting preexcitation in six of the 11 patients. In the remaining five patients, the precise site of abnormal early-emptying could not be detected. Atrial pacing increased the degree of pre-exicitation, and abnormal early-emptying segments became clear in all patients. Our study demonstrated the utility of atrial pacing in performing phase analysis for patients with the WPW syndrome. Seven patients had abnormal early-emptying segments; four of them with ECG type A, in the left ventricle, and three of them with ECG type B, in the right ventricle. These results were consistent with results of the body surface and electrophysiologic mapping. In patients with posterior septal accessory pathways, phase analysis suggested probable laterality of the accessory pathway. (author)

  14. Phase analysis of regional and global ventricular contraction patterns in Wolff-Parkinson-White syndrome

    International Nuclear Information System (INIS)

    Konishi, Tokuji; Koyama, Takao; Ichikawa, Takehiko

    1989-01-01

    Multigated blood pool scintigraphy was performed in 20 normal subjects and 39 patients with various intraventricular conduction abnormalities, including 25 patients with Wolff-Parkinson-White (WPW) syndrome. Cardiac imaging was performed in the modified left anterior oblique, right anterior oblique, and left lateral projections. In WPW syndrome, early contraction sites which were not seen in normal subjects were detected at the ventricular base in phase images. These anomalous early contraction sites disappeared after successful suppression of conduction through an accessory pathway by intravenous procainamide. These sites are believed to correspond to the location of the bundle of Kent and were consistent with the electrocardiographic findings. Phase mapping is a suitable noninvasive method to locate the position of the bundle of Kent and evaluate the ventricular contraction pattern in WPW syndrome and other intraventricular conduction abnormalities. (author)

  15. Is isoproterenol really required during electrophysiological study in patients with Wolff-Parkinson-White syndrome?

    Science.gov (United States)

    Pauriah, Maheshwar; Cismaru, Gabriel; Sellal, Jean-Marc; De Chillou, Christian; Brembilla-Perrot, Béatrice

    2013-01-01

    We have studied the results of electrophysiological study (EPS) in patients with Wolff-Parkinson-White syndrome (WPW) and spontaneous adverse clinical presentation and determined whether isoproterenol added incremental value. EPS was performed in 63 patients with WPW and adverse clinical presentation at baseline. EPS was repeated after infusion of isoproterenol in 37 patients, including 25 without criteria for a malignant form at baseline. Atrioventricular orthodromic tachycardia was induced 44%, antidromic tachycardia in 11%, atrial fibrillation (AF) in 68% at baseline. At baseline EPS, criteria for a malignant form (AF induction and shortest CL <250 ms) were noted in 60%; tachycardia was not inducible in 16%. All the patients met the criteria for a malignant form after isoproterenol. EPS at baseline missed 16% of patients at risk of life-threatening arrhythmias who had no inducible tachyarrhythmia and 40% without classical criteria for malignant form. Copyright © 2013 Elsevier Inc. All rights reserved.

  16. Sugammadex Use in a Patient with Wolff-Parkinson-White (WPW Syndrome

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    Sevtap Hekimoğlu Şahin

    2015-09-01

    Full Text Available Background: Wolff-Parkinson-White (WPW syndrome is a disease associated with episodes of supraventricular tachycardia and ventricular pre-excitation or atrial fibrillation. WPW is characterized by an aberrant electrical conduction pathway between atria and ventricles. Case Report: The major anesthetic problem connected with WPW syndrome is the risk of tachyarrhythmias due to accessory pathway. Therefore, it has been proposed that the aim of anesthetic management should be the avoidance of tachyarrhythmia and sympathetic stimulation. Sugammadex was administered as a neuromuscular reversal agent in this case. To our knowledge, this is the first case report of sugammadex use in a patient with WPW. This report presents a case of general anesthesia management in a patient with WPW syndrome. Conclusion: We think that it is appropriate to use sugammadex to reverse rocuronium for the prevention of sudden hemodynamic changes in patients with WPW who underwent general anesthesia.

  17. Theory of the Anderson impurity model: The Schrieffer endash Wolff transformation reexamined

    International Nuclear Information System (INIS)

    Kehrein, S.K.; Mielke, A.

    1996-01-01

    We test the method of infinitesimal unitary transformations recently introduced by Wegner on the Anderson single impurity model. It is demonstrated that infinitesimal unitary transformations in contrast to the Schrieffer endash Wolff transformation allow the construction of an effective Kondo Hamiltonian consistent with the established results in this well understood model. The main reason for this is the intrinsic energy scale separation of Wegner close-quote s approach with respect to arbitrary energy differences coupled by matrix elements. This allows the construction of an effective Hamiltonian without facing a vanishing energy denominator problem. Similar energy denominator problems are troublesome in many models. Infinitesimal unitary transformations have the potential to provide a general framework for the systematic derivation of effective Hamiltonians without such problems. Copyright copyright 1996 Academic Press, Inc

  18. Síndrome de Wolff-Parkinson-White associada a comunicação interatrial tipo seio venoso Wolff-Parkinson-White syndrome and the sinus venosus atrial septal defect association

    Directory of Open Access Journals (Sweden)

    Patrícia Lopes Moraes

    2005-02-01

    Full Text Available A associação de comunicação interatrial (CIA tipo seio venoso com síndrome de Wolff Parkinson White (WPW é muito rara e ainda não descrita na literatura médica especializada. Descreve-se o caso de uma jovem portadora dessa associação de patologias tratada com ablação da via acessória por radiofreqüência, seguida de correção cirúrgica do defeito do septo interatrial.The Wolff-Parkinson-White syndrome (WPW and sinus venosus atrial septal defect (ASD association is very rare and not yet reported in the literature. It is the main basis for this case report.

  19. Electroversion in treatment of arrhythmia in a patient with Wolff-Parkinson-White syndrome and cervical spinal cord injury

    Directory of Open Access Journals (Sweden)

    SHEN Peng

    2013-06-01

    Full Text Available 【Abstract】We report electroversion in treatment of atrial fibrillation (AF and atrioventricular nodal reentry ta-chycardia (AVNRT in a patient with Wolff-Parkinson-White syndrome and cervical spinal cord injury. At first, the pa-tient sustained respiratory failure and weak cough reflex, thereafter repeated bronchoscopy was used to aspirate the sputum as well as control the pneumonia, which resulted in arrhythmia (AF and AVNRT. Two doses of intravenous amiodarone failed to correct the arrhythmia. After restora-tion of sinus rhythm by electroversion, he was successfully weaned from mechanical ventilation and discharged from the intensive care unit without recurrent arrhythmia. Key words: Arrhythmia, cardiac; Atrial fibrillation; Electric countershock; Wolff-Parkinson-White syndrome; Spinal cord injuries

  20. Extracorporeal life support for cardiac arrest in a 13-year-old girl caused by Wolff-Parkinson-White syndrome.

    Science.gov (United States)

    Song, Kyoung Hwan; Lee, Byung Kook; Jeung, Kyung Woon; Lee, Dong Hun

    2015-10-01

    Generally, Wolff-Parkinson-White (WPW) syndrome presents good prognosis. However, several case reports demonstrated malignant arrhythmia or sudden cardiac death as WPW syndrome's first presentation. Cardiopulmonary resuscitation using extracorporeal life support is a therapeutic option in refractory cardiac arrest. We present a WPW syndrome patient who had sudden cardiac arrest as the first presentation of the disease and treated it using extracorporeal life support with good neurologic outcome.

  1. Noninvasive Localization of Accessory Pathways in Wolff-Parkinson-White Syndrome by Three-Dimensional Speckle Tracking Echocardiography.

    Science.gov (United States)

    Ishizu, Tomoko; Seo, Yoshihiro; Igarashi, Miyako; Sekiguchi, Yukio; Machino-Ohtsuka, Tomoko; Ogawa, Kojiro; Kuroki, Kenji; Yamamoto, Masahiro; Nogami, Akihiko; Kawakami, Yasushi; Aonuma, Kazutaka

    2016-06-01

    We have developed a noninvasive isochrone activation imaging (AI) system with 3-dimensional (3D) speckle tracking echocardiography (STE), which allows visualization of the wavefront image of mechanical propagation of the accessory pathway (ACP) in Wolff-Parkinson-White syndrome. Patients with manifest Wolff-Parkinson-White syndrome were imaged in 3D-STE AI mode, which quantified the time from QRS onset to regional endocardial deformation. In 2 patients with left- and right-side ACP, we confirmed that intraoperative contact endocardial electric mapping and the 3D-STE AI system showed comparable images pre- and postablation. In normal heart assessment by 3D-echo AI, the earliest activation sites were found at the attachment of the papillary muscles in the left ventricle and midseptum in the right ventricle, and none showed earliest activation at the peri-atrioventricular valve annuli. An analyzer who was unaware of the clinical information assessed 39 ACP locations in 38 Wolff-Parkinson-White syndrome patients using 3D-STE. All showed abnormal perimitral or tricuspid annular activations, and the location of 34 ACP (87%) showed agreement with the successful ablation sites within a 2-o'clock range. Especially for left free wall ACP, 17/18 (94%) showed consistency with the ablation site within a 2 o'clock range. Among 15 ACP at the ventricular septum, 9 (60%) showed early local activation in both right and left sides of the septum. Isochrone AI with 3D-STE may be a promising noninvasive imaging tool to assess cardiac synchronized activation in normal hearts and detect abnormal breakthrough of mechanical activation from both atrioventricular annuli in Wolff-Parkinson-White syndrome. © 2016 American Heart Association, Inc.

  2. Wolff-Parkinson-White syndrome in the era of catheter ablation: insights from a registry study of 2169 patients.

    Science.gov (United States)

    Pappone, Carlo; Vicedomini, Gabriele; Manguso, Francesco; Saviano, Massimo; Baldi, Mario; Pappone, Alessia; Ciaccio, Cristiano; Giannelli, Luigi; Ionescu, Bogdan; Petretta, Andrea; Vitale, Raffaele; Cuko, Amarild; Calovic, Zarko; Fundaliotis, Angelica; Moscatiello, Mario; Tavazzi, Luigi; Santinelli, Vincenzo

    2014-09-02

    The management of Wolff-Parkinson-White is based on the distinction between asymptomatic and symptomatic presentations, but evidence is limited in the asymptomatic population. The Wolff-Parkinson-White registry was an 8-year prospective study of either symptomatic or asymptomatic Wolff-Parkinson-White patients referred to our Arrhythmology Department for evaluation or ablation. Inclusion criteria were a baseline electrophysiological testing with or without radiofrequency catheter ablation (RFA). Primary end points were the percentage of patients who experienced ventricular fibrillation (VF) or potentially malignant arrhythmias and risk factors. Among 2169 enrolled patients, 1001 (550 asymptomatic) did not undergo RFA (no-RFA group) and 1168 (206 asymptomatic) underwent ablation (RFA group). There were no differences in clinical and electrophysiological characteristics between the 2 groups except for symptoms. In the no-RFA group, VF occurred in 1.5% of patients, virtually exclusively (13 of 15) in children (median age, 11 years), and was associated with a short accessory pathway antegrade refractory period (PParkinson-White syndrome essentially depends on intrinsic electrophysiological properties of AP rather than on symptoms. RFA performed during the same procedure after electrophysiological testing is of benefit in improving the long-term outcomes. © 2014 American Heart Association, Inc.

  3. Management of Wolff-Parkinson-White Tachyarrhythmia Presenting as Syncope with Seizure-like Activity

    Directory of Open Access Journals (Sweden)

    Samuel Kaplan

    2017-09-01

    Full Text Available Audience: Emergency Medicine residents and medical students. Introduction: An estimated 3% of the United States population suffers from recurrent convulsive episodes that are most often attributed to primary epileptic seizures.1 However, recent studies have estimated about 20%-30% of such episodes are associated with occult cardiac etiology,2 which carry one-year mortality rates of up to 30%.3 Cardiogenic cerebral hypoxia has been associated with a wide variety of neurologic disturbances, including dizzy spells, headache, syncope, focal motor deficit, generalized tonic-clonic seizure, confusion, dementia, and psychosis.4 Convulsive activity has tentatively been ascribed to the ensuing activation of the medullary reticular formation.5,6 This scenario is based on a patient that presented to University of California Irvine Medical Center Emergency Department in April 2017 who, following witnessed seizure-like episodes, was diagnosed with underlying Wolff-Parkinson-White (WPW disorder. WPW is a congenital condition involving aberrantly conductive cardiac tissue between the atria and the ventricles that provides a pathway for a reentrant tachycardia circuit and ventricular pre-excitation.7 Diagnosis is primarily based on the presence of a short PR interval and delta waves on electrocardiography.8 While definitive treatment is catheter-based radiofrequency ablation of the accessory pathway, the hallmark of acute management is vagal maneuvers and antiarrhythmic drugs in the symptomatic but hemodynamically stable patient, and synchronized cardioversion in the unstable patient.9 WPW is thought to affect between 0.1% and 0.3% of the population, and while the usual clinical course is benign, sudden cardiac death occurs in about 3%-4% of such patients.7,10 One survey found 19% of patients with WPW had a history of syncopal episodes;11 however, precise prevalence surveys of WPW-associated seizure-like episodes are lacking in the current literature. This case

  4. Síndrome de Wolff-Parkinson-White e morte súbita

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    Rafael Rafaini Lloret

    2010-06-01

    Full Text Available A síndrome de Wolff-Parkinson-White (WPW é a mais frequente das síndromes de pré-excitação caracterizadas por despolarização ventricular precoce e extranodal por meio de uma ou mais vias acessórias. Esta síndrome é considerada como fator de risco para o aparecimento de fibrilação atrial (FA pré-excitada (taquicardia com intervalo RR irregular e QRS largo. As vias anômalas podem apresentar períodos refratários curtos e a ocorrência de FA pode permitir uma despolarização ventricular muito rápida proporcionando a indução de fibrilação ventricular (FV e morte súbita. Paciente portador de taquicardia supraventricular paroxística com sintomas de baixo débito cardíaco e episódio de síncope, sem antecedentes de outras doenças ou morte súbita na família. Ao exame físico com coração em ritmo irregular taquicárdico, pulsos filiformes, FC = 180 bpm, PA = 80 x 50 mmHg. Eletrocardiograma (ECG neste momento: FA pré-excitada (QRS largo e intervalo RR irregular com alta resposta ventricular e risco de degeneração para FV e morte súbita. Submetido a cardioversão elétrica (360J para ritmo sinusal. ECG após alguns meses: taquicardia supraventricular com QRS estreito e intervalo RR regular (taquicardia reentrante ortodrômica revertida com adenosina 12 mg endovenosa e novo ECG demonstrando ritmo sinusal com intervalo PR curto e presença de onda delta (Wolff-Parkinson-White. Encaminhado para estudo eletrofisiológico (EEF e ablação por radiofreqüência de via acessória póstero-septal direita com sucesso (desaparecimento da onda delta no ECG, curado, assintomático e sem medicamentos. A eletrofisiologia cardíaca invasiva proporcionou avanços no conhecimento das arritmias com tratamento seguro, definitivo e evidente melhora na qualidade de vida e neste caso descrito, eliminando o risco de morte súbita.

  5. Duplication of 20p12.3 associated with familial Wolff-Parkinson-White syndrome.

    Science.gov (United States)

    Mills, Kimberly I; Anderson, Jacqueline; Levy, Philip T; Cole, F Sessions; Silva, Jennifer N A; Kulkarni, Shashikant; Shinawi, Marwan

    2013-01-01

    Wolff-Parkinson-White (WPW) syndrome is caused by preexcitation of the ventricular myocardium via an accessory pathway which increases the risk for paroxysmal supraventricular tachycardia. The condition is often sporadic and of unknown etiology in the majority of cases. Autosomal dominant inheritance and association with congenital heart defects or ventricular hypertrophy were described. Microdeletions of 20p12.3 have been associated with WPW syndrome with either cognitive dysfunction or Alagille syndrome. Here, we describe the association of 20p12.3 duplication with WPW syndrome in a patient who presented with non-immune hydrops. Her paternal uncle carries the duplication and has attention-deficit hyperactivity disorder and electrocardiographic findings consistent with WPW. The 769 kb duplication was detected by the Affymetrix Whole Genome-Human SNP Array 6.0 and encompasses two genes and the first two exons of a third gene. We discuss the potential role of the genes in the duplicated region in the pathogenesis of WPW and possible neurobehavioral abnormalities. Our data provide additional support for a significant role of 20p12.3 chromosomal rearrangements in the etiology of WPW syndrome. Copyright © 2012 Wiley Periodicals, Inc.

  6. Exome analysis of a family with Wolff-Parkinson-White syndrome identifies a novel disease locus.

    Science.gov (United States)

    Bowles, Neil E; Jou, Chuanchau J; Arrington, Cammon B; Kennedy, Brett J; Earl, Aubree; Matsunami, Norisada; Meyers, Lindsay L; Etheridge, Susan P; Saarel, Elizabeth V; Bleyl, Steven B; Yost, H Joseph; Yandell, Mark; Leppert, Mark F; Tristani-Firouzi, Martin; Gruber, Peter J

    2015-12-01

    Wolff-Parkinson-White (WPW) syndrome is a common cause of supraventricular tachycardia that carries a risk of sudden cardiac death. To date, mutations in only one gene, PRKAG2, which encodes the 5'-AMP-activated protein kinase subunit γ-2, have been identified as causative for WPW. DNA samples from five members of a family with WPW were analyzed by exome sequencing. We applied recently designed prioritization strategies (VAAST/pedigree VAAST) coupled with an ontology-based algorithm (Phevor) that reduced the number of potentially damaging variants to 10: a variant in KCNE2 previously associated with Long QT syndrome was also identified. Of these 11 variants, only MYH6 p.E1885K segregated with the WPW phenotype in all affected individuals and was absent in 10 unaffected family members. This variant was predicted to be damaging by in silico methods and is not present in the 1,000 genome and NHLBI exome sequencing project databases. Screening of a replication cohort of 47 unrelated WPW patients did not identify other likely causative variants in PRKAG2 or MYH6. MYH6 variants have been identified in patients with atrial septal defects, cardiomyopathies, and sick sinus syndrome. Our data highlight the pleiotropic nature of phenotypes associated with defects in this gene. © 2015 Wiley Periodicals, Inc.

  7. The use of sugammadex in a pregnant patient with Wolff-Parkinson-White syndrome.

    Science.gov (United States)

    Sengul, Turker; Saracoglu, Ayten; Sener, Sibel; Bezen, Olgac

    2016-09-01

    Wolff-Parkinson-White (WPW) syndrome is a rare pre-excitation syndrome which develops when atrioventricular conduction occurs through a pathologic accessory pathway known as the bundle of Kent instead of atrioventricular node, hence resulting in tachycardia. Patients with WPW syndrome may experience various symptoms arising from mild-to-moderate chest disease, palpitations, hypotension, and severe cardiopulmonary dysfunction. These patients are most often symptomatic because of cardiac arrhythmias. In this case report, we present an uneventful anesthetic management of a pregnant patient with WPW syndrome undergoing cesarean delivery. A 23-year-old American Society of Anesthesiologists class 2 pregnant patient was diagnosed with WPW syndrome. Her preoperative 12-lead electrocardiogram showed a sinus rhythm at 82 beats per minute, a delta wave, and a short PR interval. After an uneventful surgery, sugammadex 2mg/kg was administered as a reversal agent instead of neostigmine. Then she was discharged to her obstetrics service. Serious hemodynamic disorders may occur in patients with WPW syndrome due to development of fatal arrhythmias. Neostigmine used as a reversal agent in general anesthesia can trigger such fatal arrhythmias by leading changes in cardiac conduction. We believe that sugammadex, which is safely used in many areas in the scope of clinical practice, can be also used for patients diagnosed with WPW syndrome. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Exercise testing in children with Wolff-Parkinson-White syndrome: what is its value?

    Science.gov (United States)

    Dalili, M; Vahidshahi, K; Aarabi-Moghaddam, M Y; Rao, J Y; Brugada, P

    2014-10-01

    This study was conducted to evaluate the accuracy of exercise testing for predicting accessory pathway characteristics in children with Wolff-Parkinson-White (WPW) syndrome. The study enrolled 37 children with WPW syndrome and candidates for invasive electrophysiologic study (EPS). Exercise testing was performed for all the study participants before the invasive study. Data from the invasive EPS were compared with findings from the exercise testing. The sudden disappearance of the delta (Δ) wave was seen in 10 cases (27 %). No significant correlation was found between the Δ wave disappearance and the antegrade effective refractory period of the accessory pathway (AERP-AP) or the shortest pre-excited RR interval (SPERRI). The sensitivity, specificity, and positive and negative predictive values of Δ wave disappearance, based on AERP-AP as gold standard, were respectively 29.4, 80, 71.4, and 40 %. The corresponding values with SPERRI as the gold standard were respectively 23.8, 71.4, 71.4 and 23.8 %. Exercise testing has a medium to low rate of accuracy in detecting low-risk WPW syndrome patients in the pediatric age group.

  9. Thyroid storm in a patient with Wolff-Parkinson-White syndrome.

    Science.gov (United States)

    Naqvi, Syed Yaseen; Luebbert, Jeffrey J; Rosen, Stephen G

    2015-12-15

    A 44-year-old woman with no medical history presented to the emergency department with a 2 h history of sudden onset chest pressure, palpitations, diaphoresis and shortness of breath. She reported a 90-pound unintentional weight loss, increased appetite, irritability, night sweats and palpitations for 2 months. Physical examination revealed a heart rate (HR) of 269 bpm and a blood pressure of 116/94 mm Hg. Her ECG revealed a wide-complex tachycardia with right bundle branch morphology and an HR of 265 bpm. Intravenous adenosine was administered with resolution of the arrhythmia and symptoms. Her subsequent ECG revealed sinus tachycardia with δ waves, which was consistent with Wolff-Parkinson-White (WPW) syndrome. Laboratory findings confirmed thyroid storm and treatment began with intravenous hydrocortisone, methimazole, metoprolol, amiodarone and iodine drops. Graves' disease was confirmed based on the presence of serum thyroid-stimulating hormone receptor antibody. The patient underwent successful WPW accessory tract ablation 6 weeks after initial presentation. 2015 BMJ Publishing Group Ltd.

  10. Accessory pathway location affects brain natriuretic peptide level in patients with Wolff-Parkinson-White syndrome.

    Science.gov (United States)

    Nakatani, Yosuke; Kumagai, Koji; Naito, Shigeto; Nakamura, Kohki; Minami, Kentaro; Nakano, Masahiro; Sasaki, Takehito; Kinugawa, Koichiro; Oshima, Shigeru

    2017-01-01

    The purpose of this study was to investigate the relationship between the accessory pathway location and brain natriuretic peptide (BNP) level in patients with Wolff-Parkinson-White (WPW) syndrome. We divided 102 WPW syndrome patients with normal left ventricular systolic function into four groups: those with manifest right (MR, n = 14), manifest septal (MS, n = 11), manifest left (ML, n = 30), and concealed (C, n = 47) accessory pathways. BNP level and electrophysiological properties, including difference in timing of the ventricular electrogram between the His bundle area and the distal coronary sinus area (His-CS delay), which indicate intraventricular dyssynchrony, were compared. BNP levels (pg/dl) were higher in the MR and MS groups than in the ML and C groups (MR, 64 ± 58; MS, 55 ± 45; ML, 17 ± 15; C, 25 ± 21; P syndrome patients with normal cardiac function.

  11. Surgical treatment of Wolff-Parkinson-White syndrome: epicardial approach without the use of cardiopulmonary bypass.

    Science.gov (United States)

    Graffigna, A; Pagani, F; Vigano, M

    1993-03-01

    Epicardial dissection without the use of cardiopulmonary bypass (CPB) was performed in 88 patients (56 males and 32 females, mean age 31.9 years). With intraoperative epicardial mapping, 101 accessory pathways were detected, with multiple pathways in 11 patients. CPB was avoided in all but one patient due to frequent onset of atrial fibrillation with rapid ventricular rate. Surgical ablation was successful in 86 patients (97.6%). Three patients required multiple surgical procedures because of persistence of conduction along a component of the original pathway. All but two patients were discharged without antiarrhythmic medication; these two patients were given quinidine therapy because of atrial fibrillation, but had normal early and late electrophysiological studies. Surgical ablation of Kent bundles by the epicardial approach for the treatment of Wolff-Parkinson-White syndrome can be achieved without the use of CPB. Optimal and steady exposure of the area are mandatory for the procedure, and dissection is eased by avoidance of heparin required for CPB.

  12. Utility of Exercise Testing and Adenosine Response for Risk Assessment in Children with Wolff-Parkinson-White Syndrome.

    Science.gov (United States)

    Ergul, Yakup; Ozturk, Erkut; Ozyilmaz, Isa; Unsal, Serkan; Carus, Hayat; Tola, Hasan Tahsin; Tanidir, Ibrahim Cansaran; Guzeltas, Alper

    2015-01-01

    We aimed to determine the correlation between noninvasive testing (exercise stress testing [EST] and adenosine responsiveness of accessory pathway [AP] ) and invasive electrophysiology study (EPS) for assessment antegrade conduction of the AP in Wolff-Parkinson-White syndrome. This prospective, observational study enrolled 40 children (58% male children, median age of 13 years, and median weight of 47.5 kg) with Wolff-Parkinson-White syndrome. Conduction through the AP to a cycle length of ≤250 ms was considered rapid or high-risk; otherwise, patients were nonrapid or low-risk. The sudden disappearance of the delta-wave was seen in 10 cases (25%) during EST. Accessory pathway was found to be high-risk in 13 cases (13/40, 32.5%) while the accessory path was identified as low-risk in 27 cases; however, six patients (15%) had blocked AP conduction with adenosine during EPS. Low-risk classification by EST alone to identify patients with nonrapid conduction in baseline EPS had a specificity of 93% and a positive predictive value of 90% (accuracy 54%). Blocked AP conduction with adenosine as a marker of nonrapid baseline AP conduction had a specificity of 93% and a positive predictive value of 84%. Finally, AP was adenosine nonresponsive in the majority of patients (28/30, 93%) with persistent delta-waves, 40% of those who had a sudden disappearance of delta-waves had an adenosine-responsive AP (P value: .028). Abrupt loss of preexcitation during EST and blocked AP conduction with adenosine had high specificity and positive predictive value for nonrapid and low-risk antegrade conduction during baseline invasive EPS. Successful risk stratification of pediatric patients with Wolff-Parkinson-White is possible through the use of EST and the adenosine responsiveness of AP. © 2015 Wiley Periodicals, Inc.

  13. One-Pot Two-Step Organocatalytic Asymmetric Synthesis of Spirocyclic Piperidones via Wolff Rearrangement–Amidation–Michael–Hemiaminalization Sequence

    Directory of Open Access Journals (Sweden)

    Yanqing Liu

    2017-02-01

    Full Text Available A highly enantioselective organocatalytic Wolff rearrangement–amidation–Michael–hemiaminalization stepwise reaction is described involving a cyclic 2-diazo-1,3-diketone, primary amine and α,β-unsaturated aldehyde. Product stereocontrol can be achieved by adjusting the sequence of steps in this one-pot multicomponent reaction. This approach was used to synthesize various optically active spirocyclic piperidones with three stereogenic centers and multiple functional groups in good yields up to 76%, moderate diastereoselectivities of up to 80:20 and high enantioselectivities up to 97%.

  14. Ventricular fibrillation development following atrial fibrillation after the ingestion of sildenaphil in a patient with Wolff-Parkinson-White syndrome.

    Science.gov (United States)

    Inci, Sinan; Izgu, Ibrahim; Aktas, Halil; Dogan, Pinar; Dogan, Ali

    2015-08-01

    Complications in the accessory pathway in Wolff-Parkinson-White (WPW) syndrome could cause different clinical conditions by inducing different arrhythmias. Atrial fibrillation (AF) is one of these arrhythmias and is important as it causes life-threatening arrhythmias. It is known that some drugs, underlying cardiac diseases, and the number of accessory pathways, cause a predisposition to this condition. In the current report, we presented a patient with WPW who was admitted to the emergency department with AF, wide QRS and a rapid ventricular response that progressed to ventricular fibrillation.

  15. Spontaneous Transition of Double Tachycardias with Atrial Fusion in a Patient with Wolff-Parkinson-White Syndrome.

    Science.gov (United States)

    Kim, Dongmin; Lee, Myung-Yong

    2016-07-01

    Among patients with Wolff-Parkinson-White syndrome, atrioventricular reciprocating tachycardia (AVRT) and atrioventricular nodal reentrant tachycardia (AVNRT) can coexist in a single patient. Direct transition of both tachycardias is rare; however, it can occur after premature atrial or ventricular activity if the cycle lengths of the two tachycardias are similar. Furthermore, persistent atrial activation by an accessory pathway (AP) located outside of the AV node during ongoing AVNRT is also rare. This article describes a case of uncommon atrial activation by an AP during AVNRT and gradual transition of the two supraventricular tachycardias without any preceding atrial or ventricular activity in a patient with preexcitation syndrome.

  16. Malignant arrhythmia as the first manifestation of Wolff-Parkinson-White syndrome: a case with minimal preexcitation on electrocardiography.

    Science.gov (United States)

    Gungor, B; Alper, A T

    2013-09-01

    Wolff-Parkinson-White (WPW) syndrome is defined as the presence of an accessory atrioventricular pathway which is manifested as delta waves and short PR interval on electrocardiography (ECG). However, some WPW cases do not have typical findings on ECG and may remain undiagnosed unless palpitations occur. Sudden cardiac death may be the first manifestation of WPW and develops mostly secondary to degeneration of atrial fibrillation into ventricular fibrillation. In this report, we present a case of undiagnosed WPW with minimal preexcitation on ECG and who suffered an episode of malignant arrhythmia as the first manifestation of the disease.

  17. Wolff-Parkinson-White syndrome with an unroofed coronary sinus without persistent left superior vena cava treated with catheter cryoablation

    Directory of Open Access Journals (Sweden)

    Andrei Catanchin

    2008-08-01

    Full Text Available Coronary sinus anomalies are rare congenital defects which are usually coexistent with a persistent left superior vena cava and may be associated with cardiac arrhythmias. We report an unroofed coronary sinus without persistent left superior vena cava diagnosed during a catheter ablation procedure for Wolff-Parkinson-White syndrome. Diagnostic and therapeutic options and outcomes are discussed. This condition is of relevance to electrophysiologists performing catheter-based procedures, as well as cardiologists implanting coronary sinus pacing leads, who may encounter this anomaly in their practice.

  18. Current strategy for treatment of patients with Wolff-Parkinson-White syndrome and asymptomatic preexcitation in Europe

    DEFF Research Database (Denmark)

    Svendsen, Jesper Hastrup; Dagres, Nikolaos; Dobreanu, Dan

    2013-01-01

    network, covering 20 countries answered the survey questions. All centres were high-volume ablation centres. A younger person with asymptomatic Wolff-Parkinson-White (WPW) pattern has a higher likelihood of being risk-stratified or receiving ablation therapy compared with an older subject. Two...... of responding centres (61-69%) report that their country lack national guidelines dealing with clinical strategies related to WPW. There is a need for national guidelines dealing with clinical strategy in patients with WPW syndrome. Older individuals with asymptomatic WPW pattern have a higher risk...

  19. Electrophysiology testing and catheter ablation are helpful when evaluating asymptomatic patients with Wolff-Parkinson-White pattern: the pro perspective.

    Science.gov (United States)

    Pappone, Carlo; Santinelli, Vincenzo

    2015-09-01

    Important advances in the natural history and diagnosis of, and therapy for, asymptomatic Wolff-Parkinson-White (WPW) syndrome have been made in the last decade by our group. These data have necessitated revisiting current practice guidelines to decide on the optimal management of the asymptomatic WPW population. There has also been an emphasis on identifying initially asymptomatic individuals who are at risk by nationwide screening programs using the electrocardiogram for prophylactic catheter ablation to prevent the lifetime risk of sudden cardiac death, particularly in young asymptomatic people, because only a subgroup of them is at high risk, requiring early catheter ablation. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Successful Radiofrequency Catheter Ablation for Wolff-Parkinson-White Syndrome Within the Neck of a Coronary Sinus Diverticulum

    Science.gov (United States)

    Jang, Sung-Won; Kim, Dong-Bin; Kwon, Bum-Jun; Cho, Eun-Joo; Shin, Woo-Seung; Kim, Ji-Hoon; Jin, Seung-Won; Oh, Yong-Seog; Lee, Man-Young; Kim, Jae-Hyung

    2009-01-01

    Posteroseptal accessory pathways are often associated with coronary sinus diverticula. These diverticula contain myocardial coats which serve as a bypass tract. We report a 54-year-old woman who underwent radiofrequency (RF) catheter ablation for Wolff-Parkinson-White (WPW) syndrome. The surface electrocardiography (ECG) demonstrated pre-excitation, indicating a posteroseptal accessory pathway. A catheter ablation via a transaortic approach failed to ablate the accessory pathway. Coronary sinus venography revealed the presence of a diverticulum near the ostium. An electrogram in the neck of the diverticulum showed the coronary sinus myocardial extension potential, which was successfully ablated by delivery of RF energy. PMID:19949625

  1. Abnormal perfusion on myocardial perfusion SPECT in patients with Wolff-Parkinson-White syndrome

    International Nuclear Information System (INIS)

    Kang, Do Young; Cha, Kwang Soo; Han, Seung Ho; Park, Tae Ho; Kim, Moo Hyun; Kim, Young Dae

    2005-01-01

    Abnormal myocardial perfusion may be caused by ventricular preexcitation, but its location, extent, severity and correlation with accessory pathway (AP) are not established. We evaluated perfusion patterns on myocardial perfusion SPECT and location of AP in patients with WPW (Wolff-Parkison-White) syndrome. Adenosine Tc-99m MIBI or Tl-201 myocardial perfusion SPECT was performed in 11 patients with WPW syndrome. Perfusion defects (PD) were compared to AP location based on ECT with Fitzpatrick's algorithm of electrophysiologic study and radiofrequency catheter ablation. Patients had atypical chest discomfort or no symptom. Risk of coronary artery disease (CAD) was below 0.1 in 11 patients using the nomogram to estimate the probability of CAD. Coronary angiography was performed in 4 patients(mid-LAD 50% in one, normal in others). In 4 patients, AP localization was done by electrophysiologic study and radiofrequency catheter ablation (RFCA). Small to large extent (11.0 ± 8.5%, range:3 ∼ 35%) and mild to moderate severity (-71 ± 42.7%, range:-217 ∼ -39%) of reversible (n=9) or fixed (n=1) perfusion defects were noted. One patients with right free wall (right lateral) AP showed normal. PD locations were variable following the location of AP. One patient with left lateral wall AP was followed 6 weeks after RFCA and showed significantly decreased PD on SPECT with successful ablation. Myocardial perfusion defect showed variable extent, severity and location in patients with WPW syndrome. Abnormal perfusion defect showed in most of all patients, but if did not seem to be correlated specifically with location of accessory pathway and coronary artery disease. Therefore myocardial perfusion SPECT should be interpreted carefully in patients with WPW syndrome

  2. Early repolarization in Wolff-Parkinson-White syndrome: prevalence and clinical significance.

    Science.gov (United States)

    Mizumaki, Koichi; Nishida, Kunihiro; Iwamoto, Jotaro; Nakatani, Yosuke; Yamaguchi, Yoshiaki; Sakamoto, Tamotsu; Tsuneda, Takayuki; Inoue, Hiroshi; Sakabe, Masao; Fujiki, Akira

    2011-08-01

    Idiopathic ventricular fibrillation (IVF) with early repolarization (ER) has recently been reported; however, ER is a common finding in healthy subjects and is also found sporadically in patients with Wolff-Parkinson-White (WPW) syndrome. The present study was designed to evaluate the prevalence and clinical significance of ER in patients with WPW syndrome. One hundred and eleven patients with WPW syndrome were studied retrospectively. Early repolarization was defined as QRS slurring or notching with J-point elevation ≥ 1 mm. The prevalence of ER was determined before and after successful catheter ablation. Before ablation, ER was found in 35 of 75 patients with a left free wall, 6 of 23 with a right free wall, and 7 of 13 with a septal accessory pathway (48 of 111, 43% as a whole). Early repolarization was always observed in leads with positive deflection of the initial part of the delta wave. After successful ablation of accessory pathways, ER was preserved in 28 (25%), disappeared in 20 (18%), and newly developed in 8 (7%) patients. In the remaining 55 (50%) patients, ER was not observed either before or after ablation. In patients with persistent ER, the amplitude and width of ER were significantly decreased 3-7 days after the ablation (1.7 ± 0.7 vs. 1.4 ± 0.6 mm, P syndrome, ER could be partly related to early depolarization through the accessory pathway. However, persistent ER and new ER appearing after the ablation were frequently found. Therefore, in these patients, mechanisms other than early depolarization may be involved in the genesis of ER.

  3. Bundle branch block after ablation for Wolff-Parkinson-White syndrome.

    Science.gov (United States)

    Fuenmayor A, Abdel J; Rodríguez S, Yenny A

    2013-09-20

    Bundle branch block (BBB) is a difficult diagnosis in the Wolff-Parkinson-White syndrome (WPW). We investigated the clinical implications of BBB that appears after performing an accessory pathway (AP) ablation. We studied 199 patients with WPW who were submitted to AP ablation. Thirty (15%) exhibited BBB after the ablation. Twenty-two patients had right BBB and 8 had left BBB. Thirteen patients had right-sided AP and 17 had left-sided AP. They were compared with 82 similar patients without BBB after the AP ablation. Among the patients with BBB, 86.66% showed delays in the middle part of the QRS in the ECG recorded before ablation vs. 18.29% of the patients without BBB (p<0.05) (sensitivity 86%, specificity 81%, positive predictive value 67% and negative predictive value 93%). Forty-four percent of the patients with BBB had BBB morphology during orthodromic tachycardia vs. 10% of the patients without BBB (p<0.05) (sensitivity 44%, specificity 89%, positive predictive value 57% and negative predictive value 82%). No relationship was found between AP location and the site of the BBB. Ejection fraction was normal before (0.61 ± 0.03) and upon completion of follow-up (0.61 ± 0.07). BBB disappeared in 95.3% of the patients. Delays in the middle portion of the QRS may predict BBB after AP ablation. BBB after performing AP ablation is frequent, transient, benign, and not related to either the ablation lesion location or progression to structural heart disease. BBB after AP ablation may be related to cardiac memory. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  4. Clinical and electrophysiological evaluation of pediatric Wolff-Parkinson-White patients

    Science.gov (United States)

    Yıldırım, Işıl; Özer, Sema; Karagöz, Tevfik; Şahin, Murat; Özkutlu, Süheyla; Alehan, Dursun; Çeliker, Alpay

    2015-01-01

    Objective: Wolff-Parkinson-White (WPW) syndrome presents with paroxysmal supraventricular tachycardia and is characterized by electrocardiographic (ECG) findings of a short PR interval and a delta wave. The objective of this study was to evaluate the electrophysiological properties of children with WPW syndrome and to develop an algorithm for the management of these patients with limited access to electrophysiological study. Methods: A retrospective review of all pediatric patients who underwent electrophysiological evaluation for WPW syndrome was performed. Results: One hundred nine patients underwent electrophysiological evaluation at a single tertiary center between 1997 and 2011. The median age of the patients was 11 years (0.1-18). Of the 109 patients, 82 presented with tachycardia (median age 11 (0.1-18) years), and 14 presented with syncope (median age 12 (6-16) years); 13 were asymptomatic (median age 10 (2-13) years). Induced AF degenerated to ventricular fibrillation (VF) in 2 patients. Of the 2 patients with VF, 1 was asymptomatic and the other had syncope; the accessory pathway effective refractory period was ≤180 ms in both. An intracardiac electrophysiological study was performed in 92 patients, and ablation was not attempted for risk of atrioventricular block in 8 (8.6%). The success and recurrence rate of ablation were 90.5% and 23.8% respectively. Conclusion: The induction of VF in 2 of 109 patients in our study suggests that the prognosis of WPW in children is not as benign as once thought. All patients with a WPW pattern on the ECG should be assessed electrophysiologically and risk-stratified. Ablation of patients with risk factors can prevent sudden death in this population. PMID:26006136

  5. Electrophysiological effects of desflurane in children with Wolff-Parkinson-White syndrome: a randomized crossover study.

    Science.gov (United States)

    Hino, H; Oda, Y; Yoshida, Y; Suzuki, T; Shimada, M; Nishikawa, K

    2018-02-01

    We hypothesized that, compared with propofol, desflurane prolongs the antegrade accessory pathway effective refractory period (APERP) in children undergoing radiofrequency catheter ablation for Wolff-Parkinson-White (WPW) syndrome. In this randomized crossover study, children aged 4.1-16.1 years undergoing radiofrequency catheter ablation for WPW syndrome were randomly divided into four groups according to the concentration of desflurane and anesthetics used in the first and the second electrophysiological studies (EPS). After induction of general anesthesia with propofol and tracheal intubation, they received one of the following regimens: 0.5 minimum alveolar concentration (MAC) desflurane (first EPS) and propofol (second EPS) (Des0.5-Prop group, n = 8); propofol (first EPS) and 0.5 MAC desflurane (second EPS) (Prop-Des0.5 group, n = 9); 1 MAC desflurane (first EPS) and propofol (second EPS) (Des1.0-Prop group, n = 10); propofol (first EPS) and 1 MAC desflurane (second EPS) (Prop-Des1.0 group, n = 9). Radiofrequency catheter ablation was performed upon completion of EPS. Sample size was determined to detect a difference in the APERP. Desflurane at 1.0 MAC significantly prolonged the APERP compared with propofol, but did not affect the sinoatrial conduction time, atrio-His interval or atrioventricular node effective refractory period. Supraventricular tachycardia was induced in all children receiving propofol, but not induced in 1 and 4 children receiving 0.5 MAC and 1.0 MAC desflurane, respectively. Desflurane enhances the refractoriness and may block the electrical conduction of the atrioventricular accessory pathway, and is therefore not suitable for use in children undergoing radiofrequency catheter ablation for WPW syndrome. © 2017 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  6. Wolff-Parkinson-White Syndrome with Ventricular Hypertrophy in a Brazilian Family.

    Science.gov (United States)

    van der Steld, Lenises de Paula; Campuzano, Oscar; Pérez-Serra, Alexandra; Moura de Barros Zamorano, Mabel; Sousa Matos, Selma; Brugada, Ramon

    2017-07-10

    BACKGROUND PRKAG2 syndrome diagnosis is already well-defined as Wolff-Parkinson-White syndrome (WPW), ventricular hypertrophy (VH) due to glycogen accumulation, and conduction system disease (CSD). Because of its rarity, there is a lack of literature focused on the treatment. The present study aimed to describe appropriate strategies for the treatment of affected family members with PRKAG2 syndrome with a long follow-up period. CASE REPORT We studied 60 selected individuals from 84 family members (32 males, 53.3%) (mean age 27±16 years). Patients with WPW and/or VH were placed in a group of 18 individuals, in which 11 (61.1%) had VH and WPW, 6 (33.3%) had isolated WPW, and 1 (5.6%) had isolated VH. Palpitations occurred in 16 patients (88.9%), chest pain in 11 (61.1%), dizziness in 13 (72.2%), syncope in 15 (83.3%), and dyspnea in 13 (72%). Sudden cardiac death (SCD) occurred in 2 (11.1%), and 2 patients with cardiac arrest (CA) had asystole and pre-excited atrial flutter-fibrillation (AFL and AF) as the documented mechanism. Transient ischemic attack (TIA) and learning/language disabilities with delayed development were observed. Genetic analysis identified a new missense pathogenic variant (p.K290I) in the PRKAG2 gene. Cardiac histopathology demonstrated the predominance of vacuoles containing glycogen derivative and fibrosis. The treatment was based on hypertension and diabetes mellitus (DM) control, antiarrhythmic drugs (AD), anticoagulation, and radiofrequency catheter ablation (RCA). Six patients (33.3%) underwent pacemaker implantation (PM). CONCLUSIONS The present study describes the clinical treatment for a rare cardiac syndrome caused by a PRKAG2 mutation.

  7. Differentiating fasciculoventricular pathway from Wolff-Parkinson-White syndrome by electrocardiography.

    Science.gov (United States)

    Suzuki, Tsugutoshi; Nakamura, Yoshihide; Yoshida, Shuichiro; Yoshida, Yoko; Shintaku, Haruo

    2014-04-01

    In school-based cardiovascular screening programs in Japan, Wolff-Parkinson-White (WPW) syndrome is diagnosed based on the presence of an electrocardiographic (ECG) delta wave without differentiation from the fasciculoventricular pathway (FVP), although the risk of sudden death is associated only with the former. The purpose of this study was to differentiate FVP patients among children diagnosed with WPW syndrome by ECG. Children who were diagnosed with WPW syndrome through school screening between April 2006 and March 2008 and had QRS width ≤120 ms were included. Patients with asthma and/or coronary heart disease were excluded. FVP and WPW syndrome were differentiated based on ECG responses to adenosine triphosphate (ATP) injection. Age, PR interval, QRS width, and Rosenbaum classification were compared among patients. Thirty patients (median age 12.7 years, range 6.5-15.7 years) participated in the study. FVP was diagnosed in 23 patients (76.7%), and WPW syndrome in 7 (23.3%). In Rosenbaum type A patients, all six patients had WPW syndrome, whereas FVP was diagnosed in 23 of 24 and WPW syndrome was diagnosed in 1 of 24 of type B patients. Age, PR interval, and QRS width were not significantly different between the two conditions. ATP stress test was reliable in differentiating FVP from WPW syndrome. Although FVP is considered rare, the results of our study indicate that many WPW syndrome patients with QRS width ≤120 ms may actually have FVP. Patients categorized as type B are more likely to have FVP, whereas type A patients are most likely to have WPW syndrome. © 2013 Heart Rhythm Society Published by Heart Rhythm Society All rights reserved.

  8. Intermittent versus Persistent Wolff-Parkinson-White Syndrome in Children: Electrophysiologic Properties and Clinical Outcomes.

    Science.gov (United States)

    Kiger, Michelle E; McCanta, Anthony C; Tong, Suhong; Schaffer, Michael; Runciman, Martin; Collins, Kathryn K

    2016-01-01

    Intermittent Wolff-Parkinson-White (WPW) syndrome is considered to have a lower risk of sudden death. Fewer data exist regarding electrophysiologic (EP) characteristics and the natural history of intermittent WPW in children. All patients with WPW age 1-18 years at a single institution (1996-2013) were reviewed. Patients with intermittent preexcitation were compared to those with loss of preexcitation on Holter/exercise testing and those with persistent preexcitation. High-risk accessory pathway (AP) was defined as AP effective refractory period (APERP), block cycle length, or shortest preexcited RR interval during atrial fibrillation ≤250 ms. A total of 295 patients were included: 226 (76.6%) persistent, 39 (13.2%) intermittent, and 30 (10.2%) loss of preexcitation Holter/exercise. There were no differences in symptoms between groups. Median interquartile range APERP was significantly longer in intermittent WPW (380 [320, 488] ms vs 320 [300, 350] ms persistent, 310 [290, 330] ms loss of preexcitation Holter/exercise; P = 0.0008). At baseline, there was no difference between groups in frequency of high-risk pathways. However, when isoproterenol values were included, high-risk pathways were more frequent among patients with loss of preexcitation on Holter/exercise (54% vs 16% persistent, 11% intermittent; P = 0.005). There was one death in a patient with loss of preexcitation on exercise testing, no EP study, and prior drug use. A second patient with persistent WPW and APERP 270 ms required resuscitation following a methadone overdose. Intermittent preexcitation in children does not connote a lower risk AP by EP criteria or reduced symptoms. The low number of pediatric WPW patients who develop preexcited atrial fibrillation or sudden death warrants larger studies to investigate these outcomes. ©2015 Wiley Periodicals, Inc.

  9. POLYMORPHISMS OF ENDOTHELIAL NITRIC OXIDE SYNTHASE GENE AS PREDICTORS OF WOLFF-PARKINSON-WHITE SYNDROME

    Directory of Open Access Journals (Sweden)

    G. V. Matyushin

    2017-01-01

    Full Text Available Background. The discovery of new genetic predictors of cardiovascular diseases can be used in predicting and diagnosing latent forms of the disease. Wolff-Parkinson-White syndrome (WPW occurs in all age groups  and detected in 1-30 people per 10000, it manifests mainly in young age (on average 20 years, and the risk of sudden cardiac death is higher than in general population.Aim. To study the relationship of WPW syndrome with the polymorphism of endothelial nitric synthase gene (NOS3, and to identify genetic predictors of this syndrome.Material and methods. The study included 51 people with ECG proven WPW syndrome and 153 people with no cardiovascular disease. The patients were divided into subgroups according to sex: 21 women, 30 men. All patients underwent a standard cardiac examination (anamnesis, electrocardiography, echocardiography, bicycle ergometry, transesophageal electrical stimulation of the atria, Holter monitoring and blood was taken for molecular genetic testing of DNA.Results. The results showed a statistically significant prevalence of rare genotype 4b\\4b NOS3 gene in the control group of women (16.3%; р<0.05 compared with women from the main group, who did not have this genotype, while there was significant prevalence of genotype 4a\\4a in the main group of women (81.0%; р<0.05 compared with women from the control group.  In men this prevalence was not found.Conclusion. The presence of genotype 4b\\4b NOS3 gene reduces the likelihood of WPW syndrome and its symptoms in females. In men,  this prevalence is not found, presumably, in connection with some mechanisms of hormonal regulation. The results can be used in the genetic prediction of the course of the disease.

  10. Abnormal perfusion on myocardial perfusion SPECT in patients with Wolff-Parkinson-White syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Do Young; Cha, Kwang Soo; Han, Seung Ho; Park, Tae Ho; Kim, Moo Hyun; Kim, Young Dae [Donga University College of Medicine, Busan (Korea, Republic of)

    2005-02-15

    Abnormal myocardial perfusion may be caused by ventricular preexcitation, but its location, extent, severity and correlation with accessory pathway (AP) are not established. We evaluated perfusion patterns on myocardial perfusion SPECT and location of AP in patients with WPW (Wolff-Parkison-White) syndrome. Adenosine Tc-99m MIBI or Tl-201 myocardial perfusion SPECT was performed in 11 patients with WPW syndrome. Perfusion defects (PD) were compared to AP location based on ECT with Fitzpatrick's algorithm of electrophysiologic study and radiofrequency catheter ablation. Patients had atypical chest discomfort or no symptom. Risk of coronary artery disease (CAD) was below 0.1 in 11 patients using the nomogram to estimate the probability of CAD. Coronary angiography was performed in 4 patients(mid-LAD 50% in one, normal in others). In 4 patients, AP localization was done by electrophysiologic study and radiofrequency catheter ablation (RFCA). Small to large extent (11.0 {+-} 8.5%, range:3 {approx} 35%) and mild to moderate severity (-71 {+-} 42.7%, range:-217 {approx} -39%) of reversible (n=9) or fixed (n=1) perfusion defects were noted. One patients with right free wall (right lateral) AP showed normal. PD locations were variable following the location of AP. One patient with left lateral wall AP was followed 6 weeks after RFCA and showed significantly decreased PD on SPECT with successful ablation. Myocardial perfusion defect showed variable extent, severity and location in patients with WPW syndrome. Abnormal perfusion defect showed in most of all patients, but if did not seem to be correlated specifically with location of accessory pathway and coronary artery disease. Therefore myocardial perfusion SPECT should be interpreted carefully in patients with WPW syndrome.

  11. Atrial fibrillation in patients with Wolff-Parkinson-White syndrome: role of pulmonary veins.

    Science.gov (United States)

    Derejko, Paweł; Szumowski, Lukasz Jan; Sanders, Prashanthan; Krupa, Wojciech; Bodalski, Robert; Orczykowski, Michał; Urbanek, Piotr; Zakrzewska, Joanna; Lim, Han S; Lau, Dennis H; Kuśnierz, Jacek; Walczak, Franciszek

    2012-03-01

    We aimed to characterize electrophysiological properties of pulmonary veins (PVs) in patients with Wolff-Parkinson-White (WPW) syndrome and atrial fibrillation (AF), and to compare them to those in patients with WPW without AF. A total of 31 patients (mean age 40 ± 15 years, 23 males) with WPW were recruited: 16 patients with (AF group) and 15 without (controls) a history of AF. The basic electrophysiological (EPS) and echocardiographic data were not different between the 2 groups. Effective refractory periods (ERPs) of PVs were significantly shorter in the AF group compared to controls: left superior (LS) PV ERP 185±29 versus 230 ± 24 ms, P = 0.001; left inferior PV ERP 198 ± 25 versus 219 ± 26 ms, P = 0.04; right superior (RS) PV ERP 207 ± 25 versus 236 ± 19 ms, P = 0.001; right inferior PV ERP 208 ± 30 versus 240 ± 19 ms, P = 0.003. Maximal veno-atrial conduction delay (i.e., the maximal prolongation of interval from stimulus delivered at PV ostia to proximal coronary sinus after extrastimulus compared to the basic drive cycle) was longer in the AF group when pacing from LSPV (69.3 ± 37.9 vs 32.6 ± 16.1 ms, P = 0.01) and RSPV (74.1 ± 25.9 vs 50.2 ± 26.5 ms, P = 0.04). During EPS, AF was induced more often in the AF group (n = 7) compared to controls (n = 1; P = 0.04). Follow-up revealed that AF recurred in 3 patients in the AF group and none of the controls. Patients with WPW syndrome and AF have shorter ERPs of PVs and greater maximal veno-atrial conduction delay compared to patients with WPW without AF. These findings suggest a potential role of PVs in the development of AF in patients with WPW. © 2011 Wiley Periodicals, Inc.

  12. Tachydysrhythmia treatment and adverse events in patients with wolff-Parkinson-white syndrome.

    Science.gov (United States)

    Siegelman, Jeffrey N; Marill, Keith A; Adler, Jonathan N

    2014-09-01

    Current guidelines recommend avoiding atrioventricular-nodal blocking agents (AVNB) when treating tachydysrhythmias in Wolff-Parkinson-White syndrome (WPW) patients. We investigated medications selected and resulting outcomes for patients with tachydysrhythmias and WPW. In this single-center retrospective cohort study, we searched a hospital-wide database for the following inclusion criteria: WPW, tachycardia, and intravenous antidysrhythmics. The composite outcome of adverse events was acceleration of tachycardia, new hypotension, new malignant dysrhythmia, and cardioversion. The difference in binomial proportions of patients meeting the composite outcome after AVNB or non-AVNB (NAVNB) treatment was calculated after dividing the groups by QRS duration. A random-effects mixed linear analysis was performed to analyze the vital sign response. The initial database search yielded 1158 patient visits, with 60 meeting inclusion criteria. Patients' median age was 52.5 years; 53% were male, 43% presented in wide complex tachycardia (WCT), with 75% in atrial fibrillation (AF) or flutter. AVNBs were administered in 42 (70%) patient visits. For those patients with WCT in AF, the difference in proportions of patients meeting the composite outcome after AVNBs vs. NAVNBs treatment was an increase of 3% (95% confidence interval [CI] -39%-49%), and for those with narrow complex AF it was a decrease of 13% (95% CI -37%-81%). No instances of malignant dysrhythmia occurred. Mixed linear analysis showed no statistically significant effects on heart rate, though suggested a trend toward increasing heart rate after AVNB in wide complex AF. In this sample of WPW-associated tachydysrhythmia patients, many were treated with AVNBs. The composite outcome was similarly met after use of either AVNB or NAVNB, and no malignant dysrhythmias were observed. Copyright © 2014 Elsevier Inc. All rights reserved.

  13. Comparison of the accuracy of three algorithms in predicting accessory pathways among adult Wolff-Parkinson-White syndrome patients.

    Science.gov (United States)

    Maden, Orhan; Balci, Kevser Gülcihan; Selcuk, Mehmet Timur; Balci, Mustafa Mücahit; Açar, Burak; Unal, Sefa; Kara, Meryem; Selcuk, Hatice

    2015-12-01

    The aim of this study was to investigate the accuracy of three algorithms in predicting accessory pathway locations in adult patients with Wolff-Parkinson-White syndrome in Turkish population. A total of 207 adult patients with Wolff-Parkinson-White syndrome were retrospectively analyzed. The most preexcited 12-lead electrocardiogram in sinus rhythm was used for analysis. Two investigators blinded to the patient data used three algorithms for prediction of accessory pathway location. Among all locations, 48.5% were left-sided, 44% were right-sided, and 7.5% were located in the midseptum or anteroseptum. When only exact locations were accepted as match, predictive accuracy for Chiang was 71.5%, 72.4% for d'Avila, and 71.5% for Arruda. The percentage of predictive accuracy of all algorithms did not differ between the algorithms (p = 1.000; p = 0.875; p = 0.885, respectively). The best algorithm for prediction of right-sided, left-sided, and anteroseptal and midseptal accessory pathways was Arruda (p algorithms were similar in predicting accessory pathway location and the predicted accuracy was lower than previously reported by their authors. However, according to the accessory pathway site, the algorithm designed by Arruda et al. showed better predictions than the other algorithms and using this algorithm may provide advantages before a planned ablation.

  14. Use of phase images in radionuclide ventriculography for topical diagnosis of the Wolff-Parkinson-White syndrome and sources of abnormal rhythms in the ventricles

    International Nuclear Information System (INIS)

    Ostroumov, E.N.; Sergienko, V.B.; Golitsin, S.P.

    1990-01-01

    The paper presents the results of the mapping of various types of the Wolff-Parkinson-White syndrome and ventricular arrhythmias by using phase images of radionuclide ventriculograms as compared to 12 leads and electrophysiological studies. Phase images are a highly informative method that supplements an electrophysiological study in the topical diagnosis of abnormal tracts and ventricular arrhythmias

  15. Global and Regional Left Ventricular Contractile Impairment In Patients With Wolff-Parkinson-White Syndrome

    Directory of Open Access Journals (Sweden)

    Sony Jacob

    2009-07-01

    Full Text Available Background: To assess regional systolic function and global contractile function in patients with WPW Syndrome.Method: Eleven cases with manifest Wolff-Parkinson-White (WPW syndrome in sinus rhythm were compared to 11 age matched controls. 2D strain analysis was performed and peak segmental radial strain (pRS values obtained from basal ventricular parasternal short-axis images (70 ± 5 frames/sec using a dedicated software package. Heterogeneity of radial strain pattern in six circumferential basal left ventricular segments was measured in terms of standard deviations of peak RS (SDpRS or range (difference between maximum and minimum peak RS i.e. RangepRS. Spectral Doppler (continuous wave measurements were acquired through the left ventricular outflow tract to determine Pre Ejection Period (PEP, Left Ventricular Ejection Time (LVET and measures of left ventricular systolic performance. Results: LV segmental radial strain was profoundly heterogeneous in WPW cases in contrast to fairly homogenous strain pattern in normal subjects. Wide SDpRS values 17.5 ± 8.9 vs 3.3 ± 1.4, p<0.001 and RangepRS 42.7 ± 20.8 vs.8.5 ± 3.6 , p<0.001 were observed among WPW and healthy subjects respectively. PEP (132.4 ± 14.7 vs 4.7 ± 0.5ms, p<0.001 and corrected PEP (76.1 ± 8.0 vs 2.7 ± 0.4ms, p<0.001 were significantly longer in WPW patients compared to controls. The PEP/LVET ratio was also significantly greater in WPW cohort (0.49 ± 0.04 vs. 0.28 ± 0.05, p <0.001 suggesting global systolic dysfunction. Conclusion: Patients with manifest preexcitation (predominantly those with right-sided pathways have regional and global contractile dysfunction resulting from aberrant impulse propagation inherent to the preexcited state.

  16. PRKAG3 polymorphisms associated with sporadic Wolff-Parkinson-White syndrome among a Taiwanese population.

    Science.gov (United States)

    Weng, Ken-Pen; Yuh, Yeong-Seng; Huang, Shih-Hui; Hsiao, Hsiang-Chiang; Wu, Huang-Wei; Chien, Jen-Hung; Chen, Bo-Hau; Huang, Shih-Ming; Chien, Kuang-Jen; Ger, Luo-Ping

    2016-12-01

    The aim of this study was to investigate whether mutation in AMP-activated protein kinase (AMPK) subunit genes (PRKAG3-230) is associated with sporadic, isolated Wolff-Parkinson-White (WPW) syndrome. This study consisted of 87 patients with symptomatic WPW syndrome and 93 healthy controls. PRKAG3-230 genotypes were determined using real-time polymerase chain reaction assay. Genotype and allele frequencies of PRKAG3-230 between patients with WPW syndrome and healthy controls were ascertained using chi-square test or Fisher exact test when appropriate. PRKAG3-230 were genotyped in 87 patients (53 men and 34 women; age=24.4±18.0 years) with WPW syndrome and 93 healthy controls (57 men and 36 women; age=16.8±4.2 years). There were no significant differences between the two groups in terms of age and sex. The patients with CG and CG+CC genotypes had a significantly increased risk of WPW syndrome compared with those with GG genotype [odds ratio (OR)=1.99, 95% confidence interval (CI)=1.01-3.89, p=0.045; OR=1.99, 95% CI=1.04-3.78, p=0.037, respectively]. The allelic types were not associated with the risk of WPW syndrome. The patients with manifest type with CG and CG+CC genotypes had a significantly increased risk of WPW syndrome compared with those with GG genotype (OR=2.86, 95% CI=1.16-7.05, p=0.022; OR=2.84, 95% CI=1.19-6.80, p=0.019, respectively). The patients with right-side accessory pathways with CG and CG+CC genotypes had a significantly increased risk of WPW syndrome compared with those with GG genotype (OR=3.07, 95% CI=1.25-7.51, p=0.014; OR=2.84, 95% CI=1.19-6.80, p=0.019, respectively). The allelic types were not associated with the risk of WPW types and locations. This study shows that PRKAG3-230 may be associated with sporadic WPW syndrome among a Taiwanese population. Further studies are warranted to elucidate the role of mutations in AMPK subunit genes other than PRKAG3-230 in sporadic WPW syndrome. Copyright © 2016. Published by Elsevier Taiwan LLC.

  17. Phase analysis of regional and global ventricular contraction patterns in Wolff-Parkinson-White syndrome. Assessment by radionuclide ventriculography

    Energy Technology Data Exchange (ETDEWEB)

    Konishi, Tokuji; Koyama, Takao; Ichikawa, Takehiko and others

    1989-04-01

    Multigated blood pool scintigraphy was performed in 20 normal subjects and 39 patients with various intraventricular conduction abnormalities, including 25 patients with Wolff-Parkinson-White (WPW) syndrome. Cardiac imaging was performed in the modified left anterior oblique, right anterior oblique, and left lateral projections. In WPW syndrome, early contraction sites which were not seen in normal subjects were detected at the ventricular base in phase images. These anomalous early contraction sites disappeared after successful suppression of conduction through an accessory pathway by intravenous procainamide. These sites are believed to correspond to the location of the bundle of Kent and were consistent with the electrocardiographic findings. Phase mapping is a suitable noninvasive method to locate the position of the bundle of Kent and evaluate the ventricular contraction pattern in WPW syndrome and other intraventricular conduction abnormalities. (author).

  18. Wolff-Parkinson-White syndrome type B and left bundle-branch block: electrophysiologic and radionuclide study

    Energy Technology Data Exchange (ETDEWEB)

    Rakovec, P.; Kranjec, I.; Fettich, J.J.; Jakopin, J.; Fidler, V.; Turk, J.

    1985-01-01

    Coinciding left bundle-branch block and Wolff-Parkinson-White syndrome type B, a very rare electrocardiographic occurrence, was found in a patient with dilated cardiomyopathy. Electrophysiologic study revealed eccentric retrograde atrial activation during ventricular pacing, suggesting right-sided accessory pathway. At programmed atrial pacing, effective refractory period of the accessory pathway was 310 ms; at shorter pacing coupling intervals, normal atrioventricular conduction with left bundle-branch block was seen. Left bundle-branch block was seen also with His bundle pacing. Radionuclide phase imaging demonstrated right ventricular phase advance and left ventricular phase delay; both right and left ventricular phase images revealed broad phase distribution histograms. Combined electrophysiologic and radionuclide investigations are useful to disclose complex conduction abnormalities and their mechanical correlates.

  19. Successful ablation of a right atrium-axillary ventricular accessory pathway associated with Wolff-Parkinson-White syndrome.

    Science.gov (United States)

    Yuan, Yuan; Long, Deyong; Dong, Jianzeng; Tao, Ling; Ma, Changsheng

    2017-12-01

    We report a case of a patient with right axillary ventricular. Similar congenital anomaly of the right atrium was reported as "right appendage diverticulum or right atrial diverticulum." However, this independent chamber has its own annulus, synchronizes with the right ventricular, and generates large ventricular potential. Under the guidance of the CARTO mapping system (Biosense Webster, Diamond Bar, CA, USA), a right atrioventricular accessory pathway associated with type B Wolff-Parkinson-White syndrome was ablated successfully. This pathway was close to the annulus of the axillary ventricular. The patient remained free of arrhythmia at 1-year follow-up. © 2017 Wiley Periodicals, Inc.

  20. Wolff-Parkinson-White syndrome type B and left bundle-branch block: electrophysiologic and radionuclide study

    International Nuclear Information System (INIS)

    Rakovec, P.; Kranjec, I.; Fettich, J.J.; Jakopin, J.; Fidler, V.; Turk, J.

    1985-01-01

    Coinciding left bundle-branch block and Wolff-Parkinson-White syndrome type B, a very rare electrocardiographic occurrence, was found in a patient with dilated cardiomyopathy. Electrophysiologic study revealed eccentric retrograde atrial activation during ventricular pacing, suggesting right-sided accessory pathway. At programmed atrial pacing, effective refractory period of the accessory pathway was 310 ms; at shorter pacing coupling intervals, normal atrioventricular conduction with left bundle-branch block was seen. Left bundle-branch block was seen also with His bundle pacing. Radionuclide phase imaging demonstrated right ventricular phase advance and left ventricular phase delay; both right and left ventricular phase images revealed broad phase distribution histograms. Combined electrophysiologic and radionuclide investigations are useful to disclose complex conduction abnormalities and their mechanical correlates

  1. Electrophysiology testing and catheter ablation are helpful when evaluating asymptomatic patients with Wolff-Parkinson-White pattern: the con perspective.

    Science.gov (United States)

    Skanes, Allan C; Obeyesekere, Manoj; Klein, George J

    2015-09-01

    The association between asymptomatic Wolff-Parkinson-White (WPW) syndrome and sudden cardiac death (SCD) has been well documented. The inherent properties of the accessory pathway determine the risk of SCD in WPW, and catheter ablation essentially eliminates this risk. An approach to WPW syndrome is needed that incorporates the patient's individualized considerations into the decision making. Patients must understand that there is a trade-off of a small immediate risk of an invasive approach for elimination of a small lifetime risk of the natural history of asymptomatic WPW. Clinicians can minimize the invasive risk by only performing ablation for patients with at-risk pathways. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. Probable Association of Tachyarrhythmia With Nebulized Albuterol in a Child With Previously Subclinical Wolff Parkinson White Syndrome

    Science.gov (United States)

    Kroesen, Michiel; Maseland, Machiel; Smal, Jaime; Reimer, Annet; van Setten, Petra

    2012-01-01

    We present the case of a 2-year-old asthmatic boy with atrioventricular (AV)-reentry tachycardia following albuterol inhalation, who was later diagnosed with Wolff-Parkinson-White (WPW) syndrome. The Naranjo adverse drug reaction probability scale score for this adverse event was 7, indicating that the association between his AV-reentry tachycardia and inhalation of albuterol is probable. To our knowledge, this is the first case report that shows the potential arrhythmogenic effects of albuterol in a child with WPW syndrome. We urge clinicians to be aware of this potentially life-threatening adverse effect and to closely monitor these patients when they need beta-adrenergic drugs in case of emergency. Furthermore, this report highlights the dilemma regarding the safe treatment of pediatric patients with both asthma and WPW syndrome. PMID:23118663

  3. Preexcitación ventricular: dificultad en el tratamiento de un caso de Wolff-Parkinson-White en un deportista

    Directory of Open Access Journals (Sweden)

    A. Cis-Spoturno

    2014-06-01

    Full Text Available El síndrome de Wolff-Parkinson White (WPW puede detectarse en poblaciones de deportistas asintomáticos al realizar un electrocardiograma (ECG o presentarse con episodios de palpitaciones secundarios a arritmias. Presentamos el caso de un jugador de baloncesto, con examen previo normal, a quien se detecta patrón de preexcitación, esporádicamente sintomático, en una evaluación médico-deportiva. Realizados los estudios correspondientes, se indicó tratamiento con ablación. En su evolución posterior al procedimiento, el paciente aún mantiene síntomas y en el trazado electrocardiográfico reaparece la vía accesoria. El objetivo de este trabajo es analizar el diagnóstico, tratamiento y control adecuados de esta patología en un deportista adolescente.

  4. Percutenous Catheter Ablation of the Accessory Pathway in a Patient with Wolff-Parkinson-White Syndrome Associated with Familial Atrial Fibrillation

    Science.gov (United States)

    Cay, Serkan; Topaloglu, Serkan; Aras, Dursun

    2008-01-01

    Percutenous catheter ablation of the accessory pathway in Wolff-Parkinson-White syndrome is a highly successful mode of therapy. Sudden cardiac arrest survivors associated with WPW syndrome should undergo radiofrequency catheter ablation. WPW syndrome associated with familial atrial fibrillation is a very rare condition. Herein, we describe a case who presented with sudden cardiac arrest secondary to WPW syndrome and familial atrial fibrillation and treated via radiofrequency catheter ablation. PMID:18379660

  5. Cardiac memory in patients with Wolff-Parkinson-White syndrome: noninvasive imaging of activation and repolarization before and after catheter ablation.

    Science.gov (United States)

    Ghosh, Subham; Rhee, Edward K; Avari, Jennifer N; Woodard, Pamela K; Rudy, Yoram

    2008-08-26

    Cardiac memory refers to a change in ventricular repolarization induced by and persisting for minutes to months after cessation of a period of altered ventricular activation (eg, resulting from pacing or preexcitation in patients with Wolff-Parkinson-White syndrome). ECG imaging (ECGI) is a novel imaging modality for noninvasive electroanatomic mapping of epicardial activation and repolarization. Fourteen pediatric patients with Wolff-Parkinson-White syndrome and no other congenital disease, were imaged with ECGI a day before and 45 minutes, 1 week, and 1 month after successful catheter ablation. ECGI determined that preexcitation sites were consistent with sites of successful ablation in all cases to within a 1-hour arc of each atrioventricular annulus. In the preexcited rhythm, activation-recovery interval (ARI) was the longest (349+/-6 ms) in the area of preexcitation leading to high average base-to-apex ARI dispersion of 95+/-9 ms (normal is approximately 40 ms). The ARI dispersion remained the same 45 minutes after ablation, although the activation sequence was restored to normal. ARI dispersion was still high (79+/-9 ms) 1 week later and returned to normal (45+/-6 ms) 1 month after ablation. The study demonstrates that ECGI can noninvasively localize ventricular insertion sites of accessory pathways to guide ablation and evaluate its outcome in pediatric patients with Wolff-Parkinson-White syndrome. Wolff-Parkinson-White is associated with high ARI dispersion in the preexcited rhythm that persists after ablation and gradually returns to normal over a period of 1 month, demonstrating the presence of cardiac memory. The 1-month time course is consistent with transcriptional reprogramming and remodeling of ion channels.

  6. Percutenous Catheter Ablation of the Accessory Pathway in a Patient with Wolff-Parkinson-White Syndrome Associated with Familial Atrial Fibrillation

    Directory of Open Access Journals (Sweden)

    Serkan Cay

    2008-04-01

    Full Text Available Percutenous catheter ablation of the accessory pathway in Wolff-Parkinson-White syndrome is a highly successful mode of therapy. Sudden cardiac arrest survivors associated with WPW syndrome should undergo radiofrequency catheter ablation. WPW syndrome associated with familial atrial fibrillation is a very rare condition. Herein, we describe a case who presented with sudden cardiac arrest secondary to WPW syndrome and familial atrial fibrillation and treated via radiofrequency catheter ablation.

  7. Parametric imaging of experimentally simulated Wolff-Parkinson-White syndrome conduction abnormalities in dogs: a concise communication

    Energy Technology Data Exchange (ETDEWEB)

    Weismueller, P.H.; Henze, E.; Adam, W.E.; Roth, J.; Bitter, F.; Stauch, M.

    1986-01-01

    In order to test the diagnostic potential of phase analysis of radionuclide ventriculography (RNV) for localizing accessory bundles in Wolff-Parkinson-White (WPW) syndrome, 24 experimental runs were performed in three open chest instrumented dogs. After a baseline study, WPW syndrome was simulated by stimulation at seven different sites around the base of the ventricles, and RNV's were obtained. Subsequent data processing including Fourier transformation allowed the localization of the site of the first inward motion of the ventricles by an isophasic wave display. In sinus rhythm, the septum contracted first. During ectopic premature ventricular stimulation by triggering the atrial signal, the phase scan was altered only when the stimulus was applied earlier than 20 ms before the expected QRS complex during sinus rhythm. During stimulation with fixed frequency, only the left lateral positions of the premature stimulation were detected by phase analysis with a sensitivity of 86%. Neither the antero- or posteroseptal nor the right ventricular premature contraction pattern could be exactly localized.

  8. Phase analysis in patients with Wolff-Parkinson-White syndrome. Correlations to surgically confirmed accessory conduction pathways

    Energy Technology Data Exchange (ETDEWEB)

    Nakajima, Kenichi; Bunko, Hisashi; Tada, Akira; Taki, Junichi; Tonami, Norihisa

    1983-09-01

    Twenty-five patients with Wolff-Parkinson-White (WPW) syndrome who underwent surgical division of the accessory conduction pathway (ACP) were studied by gated blood pool studies and phase analyses. All of 11 patients with right cardiac type (R-type) had abnormal initial phase in the right ventricle (RV), while 10 out of 14 patients with left cardiac type (L-type) had initial phase in the left ventricle (LV). However, in 4 L-type patients, there were no significant differences in the initiation of both ventricular contractions. In 10 patients who had radionuclide studies before and after surgical division of the ACP, the ventricular contraction patterns were apparently changed and the abnormal wall motions induced by the presence of ACPs disappeared. These observations indicate that the abnormal initial contraction is associated with pre-excitation of WPW syndrome. Sensitivities to identify the side of preexcitation were 100% (11/11) for R-type and 71% (10/14) for L-type. However, regarding the detection of the precise site of ACP, the agreement was 48% (12/25). Therefore, as a method of preoperative study, it seemed difficult to identify the precise localization of the ACP by phase analysis alone. Phase analysis provided interesting informations and was useful for evaluating patients with WPW syndrome before and after surgery. (author).

  9. Amiodarone and Catheter Ablation as Cardiac Resynchronization Therapy for Children with Dilated Cardiomyopathy and Wolff-Parkinson-White Syndrome

    Science.gov (United States)

    Kim, Sung Hoon; Jeong, Soo In; Kang, I-Seok; Lee, Heung Jae

    2013-01-01

    Preexcitation by accessory pathways (APs) is known to cause dyssynchrony of the ventricle, related to ventricular dysfunction. Correction of ventricular dyssynchrony can improve heart failure in cases of dilated cardiomyopathy (DCMP) with preexcitation. Here, we report the first case of a child with DCMP and Wolff-Parkinson-White (WPW) syndrome treated with amiodarone and radiofrequency catheter ablation (RFCA) in Korea. A 7-year-old boy, who suffered from DCMP and WPW syndrome, showed improved left ventricular function and clinical functional class after treatment with amiodarone to eliminate preexcitation. QRS duration and left ventricular ejection fraction (LVEF) were inversely correlated with amiodarone dosage. After confirming the reduction of preexcitation effects in DCMP, successful RFCA of the right anterior AP resulted in LVEF improvement, along with the disappearance of preexcitation. Our findings suggest that ventricular dyssynchrony, caused by preexcitation in DCMP with WPW syndrome, can worsen ventricular function and amiodarone, as well as RFCA, which should be considered as a treatment option, even in young children. PMID:23407697

  10. [Cardioversion for paroxysmal supraventricular tachycardia during lung surgery in a patient with concealed Wolff-Parkinson-White syndrome].

    Science.gov (United States)

    Sato, Yoshiharu; Nagata, Hirofumi; Inoda, Ayako; Miura, Hiroko; Watanabe, Yoko; Suzuki, Kenji

    2014-10-01

    We report a case of paroxysmal supraventricular tachycardia (PSVT) that occurred during video-assisted thoracoscopic (VATS) lobectomy in a patient with concealed Wolff-Parkinson-White (WPW) syndrome. A 59-year-old man with lung cancer was scheduled for VATS lobectomy under general anesthesia. After inserting a thoracic epidural catheter, general anesthesia was induced with intravenous administration of propofol. Anesthesia was maintained with inhalation of desfurane in an air/oxygen mixture and intravenous infusion of remifentanil. Recurrent PSVT occurred three times, and the last episode of PSVT continued for 50 minutes regardless of administration of antiarrhythmic drugs. Synchronized electric shock via adhesive electrode pads on the patient's chest successfully converted PSVT back to normal sinus rhythm. The remaining course and postoperative period were uneventful. An electrophysiological study performed after hospital discharge detected concealed WPW syndrome, which had contributed to the development of atrioventricular reciprocating tachycardia. Concealed WPW syndrome is a rare, but critical complication that could possibly cause lethal atrial tachyarrhythmias during the perioperative period. In the present case, cardioversion using adhesive electrode pads briefly terminated PSVT in a patient with concealed WPW syndrome.

  11. Phase analysis in the Wolff-Parkinson-White syndrome with surgically proven accessory conduction pathways: concise communication

    International Nuclear Information System (INIS)

    Nakajima, K.; Bunko, H.; Tada, A.; Taki, J.; Tonami, N.; Hisada, K.; Misaki, T.; Iwa, T.

    1984-01-01

    Twenty-one patients with the Wolff-Parkinson-White (WPW) syndrome who underwent surgical division of the accessory conduction pathway (ACP) were studied by gated blood-pool scintigraphy. In each case, a functional image of the phase was generated, based on the fundamental frequency of the Fourier transform. The location of the ACP was confirmed by electrophysiologic study, epicardial mapping, and surgery. Phase analysis identified the side of preexcitation correctly in 16 out of 20 patients with WPW syndrome with a delta wave. All patients with right-cardiac type (N=9) had initial contraction in the right ventricle (RV). In patients with left-cardiac type (N=10), six had initial movement in the left ventricle (LV); but in the other four the ACPs in the anterior or lateral wall of the left ventricle (LV) could not be detected. In patients with multiple ACPs (N=2), one right-cardiac type had initial contraction in the RV, while in the other (with an intermittent WPW syndrome) the ACP was not detected. These observations indicate that abnormal wall motion is associated with the conduction anomalies of the WPW syndrome. We conclude that phase analysis can correctly identify the side of initial contraction in the WPW syndrome before and after surgery. However, as a method of preoperative study, it seems difficult to determine the precise site of the ACP by phase analysis alone

  12. Phase analysis in the Wolff-Parkinson-White syndrome with surgically proven accessory conduction pathways: concise communication

    Energy Technology Data Exchange (ETDEWEB)

    Nakajima, K.; Bunko, H.; Tada, A.; Taki, J.; Tonami, N.; Hisada, K.; Misaki, T.; Iwa, T.

    1984-01-01

    Twenty-one patients with the Wolff-Parkinson-White (WPW) syndrome who underwent surgical division of the accessory conduction pathway (ACP) were studied by gated blood-pool scintigraphy. In each case, a functional image of the phase was generated, based on the fundamental frequency of the Fourier transform. The location of the ACP was confirmed by electrophysiologic study, epicardial mapping, and surgery. Phase analysis identified the side of preexcitation correctly in 16 out of 20 patients with WPW syndrome with a delta wave. All patients with right-cardiac type (N=9) had initial contraction in the right ventricle (RV). In patients with left-cardiac type (N=10), six had initial movement in the left ventricle (LV); but in the other four the ACPs in the anterior or lateral wall of the left ventricle (LV) could not be detected. In patients with multiple ACPs (N=2), one right-cardiac type had initial contraction in the RV, while in the other (with an intermittent WPW syndrome) the ACP was not detected. These observations indicate that abnormal wall motion is associated with the conduction anomalies of the WPW syndrome. We conclude that phase analysis can correctly identify the side of initial contraction in the WPW syndrome before and after surgery. However, as a method of preoperative study, it seems difficult to determine the precise site of the ACP by phase analysis alone.

  13. Mutation of Mitochondrial DNA G13513A Presenting with Leigh Syndrome, Wolff-Parkinson-White Syndrome and Cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Shi-Bing Wang

    2008-08-01

    Full Text Available Mutation of mitochondrial DNA (mtDNA G13513A, encoding the ND5 subunit of respiratory chain complex I, can cause mitochondrial encephalopathy with lactic acidosis and stroke-like episodes (MELAS and Leigh syndrome. Wolff-Parkinson-White (WPW syndrome and optic atrophy were reported in a high proportion of patients with this mutation. We report an 18-month-old girl, with an 11-month history of psychomotor regression who was diagnosed with WPW syndrome and hypertrophic cardiomyopathy, in association with Leigh syndrome. Supplementation with coenzyme Q10, thiamine and carnitine prevented further regression in gross motor function but the patient's heart function deteriorated and dilated cardiomyopathy developed 11 months later. She was found to have a mutation of mtDNA G13513A. We suggest that mtDNA G13513A mutation is an important factor in patients with Leigh syndrome associated with WPW syndrome and/or optic atrophy, and serial heart function monitoring by echocardiography is recommended in this group of patients.

  14. Dyssynchronous Ventricular Activation in Asymptomatic Wolff-Parkinson-White Syndrome: A Risk Factor for Development of Dilated Cardiomyopathy

    Science.gov (United States)

    Udink ten Cate, Floris EA; Wiesner, Nathalie; Trieschmann, Uwe; Khalil, Markus; Sreeram, Narayanswami

    2010-01-01

    A subset of children and adults with Wolff-Parkinson-White (WPW) syndrome develop dilated cardiomyopathy (DCM). Although DCM may occur in symptomatic WPW patients with sustained tachyarrhythmias, emerging evidence suggests that significant left ventricular dysfunction may arise in WPW in the absence of incessant tachyarrhythmias. An invariable electrophysiological feature in this non-tachyarrhythmia type of DCM is the presence of a right-sided septal or paraseptal accessory pathway. It is thought that premature ventricular activation over these accessory pathways induces septal wall motion abnormalities and ventricular dyssynchrony. LV dyssynchrony induces cellular and structural ventricular remodelling, which may have detrimental effects on cardiac performance. This review summarizes recent evidence for development of DCM in asymptomatic patients with WPW, discusses its pathogenesis, clinical presentation, management and treatment. The prognosis of accessory pathway-induced DCM is excellent. LV dysfunction reverses following catheter ablation of the accessory pathway, suggesting an association between DCM and ventricular preexcitation. Accessory pathway-induced DCM should be suspected in all patients presenting with heart failure and overt ventricular preexcitation, in whom no cause for their DCM can be found. PMID:20552060

  15. Effect of Radiofrequency Catheter Ablation on Quality of Life in Patients with Wolff-Parkinson-White Syndrome

    Directory of Open Access Journals (Sweden)

    Shokhrukh Erkaboev

    2015-09-01

    Full Text Available Wolff-Parkinson-White (WPW syndrome is one of several disorders of the conduction system of the heart that are commonly referred to as pre-excitation syndromes. As the syndrome significantly reduces the patients’ quality of life (QoL, the purpose of the current study was to compare QoL scores in patients with WPW syndrome before and after a radiofrequency catheter ablation (RFA procedure. To assess the patients’ QoL, the MOS 36-Item Short-Form Health Survey was used. Immediate and long-term outcomes of radiofrequency catheter ablation were analyzed in 60 patients diagnosed with WPW syndrome, 41(68.3% men and 19(31.7% women. As compared with the controls (28 apparently healthy persons, patients with WPW syndrome before RFA experienced significant reduction in both physical and mental health components. RFA was found effective in 93.3% of patients with WPW syndrome. At 3 months after RFA, patients showed significant improvement in both physical (13.5% and mental (17.2% health components; at 12 months, QoL parameters reached those of the controls.

  16. Paroxysmal supraventricular tachycardia and Wolff-Parkinson-White syndrome in ankylosing spondylitis: a large cohort observation study and literature review.

    Science.gov (United States)

    Ho, Huei-Huang; Yeh, San-Jou; Tsai, Wen-Pin; Wang, Chin-Man; Chen, Ji Yih

    2012-12-01

    To investigate the associations of paroxysmal supraventricular tachycardia (PSVT) and Wolff-Parkinson-White (WPW) syndrome with ankylosing spondylitis (AS). We conducted a retrospective cohort study by reviewing the medical records of 1503 consecutive AS patients diagnosed at a tertiary medical center. The clinical and electrocardiographic (ECG) characteristics of 641 AS patients having 12-lead ECG available were further analyzed in a precise manner. Among the 641 AS patients with 12-lead ECG available for detecting cardiac abnormalities, 14 were identified as having PSVT, including 3 with WPW syndrome and 1 having a WPW (ventricular preexcitation) ECG pattern. A higher proportion of AS patients presented with PSVT (21.8/1000) compared with a general population-based study (2.25/1000). Also, AS patients demonstrated a higher prevalence of WPW syndrome or WPW pattern (6.24/1000) than found in general population-based studies (0.9 to 1.5/1000). Ankylosing spondylitis patients with PSVT or WPW syndrome had significantly higher rates of peripheral arthritis (78.6%; P = 0.002), acute anterior uveitis (64.3%; P = 0.003), bamboo spine (64.3%; P = 0.001), and other cardiovascular disorders (85.7%; P syndrome. Detailed ECG and electrophysiological examinations are required for early detection of PSVT and WPW syndrome for prompt resolution of potentially life-threatening complications in all AS patients, especially those presenting with the symptoms of palpitation, dizziness, dyspnea, or syncope. Copyright © 2012 Elsevier Inc. All rights reserved.

  17. Parametric imaging of experimentally simulated Wolff-Parkinson-White syndrome conduction abnormalities in dogs: a concise communication

    International Nuclear Information System (INIS)

    Weismueller, P.H.; Henze, E.; Adam, W.E.; Roth, J.; Bitter, F.; Stauch, M.

    1986-01-01

    In order to test the diagnostic potential of phase analysis of radionuclide ventriculography (RNV) for localizing accessory bundles in Wolff-Parkinson-White (WPW) syndrome, 24 experimental runs were performed in three open chest instrumented dogs. After a baseline study, WPW syndrome was simulated by stimulation at seven different sites around the base of the ventricles, and RNV's were obtained. Subsequent data processing including Fourier transformation allowed the localization of the site of the first inward motion of the ventricles by an isophasic wave display. In sinus rhythm, the septum contracted first. During ectopic premature ventricular stimulation by triggering the atrial signal, the phase scan was altered only when the stimulus was applied earlier than 20 ms before the expected QRS complex during sinus rhythm. During stimulation with fixed frequency, only the left lateral positions of the premature stimulation were detected by phase analysis with a sensitivity of 86%. Neither the antero- or posteroseptal nor the right ventricular premature contraction pattern could be exactly localized

  18. Members of the emergency medical team may have difficulty diagnosing rapid atrial fibrillation in Wolff-Parkinson-White syndrome.

    Science.gov (United States)

    Koźluk, Edward; Timler, Dariusz; Zyśko, Dorota; Piątkowska, Agnieszka; Grzebieniak, Tomasz; Gajek, Jacek; Gałązkowski, Robert; Fedorowski, Artur

    2015-01-01

    Atrial fibrillation (AF) in patients with Wolff-Parkinson-White (WPW) syndrome is potentially life-threatening as it may deteriorate into ventricular fibrillation. The aim of this study was to assess whether the emergency medical team members are able to diagnose AF with a rapid ventricular response due to the presence of atrioventricular bypass tract in WPW syndrome. The study group consisted of 316 participants attending a national congress of emergency medicine. A total of 196 questionnaires regarding recognition and management of cardiac arrhythmias were distributed. The assessed part presented a clinical scenario with a young hemodynamically stable man who had a 12-lead electrocardiogram performed in the past with signs of pre-excitation, and who presented to the emergency team with an irregular broad QRS-complex tachycardia. A total of 71 questionnaires were filled in. Only one responder recognized AF due to WPW syndrome, while 5 other responders recognized WPW syndrome and paroxysmal supraventricular tachycardia or broad QRS-complex tachycardia. About 20% of participants did not select any diagnosis, pointing out a method of treatment only. The most common diagnosis found in the survey was ventricular tachycardia/broad QRS-complex tachycardia marked by approximately a half of the participants. Nearly 18% of participants recognized WPW syndrome, whereas AF was recognized by less than 10% of participants. Members of emergency medical teams have limited skills for recognizing WPW syndrome with rapid AF, and ventricular tachycardia is the most frequent incorrect diagnosis.

  19. Electrophysiologic profile and results of invasive risk stratification in asymptomatic children and adolescents with the Wolff-Parkinson-White electrocardiographic pattern.

    Science.gov (United States)

    Kubuš, Peter; Vít, Pavel; Gebauer, Roman A; Materna, Ondřej; Janoušek, Jan

    2014-04-01

    Data on the results and clinical effect of an invasive risk stratification strategy in asymptomatic young patients with the Wolff-Parkinson-White electrocardiographic pattern are scarce. Eighty-five consecutive patients agedWolff-Parkinson-White pattern and persistent preexcitation at maximum exercise undergoing invasive risk stratification were retrospectively studied. Adverse accessory pathway (AP) properties were defined according to currently consented criteria as any of the following: shortest preexcited RR interval during atrial fibrillation/rapid atrial pacing≤250 ms (or antegrade effective refractory period≤250 ms if shortest preexcited RR interval was not available) or inducible atrioventricular re-entrant tachycardia. Age at evaluation was median 14.9 years. Eighty-two patients had a structurally normal heart and 3 had hypertrophic cardiomyopathy. A single manifest AP was present in 80, 1 manifest and 1 concealed AP in 4, and 2 manifest APs in 1 patient. Adverse AP properties were present in 32 of 85 patients (37.6%) at baseline and in additional 16 of 44 (36.4%) after isoproterenol. Ablation was performed in 41 of these 48 patients. Ablation was deferred in the remaining 7 for pathway proximity to the atrioventricular node. In addition, 18 of the low-risk patients were ablated based on patient/parental decision. Adverse AP properties at baseline were exhibited by 37.6% of the evaluated patients with an asymptomatic Wolff-Parkinson-White preexcitation persisting at peak exercise. Isoproterenol challenge yielded additional 36.4% of those tested at higher risk. Ablation was performed in a total of 69.4% of patients subjected to invasive risk stratification.

  20. Gated blood-pool SPECT assessment of Wolff-Parkinson-White syndromes before and after radiofrequency ablation of accessory pathways; Evaluation fonctionnelle par tomographie cavitaire du syndrome de Wolff-Parkinson-White, avant et apres traitement par radiofrequence

    Energy Technology Data Exchange (ETDEWEB)

    Bontemps, L.; Ben Brahim, H.; Kraiem, T.; Chevalier, P.; Kirkorian, G.; Touboul, P.; Itti, R. [Hopital Cardiologique de Lyon, 69 (France)

    1997-08-01

    Radiofrequency (RF) ablation of accessory pathways in Wolff-Parkinson-White (WPW) syndrome is supposed to be less aggressive than fulguration while providing excellent results. The aims of our study were therefore the evaluation of the functional results of this therapy in terms of left or right ejection fractions and its effects on the contraction synchronism between both ventricular chambers, derived from bi-ventricular Fourier phase histograms. A consecutive series of 44 patients has been investigated within 48 hours before and after RF therapy: 14 patients had right sided WPW and 30 patients left sided WPW. Only patients for whom RF treatment was considered as a success have been included in the study. Gated blood pool tomography has been performed in order to localize the site of pre-excitation and to build-up the phase histograms for both ventricles, and planar gated imaging has been used for right and left ejection fraction determination. Functional results demonstrate the absence of deleterious effect of RF on ventricular contraction and rather a slight increase of ejection fractions, with a more statistically significant difference for left WPW (LVEF = 62.2 % before RF vs 64.4 % after RF; p = 0.02) than for right WPW (RVEF = 36.3 % before RF vs 39.7 after RF; p = 0.16). Phase analysis, on the contrary, show only significant differences for right WPW, with a noticeable decrease of the pre-excitation (left-to-right phase difference 14.4 deg before RF vs 7.5 deg after RF; p = 0.03) and a significant reduction of the right ventricular phase dispersion (right phase standard deviation 26.5 deg before RF vs 19.0 deg after RF; p = 0.03). For left WPW no measurable differences can be demonstrated in the basal state and it is suggested to use stimulation techniques in order to enhance the competition between the normal and accessory conduction pathways. (authors). 17 refs.

  1. Usefulness of severe cardiac sympathetic dysfunction to predict the occurrence of rapid atrial fibrillation in patients with Wolff-Parkinson-White syndrome.

    Science.gov (United States)

    Akutsu, Yasushi; Kaneko, Kyouichi; Kodama, Yusuke; Li, Hui-Ling; Asano, Taku; Suyama, Jumpei; Tanno, Kaoru; Namiki, Atsuo; Shinozuka, Akira; Gokan, Takehiko; Kobayashi, Youichi

    2013-09-01

    Atrial fibrillation (AF) can be a potentially life-threatening arrhythmia when it conducts rapidly through the accessory pathway, which was not predicted by the noninvasive method. We evaluated the cardiac sympathetic activity for predicting the occurrence of AF in patients with Wolff-Parkinson-White (WPW) syndrome. Iodine-123 metaiodobenzylguanidine scintigraphy was performed under stable sinus rhythm conditions at rest syndrome than in the normal control group, and in the 15 patients with AF induced during EPS than in the 30 patients without AF (p syndrome. Copyright © 2013 Elsevier Inc. All rights reserved.

  2. Rapid recovery from congestive heart failure following successful radiofrequency catheter ablation in a patient with late onset of Wolff-Parkinson-White syndrome.

    Science.gov (United States)

    Yodogawa, Kenji; Ono, Norihiko; Seino, Yoshihiko

    2012-01-01

    A 56-year-old man was admitted because of palpitations and dyspnea. A 12-lead electrocardiogram showed irregular wide QRS complex tachycardia with a slur at the initial portion of the QRS complex. He had preexisting long-standing persistent atrial fibrillation, but early excitation syndrome had never been noted. Chest X-ray showed heart enlargement and pulmonary congestion. He was diagnosed with late onset of Wolff-Parkinson-White syndrome, and congestive heart failure was probably caused by rapid ventricular response of atrial fibrillation through the accessory pathway. Emergency catheter ablation for the accessory pathway was undertaken, and heart failure was dramatically improved.

  3. Methodological study of radionuclide tomographic phase analysis in localization of accessory conduction pathway in patients with wolff-parkinson-white syndrome

    International Nuclear Information System (INIS)

    Wo Jinshan; Zhu Junren; Li Zhishan

    1994-01-01

    In this study, the methodology of tomographic phase analysis to detect the site of accessory conduction pathway (ACP) in patients with Wolff-Parkinson-White syndrome was presented. We analyzed the major factors that affect image reconstruction, selection of tomographic planes and phase analysis, also discussed the key step for reconstruction short-axial section that parallel and closest to the level of atrio-ventricular rings. Of five patients undergoing this procedure prior to surgery, tomographic phase analysis correctly identified the site of ACP confirmed by epicardial mapping in all of the five patients. Our results suggest this approach to be an objective, clear and correct one for localizing ACP

  4. Anesthetic management for surgical repair of Ebstein′s anomaly along with coexistent Wolff-Parkinson-White syndrome in a patient with severe mitral stenosis

    Directory of Open Access Journals (Sweden)

    Sinha Prabhat

    2010-01-01

    Full Text Available Ebstein′s anomaly (EA is the most common cause of congenital tricuspid regurgitation. The associated anomalies commonly seen are atrial septal defect or patent foramen ovale and accessory conduction pathways. Its association with coexisting mitral stenosis (MS has uncommonly been described. The hemodynamic consequences and anesthetic implications, of a combination of EA and rheumatic MS, have not so far been discussed in the literature. We report successful anesthetic management of a repair of EA and mitral valve replacement in a patient with coexisting Wolff-Parkinson-White (WPW syndrome.

  5. Tomographic phase analysis to detect the site of accessory conduction pathway in Wolff-Parkinson-White syndrome

    International Nuclear Information System (INIS)

    Nakajima, K.; Bunko, H.; Tada, A.; Tonami, N.; Taki, J.; Nanbu, I.; Hisada, K.; Misaki, T.; Iwa, T.

    1984-01-01

    Phase analysis has been applied to Wolff-Parkinson-White syndrome (WPW) to detect the site of accessory conduction pathway (ACP); however, there was a limitation to estimate the precise location of ACP by planar phase analysis. In this study, the authors applied phase analysis to gated blood pool tomography. Twelve patients with WPW who underwent epicardial mapping and surgical division of ACP were studied by both of gated emission computed tomography (GECT) and routine gated blood pool study (GBPS). The GBPS was performed with Tc-99m red blood cells in multiple projections; modified left anterior oblique, right anterior oblique and/or left lateral views. In GECT, short axial, horizontal and vertical long axial blood pool images were reconstructed. Phase analysis was performed using fundamental frequency of the Fourier transform in both GECT and GBPS images, and abnormal initial contractions on both the planar and tomographic phase analysis were compared with the location of surgically confirmed ACPs. In planar phase analysis, abnormal initial phase was identified in 7 out of 12 (58%) patients, while in tomographic phase analysis, the localization of ACP was predicted in 11 out of 12 (92%) patients. Tomographic phase analysis is superior to planar phase images in 8 out of 12 patients to estimate the location of ACP. Phase analysis by GECT can avoid overlap of blood pool in cardiac chambers and has advantage to identify the propagation of phase three-dimensionally. Tomographic phase analysis is a good adjunctive method for patients with WPW to estimate the site of ACP

  6. Phase mapping of radionuclide gated biventriculograms in patients with sustained ventricular tachycardia or Wolff-Parkinson-White syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Le Guludec, D.; Bourguignon, M.; Sebag, C.; Valette, H.; Sirinelli, A.; Davy, J.M.; Syrota, A.; Motte, G.

    1987-01-01

    Accuracy of Fourier phase mapping of radionuclide gated biventriculograms in detecting the origin of abnormal ventricular activation was studied during ventricular tachycardia or preexcitation. Group I included six patients suffering from clinical recurrent VT; 3 gated blood pool studies were acquired for each patient: during sinus rhythm, right ventricular pacing, and induced sustained VT-Group II included seven patients with Wolff-Parkinson-White syndrome and recurrent paroxysmal tachycardia; 3 gated blood pool studies were acquired for each patient: during sinus rhythm, right atrial pacing and orthodromic reciprocating tachycardia. Each acquisition lasted 5 min, in 30 degrees-40 degrees left anterior oblique projection. In Group I, the Fourier phase mapping was consistent with QRS morphology and axis during VT (5/6), except in one patient with LV aneurysm and LBBB electrical pattern during VT. Origin of VT on phase mapping was located in the right ventricle (n = 2) or in left ventricle (n = 4), at the border of wall motion abnormalities each time they existed (5/6). In Group II, the phase advance correlated with the location of the accessory pathway determined by ECG and endocardial mapping (n = 6) and per-operative epicardial mapping (n = 1). Discrimination between anterior and posterior localization of paraseptal pathways and location of intermittent preexcitation was not possible. We conclude that Fourier phase mapping is an accurate method for locating the origin of VT and determining its etiology. It can help locate the site of ventricular preexcitation in patients with only one accessory pathway; its accuracy in locating multiple accessory pathways remains unknown.

  7. Exercise testing and thallium-201 myocardial perfusion scintigraphy in the clinical evaluation of patients with Wolff Parkinson White syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Poyatos, M.E.; Suarez, L.; Lerman, J.; Guibourg, H.; Camps, J.; Perosio, A.

    1986-10-01

    In 58 patients with Wolff Parkinson White syndrome (WPW), we performed exercise stress testing in order to investigate the incidence of normalization of the auriculo-ventricular conduction and the ST-segment changes. For a more accurate evaluation of the latter, exercise and redistribution radionuclide images with Thallium-201 were obtained in 18 cases. Forty-nine had type A and nine had type B of WPW. Forty-eight had permanent, four had alternant and six had no pre-excitation (PE) when they started the test. Mean maximal functional capacity, mean maximal heart rate and mean maximal double product were not different when compared to an age-matched control group. Of the 48 patients who began the test with PE, in 23 (48%) it disappeared while PE persisted in 25 (52%). In 16 cases the disappearance of the PE was sudden and in seven it was progressive. Pre-excitation persisted in 39.5% of patients with type A and in 88.8% with type B (p less than 0.01). ST-segment depression was observed in 76.6% of patients with PE and in 28.6% of cases without PE (p less than 0.01). ST-segment depression occurred in 44.8% of patients with type A and in 100% of cases with type B (p less than 0.05). Transient abnormal Thallium-201 scans were observed in 62.5% of patients without PE and in 20% with PE. No patients showed exertional arrhythmias. This study suggests the possibility of measuring the duration of the refractory period of the accessory pathway in those patients n which the PE disappears suddenly, at a given heart rate.

  8. Dyssynchronous ventricular contraction in Wolff-Parkinson-White syndrome: a risk factor for the development of dilated cardiomyopathy.

    Science.gov (United States)

    Dai, Chen-Cheng; Guo, Bao-Jing; Li, Wen-Xiu; Xiao, Yan-Yan; Jin, Mei; Han, Lin; Sun, Jing-Ping; Yu, Cheuk-Man; Dong, Jian-Zeng

    2013-11-01

    Emerging evidence suggests that significant left ventricular dysfunction may arise in right-sided septal or paraseptal accessory pathways (APs) with Wolff-Parkinson-White syndrome, even in the absence of recurrent or incessant tachycardia. During 1 year and 9 months, we identified four consecutive female children with median age of 8 years diagnosed as having dilated cardiomyopathy (DCM) combined with overt right-sided APs several years ago. Incessant or recurrent tachycardia as the cause of DCM could be excluded. Anti-heart failure chemotherapy did not produce satisfactory effects. The patients underwent radiofrequency ablations (RFCAs). This report describes the clinical and echocardiographic characteristics of the cases before and after the ablation. Dyssynchronous ventricular contraction was observed in all patients. The locations of the APs were the right-sided anteroseptum and the free wall (n = 2 each). All patients received successful RFCAs. Their physical activities and growth improved greatly, and the echocardiographic data demonstrated that their left ventricular (LV) contraction recovered to synchrony shortly after the ablation and that their LV function recovered to normal gradually during the follow-up. A causal relationship between overt ventricular preexcitation and the development of DCM is supported by the complete recovery of LV function and reversed LV remodeling after the loss of ventricular preexcitation. Preexcitation-related dyssynchrony was probably the crucial mechanism. Not only right-sided septal or paraseptal but also free wall overt APs may induce LV dysfunction and even DCM. AP-induced DCM is an indication for ablation with a good prognosis.

  9. Physiological Expression of AMPKγ2RG Mutation Causes Wolff-Parkinson-White Syndrome and Induces Kidney Injury in Mice.

    Science.gov (United States)

    Yang, Xiaodong; Mudgett, John; Bou-About, Ghina; Champy, Marie-France; Jacobs, Hugues; Monassier, Laurent; Pavlovic, Guillaume; Sorg, Tania; Herault, Yann; Petit-Demoulière, Benoit; Lu, Ku; Feng, Wen; Wang, Hongwu; Ma, Li-Jun; Askew, Roger; Erion, Mark D; Kelley, David E; Myers, Robert W; Li, Cai; Guan, Hong-Ping

    2016-11-04

    Mutations of the AMP-activated kinase gamma 2 subunit (AMPKγ2), N488I (AMPKγ2 NI ) and R531G (AMPKγ2 RG ), are associated with Wolff-Parkinson-White (WPW) syndrome, a cardiac disorder characterized by ventricular pre-excitation in humans. Cardiac-specific transgenic overexpression of human AMPKγ2 NI or AMPKγ2 RG leads to constitutive AMPK activation and the WPW phenotype in mice. However, overexpression of these mutant proteins also caused profound, non-physiological increase in cardiac glycogen, which might abnormally alter the true phenotype. To investigate whether physiological levels of AMPKγ2 NI or AMPKγ2 RG mutation cause WPW syndrome and metabolic changes in other organs, we generated two knock-in mouse lines on the C57BL/6N background harboring mutations of human AMPKγ2 NI and AMPKγ2 RG , respectively. Similar to the reported phenotypes of mice overexpressing AMPKγ2 NI or AMPKγ2 RG in the heart, both lines developed WPW syndrome and cardiac hypertrophy; however, these effects were independent of cardiac glycogen accumulation. Compared with AMPKγ2 WT mice, AMPKγ2 NI and AMPKγ2 RG mice exhibited reduced body weight, fat mass, and liver steatosis when fed with a high fat diet (HFD). Surprisingly, AMPKγ2 RG but not AMPKγ2 NI mice fed with an HFD exhibited severe kidney injury characterized by glycogen accumulation, inflammation, apoptosis, cyst formation, and impaired renal function. These results demonstrate that expression of AMPKγ2 NI and AMPKγ2 RG mutations at physiological levels can induce beneficial metabolic effects but that this is accompanied by WPW syndrome. Our data also reveal an unexpected effect of AMPKγ2 RG in the kidney, linking lifelong constitutive activation of AMPK to a potential risk for kidney dysfunction in the context of an HFD. © 2016 by The American Society for Biochemistry and Molecular Biology, Inc.

  10. Is Exercise Stress Testing a Cost-Saving Strategy For Risk Assessment of Pediatric Wolff-Parkinson-White Syndrome Patients?

    Science.gov (United States)

    Moltedo, Jose M.; Iyer, Ramesh V.; Forman, Howard; Fahey, John; Rosenthal, Geoffrey; Snyder, Christopher S.

    2006-01-01

    Background: In Wolff-Parkinson-White syndrome (WPW) patients the loss of pre-excitation in a single heartbeat during exercise stress testing (EST) is a predictor of low risk of sudden death. The purpose of this study was to: 1) assess the frequency of loss of pre-excitation in a single heartbeat during exercise testing, and 2) compare the cost of EST versus trans-catheter electrophysiology study (EPS) in the risk assessment of WPW patients. Methods: A retrospective review of 50 cases of patients with WPW who underwent EST was conducted including demographics, history of supraventricular tachycardia, associated congenital heart disease, maximum heart rate achieved, and loss of pre-excitation in a single heartbeat. Hospital costs of EST and EPS were compared. Results: Of the 50 patients who underwent EST, 4 (8%), lost pre-excitation in a single heartbeat during EST. No differences were found regarding gender, age at diagnosis or EST, history of supraventricular tachycardia, presence of congenital heart disease or maximal heart rate. A cost comparison, utilizing the cost data: EST ($62.75) and EPS ($5,597) found EST to be a cost-saving approach in WPW patients. With 4 patients losing pre-excitation during EST, the cost saving of EST was $22,388 for this population of WPW patients. Conclusions: A frequency of 8% loss of pre-excitation was found in a pediatric sample that underwent EST. Additionally, EST was shown to be a cost-saving strategy in risk assessment of pediatric WPW patients. PMID:21845141

  11. Physiological Expression of AMPKγ2RG Mutation Causes Wolff-Parkinson-White Syndrome and Induces Kidney Injury in Mice*

    Science.gov (United States)

    Yang, Xiaodong; Mudgett, John; Bou-About, Ghina; Champy, Marie-France; Jacobs, Hugues; Monassier, Laurent; Pavlovic, Guillaume; Sorg, Tania; Herault, Yann; Petit-Demoulière, Benoit; Lu, Ku; Feng, Wen; Wang, Hongwu; Ma, Li-Jun; Askew, Roger; Erion, Mark D.; Kelley, David E.; Myers, Robert W.; Li, Cai

    2016-01-01

    Mutations of the AMP-activated kinase gamma 2 subunit (AMPKγ2), N488I (AMPKγ2NI) and R531G (AMPKγ2RG), are associated with Wolff-Parkinson-White (WPW) syndrome, a cardiac disorder characterized by ventricular pre-excitation in humans. Cardiac-specific transgenic overexpression of human AMPKγ2NI or AMPKγ2RG leads to constitutive AMPK activation and the WPW phenotype in mice. However, overexpression of these mutant proteins also caused profound, non-physiological increase in cardiac glycogen, which might abnormally alter the true phenotype. To investigate whether physiological levels of AMPKγ2NI or AMPKγ2RG mutation cause WPW syndrome and metabolic changes in other organs, we generated two knock-in mouse lines on the C57BL/6N background harboring mutations of human AMPKγ2NI and AMPKγ2RG, respectively. Similar to the reported phenotypes of mice overexpressing AMPKγ2NI or AMPKγ2RG in the heart, both lines developed WPW syndrome and cardiac hypertrophy; however, these effects were independent of cardiac glycogen accumulation. Compared with AMPKγ2WT mice, AMPKγ2NI and AMPKγ2RG mice exhibited reduced body weight, fat mass, and liver steatosis when fed with a high fat diet (HFD). Surprisingly, AMPKγ2RG but not AMPKγ2NI mice fed with an HFD exhibited severe kidney injury characterized by glycogen accumulation, inflammation, apoptosis, cyst formation, and impaired renal function. These results demonstrate that expression of AMPKγ2NI and AMPKγ2RG mutations at physiological levels can induce beneficial metabolic effects but that this is accompanied by WPW syndrome. Our data also reveal an unexpected effect of AMPKγ2RG in the kidney, linking lifelong constitutive activation of AMPK to a potential risk for kidney dysfunction in the context of an HFD. PMID:27621313

  12. Long-Term Natural History of Adult Wolff-Parkinson-White Syndrome Patients Treated With and Without Catheter Ablation.

    Science.gov (United States)

    Bunch, T Jared; May, Heidi T; Bair, Tami L; Anderson, Jeffrey L; Crandall, Brian G; Cutler, Michael J; Jacobs, Victoria; Mallender, Charles; Muhlestein, Joseph B; Osborn, Jeffrey S; Weiss, J Peter; Day, John D

    2015-12-01

    There are a paucity of data about the long-term natural history of adult Wolff-Parkinson-White syndrome (WPW) patients in regard to risk of mortality and atrial fibrillation. We sought to describe the long-term outcomes of WPW patients and ascertain the impact of ablation on the natural history. Three groups of patients were studied: 2 WPW populations (ablation: 872, no ablation: 1461) and a 1:5 control population (n=11 175). Long-term mortality and atrial fibrillation rates were determined. The average follow-up for the WPW group was 7.9±5.9 (median: 6.9) years and was similar between the ablation and nonablation groups. Death rates were similar between the WPW group versus the control group (hazard ratio, 0.96; 95% confidence interval, 0.83-1.11; P=0.56). Nonablated WPW patients had a higher long-term death risk compared with ablated WPW patients (hazard ratio, 2.10; 95% confidence interval: 1.50-20.93; P<0.0001). Incident atrial fibrillation risk was higher in the WPW group compared with the control population (hazard ratio, 1.55; 95% confidence interval, 1.29-1.87; P<0.0001). Nonablated WPW patients had lower risk than ablated patients (hazard ratio, 0.39; 95% confidence interval, 0.28-0.53; P<0.0001). Long-term mortality rates in WPW patients are low and similar to an age-matched and gender-matched control population. WPW patients that underwent the multifactorial process of ablation had a lower mortality compared to nonablated WPW patients. Atrial fibrillation rates are high long-term, and ablation does not reduce this risk. © 2015 American Heart Association, Inc.

  13. Phase mapping of radionuclide gated biventriculograms in patients with sustained ventricular tachycardia or Wolff-Parkinson-White syndrome

    International Nuclear Information System (INIS)

    Le Guludec, D.; Bourguignon, M.; Sebag, C.; Valette, H.; Sirinelli, A.; Davy, J.M.; Syrota, A.; Motte, G.

    1987-01-01

    Accuracy of Fourier phase mapping of radionuclide gated biventriculograms in detecting the origin of abnormal ventricular activation was studied during ventricular tachycardia or preexcitation. Group I included six patients suffering from clinical recurrent VT; 3 gated blood pool studies were acquired for each patient: during sinus rhythm, right ventricular pacing, and induced sustained VT-Group II included seven patients with Wolff-Parkinson-White syndrome and recurrent paroxysmal tachycardia; 3 gated blood pool studies were acquired for each patient: during sinus rhythm, right atrial pacing and orthodromic reciprocating tachycardia. Each acquisition lasted 5 min, in 30 degrees-40 degrees left anterior oblique projection. In Group I, the Fourier phase mapping was consistent with QRS morphology and axis during VT (5/6), except in one patient with LV aneurysm and LBBB electrical pattern during VT. Origin of VT on phase mapping was located in the right ventricle (n = 2) or in left ventricle (n = 4), at the border of wall motion abnormalities each time they existed (5/6). In Group II, the phase advance correlated with the location of the accessory pathway determined by ECG and endocardial mapping (n = 6) and per-operative epicardial mapping (n = 1). Discrimination between anterior and posterior localization of paraseptal pathways and location of intermittent preexcitation was not possible. We conclude that Fourier phase mapping is an accurate method for locating the origin of VT and determining its etiology. It can help locate the site of ventricular preexcitation in patients with only one accessory pathway; its accuracy in locating multiple accessory pathways remains unknown

  14. Exercise testing and thallium-201 myocardial perfusion scintigraphy in the clinical evaluation of patients with Wolff Parkinson White syndrome

    International Nuclear Information System (INIS)

    Poyatos, M.E.; Suarez, L.; Lerman, J.; Guibourg, H.; Camps, J.; Perosio, A.

    1986-01-01

    In 58 patients with Wolff Parkinson White syndrome (WPW), we performed exercise stress testing in order to investigate the incidence of normalization of the auriculo-ventricular conduction and the ST-segment changes. For a more accurate evaluation of the latter, exercise and redistribution radionuclide images with Thallium-201 were obtained in 18 cases. Forty-nine had type A and nine had type B of WPW. Forty-eight had permanent, four had alternant and six had no pre-excitation (PE) when they started the test. Mean maximal functional capacity, mean maximal heart rate and mean maximal double product were not different when compared to an age-matched control group. Of the 48 patients who began the test with PE, in 23 (48%) it disappeared while PE persisted in 25 (52%). In 16 cases the disappearance of the PE was sudden and in seven it was progressive. Pre-excitation persisted in 39.5% of patients with type A and in 88.8% with type B (p less than 0.01). ST-segment depression was observed in 76.6% of patients with PE and in 28.6% of cases without PE (p less than 0.01). ST-segment depression occurred in 44.8% of patients with type A and in 100% of cases with type B (p less than 0.05). Transient abnormal Thallium-201 scans were observed in 62.5% of patients without PE and in 20% with PE. No patients showed exertional arrhythmias. This study suggests the possibility of measuring the duration of the refractory period of the accessory pathway in those patients n which the PE disappears suddenly, at a given heart rate

  15. Tomographic phase analysis to detect the site of accessory conduction pathway in Wolff-Parkinson-White syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Nakajima, K.; Bunko, H.; Tada, A.; Tonami, N.; Taki, J.; Nanbu, I.; Hisada, K.; Misaki, T.; Iwa, T.

    1984-01-01

    Phase analysis has been applied to Wolff-Parkinson-White syndrome (WPW) to detect the site of accessory conduction pathway (ACP); however, there was a limitation to estimate the precise location of ACP by planar phase analysis. In this study, the authors applied phase analysis to gated blood pool tomography. Twelve patients with WPW who underwent epicardial mapping and surgical division of ACP were studied by both of gated emission computed tomography (GECT) and routine gated blood pool study (GBPS). The GBPS was performed with Tc-99m red blood cells in multiple projections; modified left anterior oblique, right anterior oblique and/or left lateral views. In GECT, short axial, horizontal and vertical long axial blood pool images were reconstructed. Phase analysis was performed using fundamental frequency of the Fourier transform in both GECT and GBPS images, and abnormal initial contractions on both the planar and tomographic phase analysis were compared with the location of surgically confirmed ACPs. In planar phase analysis, abnormal initial phase was identified in 7 out of 12 (58%) patients, while in tomographic phase analysis, the localization of ACP was predicted in 11 out of 12 (92%) patients. Tomographic phase analysis is superior to planar phase images in 8 out of 12 patients to estimate the location of ACP. Phase analysis by GECT can avoid overlap of blood pool in cardiac chambers and has advantage to identify the propagation of phase three-dimensionally. Tomographic phase analysis is a good adjunctive method for patients with WPW to estimate the site of ACP.

  16. Accuracy of the Electrocardiogram in Localizing the Accessory Pathway in Patients with Wolff-Parkinson-White Pattern

    Directory of Open Access Journals (Sweden)

    Carlos Manuel Teixeira

    Full Text Available Abstract Background: There are currently several electrocardiographic algorithms to locate the accessory pathway (AP in patients with Wolff-Parkinson-White (WPW syndrome. Objective: To compare the ability of electrocardiographic algorithms in identifying the location of the AP in patients with WPW pattern referred for ablation. Methods: Observational, cross-sectional, retrospective study with 111 patients with WPW syndrome referred for AP ablation. The electrocardiogram (ECG obtained prior to the ablation was analyzed by an experienced observer who consecutively applied seven algorithms to identify non-invasively the AP. We then compared the location estimated with this assessment with that obtained in the electrophysiological study and calculated the agreement rates. Results: Among the APs, 59 (53.15% were distributed around the mitral annulus and the remaining 52 (46.85% were located around the tricuspid annulus. The overall absolute accuracy of the algorithms evaluated varied between 27% and 47%, increasing to between 40% and 76% when we included adjacent locations. The absolute agreement rate by AP location was 2.00-52.20% for septal APs (n = 51, increasing to 5.90-90.20% when considering adjacent locations; 7.70-69.20% for right APs (n = 13, increasing to 42.90-100% when considering adjacent locations; and 21.70-54.50% for left APs (n = 47, increasing to 50-87% when considering adjacent locations. Conclusion: The agreement rates observed for the analyzed scores indicated a low discriminative ability of the ECG in locating the AP in patients with WPW.

  17. Noninvasive Localization of Accessory Pathways in Patients with Wolff-Parkinson-White Syndrome: A Strain Imaging Study

    Science.gov (United States)

    Esmaeilzadeh, Maryam; Omran, Mohammad Taghi Salehi; Maleki, Majid; Haghjoo, Majid; Noohi, Feridoun; Haghighi, Zahra Ojaghi; Sadeghpour, Anita; Davari, Paridokht Nakhostin; Abkenar, Hooman Bakhshandeh

    2013-01-01

    Background: Noninvasive techniques for the localization of the accessory pathways (APs) might help guide mapping procedures and ablation techniques. We sought to examine the diagnostic accuracy of strain imaging for the localization of the APs in Wolff-Parkinson-White syndrome. Methods: We prospectively studied 25 patients (mean age = 32 ± 17 years, 58.3% men) with evidence of pre-excitation on electrocardiography (ECG). Electromechanical interval was defined as the time difference between the onset of delta wave and the onset of regional myocardial contraction. Time differences between the onset of delta wave (δ) and the onset of regional myocardial contraction (δ-So), peak systolic motion (δ-Sm), regional strain (δ-ε), peak strain (δ-εp), and peak strain rate (δ-SRp) were measured. Results: There was a significant difference between time to onset of delta wave to onset of peak systolic motion (mean ± SD) in the AP location (A) and normal segments (B) versus that in the normal volunteers (C) [A: (57.08 ± 23.88 msec) vs. B: (75.20 ± 14.75) vs. C: (72.9 0 ± 11.16); p value (A vs. B) = 0.004 and p value (A vs. C) = 0.18] and [A: (49.17 ± 35.79) vs. B: (67.60 ± 14.51) vs. C: (67.40 ± 6.06 msec); p value (A vs. B) < 0.001 and p value (A vs. C) = 0.12, respectively]. Conclusion: Our study showed that strain imaging parameters [(δ-So) and (δ-Strain)] are superior to the ECG in the localization of the APs (84% vs. 76%). PMID:23967027

  18. Gated blood-pool SPECT assessment of Wolff-Parkinson-White syndromes before and after radiofrequency ablation of accessory pathways

    International Nuclear Information System (INIS)

    Bontemps, L.; Ben Brahim, H.; Kraiem, T.; Chevalier, P.; Kirkorian, G.; Touboul, P.; Itti, R.

    1997-01-01

    Radiofrequency (RF) ablation of accessory pathways in Wolff-Parkinson-White (WPW) syndrome is supposed to be less aggressive than fulguration while providing excellent results. The aims of our study were therefore the evaluation of the functional results of this therapy in terms of left or right ejection fractions and its effects on the contraction synchronism between both ventricular chambers, derived from bi-ventricular Fourier phase histograms. A consecutive series of 44 patients has been investigated within 48 hours before and after RF therapy: 14 patients had right sided WPW and 30 patients left sided WPW. Only patients for whom RF treatment was considered as a success have been included in the study. Gated blood pool tomography has been performed in order to localize the site of pre-excitation and to build-up the phase histograms for both ventricles, and planar gated imaging has been used for right and left ejection fraction determination. Functional results demonstrate the absence of deleterious effect of RF on ventricular contraction and rather a slight increase of ejection fractions, with a more statistically significant difference for left WPW (LVEF = 62.2 % before RF vs 64.4 % after RF; p = 0.02) than for right WPW (RVEF = 36.3 % before RF vs 39.7 after RF; p = 0.16). Phase analysis, on the contrary, show only significant differences for right WPW, with a noticeable decrease of the pre-excitation (left-to-right phase difference 14.4 deg before RF vs 7.5 deg after RF; p = 0.03) and a significant reduction of the right ventricular phase dispersion (right phase standard deviation 26.5 deg before RF vs 19.0 deg after RF; p = 0.03). For left WPW no measurable differences can be demonstrated in the basal state and it is suggested to use stimulation techniques in order to enhance the competition between the normal and accessory conduction pathways. (authors)

  19. Inaccuracy of Wolff-Parkinson-white accessory pathway localization algorithms in children and patients with congenital heart defects.

    Science.gov (United States)

    Bar-Cohen, Yaniv; Khairy, Paul; Morwood, James; Alexander, Mark E; Cecchin, Frank; Berul, Charles I

    2006-07-01

    ECG algorithms used to localize accessory pathways (AP) in patients with Wolff-Parkinson-White (WPW) syndrome have been validated in adults, but less is known of their use in children, especially in patients with congenital heart disease (CHD). We hypothesize that these algorithms have low diagnostic accuracy in children and even lower in those with CHD. Pre-excited ECGs in 43 patients with WPW and CHD (median age 5.4 years [0.9-32 years]) were evaluated and compared to 43 consecutive WPW control patients without CHD (median age 14.5 years [1.8-18 years]). Two blinded observers predicted AP location using 2 adult and 1 pediatric WPW algorithms, and a third blinded observer served as a tiebreaker. Predicted locations were compared with ablation-verified AP location to identify (a) exact match for AP location and (b) match for laterality (left-sided vs right-sided AP). In control children, adult algorithms were accurate in only 56% and 60%, while the pediatric algorithm was correct in 77%. In 19 patients with Ebstein's anomaly, diagnostic accuracy was similar to controls with at times an even better ability to predict laterality. In non-Ebstein's CHD, however, the algorithms were markedly worse (29% for the adult algorithms and 42% for the pediatric algorithms). A relatively large degree of interobserver variability was seen (kappa values from 0.30 to 0.58). Adult localization algorithms have poor diagnostic accuracy in young patients with and without CHD. Both adult and pediatric algorithms are particularly misleading in non-Ebstein's CHD patients and should be interpreted with caution.

  20. Risk of malignant arrhythmias in initially symptomatic patients with Wolff-Parkinson-White syndrome: results of a prospective long-term electrophysiological follow-up study.

    Science.gov (United States)

    Pappone, Carlo; Vicedomini, Gabriele; Manguso, Francesco; Baldi, Mario; Pappone, Alessia; Petretta, Andrea; Vitale, Raffaele; Saviano, Massimo; Ciaccio, Cristiano; Giannelli, Luigi; Calovic, Zarko; Tavazzi, Luigi; Santinelli, Vincenzo

    2012-02-07

    The available amount of detailed long-term data in patients with Wolff-Parkinson-White syndrome is limited, and no prospective electrophysiological studies looking at predictors of malignant arrhythmia are available. Among 8575 symptomatic Wolff-Parkinson-White patients with atrioventricular reentrant tachycardia referred for electrophysiological test, 369 (mean age, 23±12.5 years) declined catheter ablation and were followed up. The primary end point of the study was to evaluate over a 5-year follow-up the predictors and characteristics of patients who develop malignant arrhythmias. After a mean follow-up of 42.1±10 months, malignant arrhythmias developed in 29 patients (mean age, 13.9±5.6 years; 26 male), resulting in presyncope/syncope (25 patients), hemodynamic collapse (3 patients), or cardiac arrest caused by ventricular fibrillation (1 patient). Of the remaining 340 patients, 168 (mean age, 34.2±9.0 years) remained asymptomatic up to 5 years, and 172 (mean age, 13.6±5.1 years) had benign recurrence, including sustained atrioventricular reentrant tachycardia (132 patients) or atrial fibrillation (40 patients). Compared with the group with no malignant arrhythmias, the group with malignant arrhythmias showed shorter accessory-pathway effective refractory period (PWolff-Parkinson-White syndrome generally have a good outcome, and predictors of malignant arrhythmias are similar to those reported for asymptomatic patients with ventricular pre-excitation.

  1. Reversion of left ventricular systolic dysfunction and abnormal stress test: by catheter ablation, in a patient with Wolff-Parkinson-White syndrome from Para-Hisian Kent bundle.

    Science.gov (United States)

    Tu, Chung-Ming; Chu, Kai-Ming; Cheng, Cheng-Chung; Cheng, Shu-Mung; Lin, Wei-Shiang

    2010-01-01

    The diagnosis of Wolff-Parkinson-White syndrome is typically reserved for patients who experience ventricular pre-excitation and symptoms that are related to paroxysmal supraventricular tachycardia, such as chest pain, dyspnea, dizziness, palpitations, or syncope. Herein, we report the case of a 38-year-old woman who presented at our outpatient department because of exercise intolerance. Cardiac auscultation revealed a grade 2/6 pansystolic murmur over the left lower sternal border. Twelve-lead electrocardiography showed sinus rhythm at a rate of 76 beats/min, with a significant delta wave. Transthoracic echocardiography revealed abnormal left ventricular systolic function. The results of a thallium stress test were also abnormal. Coronary artery disease was suspected; however, coronary angiography yielded normal results. Electrophysiologic study revealed a para-Hisian Kent bundle and a dual atrioventricular nodal pathway. After radiofrequency catheter ablation was performed, the patient's left ventricular function improved and her symptoms disappeared. In Wolff-Parkinson-White syndrome, left ventricular systolic dyssynchrony can yield abnormal findings on echocardiography and thallium scanning--even in persons who have no cardiovascular risk factors. Physicians who are armed with this knowledge can avoid performing coronary angiography unnecessarily. Catheter ablation can reverse the dyssynchrony of the ventricle and improve the patient's symptoms.

  2. The prevalence of early repolarization in Wolff-Parkinson-White syndrome with a special reference to J waves and the effects of catheter ablation.

    Science.gov (United States)

    Yagihara, Nobue; Sato, Akinori; Iijima, Kenichi; Izumi, Daisuke; Furushima, Hiroshi; Watanabe, Hiroshi; Irie, Tadanobu; Kaneko, Yoshiaki; Kurabayashi, Masahiko; Chinushi, Masaomi; Satou, Masahito; Aizawa, Yoshifusa

    2012-01-01

    We determined the prevalence of J waves in the electrocardiograms (ECG) of 120 patients with Wolff-Parkinson-White syndrome in comparison with J-wave prevalence in a control group of 1936 men and women with comparable demographic and ECG characteristics and with normal atrioventricular conduction. J waves were present only during manifest preexcitation in 22 of 120 patients (18.3%), disappearing after catheter ablation and suggesting that J waves were associated with the presence of preexcitation. J waves were present in 19 (15.8%) of 120 patients only after ablation, apparently having been masked by early depolarization of the preexcited myocardial region, and in 22 patients (18.3%), J waves were not altered significantly by preexcitation. Thus, the overall J-wave prevalence was 52.5% (63/120) and, excluding those apparently due to preexcitation, 34.8% (41/120), both substantially higher than the prevalence (11.5%) in the control group (P Wolff-Parkinson-White syndrome and is influenced by manifest preexcitation. Copyright © 2012 Elsevier Inc. All rights reserved.

  3. Recurrence of atrial fibrillation after successful radiofrequency catheter ablation of accessory pathway in patients with Wolff-Parkinson-White syndrome

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    Mujović Nebojša

    2010-01-01

    Full Text Available Introduction. Paroxysmal atrial fibrillation (AF occurs in 11.5-39% of the patients with Wolff-Parkinson-White (WPW syndrome and frequently, but not always, disappears after successful accessory pathway (AP ablation. Objective. To determine AF recurrence rate, time to AF recurrence and predictors of AF recurrence after radiofrequency (RF catheter-ablation of AP in WPW-patients with AF. Methods. Data from 245 consecutive patients with WPW-syndrome who underwent RF catheter-ablation of AP were analyzed. A total of 52 patients (43 men, mean age: 42.5±14.1 years with preablation history of spontaneous AF were followed up after definitive AP ablation. At baseline, structural heart disease and comorbidities were diagnosed in 19.2% and 21.2% of the patients, respectively. Results. During the follow-up of 5.2±3.7 years, 3 patients (5.7% died; one of these patients, previously known for recurrent AF, died from ischaemic stroke. Symptomatic recurrence of AF was detected in 9 of 52 patients (17.3%. In 66.7% of these patients, AF recurrence was identified in the first year following the procedure. Kaplan-Meier analysis demonstrated that freedom from recurrent AF after 3 months was 94.2%, after 1 year 87.5% and after 4 years 84.3%. Univariate analysis showed that older age (p=0.023, presence of structural heart disease (p=0.05 and dilated left atrium (p=0.013 were significantly related to AF recurrence. However, using multivariate Cox regression, older age was the only independent predictor of AF recurrence (HR=2.44 for every life decade; p=0.006. Analysis of ROC curves showed that, after the age of 36, the risk of AF recurrence abruptly increased. Conclusion. Symptomatic recurrence of AF was detected in 17% of WPW-patients after definite RF ablation of AP. The timedependent occurrence of AF recurrences and age-dependent increase in the rate of AF recurrence were identified. Closer follow-up and/or extension of drug therapy in older patients, at least in

  4. Wolff-Parkinson-White syndrome in young people, from childhood to young adulthood: relationships between age and clinical and electrophysiological findings

    Science.gov (United States)

    Jung, Hae Jung; Ju, Hwang Young; Hyun, Myung Chul; Lee, Sang Bum

    2011-01-01

    Purpose The aim of the present study was to evaluate the characteristics of electrophysiologic studies (EPS) and radiofrequency ablation (RFA) performed in subjects aged less than 30 years with Wolff-Parkinson-White (WPW) syndrome, particularly pediatric patients under 18 years of age, based on our experience. Methods Two hundred and one consecutive patients with WPW syndrome were recruited and divided to 3 groups according to age: group 1, 6 to 17 years; group 2, 18 to 29 years; and group 3, 30 to 60 years. The clinical, electrophysiological, and therapeutic data for these patients were evaluated by a retrospective medical record review. Results A total of 73 (36%) of these patients were syndrome. Therefore, when EPS and RFA are performed in children and adolescence with WPW syndrome, we recommend that these characteristics be considered. PMID:22323907

  5. Atrial fibrillation with wide QRS tachycardia and undiagnosed Wolff-Parkinson-White syndrome: diagnostic and therapeutic dilemmas in a pediatric patient.

    Science.gov (United States)

    Panduranga, Prashanth; Al-Farqani, Abdullah; Al-Rawahi, Najib

    2012-11-01

    A 10-year-old girl presented to the emergency department of a regional hospital with 1 episode of generalized tonic-clonic seizures. Postictal monitoring followed by a 12-lead electrocardiogram showed fast atrial fibrillation with intermittent wide QRS regular tachycardia. Immediately following this, her rhythm changed to wide QRS irregular tachycardia without hemodynamic compromise. She was suspected to have ventricular tachycardia and was treated with intravenous amiodarone with cardioversion to sinus rhythm. Subsequent electrocardiogram in sinus rhythm showed typical features of manifest Wolff-Parkinson-White (WPW) accessory pathway. This case illustrates the diagnostic and therapeutic dilemmas in patients with atrial fibrillation, wide QRS tachycardia, and undiagnosed WPW syndrome with antidromic conduction of atrial arrhythmias through the accessory pathway. Furthermore, this case demonstrates that undiagnosed wide QRS tachycardias need to be treated with drugs acting on the accessory pathway, thus keeping in mind underlying WPW syndrome as a possibility to avoid potentially catastrophic events.

  6. Assessment of atrial fibrillation and vulnerability in patients with Wolff-Parkinson-White syndrome using two-dimensional speckle tracking echocardiography.

    Science.gov (United States)

    Li, Jing-Jie; Wei, Fang; Chen, Ju-Gang; Yu, Yan-Wei; Gu, Hong-Yue; Jiang, Rui; Wu, Xiu-Li; Sun, Qian

    2014-01-01

    The aim was to assess atrial fibrillation (AF) and vulnerability in Wolff-Parkinson-White (WPW) syndrome patients using two-dimensional speckle tracking echocardiography (2D-STE). All patients were examined via transthoracic echocardiography and 2D-STE in order to assess atrial function 7 days before and 10 days after RF catheter ablation. A postoperative 3-month follow-up was performed via outpatient visit or telephone calls. Results showed significant differences in both body mass index (BMI) and supraventricular tachycardia (SVT) duration between WPW patients and DAVNP patients (both Psyndrome may result in increased atrial vulnerability and contribute to the development of AF. Further, RF catheter ablation of AAV pathway can potentially improve atrial function in WPW syndrome patients. Two-dimensional speckle tracking echocardiography imaging in WPW patients would be necessary in the evaluation and improvement of the overall function of RF catheter ablation in a long-term follow-up period.

  7. Left Ventricular Dysfunction and Dilated Cardiomyopathy in Infants and Children with Wolff-Parkinson-White Syndrome in the Absence of Tachyarrhythmias

    Science.gov (United States)

    2012-01-01

    Left ventricular (LV) dysfunction and dilated cardiomyopathy (DCM) are rarely attributable to sustained or incessant tachyarrhythmias in infants and children with Wolff-Parkinson-White (WPW) syndrome. However, several recent reports suggested that significant LV dysfunction may develop in WPW syndrome in the absence of tachyarrhythmias. It is assumed that an asynchronous ventricular activation over the accessory pathway, especially right-sided, induces septal wall motion abnormalities, ventricular remodeling and ventricular dysfunction. The prognosis of DCM associated with asymptomatic WPW is excellent. Loss of ventricular pre-excitation results in mechanical resynchronization and reverse remodeling where LV function recovers completely. The reversible nature of LV dysfunction after loss of ventricular pre-excitation supports the causal relationship between LV dysfunction and ventricular pre-excitation. This review summarizes recent clinical and electrophysiological evidence for development of LV dysfunction or DCM in asymptomatic WPW syndrome, and discusses the underlying pathophysiological mechanism. PMID:23323117

  8. Cardiomiopatía hipertrófica y síndrome de Wolff-Parkinson-White con bloqueo aurículo-ventricular completo. Una extraña asociación: Reporte de un caso Hypertrophic cardiomyopathy and Wolff-Parkinson-White Syndrome with complete auriculoventricular block. A strange association: Report of one case

    Directory of Open Access Journals (Sweden)

    Franco J Vallejo

    2007-12-01

    Full Text Available Paciente masculino de 22 años quien ingresa por episodio de síncope. En el electrocardiograma se encuentra patrón de Wolff-Parkinson-White y signos de sobrecarga auricular e hipertrofia ventricular izquierda con bloqueo aurículo-ventricular completo. El ecocardiograma transtorácico es compatible con cardiomiopatía hipertrófica no obstructiva. Se lleva a estudio electrofisiológico donde se encuentra pre-excitación por vía accesoria y bloqueo aurículo-ventricular infrahisiano; se realiza ablación y se implanta marcapasos bicameral.A 22 years old male patient is admitted for a syncope episode. An electrocardiogram shows a Wolff-Parkinson-White pattern and signs of auricular overload with left ventricular hypertrophy and complete auriculoventricular block. The transthoracic echocardiogram is compatible with non-obstructive hypertrophic cardiomyopathy. An electrophysiological study is carried out, finding pre-excitation through an accessory way and infra-His auriculoventricular block. An ablation is performed and a bicameral pacemaker is implanted.

  9. Unusual reactions of diazocarbonyl compounds with α,β-unsaturated δ-amino esters: Rh(II-catalyzed Wolff rearrangement and oxidative cleavage of N–H-insertion products

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    Valerij A. Nikolaev

    2016-08-01

    Full Text Available Rh(II-сatalyzed reactions of aroyldiazomethanes, diazoketoesters and diazodiketones with α,β-unsaturated δ-aminoesters, in contrast to reactions of diazomalonates and other diazoesters, give rise to the Wolff rearrangement and/or oxidative cleavage of the initially formed N–H-insertion products. These oxidation processes are mediated by Rh(II catalysts possessing perfluorinated ligands. The formation of pyrrolidine structures, characteristic for catalytic reactions of diazoesters, was not observed in these processes at all.

  10. LV dyssynchrony as assessed by phase analysis of gated SPECT myocardial perfusion imaging in patients with Wolff-Parkinson-White syndrome.

    Science.gov (United States)

    Chen, Chun; Li, Dianfu; Miao, Changqing; Feng, Jianlin; Zhou, Yanli; Cao, Kejiang; Lloyd, Michael S; Chen, Ji

    2012-07-01

    The purpose of this study was to evaluate left ventricular (LV) mechanical dyssynchrony in patients with Wolff-Parkinson-White (WPW) syndrome pre- and post-radiofrequency catheter ablation (RFA) using phase analysis of gated single photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI). Forty-five WPW patients were enrolled and had gated SPECT MPI pre- and 2-3 days post-RFA. Electrophysiological study (EPS) was used to locate accessory pathways (APs) and categorize the patients according to the AP locations (septal, left and right free wall). Electrocardiography (ECG) was performed pre- and post-RFA to confirm successful elimination of the APs. Phase analysis of gated SPECT MPI was used to assess LV dyssynchrony pre- and post-RFA. Among the 45 patients, 3 had gating errors, and thus 42 had SPECT phase analysis. Twenty-two patients (52.4%) had baseline LV dyssynchrony. Baseline LV dyssynchrony was more prominent in the patients with septal APs than in the patients with left or right APs (p syndrome. Septal APs result in the greatest degree of LV mechanical dyssynchrony and afford the most benefit after RFA. This study supports further investigation in the relationship between electrical and mechanical activation using EPS and phase analysis of gated SPECT MPI.

  11. An evaluation of the diagnostic efficacy of phase analysis of data from radionuclide ventriculograms in patients with Wolff-Parkinson-White syndrome

    International Nuclear Information System (INIS)

    Dormehl, I.C.; Bitter, F.; Henze, E.; Adam, W.E.; Weismueller, P.

    1985-01-01

    It has been suggested that phase analysis of radionuclide ventriculograms may be of value for detecting and localising the abnormal sequence of ventricular contraction secondary to Wolff-Parkinson-White (WPW) symdrome. The present study was undertaken to test this hypothesis. The space - time sequences of right- and left-ventricular action obtained from radionuclide ventriculograms obtained during rest studies were evaluated in 8 patients with WPW syndrome (confirmed by 12-lead surface electrocardiography) and compared to those of 14 normal subjects. All of the latter showed a consistent ventricular activation pattern, i.e. the first site of ventricular activity in the upper septal region followed by a second site either at the base of the left ventricle or located apically. It was possible to diagnose 11 of the 14 normal subjects (specificity, 79%) and 7 of the 8 patients (sensitivity, 88%). The 4 patients who had been classified as having a left-sided accessory bundle by surface electrocardiography were likewise diagnosed by phase analysis, as were the 2 patients with a confirmed right-sided bypass tract. Two patients with septal posterior accessory pathways could not be identified by phase analysis. Furthermore, cases with an activation pattern which closely resembled that of the 2 patients with right-sided accessory bundles were found to be normal from their ECGs. It is now necessary to evaluate phase analysis against invasive electrophysiological methods in such patients. (orig.)

  12. LV dyssynchrony as assessed by phase analysis of gated SPECT myocardial perfusion imaging in patients with Wolff-Parkinson-White syndrome

    International Nuclear Information System (INIS)

    Chen, Chun; Li, Dianfu; Miao, Changqing; Zhou, Yanli; Cao, Kejiang; Feng, Jianlin; Lloyd, Michael S.; Chen, Ji

    2012-01-01

    The purpose of this study was to evaluate left ventricular (LV) mechanical dyssynchrony in patients with Wolff-Parkinson-White (WPW) syndrome pre- and post-radiofrequency catheter ablation (RFA) using phase analysis of gated single photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI). Forty-five WPW patients were enrolled and had gated SPECT MPI pre- and 2-3 days post-RFA. Electrophysiological study (EPS) was used to locate accessory pathways (APs) and categorize the patients according to the AP locations (septal, left and right free wall). Electrocardiography (ECG) was performed pre- and post-RFA to confirm successful elimination of the APs. Phase analysis of gated SPECT MPI was used to assess LV dyssynchrony pre- and post-RFA. Among the 45 patients, 3 had gating errors, and thus 42 had SPECT phase analysis. Twenty-two patients (52.4 %) had baseline LV dyssynchrony. Baseline LV dyssynchrony was more prominent in the patients with septal APs than in the patients with left or right APs (p < 0.05). RFA improved LV synchrony in the entire cohort and in the patients with septal APs (p < 0.01). Phase analysis of gated SPECT MPI demonstrated that LV mechanical dyssynchrony can be present in patients with WPW syndrome. Septal APs result in the greatest degree of LV mechanical dyssynchrony and afford the most benefit after RFA. This study supports further investigation in the relationship between electrical and mechanical activation using EPS and phase analysis of gated SPECT MPI. (orig.)

  13. Detecting Regional Myocardial Abnormalities in Patients With Wolff-Parkinson-White Syndrome With the Use of ECG-Gated Cardiac MDCT.

    Science.gov (United States)

    Lee, Hye-Jeong; Uhm, Jae-Sun; Joung, Boyoung; Hong, Yoo Jin; Hur, Jin; Choi, Byoung Wook; Kim, Young Jin

    2016-04-01

    Myocardial dyskinesia caused by the accessory pathway and related reversible heart failure have been well documented in echocardiographic studies of pediatric patients with Wolff-Parkinson-White (WPW) syndrome. However, the long-term effects of dyskinesia on the myocardium of adult patients have not been studied in depth. The goal of the present study was to evaluate regional myocardial abnormalities on cardiac CT examinations of adult patients with WPW syndrome. Of 74 patients with WPW syndrome who underwent cardiac CT from January 2006 through December 2013, 58 patients (mean [± SD] age, 52.2 ± 12.7 years), 36 (62.1%) of whom were men, were included in the study after the presence of combined cardiac disease was excluded. Two observers blindly evaluated myocardial thickness and attenuation on cardiac CT scans. On the basis of CT findings, patients were classified as having either normal or abnormal findings. We compared the two groups for other clinical findings, including observations from ECG, echocardiography, and electrophysiologic study. Of the 58 patients studied, 16 patients (27.6%) were found to have myocardial abnormalities (i.e., abnormal wall thinning with or without low attenuation). All abnormal findings corresponded with the location of the accessory pathway. Patients with abnormal findings had statistically significantly decreased left ventricular function, compared with patients with normal findings (p syndrome. These abnormal findings might reflect the long-term effects of dyskinesia, suggesting irreversible myocardial injury that ultimately causes left ventricular dysfunction.

  14. Evaluation of the diagnostic efficacy of phase analysis of data from radionuclide ventriculograms in patients with Wolff-Parkinson-White syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Dormehl, I.C.; Bitter, F.; Henze, E.; Adam, W.E.; Weismueller, P.

    1985-10-01

    It has been suggested that phase analysis of radionuclide ventriculograms may be of value for detecting and localising the abnormal sequence of ventricular contraction secondary to Wolff-Parkinson-White (WPW) symdrome. The present study was undertaken to test this hypothesis. The space-time sequences of right- and left-ventricular action obtained from radionuclide ventriculograms obtained during rest studies were evaluated in 8 patients with WPW syndrome (confirmed by 12-lead surface electrocardiography) and compared to those of 14 normal subjects. All of the latter showed a consistent ventricular activation pattern, i.e. the first site of ventricular activity in the upper septal region followed by a second site either at the base of the left ventricle or located apically. It was possible to diagnose 11 of the 14 normal subjects (specificity, 79%) and 7 of the 8 patients (sensitivity, 88%). The 4 patients who had been classified as having a left-sided accessory bundle by surface electrocardiography were likewise diagnosed by phase analysis, as were the 2 patients with a confirmed right-sided bypass tract. Two patients with septal posterior accessory pathways could not be identified by phase analysis. Furthermore, cases with an activation pattern which closely resembled that of the 2 patients with right-sided accessory bundles were found to be normal from their ECGs. It is now necessary to evaluate phase analysis against invasive electrophysiological methods in such patients.

  15. LV dyssynchrony as assessed by phase analysis of gated SPECT myocardial perfusion imaging in patients with Wolff-Parkinson-White syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Chun; Li, Dianfu; Miao, Changqing; Zhou, Yanli; Cao, Kejiang [First Affiliated Hospital of Nanjing Medical University, Department of Cardiology, Nanjing, Jiangsu (China); Feng, Jianlin [First Affiliated Hospital of Nanjing Medical University, Department of Nuclear Medicine, Nanjing, Jiangsu (China); Lloyd, Michael S. [Emory University School of Medicine, Division of Cardiology, Atlanta, GA (United States); Chen, Ji [Emory University School of Medicine, Department of Radiology and Imaging Sciences, Atlanta, GA (United States)

    2012-07-15

    The purpose of this study was to evaluate left ventricular (LV) mechanical dyssynchrony in patients with Wolff-Parkinson-White (WPW) syndrome pre- and post-radiofrequency catheter ablation (RFA) using phase analysis of gated single photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI). Forty-five WPW patients were enrolled and had gated SPECT MPI pre- and 2-3 days post-RFA. Electrophysiological study (EPS) was used to locate accessory pathways (APs) and categorize the patients according to the AP locations (septal, left and right free wall). Electrocardiography (ECG) was performed pre- and post-RFA to confirm successful elimination of the APs. Phase analysis of gated SPECT MPI was used to assess LV dyssynchrony pre- and post-RFA. Among the 45 patients, 3 had gating errors, and thus 42 had SPECT phase analysis. Twenty-two patients (52.4 %) had baseline LV dyssynchrony. Baseline LV dyssynchrony was more prominent in the patients with septal APs than in the patients with left or right APs (p < 0.05). RFA improved LV synchrony in the entire cohort and in the patients with septal APs (p < 0.01). Phase analysis of gated SPECT MPI demonstrated that LV mechanical dyssynchrony can be present in patients with WPW syndrome. Septal APs result in the greatest degree of LV mechanical dyssynchrony and afford the most benefit after RFA. This study supports further investigation in the relationship between electrical and mechanical activation using EPS and phase analysis of gated SPECT MPI. (orig.)

  16. Radiofrequency ablation of accessory pathways in patients with the Wolff-Parkinson-White syndrome: the long-term mortality and risk of atrial fibrillation.

    Science.gov (United States)

    Borregaard, Rune; Lukac, Peter; Gerdes, Christian; Møller, Dorthe; Mortensen, Peter Thomas; Pedersen, Lars; Nielsen, Jens Cosedis; Jensen, Henrik Kjærulf

    2015-01-01

    To assess the long-term mortality and occurrence of post-ablation atrial fibrillation in patients undergoing a radiofrequency ablation for the Wolff-Parkinson-White (WPW) syndrome. A retrospective cohort study of patients (N = 362) subjected to radiofrequency ablation of the WPW syndrome at Aarhus University Hospital from 1990 to 2011. A comparison cohort (N = 3619) was generated from the Danish National Board of Health Central Population Registry. We found no significant difference in all-cause mortality when comparing the WPW group with the control group [hazard ratio (HR): 0.77 and confidence interval (CI): 0.47-1.25]. After radiofrequency ablation, the WPW group had a significantly higher risk of atrial fibrillation than the control group (HR: 4.77 and CI: 3.05-7.43). Atrial fibrillation prior to ablation (HR: 4.66 and CI: 2.09-10.41) and age over 50 years (HR: 9.79 and CI: 4.29-22.36) at the time of ablation were independent risk factors for post-ablation atrial fibrillation in the WPW group. Patients with radiofrequency ablation-treated WPW syndrome have a post-ablation mortality that is similar to the background population. The risk of atrial fibrillation remains high after radiofrequency ablation of the WPW syndrome. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014. For permissions please email: journals.permissions@oup.com.

  17. Wolff-Parkinson-White syndrome in young people, from childhood to young adulthood: relationships between age and clinical and electrophysiological findings

    Directory of Open Access Journals (Sweden)

    Hae Jung Jung

    2011-12-01

    Full Text Available Purpose : The aim of the present study was to evaluate the characteristics of electrophysiologic studies (EPS and radiofrequency ablation (RFA performed in subjects aged less than 30 years with Wolff-Parkinson-White (WPW syndrome, particularly pediatric patients under 18 years of age, based on our experience. Methods : Two hundred and one consecutive patients with WPW syndrome were recruited and divided to 3 groups according to age: group 1, 6 to 17 years; group 2, 18 to 29 years; and group 3, 30 to 60 years. The clinical, electrophysiological, and therapeutic data for these patients were evaluated by a retrospective medical record review. Results : A total of 73 (36% of these patients were &lt;30 years of age. Although there were more males than females in group 2 (male:female, 31:11, there was no sex difference in group 1 (male:female, 16:15. Left accessory pathway was detected less frequently in group 1 (32%, 10/31 than in group 2 (57%, 24/42 and group 3 (63%, 81/128 (P=0.023 and P=0.002, respectively. Conclusion : The present study describes several different electrophysiological characteristics in children and adolescents with WPW syndrome. Therefore, when EPS and RFA are performed in children and adolescence with WPW syndrome, we recommend that these characteristics be considered.

  18. An Asymptomatic Case of Wolff-Parkinson-White Syndrome with Right-sided Free-wall Accessory Pathway and Left Ventricular Dysfunction

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    Takanao Mine, MD

    2011-01-01

    Full Text Available A 16-year-old girl with a known history of asymptomatic Wolff-Parkinson-White syndrome exhibited signs of left ventricular (LV septal akinesia and LV dysfunction during routine follow-up. A 12-lead surface ECG showed pre-excitation, a predominantly negative delta wave in V1 and left axis deviation, which was consistent with the presence of a right free-wall accessory pathway. Radiofrequency ablation of the anterolateral right atrium around the local shortest atrium-to-ventricle interval created the accessory pathway block. An echocardiogram taken one month after the procedure revealed that LV septal wall motion had normalized and that LV ejection fraction had improved from 50% before the ablation to 64% after the ablation. Most previous reports of asymptomatic patients of WPW with LV septal dyskinesia and dysfunction have described right septal or posteroseptal accessory pathways. This patient reported here represents a rare case with right free-wall accessory pathway and LV dysfunction without tachycardia.

  19. Wolff-Parkinson-White syndrome and noncompaction in Leber's hereditary optic neuropathy due to the variant m.3460G>A.

    Science.gov (United States)

    Finsterer, Josef; Stollberger, Claudia; Gatterer, Edmund

    2018-05-01

    This report describes a 66-year-old Caucasian male who acutely developed severe, bilateral impairment of visual acuity at 24 years of age. Leber's hereditary optic neuropathy (LHON) was suspected but the diagnosis was not genetically confirmed until the age of 49 years when the primary LHON mutation m.3460G>A was detected. Since onset, visual acuity had slightly improved. The family history was positive for LHON (brother, two sisters of mother, female cousin) and genetically confirmed in his brother and one aunt. Since the age of 65 years, he had experienced recurrent vertigo. His cardiological history was positive for arterial hypertension, noncompaction, myocardial thickening, intermittent right bundle-branch-block (RBBB) and Wolff-Parkinson-White (WPW) syndrome. In addition to LHON, he presented with polyneuropathy, hyperCKaemia, carotid artery occlusion, and a history of stroke. Cardiological investigations at 66 years of age revealed mildly reduced systolic function, enlarged atria, and nonsustained ventricular tachycardias. He underwent an electrophysiological investigation, but radiofrequency ablation was ruled out due to a 'bizarre' cardiac conduction system. Instead, an implantable cardioverter defibrillator was proposed but refused by the patient. Since the vertigo did not resolve it was attributed to polyneuropathy. This case demonstrates that LHON may be associated with noncompaction, myocardial thickening, reduced systolic function, enlarged atria, RBBB, WPW syndrome and nonsustained ventricular tachycardias. WPW syndrome in LHON may require invasive antiarrhythmic treatment.

  20. A Case of Multiple Cardiovascular and Tracheal Anomalies Presented with Wolff-Parkinson-White Syndrome in a Middle-aged Adult.

    Science.gov (United States)

    Shi, Hyejin; Sohn, Sungmin; Wang, SungHo; Park, Sungrock; Lee, SangKi; Kim, Song Yi; Jeong, Sun Young; Kim, Changhwan

    2017-12-01

    Congenital cardiovascular anomalies, such as dextrocardia, persistent left superior vena cava (SVC), and pulmonary artery (PA) sling, are rare disorders. These congenital anomalies can occur alone, or coincide with other congenital malformations. In the majority of cases, congenital anomalies are detected early in life by certain signs and symptoms. A 56-year-old man with no previous medical history was admitted due to recurrent wide QRS complex tachycardia with hemodynamic collapse. A chest radiograph showed dextrocardia. After synchronized cardioversion, an electrocardiogram revealed Wolff-Parkinson-White (WPW) syndrome. Persistent left SVC, PA sling, and right tracheal bronchus were also detected by a chest computed tomography (CT) scan. He was diagnosed with paroxysmal supraventricular tachycardia (PSVT) associated with WPW syndrome, and underwent radiofrequency ablation. We reported the first case of situs solitus dextrocardia coexisting with persistent left SVC, PA sling and right tracheal bronchus presented with WPW and PSVT in a middle-aged adult. In patients with a cardiovascular anomaly, clinicians should consider thorough evaluation of possibly combined cardiovascular and airway malformations and cardiac dysrhythmia. © 2017 The Korean Academy of Medical Sciences.

  1. Type A Wolff-Parkinson-White Syndrome Generating an Antidromic Atrioventricular (AV Reentrant Tachycardia (AVRT and an Orthodromic AVRT with a Long RP Interval Initiated only after Incomplete Impairment of an AV Accessory Pathway

    Directory of Open Access Journals (Sweden)

    Kazushi Tanaka, MD PhD

    2011-01-01

    Full Text Available We report on a case of a 23-year-old male with Wolff-Parkinson-White syndrome. At baseline, constant right atrial pacing induced antidromic atrioventricular reentrant tachycardia (AVRT, whereas constant right ventricular (RV pacing only revealed a normal His-Purkinje system. Mapping below the mitral annulus during sinus rhythm revealed fusion of atrial and ventricular potentials at multiple lateral sites. After unsuccessful ablation at these sites, constant RV pacing induced a long RP interval, orthodromic AVRT with the earliest atrial site being located at an anterior aspect, where successful ablation was later achieved. These phenomena may indicate an unexpected arrhythmogenic effect of initial ablations.

  2. EL JUEGO Y EL RITO COMO FUNDAMENTOS DE LA ESTRUCTURA DRAMÁTICA EN TRES OBRAS DE EGON WOLFF: LOS INVASORES, FLORES DE PAPEL Y CICATRICES

    Directory of Open Access Journals (Sweden)

    Eduardo Thomas Dublé

    2005-04-01

    Full Text Available El tema del juego tiene un lugar importante en la obra de Egon Wolff. Sus muy diversos modos de actualización en la extensa dramaturgia de este autor pueden sintetizarse en dos, que aparecen a lo largo de su producción con distintos matices y combinaciones. Por una parte, fundamenta las convenciones rituales de la cotidianeidad de los personajes, con funciones de disimulo y protección ante la realidad social que éstos perciben hostil. En este caso, el juego constituye un recurso para neutralizar y manipular al otro en beneficio propio, mediante el enmascaramiento. Pero también lo lúdico aparece con las características libertarias y creativas que le son propias, presentándose como una opción autentificadoraInside the dramatic world of Egon Wolf, social playacting establishes itself as a major theme. Its multiple and diverse modes of representation in his extensive dramaturgy could be summarized in two, appearing with different mances and combination throughout his work. On the one hand, they become the fundament of the ritual conventions of the commonplace acts of the characters, with the function of dissembling and self protection in front of the social reality which is perceived as hostile. In this case, playacting is a resource intended to neutralize and manipulate the other for personal benefit through masking strategies; but also the ludic element appears with creative and libertarian characteristics that are the character’s own, as an option for authenticity

  3. Radiofrequency ablation of accessory pathways in patients with the Wolff-Parkinson-White syndrome: long-term risk of mortality and coronary events.

    Science.gov (United States)

    Wongcharoen, Wanwarang; Lin, Yenn-Jiang; Chung, Fa-Po; Chen, Yun-Yu; Chao, Tze-Fan; Chen, Pei-Chun; Chien, Kuo-Liong; Chen, Shih-Ann

    2017-06-10

    The long-term outcomes of radiofrequency catheter ablation (RFCA) in patients with Wolff-Parkinson-White syndrome (WPW) remain unclear. We investigated the impact of RFCA on the long-term risk of coronary events and mortality in WPW patients. We conducted a prospective cohort study utilizing the Taiwan National Health Insurance Research Database. Between 2000 and 2003, WPW patients with no prior coronary artery disease (CAD) history, aged over 18 years, who underwent RFCA were identified. WPW patients without RFCA were matched with propensity-score 1:4 matching for confounding coronary risk factors. The study outcomes were total mortality and coronary events. A total of 1524 matched non-ablated WPW patients (Group 1) and 381 ablated WPW patients (Group 2) were included. After a mean follow-up of 9.6 ± 2.9 and 10.3 ± 1.9 years, respectively, ablation group demonstrated a lower incidence of mortality compared with non-ablation group (17 vs. 26/1000 person-years, P < 0.001; adjusted HR: 0.57, 95% CI: 0.44-0.7). However, ablation group had a higher incidence of coronary events compared with non-ablation group (47 vs. 82/1000 person-years, P < 0.001; adjusted HR: 1.69, 95% CI: 1.4-2.04). The ablation-treated WPW patients had lower risk of total mortality but higher risk of coronary events than non-ablated WPW patients during the long-term follow-up. Coronary artery injury produced by RFCA may account for the increased risk of coronary events. Therefore, the ablation strategies to avoid coronary artery injury should be implemented. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions, please email: journals.permissions@oup.com.

  4. Assessment of atrial fibrillation and vulnerability in patients with Wolff-Parkinson-White syndrome using two-dimensional speckle tracking echocardiography.

    Directory of Open Access Journals (Sweden)

    Jing-Jie Li

    Full Text Available PURPOSE: The aim was to assess atrial fibrillation (AF and vulnerability in Wolff-Parkinson-White (WPW syndrome patients using two-dimensional speckle tracking echocardiography (2D-STE. METHODS: All patients were examined via transthoracic echocardiography and 2D-STE in order to assess atrial function 7 days before and 10 days after RF catheter ablation. A postoperative 3-month follow-up was performed via outpatient visit or telephone calls. RESULTS: Results showed significant differences in both body mass index (BMI and supraventricular tachycardia (SVT duration between WPW patients and DAVNP patients (both P<0.05. Echocardiography revealed that the maximum left atrial volume (LAVmax and the left ventricular mass index (LVMI in diastole increased noticeably in patients with WPW compared to patients with DAVNP both before and after ablation (all P<0.05. Before ablation, there were obvious differences in the levels of SRs, SRe, and SRa from the 4-chamber view (LA in the WPW patients group compared with patients in the DAVNP group (all P<0.05. In the AF group, there were significant differences in the levels of systolic strain rate (SRs, early diastolic strain rate (SRe, and late diastolic strain rate (SRa from the 4-chamber view (LA both before and after ablation (all P<0.05. In the non-AF group, there were decreased SRe levels from the 4-chamber view (LA/RA pre-ablation compared to post-ablation (all P<0.05. CONCLUSION: Our findings provide convincing evidence that WPW syndrome may result in increased atrial vulnerability and contribute to the development of AF. Further, RF catheter ablation of AAV pathway can potentially improve atrial function in WPW syndrome patients. Two-dimensional speckle tracking echocardiography imaging in WPW patients would be necessary in the evaluation and improvement of the overall function of RF catheter ablation in a long-term follow-up period.

  5. The impact of B-type natriuretic peptide levels on the suppression of accompanying atrial fibrillation in Wolff-Parkinson-White syndrome patients after accessory pathway ablation.

    Science.gov (United States)

    Kawabata, Mihoko; Goya, Masahiko; Takagi, Takamitsu; Yamashita, Shu; Iwai, Shinsuke; Suzuki, Masahito; Takamiya, Tomomasa; Nakamura, Tomofumi; Hayashi, Tatsuya; Yagishita, Atsuhiko; Sasaki, Takeshi; Takahashi, Yoshihide; Ono, Yuhichi; Hachiya, Hitoshi; Yamauchi, Yasuteru; Otomo, Kenichiro; Nitta, Junichi; Okishige, Kaoru; Nishizaki, Mitsuhiro; Iesaka, Yoshito; Isobe, Mitsuaki; Hirao, Kenzo

    2016-12-01

    Atrial fibrillation (AF) often coexists with Wolff-Parkinson-White (WPW) syndrome. We compared the efficacy of Kent bundle ablation alone and additional AF ablation on accompanying AF, and examined which patients would still have a risk of AF after successful Kent bundle ablation. This retrospective multicenter study included 96 patients (56±15 years, 72 male) with WPW syndrome and AF undergoing Kent bundle ablation. Some patients underwent simultaneous pulmonary vein isolation (PVI) for AF. The incidence of post-procedural AF was examined. Sixty-four patients underwent only Kent bundle ablation (Kent-only group) and 32 also underwent PVI (+PVI group). There was no significant difference in the basic patient characteristics between the groups. Additional PVI did not improve the freedom from residual AF compared to Kent bundle ablation alone (p=0.53). In the Kent-only group, AF episodes remained in 25.0% during the follow-up (709 days). A univariate analysis showed that age ≥60 years, left atrial dimension ≥38mm, B-type natriuretic peptide (BNP) ≥40pg/ml, and concomitant hypertension were predictive factors for residual AF. However, in the multivariate analysis, only BNP ≥40pg/ml remained as an independent predictive factor (HR=17.1 and CI: 2.3-128.2; p=0.006). Among patients with WPW syndrome and AF, Kent bundle ablation alone may have a sufficient clinical impact of preventing recurrence of AF in select patients. Screening the BNP level would help decide the strategy to manage those patients. Copyright © 2016 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

  6. Does accessory pathway significantly alter left ventricular twist/torsion? A study in Wolff-Parkinson-White syndrome by velocity vector imaging.

    Science.gov (United States)

    Aminian, Farimah; Esmaeilzadeh, Maryam; Moladoust, Hassan; Maleki, Majid; Shahrzad, Soraya; Emkanjoo, Zahra; Sadeghpour, Anita

    2014-08-01

    The aim of this study was to determine the impact of manifest accessory pathway on left ventricle (LV) twist physiology in Wolff-Parkinson-White (WPW) patients. Although this issue was addressed in 1 study based on speckle tracking method, there was no comparative study with a different technique. We planned to use velocity vector imaging (VVI) to find out how much an accessory pathway can affect LV twist mechanics. Thirty patients were enrolled regarding inclusion and exclusion criteria. Two serial comprehensive transthoracic echocardiography evaluations were performed before and after radiofrequency catheter ablation (RFCA) within 24 hours. Stored cine loops were analyzed using VVI technique and LV twist and related parameters were extracted. Comparing pre- and post-RFCA data, no significant changes were observed in LV systolic and diastolic dimensions, LV ejection fraction (LVEF), and Doppler and tissue Doppler-related parameters. VVI study revealed remarkable rise in peak LV apical rotation (10.3º ± 3.0º to 13.8º ± 3.6º, P < 0.001) and basal rotation (-6.0 ± 1.8º to -7.7 ± 1.8º, P < 0.001) after RFCA. Subsequently LV twist showed a surge from 14.7º ± 3.9º to 20.2º ± 4.4º (P < 0.001). LV untwisting rate changed significantly from -96 ± 67 to -149.0 ± 47.5°/sec (P < 0.001) and apical-basal rotation delay showed a remarkable decline after RFCA (106 ± 81 vs. 42.8 ± 26.0 msec, P < 0.001). Accessory pathways have a major impact on LV twist mechanics. © 2013, Wiley Periodicals, Inc.

  7. Detection and quantification by deformation imaging of the functional impact of septal compared to free wall preexcitation in the Wolff-Parkinson-White syndrome.

    Science.gov (United States)

    De Boeck, Bart W L; Teske, Arco J; Leenders, Geert E; Mohamed Hoesein, Firdaus A A; Loh, Peter; van Driel, Vincent J; Doevendans, Pieter A; Prinzen, Frits W; Cramer, Maarten J

    2010-08-15

    Pacing experiments in healthy animal hearts have suggested a larger detrimental effect of septal compared to free wall preexcitation. We investigated the intrinsic relation among the site of electrical preexcitation, mechanical dyssynchrony, and dysfunction in human patients. In 33 patients with Wolff-Parkinson-White (WPW) syndrome and 18 controls, regional myocardial deformation was assessed by speckle tracking mapping (ST-Map) to assess the preexcitation site, shortening sequences and dyssynchrony, and the extent of local and global ejecting shortening. The ST-Map data in patients with accessory atrioventricular pathways correctly diagnosed as located in the interventricular septum (IVS) (n = 11) or left ventricular free wall (LFW) (n = 12) were compared to the corresponding control values. A local ejecting shortening of <2 SD of the control values identified hypokinetic segments. The localization of the atrioventricular pathways by ST-Map matched with the invasive electrophysiology findings in 23 of 33 patients and was one segment different in 5 of 33 patients. In both WPW-IVS and WPW-LFW, local ejecting shortening was impaired at the preexcitation site (p <0.01). However, at similar electrical and mechanical dyssynchrony, WPW-IVS had more extensive hypokinesia than did WPW-LFW (3.6 +/- 0.9 vs 1.8 +/- 1.3 segments, p <0.01). Compared to controls, the left ventricular function was significantly reduced only in WPW-IVS (global ejecting shortening 17 +/- 2% vs 19 +/- 2%, p = 0.01; ejection fraction 55 +/- 5% vs 59 +/- 3%, p = 0.02). In conclusion, preexcitation is associated with local hypokinesia, which at comparable preexcitation is more extensive in WPW-IVS than in WPW-LFW and could adversely affect ventricular function. ST-Map might have a future role in detecting and guiding treatment of septal pathways with significant mechanical effects.

  8. Epidemiological profile of Wolff-Parkinson-White syndrome in a general population younger than 50 years of age in an era of radiofrequency catheter ablation.

    Science.gov (United States)

    Lu, Chun-Wei; Wu, Mei-Hwan; Chen, Hui-Chi; Kao, Feng-Yu; Huang, San-Kuei

    2014-07-01

    The prevalence of Wolff-Parkinson-White (WPW) syndrome varies between 0.68 and 1.7/1000. The epidemiological profile may be modified after the introduction of transcatheter interventions. The aim of this study is to investigate the epidemiological trends of the WPW syndrome in a general population during a period with available and reimbursed transcatheter ablation. Data of WPW patients <50 years old were retrieved from our national database (2000-2010). We identified 6086 (61% male) patients, accounting for an overall prevalence of 0.36/1000 with a peak of 0.61/1000 in ages 20-24 years. The risk of death and sudden death was 0.071% and 0.02% per patient-year, respectively. The 42 deaths occurred at a median age of 29 years. Associated congenial heart disease was noted in 158 (2.6%) patients, including 42 with Ebstein's anomaly that increased the mortality risk (P=0.001, OR=8.5). In those without congenital heart disease, myocardial dysfunction occurred in 115 (1.9%) patients and increased the risk of death (P<0.001, OR=10.6) and sudden death. Radiofrequency catheter ablation was performed in 2527 patients at a median age of 25.7 years (4.54% per patient-year, discharge mortality 0.16%); 11 (0.4%) before the age of 5, and 2231 (88%) after the age of 15. Whereas repeated ablation procedures accounted for 6.0% of the procedures, those in Ebstein's patients were 25%. Radiofrequency catheter ablation is already a common treatment for WPW patients, particularly during young adulthood, which accounts for a lower prevalence. Myocardial dysfunction and associated congenital heart disease remain as risks of mortality. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  9. Current strategy for treatment of patients with Wolff-Parkinson-White syndrome and asymptomatic preexcitation in Europe: European Heart Rhythm Association survey.

    Science.gov (United States)

    Svendsen, Jesper Hastrup; Dagres, Nikolaos; Dobreanu, Dan; Bongiorni, Maria Grazia; Marinskis, Germanas; Blomström-Lundqvist, Carina

    2013-05-01

    The aims of this survey was to provide insight into treatment activity, the strategy of treatment, and risk stratification of patients with asymptomatic and symptomatic ventricular pre-excitation across Europe. Fifty-eight centres, members of the European Heart Rhythm Association EP research network, covering 20 countries answered the survey questions. All centres were high-volume ablation centres. A younger person with asymptomatic Wolff-Parkinson-White (WPW) pattern has a higher likelihood of being risk-stratified or receiving ablation therapy compared with an older subject. Two-thirds of centres report that they have observed a decline in the number of patients ablated for an accessory pathway during the last 10 years. Pre-excited atrial fibrillation is rarely seen. Discontinuation of a scheduled WPW ablation due to close vicinity of the accessory pathway to the AV node happens very rarely. Patients with a first episode of pre-excited atrial fibrillation would immediately be referred for catheter ablation to be performed within weeks by 80.4% of the centres. A significant proportion of responders (50.9%) would use electrical cardioversion to restore sinus rhythm in a patient with pre-excited atrial fibrillation. With respect to the choice of antiarrhythmic medication for a patient with pre-excited AF, the majority (80.0%) would choose class 1C antiarrhytmic drugs while waiting for a catheter ablation. A patient seen in the emergency room with a second episode of orthodromic atrioventricular reentry tachycardia would be referred for immediate ablation by 79.2-90.6% of centres depending on the presence of pre-excitation. The volume of paediatric ablations performed on children younger than 12 years was low (46.4%: 0 patients per year; 46.4%: 1-9 patients per year). The majority of responding centres (61-69%) report that their country lack national guidelines dealing with clinical strategies related to WPW. There is a need for national guidelines dealing with

  10. The impact of left ventricular deformation and dyssynchrony on improvement of left ventricular ejection fraction following radiofrequency catheter ablation in Wolff-Parkinson-White syndrome: A comprehensive study by speckle tracking echocardiography.

    Science.gov (United States)

    Nagai, Tomoo; Hamabe, Akira; Arakawa, Junko; Tabata, Hirotsugu; Nishioka, Toshihiko

    2017-11-01

    The purpose of this study was to evaluate left ventricular (LV) deformation and LV dyssynchrony in patients with Wolff-Parkinson-White (WPW) syndrome and to identify the factors that affect the efficacy of radiofrequency catheter ablation (RFCA). Thirty patients (26 men, mean age 40 ± 12 years) with WPW syndrome were prospectively recruited for this study. They underwent 2-dimensional transthoracic echocardiography with speckle tracking analysis before RFCA and again within 48 hours after RFCA. Control group consisted of 15 age and sex-matched healthy volunteers. The patients had significantly lower LV ejection fraction (LVEF), global longitudinal strain (S l ), and global circumferential strain (S c ) compared with healthy controls (64% ± 8% vs 68% ± 5%, P = .049; -17.6% ± 3.2% vs -19.9% ± 3.3%, P = .037, -15.2% ± 2.5% vs -19.4% ± 2.5%, P syndrome, impaired LV circumferential deformation can be restored by RFCA with concomitant improvement in LV dyssynchrony and LVEF. © 2017, Wiley Periodicals, Inc.

  11. Three-Catheter Technique for Ablation of Left-Sided Accessory Pathways in Wolff-Parkinson-White is Less Expensive and Equally Successful When Compared to a Five-Catheter Technique.

    Science.gov (United States)

    Capone, Christine A; Ceresnak, Scott R; Nappo, Lynn; Gates, Gregory J; Schechter, Clyde B; Pass, Robert H

    2015-12-01

    To compare the efficacy, safety, and cost-effectiveness of a three-catheter approach with a conventional five-catheter approach for the mapping and ablation of supraventricular tachycardia in pediatric patients with Wolff-Parkinson-White Syndrome (WPW) and concealed accessory pathways (APs). A retrospective review from 2008 to 2012 of patients less than 21 years with WPW who underwent a three-catheter radiofrequency (RF) ablation of a left-sided AP (ablation, right ventricular [RV] apical, and coronary sinus [CS] decapolar catheters) was performed. The three-catheter group was compared to a control group who underwent a standard five-catheter (ablation, RV apical, CS decapolar, His catheter, and right atrial catheter) ablation for the treatment of left-sided WPW or concealed AP. Demographics, ablation outcomes, and costs were compared between groups. Twenty-eight patients met inclusion criteria with 28 control patients. The groups did not differ in gender, age, weight, or body surface area. Locations of the AP on the mitral annulus were similar between the groups. All patients were ablated via transseptal approach. Note that 28 of 28 in the three-catheter group (100%) and 27 of 28 (96%) controls were acutely successfully ablated (P = 0.31). No complications were encountered. There was no difference in procedural time, time to loss of AP conduction, or number of RF applications. Use of the three-catheter technique resulted in a total savings of $2,465/case, which includes the $680 savings from using fewer catheters as well as the savings from a shortened procedure time. Ablation in patients with WPW and a left-sided AP can be performed using three catheters with similar efficacy and safety while offering significant cost savings compared to a conventional five-catheter approach. © 2015 Wiley Periodicals, Inc.

  12. The Wolff rearrangement of cyclic 2-diazo-1,3-diketones in electron impact - mass spectrometry - controlling the molecular fragmentation by means of low-energy electrons 18 to 70 eV

    International Nuclear Information System (INIS)

    Kuruc, J.; Kardosova, E.; Nikolaev, V. A.

    2016-01-01

    The electron-impact-induced fragmentations (the mass spectra, 17 - 70 eV) of cyclic 2-diazo-1,3-diketones were studied. As the suitable compounds were selected the following cyclic 2-diazo-1,3-diketones: 2-diazo-1,3-cyclohexanedione, Ia; 2-diazo-4,4-dimethyl-1,3-cyclohexanedione, Ib; 2-diazo-5,5-dimethyl-1,3-cyclohexanedione, Ic; 2-diazo-4,6-dioxa-5,5-dimethyl-1,3-cyclohexanedione, Id; and 2-diazo-5-phenyl-1,3-cyclohexanedione, Ie). The mass spectra were measured with Varian MAT 111 instrument with direct introduction of samples, with a source temperature of 120 grad C, energy of ionising electrons was in the range (17 - 70) eV. The elimination of the diazo group is the typical reaction of the fragmentation of the cyclic diazo-1,3-diketones after ionization of molecules by electron impact. All our studied cyclic diazo-1,3-diketones have a molecular ion with a relative intensity from 0.7 to 86.4%. Typical ions are [M]"+·, [M-N"_2]"+"·, [M-N_2-CO]"+"·, [M-N_2-CO-CH_2]"+"·, [M-N_2-CO-CH_3]"+"·. For all treatment cyclic diazo-1,3-diketones have been registered 3D mass spectra, for each cyclic diazo-1,3-diketone was proposed fragmentation scheme, including the general fragmentation scheme. The Wolff rearrangement is observed in all studied cyclic diazo-1,3-diketones after cleavage of nitrogen molecules. The energy of ionizing electrons ∼20 eV in the case of compounds Ib, Id - Ie dominating ions are fragments of the [M-N_2]"+"·, in the compound Ia at 18 and 20 eV is dominant fragment [M-N_2-CO-C_2H_2-H]"+"· and for the Ic at 30 eV becomes a dominant fragment [M-N_2-CH_3]"+"· (m/z = 123) but at (25 - 18) eV the most intensive ion is [M-N_2]"+"· (m/z = 138). (authors)

  13. 明党参根皮中异欧前胡素的体内抗肿瘤活性研究%Study on Anti-tumor Activity of Isoimperatorin in the Root Bark of Changium Smyrnioides Wolff in Vivo

    Institute of Scientific and Technical Information of China (English)

    王萌

    2016-01-01

    Objective: To study anti-tumor activity of isoimperatorin in the root bark of Changium smyrnioides Wolff in vivo. Methods:There are three dose groups of isoimperatorin, low dose group (0.2mg·kg-1), middle dose group (0.4mg·kg-1), high dose group (0.8mg·kg-1);Positive drug group (cyclophosphamide 30mg·kg-1). This research uses the method of transplanted tumor model, to observe the growth of solid tumor, and calculate the anti-tumor rate of each group. Results:The anti-tumor rates of isoimperatorin in low, middle, high dose group are 28.67%, 59.29%, 66.38%; anti-tumor rate of the positive drug group is 66.93%, but the immune organs of mice are damaged. Conclusion:Isoimperatorin has obvious anti-tumor effect on liver cancer transplanted tumor in mice, and has a protective effect on immune organs.%目的:研究明党参根皮中异欧前胡素的体内抗肿瘤作用.方法:异欧前胡素设三个剂量组,低剂量组(0.2mg·kg-1)、中剂量组(0.4mg·kg-1)、高剂量组(0.8mg·kg-1),阳性药物组(环磷酰胺30mg·kg-1),采用移植性肿瘤模型的方法,观察实体瘤生长情况,并计算各组抑瘤率.结果:异欧前胡素低、中、高剂量组的抑瘤率分别为28.67%、59.29%、66.38%,阳性药物组的抑瘤率为66.93%,但对小鼠免疫器官有损伤.结论:异欧前胡素对小鼠肝癌移植瘤有明显的抗肿瘤作用,并对机体免疫器官有保护作用.

  14. 'Knowledge and Knowers' in Engineering Assessment | Wolff ...

    African Journals Online (AJOL)

    In multidisciplinary technology-based engineering diploma programmes in South Africa, the curriculum is often structured into distinctly theoretical and practical components, each of which is taught and assessed at different stages by different disciplinary or technical specialists. This separation does not necessarily reflect ...

  15. Elemente einer Soziolinguistik Nordafrikas | Ekkehard Wolff ...

    African Journals Online (AJOL)

    Stellenbosch Papers in Linguistics Plus. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 38 (2009) >. Log in or Register to get access to full text downloads.

  16. 'Knowledge and Knowers' in Engineering Assessment | Wolff ...

    African Journals Online (AJOL)

    Critical Studies in Teaching and Learning. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 2, No 1 (2014) >. Log in or Register to get access to full text downloads.

  17. Kateedrid ja katedraalid / Jonathan Wolff ; interv. Jüri Lipping

    Index Scriptorium Estoniae

    Wolff, Jonathan

    2005-01-01

    Vestlus tuntud poliitikafilosoofi Jonathan Wolffiga. Huvi tekkimine poliitilise mõtlemise vastu, poliitilise filosoofia traditsioonidest, poliitiline liberalism, analüütiline filosoofia, ajaloo suurnimed

  18. Surgical cure ofthe Wolff-Parkinson-White syndrome a comparison ...

    African Journals Online (AJOL)

    a comparison oftwo techniques. u. o. VON OPPELL, R. N. .... Surgical techniques. The surgical techniques used between 1987 and 1989 varied. Localised epicardial dissections were done in the first 2 patients (Fig. 1). However, these failed to ... before significant manipulation of the heart and cardio- pulmonary bypass.

  19. Surgery for the Wolff-Parkinson-White syndrome

    African Journals Online (AJOL)

    artery disease died unexpectedly 10 days after 4-vessel coronary bypass ... Before 1981, the failure rate of WPW .... of right ventricular dysfunction and tricuspid regurgitation, but she .... Tcu:hycardias: Mechanism, Diagnosis and. Treatmenr.

  20. Migration of the phosphoryl group in the photochemical and thermal Wolff rearrangement

    International Nuclear Information System (INIS)

    Polozov, A.M.; Pavlov, V.A.; Polezhaeva, N.A.; Liorber, B.G.; Tarzivolova, T.A.; Arbuzov, B.A.

    1986-01-01

    For the study of the rearrangement the authors prepared methyl 2-diazo-3-(diisopropoxyphosphinyl)-3-oxopropinoate by the diazo-transfer method. By the same method they prepared methyl 2-diazo-3-(diethoxyphosphinyl)-3-oxopropioinate. Unlike its carbonyl analog, the first compound proved to be extremely unstable. In vacuum distillation or chromatography on silica gel it decomposes. The structure of the ester was proved by elemental analysis and methods of 1 H and 31 P NMR spectroscopy

  1. [Clinical demonstrations: Heart rupture in acute myocardial infarct. Infectious endocarditis. Wolff-Parkinson-White syndrome].

    Science.gov (United States)

    Nager, F

    1984-12-08

    This clinical demonstration includes three topics of clinical cardiology: myocardial rupture in acute myocardial infarction, infective endocarditis, and WPW-syndrome with paroxysmal supraventricular tachycardia. In the first part three cases with septal perforation or papillary muscle rupture are demonstrated. Our experience with myocardial rupture (free wall, septum, papillary muscle) during the last six years is summarized with special reference to the significance and the differential diagnosis of systolic regurgitant murmurs after myocardial infarction. Special features of acute mitral incompetence (papillary muscle dysfunction) in myocardial infarction are outlined and diagnostic guidelines for differentiation between septal perforation and papillary muscle rupture are discussed. In the second part two patients with aortic (e.g. mitral) valve rupture in the course of infective endocarditis are presented. The synoptic comparison of these two patients is related to the results of our own clinical studies on the changing pattern of infective endocarditis (epidemiologically, clinically) during the last three decades. The clinical picture of acute aortic valve rupture is outlined and the bedside signs indicating catastrophic complications of infective endocarditis are summarized. In the third part the odyssey of a patient with WPW-syndrome and consecutive paroxysmal supraventricular tachycardia is described. Progress in electrophysiological analysis of the re-entry circles in preexcitation syndromes is outlined.

  2. Coexistence of Wolff-Parkinson-white and Brugada syndrome: mere curiosity?

    Science.gov (United States)

    Kaiser, Elisabeth; Sacilotto, Luciana; Darrieux, Francisco; Sosa, Eduardo

    2014-09-01

    The association between Brugada syndrome (BS) and ventricular preexcitation is a rare condition, with sporadic cases already reported. We report the case of a 29-year-old man, with palpitation unrelated to physical or emotional stress. The electrocardiogram of the first visit revealed a ventricular preexcitation pattern and an end-conduction delay, with negative T wave in V1 and intraventricular conduction disturbance in V2 (atypical for BS). The typical aspect of BS occurred after introduction of propafenone for the prevention of atrioventricular tachycardia. We discuss the recognition of this rare association, the proarrhythmic effects of some drugs, treatment options, and prognosis. © 2014 Wiley Periodicals, Inc.

  3. Anaesthetic management of a case of Wolff-Parkinson-White syndrome

    Science.gov (United States)

    Kabade, Savitri D; Sheikh, Safiya; Periyadka, Bhavya

    2011-01-01

    We report a case of fibroid uterus with Wolff–Parkinson–White (WPW) syndrome in a 48-year-old female, posted for elective hysterectomy. Patient gave history of short recurrent episodes of palpitation and electrocardiograph confirmed the diagnosis of WPW syndrome. The anaesthetic management of these patients is challenging as they are known to develop life threatening tachyarrhythmia like paroxysmal supra-ventricular tachycardia (PSVT) and atrial fibrillation (AF). Epidural anaesthesia is preferred compared to general anaesthesia to avoid polypharmacy, noxious stimuli of laryngoscopy and intubation. To deal with perioperative complications like PSVT and AF, anti-arrhythmic drugs like adenosine, beta blockers and defibrillator should be kept ready. Perioperative monitoring is essential as patients can develop complications. PMID:22013256

  4. Wolff-Parkinson-White (WPW) syndrome: the detection of delta wave in an electrocardiogram (ECG).

    Science.gov (United States)

    Mahamat, Hassan Adam; Jacquir, Sabir; Khalil, Cliff; Laurent, Gabriel; Binczak, Stephane

    2016-08-01

    The delta wave remains an important indicator to diagnose the WPW syndrome. In this paper, a new method of detection of delta wave in an ECG signal is proposed. Firstly, using the continuous wavelet transform, the P wave, the QRS complex and the T wave are detected, then their durations are computed after determination of the boundary location (onsets and offsets of the P, QRS and T waves). Secondly, the PR duration, the QRS duration and the upstroke of the QRS complex are used to determine the presence or absence of the delta wave. This algorithm has been tested on the Physionel database (ptbdb) in order to evaluate its robustness. It has been applied to clinical signals from patients affected by WPW syndrome. This method can provide assistance to practitioners in order to detect the WPW syndrome.

  5. Long term risk of Wolff-Parkinson-White pattern and syndrome.

    Science.gov (United States)

    Kim, Susan S; Knight, Bradley P

    2017-05-01

    For years, conventional wisdom has held that patients with asymptomatic ventricular pre-excitation (asymptomatic WPW or WPW pattern) were at low risk for adverse outcomes. This assumption has been challenged more recently in a number of observational/natural history studies as well as in prospective trials in which patients were more aggressively studied via invasive electrophysiology study (EPS) and more aggressively treated, in some cases, with pre-emptive catheter ablation, despite the lack of symptoms. In sum, the data do not definitively support one approach (early, up-stream EPS and/or ablation) vs. the other (watchful waiting with close monitoring). The most recent pediatric and adult guidelines reflect this ambiguity with a broad spectrum of approaches endorsed. Copyright © 2017. Published by Elsevier Inc.

  6. [AV-reentrant tachycardia and Wolff-Parkinson-White syndrome : Diagnosis and treatment].

    Science.gov (United States)

    Voss, Frederik; Eckardt, Lars; Busch, Sonia; Estner, Heidi L; Steven, Daniel; Sommer, Philipp; von Bary, Christian; Neuberger, Hans-Ruprecht

    2016-12-01

    The AV-reentrant tachycardia (AVRT) is a supraventricular tachycardia with an incidence of 1-3/1000. The pathophysiological basis is an accessory atrioventricular pathway (AP). Patients with AVRT typically present with palpitations, an on-off characteristic, anxiety, dyspnea, and polyuria. This type of tachycardia may often be terminated by vagal maneuvers. Although the clinical presentation of AVRT is quite similar to AV-nodal reentrant tachycardias, the correct diagnosis is often facilitated by analyzing a standard 12-lead ECG at normal heart rate showing ventricular preexcitation. Curative catheter ablation of the AP represents the therapy of choice in symptomatic patients. This article is the fourth part of a series written to improve the professional education of young electrophysiologists. It explains pathophysiology, symptoms, and electrophysiological findings of an invasive EP study. It focusses on mapping and ablation of accessory pathways.

  7. Celebrating science education from people for people: A tribute to Wolff-Michael Roth

    NARCIS (Netherlands)

    Eijck, van M.W.; Lee, Y.-J.; Ardenghi, D.M.; Emad, G.-R.; Hsu, P.-L.; Jayme, B.; Kim, M.; Maheux, J.F.; Pozzer-Ardenghi, L.

    2011-01-01

    I (Giuliano) remember being in a room full of scientists and educators who were collaborating together in a million-dollar interdisciplinary project. Michael—as he repeatedly told us to call him (Roth et al. 2007)—had invited a few of his graduate students to attend the meeting because we were

  8. 77 FR 5105 - Randall L. Wolff, M.D.; Decision and Order

    Science.gov (United States)

    2012-02-01

    ...'' and ``getting more in the way of diagnostics such as x-rays, nerve conduction studies'' and an... had made this statement, because he ``was very disturbed that he would do such a thing'' and what he... that he had been taking opioids for twelve years and had done so as recently as two weeks before his...

  9. Criticality of the random-site Ising model: Metropolis, Swendsen-Wang and Wolff Monte Carlo algorithms

    Directory of Open Access Journals (Sweden)

    D.Ivaneyko

    2005-01-01

    Full Text Available We apply numerical simulations to study of the criticality of the 3D Ising model with random site quenched dilution. The emphasis is given to the issues not being discussed in detail before. In particular, we attempt a comparison of different Monte Carlo techniques, discussing regions of their applicability and advantages/disadvantages depending on the aim of a particular simulation set. Moreover, besides evaluation of the critical indices we estimate the universal ratio Γ+/Γ- for the magnetic susceptibility critical amplitudes. Our estimate Γ+/Γ- = 1.67 ± 0.15 is in a good agreement with the recent MC analysis of the random-bond Ising model giving further support that both random-site and random-bond dilutions lead to the same universality class.

  10. Localization of accessory pathway in patients with wolff-parkinson-white syndrome from surface ecg using arruda algorithm

    International Nuclear Information System (INIS)

    Saidullah, S.; Shah, B.

    2016-01-01

    Background: To ablate accessory pathway successfully and conveniently, accurate localization of the pathway is needed. Electrophysiologists use different algorithms before taking the patients to the electrophysiology (EP) laboratory to plan the intervention accordingly. In this study, we used Arruda algorithm to locate the accessory pathway. The objective of the study was to determine the accuracy of the Arruda algorithm for locating the pathway on surface ECG. Methods: It was a cross-sectional observational study conducted from January 2014 to January 2016 in the electrophysiology department of Hayat Abad Medical Complex Peshawar Pakistan. A total of fifty nine (n=59) consecutive patients of both genders between age 14-60 years presented with WPW syndrome (Symptomatic tachycardia with delta wave on surface ECG) were included in the study. Patient's electrocardiogram (ECG) before taking patients to laboratory was analysed on Arruda algorithm. Standard four wires protocol was used for EP study before ablation. Once the findings were confirmed the pathway was ablated as per standard guidelines. Results: A total of fifty nine (n=59) patients between the age 14-60 years were included in the study. Cumulative mean age was 31.5 years ± 12.5 SD. There were 56.4% (n=31) males with mean age 28.2 years ± 10.2 SD and 43.6% (n=24) were females with mean age 35.9 years ± 14.0 SD. Arruda algorithm was found to be accurate in predicting the exact accessory pathway (AP) in 83.6% (n=46) cases. Among all inaccurate predictions (n=9), Arruda inaccurately predicted two third (n=6; 66.7%) pathways towards right side (right posteroseptal, right posterolateral and right antrolateral). Conclusion: Arruda algorithm was found highly accurate in predicting accessory pathway before ablation. (author)

  11. Jonathan F. Reichert and Barbara Wolff-Reichert Award for Excellence in Advanced Laboratory Instruction: Advanced Instructional Labs: Why Bother?

    Science.gov (United States)

    Bistrow, Van

    What aren't we teaching about physics in the traditional lecture course? Plenty! By offering the Advanced Laboratory Course, we hope to shed light on the following questions: How do we develop a systematic process of doing experiments? How do we record procedures and results? How should we interpret theoretical concepts in the real world? What experimental and computational techniques are available for producing and analyzing data? With what degree of confidence can we trust our measurements and interpretations? How well does a theory represent physical reality? How do we collaborate with experimental partners? How do we best communicate our findings to others?These questions are of fundamental importance to experimental physics, yet are not generally addressed by reading textbooks, attending lectures or doing homework problems. Thus, to provide a more complete understanding of physics, we offer laboratory exercises as a supplement to the other modes of learning. The speaker will describe some examples of experiments, and outline the history, structure and student impressions of the Advanced Lab course at the University of Chicago Department of Physics.

  12. The role of the accessory pathway radiofrequency catheter ablation in the secondary prevention of the malignant tachyarrhythmias in patients with Wolff-Parkinson-White syndrome

    Directory of Open Access Journals (Sweden)

    Mujović Nebojša

    2010-01-01

    Full Text Available Background/Aim. The occurrence of atrial fibrillation (AF in the presence of an accessory pathway (AP that conducts rapidly is potentially lethal because the rapid ventricular response may lead to ventricular fibrillation (VF. The aim of the study was to determine long-term efficacy of AP catheter-ablation using radiofrequency (RF current in secondary prevention of VF in WPW patients. Methods. Study included a total of 192 symptomatic WPW patients who underwent RF catheter-ablation of AP in our institution from 1994 to 2007 and were available for clinical follow-up for more than 3 months after procedure. Results. Before ablation, VF was recorded in total of 27 patients (14.1%. In 14 of patients (51.9% VF was the first clinical manifestation of WPW syndrome. A total of 35 VF episodes were identified in 27 patients. The occurrence of VF was preceded by physical activity or emotional stress in 17.1% of cases, by alcohol abuse in 2.9% and by inappropriate intravenous drug administration in 28.6%. In addition, no clear precipitating factor was identified in 40% of VF cases, while informations about activities preceding 11.4% of VF episodes were not available. The follow-up of 5.7 ± 3.3 years was obtained in all of 27 VF patients. Of the 20 patients who underwent successful AP ablation, all were alive, without syncope or ventricular tachyarrhythmias during long-term follow-up. In 4 of 7 unsuccessfully treated patients, recurrence of supraventricular tachycardia and/or preexcited atrial fibrillation were recorded; one of these patients suddenly died of VF, 6 years after procedure. Conclusion. In significant proportion of WPW patients, VF was the first clinical manifestation of WPW syndrome, often precipitated by physical activity, emotional stress or inappropriate drug administration. Successful elimination of AP by percutaneous RF catheter-ablation is highly effective in secondary prevention of life-threatening tachyarrhythmias in patients with ventricular preexcitation.

  13. „Verfassungshütung“ im Commonwealth als Vorbild für den deutschen Verfassungsstaat? Zugleich ein Beitrag zur Legitimation verfassungsgerichtlicher Normenkontrollrechte / Roman Kaiser, Daniel Wolff

    Index Scriptorium Estoniae

    Kaiser, Roman

    2017-01-01

    Konstitutsioonikohtust kui kõrgeimast instantsist põhiseaduse normide tõlgendajana; põhiseaduslikkuse kaitse uuest mudelist (new commonwealth model of constitutionalism) Suurbritannias, Kanadas, Uus-Meremaal ja osal Austraalia territooriumil)

  14. The mitochondrial 13513G > A mutation is most frequent in Leigh syndrome combined with reduced complex I activity, optic atrophy and/or Wolff-Parkinson-White.

    NARCIS (Netherlands)

    Ruiter, E.M.; Siers, M.H.; Elzen, C. van der; Engelen, B.G.M. van; Smeitink, J.A.M.; Rodenburg, R.J.T.; Hol, F.A.

    2007-01-01

    The m.13513G > A transition in the mitochondrial gene encoding the ND5 subunit of respiratory chain complex I, can cause mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes (MELAS) and has been reported to be a frequent cause of Leigh syndrome (LS). We determined the

  15. Non-invasive diagnostic method using the phase image for the Kent fiber position in Wolff-Parkinson-White (WPW) syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Konishi, Tokuji; Makino, Katsutoshi; Ichikawa, Takehiko; Futagami, Yasuo; Hamada, Masayuki (Mie Univ., Tsu (Japan). School of Medicine)

    1983-10-01

    Gated blood pool scintigraphy with sup(99m)Tc-RBC was performed in patients with WPW syndrome and healthy controls. The contraction of the normal ventricle and the Kent fiber position in cases of WPW syndrome were observed on the phase image obtained by Fourier-transformation of the time activity curve. This method is considered to be more valuable than the other non-invasive procedures in cases of WPW syndrome, especially in the preoperative examination for transecting Kent fibers.

  16. Non-invasive diagnostic method using the phase image for the Kent fiber position in Wolff-Parkinson-White (WPW) syndrome

    International Nuclear Information System (INIS)

    Konishi, Tokuji; Makino, Katsutoshi; Ichikawa, Takehiko; Futagami, Yasuo; Hamada, Masayuki

    1983-01-01

    Gated blood pool scintigraphy with sup(99m)Tc-RBC was performed in patients with WPW syndrome and healthy controls. The contraction of the normal ventricle and the Kent fiber position in cases of WPW syndrome were observed on the phase image obtained by Fourier-transformation of the time activity curve. This method is considered to be more valuable than the other non-invasive procedures in cases of WPW syndrome, especially in the preoperative examination for transecting Kent fibers. (Namekawa, K.)

  17. Plantas cultivadas e invasoras como habitat para predadores do gênero Orius(Wolff (Heteroptera: anthocoridae Crops and weeds as host plants Orius species (Heteroptera: anthocoridae

    Directory of Open Access Journals (Sweden)

    Luís Cláudio Paterno Silveira

    2003-01-01

    Full Text Available O objetivo deste trabalho foi registrar as espécies de Orius associadas a plantas cultivadas e invasoras presentes em uma localidade de Minas Gerais e três de São Paulo, nos anos de 1999 e 2000. As coletas foram realizadas através de batidas das plantas no interior de sacos plásticos para desalojar os insetos. Posteriormente, as espécies foram separadas em laboratório. O predador Orius insidiosus (Say foi coletado nas culturas de milho (Zea mays L., milheto (Pennisetum glaucum (L. R.Br., sorgo (Sorghum spp., feijão (Phaseolus vulgaris L., girassol (Helianthus annuus L., alfafa (Medicago sativa L., soja [Glycine max (L. Merr.], crisântemo (Chrysanthemum spp., tango (Solidago canadensis L. e cartamus (Carthamus tinctorius L. e nas plantas invasoras picão-preto (Bidens pilosa L., caruru (Amaranthus sp., losna-branca (Parthenium hysterophorus L. e apaga-fogo (Alternanthera ficoidea L.. Orius thyestes Herring foi encontrado nas plantas invasoras picão-preto, caruru e apaga-fogo. Orius perpunctatus (Reuter e Orius sp. foram coletados principalmente nas plantas invasoras picão-preto, caruru e apaga-fogo e no milho. Constatou-se que muitas dessas plantas são reservatórios naturais para esses predadores, em termos de habitat, abrigo, presas e pólen.The aim of this research was to record the Orius species present on some crops and weeds in areas located in the southeast region in Brazil, during 1999 and 2000. The insect collections were made through the tapping method to dislodge the insects from the plant into a plastic bag. The identifications of the specimens was done in the laboratory. Orius insidiosus (Say was collected on the following crops: corn (Zea mays L., pearl millet (Pennisetum glaucum (L. R.Br., sorghum (Sorghum spp., bean (Phaseolus vulgaris L., sunflower (Helianthus annuus L., alfalfa (Medicago sativa L., soybean (Glycine max (L. Merr., chrysanthemum (Chrysanthemum spp., tango (Solidago canadensis L. and carthamus (Carthamus tinctorius L.. On weeds, O. insidiosus was found on farmer's friend (Bidens pilosa L., amaranth (Amaranthus sp., parthenium weed (Parthenium hysterophorus L. and Joseph's coat (Alternanthera ficoidea L.. Orius thyestes Herring was found on weed plants farmer's friend, amaranth and Joseph's coat. Orius perpunctatus (Reuter and Orius sp. were collected mainly on weed plants (farmer's friend, amaranth and Joseph's coat and corn. Many of these plants are natural hosts for these predators, providing refuge, prey and pollen.

  18. TOXICITY PROPENSITIES OF SOME MARINE AND FRESH-WATERALGAE AS THEIR CHEMICAL DEFENSE

    OpenAIRE

    ORHAN, İlkay; WISESPONGPAND, Puntip; ATICI, Tahir; ŞENER, Bilge

    2003-01-01

    Five species of the marine brown-algae, namely Halopteris scoparia (L.) Sauvagau, Padina vickersiae Hoyt, Dictyota dichotoma (Huds) Lam., Scinaia furcellata L., and Sargassum natans (L.) J. Meyer, a species of the marine green-alga, Ulva lactuca L., a species of the sea grass, Posidonia oceanica L., six species of fresh-water green-algae, namely Vaucheria sessilis (Vauch.) De Candolle, Zygnema pectinatum (Vauch.) C.A. Agardh, Maugeotia sp. (C.A. Agardh) Wittrock, Cladophora fracta (Dilw.) Kti...

  19. Liberalistlik sissejuhatus poliitilisse filosoofiasse / Tanel Vallimäe, Peeter Selg

    Index Scriptorium Estoniae

    Vallimäe, Tanel, 1975-

    2008-01-01

    Vastukaja arvustusele: Reiland, Indrek. Normatiivse poliitikafilosoofia peateemad (Rets. rmt.: Wolff, Jonathan. Sissejuhatus poliitikafilosoofiasse / tlk. Tiiu Hallap. Tartu, 2005). Akadeemia, 2008, nr. 4, lk. 880-883

  20. Õhulised ruumid ja vasekuma / Suvi Ruotsi

    Index Scriptorium Estoniae

    Ruotsi, Suvi

    2008-01-01

    Soomes Reposaarel asuva vaskse katuse ja detailidega puitvilla Luvata (arhitekt Martin Wolff) sisekujundusest. Sisustuse kavandas soome sisearhitekt Helena Karihtala, tema kommentaarid. Plaan, 9 värv. vaadet

  1. A STUDY OF CRYPTOLECHIA ZELLER(LEPIDOPTERA. OECOPHORIDAE) IN CHINA (Ⅱ): SPECIES FROM GUIZHOU PROVINCE

    Institute of Scientific and Technical Information of China (English)

    Shu-xiaWang

    2004-01-01

    The present paper reports fourteen species of the genus Cryptolechia from Guizhou Province, China. Eleven species are described as new: C. proximideflecta sp. nov., C. muscosa sp.nov., C. solifasciaria sp. nov., C. spinifera sp. nov., C. denticulata sp. nov., C. furcellata sp. nov.,C. latifascia sp. nov., C. acutiuscula sp. nov., C. fasciculifera sp. nov., C. hamatilis sp. nov. and C.concaviuscula sp. nov. The female of C. gei Wang is reported for the first time, and the genital structures of the new species are illustrated.

  2. A re-evaluation of Scinaia (Nemaliales, Rhodophyta) in the Azores

    Science.gov (United States)

    León-Cisneros, K.; Riosmena-Rodríguez, R.; Neto, A. I.

    2011-06-01

    The genus Scinaia in the Azores is re-evaluated based on historical and recent collections. A combination of morphological and anatomical diagnostic characters was used for species segregation, and a key for Azorean species determination is presented. Anatomical information associated to the hair development is described for the first time for the genus. The occurrence of S. furcellata and S. interrupta is confirmed for the archipelago. The presence of S. acuta is reported for the first time in the Azores, representing a spread from Australia to the N-Atlantic and specifically into the Macaronesian region. Its occurrence in the archipelago and the Canaries is discussed as a possible introduction.

  3. 78 FR 10191 - Changes in Flood Hazard Determinations

    Science.gov (United States)

    2013-02-13

    ... Center at www.msc.fema.gov . FOR FURTHER INFORMATION CONTACT: Luis Rodriguez, Chief, Engineering..., 2012 480035 1257). of Bexar County (11- Wolff, Bexar County Infrastructure 06-4222P). Judge, Paul... County (11- Wolff, Bexar County Infrastructure 06-4323P). Judge, Paul Elizondo Services Tower, 101 West...

  4. 78 FR 78989 - Changes in Flood Hazard Determinations

    Science.gov (United States)

    2013-12-27

    ... Center at www.msc.fema.gov . FOR FURTHER INFORMATION CONTACT: Luis Rodriguez, Chief, Engineering [[Page...- Wolff, Bexar County Works Department, 06-0089P). Judge, Paul Elizondo 233 North Pecos-La Tower, 101 West..., 2013 480035 1341). of Bexar County, (13- Wolff, Bexar County Works Department, 06-2069P). Judge, Paul...

  5. M Current-Based Therapies for Nerve Agent Seizures

    Science.gov (United States)

    2013-07-01

    synaptic transmission. Science 264, 107-111. Wolff, C., Gillard , M., Fuks, B., & Chatelain, P. (2005). [3H]linopirdine binding to rat brain membranes is...supporting hippocampal synaptic transmission. Science 264, 107–111. Wolff C, Gillard M, Fuks B & Chatelain P (2005). [3H]Linopirdine binding to rat

  6. 78 FR 48885 - Changes in Flood Hazard Determinations

    Science.gov (United States)

    2013-08-12

    ... INFORMATION CONTACT: Luis Rodriguez, Chief, Engineering Management Branch, Federal Insurance and Mitigation.... Wolff, Public Works team.com/lomrs.htm. County (13-06- Bexar County Department, 233 2069P). Judge, Paul...

  7. 78 FR 28887 - Changes in Flood Hazard Determinations

    Science.gov (United States)

    2013-05-16

    ... Center at www.msc.fema.gov . FOR FURTHER INFORMATION CONTACT: Luis Rodriguez, Chief, Engineering..., 2013 480035 1290). of Bexar County (12- Wolff, Bexar County Works Department, 06-2065P). Judge, Paul...

  8. (Abelmoschus esculentus (L.) Moench)

    Indian Academy of Sciences (India)

    Kundapura V. Ravishankar

    as okra, is one of the important pod vegetable crops in tropics and subtropics .... study. Genotypes/accession number. 1. Kashi Vibhuti. 2. Komal 2486. 3. Kashi Lalima. 4 ..... the microsatellite-enriched library method (Phuekvilai and. Wolff 2013 ...

  9. Pediatric Electrocardiographic Imaging (ECGI) Applications

    Science.gov (United States)

    Silva, Jennifer N. A.

    2014-01-01

    Summary Noninvasive electrocardiographic imaging (ECGI) has been used in pediatric and congenital heart patients to better understand their electrophysiologic substrates. In this article we focus on the 4 subjects related to pediatric ECGI: 1) ECGI in patients with congenital heart disease and Wolff-Parkinson-White syndrome, 2) ECGI in patients with hypertrophic cardiomyopathy and pre-excitation, 3) ECGI in pediatric patients with Wolff-Parkinson-White syndrome, and 4) ECGI for pediatric cardiac resynchronization therapy. PMID:25722754

  10. Stochastic Petri Net Modeling of Wave Sequences in Cardiac Arrhythmias.

    Science.gov (United States)

    1987-11-01

    Wolff - Parkinson - White syndrome . The ventricles are divided into two parts. One of these is excited normally and produces R...example, in a condition called the Wolff - Parkinson - White syn- drome the ECG displays an abnormally early onset of the ventricular activity. It also...8217. , ’ ", -’ , .’ %,,? .’ ,; ’ .- ’ ’ -’ € ’ , . ’ - I. 32 Wolfe- Parkinson - White Syndrome (Fig. 8c) This model uses "basic" elements for the

  11. Determinants of Conflict in the Philippines

    Science.gov (United States)

    2012-06-01

    1965), 13. 137 Tedd Gurr, Why Men Rebel (1965), 13. 138 Jonathan Wolff, " Karl Marx ," The Stanford Encyclopedia of Philosophy (Spring 2011 Edition...490961276. Wolff, Jonathan. “ Karl Marx .” The Stanford Encyclopedia of Philosophy. Spring 2011 Edition (n.d.). http://plato.stanford.edu/archives...accessed March 10, 2011, http://plato.stanford.edu/archives/spr2011/entries/ marx /. 139 Tedd Gurr, Why Men Rebel, (Princeton: Princeton University

  12. Axes, planes and tubes, or the geometry of embryogenesis.

    Science.gov (United States)

    Brauckmann, Sabine

    2011-12-01

    The paper presents selected figures of chick embryogenesis as depicted in the classic studies of Caspar Friedrich Wolff (1734-1794), Christian Heinrich Pander (1794-1865) and Karl Ernst von Baer (1792-1786). My main objective here is (1) to demonstrate how the imagery of Wolff, Pander and Baer attempted to project an image of a 3-dimensional rotating body into static figures on paper by means of linear contours, and (2) to ponder on the efficacy and pervasiveness of dots, lines and arrows for depicting embryogenesis. Copyright © 2011 Elsevier Ltd. All rights reserved.

  13. Hoe maak je gebruik van tablets voor leren?

    NARCIS (Netherlands)

    Kalz, Marco; Kluijfhout, Eric; Börner, Dirk; Tabuenca, Bernardo; Kester, Liesbeth; Wolff, Charlotte; Bahreini, Kiavash; Gijselaers, Jérôme; Andeweg, Cisca; De Vries, Fred; Berkhout, Jeroen; Storm, Jeroen

    2012-01-01

    Kalz, M., Kluijfhout, E., Börner, D., Tabuenca, B., Kester, L., Wolff, C., Bahreini, K., Gijselaers. J., De Vries, F., Andeweg, C., Berkhout, J., & Storm, J. (2012, 28 September). Hoe maak je gebruik van tablets voor leren? Masterclass in de OpenU community. Open Universiteit, Heerlen, Nederland.

  14. 40 CFR 79.65 - In vivo sister chromatid exchange assay.

    Science.gov (United States)

    2010-07-01

    ... PROGRAMS (CONTINUED) REGISTRATION OF FUELS AND FUEL ADDITIVES Testing Requirements for Registration § 79.65... appropriate concentration level, a pilot or trial study may be advisable. Initially, one concentration of the...., “Cytogenetic Studies of Mice Exposed to Styrene by Inhalation.”, Mutation Research, 280:35-43, 1992. (7) Wolff...

  15. When Russians Learn English: How the Semantics of Causation May Change

    Science.gov (United States)

    Wolff, Phillip; Ventura, Tatyana

    2009-01-01

    We examined how the semantics of causal expressions in Russian and English might differ and how these differences might lead to changes in the way second language learners understand causal expressions in their first language. According to the dynamics model of causation (Wolff, 2007), expressions of causation based on CAUSE verbs (make, force)…

  16. Mitral valve perforation appearing years after radiofrequency ablation

    DEFF Research Database (Denmark)

    Fisch-Thomsen, Marie; Jensen, Jesper K; Egeblad, Henrik

    2011-01-01

    The case is reported of a young adult with Wolff-Parkinson-White (WPW) syndrome who, three years after a complicated radiofrequency (RF) catheter ablation procedure, developed dyspnea on exertion. Echocardiography revealed severe mitral valve regurgitation caused by a perforation of the posterior...

  17. Muusikamaailm : Kaija Saariaho uusooper Salzburgis. Rossini festival Pesaros. Bachi arhiivile uus juhataja. Noorte kunstikohtumised Bayreuthis / Priit Kuusk

    Index Scriptorium Estoniae

    Kuusk, Priit, 1938-

    2000-01-01

    K. Saariaho uusooperi "Kauge armastus" ("L'Amour de loin") maailmaesiettekandest 15. aug. Salzburgi festivalil, lühidalt ooperist. Rossini ooperifestivalist Pesaros Itaalias. C. Wolff asub 1. jaanuarist 2001 Leipzigi Bachi-Arhiivi juhataja kohale. Bayreuthis toimuvast noortefestivalist "Internationales Jugendfestspieltreffen"

  18. Expanding Our View of Authentic Learning: Bridging in and Out-of-School Experiences

    Science.gov (United States)

    Quigley, Cassie

    2014-01-01

    In this review, I explore the affordances of Wolff-Michael Roth and Pei-Ling Hsu's article, "Space, relations and the learning of science" which brings attention to a largely unexplored area of science education research--the importance of spatial organization within the laboratory. This forum piece examines the four components of…

  19. Current Titles in Turkish Science. Volume 6. Numbers 7-9, July-August-September 1979

    Science.gov (United States)

    1979-01-01

    19 (2) 173-177. (5 refs. Tu. , en.) (79-1882) KARACADAÜ §., BERlLGEN A. Dysphagia due to cervical osteophytes (A case report). Hacettepe...gulairova D. Tip Fak. Derg. (1979) 4 (I) 26-33. (19 refs. Tu., en. ) (79-1923) ONAT, Allan. Dradycardio-depondent Wolff- Parkinson -White

  20. 2013 Aerospace Medical Certification Statistical Handbook

    Science.gov (United States)

    2014-12-01

    23,020 4.02 Other esophagus, stomach, and duodenal conditions – severe gastritis, esophageal reflux, achalasia, GERD, gastroplasty, dysphagia ...fever 13,849 2.42 Asthma 12,096 2.11 Other general heart pathology (abnormal ECG, open heart surgery, etc.). Wolff- Parkinson -White syndrome, ablation

  1. 78 FR 45941 - Changes in Flood Hazard Determinations

    Science.gov (United States)

    2013-07-30

    ... Center at www.msc.fema.gov . FOR FURTHER INFORMATION CONTACT: Luis Rodriguez, Chief, Engineering... Department of Public 06-0093P). County Judge, Paul Works, 233 North Elizondo Tower, 101 Pecos-La Trinidad... County (12- W. Wolff, Bexar Department of Public 06-1791P). County Judge, Paul Works, 233 North Elizondo...

  2. On Scambicornus Heegard, 1944, a senior synonym of Preherrmannella Seymour Sewell, 1949 (Copepoda, Cyclopoida)

    NARCIS (Netherlands)

    Stock, J.H.

    1964-01-01

    During the preparation of a report dealing with poecilostomes associated with holothurians, it was found desirable to obtain more information concerning a number of genera formerly described. Through the courtesy of Dr. T.Wolff of the Zoologisk Museum of Copenhagen, I was able to reexamine the

  3. 78 FR 8174 - Changes in Flood Hazard Determinations

    Science.gov (United States)

    2013-02-05

    ....rampp- March 28, 2013 400360 Collinsville (12- Weaver, Mayor, Street, team.com/lomrs.hrm. 06-4005P... Smaligo, Chairman, Building, 633 West team.com/lomrs.hrm. County (12-06- Tulsa County Board 3rd Street... Bexar Nelson W. Wolff, Works Department, team.com/lomrs.hrm. County (12-06- Bexar County 233 North Pecos...

  4. Arctic Haze: Natural or Pollution?

    Science.gov (United States)

    1986-11-01

    327-342 of Particulate Carbon, Atmospheric Life Cycle, eds. G.T. Wolff and R.T. Klirisch, Plenum Press, New York, 411 pp. Va AN...effects are con- One of our greatest disappointments at the Uiversity of Rhode Island’s Grad- stantly compounded. has been the Soviet Union’s lack of co

  5. Two new species of Quichuana Knab (Diptera: Syrphidae) from the paramo ecosystems in Colombia.

    Science.gov (United States)

    Montoya, Augusto L; Ricarte, Antonio; Wolff, Marta

    2017-03-20

    Two new species of Quichuana Knab (Diptera: Syrphidae), Quichuana citara Montoya & Wolff sp. n. and Quichuana nigropilosa Montoya & Ricarte sp. n. are described from highlands of the Colombian Andes. Images of type material, including drawings of male genitalia are provided. An adjustment for the latest identification key for the Quichuana species and distribution maps for those species occurring in Colombia are given.

  6. A multicenter, long-term study on arrhythmias in children with Ebstein anomaly.

    NARCIS (Netherlands)

    Delhaas, T.; Sarvaas, G.J.; Rijlaarsdam, M.E.; Strengers, J.L.; Eveleigh, R.M.; Poulino, S.E.; Korte, C.L. de; Kapusta, L.

    2010-01-01

    To assess the prevalence, history, and treatment of arrhythmias, in particular preexcitation and Wolff-Parkinson-White (WPW) syndrome, in patients with Ebstein anomaly (EA) during childhood and adolescence, we performed a multicenter retrospective study of all consecutive live-born patients with EA,

  7. A Serious Cause of Panic Attack

    Science.gov (United States)

    O'Connell, Michael; Bernard, Aaron

    2012-01-01

    We report on a case of a patient with atrial fibrillation in the setting of Wolff-Parkinson-White syndrome. The patient underwent synchronized electrical cardioversion, typically considered safe and effective, which resulted in a dangerous complication for the patient (degeneration into ventricular fibrillation). Discussion of common rhythm disturbances in WPW and management strategies are reviewed. PMID:23326712

  8. A long slanted transseptal accessory pathway

    Directory of Open Access Journals (Sweden)

    Hui-Min Wang

    2011-05-01

    Full Text Available A 63-year-old male with Wolff-Parkinson-White syndrome was admitted for ablation of accessory pathway. Intracardiac electrogram revealed a left-side accessory pathway during tachycardia, which was successfully ablated from the right posterior tricuspid annulus because of a long slanted transseptal accessory pathway (2.2 cm.

  9. A Serious Cause of Panic Attack

    Directory of Open Access Journals (Sweden)

    Michael O'Connell

    2012-01-01

    Full Text Available We report on a case of a patient with atrial fibrillation in the setting of Wolff-Parkinson-White syndrome. The patient underwent synchronized electrical cardioversion, typically considered safe and effective, which resulted in a dangerous complication for the patient (degeneration into ventricular fibrillation. Discussion of common rhythm disturbances in WPW and management strategies are reviewed.

  10. A Multicenter, Long-Term Study on Arrhythmias in Children with Ebstein Anomaly

    NARCIS (Netherlands)

    Delhaas, Tammo; Sarvaas, Gideon J. du Marchie; Rijlaarsdam, Marry E.; Strengers, Jan L.; Eveleigh, Rhona M.; Poulino, Sumayah E.; de Korte, Chris L.; Kapusta, Livia

    To assess the prevalence, history, and treatment of arrhythmias, in particular preexcitation and Wolff-Parkinson-White (WPW) syndrome, in patients with Ebstein anomaly (EA) during childhood and adolescence, we performed a multicenter retrospective study of all consecutive live-born patients with EA,

  11. Examination of the Financial Costs of Teacher Turnover in Mid-Sized Urban School Districts

    Science.gov (United States)

    Synar, Edwyna Anne

    2010-01-01

    It is estimated that 50% of beginning teachers leave the profession within the first five years on the job (Murnane, Singer, Willett, Kemple, & Olsen, 1991; Colbert & Wolff, 1992; Ingersoll, 2003b; Schlechty & Vance, 1981). When teachers depart, they take with them their knowledge of instructional techniques, students' learning styles, and…

  12. Die filosofie van Immanuel Kant en Protestants-teologiese ...

    African Journals Online (AJOL)

    The philosophy of Immanuel Kant and Protestant theological structures. Kant's critical epistemology destroyed the idea of scientific metaphysics (valid up to Wolff) as the foundation of theology. Kant, however, reconstructed his own metaphysics on the basis of practical reason. In this scheme metaphysics and ethics are ...

  13. Collaborative Project-Based Learning: An Integrative Science and Technological Education Project

    Science.gov (United States)

    Baser, Derya; Ozden, M. Yasar; Karaarslan, Hasan

    2017-01-01

    Background: Blending collaborative learning and project-based learning (PBL) based on Wolff (2003) design categories, students interacted in a learning environment where they developed their technology integration practices as well as their technological and collaborative skills. Purpose: The study aims to understand how seventh grade students…

  14. Cyber Attacks, Attribution, and Deterrence: Three Case Studies

    Science.gov (United States)

    2015-05-23

    http://www.zdnet.com/blog/ igeneration /lulzsec- spokesperson-arrested-by-scotland-yard/11759. 111 Olson, We Are Anonymous, 406, 458. 112 Kim Zetter...www.zdnet.com/blog/ igeneration /lulzsec- spokesperson-arrested-by-scotland-yard/11759. Wolff, Josephine. "Howard Schmidt: Hackers and spies have

  15. Angina pectoris in a child with sickle cell anemia.

    Science.gov (United States)

    Hamilton, W; Rosenthal, A; Berwick, D; Nadas, A S

    1978-06-01

    A 7-year-old black boy with sickle cell disease, Wolff-Parkinson-White syndrome, mild left ventricular dysfunction, and normal coronary arteries developed angina pectoris five months after cessation of hypertransfusion therapy. Exercise-induced ECG ST segment depression associated with angina disappeared following transfusion therapy.

  16. Single-cluster dynamics for the random-cluster model

    NARCIS (Netherlands)

    Deng, Y.; Qian, X.; Blöte, H.W.J.

    2009-01-01

    We formulate a single-cluster Monte Carlo algorithm for the simulation of the random-cluster model. This algorithm is a generalization of the Wolff single-cluster method for the q-state Potts model to noninteger values q>1. Its results for static quantities are in a satisfactory agreement with those

  17. JST Thesaurus Headwords and Synonyms: Wolff‐Parkinson‐White症候群 [MeCab user dictionary for science technology term[Archive

    Lifescience Database Archive (English)

    Full Text Available MeCab user dictionary for science technology term Wolff‐Parkinson‐White症候群 名詞 一般 * ...ーショーコウグン Thesaurus2015 200906090911098844 C LS51 UNKNOWN_2 Wolff ‐ Parkinson ‐ White 症候群

  18. Practitioners – School ‘Mathematicians’

    DEFF Research Database (Denmark)

    Høyrup, Jens

    2017-01-01

    The paper starts by looking at how ‘practical’ and ‘theoretical’ mathematics and their relation have been understood from the Greeks to Christian Wolff and by historians of mathematics from Montucla to recent days. Drawing on earlier work of mine, and on the giants on whose shoulders I (try to) s...

  19. Can a Microwave Heat up Coffee? How English- and Japanese-Speaking Children Choose Subjects in Lexical Causative Sentences

    Science.gov (United States)

    Kanero, Junko; Hirsh-Pasek, Kathy; Golinkoff, Roberta Michnick

    2016-01-01

    Languages differ greatly in how they express causal events. In languages like Japanese, the subjects of causative sentences, or "causers," are generally animate and intentional, whereas in other languages like English, causers range widely from animate beings to inanimate objects (e.g. Wolff, Jeon & Li, 2009). This paper explores…

  20. How Can Science Education Foster Students' Rooting?

    Science.gov (United States)

    Østergaard, Edvin

    2015-01-01

    The question of how to foster rooting in science education points towards a double challenge; efforts to "prevent" (further) uprooting and efforts to "promote" rooting/re-rooting. Wolff-Michael Roth's paper discusses the uprooting/rooting pair of concepts, students' feeling of alienation and loss of fundamental sense of the…

  1. How Old Is Scientific Psychology?

    Science.gov (United States)

    Harding, John S.

    Scientific psychology did not begin with Fechner and Wundt in the 19th century; its roots actually stretch back to 18th century Germany. The only detailed account of this period was published by Max Dessoir more than 80 years ago. Dessoir identified some of the crucial figures in early psychology, including Wolff, Bonnet, Kruger, Hissman, and…

  2. 78 FR 68137 - Qualification of Drivers; Exemption Applications; Vision

    Science.gov (United States)

    2013-11-13

    .... Valles (TX) James A. Welch (NH) Gary M. Wolff (IL) John C. Young (VA) Michael E. Yount (ID) The... 31315. However, FMCSA requests that interested parties with specific data concerning the safety records... renewal of an exemption under 49 U.S.C. 31136(e) and 31315 can be satisfied by initially granting the...

  3. The Milkwood Casebook.

    Science.gov (United States)

    De Anda, Diane

    2000-01-01

    Examines the female characters in Dylan Thomas's "Under Milkwood" from a Jungian perspective employing Toni Wolff's framework for analyzing the female psyche as well as female archetypes proposed by Jung. Examines only the "womenfolk" of the town, but through them also gain some insight into their men. (SC)

  4. Too Many References, Just Cut a Few and It Will Be Perfect: APA vs. Chicago

    Science.gov (United States)

    Matusov, Eugene

    2011-01-01

    The purpose of the author's rebuttal is to provide a sociocultural critique of Wolff-Michael Roth and Michael Cole's arguments and of the current "Mind, Culture, and Activity" ("MCA") policy regarding referencing. In sum, Roth and Cole write that some unnamed "MCA" authors (and some scholars in general) abuse the reference practice by…

  5. An Assessment of the Tinder Mobile Dating Application for Individuals Who Are Visually Impaired

    Science.gov (United States)

    Kapperman, Gaylen; Kelly, Stacy M.; Kilmer, Kylie; Smith, Thomas J.

    2017-01-01

    People with visual impairments (that is, those who are blind or have low vision) have a disadvantage in the process of being selected as a romantic partner. It is further underscored that these difficulties with dating and fitting in among sighted individuals extend beyond formative years into adulthood (Sacks & Wolffe, 2006). Thus, the…

  6. Further X-Ray Observations of EXO 0748-676 in Quiescence: Evidence for a Cooling Neutron Star Crust

    Science.gov (United States)

    2010-07-01

    the unambiguous determination of the orbital period of the binary (Parmar et al. 1986; Wolff et al. 2009). At the time of its discovery , EXO 0748–676...L41 Jonker P. G., 2008, in C. Bassa, Z. Wang, A. Cumming, & V. M. Kaspi eds, 40 Years of Pulsars : Millisecond Pulsars , Magnetars and More, AIP Conf

  7. Vesuvius, the Tengger Mountains and the problem of calderas

    NARCIS (Netherlands)

    Escher, B.G.

    1926-01-01

    Until recently there was no good general map of the Tengger Mountains, so that in 1914 F. von Wolff (bibl. 1) in his work „Der Vulkanismus”, vol. I, p. 510—511, gives a reproduction of Pr. Junghuhn's map of 1844. For a volcanic district that has frequently been used as an example of a caldera and

  8. Bolzano’s early quest for a priori synthetic principles : Mereological aspects of the analytic-synthetic distinction in Kant and the early Bolzano

    NARCIS (Netherlands)

    Blok, Johan

    2016-01-01

    The aim of the present study is to gain insight into the development of the ideas of Bolzano, often described as the grandfather of analytic philosophy, out of the German philosophy of the eighteenth century. It provides an analysis of Wolff's influential mathematical method and argues that the

  9. Legon Journal of the Humanities - Vol 25 (2014)

    African Journals Online (AJOL)

    Responding to Robert Wolff's In Defense of Anarchism · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. Emmanuel Ifeanyi Ani, 104-126. http://dx.doi.org/10.4314/ljh.v25i1.6 ...

  10. Die filosofíe van Immanuel Kant en Protestants'teologiese ...

    African Journals Online (AJOL)

    Kant's critical epistemology destroyed the idea of scien tific metaphysics (valid up to Wolff) as the foundation of theology. Kant, however, reconstructed his own meta physics on the basis of practical reason. In this scheme metaphysics and ethics are interwoven and culminate in a religion exclusively based on and ...

  11. Medicinal and Environmental Indicator Species of Utricularia from Montane Forest of Peninsular Malaysia

    Science.gov (United States)

    Haron, Noorma Wati; Chew, Ming Yee

    2012-01-01

    The carnivorous Utricularia (Lentibulariaceae) is a small herb of multifarious wet habitats worldwide. Eleven of the 14 Peninsular Malaysian species range into the mountains. Distribution, disturbance adaptability and collection frequency were used to formulate their commonness category. Common (U. aurea, U. bifida, and U. minutissima) and fairly common (U. gibba and U. uliginosa) species are mostly lowland plants that ascend to open montane microhabitats, while the fairly common (U. striatula), narrow-range (U. caerulea pink form and U. involvens), rare (U. furcellata and U. scandens), and endemic (U. vitellina) species are restricted to mountainous sites. Common species that colonise dystrophic to oligotrophic man-made sites in late succession could serve as predictors for general health and recovery of wet habitats. Rarer species are often locally abundant, their niches situated around pristine forest edges. When in decline, they indicate the beginning of problems affecting the forest. Utricularia is reportedly nutritious, mildly astringent, and diuretic. Preadapted to nutrient-poor, waterlogged soils, U. bifida is suitable as an alternative for small-scale herb cultivation on low pH, wet poor soils usually deemed not suitable for any crops. PMID:22619629

  12. The role of tone sensation and musical stimuli in early experimental psychology.

    Science.gov (United States)

    Klempe, Sven Hroar

    2011-01-01

    In this article, the role of music in early experimental psychology is examined. Initially, the research of Wilhelm Wundt is considered, as tone sensation and musical elements appear as dominant factors in much of his work. It is hypothesized that this approach was motivated by an understanding of psychology that dates back to Christian Wolff 's focus on sensation in his empirical psychology of 1732. Wolff, however, had built his systematization of psychology on Gottfried Wilhelm von Leibniz, who combined perception with mathematics,and referred to music as the area in which sensation is united with numerical exactitude. Immanuel Kant refused to accept empirical psychology as a science, whereas Johann Friedrich Herbart reintroduced the scientific basis of empirical psychology by, among other things, referring to music.

  13. 2012 Aerospace Medical Certification Statistical Handbook

    Science.gov (United States)

    2013-12-01

    2012 Aerospace Medical Certification Statistical Handbook Valerie J. Skaggs Ann I. Norris Civil Aerospace Medical Institute Federal Aviation...Certification Statistical Handbook December 2013 6. Performing Organization Code 7. Author(s) 8. Performing Organization Report No. Skaggs VJ, Norris AI 9...2.57 Hayfever 14,477 2.49 Asthma 12,558 2.16 Other general heart pathology (abnormal ECG, open heart surgery, etc.). Wolff-Parkinson-White syndrome

  14. Department of Defense Report on Search for Human Radiation Experiment Records, 1944 - 1994, Volume 1

    Science.gov (United States)

    1997-06-01

    the femoropopliteal artery CID88-098 Comparison of flecainide vs procainamide in patients with Wolff- Parkinson - White syndrome using...Hospital, Portsmouth, VA (continued) Start Date Number Title 1986 1987 1987 1987 NMCSD-125 Utility of endoscopy for x-ray negative dysphagia ...of endoscopy for x-ray negative dysphagia : Prospective analysis Effect of race in responsiveness to atrial natriuretic peptide C-reactive levels in

  15. Commentary on: "P&S Requirements for ePartner-supported Astronaut-Rover Teams during Planetary Surface Operations"

    OpenAIRE

    Cesta, Amedeo; Cortellessa, Gabriella

    2011-01-01

    The article (Grant, Neerincx, and Wolff 2011) introduces some considerations taken from the experience of the authors participation in the ESA project called MECA (Mission Execution Crew Assistant). The idea of MECA is to form a network of agents (both human and software), in which each unit, called e-partner, is capable of detecting and influencing the physical, cognitive and affective state of its respective human users. The article describes the three stages along which the project evolves...

  16. Variational method for magnetic impurities in metals: impurity pairs

    Energy Technology Data Exchange (ETDEWEB)

    Oles, A M [Max-Planck-Institut fuer Festkoerperforschung, Stuttgart (Germany, F.R.); Chao, K A [Linkoeping Univ. (Sweden). Dept. of Physics and Measurement Technology

    1980-01-01

    Applying a variational method to the generalized Wolff model, we have investigated the effect of impurity-impurity interaction on the formation of local moments in the ground state. The direct coupling between the impurities is found to be more important than the interaction between the impurities and the host conduction electrons, as far as the formation of local moments is concerned. Under certain conditions we also observe different valences on different impurities.

  17. Die filosofie van Immanuel Kant en Protestants-teologiese denkstrukture

    OpenAIRE

    P. S. Dreyer

    1990-01-01

    The philosophy of Immanuel Kant and Protestant theological structures Kant’s critical epistemology destroyed the idea of scientific metaphysics (valid up to Wolff) as the foundation of theology. Kant, however, reconstructed his own metaphysics on the basis of practical reason. In this scheme metaphysics and ethics are interwoven and culminate in a religion exclusively based on and conditioned by pure reason, usually known as Kant’s moral theology or rational religion. The purpose of this ...

  18. Enlightened Travelers and Their Mental Maps

    OpenAIRE

    Nikolay Aretov

    2015-01-01

    Enlightened Travelers and Their Mental Maps The issue of mental mapping of Eastern Europe (Wolff), posed during the Enlightenment, and the similar problem of the image of the Balkans (Todorova), are both multifaceted. This paper deals with three aspects of these processes and seeks to analyse them through the prism of the Orientalism-Occidentalism opposition. The article opens with a very general description of the Oriental mental maps on the part of 19th-century Bulgarian revolutiona...

  19. Eurasianism: A Historical and Contemporary Context

    Science.gov (United States)

    2015-03-01

    Wolff, “The Three Romes: The Migration of an Ideology and the Making of an Autocrat ,” Daedalus 88, no. 2, (1959): 292, http://www.jstor.org/stable...need for authoritarian leadership in Russia. According to Boris Ishboldin, “Savitskii accepted these political views of Trubetskoi, agreeing that...1987, the year Gorbachev referred to as “the Year of Europe,” the Soviet Union sought to create increasingly more European style

  20. [Surgical treatment of supraventricular tachycardia].

    Science.gov (United States)

    Vigano, A N; Minzioni, G; Graffigna, A; Paganini, F; Salerno, J A

    1991-10-01

    The article deals with the modern approaches to the treatment of supraventricular tachycardia . The authors analyse the results of operations in ectopic atrial tachycardias, the Wolff-Parkinson-White syndrome, modal re-entry tachycardias, and atrial fibrillation . The last-named is of most interest because the authors possess experience in a new operation for isolation of the internodal tracts. In all conditions the authors obtained convincing evidence on the efficacy of modern surgical treatment in supraventricular tachycardias.

  1. GEP 6.5LT Engine Cetane Window Evaluation for ATJ/JP-8 Fuel Blends

    Science.gov (United States)

    2015-09-01

    matching pre- calibrated amplifier • BEI Shaft Encoder (0.2 CAD) • Wolff Instrumented Injector for needle lift The high speed data was recorded and post...14. ABSTRACT The European Stationary Cycle 13 Mode test and a power curve was performed on a 6.5L turbocharged V-8 diesel engine for three ATJ...15. SUBJECT TERMS ATJ, Alcohol to Jet, Cetane Number, Synthetic Fuel, JP-8, diesel engine, combustion 16. SECURITY CLASSIFICATION OF: 17

  2. Engine Cold Start

    Science.gov (United States)

    2015-09-01

    matching pre- calibrated amplifier • BEI Shaft Encoder (0.2 CAD) • Wolff Instrumented Injector The high speed data was recorded and post-processed by...14. ABSTRACT These fuels were used for testing a GEP 6.5L turbocharged V-8 diesel engine operation in a cold box. This engine architecture is...Z39.18 UNCLASSIFIED UNCLASSIFIED v EXECUTIVE SUMMARY A fuel’s cetane number is very important for the operation of modern diesel

  3. Browse Author Index

    African Journals Online (AJOL)

    A B C D E F G H I J K L M N O P Q R S T U V W X Y Z All. W. Walker, Melanie · Walters, Shirley · Williams, Kevin · Winberg, Chris · Winberg, Christine · Wisker, Gina · Wolff, Karin 1 - 7 of 7 Items. ISSN: 2310-7103. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More ...

  4. Conditioning Military Women for Optimal Performance: Effects of Contraceptive Use

    Science.gov (United States)

    1998-10-01

    Cannon JG, Wolff SM, et al. Tumor necrosis factor (cachectin) is an endogenous pyrogen and induces production of interleukin-1. J Exp Med 1986; 163:1433...1989;39(1): 119-124. 9. Bannister RG. Anhidrosis following intravenous bacterial pyrogen . Lancet 1960;ii: 118-122. 10. Borg G. Perceived exertion as an...Siddiqui S, Shail E, Rezeig M. Elevated pyrogenic cytokines in heatstroke. Chest 1993;104:1498-1502. 15. Brock-Utne JG, Gaffin SL, Wells MT, et al

  5. A patient with WPW syndrome and coronary artery disease

    International Nuclear Information System (INIS)

    Zarebinski, M.; Krupienicz, A.; Marciniak, W.; Ostrowski, M.

    1993-01-01

    A 61-year-old patient with Wolff-Parkinson-White's syndrome, and hypertension was admitted to the CCU, because of the first episode of substernal chest pain. ECG was deformed by Wolff-Parkinson-White's syndrome, type B, with accessory pathway located on the right side, without evolution. Serum enzymes remained low. Echocardiography showed akinesis of the posterior wall and hypokinesis of the lateral wall (the same contraction disorders were described in previous echocardiographical examination 5 years ago), it was observed that the first portion of myocardium to contract was the base of the right ventricle. To elucidate the etiology of the contraction disorders, scintigraphy of the heart, using thallium 201, was performed, showing normal perfusion of the myocardium. To illustrate the dependence of the contraction disorders and abnormal depolarization pattern of the heart, echocardiographical examination was repeated, confirming the previous results, then 100 mg of Ajmaline was given to the patient intravenously, and echocardiographical examination was continued. Administration of the drug caused antidromic atrioventricular re-entrant tachycardia during which the lateral wall of the heart had been contracting properly. This case shows contraction disorders of the heart caused by the abnormal depolarization pattern, resulting from the presence of accessory pathway. It also illustrates the diagnostic difficulties in patients with Wolff-Parkinson-White's syndrome and suspected myocardial infarction, at the same time showing that scintigraphy of the heart might be very helpful in such patients. This case confirms the usefulness of echocardiography for localization of the accessory pathway. (author)

  6. 2-Diazo-1-(4-hydroxyphenyl)ethanone: a versatile photochemical and synthetic reagent.

    Science.gov (United States)

    Senadheera, Sanjeewa N; Evans, Anthony S; Toscano, John P; Givens, Richard S

    2014-02-01

    α-Diazo arylketones are well-known substrates for Wolff rearrangement to phenylacetic acids through a ketene intermediate by either thermal or photochemical activation. Likewise, α-substituted p-hydroxyphenacyl (pHP) esters are substrates for photo-Favorskii rearrangements to phenylacetic acids by a different pathway that purportedly involves a cyclopropanone intermediate. In this paper, we show that the photolysis of a series of α-diazo-p-hydroxyacetophenones and p-hydroxyphenacyl (pHP) α-esters both generate the identical rearranged phenylacetates as major products. Since α-diazo-p-hydroxyacetophenone (1a, pHP N2) contains all the necessary functionalities for either Wolff or Favorskii rearrangement, we were prompted to probe this intriguing mechanistic dichotomy under conditions favorable to the photo-Favorskii rearrangement, i.e., photolysis in hydroxylic media. An investigation of the mechanism for conversion of 1a to p-hydroxyphenyl acetic acid (4a) using time-resolved infrared (TRIR) spectroscopy clearly demonstrates the formation of a ketene intermediate that is subsequently trapped by solvent or nucleophiles. The photoreaction of 1a is quenched by oxygen and sensitized by triplet sensitizers and the quantum yields for 1a-c range from 0.19 to a robust 0.25. The lifetime of the triplet, determined by Stern-Volmer quenching, is 31 ns with a rate for appearance of 4a of k = 7.1 × 10(6) s(-1) in aq. acetonitrile (1 : 1 v : v). These studies establish that the primary rearrangement pathway for 1a involves ketene formation in accordance with the photo-Wolff rearrangement. Furthermore we have also demonstrated the synthetic utility of 1a as an esterification and etherification reagent with a variety of substituted α-diazo-p-hydroxyacetophenones, using them as synthons for efficiently coupling it to acids and phenols to produce pHP protect substrates.

  7. 2-Diazo-1-(4-hydroxyphenyl)ethanone: A Versatile Photochemical and Synthetic Reagenta

    Science.gov (United States)

    Senadheera, Sanjeewa N.; Evans, Anthony S.; Toscano, John P.; Givens, Richard S.

    2014-01-01

    α-Diazo arylketones are well-known substrates for Wolff rearrangement to phenylacetic acids through a ketene intermediate by either thermal or photochemical activation. Likewise, α-substituted p-hydroxyphenacyl (pHP) esters are substrates for photo-Favorskii rerrangements to phenylacetic acids by a different pathway that purportedly involves a cyclopropanone intermediate. In this paper, we show that the photolysis of a series of α-diazo-p-hydroxyacetophenones and p-hydroxyphenacyl (pHP) α-esters both generate the identical rearranged phenylacetates as major products. Since α-diazo-p-hydroxyacetophenone (1a, pHP N2) contains all the necessary functionalities for either Wolff or Favorskii rearrangement, we were prompted to probe this intriguing mechanistic dichotomy under conditions favorable to the photo-Favorskii reangement, i.e., photolysis in hydroxylic media. An investigation of the mechanism for conversion of 1a to p-hydroxyphenyl acetic acid (4a) using time-resolved infrared (TRIR) spectroscopy clearly demonstrates the formation of a ketene intermediate that is subsequently trapped by solvent or nucleophiles. The photoreaction of 1a is quenched by oxygen and sensitized by triplet sensitizers and the quantum yields for 1a–c range from 0.19 to a robust 0.25. The lifetime of the triplet, determined by Stern-Volmer quenching, is 15 ns with a rate for appearance of 4a of k = 7,1 × 106 s−1 in aq. acetonitrile (1:1 v:v). These studies establish that the primary rearrangement pathway for 1a involves ketene formation in accordance with the photo-Wolff rearrangement. Furthermore we have also demonstrated the synthetic utility of 1a as an esterification and etherification reagent with a variety of substituted α-diazo-p-hydroxyacetophenones, using them as synthons for efficiently coupling it to acids and phenols to produce pHP protect substrates. PMID:24305682

  8. A patient with WPW syndrome and coronary artery disease; Wspolistnienie zespolu WPW, choroby wiencowej i odcinkowych zaburzen kurczliwosci miesnia serca

    Energy Technology Data Exchange (ETDEWEB)

    Zarebinski, M.; Krupienicz, A.; Marciniak, W.; Ostrowski, M. [Centralny Szpital Kliniczny, Wojskowa Akademia Medyczna, Warsaw (Poland)

    1993-12-31

    A 61-year-old patient with Wolff-Parkinson-White`s syndrome, and hypertension was admitted to the CCU, because of the first episode of substernal chest pain. ECG was deformed by Wolff-Parkinson-White`s syndrome, type B, with accessory pathway located on the right side, without evolution. Serum enzymes remained low. Echocardiography showed akinesis of the posterior wall and hypokinesis of the lateral wall (the same contraction disorders were described in previous echocardiographical examination 5 years ago), it was observed that the first portion of myocardium to contract was the base of the right ventricle. To elucidate the etiology of the contraction disorders, scintigraphy of the heart, using thallium 201, was performed, showing normal perfusion of the myocardium. To illustrate the dependence of the contraction disorders and abnormal depolarization pattern of the heart, echocardiographical examination was repeated, confirming the previous results, then 100 mg of Ajmaline was given to the patient intravenously, and echocardiographical examination was continued. Administration of the drug caused antidromic atrioventricular re-entrant tachycardia during which the lateral wall of the heart had been contracting properly. This case shows contraction disorders of the heart caused by the abnormal depolarization pattern, resulting from the presence of accessory pathway. It also illustrates the diagnostic difficulties in patients with Wolff-Parkinson-White`s syndrome and suspected myocardial infarction, at the same time showing that scintigraphy of the heart might be very helpful in such patients. This case confirms the usefulness of echocardiography for localization of the accessory pathway. (author) 3 refs, 4 figs

  9. An Update on the Journal Astronomy Education Review and Why Your Work Isn't Done Until You Have Published

    Science.gov (United States)

    Wolff, S.; Fraknoi, A.; Hockey, T.; Biemesderfer, C.; Johnson, J.

    2010-08-01

    Astronomy Education Review (AER) is an online journal and magazine, covering astronomy and space science education and outreach. Founded in 2001 by Andrew Fraknoi and Sidney Wolff, and published until recently by National Optical Astronomy Observatories (NOAO), the journal is now a proud part of the journals operation of the American Astronomical Society (AAS) found online at http://aer.aip.org. If you are presenting at this conference, or reading the conference proceedings, you may be an ideal candidate to publish in AER. Later in this paper, we present some encouraging hints and guidelines for publishing in the journal.

  10. An observational study on MR images of the effect of the discoid meniscus on articular cartilage thickness.

    Science.gov (United States)

    Oni, David Babajide; Jeyapalan, K; Oni, Olusola O A

    2011-06-01

    The discoid meniscus is known to affect the morphology and mechanics of the knee compartment in which it is housed. To determine whether it also is determinative of the articular cartilage thickness, measurements were made on MR images. There was no statistically significant difference in femoral or tibial articular cartilage thickness between compartments with normal meniscus and compartments with discoid meniscus. These findings suggest that mechanical disturbances wrought by the discoid shape do not have a 'Wolff law' effect. Copyright © 2010. Published by Elsevier B.V.

  11. Integrating Vygotsky's theory of relational ontology into early childhood science education

    Science.gov (United States)

    Kirch, Susan A.

    2014-03-01

    In Science Education during Early Childhood: A Cultural- Historical Perspective, Wolff-Michael Roth, Maria Inês Mafra Goulart and Katerina Plakitsi explore the practical application of Vygotsky's relational ontological theory of human development to early childhood science teaching and teacher development. In this review, I interrogate how Roth et al. conceptualize "emergent curriculum" within the Eurocentric cultural-historical traditions of early childhood education that evolved primarily from the works of Vygotsky and Piaget and compare it to the conceptualizations from other prominent early childhood researchers and curriculum developers. I examine the implications of the authors' interpretation of emergence for early childhood science education and teacher preparation.

  12. Left Ventricular Dysfunction Caused by Unrecognized Surgical AV block in a Patient with a Manifest Right Free Wall Accessory Pathway

    Directory of Open Access Journals (Sweden)

    Rakesh Gopinathannair, MD, MA

    2013-05-01

    Full Text Available A 24-year-old male with Wolff-Parkinson-White syndrome developed systolic cardiomyopathy and severe heart failure following membranous ventricular septal defect repair and tricuspid valve replacement. Following successful catheter ablation of a right anterolateral accessory pathway (AP, complete AV block with junctional escape rhythm was noted. Patient subsequently underwent implantation of a biventricular ICD. Heart failure symptoms significantly improved soon after and left ventricular systolic function normalized 3 months post-procedure. In this case, surgically acquired AV block likely explains development of postoperative cardiomyopathy by facilitating ventricular activation solely via the AP and thereby increasing the degree of ventricular dyssynchrony.

  13. Frequency of Syncope in Patients with Accessory Atrioventricular Connection

    Directory of Open Access Journals (Sweden)

    A Aslani

    2010-03-01

    Full Text Available Background: Syncope in patients with Wolff-Parkinson-White (WPW syndrome is related to rapid reciprocating tachycardia or rapid ventricular response over the accessory pathway during atrial fibrillation (AF. The aim of this retrospective study is to evaluate the frequency of syncope in patients with WPW syndrome. Methods: We reviewed the records of 150 consecutive patients with WPW syndrome.Results: There were 20 patients (13.3% who reported at least one episode of syncope and 130 patients (86.7% without such a history.Conclusion: Syncope is relatively frequent in patients with WPW. Patient with WPW syndrome who has experienced this symptom should be thoroughly evaluated.

  14. Posterior Coronary Vein as the Substrate for an Epicardial Accessory Pathway

    Directory of Open Access Journals (Sweden)

    Laura Cipoletta, MD

    2013-07-01

    Full Text Available Catheter ablation of Wolff-Parkinson-White syndrome is associated with up to 5% of failure. Coronary sinus (CS abnormalities or connections between CS myocardial coat and left ventricular epicardium are associated with posteroseptal and left posterior accessory pathways (AP. A 41-year-old patient with WPW syndrome was referred to our hospital after three unsuccessful ablations. The 12-lead ECG suggested a left posteroseptal AP. CT imaging and electro-anatomic mapping showed a relationship between AP electrical course and CS posterior branch. This finding supports the hypothesis CSAPs lie in the myocardial coat around CS and represent an extensive connection between atrial and ventricular epicardial surface.

  15. A modified van der Pol equation with delay in a description of the heart action

    Directory of Open Access Journals (Sweden)

    Zduniak Beata

    2014-12-01

    Full Text Available In this paper, a modified van der Pol equation is considered as a description of the heart action. This model has a number of interesting properties allowing reconstruction of phenomena observed in physiological experiments as well as in Holter electrocardiographic recordings. Our aim is to study periodic solutions of the modified van der Pol equation and take into consideration the influence of feedback and delay which occur in the normal heart action mode as well as in pathological modes. Usage of certain values for feedback and delay parameters allows simulating the heart action when an accessory conducting pathway is present (Wolff-Parkinson-White syndrome.

  16. Gated cardiac blood pool studies in arrhythmias

    International Nuclear Information System (INIS)

    Itti, R.; Casset, D.; Philippe, L.; Cosnay, P.; Fauchier, J.P.

    1988-01-01

    Biventricular phase analysis a gated blood pool studies may help to solve two fundamental questions raised by patients suffering from arrhythmias: localization of an electrical cardiac activation abnormality by means of contraction mapping and assesment of an underlying organic disease using the phase histograms and their standard deviations. Three groups of patients have been evaluated to demonstrate the usefulness of radioisotopic techniques in arrhythmias: 36 patients with a Wolff-Parkinson-White syndrom, 27 patients studied during a ventricular tachycardia attack and 32 patients suspected of arrhythmogenic ventricular dysplasia. Correlations with invasive electrophysiologic studies are presented and the diagnostic and therapeutic implications of these results are discussed [fr

  17. Hypertrophic Cardiomyopathy due to Mitochondrial Disease: Prenatal Diagnosis, Management, and Outcome

    Directory of Open Access Journals (Sweden)

    Lutgardo García-Díaz

    2013-01-01

    Full Text Available A case of prenatally diagnosed fetal hypertrophic cardiomyopathy is reported. The mother was referred to our department at 37 weeks' gestation because of suspected congenital heart disease. Prenatal echocardiography showed biventricular hypertrophy and pericardial effusion, without additional abnormalities. Postnatal echocardiography confirmed prenatal diagnosis. Neonatal EKG showed biventricular hypertrophy and Wolff-Parkinson-White syndrome. Skeletal muscle biopsy was consistent with mitochondrial oxidative phosphorylation defect involving a combined defect of respiratory complexes I and IV. Echocardiographic followup during the first year of life showed progressive regression of hypertrophy and evolution to left ventricular myocardial noncompaction.

  18. Cardiac angioscintigraphy in patients with arrhytmias

    International Nuclear Information System (INIS)

    Itti, R.; Bontemps, L.; Philippe, L.; Casset-Senon, D.; Cosnay, P.; Fauchier, J.P.

    1990-01-01

    The time course of ventricular activation can be characterized by the Fourier analysis of a dynamic series of cardiac images. Bi-ventricular activation mapping and quantitative phase histogram analysis may be useful for evaluation of patients with arrhythmias. Three clinical problems can benefit from the method: localization of the site of pre-excitation in the Wolff-Parkinson-White syndrom, assessment of an ectopic activation focus responsible for premature contraction in patients with ventricular tachycardia and diagnosis of an underlying organic disease when arrhytmogenic right ventricular dysplasia is suspected [fr

  19. Advanced computer techniques for inverse modeling of electric current in cardiac tissue

    Energy Technology Data Exchange (ETDEWEB)

    Hutchinson, S.A.; Romero, L.A.; Diegert, C.F.

    1996-08-01

    For many years, ECG`s and vector cardiograms have been the tools of choice for non-invasive diagnosis of cardiac conduction problems, such as found in reentrant tachycardia or Wolff-Parkinson-White (WPW) syndrome. Through skillful analysis of these skin-surface measurements of cardiac generated electric currents, a physician can deduce the general location of heart conduction irregularities. Using a combination of high-fidelity geometry modeling, advanced mathematical algorithms and massively parallel computing, Sandia`s approach would provide much more accurate information and thus allow the physician to pinpoint the source of an arrhythmia or abnormal conduction pathway.

  20. Finite-temperature symmetry restoration in the four-dimensional Φ4 model with four components

    International Nuclear Information System (INIS)

    Jansen, K.

    1990-01-01

    The finite-temperature symmetry restoration in the four-dimensional φ 4 theory with four components and with an infinite self-coupling is studied by means of Monte Carlo simulations on lattices with time extensions L t =4,5,6 and space extensions 12 3 -28 3 . The numerical calculations are done by means of the Wolff cluster algorithm which is very efficient for simulations near a phase transition. The numerical results are in good agreement with an improved one-loop expansion and with the 1/N-expansion, indicating that in the electroweak theory the symmetry restoration temperature T sr is about 350 GeV. (orig.)

  1. Die filosofie van Immanuel Kant en Protestants-teologiese denkstrukture

    Directory of Open Access Journals (Sweden)

    P. S. Dreyer

    1990-01-01

    Full Text Available The philosophy of Immanuel Kant and Protestant theological structures Kant’s critical epistemology destroyed the idea of scientific metaphysics (valid up to Wolff as the foundation of theology. Kant, however, reconstructed his own metaphysics on the basis of practical reason. In this scheme metaphysics and ethics are interwoven and culminate in a religion exclusively based on and conditioned by pure reason, usually known as Kant’s moral theology or rational religion. The purpose of this paper is, firstly, to give a very short exposition of the basic concepts of Kant’s moral theology, and secondly, to show its decisive influence on post Kantian protestant view of religion.

  2. HUSUM Wind Energy 2012 - side event on wind energy in France

    International Nuclear Information System (INIS)

    Wolff, Nicolas; Cassin, Fabrice

    2012-01-01

    The French-German office for Renewable energies (OFAEnR) organised a conference on wind energy in France. In the framework of this French-German exchange of experience, about a hundred participants exchanged views on the status of the French wind energy market and to present the perspectives of this industry for the coming years. Emphasis was given on the legal framework and on the authorization procedures actually in force. This document brings together the two presentations (slides) made during this event: 1 - Current status and perspectives of the French wind energy market (Nicolas Wolff); 2 - Regulatory framework for wind energy and authorisation procedures in France (Fabrice Cassin)

  3. Improved numerical methods for quantum field theory (Outstanding junior investigator award)

    International Nuclear Information System (INIS)

    Sokal, A.D.

    1992-01-01

    We are developing new and more efficient numerical methods for problems in quantum field theory. Our principal goal is to achieve radical reductions in critical slowing-down. We are concentrating at present on three new families of algorithms: multi-grid Monte Carlo, Swendsen-Wang and generalized Wolff-type embedding algorithms. In addition, we are making a high-precision numerical study of the hyperscaling conjecture for the self-avoiding walk, which is closely related to the triviality problem for var-phi 4 quantum field theory

  4. Improved numerical methods for quantum field theory (Outstanding junior investigator award)

    International Nuclear Information System (INIS)

    Sokal, A.D.

    1993-01-01

    We are developing new and more efficient numerical methods for problems in quantum field theory. Our principal goal is to achieve radical reductions in critical slowing-down. We are concentrating at present on three new families of algorithms: multi-grid Monte Carlo (MGMC), Swendsen-Wang (SW) and generalized Wolff-type embedding algorithms. In addition, we are making a high-precision numerical study of the hyperscaling conjecture for the self-avoiding walk, which is closely related to the triviality problem for var-phi 4 quantum field theory

  5. Synthesis of [14α-methyl-3H]-24,25-dihydrolanosterol

    International Nuclear Information System (INIS)

    DeKeczer, S.; Kertesz, D.; Parnes, H.

    1993-01-01

    We describe the first synthesis of isomerically pure title compound (6) at high specific activity. This required the development of a convenient, regiospecific synthesis of the δ 8(9) -15-ketone and subsequent alkylation with methyl-[ 3 H 3 ]iodide. A key step in our procedure was the use of an electrochemical reduction of the intermediate [14α-methyl- 3 H]-15-oxo-dihydrolanosterol. This process was effected cleanly and in high yield to give (6), an important assay tool in the search for cholesterol lowering agents. This approach was found to be significantly superior to the Wolff-Kishner reduction of the corresponding 3-benzoate. (Author)

  6. Cardiac angioscintigraphy in patients with arrhytmias. l'angioscintigraphie cardiaque en rythmologie

    Energy Technology Data Exchange (ETDEWEB)

    Itti, R.; Bontemps, L. (Hopital Louis Pradel, 69 - Lyon (FR)); Philippe, L.; Casset-Senon, D.; Cosnay, P.; Fauchier, J.P. (Centre Hospitalier Universitaire Trousseau, 37 - Tours (FR))

    1990-01-01

    The time course of ventricular activation can be characterized by the Fourier analysis of a dynamic series of cardiac images. Bi-ventricular activation mapping and quantitative phase histogram analysis may be useful for evaluation of patients with arrhythmias. Three clinical problems can benefit from the method: localization of the site of pre-excitation in the Wolff-Parkinson-White syndrom, assessment of an ectopic activation focus responsible for premature contraction in patients with ventricular tachycardia and diagnosis of an underlying organic disease when arrhytmogenic right ventricular dysplasia is suspected.

  7. Gated cardiac blood pool studies in arrhythmias

    Energy Technology Data Exchange (ETDEWEB)

    Itti, R.; Casset, D.; Philippe, L.; Cosnay, P.; Fauchier, J.P.

    1988-01-01

    Biventricular phase analysis a gated blood pool studies may help to solve two fundamental questions raised by patients suffering from arrhythmias: localization of an electrical cardiac activation abnormality by means of contraction mapping and assesment of an underlying organic disease using the phase histograms and their standard deviations. Three groups of patients have been evaluated to demonstrate the usefulness of radioisotopic techniques in arrhythmias: 36 patients with a Wolff-Parkinson-White syndrom, 27 patients studied during a ventricular tachycardia attack and 32 patients suspected of arrhythmogenic ventricular dysplasia. Correlations with invasive electrophysiologic studies are presented and the diagnostic and therapeutic implications of these results are discussed.

  8. Models in Insurance: Paradigms, Puzzles, Communications and Revolutions.

    Science.gov (United States)

    1980-06-01

    80.7] G. Buoro, G. Pavesi and G. Zucchiatti, "Osservazioni sul Sistema di Calcolo del Margine di Solvabiliti," 71-80. [80.8] J. Calcanis and A...Vegas, "Un Ensayo sobre la Concepci6n Sistema aplicada a la Empresa de Seguros," 443-462. [80.41] K. H. Wolff, "Zur numerischen Berechnung der... Teoria della Credibilit&," Giornale dell’ Istituto degli Attuari, 27, 219-231 (1964). (D51 N. De Pril, "The Efficiency of a Bonus-Malus System," AB, 10

  9. Asynchronous variational integration using continuous assumed gradient elements.

    Science.gov (United States)

    Wolff, Sebastian; Bucher, Christian

    2013-03-01

    Asynchronous variational integration (AVI) is a tool which improves the numerical efficiency of explicit time stepping schemes when applied to finite element meshes with local spatial refinement. This is achieved by associating an individual time step length to each spatial domain. Furthermore, long-term stability is ensured by its variational structure. This article presents AVI in the context of finite elements based on a weakened weak form (W2) Liu (2009) [1], exemplified by continuous assumed gradient elements Wolff and Bucher (2011) [2]. The article presents the main ideas of the modified AVI, gives implementation notes and a recipe for estimating the critical time step.

  10. Thermistor guided radiofrequency ablation of atrial insertion sites in patients with accessory pathways.

    Science.gov (United States)

    Tracy, C M; Moore, H J; Solomon, A J; Rodak, D J; Fletcher, R D

    1995-11-01

    Radiofrequency ablation has gained acceptance in the treatment of patients with symptomatic Wolff-Parkinson-White syndrome. The purpose of this study was to characterize the relation between temperature and other electroconductive parameters in patients undergoing atrial insertion accessory pathway ablation utilizing a thermistor equipped catheter. The mean temperature and power at sites of atrial insertion ablation are lower than has been previously associated with creation of radiofrequency lesions in the ventricle. While high cavitary blood flow in the atrium may result in cooling, the thinner atrial tissue may require less energy to achieve adequate heating than ventricular myocardium.

  11. Contemporary demands on the community nurse

    Directory of Open Access Journals (Sweden)

    O.H. Muller

    1984-09-01

    Full Text Available A quarter of a century ago Mr Harold MacMillan delivered his famous Winds o f Change speech in Cape Town. In 1975 Dr. Wolff Bodenstein, in delivering a paper on primary health care, referred to the storms o f change. Now, a decade later, John Naisbitt speaks of megatrends when elaborating on change on a worldwide scale from an industrial society to an informational society. Alvin Toffler’s widely read The Third Wave speaks of similar trends on a scale comparable to the agricultural revolution and the industrial revolution.

  12. Evaluation of Human Epidermal Growth Factor Receptor 2 (HER2) Gene Status in Human Breast Cancer Formalin-Fixed Paraffin-Embedded (FFPE) Tissue Specimens by Fluorescence In Situ Hybridization (FISH).

    Science.gov (United States)

    Hwang, Harry C; Gown, Allen M

    2016-01-01

    Current standard of care requires that HER2 gene testing be performed on all newly diagnosed invasive breast cancers in order to determine eligibility for anti-HER2 antibody therapy and should be performed in accordance with current ASCO-CAP guidelines (Hammond et al., J Clin Oncol 29(15):e458, 2011; Wolff et al., J Clin Oncol 31(31):3997-4013, 2013). Here we describe a HER2 FISH methodology to evaluate HER2 gene status in FFPE breast tumor specimens.

  13. Usefulness of tomographic phase image in ventricular conduction abnormalities

    International Nuclear Information System (INIS)

    Sakurai, Mitsuru; Watanabe, Yoshihiko; Kondo, Takeshi

    1985-01-01

    In order to evaluate three-dimensional phase changes in ventricular conduction abnormalities, tomographic phase images were constructed in 7 normal subjects, 12 patients with ventricular pacing, 21 patients with bundle branch block and 12 patients with Wolff-Parkinson-White syndrome. Eight to 12 slices of the short-axis ventricular tomographic phase image (TPI) were derived using a 7-pinhole collimator, and compared with planar phase images (PPIs) in left anterior oblique (LAO) and right anterior oblique (RAO) projections. TPIs were excellent for observing biventricular phase changes in the long-axis direction. In 6 cases of complete right bundle branch block with left axis deviation (beyond -30 0 ), the phase delay in the left ventricular anterior wall was recognized in 5 cases by TPI, although it was difficult to be detected by PPIs. The site of the pacing electrode was identified by TPI in 11 out of 12 cases, compared to 8 cases by PPIs in LAO and RAO projections. The site of the accessory pathway in Wolff-Parkinson-White syndrome was detected in the basal slice of TPIs in 10 out of 12 cases, compared to 8 cases by PPI in the LAO projection. Therefore, it is obvious that TPIs offer more valid information than PPIs. In conclusion, TPI is useful for investigation of ventricular conduction abnormalities. (author)

  14. Geology of the Early Arikareean sharps formation on the Pine Ridge Indian Reservation and surrounding areas of South Dakota and Nebraska.

    Science.gov (United States)

    McConnell, Thomas H; Dibenedetto, Joseph N

    2012-01-01

    Based on geologic mapping, measured sections, and lithologic correlations, the local features of the upper and lower type areas of the Early Arikareean (30.8-20.6 million years ago) Sharps Formation are revised and correlated. The Sharps Formation above the basal Rockyford Member is divided into two members of distinct lithotypes. The upper 233 feet of massive siltstones and sandy siltstones is named the Gooseneck Road Member. The middle member, 161 feet of eolian volcaniclastic siltstones with fluvially reworked volcaniclastic lenses and sandy siltstone sheets, is named the Wolff Camp Member. An ashey zone at the base of the Sharps Formation is described and defined as the Rockyford Ash Zone (RAZ) in the same stratigraphic position as the Nonpareil Ash Zone (NPAZ) in Nebraska. Widespread marker beds of fresh water limestones at 130 feet above the base of the Sharps Formation and a widespread reddish-brown clayey siltstone at 165 feet above the base of the Sharps Formation are described. The Brown Siltstone Beds of Nebraska are shown to be a southern correlative of the Wolff Camp Member and the Rockyford Member of the Sharps Formation. Early attempts to correlate strata in the Great Plains were slow in developing. Recognition of the implications of the paleomagnetic and lithologic correlations of this paper will provide an added datum assisting researchers in future biostratigraphic studies. Based on similar lithologies, the Sharps Formation, currently assigned to the Arikaree Group, should be reassigned to the White River Group.

  15. The self invented personality? Reflections on authenticity and writing analytic papers.

    Science.gov (United States)

    Astor, James

    2005-09-01

    One of the great themes of American literature is the self-invented personality, whether it is Scott Fitzgerald's Gatsby or one of Philip Roth's alter egos, such as Nathaniel Zuckerman. This is just one of several approaches which novelists employ. They take a problem from life, perhaps their own, and then embark on solving the problem of the book-which is how to write about this. Sometimes, as in Tobias Wolff's novel Old School, the personality of the narrator is woven into an exploration of the creative process itself. Wolff's novel concerns itself not just with writing but with how to become a writer. I explore how this process is similar to both writing about analysis and becoming an analyst. In doing this I discuss issues of authenticity, fiction, art, the effects of identification, the power of the super-ego, supervision and learning, integrity of life and work, envy and the xenocidal impulse, the regulation of our profession and the loss of trust, and in so doing join in discussion with Plaut, Wharton, Tuckett and others about professional communications, the internal world and the mysteriousness of our relation to our internal objects.

  16. Interest of non-invasive and semi-invasive testings in asymptomatic children with pre-excitation syndrome.

    Science.gov (United States)

    Brembilla-Perrot, B; Chometon, F; Groben, L; Ammar, S; Bertrand, J; Marcha, C; Cloez, J L; Tisserand, A; Huttin, O; Tatar, C; Duhoux, F; Yangni N'da, O; Beurrier, D; Terrier de Chaise, A; Zhang, N; Abbas, M; Cedano, J; Marçon, F

    2007-09-01

    To determine the feasibility and the results of exercise testing (ET) and electrophysiological study (EPS) in outpatient asymptomatic children with a Wolff-Parkinson-White (WPW) syndrome. Exercise testing and transesophageal EPS were performed in 55 outpatient asymptomatic children aged 6 to 19 years old (14 +/- 3) with WPW. Wolff-Parkinson-White persisted during maximal exercise. Isoproterenol was not required in five children younger than 10 years old, because they developed a catecholaminergic sinus tachycardia. Maximal rate conducted through accessory pathway (AP) was higher in children younger than 16 years old than in teenagers (P < 0.05). Atrioventricular re-entrant tachycardia (AVRT) was induced in six children; atrial fibrillation (AF) in 12 children. The induction of tachycardias and the dangerous forms (18%) were not influenced by age. After 5 +/- 1 years, one child, 12 year old with inducible rapid AF, had a sudden cardiac arrest; two children became symptomatic after ablation. Transesophageal EPS was required to determine the prognosis of asymptomatic WPW in children. The maximal rate conducted in AP was higher in children younger than 16 years old than in teenagers; other data did not differ. AVRT was rare; 71% of children had no inducible arrhythmia and were authorized to resume physical activities.

  17. Synthesis and antimicrobial properties of 3-aryl-1-(1,1'-biphenyl-4-yl)-2-(1H-imidazol-1-yl)propanes as 'carba-analogues' of the N-arylmethyl-N-[(1,1'-biphenyl)-4-ylmethyl])-1H-imidazol-1-amines, a new class of antifungal agents.

    Science.gov (United States)

    Castellano, Sabrina; Stefancich, Giorgio; Chillotti, Annalisa; Poni, Graziella

    2003-08-01

    A new series of 3-phenyl-1-(1,1'-biphenyl-4-yl)-2-(1H-imidazol-1-yl)propane derivatives 2a-l (related to the antifungal bifonazole) was synthesized and tested for antimicrobial activity. A number of substituents on the phenyl ring were chosen to compare the relative biological properties with those of corresponding aza-analogues, previously described by us. The in vitro antifungal activities of the newly synthesized azoles were tested against several pathogenic fungi responsible for human disease. Test pathogens included representatives of yeasts (Candida albicans, Candida parapsilosis, Criptococcus neoformans), dermathophytes (Tricophyton verrucosum, Tricophyton rubrum, Microsporum gypseum) and moulds (Aspergillus fumigatus). Bifonazole and miconazole were used as reference drugs. Title compounds were prepared by alkylation of 1-biphenyl-4-yl-2-imidazol-1-yl-ethanone with the proper arylmethyl halide and subsequent reduction of corresponding ketones applying the Huang-Minlon modification of the Wolff-Kishner reaction.

  18. Canyon of current suppression in an interacting two-level quantum dot

    DEFF Research Database (Denmark)

    Karlström, O; Pedersen, Jonas Nyvold; Samuelsson, P

    2011-01-01

    Motivated by the recent discovery of a canyon of conductance suppression in a two-level equal-spin quantum dot system [Phys. Rev. Lett. 104, 186804 (2010)], the transport through this system is studied in detail. At low bias and low temperature a strong current suppression is found around...... the electron-hole symmetry point independent of the couplings, in agreement with previous results. By means of a Schrieffer–Wolff transformation we are able to give an intuitive explanation to this suppression in the low-energy regime. In the general situation, numerical simulations are carried out using...... for the current suppression. It is also shown how broadening, interference, and a finite interaction energy cause a shift of the current minimum away from degeneracy. Finally we see how an increased population of the upper level leads to current peaks on each side of the suppression line. At sufficiently high...

  19. Batch and Flow Photochemical Benzannulations Based on the Reaction of Ynamides and Diazo Ketones. Application to the Synthesis of Polycyclic Aromatic and Heteroaromatic Compounds

    Science.gov (United States)

    Willumstad, Thomas P.; Haze, Olesya; Mak, Xiao Yin; Lam, Tin Yiu; Wang, Yu-Pu; Danheiser*, Rick L.

    2013-01-01

    Highly substituted polycyclic aromatic and heteroaromatic compounds are produced via a two-stage tandem benzannulation/cyclization strategy. The initial benzannulation step proceeds via a pericyclic cascade mechanism triggered by thermal or photochemical Wolff rearrangement of a diazo ketone. The photochemical process can be performed using a continuous flow reactor which facilitates carrying out reactions on a large scale and minimizes the time required for photolysis. Carbomethoxy ynamides as well as more ketenophilic bissilyl ynamines and N-sulfonyl and N-phosphoryl ynamides serve as the reaction partner in the benzannulation step. In the second stage of the strategy, RCM generates benzofused nitrogen heterocycles, and various heterocyclization processes furnish highly substituted and polycyclic indoles of types that were not available by using the previous cyclobutenone-based version of the tandem strategy. PMID:24116731

  20. Supplementary notes to the biology of Cordyceps entomorrhiza (Dicks. ex Fr. Link and the morphology of its conidial stages

    Directory of Open Access Journals (Sweden)

    Stanisław Bałazy

    2014-08-01

    Full Text Available Cordyceps entomorrhiza develops on the larvae, pupae and adults on the ground beetles Carabus spp. (Coleoptera, Carabidae and on the bugs (Heteroptera, Nabidae ot the genera Himacerus Wolff et Nabis Latr. There are two forms of the conidial sporulation of this fungus with an identical sporogenesis type (Phialosporae but different as to the arrangement of sporogenous cells (Tilachiadtopsis and Hymenostilbe-like The names Tilachlidiopsis hippotrichoides (Lindau Keisler and T. nigra Yakushiji et Kumazawa should be treated as synonymous; they refer to the conidial stage of C. entomorrhiza, Hirsutella dla eleutheratorum (Nees ex Fr. Petch — contrary to the hitherto existing notion — is not connected with the above mentioned fungus. It constitutes a separate species, close to or identical with H. entomophila Pat.

  1. Radiofrequency catheter ablation in the treatment of cardiac arrhythmias (first of two parts)

    International Nuclear Information System (INIS)

    Kou, W.H; Morady, F.

    1997-01-01

    The intravenous radiofrequency catheter inside cardiac s chambers, for inspect signals intracardiac s and to encourage, has been developed as diagnostic tool with the purpose to search arrhythmias physiology and physiopathology.Many energy sources has been used: direct energy, radiofrequency 11-15, laser 6,17, and microwave 18,19. A comparison between radiofrequency and electric energy shock has been described in cardiac arrhythmias treatment, in the present article. It has been tested the radiation biological effects and risk in Wolff Parkinson White patients as well as doctors who handling the fluoroscopy for image during the radiofrequency ablation. Has been described the following techniques: Catheter ablation radiofrequency slow way and fast way

  2. American Crystallographic Association Project: numerical ratings of powder diffraction patterns

    International Nuclear Information System (INIS)

    Smith, G.S.; Snyder, R.L.

    1977-01-01

    At present, nearly 30,000 powder diffraction patterns are available as references. It is proposed that the patterns in this file as well as new patterns submitted for publication be given quantitative quality factors. A simple-to-use figure of merit, F/sub N/, covering both accuracy of d-values and completeness of a pattern was derived. This figure of merit provides the user with a means of rapid evaluation of powder patterns in much the same way that the R-factor does for single-crystal structure determinations. The present F/sub N/ ranking scheme is shown to be superior to de Wolff's M 20 ranking scheme. It is recommended that the latter be discontinued. Guidelines are given on the use and implementation of F/sub N/ rating of powder diffraction patterns

  3. Epigenesis in Kant: Recent reconsiderations.

    Science.gov (United States)

    Zammito, John H

    2016-08-01

    Epigenesis has become a far more exciting issue in Kant studies recently, especially with the publication of Jennifer Mensch's Kant' Organicism. In my commentary, I propose to clarify my own position on epigenesis relative to that of Mensch and others by once again considering the discourse of epigenesis in the wider eighteenth century. Historically, I maintain that Kant was never fully an epigenesist because he feared its materialist implications. This makes it highly unlikely that he drew heavily, as other interpreters like Dupont and Huneman have suggested, on Caspar Friedrich Wolff for his ultimate theory of "generic preformation." In order to situate more precisely what Kant made of epigenesis, I distinguish his metaphysical use, as elaborated by Mensch, from his view of it as a theory for life science. In that light, I raise questions about the scope and authority of philosophy vis a vis natural science. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. [Suicide by double bolt gunshot wound to the head: case report and review of the literature].

    Science.gov (United States)

    Grellner, W; Buhmann, D; Wilske, J

    2000-01-01

    Suicidal gunshot wounds from a livestock stunner with infliction of two shots against the head are extremely rare events. A case with these characteristics is presented and the corresponding literature is reviewed. A 61-year-old butcher was found dead with two entry wounds of the forehead on the right side and in the centre being typical for captive bolt pistols (symmetrically localized powder burns). The issues of the sequence of shots and the capacity of action are discussed on the basis of morphological findings and pathophysiological considerations. A literature review revealed only 4 case reports with double gunshot wounds of the skull caused by "humane killers" (Tovo 1956, Wolff and Laufer 1965, Schiermeyer 1973, Pollak 1977).

  5. Duchenne muscular dystrophy and idiopathic hyperCKemia segregating in a family

    Energy Technology Data Exchange (ETDEWEB)

    Frydman, M.; Straussberg, R.; Shomrat, R.; Legum, C. [Tel Aviv Univ. (Israel)] [and others

    1995-09-11

    A 7-month-old boy with gross motor delay and failure to thrive presented with rhabdomyolysis following an acute asthmatic episode. During hospitalization an electrocardiographic conversion to a Wolff-Parkinson-White type 1 (WPW) pattern took place. Duchenne muscular dystrophy (DMD) was suspected based on elevated creatine kinase (CK) serum levels, muscle biopsy, and family history. The diagnosis was confirmed by molecular analysis, which documented a deletion corresponding to cDNA probe 1-2a in the dystrophin gene, in the propositus and in an affected male cousin of his mother. {open_quotes}Idiopathic{close_quotes} hyperCKemia was found in the propositus, his father, and 5 of his relatives. We suggest that the unusually early and severe manifestations of DMD in this patient may be related to the coincidental inheritance of the maternal DMD gene and of a paternal gene, causing hyperCKemia. 13 refs., 3 figs., 1 tab.

  6. Antegrade or Retrograde Accessory Pathway Conduction: Who Dies First?

    Directory of Open Access Journals (Sweden)

    Claudio Hadid, MD

    2012-05-01

    Full Text Available A 36 year-old man with Wolff Parkinson White syndrome due to a left-sided accessory pathway (AP was referred for catheter ablation. Whether abolition of antegrade and retrograde AP conduction during ablation therapy occurs simultaneously, is unclear. At the ablation procedure, radiofrequency delivery resulted in loss of preexcitation followed by a short run of orthodromic tachycardia with eccentric atrial activation, demonstrating persistence of retrograde conduction over the AP after abolition of its antegrade conduction. During continued radiofrequency delivery at the same position, the fifth non-preexcitated beat failed to conduct retrogradely and the tachycardia ended. In this case, antegrade AP conduction was abolished earlier than retrograde conduction.

  7. Atriofascicular Mahaim with Ebstein anomaly: A case report

    Directory of Open Access Journals (Sweden)

    Kazushi Ueshima, MD

    2017-10-01

    Full Text Available We report a case of a 7-year-old girl with atriofascicular Mahaim (AFM pathway concomitant with Ebstein's anomaly. The QRS wave showed left bundle branch block pattern on electrocardiogram. Holter electrocardiogram showed prolongation of the PR interval and QRS morphological change during sinus tachycardia. An electrophysiological study demonstrated that the distal His potential appeared earlier than the proximal His potential, which suggested retrograde His conduction toward the atrioventricular node. Conduction from the Mahaim fiber to the His bundle was faster than that from the atrioventricular node towards the His bundle. The findings of this important case allowed a differential diagnosis between AFM and Wolff-Parkinson-White (WPW syndrome.

  8. Electrocardiography as an early cardiac screening test in children with mitochondrial disease

    Directory of Open Access Journals (Sweden)

    Ran Baik

    2010-05-01

    Full Text Available Purpose : To evaluate myocardial conductivity to understand cardiac involvement in patients with mitochondrial disease. Methods : We performed retrospective study on fifty-seven nonspecific mitochondrial encephalopathy patients with no clinical cardiac manifestations. The patients were diagnosed with mitochondrial respiratory chain complex defects through biochemical enzyme assays of muscle tissue. We performed standard 12-lead electrocardiography (ECG on all patients. Results : ECG abnormalities were observed in 30 patients (52.6%. Prolongation of the QTc interval (&gt;440 ms was seen in 19 patients (33.3%, widening of the corrected QRS interval in 15 (26.3%, and bundle branch block in four (7.0%. Atrioventricular block, premature atrial contraction and premature ventricular contraction were seen in two patients each (3.5% and Wolff-Parkinson-White syndrome in one patient (1.8%. Conclusion : Given this finding, we recommend active screening with ECG in patients with mitochondrial disease even in patients without obvious cardiac manifestation.

  9. Discussion of Source Reconstruction Models Using 3D MCG Data

    Science.gov (United States)

    Melis, Massimo De; Uchikawa, Yoshinori

    In this study we performed the source reconstruction of magnetocardiographic signals generated by the human heart activity to localize the site of origin of the heart activation. The localizations were performed in a four compartment model of the human volume conductor. The analyses were conducted on normal subjects and on a subject affected by the Wolff-Parkinson-White syndrome. Different models of the source activation were used to evaluate whether a general model of the current source can be applied in the study of the cardiac inverse problem. The data analyses were repeated using normal and vector component data of the MCG. The results show that a distributed source model has the better accuracy in performing the source reconstructions, and that 3D MCG data allow finding smaller differences between the different source models.

  10. Cardiac ablation

    Directory of Open Access Journals (Sweden)

    Kelly Ratheal

    2016-01-01

    Full Text Available Cardiac ablation is a procedure that uses either radiofrequency or cryothermal energy to destroy cells in the heart to terminate and/or prevent arrhythmias. The indications for cardiac catheter ablation include refractory, symptomatic arrhythmias, with more specific guidelines for atrial fibrillation in particular. The ablation procedure itself involves mapping the arrhythmia and destruction of the aberrant pathway in an effort to permanently prevent the arrhythmia. There are many types of arrhythmias, and they require individualized approaches to ablation based on their innately different electrical pathways. Ablation of arrhythmias, such as Wolff-Parkinson-White syndrome, AV nodal reentrant tachycardia, and atrial-fibrillation, is discussed in this review. Ablation has a high success rate overall and minimal complication rates, leading to improved quality of life in many patients.

  11. Application of radionuclide ventriculography phase analysis in patients with atrial or ventricular pacing for detecting ventricular abnormal excitation

    International Nuclear Information System (INIS)

    Shi Rongfang; Wang Zhonggan; Li Shengting

    1996-01-01

    The aim of the study was to increase the accuracy of detecting ventricular abnormal excitation. During atrial or ventricular pacing, radionuclide ventriculography phase analysis (RNV-PA) was performed in 17 patients with Wolff-Parkinson-White (W-P-W) syndrome and paroxysmal supra ventricular tachycardia (PSVT) and ventricular tachycardia (PVT). During pacing, detection rate of abnormal excitation by RNV-PA was 95.5%, compared with 68.2% during basic conduction. Atrial or ventricular pacing can significantly increase the detection rate of abnormal excitation by RNV-PA in patients with W-P-W syndrome. It may be a valuable method for identifying the abnormal excitation and estimating the therapeutic effect of ablation

  12. Epidemiology of Arrhythmias in Children

    Directory of Open Access Journals (Sweden)

    R Prem Sekar

    2008-05-01

    Full Text Available Unlike the adult population, arrhythmias occur less commonly in childhood. Only 5% of the emergency hospital admissions in the paediatric population is attributed to symptomatic arrhythmias. Majority of these tend to be accessory pathway mediated supraventricular tachyarrhythmias such as Wolff-Parkinson-White (WPW syndrome, permanent junctional reciprocating tachycardia (PJRT and Mahaim tachycardia. The non accessory pathway mediated supraventricular tachyarrhythmias commonly seen in children are junctional ectopic tachycardia (JET and automatic ectopic atrial tachycardia (AET and occur mostly in the post operative period after intracardiac repair for a structural heart defect. Ventricular tachycardia (VT although uncommon, occurs in the paediatric age group in association with hypertrophic cardiomyopathy (HCM, long QT syndrome (LQTS and Brugada syndrome. Occasionally, VT can also present symptomatically as incessant idiopathic infant ventricular tachycardia, right ventricular outflow tract tachycardia, benign VT, catecholaminic VT, idiopathic left ventricular tachycardia and in post cardiac surgical patients.

  13. Evaluation of the effect of RFCA in patients with WPW syndrome using RPA

    International Nuclear Information System (INIS)

    Zhang Wei; Dong Shenan; Jiang Yimin

    1996-01-01

    Whether radionuclide phase analysis (RPA) could evaluate the effect of radiofrequency current ablation (RFCA) in patients with Wolff-Parkinson-White (WPW) syndrome was evaluated. 18 patients with WPW syndrome were studied using RPA pre- and post-RFCA. RPA identified the sites of pre-excitation in all patients before RFCA. Compared with the pre-RFCA study, the sites of pre-excitation disappeared in 12 cases, disappeared gradually in 4 cases and unchanged in 2 cases. 50 RFCA was successful in the former two patterns, but failed in the last pattern. RPA can evaluate the changes of pre-excitation sites in patients with WPW syndrome before and after RFCA. It was a noninvasive and reliable method for assessing and monitoring the effect of RFCA in patients with WPW syndrome

  14. Quantum phase transition and quench dynamics in the anisotropic Rabi model

    Science.gov (United States)

    Shen, Li-Tuo; Yang, Zhen-Biao; Wu, Huai-Zhi; Zheng, Shi-Biao

    2017-01-01

    We investigate the quantum phase transition (QPT) and quench dynamics in the anisotropic Rabi model when the ratio of the qubit transition frequency to the oscillator frequency approaches infinity. Based on the Schrieffer-Wolff transformation, we find an anti-Hermitian operator that maps the original Hamiltonian into a one-dimensional oscillator Hamiltonian within the spin-down subspace. We analytically derive the eigenenergy and eigenstate of the normal and superradiant phases and demonstrate that the system undergoes a second-order quantum phase transition at a critical border. The critical border is a straight line in a two-dimensional parameter space which essentially extends the dimensionality of QPT in the Rabi model. By combining the Kibble-Zurek mechanism and the adiabatic dynamics method, we find that the residual energy vanishes as the quench time tends to zero, which is a sharp contrast to the universal scaling where the residual energy diverges in the same limit.

  15. Catalytic activity trends of CO oxidation – A DFT study

    DEFF Research Database (Denmark)

    Jiang, Tao

    theoretical study of CO oxidation with experimental studies. The latter shows promoted catalytic activity when gold particle size decreases to 5 nm. Oxidizing CO by N2O was found to involve a CO␣O transition state, with atomic O adsorbed on the gold B5 sites and CO on the corners. On the other hand, CO...... and experiment were found to be the same. The experiment findings are in good agreement with our theoretical calculations. The second part of the thesis focuses on improving the convergence property of Quasi-Newton algorithm. The eigenvalues of the Hessian matrix of 54 atoms bulk Cu model are calculated......, and the sizes of eigenvalues follow power-law distribution. It is found that the anharmonicity of the weak modes lead to poor Newton step and poor Hessian update in BFGS type Quasi-Newton algorithm, which slow down the geometry optimization. Line search that fulfills Wolff conditions is then applied to improve...

  16. Tourette's syndrome in famous musicians

    Directory of Open Access Journals (Sweden)

    Carlos Henrique F. Camargo

    2015-01-01

    Full Text Available Tourette's syndrome (TS is defined as a disorder characterized by multiple motor tics and at least one vocal tic that have lasted for not less than one year. It is a relatively complex neurobehavioral disorder, in which patients may present with coexistent attention deficit hyperactivity disorder, obsessive-compulsive disorder or other behavioral comorbidities. The musical genius Wolfgang Amadeus Mozart (1756-1791 and the rock star Kurt Cobain (1967-1994 may both have suffered from TS, and some contemporary musicians have had their clinical condition confirmed as TS. Our hypothetical diagnosis of TS in Mozart and Cobain is based on the presence of tics and psychiatric comorbidities. In contemporary musicians, such as Michael Wolff, Nick Van Bloss and James Durbin, TS has often only been diagnosed after a considerable delay. This delay in diagnosis and the controversies surrounding the clinical case of Mozart show how difficult a confirmatory diagnosis of this complex disease is.

  17. Linking experiences with emotions and the development of interpretive repertoires

    Science.gov (United States)

    McRae, Norah I.

    2010-03-01

    In this paper I consider the case of one student, Todd Alexander, through analyzing the transcripts of his interviews between him and his teacher (Wolff-Michael Roth). I examine the role that emotions play in the development of the interpretive repertoires that Todd employed as he talked about his scientific and his religious beliefs. I identify how lived experiences support the development of emotions and what educational conditions are necessary to allow for appropriate lived experiences. In so doing we might be able to support educational conditions that result in interpretive repertoires that allow for acceptance of multiple perspectives with a moral grounding, leading to students who are well positioned to be valuable contributors to society.

  18. A new mutation of the fukutin gene causing late-onset limb girdle muscular dystrophy

    DEFF Research Database (Denmark)

    Riisager, Maria; Duno, M; Hansen, Flemming Juul

    2013-01-01

    to aberrations of FKTN is rare, with only eight reported cases of limb girdle phenotype (LGMD2M). We describe the mildest affected patient outside Japan with genetically confirmed LGMD2M and onset of symptoms at age 14. She was brought to medical attention at age 12, not because of muscle weakness, but due...... to episodes of tachycardia caused by Wolff-Parkinson-White syndrome. On examination, she had rigid spine syndrome, a typical limb girdle dystrophy pattern of muscle weakness, cardiomyopathy, and serum CK levels >2000 IU/L (normal G; p.Y306C mutation in the FKTN gene was found. The case confirms FKTN mutations...... as a cause of LGMD2M without mental retardation and expands the phenotypic spectrum for LGMD2M to include cardiomyopathy and rigid spine syndrome in the mildest affected non-Japanese patient reported so far....

  19. WNT4 signaling in female gonadal development.

    Science.gov (United States)

    Pellegrino, Miriam; Maiorino, Raffaella; Schonauer, Sergio

    2010-06-01

    WNT4 signaling pathways represent an important step in the multi-faceted process of mammalian gonadal differentiation and the development of internal genitalia. WNT4 protein controls the cytoplasmatic stability of specific transcriptional coactivator beta catenin during both embriogenesis and adult homeostasis. The biological significance of WNT4 consists in determining the final female reproductive system, inhibiting Wolff ducts' differentiation, male steroidogenesis and vascular cell migration. An overview of WNT4 cellular mechanisms is given in order to understand its critical role in the genesis of various human diseases such as congenital malformations and gynecological disorders like polycystic ovary syndrome (PCOS). The final discussion focusses on several possible therapeutic uses of Wnt4 both during pregnancy in order to correct the genetic loss of function of the protein and during adulthood in order to normalize fertility in PCOS-affected females planning pregnancy.

  20. Reentry Tachycardia in Children: Adenosine Can Make It Worse.

    Science.gov (United States)

    Hien, Maximilian D; Benito Castro, Fernando; Fournier, Philippe; Filleron, Anne; Tran, Tu-Anh

    2016-10-08

    We report on a rare but severe complication of adenosine use in a child with reentry tachycardia. Treatment with adenosine, which is the standard medical therapy of atrioventricular reentry tachycardia, led to the development of an irregular wide complex tachycardia, caused by rapid ventricular response to atrial fibrillation. The girl was finally stabilized with electrical cardioversion. We analyze the pathomechanism and discuss possible treatment options. Atrial fibrillation, as well as its conduction to the ventricles, can be caused by adenosine. Rapid ventricular response in children with Wolff-Parkinson-White syndrome is more frequent than previously believed. A patient history of atrial fibrillation is a contraindication for cardioversion with adenosine and needs to be assessed in children with reentry tachycardia. High-risk patients may potentially profit from prophylactic comedication with antiarrhythmic agents, such as flecainide, ibutilide, or vernakalant, before adenosine administration.

  1. [Fungi isolated from diseased medicinal plants].

    Science.gov (United States)

    Sato, T; Matsuhashi, M; Iida, O

    1992-01-01

    One hundred and forty-four fungal isolates were obtained from diseased Paeonia albiflora Pall. var. trichocarpa Bung., Astragalus membranaceus Bung., Lithospermum erythrorhizon Sieb. et Zucc., Ledebouriella seseloides Wolff and Bupleurum falcatum L. which were collected in the test field of Tsukuba Medicinal Plant Research Station, National Institute of Hygienic Sciences. Most of them were identified into 15 genera containing 8 species. Fungal species presumed to be pathogens of the host plants were as follows: Cladosporium paeoniae, Pestalotia paeoniicola, Glomerella cingulata, Hainesia lythri, Guignardia sp. and Alternaria sp. from P. albiflora, Fusarium spp., Rhizoctonia spp. and Neocosmospora vasinfecta from A. membranaceus, Colletotrichum gloeosporioides from L. erythrorhizon, Rhizoctonia sp., Fusarium spp., Phoma sp. and Pyrenochaeta sp. from L. seseloides, and Fusarium sp., Alternaria alternata, Phyllosticta sp., Phoma sp., Phomopsis sp. and C. gloeosporioides from B. falcatum. Roots of B. falcatum were found to be parasitized by Meloidogyne sp.

  2. Investigation of relationship between karyotype pattern, effective chromosome-arm number and chromosome aberrations in peripheral blood lymphocytes of three species: man, rabbit, swine. Part of a coordinated programme on radiation induced chromosomal aberrations for genetic risk evaluation in man

    International Nuclear Information System (INIS)

    Liniecki, J.

    1980-08-01

    Blood from 3 donors of each species: man, rabbit and pig was irradiated with a dose of 2.5Gy 60 Co gamma-rays. Microcultures of lymphocytes, established in presence of BrdUrd, were harvested at 6 different times after PHA-stimulation. The preparations containing metaphase figures were stained acc. to Perry and Wolff to permit differentiation of the cells in first and later mitoses. In all individuals and species studied there was a highly significant negative correlation between dicentric yield and time from stimulation to the harvest. The decline of the yield with time of harvest varied in the three species between 1.0 and 3.6 per cent per hour. Implications for biological dosimetry are discussed

  3. An Unusual Case of Alternating Ventricular Morphology on the 12-Lead Electrocardiogram.

    Science.gov (United States)

    Sammon, Maura; Dawood, Alveena; Beaudoin, Scott; Harrigan, Richard A

    2017-03-01

    One of the principal tasks of an emergency physician is identifying potentially life-threatening conditions in the undifferentiated patient; cardiac dysrhythmia is an example of such a condition. A systematic approach to a patient with atypical dysrhythmia enables proper identification of such-life threatening conditions. We describe a 31-year-old man presenting to the emergency department with an undifferentiated dysrhythmia after naloxone reversal of an opiate overdose. A systematic approach to the electrocardiogram led to the rare diagnosis of Wolff-Parkinson-White (WPW) alternans. We review the differential diagnosis of this dysrhythmia and the initial evaluation of a patient with the WPW pattern present on their electrocardiogram. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Emergency physicians should be prepared to use a systematic approach to an undifferentiated dysrhythmia to identify potentially life-threatening conditions. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Influence of dietary cholesterol on 26-hydroxycholesterol and the effect of 26-hydroxycholesterol on the intracellular free calcium level

    International Nuclear Information System (INIS)

    Kou, I.L.

    1987-01-01

    The purpose of this study was to investigate the factors influencing serum level of 26-hydroxycholesterol after long-term consumption of cholesterol by animals. It is also to examine the effect of this sterol on intracellular free calcium level. Purified 26-hydroxycholesterol was synthesized from kryptogenin by the Clemmemsen and Wolff-Kishner reduction method. 26-Hydroxycholesterol was also used for fatty acid esters syntheses, and to study its influence on membranes. Tritiated 26-hydroxycholesterol which was synthesized by an enzymatic method, was used to monitor the 26-hydroxycholesterol loss during the procedure. The ester form of 26-hydroxycholesterol was also synthesized, and used to investigate its effects on membranes. The HPLC method that was developed for the analysis of 26-hydroxycholesterol levels in animal tissues was accurate, efficient, and reproducible for the determination of 26-hydroxycholesterol in plasma. However, it was not suitable for the analysis of other tissues, due to the overlapping of peaks making quantitation difficult

  5. Ablación por radiofrecuencia de vía anómala en paciente con agenesia de la vena cava inferior

    Directory of Open Access Journals (Sweden)

    Carlos A. Gómez

    2015-05-01

    Full Text Available Describimos un caso de una paciente de sexo femenino de 55 años de edad a quien se le diagnosticó síndrome de Wolff-Parkinson-White, y al ser llevada al procedimiento de ablación se le encuentra agenesia de la vena cava inferior, con continuidad hacia las cavidades cardiacas derechas a través de la vena ácigos. La realización posterior del procedimiento a través de dicha vena se consideró exitosa, pero ante la recurrencia de las alteraciones electrocardiográficas y nuevos episodios de taquicardia se le realizó nuevo estudio electrofisiológico y ablación por vía yugular interna derecha con éxito. Presentamos además una revisión de la literatura sobre este tópico.

  6. Generalized analytic continuation

    CERN Document Server

    Ross, William T

    2002-01-01

    The theory of generalized analytic continuation studies continuations of meromorphic functions in situations where traditional theory says there is a natural boundary. This broader theory touches on a remarkable array of topics in classical analysis, as described in the book. This book addresses the following questions: (1) When can we say, in some reasonable way, that component functions of a meromorphic function on a disconnected domain, are "continuations" of each other? (2) What role do such "continuations" play in certain aspects of approximation theory and operator theory? The authors use the strong analogy with the summability of divergent series to motivate the subject. In this vein, for instance, theorems can be described as being "Abelian" or "Tauberian". The introductory overview carefully explains the history and context of the theory. The authors begin with a review of the works of Poincaré, Borel, Wolff, Walsh, and Gončar, on continuation properties of "Borel series" and other meromorphic func...

  7. Acute supraventricular tachycardia in children.

    Science.gov (United States)

    Paul, Siba Prosad; Blaikley, Sarah; Peevers, Camilla; Fitz-John, Lin

    2012-10-01

    This article describes the management in emergency departments of supraventricular tachycardia (SVT) in children. Of all forms of symptomatic arrhythmia in infants, children and adolescents, SVT is the most common. Its clinical presentation varies with the child's age, and it can be difficult to diagnose in infants and young children. It is important that the nurses in the emergency department consider a diagnosis of SVT in young children with histories of poor feeding, lethargy, irritability, excessive sweating or pallor (Zeigler 1994) and in older children with histories of palpitations, dizziness, chest pain, syncope or shortness of breath (Uzun 2010). If SVT is suspected, a 12-lead electrocardiogram should be recorded. Vagal manoeuvre may be successful but in some cases intravenous adenosine is necessary. Children with Wolff-Parkinson-White syndrome are at risk of sudden cardiac death associated with SVT, and should not be treated with calcium channel blockers or digoxin.

  8. A Non-parametric Method for Calculating Conditional Stressed Value at Risk

    Directory of Open Access Journals (Sweden)

    Kohei Marumo

    2017-01-01

    Full Text Available We consider the Value at Risk (VaR of a portfolio under stressed conditions. In practice, the stressed VaR (sVaR is commonly calculated using the data set that includes the stressed period. It tells us how much the risk amount increases if we use the stressed data set. In this paper, we consider the VaR under stress scenarios. Technically, this can be done by deriving the distribution of profit or loss conditioned on the value of risk factors. We use two methods; the one that uses the linear model and the one that uses the Hermite expansion discussed by Marumo and Wolff (2013, 2016. Numerical examples shows that the method using the Hermite expansion is capable of capturing the non-linear effects such as correlation collapse and volatility clustering, which are often observed in the markets.

  9. PHILOSOPHIE(GESCHICHTE AUF GRUNDLAGE VON GAARDERS «SOFIES WELT» IM DAF-SACHUNTERRICHT NACH LDL

    Directory of Open Access Journals (Sweden)

    Guido Oebel

    2011-11-01

    Full Text Available : Thoroughly positive experience previously gained from both philosophical and issues of philosophical history in social study classes (cf. Hengelbrock 1991a; b; c; 1992; Heller 1994 convinced the author to even go beyond that by implementing Jostein Gaarder’s project idea “Sophie’s World” in a kind of special classroom of German as foreign language (cf. Oebel 2005a; b; c; 2007. In this context, Jean-Pol Martin’s “holistic approach” (Abendroth-Timmer LdL (“Learning-by-Teaching” for German “Lernen-durch-Lehren” seems to be the probably most emphatic constructivistic project teaching method (cf. Scheelhaas 1997; 2003; Wolff 2002, a fact that it has already proved impressively and sustainably not only in the follow-up project presently described but on several other occasions.

  10. Metaphysics for an enlightened public: The controversy over monads in Germany, 1746-1748.

    Science.gov (United States)

    Broman, Thomas

    2012-03-01

    This essay analyzes the controversy that attended the prize essay question on monads proposed by the Berlin Academy of Sciences in 1746. The controversy was first touched off by an anonymous pamphlet published by the mathematician Leonhard Euler, the academy's most well known member, that attacked the doctrine of monads. It peaked with the awarding of the prize to Johann Heinrich Gottlob Justi, whose winning essay closely followed Euler's arguments. This essay discusses the controversy as one instance in a broader quarrel in the German academic community over the suitability of Christian Wolff's philosophy as the foundation for a broad range of academic disciplines, including natural philosophy. It also analyzes the controversy as displaying the central role of the periodical press in the emergent German public sphere.

  11. Can sudden cardiac death in the young be predicted and prevented? Lessons from autopsy for the emergency physician.

    Science.gov (United States)

    White, Jennifer L; Chang, Anna Marie; Cesar, Sergi; Sarquella-Brugada, Georgia

    2018-06-01

    Sudden unexpected death in the young, though rare, is devastating for both the family and the community. Although only 1.3 to 8.5 cases of sudden cardiac death (SCD) occur per 100 000 young people, autopsy is often inconclusive. Many causes of SCD are related to autosomal dominant inherited risk, however; therefore, answers are important for survivors. Causes of autopsy-positive SCD in young patients include hypertrophic cardiomyopathy and arrhythmogenic right ventricular dysplasia. Autopsy-negative SCD has been related to inherited arrhythmogenic causes such as long QT syndrome, Brugada syndrome, catecholaminergic polymorphic ventricular tachycardia, Wolff- Parkinson-White syndrome, and idiopathic ventricular fibrillation. The important question for the emergency physician is how SCD can be predicted and prevented in the young so that there is no need for an autopsy.

  12. Monte Carlo analysis of critical phenomenon of the Ising model on memory stabilizer structures

    International Nuclear Information System (INIS)

    Viteri, C. Ricardo; Tomita, Yu; Brown, Kenneth R.

    2009-01-01

    We calculate the critical temperature of the Ising model on a set of graphs representing a concatenated three-bit error-correction code. The graphs are derived from the stabilizer formalism used in quantum error correction. The stabilizer for a subspace is defined as the group of Pauli operators whose eigenvalues are +1 on the subspace. The group can be generated by a subset of operators in the stabilizer, and the choice of generators determines the structure of the graph. The Wolff algorithm, together with the histogram method and finite-size scaling, is used to calculate both the critical temperature and the critical exponents of each structure. The simulations show that the choice of stabilizer generators, both the number and the geometry, has a large effect on the critical temperature.

  13. Pushing the limits of Monte Carlo simulations for the three-dimensional Ising model

    Science.gov (United States)

    Ferrenberg, Alan M.; Xu, Jiahao; Landau, David P.

    2018-04-01

    While the three-dimensional Ising model has defied analytic solution, various numerical methods like Monte Carlo, Monte Carlo renormalization group, and series expansion have provided precise information about the phase transition. Using Monte Carlo simulation that employs the Wolff cluster flipping algorithm with both 32-bit and 53-bit random number generators and data analysis with histogram reweighting and quadruple precision arithmetic, we have investigated the critical behavior of the simple cubic Ising Model, with lattice sizes ranging from 163 to 10243. By analyzing data with cross correlations between various thermodynamic quantities obtained from the same data pool, e.g., logarithmic derivatives of magnetization and derivatives of magnetization cumulants, we have obtained the critical inverse temperature Kc=0.221 654 626 (5 ) and the critical exponent of the correlation length ν =0.629 912 (86 ) with precision that exceeds all previous Monte Carlo estimates.

  14. Accurate means of detecting and characterizing abnormal patterns of ventricular activation by phase image analysis

    Energy Technology Data Exchange (ETDEWEB)

    Botvinick, E.H.; Frais, M.A.; Shosa, D.W.; O' Connell, J.W.; Pacheco-Alvarez, J.A.; Scheinman, M.; Hattner, R.S.; Morady, F.; Faulkner, D.B.

    1982-08-01

    The ability of scintigraphic phase image analysis to characterize patterns of abnormal ventricular activation was investigated. The pattern of phase distribution and sequential phase changes over both right and left ventricular regions of interest were evaluated in 16 patients with normal electrical activation and wall motion and compared with those in 8 patients with an artificial pacemaker and 4 patients with sinus rhythm with the Wolff-Parkinson-White syndrome and delta waves. Normally, the site of earliest phase angle was seen at the base of the interventricular septum, with sequential change affecting the body of the septum and the cardiac apex and then spreading laterally to involve the body of both ventricles. The site of earliest phase angle was located at the apex of the right ventricle in seven patients with a right ventricular endocardial pacemaker and on the lateral left ventricular wall in one patient with a left ventricular epicardial pacemaker. In each case the site corresponded exactly to the position of the pacing electrode as seen on posteroanterior and left lateral chest X-ray films, and sequential phase changes spread from the initial focus to affect both ventricles. In each of the patients with the Wolff-Parkinson-White syndrome, the site of earliest ventricular phase angle was located, and it corresponded exactly to the site of the bypass tract as determined by endocardial mapping. In this way, four bypass pathways, two posterior left paraseptal, one left lateral and one right lateral, were correctly localized scintigraphically. On the basis of the sequence of mechanical contraction, phase image analysis provides an accurate noninvasive method of detecting abnormal foci of ventricular activation.

  15. Accurate means of detecting and characterizing abnormal patterns of ventricular activation by phase image analysis

    International Nuclear Information System (INIS)

    Botvinick, E.H.; Frais, M.A.; Shosa, D.W.; O'Connell, J.W.; Pacheco-Alvarez, J.A.; Scheinman, M.; Hattner, R.S.; Morady, F.; Faulkner, D.B.

    1982-01-01

    The ability of scintigraphic phase image analysis to characterize patterns of abnormal ventricular activation was investigated. The pattern of phase distribution and sequential phase changes over both right and left ventricular regions of interest were evaluated in 16 patients with normal electrical activation and wall motion and compared with those in 8 patients with an artificial pacemaker and 4 patients with sinus rhythm with the Wolff-Parkinson-White syndrome and delta waves. Normally, the site of earliest phase angle was seen at the base of the interventricular septum, with sequential change affecting the body of the septum and the cardiac apex and then spreading laterally to involve the body of both ventricles. The site of earliest phase angle was located at the apex of the right ventricle in seven patients with a right ventricular endocardial pacemaker and on the lateral left ventricular wall in one patient with a left ventricular epicardial pacemaker. In each case the site corresponded exactly to the position of the pacing electrode as seen on posteroanterior and left lateral chest X-ray films, and sequential phase changes spread from the initial focus to affect both ventricles. In each of the patients with the Wolff-Parkinson-White syndrome, the site of earliest ventricular phase angle was located, and it corresponded exactly to the site of the bypass tract as determined by endocardial mapping. In this way, four bypass pathways, two posterior left paraseptal, one left lateral and one right lateral, were correctly localized scintigraphically. On the basis of the sequence of mechanical contraction, phase image analysis provides an accurate noninvasive method of detecting abnormal foci of ventricular activation

  16. Phase Image Analysis in Conduction Disturbance Patients

    International Nuclear Information System (INIS)

    Kwark, Byeng Su; Choi, Si Wan; Kang, Seung Sik; Park, Ki Nam; Lee, Kang Wook; Jeon, Eun Seok; Park, Chong Hun

    1994-01-01

    It is known that the normal His-Purkinje system provides for nearly synchronous activation of right (RV) and left (LV) ventricles. When His-Purkinje conduction is abnormal, the resulting sequence of ventricular contraction must be correspondingly abnormal. These abnormal mechanical consequences were difficult to demonstrate because of the complexity and the rapidity of its events. To determine the relationship of the phase changes and the abnormalities of ventricular conduction, we performed phase image analysis of Tc-RBC gated blood pool scintigrams in patients with intraventricular conduction disturbances (24 complete left bundle branch block (C-LBBB), 15 complete right bundle branch block (C-RBBB), 13 Wolff-Parkinson-White syndrome (WPW), 10 controls). The results were as follows; 1) The ejection fraction (EF), peak ejection rate (PER), and peak filling rate (PFR) of LV in gated blood pool scintigraphy (GBPS) were significantly lower in patients with C-LBBB than in controls (44.4 ± 13.9% vs 69.9 ± 4.2%, 2.48 ± 0.98 vs 3.51 ± 0,62, 1.76 ± 0.71 vs 3.38 ± 0.92, respectively, p<0.05). 2) In the phase angle analysis of LV, Standard deviation (SD), width of half maximum of phase angle (FWHM), and range of phase angle were significantly increased in patients with C-LBBB than in controls (20.6 + 18.1 vs S.6 + I.8, 22. 5 + 9.2 vs 16.0 + 3.9, 95.7 + 31.7 vs 51.3 + 5.4, respectively, p<0.05). 3) There was no significant difference in EF, PER, PFR between patients with the WolffParkinson-White syndrome and controls. 4) Standard deviation and range of phase angle were significantly higher in patients with WPW syndrome than in controls (10.6 + 2.6 vs 8.6 + 1.8, p<0.05, 69.8 + 11.7 vs 51.3 + 5 4, p<0.001, respectively), however, there was no difference between the two groups in full width of half maximum. 5) Phase image analysis revealed relatively uniform phase across the both ventriles in patients with normal conduction, but markedly delayed phase in the left ventricle

  17. Phase Image Analysis in Conduction Disturbance Patients

    Energy Technology Data Exchange (ETDEWEB)

    Kwark, Byeng Su; Choi, Si Wan; Kang, Seung Sik; Park, Ki Nam; Lee, Kang Wook; Jeon, Eun Seok; Park, Chong Hun [Chung Nam University Hospital, Daejeon (Korea, Republic of)

    1994-03-15

    It is known that the normal His-Purkinje system provides for nearly synchronous activation of right (RV) and left (LV) ventricles. When His-Purkinje conduction is abnormal, the resulting sequence of ventricular contraction must be correspondingly abnormal. These abnormal mechanical consequences were difficult to demonstrate because of the complexity and the rapidity of its events. To determine the relationship of the phase changes and the abnormalities of ventricular conduction, we performed phase image analysis of Tc-RBC gated blood pool scintigrams in patients with intraventricular conduction disturbances (24 complete left bundle branch block (C-LBBB), 15 complete right bundle branch block (C-RBBB), 13 Wolff-Parkinson-White syndrome (WPW), 10 controls). The results were as follows; 1) The ejection fraction (EF), peak ejection rate (PER), and peak filling rate (PFR) of LV in gated blood pool scintigraphy (GBPS) were significantly lower in patients with C-LBBB than in controls (44.4 +- 13.9% vs 69.9 +- 4.2%, 2.48 +- 0.98 vs 3.51 +- 0,62, 1.76 +- 0.71 vs 3.38 +- 0.92, respectively, p<0.05). 2) In the phase angle analysis of LV, Standard deviation (SD), width of half maximum of phase angle (FWHM), and range of phase angle were significantly increased in patients with C-LBBB than in controls (20.6 + 18.1 vs S.6 + I.8, 22. 5 + 9.2 vs 16.0 + 3.9, 95.7 + 31.7 vs 51.3 + 5.4, respectively, p<0.05). 3) There was no significant difference in EF, PER, PFR between patients with the WolffParkinson-White syndrome and controls. 4) Standard deviation and range of phase angle were significantly higher in patients with WPW syndrome than in controls (10.6 + 2.6 vs 8.6 + 1.8, p<0.05, 69.8 + 11.7 vs 51.3 + 5 4, p<0.001, respectively), however, there was no difference between the two groups in full width of half maximum. 5) Phase image analysis revealed relatively uniform phase across the both ventriles in patients with normal conduction, but markedly delayed phase in the left ventricle

  18. Study of building typology of school constructed during the Dutch Colonial Period in Indonesia. Case study of Hoogere Burgerschool (HBS) in Bandung

    Science.gov (United States)

    Sarwo Wibowo, Arif

    2018-03-01

    Bandung is one of the most important colonial cities in Indonesia. In the early 20th century the capital city of Dutch East-Indies Government planned to move in Bandung. Critical infrastructures were intensively built during that period, such as streets and railways, houses, governmental buildings, train stations, hospitals and educational facilities. Besides the famous campus of Technische Hoogeschool te Bandoeng (ITB), still in the same period, several schools were also constructed. One of the most important schools was Hoogere Burgerschool in Bandung (HBS Bandung), now SMUN 3 and 5, Bandung designed by Charles Prosper Wolff Schoemaker and constructed in 1915. HBS Bandung was the fourth HBS constructed by Dutch East Indies Government, therefore became important and put itself as a reference for the later school buildings in Bandung. This study is analyzing how the architects’ frame of mind in producing this design works. Survey and direct data collecting were used to take the exact embodiment of building design. Usage and functional analysis were also used to match space and other standard used in a school building at that time. This study will give an understanding of building typology of school during the Dutch Colonial Period in Indonesia.

  19. Nonequilibrium steady states and resonant tunneling in time-periodically driven systems with interactions

    Science.gov (United States)

    Qin, Tao; Hofstetter, Walter

    2018-03-01

    Time-periodically driven systems are a versatile toolbox for realizing interesting effective Hamiltonians. Heating, caused by excitations to high-energy states, is a challenge for experiments. While most setups so far address the relatively weakly interacting regime, it is of general interest to study heating in strongly correlated systems. Using Floquet dynamical mean-field theory, we study nonequilibrium steady states (NESS) in the Falicov-Kimball model, with time-periodically driven kinetic energy or interaction. We systematically investigate the nonequilibrium properties of the NESS. For a driven kinetic energy, we show that resonant tunneling, where the interaction is an integer multiple of the driving frequency, plays an important role in the heating. In the strongly correlated regime, we show that this can be well understood using Fermi's golden rule and the Schrieffer-Wolff transformation for a time-periodically driven system. We furthermore demonstrate that resonant tunneling can be used to control the population of Floquet states to achieve "photodoping." For driven interactions introduced by an oscillating magnetic field near a widely adopted Feshbach resonance, we find that the double occupancy is strongly modulated. Our calculations apply to shaken ultracold-atom systems and to solid-state systems in a spatially uniform but time-dependent electric field. They are also closely related to lattice modulation spectroscopy. Our calculations are helpful to understand the latest experiments on strongly correlated Floquet systems.

  20. λ5-Phosphorus-Containing α-Diazo Compounds: A Valuable Tool for Accessing Phosphorus-Functionalized Molecules.

    Science.gov (United States)

    Marinozzi, Maura; Pertusati, Fabrizio; Serpi, Michaela

    2016-11-23

    The compounds characterized by the presence of a λ 5 -phosphorus functionality at the α-position with respect to the diazo moiety, here referred to as λ 5 -phosphorus-containing α-diazo compounds (PCDCs), represent a vast class of extremely versatile reagents in organic chemistry and are particularly useful in the preparation of phosphonate- and phosphinoxide-functionalized molecules. Indeed, thanks to the high reactivity of the diazo moiety, PCDCs can be induced to undergo a wide variety of chemical transformations. Among them are carbon-hydrogen, as well as heteroatom-hydrogen insertion reactions, cyclopropanation, ylide formation, Wolff rearrangement, and cycloaddition reactions. PCDCs can be easily prepared from readily accessible precursors by a variety of different methods, such as diazotization, Bamford-Stevens-type elimination, and diazo transfer reactions. This evidence along with their relative stability and manageability make them appealing tools in organic synthesis. This Review aims to demonstrate the ongoing utility of PCDCs in the modern preparation of different classes of phosphorus-containing compounds, phosphonates, in particular. Furthermore, to address the lack of precedent collective papers, this Review also summarizes the methods for PCDCs preparation.

  1. Argumentation in elementary science education: addressing methodological issues and conceptual understanding

    Science.gov (United States)

    Kaya, Ebru

    2017-11-01

    In this review essay I respond to issues raised in Mijung Kim and Wolff-Michael Roth's paper titled "Dialogical argumentation in elementary science classrooms", which presents a study dealing with dialogical argumentation in early elementary school classrooms. Since there is very limited research on lower primary school students' argumentation in school science, their paper makes a contribution to research on children's argumentation skills. In this response, I focus on two main issues to extend the discussion in Kim and Roth's paper: (a) methodological issues including conducting a quantitative study on children's argumentation levels and focusing on children's written argumentation in addition to their dialogical argumentation, and (b) investigating children's conceptual understanding along with their argumentation levels. Kim and Roth emphasize the difficulty in determining the level of children's argumentation through the Toulmin's Argument Pattern and lack of high level arguments by children due to their difficulties in writing texts. Regarding these methodological issues, I suggest designing quantitative research on coding children's argument levels because such research could potentially provide important findings on children's argumentation. Furthermore, I discuss alternative written products including posters, figures, or pictures generated by children in order to trace children's arguments, and finally articulating argumentation and conceptual understanding of children.

  2. [Contribution of Berlin clinics and especially the Charité to the development of modern anesthesia in Germany].

    Science.gov (United States)

    Wauer, H J; Kühne, H; Kox, W J

    2000-01-01

    Soon after announcement of the first American ether anesthesias in 1846 one started to anesthetize with ether in Europe. The first ether anesthesia in Germany took place on January 24th, 1947, and was given by Johann Ferdinand Heyfelder in Erlangen. Two weeks later the first ether anesthesia in Berlin was given on February 6th, 1847, by the orthopaedic surgeon Heimann-Wolff Berend. On February 12th, 1847, the surgeon Johann Friedrich Dieffenbach used ether to anesthetize a patient in the Berlin university hospital. Still in 1847 he published his book "The Ether against Pain" which used to be the standard textbook of anesthesia in Germany for many years to come. On February 15th, 1847, Johann Christian Jüngken operated his first patient under ether anesthesia in the surgical department of the Charité hospital assisted by Rudolf Virchow. Since then several famous Berlin surgeons influenced the development of modern anesthesia until the middle of the 20th century. The nitrous oxide bottle was introduced into practice by the Barth company in cooperation with the dentist Carl Sauer and Kurt Schimmelbusch introduced his mask for ether anesthesia. Carl Ludwig Schleich reported at the German congress of surgery in 1894 about his first experience with infiltration anesthesia. Spinal anesthesia developed by August Bier in Kiel was improved during his time in Berlin.

  3. Parliamentarian sovereignty and technical development

    International Nuclear Information System (INIS)

    Dreier, H.; Hofmann, J.

    1986-01-01

    The title indicates the points of main emphasis of the contributions, and points to the programme embodied in the volume. The question is - given the tremendous and ever increasing amount of secondary problems associated with a heated technology development - whether the 'sovereign' state is at all capable of controlling, piloting and fostering technic-scientific processes. The first part ('sovereignty and parliamentarian legislator state') concentrates on the history of notions and ideas in the concept of the sovereign, modern state, and on the constitutional law in force (Dreier, Frohn); the current efficiency of parliament as an organ of control in the process of legislation is investigated (Schulze-Fielitz). The central concern of part 2 ('environmental law and technical development') are topical questions of environmental law (Hofmann, Luebbe-Wolff). Besides the analysis of dogmatic problems of a special administrative law, the major issue is whether and in how far - given modern large-scale technologies - law can adequately govern technique (Schmidt). By analyzing the relationship between technical development and possibilities for guidance by a parliamentarian constitutional state, the articles deal with a central point of intersection between state and administrative law. (orig./HP) [de

  4. Building-Up of a DNA Barcode Library for True Bugs (Insecta: Hemiptera: Heteroptera) of Germany Reveals Taxonomic Uncertainties and Surprises

    Science.gov (United States)

    Raupach, Michael J.; Hendrich, Lars; Küchler, Stefan M.; Deister, Fabian; Morinière, Jérome; Gossner, Martin M.

    2014-01-01

    During the last few years, DNA barcoding has become an efficient method for the identification of species. In the case of insects, most published DNA barcoding studies focus on species of the Ephemeroptera, Trichoptera, Hymenoptera and especially Lepidoptera. In this study we test the efficiency of DNA barcoding for true bugs (Hemiptera: Heteroptera), an ecological and economical highly important as well as morphologically diverse insect taxon. As part of our study we analyzed DNA barcodes for 1742 specimens of 457 species, comprising 39 families of the Heteroptera. We found low nucleotide distances with a minimum pairwise K2P distance 2.2% were detected for 16 traditionally recognized and valid species. With a successful identification rate of 91.5% (418 species) our study emphasizes the use of DNA barcodes for the identification of true bugs and represents an important step in building-up a comprehensive barcode library for true bugs in Germany and Central Europe as well. Our study also highlights the urgent necessity of taxonomic revisions for various taxa of the Heteroptera, with a special focus on various species of the Miridae. In this context we found evidence for on-going hybridization events within various taxonomically challenging genera (e.g. Nabis Latreille, 1802 (Nabidae), Lygus Hahn, 1833 (Miridae), Phytocoris Fallén, 1814 (Miridae)) as well as the putative existence of cryptic species (e.g. Aneurus avenius (Duffour, 1833) (Aradidae) or Orius niger (Wolff, 1811) (Anthocoridae)). PMID:25203616

  5. Synthesis of three bromophenols from red algae as PTP1B inhibitors

    Science.gov (United States)

    Guo, Shuju; Li, Jing; Li, Ting; Shi, Dayong; Han, Lijun

    2011-01-01

    Bromophenols are a set of natural products widely distributed in seaweed, most of which exhibit interesting and useful biological activities. To develop a reliable and efficient synthetic route to these natural bromophenols, three of them, 3,4-dibromo-5-(2'-bromo-3',4'-dihydroxy-6'-methoxymethyl-benzyl)-benzene-1,2-diol (compound 9), 3,4-dibromo-5-(2'-bromo-6'-ethoxy methyl-3',4'-dihydroxybenzyl)-benzene-1,2-diol (compound 10), and 3-bromo-4-(3'-bromo-4',5'-dihydroxy benzyl)-5-(ethoxymethyl)-benzene-1,2-diol (compound 14), isolated from red marine algae, have been synthesized in eight steps with an overall yield of 14.4%, 14.4%, and 18.2% respectively, via a practical approach employing bromination, Wolff-Kishner-Huang reduction and a Friedel-Crafts reaction as key steps. The protein tyrosine phosphatase 1B (PTP1B) inhibitory activities of the synthetic compounds were evaluated by the colorimetric assay. The results show that these compounds are moderate PTP1B inhibitors. The synthesis of these bromophenol derivatives makes in vivo studies of their structure-activity relationships and inhibition activity against PTP1B possible.

  6. The Wolffian roots of Kant's teleology.

    Science.gov (United States)

    van den Berg, Hein

    2013-12-01

    Kant's teleology as presented in the Critique of Judgment is commonly interpreted in relation to the late eighteenth-century biological research of Johann Friedrich Blumenbach. In the present paper, I show that this interpretative perspective is incomplete. Understanding Kant's views on teleology and biology requires a consideration of the teleological and biological views of Christian Wolff and his rationalist successors. By reconstructing the Wolffian roots of Kant's teleology, I identify several little known sources of Kant's views on biology. I argue that one of Kant's main contributions to eighteenth-century debates on biology consisted in demarcating biology from metaphysics. Kant rejected Wolffian views on the hierarchy of sciences, according to which propositions specifying the functions of organisms are derived from theological truths. In addition, Kant argued that organic self-organization necessitates a teleological description in order to show that self-organization does not support materialism. By demarcating biology and metaphysics, Kant made a small yet important contribution to establishing biology as a science. Copyright © 2013 Elsevier Ltd. All rights reserved.

  7. Charles Darwin and the origins of plant evolutionary developmental biology.

    Science.gov (United States)

    Friedman, William E; Diggle, Pamela K

    2011-04-01

    Much has been written of the early history of comparative embryology and its influence on the emergence of an evolutionary developmental perspective. However, this literature, which dates back nearly a century, has been focused on metazoans, without acknowledgment of the contributions of comparative plant morphologists to the creation of a developmental view of biodiversity. We trace the origin of comparative plant developmental morphology from its inception in the eighteenth century works of Wolff and Goethe, through the mid nineteenth century discoveries of the general principles of leaf and floral organ morphogenesis. Much like the stimulus that von Baer provided as a nonevolutionary comparative embryologist to the creation of an evolutionary developmental view of animals, the comparative developmental studies of plant morphologists were the basis for the first articulation of the concept that plant (namely floral) evolution results from successive modifications of ontogeny. Perhaps most surprisingly, we show that the first person to carefully read and internalize the remarkable advances in the understanding of plant morphogenesis in the 1840s and 1850s is none other than Charles Darwin, whose notebooks, correspondence, and (then) unpublished manuscripts clearly demonstrate that he had discovered the developmental basis for the evolutionary transformation of plant form.

  8. Effects of repeated potassium iodide administration on genes involved in synthesis and secretion of thyroid hormone in adult male rat.

    Science.gov (United States)

    Lebsir, Dalila; Manens, Line; Grison, Stephane; Lestaevel, Philippe; Ebrahimian, Teni; Suhard, David; Phan, Guillaume; Dublineau, Isabelle; Tack, Karine; Benderitter, Marc; Pech, Annick; Jourdain, Jean-Rene; Souidi, Maâmar

    2018-02-26

    A single dose of potassium iodide (KI) is recommended to reduce the risk of thyroid cancer during nuclear accidents. However in case of prolonged radioiodine exposure, more than one dose of KI may be necessary. This work aims to evaluate the potential toxic effect of repeated administration of KI. Adult Wistar rats received an optimal dose of KI 1 mg/kg over a period of 1, 4 or 8 days. hormonal status (TSH, FT4) of treated rats was unaffected. Contrariwise, a sequential Wolff-Chaikoff effect was observed, resulting in a prompt decrease of NIS and MCT8 mRNA expression (-58% and -26% respectively), followed by a delayed decrease of TPO mRNA expression (-33%) in conjunction with a stimulation of PDS mRNA expression (+62%). we show for the first time that repeated administration of KI at 1 mg/kg/24h doesn't cause modification of thyroid hormones level, but leads to a reversible modification of the expression of genes involved in the synthesis and secretion of thyroid hormones. Copyright © 2018 Elsevier B.V. All rights reserved.

  9. Erazm Goldman’s List of Archives of Old Documents in the Kingdom [of Poland

    Directory of Open Access Journals (Sweden)

    Rafał Jaworski

    2017-12-01

    Full Text Available This edition concerns the 19th-century inventory of Old-Polish noble courts records and municipal records created by Erazm Goldman, an archivist in the Archives of Historical Records in Piotrków. Until now the inventory has been known only indirectly, through Adam Wolff’s publication. During World War II most of Old-Polish judicial and municipal records stored in the Archives of Historical Records in Warsaw were destroyed. Along with archival materials, also finding aids burnt down. In this situation Wolff, preparing a list of losses of pre-partition juducial and municipal records, used the Goldman’s inventory as a fundamental source about the fonds, their internal division and dates. The inventory was created probably between 1843 and 1860. The ground for this edition is a copy of the inventory made in 1872 by Goldman for a legal historian Romuald Hube. It seems that Goldman worked using lists of holdings of particular archives of historical records, produced periodically for the Governmental Committee for Justice. This resulted in dividing materials according to archives and Old-Polish judicial districts. Later the inventory enlists records of municipal courts and provincial courts, divided into series, with dates and numbers of books. In case of municipal records Goldman listed only these towns, which records were stored in a particular archives of historical records.

  10. High-Flow Nasal Cannula Therapy in a Patient with Reperfusion Pulmonary Edema following Percutaneous Transluminal Pulmonary Angioplasty

    Directory of Open Access Journals (Sweden)

    Kiyoshi Moriyama

    2014-01-01

    Full Text Available A 62-year-old woman with Wolff-Parkinson-White syndrome was with recent worsening of dyspnea to New York Heart Association functional status Class III. The patient was diagnosed as having central type chronic thromboembolic pulmonary hypertension. By cardiac catheterization, her mean pulmonary artery pressure was 53 mmHg with total pulmonary resistance 2238 dynes·sec·cm−5. After medical therapies with tadalafil, furosemide, ambrisentan, beraprost, and warfarin were initiated, percutaneous transluminal pulmonary angioplasty (PTPA was performed. Following PTPA, life-threating hypoxemia resulting from postoperative reperfusion pulmonary edema developed. High-flow nasal cannula therapy (HFNC was applied, and 100% oxygen at 50 L/min of flow was required to keep oxygenation. HFNC was continued for 3 days, and the patient was discharged on 8th postoperative day with SpO2 of 97% on 3 L/min of oxygen inhalation. Because of the simplicity of the technique, the lower cost of equipment, and remarkable patient tolerance to the treatment, we speculate that HFNC can take over the post of noninvasive ventilation as first-line therapy for patients with acute respiratory failure.

  11. Diagnosis of accessory conduction pathway using ECG-gated emission CT analysis. Studies in patients with WPW syndrome who underwent surgery

    Energy Technology Data Exchange (ETDEWEB)

    Misaki, Takuro; Mukai, Keiichi; Tsubota, Makoto; Iwa, Takashi; Nakajima, Ken-ichi; Hisada, Kin-ichi

    1987-09-01

    Pinpointing the location of accessory conduction pathway (ACP) is of great importance in the surgical treatment for Wolff-Parkinson-White (WPW) syndrome. For this purpose, this study explored the usefulness of ECG-gated emission computed tomography (Gated-ECT) in 30 patients who preoperatively underwent Gated-ECT. The site of earliest contraction at level of atrioventicular valves, obtained on tomographic phase analysis, was compared with the site of earliest activation, obtained on epicardial mapping during surgery. The concordance rate of the two methods was 94 % (28/30). Among them, one patient was found to have the association of corrected transposition of great arteries on Gated-ECT. Gated-ECT was, however, of limited value in differentiating right posterior ACP from right postseptal ACP. The discordance between the sites of earliest contraction and activation, which was observed in the two others, was likely due to decreased wall motion resulting from myocardial disturbance. Gated-ECT may have a diagnostic potential for the location of ACP, especially in view of providing images that corresponded to the surgical anatomy. (Namekawa, K.).

  12. Ebstein's anomaly as a cause of paroxysmal atrial fibrillation

    Directory of Open Access Journals (Sweden)

    Damjanović Miodrag R.

    2008-01-01

    Full Text Available Background. Ebstein's anomaly is characterized by a displacement of the tricuspid valve toward apex, because of anomalous attachment of the tricuspid leaflets. There are type B of Wolff-Parkinson-White (WPW syndrome and paroxysmal arrhythmias in more than a half of all patients. Case report. We presented a female, 32-year old, with frequent paroxysms of atrial fibrillation. After conversion of rhythm an ECG showed WPW syndrome. Echocardiographic examination discovered normal size of the left cardiac chambers with paradoxical ventricular septal motion. The right ventricle was very small because of its atrialization. The origin of the tricuspid valve was 20 mm closer to apex of the right ventricle than the origin of the mitral valve. Electrophysiological examination showed a posterolateral right accesorial pathway. Atrial fibrillation was induced very easily in electrophysiological laboratory and a successful ablation of accessorial pathway was made. There were no WPW syndrome and paroxysms of atrial fibrillation after that. Conclusion. Ebstein's anomaly is one of the reasons of paroxysmal atrial fibrillation, especially in young persons with WPW syndrome.

  13. Diagnosis of accessory conduction pathway using ECG-gated emission CT analysis

    International Nuclear Information System (INIS)

    Misaki, Takuro; Mukai, Keiichi; Tsubota, Makoto; Iwa, Takashi; Nakajima, Ken-ichi; Hisada, Kin-ichi

    1987-01-01

    Pinpointing the location of accessory conduction pathway (ACP) is of great importance in the surgical treatment for Wolff-Parkinson-White (WPW) syndrome. For this purpose, this study explored the usefulness of ECG-gated emission computed tomography (Gated-ECT) in 30 patients who preoperatively underwent Gated-ECT. The site of earliest contraction at level of atrioventicular valves, obtained on tomographic phase analysis, was compared with the site of earliest activation, obtained on epicardial mapping during surgery. The concordance rate of the two methods was 94 % (28/30). Among them, one patient was found to have the association of corrected transposition of great arteries on Gated-ECT. Gated-ECT was, however, of limited value in differentiating right posterior ACP from right postseptal ACP. The discordance between the sites of earliest contraction and activation, which was observed in the two others, was likely due to decreased wall motion resulting from myocardial disturbance. Gated-ECT may have a diagnostic potential for the location of ACP, especially in view of providing images that corresponded to the surgical anatomy. (Namekawa, K.)

  14. Lysosome-associated hypertrophic cardiomyopathy (Danon's disease in two siblings

    Directory of Open Access Journals (Sweden)

    I. V. Leontyeva

    2015-01-01

    Full Text Available The paper presents a clinical observation of two siblings with Danon's disease (lysosome-associated cardiomyopathy verified by genetic examination. Heart lesion in Danon's disease bears a phenotypic similarity to the primary forms of hypertrophic cardiomyopathy; in this connection the correct etiology of the disease has remained long unestablished. The presence of laboratory markers as the significantly raised levels of transaminases, creatine phosphokinase, and lactate dehydrogenase was as a guide for suspecting the metabolic origin of the disease. Two siblings with a similar LAMP gene mutation were observed to have a different clinical course: a severer clinical course of cardiomyopathy with extreme myocardial hypertrophy, myocardial electric instability, and mental development retardation in one case and a more favorable course in the other; although a 2-year follow-up also revealed negative changes. For the prevention of sudden cardiac death, a cardioverter defibrulator was implanted and continuous therapy with p-adrenoblockers was performed. The specific feature of the cases was no symptoms of skeletal myopathy, moderate mental retardation only in the elder brother, no evidence of an accessory atrioventricular junction despite the fact that there were ECG manifestations of Wolff-Parkinson-White syndrome

  15. A Case Report of Coronary Arteriovenous Fistulas with an Unruptured Coronary Artery Aneurysm Successfully Treated by Surgery

    Directory of Open Access Journals (Sweden)

    Nobuhiro Takeuchi

    2012-01-01

    Full Text Available A 58-year-old female with a history of Wolff-Parkinson-White syndrome presented at our institution with palpitations and chest pain. Electrocardiography revealed paroxysmal supraventricular tachycardia with a heart rate of 188 beats/min. Antiarrhythmic drugs were ineffective, and tachycardia was resolved by electrical cardioversion. Transthoracic echocardiography revealed abnormal vessels around the right coronary artery (RCA and pulmonary artery (PA; in addition, we suspected coronary arteriovenous fistula (CAVF. Coronary angiography and coronary computed tomography revealed dilated fistula vessels, with a 1 cm saccular aneurysm around the RCA, originating from the proximal RCA and left anterior descending artery into the main trunk of PA. Therefore, we confirmed the diagnosis of CAVF with an unruptured aneurysm. We surgically ligated and clipped the fistula vessels and resected the aneurysm. The resected aneurysm measured  cm in size. Pathological examination of the resected aneurysm revealed hypertrophic walls comprising proliferating fibroblasts cells thin elastic fibers. Very few atherosclerotic changes manifested in the aneurysm walls. We report the case of a patient with CAVF and an unruptured coronary artery aneurysm who was successfully treated by surgery.

  16. Model-based imaging of cardiac electrical function in human atria

    Science.gov (United States)

    Modre, Robert; Tilg, Bernhard; Fischer, Gerald; Hanser, Friedrich; Messnarz, Bernd; Schocke, Michael F. H.; Kremser, Christian; Hintringer, Florian; Roithinger, Franz

    2003-05-01

    Noninvasive imaging of electrical function in the human atria is attained by the combination of data from electrocardiographic (ECG) mapping and magnetic resonance imaging (MRI). An anatomical computer model of the individual patient is the basis for our computer-aided diagnosis of cardiac arrhythmias. Three patients suffering from Wolff-Parkinson-White syndrome, from paroxymal atrial fibrillation, and from atrial flutter underwent an electrophysiological study. After successful treatment of the cardiac arrhythmia with invasive catheter technique, pacing protocols with stimuli at several anatomical sites (coronary sinus, left and right pulmonary vein, posterior site of the right atrium, right atrial appendage) were performed. Reconstructed activation time (AT) maps were validated with catheter-based electroanatomical data, with invasively determined pacing sites, and with pacing at anatomical markers. The individual complex anatomical model of the atria of each patient in combination with a high-quality mesh optimization enables accurate AT imaging, resulting in a localization error for the estimated pacing sites within 1 cm. Our findings may have implications for imaging of atrial activity in patients with focal arrhythmias.

  17. Phase analysis in gated blood pool tomography

    International Nuclear Information System (INIS)

    Nakajima, Kenichi; Bunko, Hisashi; Tada, Akira; Taki, Junichi; Nanbu, Ichiro

    1984-01-01

    Phase analysis of gated blood pool study has been applied to detect the site of accessory conduction pathway (ACP) in the Wolff-Parkinson-White (WPW) syndrome; however, there was a limitation to detect the precise location of ACP by phase analysis alone. In this study, we applied phase analysis to gated blood pool tomography using seven pin hole tomography (7PT) and gated emission computed tomography (GECT) in 21 patients with WPW syndrome and 3 normal subjects. In 17 patients, the sites of ACPs were confirmed by epicardial mapping and the result of the surgical division of ACP. In 7PT, the site of ACP grossly agreed to the abnormal initial phase in phase image in 5 out of 6 patients with left cardiac type. In GECT, phase images were generated in short axial, vertical and horizontal long axial sections. In 8 out of 9 patients, the site of ACP was correctly identified by phase images, and in a patient who had two ACPs, initial phase corresponded to one of the two locations. Phase analysis of gated blood pool tomography has advantages for avoiding overlap of blood pools and for estimating three-dimensional propagation of the contraction, and can be a good adjunctive method in patients with WPW syndrome. (author)

  18. Quantification of wall motion and phase of contraction in tomographic gated blood pool studies using length-based Fourier analysis

    Energy Technology Data Exchange (ETDEWEB)

    Nakajima, Kenichi; Bunko, Hisashi; Taki, Junichi; Nambu, Ichiro; Shiire, Yasushi; Tonami, Norihisa; Hisada, Kinichi; Tada, Akira; Kojima, Kazuhkio

    1985-03-01

    Length-based Fourier analysis, a new method for quantification of wall motion and timing of contraction, was applied to tomographic gated blood pool study. Two parameters, percent-length shortening (%LS) and length-based phase were calculated based on the time-length curves from a center to ventricular edges, and compared with the count-based method. In mathematical models for tomographic gated blood pool images, the severity of asynergy was easily determined by length-based method, and the accuracy of the parameters was good. As to the setting of the center, fixed center provided more reliable parameters than the method using movable center, i.e., when a center of gravity was determined in each frame. By length-based Fourier analysis, quantification of wall motion was easily performed, and the initial inward movement caused by the accessory conduction pathway was assessed in patients with Wolff-Parkinson-White syndrome. Length-based approach was considered to be reasonable and effective because the movements of the ventricular edges are essential in tomographic gated blood pool images.

  19. Pre-excitation pattern associated with accessory pathway related tachycardia: Case report

    Directory of Open Access Journals (Sweden)

    Burazor Mirko

    2010-01-01

    Full Text Available Introduction. Pre-excitation is based on an accessory conduction pathway between the atrium and ventricle. The term Wolff- Parkinson-White (WPW syndrome is used for patients with the pre-excitation/WPW pattern associated with AP-related tachycardia. Case Outline. We present a 52-year-old man with severe palpitation, fatigue, lightheadedness and difficulty breathing. The initial ECG showed tachyarrhythmia with heart rate between 240 and 300/min. He was treated with antiarrhythmics (Digitalis, Verapamil, Lidocaine with no response. Then, the patient was treated with electrical cardioversion and was referred to our Clinic for further evaluation with the diagnosis: “Ventricular tachycardia”. During in-hospital stay, the previously undiagnosed WPW pattern had been seen. Additional diagnostic tests confirmed permanent pre-excitacion pattern (ECG Holter recording, exercises test. The patient was referred to an electrophysiologist for further evaluation. Mapping techniques provided an accurate assessment of the position of the accessory pathway which was left lateral. The elimination of the accessory pathway by radiofrequent catheter ablation is highly effective in termination and elimination of tacchyarrhythmias. Conclusion. Symptomatic, life-threatening arrhythmia, first considered as ventricular tachycardia, reflected atrial fibrillation with ventricular pre-excitation over an accessory pathway in a patient with previously undiagnosed WPW syndrome.

  20. Quantification of wall motion and phase of contraction in tomographic gated blood pool studies using length-based Fourier analysis

    International Nuclear Information System (INIS)

    Nakajima, Kenichi; Bunko, Hisashi; Taki, Junichi; Nambu, Ichiro; Shiire, Yasushi; Tonami, Norihisa; Hisada, Kinichi; Tada, Akira; Kojima, Kazuhiko.

    1985-01-01

    Length-based Fourier analysis, a new method for quantification of wall motion and timing of contraction, was applied to tomographic gated blood pool study. Two parameters, percent-length shortening (%LS) and length-based phase were calculated based on the time-length curves from a center to ventricular edges, and compared with the count-based method. In mathematical models for tomographic gated blood pool images, the severity of asynergy was easily determined by length-based method, and the accuracy of the parameters was good. As to the setting of the center, fixed center provided more reliable parameters than the method using movable center, i.e., when a center of gravity was determined in each frame. By length-based Fourier analysis, quantification of wall motion was easily performed, and the initial inward movement caused by the accessory conduction pathway was assessed in patients with Wolff-Parkinson-White syndrome. Length-based approach was considered to be reasonable and effective because the movements of the ventricular edges are essential in tomographic gated blood pool images. (author)

  1. Normal and abnormal electrical activation of the heart. Imaging patterns obtained by phase analysis of equilibrium cardiac studies

    International Nuclear Information System (INIS)

    Pavel, D.; Byrom, E.; Swiryn, S.; Meyer-Pavel, C.; Rosen, K.

    1981-01-01

    By using a temporal Fourier analysis of gated equilibrium cardiac studies, phase images were obtained. These functional images were analysed qualitatively and quantitatively to determine if specific patterns can be found for normal versus abnormal electrical activation of the heart. The study included eight subjects with normal cardiac function and 24 patients with abnormal electrical activation: eight with left bundle branch block (LBBB), two with right bundle branch block (RBBB), six with Wolff-Parkinson-White syndrome (WPW), one with junctional rhythm, one with spontaneous sustained ventricular tachycardia (VT) (all with normal wall motion), two with chronic transvenous pacemakers, and four with induced sustained VT (all with regional wall motion abnormalities). The results show that the two ventricals have the same mean phase (within +-9 0 ) in normals, but significantly different mean phases in all patients with bundle branch blocks. Of the six WPW patients, three had a distinctive abnormal pattern. The patient with junctional rhythm, those with transvenous pacemakers, and those with VT all had abnormal patterns on the phase image. The phase image is capable of showing differences between patients with electrical activation and a variety of electrical abnormalities. Within the latter category distinct patterns can be associated with each type of abnormality. (author)

  2. Phase analysis in gated blood pool tomography. Detection of accessory conduction pathway

    Energy Technology Data Exchange (ETDEWEB)

    Nakajima, Kenichi; Bunko, Hisashi; Tada, Akira; Taki, Junichi; Nanbu, Ichiro (Kanazawa Univ. (Japan). School of Medicine)

    1984-02-01

    Phase analysis of gated blood pool study has been applied to detect the site of accessory conduction pathway (ACP) in the Wolff-Parkinson-White (WPW) syndrome; however, there was a limitation to detect the precise location of ACP by phase analysis alone. In this study, we applied phase analysis to gated blood pool tomography using seven pin hole tomography (7PT) and gated emission computed tomography (GECT) in 21 patients with WPW syndrome and 3 normal subjects. In 17 patients, the sites of ACPs were confirmed by epicardial mapping and the result of the surgical division of ACP. In 7PT, the site of ACP grossly agreed to the abnormal initial phase in phase image in 5 out of 6 patients with left cardiac type. In GECT, phase images were generated in short axial, vertical and horizontal long axial sections. In 8 out of 9 patients, the site of ACP was correctly identified by phase images, and in a patient who had two ACPs, initial phase corresponded to one of the two locations. Phase analysis of gated blood pool tomography has advantages for avoiding overlap of blood pools and for estimating three-dimensional propagation of the contraction, and can be a good adjunctive method in patients with WPW syndrome.

  3. Persistent Visual Aura following Catheter Ablation in a Patient with WPW Syndrome

    Directory of Open Access Journals (Sweden)

    Shinichi Koyama

    2007-01-01

    Full Text Available We report a patient who has had persistent visual disturbances since she underwent catheter ablation to treat her Wolff-Parkinson-White (WPW syndrome. We examined her visual symptoms carefully and quantitatively by means of our newly developed method combining image-processing and psychophysics. We first simulated the patient’s visual symptoms using image-processing techniques. Since the simulation indicated that she would be very sensitive to the edges of the visual stimuli, we evaluated her sensitivity to the edges using psychophysics. The results indicated that she was hypersensitive to the clear-cut edges of the visual stimuli. Her visual symptoms were very similar to those of visual aura of migraine, rather than those of photosensitive epilepsy. Magnetic resonance imaging (MRI and single photon emission computed tomography (SPECT, electroenchepalogram (EEG, and visual-evoked potentials (VEP in the patient were normal. No abnormalities in her fundus, visual field, or electroretinogram were found, either. Transesophageal echocardiography with bubble study indicated that she had a preexisting right-to-left shunt. We hypothesize that visual aura of migraine was triggered and made persistent by the catheter ablation in this patient. Although the relationship between migraine, catheter ablation, and right-to-left shunts is unknown, previous studies on the transcatheter closure of patent foramen ovale suggest a possible link between them. Catheter ablation in patients with migraine and preexisting shunts may lead to exacerbations in migraine symptoms.

  4. Parental practices of Italian mothers and fathers during early infancy: The role of knowledge about parenting and child development.

    Science.gov (United States)

    Scarzello, Donatella; Arace, Angelica; Prino, Laura Elvira

    2016-08-01

    Our contribution aims to verify whether parental knowledge about child development and parenting constitutes a protective factor in the application of dysfunctional educational practices. Numerous studies have found that parental knowledge has a great influence on parenting, however it remains unclear whether both are casually linked in a direct and linear way. Data currently available on parental knowledge almost exclusively refers to mothers and subjects at risk. Furthermore, there are almost no studies which take into consideration subjects who are Italian citizens. In contrast our work takes into consideration a normative sample of 157 Italian couples who are the parents of children aged between 16 and 36 months and who completed the Knowledge of Infant Development Inventory (KIDI; MacPhee, 1981) and the Parenting Scale (Arnold, O'Leary, Wolff, & Acker, 1993). The results highlight differences between mothers and fathers, both in terms of knowledge levels (higher for mothers) and educational practices (maternal practices are more frequently dysfunctional); knowledge influences educational practices above all in the case of fathers, although said effect is slight, which supports the idea that interaction between knowledge and parental practices is not linear but rather mediated by other factors. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. THE NuSTAR X-RAY SPECTRUM OF HERCULES X-1: A RADIATION-DOMINATED RADIATIVE SHOCK

    Energy Technology Data Exchange (ETDEWEB)

    Wolff, Michael T.; Wood, Kent S. [Space Science Division, Naval Research Laboratory, Washington, DC 20375-5352 (United States); Becker, Peter A. [Department of Physics and Astronomy, George Mason University, Fairfax, VA 22030-4444 (United States); Gottlieb, Amy M.; Marcu-Cheatham, Diana M.; Pottschmidt, Katja [Department of Physics and Center for Space Science and Technology, University of Maryland Baltimore County, Baltimore, MD 21250 (United States); Fürst, Felix [Cahill Center for Astronomy and Astrophysics, California Institute of Technology, Pasadena, CA 91125 (United States); Hemphill, Paul B. [Center for Astrophysics and Space Sciences, University of California, San Diego, 9500 Gilman Dr., La Jolla, CA 92093-0424 (United States); Schwarm, Fritz-Walter; Wilms, Jörn [Dr. Karl-Remeis-Sternwarte and ECAP, Sternwartstr, 7, D-96049 Bamberg (Germany)

    2016-11-10

    We report on new spectral modeling of the accreting X-ray pulsar Hercules X-1. Our radiation-dominated radiative shock model is an implementation of the analytic work of Becker and Wolff on Comptonized accretion flows onto magnetic neutron stars. We obtain a good fit to the spin-phase-averaged 4–78 keV X-ray spectrum observed by the Nuclear Spectroscopic Telescope Array during a main-on phase of the Her X-1 35 day accretion disk precession period. This model allows us to estimate the accretion rate, the Comptonizing temperature of the radiating plasma, the radius of the magnetic polar cap, and the average scattering opacity parameters in the accretion column. This is in contrast to previous phenomenological models that characterized the shape of the X-ray spectrum, but could not determine the physical parameters of the accretion flow. We describe the spectral fitting details and discuss the interpretation of the accretion flow physical parameters.

  6. Value of local electrogram characteristics predicting successful catheter ablation of left-versus right-sided accessory atrioventricular pathways by radiofrequency current.

    Science.gov (United States)

    Lin, J L; Schie, J T; Tseng, C D; Chen, W J; Cheng, T F; Tsou, S S; Chen, J J; Tseng, Y Z; Lien, W P

    1995-01-01

    Despite similar guidance by local electrogram criteria, catheter ablation of right-sided accessory atrioventricular (AV) pathways by radiofrequency current has been less effective than that of left-sided ones. In order to elucidate the possible diversities in local electrosignal criteria, we systematically analyzed the morphological and timing characteristics of 215 bipolar local electrograms from catheter ablation sites of 65 left-sided accessory AV pathways and of 356 from those of 37 right-sided ones in 92 consecutive patients with Wolff-Parkinson-White syndrome or AV reentrant tachycardia incorporating concealed accessory AV pathways. After stepwise multivariate analysis, we selected the presence of a possible accessory pathway potential, local ventricular activation preceding QRS complex for 20 ms or more during ventricular insertion mapping, and the local retrograde ventriculoatrial (VA) continuity, local retrograde VA interval right-sided targets only) during atrial insertion mapping, as independent local electrogram predictors for successful ablation of left- and right-sided accessory AV pathways. Combination of all local electrogram predictors could have moderate chance of success (80 and 51%) for the ventricular and atrial insertion ablation of left-sided accessory AV pathways, but only low probability of success (40% in ventricular insertion ablation) or very low sensitivity (12.5% in atrial insertion ablation) for right-sided ones. In conclusion, with the present approach, successful catheter ablation of right-sided accessory AV pathways, compared to left-sided ones, still necessitate a breakthrough in the precision mapping and the efficiency of energy delivery.

  7. Realization of a scenario with two relaxation rates in the Hubbard Falicov-Kimball model

    Science.gov (United States)

    Barman, H.; Laad, M. S.; Hassan, S. R.

    2018-02-01

    A single transport relaxation rate governs the decay of both longitudinal and Hall currents in Landau Fermi liquids (FL). Breakdown of this fundamental feature, first observed in two-dimensional cuprates and subsequently in other three-dimensional correlated systems close to the Mott metal-insulator transition, played a pivotal role in emergence of a non-FL (NFL) paradigm in higher dimensions D (>1 ) . Motivated hereby, we explore the emergence of this "two relaxation rates" scenario in the Hubbard Falicov-Kimball model (HFKM) using the dynamical mean-field theory (DMFT). Specializing to D =3 , we find, beyond a critical Falicov-Kimball (FK) interaction, that two distinct relaxation rates governing distinct temperature (T ) dependence of the longitudinal and Hall currents naturally emerges in the NFL metal. Our results show good accord with the experiment in V2 -yO3 near the metal-to-insulator transition (MIT). We rationalize this surprising finding by an analytical analysis of the structure of charge and spin Hamiltonians in the underlying impurity problem, specifically through a bosonization method applied to the Wolff model and connecting it to the x-ray edge problem.

  8. High speed photometry of AN UMa

    International Nuclear Information System (INIS)

    Imamura, J.N.; Steiman-Cameron, T.Y.; Durisen, R.H.

    1985-01-01

    As a class, the AM Her objects exhibit temporal variability on time scales ranging from seconds to years. Most of the variations can be adequately described by ''shot noise'' models (Cordova and Mason 1982). Exceptions to this are the strictly periodic features modulated on the orbital periods of the systems (typically several hours) and the one to two second features which show up as ''excesses'' of power in the time averaged power spectra of AN UMa (Middleditch 1982) and E1405-451 (Mason et al. 1983; Larsson 1985). It has been suggested that the short time scale features are due to an oscillatory ''instability'' of radiative accretion shocks discovered by Langer, Chanmugam, and Shaviv (1981, 1982). This is an interesting suggestion because, if true, it would allow the masses of the accreting white dwarfs to be inferred and would provide other significant constraints on the physics of the accretion flows (see Langer et al. 1981, 1982; Chevalier and Imamura 1982; Imamura, Wolff, and Durisen 1984; Imamura 1985). Unfortunately, a direct physical relationship between the one to two second optical variations and shock oscillations has not yet been demonstrated. Because of the potential importance of such a result further study of these systems is clearly warranted. In this work, we examine the short time scale behavior of AN UMa in more detail and improve on the work of Middleditch (1982) by resolving the feature in time

  9. Whole ceramic-like microreactors from inorganic polymers for high temperature or/and high pressure chemical syntheses.

    Science.gov (United States)

    Ren, Wurong; Perumal, Jayakumar; Wang, Jun; Wang, Hao; Sharma, Siddharth; Kim, Dong-Pyo

    2014-02-21

    Two types of whole ceramic-like microreactors were fabricated from inorganic polymers, polysilsesquioxane (POSS) and polyvinylsilazane (PVSZ), that were embedded with either perfluoroalkoxy (PFA) tube or polystyrene (PS) film templates, and subsequently the templates were removed by physical removal (PFA tube) or thermal decomposition (PS). A POSS derived ceramic-like microreactor with a 10 cm long serpentine channel was obtained by an additional "selective blocking of microchannel" step and subsequent annealing at 300 °C for 1 h, while a PVSZ derived ceramic-like microreactor with a 14 cm long channel was yielded by a co-firing process of the PVSZ-PS composite at 500 °C for 2 h that led to complete decomposition of the film template leaving a microchannel behind. The obtained whole ceramic-like microfluidic devices revealed excellent chemical and thermal stabilities in various solvents, and they were able to demonstrate unique chemical performance at high temperature or/and high pressure conditions such as Michaelis-Arbuzov rearrangement at 150-170 °C, Wolff-Kishner reduction at 200 °C, synthesis of super-paramagnetic Fe3O4 nanoparticles at 320 °C and isomerisation of allyloxybenzene to 2-allylphenol (250 °C and 400 psi). These economic ceramic-like microreactors fabricated by a facile non-lithographic method displayed excellent utility under challenging conditions that is superior to any plastic microreactors and comparable to glass and metal microreactors with high cost.

  10. Successful Ablation of Antero-septal Accessory Pathway in the Non-Coronary Cusp in a Child

    Directory of Open Access Journals (Sweden)

    Daisuke Kobayashi, MD

    2012-05-01

    Full Text Available A 15-year-old boy with Wolff-Parkinson-White syndrome underwent an electrophysiology study for symptoms of palpitations and persistence of pre-excitation during peak exercise. He was detected to have right antero-septal accessory pathway with relatively long effective refractory period and no inducible tachycardia. He had only transient normalization with cryoablation. Eight months later, he presented again with two episodes of seizures with preceding palpitations. Neurology evaluation was unremarkable with a normal electroencephalogram. In view of his symptoms in association with evidence of pre-excitation, he underwent a second electrophysiology study with ablation. Cryoablation in the anterior septum again achieved only transient normalization. Mapping in the non-coronary cusp identified an earliest accessory pathway potential. RF ablation was performed in the non- coronary cusp with immediate normalization of his electrocardiogram. At 6 month follow-up, he continues to have no pre-excitation on his EKG. Ablation of the anteroseptal accessory pathway in the non-coronary cusp can be safely performed in patients’ refractory to conventional ablation sites and techniques.

  11. Explicit construction of quasiconserved local operator of translationally invariant nonintegrable quantum spin chain in prethermalization

    Science.gov (United States)

    Lin, Cheng-Ju; Motrunich, Olexei I.

    2017-12-01

    We numerically construct translationally invariant quasiconserved operators with maximum range M , which best commute with a nonintegrable quantum spin chain Hamiltonian, up to M =12 . In the large coupling limit, we find that the residual norm of the commutator of the quasiconserved operator decays exponentially with its maximum range M at small M , and turns into a slower decay at larger M . This quasiconserved operator can be understood as a dressed total "spin-z " operator, by comparing with the perturbative Schrieffer-Wolff construction developed to high order reaching essentially the same maximum range. We also examine the operator inverse participation ratio of the operator, which suggests its localization in the operator Hilbert space. The operator also shows an almost exponentially decaying profile at short distance, while the long-distance behavior is not clear due to limitations of our numerical calculation. Further dynamical simulation confirms that the prethermalization-equilibrated values are described by a generalized Gibbs ensemble that includes such quasiconserved operator.

  12. Capturing microscopic features of bone remodeling into a macroscopic model based on biological rationales of bone adaptation.

    Science.gov (United States)

    Kim, Young Kwan; Kameo, Yoshitaka; Tanaka, Sakae; Adachi, Taiji

    2017-10-01

    To understand Wolff's law, bone adaptation by remodeling at the cellular and tissue levels has been discussed extensively through experimental and simulation studies. For the clinical application of a bone remodeling simulation, it is significant to establish a macroscopic model that incorporates clarified microscopic mechanisms. In this study, we proposed novel macroscopic models based on the microscopic mechanism of osteocytic mechanosensing, in which the flow of fluid in the lacuno-canalicular porosity generated by fluid pressure gradients plays an important role, and theoretically evaluated the proposed models, taking biological rationales of bone adaptation into account. The proposed models were categorized into two groups according to whether the remodeling equilibrium state was defined globally or locally, i.e., the global or local uniformity models. Each remodeling stimulus in the proposed models was quantitatively evaluated through image-based finite element analyses of a swine cancellous bone, according to two introduced criteria associated with the trabecular volume and orientation at remodeling equilibrium based on biological rationales. The evaluation suggested that nonuniformity of the mean stress gradient in the local uniformity model, one of the proposed stimuli, has high validity. Furthermore, the adaptive potential of each stimulus was discussed based on spatial distribution of a remodeling stimulus on the trabecular surface. The theoretical consideration of a remodeling stimulus based on biological rationales of bone adaptation would contribute to the establishment of a clinically applicable and reliable simulation model of bone remodeling.

  13. The Universe according to Schroedinger and Milo

    Science.gov (United States)

    Wolff, Milo

    2009-10-01

    The puzzling electron is due to the belief that it is a discrete particle. Schroedinger, (1937) eliminated discrete particles writing: What we observe as material bodies and forces are nothing but shapes and variations in the structure of space. Particles are just schaumkommen (appearances). Thus he rejected wave-particle duality. Schroedinger's concept was developed by Milo Wolff using a Scalar Wave Equation in 3D quantum space to find wave solutions. The resulting Wave Structure of Matter (WSM) contains all the electron's properties including the Schroedinger Equation. Further, Newton's Law F=ma is no longer a puzzle; It originates from Mach's principle of inertia (1883) that depends on the space medium and the WSM. These the origin of all the Natural Laws. Carver Mead (1999) at CalTech used the WSM to design Intel micro-chips and to correct errors of Maxwell's Equations. Applications of the WSM describe matter at molecular dimensions: Industrial alloys, catalysts, biology and medicine, molecular computers and memories. See book ``Schroedinger's Universe'' - at Amazon.com. Pioneers of the WSM are growing rapidly. Some are: SpaceAndMotion.com, QuantumMatter.com, treeincarnation.com/audio/milowolff.htm, daugerresearch.com/orbitals/index.shtml, glafreniere.com/matter.html =A new Universe.

  14. Schroedinger's Wave Structure of Matter (WSM)

    Science.gov (United States)

    Wolff, Milo; Haselhurst, Geoff

    2009-10-01

    The puzzling electron is due to the belief that it is a discrete particle. Einstein deduced this structure was impossible since Nature does not allow the discrete particle. Clifford (1876) rejected discrete matter and suggested structures in `space'. Schroedinger, (1937) also eliminated discrete particles writing: What we observe as material bodies and forces are nothing but shapes and variations in the structure of space. Particles are just schaumkommen (appearances). He rejected wave-particle duality. Schroedinger's concept was developed by Milo Wolff and Geoff Haselhurst (SpaceAndMotion.com) using the Scalar Wave Equation to find spherical wave solutions in a 3D quantum space. This WSM, the origin of all the Natural Laws, contains all the electron's properties including the Schroedinger Equation. The origin of Newton's Law F=ma is no longer a puzzle; It originates from Mach's principle of inertia (1883) that depends on the space medium and the WSM. Carver Mead (1999) at CalTech used the WSM to design Intel micro-chips correcting errors of Maxwell's magnetic Equations. Applications of the WSM also describe matter at molecular dimensions: alloys, catalysts, biology and medicine, molecular computers and memories. See ``Schroedinger's Universe'' - at Amazon.com

  15. Space: the final frontier in the learning of science?

    Science.gov (United States)

    Milne, Catherine

    2014-03-01

    In Space, relations, and the learning of science, Wolff-Michael Roth and Pei-Ling Hsu use ethnomethodology to explore high school interns learning shopwork and shoptalk in a research lab that is located in a world class facility for water quality analysis. Using interaction analysis they identify how spaces, like a research laboratory, can be structured as smart spaces to create a workflow (learning flow) so that shoptalk and shopwork can projectively organize the actions of interns even in new and unfamiliar settings. Using these findings they explore implications for the design of curriculum and learning spaces more broadly. The Forum papers of Erica Blatt and Cassie Quigley complement this analysis. Blatt expands the discussion on space as an active component of learning with an examination of teaching settings, beyond laboratory spaces, as active participants of education. Quigley examines smart spaces as authentic learning spaces while acknowledging how internship experiences all empirical elements of authentic learning including open-ended inquiry and empowerment. In this paper I synthesize these ideas and propose that a narrative structure might better support workflow, student agency and democratic decision making.

  16. Iodide-induced thyrotoxicosis in a thyroidectomized patient with metastatic thyroid carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Yoshinari, M.; Tokuyama, T.; Okamura, K.; Sato, K.; Kusuda, K.; Fujishima, M.

    1988-04-15

    An unusual case of iodide-induced thyrotoxicosis is documented in this article. The patient was a 64-year-old euthyroid man with acromegaly. He also had multiple follicular and papillary thyroid carcinomas with a metastatic lesion in the lumbar vertebrae. After a total thyroidectomy, he became slightly hypothyroid, and the lumbar lesion began to incorporate /sup 131/I by scintigraphy. When an iodine-containing contrast medium happened to be injected, a transient increase of serum thyroid hormone level was observed. After complete thyroid ablation with 83 mCi of /sup 131/I, the oral administration of 100 mg of potassium iodide for 7 days induced a prominent increase of serum thyroid hormone level. These findings indicated that the metastatic thyroid carcinoma could produce excess thyroid hormone insofar as a sufficient amount of iodide was given. Although this is the first report of such a case, iodide-induced thyrotoxicosis may not be rare in patients with thyroid carcinomas because the Wolff-Chaikoff effect is thought to be lost, and the organic iodinating activity and lysosomal protease activity are well-preserved.

  17. Relation between radio-adaptive response and cell to cell communication

    International Nuclear Information System (INIS)

    Keiichiro Ishii

    1996-01-01

    Ionizing radiation has been considered to cause severe damages to DNA and do harm to cells in proportion to the dose, however low it might be. In 1984, Wolff et al. showed that human peripheral lymphocytes adapted to the low-dose radiation from 3 H-TdR added in culture medium and became resistant to the subsequent irradiation with high-doses of X-rays. This response, which is called radio-adaptive response, is also induced by X-rays and gamma-rays in human lymphocytes and Chinese hamster V79 cells. However, the mechanisms of and conditions for adaptive responses to radiation have not been clarified. With an objective of clarifying the conditions for adaptive responses of cells to radiation, we examined how the cell to cell communication is involved in the adaptive responses. We irradiated normal human embryo-derived (HE) cells and cancer cells (HeLa) in culture at high density with low-dose X-ray and examined their radio-adaptive responses by measuring the changes in sensitivity to subsequent high-dose X-ray irradiation using the Trypan Blue dye-exclusion test method. We also conducted experiments to examine the effects of Ca 2+ ions and Phorbol 12-Myristate 13-Acetate (TPA) which are supposed to be involved in cell to cell communication. (author)

  18. The 12-lead electrocardiogram and risk of sudden death: current utility and future prospects.

    Science.gov (United States)

    Narayanan, Kumar; Chugh, Sumeet S

    2015-10-01

    More than 100 years after it was first invented, the 12-lead electrocardiogram (ECG) continues to occupy an important place in the diagnostic armamentarium of the practicing clinician. With the recognition of relatively rare but important clinical entities such as Wolff-Parkinson-White and the long QT syndrome, this clinical tool was firmly established as a test for assessing risk of sudden cardiac death (SCD). However, over the past two decades the role of the ECG in risk prediction for common forms of SCD, for example in patients with coronary artery disease, has been the focus of considerable investigation. Especially in light of the limitations of current risk stratification approaches, there is a renewed focus on this broadly available and relatively inexpensive test. Various abnormalities of depolarization and repolarization on the ECG have been linked to SCD risk; however, more focused work is needed before they can be deployed in the clinical arena. The present review summarizes the current knowledge on various ECG risk markers for prediction of SCD and discusses some future directions in this field. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.

  19. Utility of the exercise electrocardiogram testing in sudden cardiac death risk stratification.

    Science.gov (United States)

    Refaat, Marwan M; Hotait, Mostafa; Tseng, Zian H

    2014-07-01

    Sudden cardiac death (SCD) remains a major public health problem. Current established criteria identifying those at risk of sudden arrhythmic death, and likely to benefit from implantable cardioverter defibrillators (ICDs), are neither sensitive nor specific. Exercise electrocardiogram (ECG) testing was traditionally used for information concerning patients' symptoms, exercise capacity, cardiovascular function, myocardial ischemia detection, and hemodynamic responses during activity in patients with hypertrophic cardiomyopathy. We conducted a systematic review of MEDLINE on the utility of exercise ECG testing in SCD risk stratification. Exercise testing can unmask suspected primary electrical diseases in certain patients (catecholaminergic polymorphic ventricular tachycardia or concealed long QT syndrome) and can be effectively utilized to risk stratify patients at an increased (such as early repolarization syndrome and Brugada syndrome) or decreased risk of SCD, such as the loss of preexcitation on exercise testing in asymptomatic Wolff-Parkinson-White syndrome. Exercise ECG testing helps in SCD risk stratification in patients with and without arrhythmogenic hereditary syndromes. © 2014 Wiley Periodicals, Inc.

  20. Electrocardiogram: his bundle potentials can be recorded noninvasively beat by beat on surface electrocardiogram.

    Science.gov (United States)

    Wang, Gaopin; Liu, Renguang; Chang, Qinghua; Xu, Zhaolong; Zhang, Yingjie; Pan, Dianzhu

    2017-03-15

    The micro waveform of His bundle potential can't be recorded beat-to-beat on surface electrocardiogram yet. We have found that the micro-wavelets before QRS complex may be related to atrioventricular conduction system potentials. This study is to explore the possibility of His bundle potential can be noninvasively recorded on surface electrocardiogram. We randomized 65 patients undergoing radiofrequency catheter ablation of paroxysmal superventricular tachycardia (exclude overt Wolff-Parkinson-White syndrome) to receive "conventional electrocardiogram" and "new electrocardiogram" before the procedure. His bundle electrogram was collected during the procedure. Comparative analysis of PA s (PA interval recorded on surface electrocardiogram), AH s (AH interval recorded on surface electrocardiogram) and HV s (HV interval recorded on surface electrocardiogram) interval recorded on surface "new electrocardiogram" and PA, AH, HV interval recorded on His bundle electrogram was investigated. There was no difference (P > 0.05) between groups in HV s interval (49.63 ± 6.19 ms) and HV interval (49.35 ± 6.49 ms). Results of correlational analysis found that HV S interval was significantly positively associated with HV interval (r = 0.929; P electrocardiogram. Noninvasive His bundle potential tracing might represent a new method for locating the site of atrioventricular block and identifying the origin of a wide QRS complex.

  1. Danon disease: A case report and literature overview

    Directory of Open Access Journals (Sweden)

    Ćatović Suad

    2007-01-01

    Full Text Available Danon disease, a rare glycogen storage disease, is a dominant X-linked disorder. It is due to mutation in gene for lysosome-associated membrane protein 2 (LAMP 2. The LAMP 2 gene is located on Xq24, and its mutation causes primary deficiency of LAMP 2 and myocyte hypertrophy by accumulations of vacuoles containing glycogen. Danon disease is clinically characterized by the triad of hypertrophic cardiomyopathy (HCM, proximal myopathy and mental retardation. Myopathy and mental retardation can be absent, and cardiomyopathy is usually hypertrophic. This is a case report of the patient with genetically confirmed Danon disease and mixed cardiomyopathy, but without myopathy and mental retardation. ECG showed typical Wolff-Parkinson-White (WPW pattern while echocardiography demonstrated hypertrophy and dilatation of all cardiac chambers with impaired systolic and diastolic function. Male sex, early onset of symptoms, massive hypertrophy of the myocardium and ventricular preexcitation indicate a genetic basis for HCM. Therapeutic measures, except heart transplantation, do not improve prognosis substantially. Only an accurate diagnosis in patients with unexplained HCM helps in establishing of the appropriate treatment strategies and adequate genetic consultation. .

  2. TREATMENT OPTIMIZATION IN PATIENTS WITH STABLE ANGINA PECTORIS: FOCUS ON VERAPAMIL SR

    Directory of Open Access Journals (Sweden)

    I. M. Sokolov

    2011-01-01

    Full Text Available Possibilities of angina pectoris pharmacotherapy are analyzed. Achievement of target heart rate (HR 55-60 beats per minute in these patients is possible due to three classes of antianginal medications that slow down HR: beta blockers (BB, If-channel inhibitors, nondihydropyridine calcium channel blockers (CCB. Nondihydropyridine CCB verapamil in slow release (SR formulation is focused. The main results of randomized clinical trials (APSIS, VHAS, CRIS, EVERESTH, VAMPHYRE, INVEST, VESPA, DAVIT-1, DAVIT-2, which have proven efficacy and safety, are presented. Verapamil SR is indicated for the treatment of angina pectoris in patients without history of myocardial infarction (MI; angina patients experienced MI without systolic heart failure and with contraindications to BB; angina with arterial hypertension; left ventricular diastolic dysfunction; peripheral arteries obliterating atherosclerosis; silent myocardial ischemia; vasospastic angina; angina associated with supraventricular cardiac arrhythmias (especially in permanent atrial fibrillation except Wolff-Parkinson-White and Lown-Ganong-Levine syndromes; after coronary angioplasty and the placement of bare metal stents.

  3. Transport through semiconductor nanowire quantum dots in the Kondo regime

    Energy Technology Data Exchange (ETDEWEB)

    Schmaus, Stefan; Koerting, Verena; Woelfle, Peter [Institut fuer Theorie der Kondensierten Materie, Universitaet Karlsruhe, Wolfgang-Gaede-Strasse 1, 76131 Karlsruhe (Germany)

    2008-07-01

    Recent experiments on quantum dots made of semiconductor nanowires in the Coulomb blockade regime have shown the influence of several approximately equidistant levels on the conductance. We study a model with three levels occupied by three electrons. At finite bias voltage charge energy conserving excitations into several higher lying states occur leading to features in the differential conductance. We restrict our study to the six lowest lying states by performing a Schrieffer-Wolff type projection onto this subspace. The emerging effective Kondo Hamiltonian is treated in non-equilibrium perturbation theory in the coupling to the leads. For convenience we use a pseudoparticle representation and an exact projection method. The voltage-dependence of the occupation numbers is discussed. The density matrix on the dot turns out to be off-diagonal in the dot eigenstate Hilbert space in certain parameter regimes. The dependence of the differential conductance on magnetic field and temperature is calculated in lowest order in the dot-lead coupling and the results are compared with experiment.

  4. Multiobjective topology optimization of trabecular Bone Structure in the spine and the femur: Implications for biomimcry

    Science.gov (United States)

    Elbanna, Ahmed; Peetz, Darin

    Bone is classically considered to be a self-optimizing structure in accordance with Wolff's law. However, while the structure's ability to adapt to changing stress patterns has been well documented, whether it is fully optimal for compliance is less certain (Sigmund, 2002). Given the complexity of many biological systems, it is expected that this structure serves several purposes. We present a multi-objective topology optimization formulation for trabecular bone in the human body at two locations: the vertebrae and the femur. We account for the effect of different conflicting objectives such as maximization of stiffness, maximization of surface area, and minimization of buckling susceptibility. Our formulation enables us to determine the relative role of each of these objective in optimizing the structure. Moreover, it provides an opportunity to explore what structural features have to evolve to meet a certain objective requirements that may have been absent otherwise. For example, inclusion of stability considerations introduce numerous horizontal and diagonal members in the topology in the case of human vertebrae under vertical loading. However, the stability is found to play a lesser role in the case of the femur bone optimization. Our formulation enables investigation of bone adaptation at different locations of the body as well as under different loading and boundary conditions (e.g. healthy and diseased discs for the case of the spine). We discuss the implications of our findings on developing design rules for bio-inspired and bio-mimetic architectured materials. National Science Foundation: CMMI.

  5. Ensemble-free configurational temperature for spin systems

    Science.gov (United States)

    Palma, G.; Gutiérrez, G.; Davis, S.

    2016-12-01

    An estimator for the dynamical temperature in an arbitrary ensemble is derived in the framework of the conjugate variables theorem. We prove directly that its average indeed gives the inverse temperature and that it is independent of the ensemble. We test this estimator numerically by a simulation of the two-dimensional X Y model in the canonical ensemble. As this model is critical in the whole region of temperatures below the Berezinski-Kosterlitz-Thouless critical temperature TBKT, we use a generalization of Wolff's unicluster algorithm. The numerical results allow us to confirm the robustness of the analytical expression for the microscopic estimator of the temperature. This microscopic estimator has also the advantage that it gives a direct measure of the thermalization process and can be used to compute absolute errors associated with statistical fluctuations. In consequence, this estimator allows for a direct, absolute, and stringent test of the ergodicity of the underlying Markov process, which encodes the algorithm used in a numerical simulation.

  6. Judeus no Brasil Imperial: uma pesquisa nos Documentos e Noticiário Carioca da Época

    Directory of Open Access Journals (Sweden)

    Frida Flaksberg

    1977-09-01

    Full Text Available WOLFF, Egon e Frieda. Judeus no Brasil Imperial: uma pesquisa nos Documentos e Noticiário Carioca da Época. São Paulo: Centro de Estudos Judaicos da Universidade de São Paulo, 1975. No 1. 549 pp. (4a. parágrafo do texto Esta obra tem como meta o levantamento de fontes para o estudo dos judeus no Brasil Imperial. Ela apresenta um caráter inédito o qual pode ser apreendido nas próprias palavras do Prof. Dr. Eurípedes Simões de Paula:  "o caráter inédito dos trabalhos consiste justamente no fato de que o período do nosso Império ainda não foi até agora devidamente estudado sob o ângulo da presença dos judeus e sua participação social e econômica naquele período. É importante e necessário era que se fizesse antes de tudo uma avaliação básica das fontes disponíveis para os futuros estudiosos".

  7. (Ooraftelbaarheid

    Directory of Open Access Journals (Sweden)

    D.F.M. Strauss

    2011-09-01

    Full Text Available (Nondenumerability The focus of this article is the rise of modern set theory which, according to Meschkowski, coincides with the first proof given in 1874 by Cantor of the non-denumerability of the real numbers. Later on he developed his well-known diagonal proof, which occupies a central position in this article. The argument of this article is directed towards the implicit supposition of the diagonal proof, to wit the acceptance of the actual infinite (preferably designated as the at once infinite. Without this assumption no conclusion to non-denumerability is possible. Various mathematicians and mathematical traditions of the twentieth century questioned the use of the actual infinite. A closer investigation is conducted in respect of two opponents of the actual infinite, namely Kaufmann and Wolff. The circular reasoning contained in their approach is highlighted and as alternative a non-circular understanding of the at once infinite is explained. At the same time the assumed exact nature (and neutrality of mathematics is questioned (in the spirit of „Koers‟ as a Christian academic journal. This contemplation disregards the question of what mathematics is (for example by including topology, category theory and topos theory, which would have diverted our attention to contemporary views of figures such as Tait, Penelope and Shapiro who, among others, acts as the editors of and contributors to the encompassing work „Handbook of Philosophy of Mathematics and Logic‟ (2005.

  8. Sister chromatid exchanges (SCEs) in lymphocytes of inhabitants in high background radiation area

    International Nuclear Information System (INIS)

    Li Jinsheng; Zheng Qiaoling

    1985-01-01

    Blood samples were taken from 126 students of 15-16 years old, living in the high background radiation area, and from 124 controls of the same age range, living in the normal background radiation area. All students were interviewed for evaluation of their health status. Whole blood cultures were done with RPMI 1640 medium supplemented with 20% fetal calf serum and antibiotics, The culture were incubated for 54-56 h in the presence of BrdU (10 μg/ml). Metaphases were stained for SCE using a modified techniqu of perry and Wolff. From each person 20 second division metaphases were analysed for SCEs. The average frequencies of SCEs observed in the high background group and the control group are presented. More SCEs were observed in the high background group than in the control with a statistically signigicant difference. In regard to the sex factor, it was found that the SCE frequencies in both sexes of the high background group were slightly higher than those in the control group. These findings suggest that continuous low-level irradiation by the high background radiation may induce increased frequency of SCEs

  9. The Rise of Basic Research at tha Bell Labs: Young Turks and Younger Turks

    Science.gov (United States)

    Anderson, Philip

    2004-03-01

    ABSTRACT Even before World War II, a certain amount of fundamental physics research came out of the Bell Labs. Already in the 20's, before the Labs were five years old, the discoveries of electron diffraction by Davisson and Germer, and of thermal noise by Johnson and Nyquist, had come as byproducts of wide-ranging technological studies. By the late '30's, there was a small group of broadly-trained scientists who formed a nucleus around which the "young turks" in management --J B Fisk, M J Kelly, W Shockley, perhaps others--formed the postwar physical research department, comprising at first perhaps 50 people with a mandate to do exploratory but "relevant" research. This talk will diiscuss how some of the generation of postwar hires, with the cooperation of enlightened managers like W O Baker and A H White, further tested and enlarged their freedom to do basic, curiosity-driven research in an academic atmosphere. I call this group, consisting of individuals like B T Matthias, G H Wannier, R G Shulman, P A Wolff, myself , and a number of others, the "younger Turks".

  10. Radioiodinated 5-iodothienyl-2-substituted long chain fatty acids for myocardial imaging

    International Nuclear Information System (INIS)

    Goodman, M.M.; Knapp, F.F. Jr.; Kirsch, G.; Owen, B.A.

    1984-01-01

    Thienyl-2-alkyl derivatives undergo facile iodination regiospecifically at the 5-position of the thiophene ring and are alternatives to iodophenyl agents. /sup 125/I-labeled 2-(17-oxoheptadecanoly)-5-iodothiophene (VIIIa) and /sup 125/I-labeled 2-(13-oxotridecanoyl)-5-iodothiophene (VIIIb) were prepared as model agents. The substrate was 2-(17-oxoheptadecanoyl)thiophene (VIa), in which the thiophene ring was attached to the terminal position of heptadecanoic acid. (VIa) was prepared by Friedel-Crafts condensation of 16-iodohexadecanoyl chloride, with thiophene followed by -I + CN/sup -/ → -CN; Wolff-Kishner reduction; -CN + OH/sup -/ → -COOH (VI). Regiospecific rho-[bis-(trifluoroacety 1)] thallation of (VIa), followed by treatment with KI gave 2-(17-oxoheptadecanoyl)-5-iodothiophene (VIIIa). Compound VIIIb was prepared in the same manner. Compounds Ia, b-VIIIa,b, were analyzed by TLC, IR, MS, NMR, and CandH. I-125-labeled (VIIIa) and (VIIIb) were prepared in the same manner. I-125 (VIIIb) showed high myocardial uptake in rats (4/group). Iodothienyl fatty acids may represent alternatives to iodophenyl substituted fatty acids for myocardial imaging

  11. [The nonpharmacological treatment of tachyarrhythmias. The surgery of supraventricular arrhythmias not due to pre-excitation].

    Science.gov (United States)

    Viganò, M; Graffigna, A; Pagani, F; Salerno, J A

    1991-12-01

    Surgery can provide treatment for supraventricular tachyarrhythmias without operative risk and with a definite improvement of patients' quality of life. Ectopic atrial tachycardia is a rare but invalidating arrhythmia that may lead to cardiomyopathy: intraoperative mapping is necessary for the location of the location of the ectopic focus; in our experience, surgical, cryothermal or isolation ablation of the area were effective in 9 patients out of 9, with regression of the cardiomyopathy. Atrioventricular node reentry tachycardia is a reentry tachycardia which is often associated with Wolff-Parkinson-White syndrome and is amenable to surgical treatment. Discrete cryolesions around the Koch triangle are effective in interrupting the atrial inputs to the atrioventricular node and therefore the reentry mechanism: in our experience, 7 patients were successfully treated without operative mortality: 3 patients underwent surgical ablation of Kent bundles as well. Atrial fibrillation is not based on a well-defined mechanism, and therefore does not permit an electrically-guided surgical treatment. However, in case of atrial septal defect it is possible to isolate the enlarged right atrium in order to allow sinus rhythm to activate the left atrium and ventricles.(ABSTRACT TRUNCATED AT 250 WORDS)

  12. Conference scene: DGVS spring conference 2009.

    Science.gov (United States)

    Kolligs, Frank Thomas

    2009-10-01

    The 3rd annual DGVS Spring Conference of the German Society for Gastroenterology (Deutsche Gesellschaft für Verdauungs- und Stoffwechselkrankheiten) was held at the Seminaris Campus Hotel in Berlin, Germany, on 8-9 May, 2009. The conference was organized by Roland Schmid and Matthias Ebert from the Technical University of Munich, Germany. The central theme of the meeting was 'translational gastrointestinal oncology: towards personalized medicine and individualized therapy'. The conference covered talks on markers for diagnosis, screening and surveillance of colorectal cancer, targets for molecular therapy, response prediction in clinical oncology, development and integration of molecular imaging in gastrointestinal oncology and translational research in clinical trial design. Owing to the broad array of topics and limitations of space, this article will focus on biomarkers, response prediction and the integration of biomarkers into clinical trials. Presentations mentioned in this summary were given by Matthias Ebert (Technical University of Munich, Germany), Esmeralda Heiden (Epigenomics, Berlin, Germany), Frank Kolligs (University of Munich, Germany), Florian Lordick (University of Heidelberg, Germany), Hans Jorgen Nielsen (University of Copenhagen, Denmark), Anke Reinacher-Schick (University of Bochum, Germany), Christoph Röcken (University of Berlin, Germany), Wolff Schmiegel (University of Bochum, Germany) and Thomas Seufferlein (University of Halle, Germany).

  13. Non-targeted effects of radiation: applications for radiation protection and contribution to LNT discussion

    International Nuclear Information System (INIS)

    Belyakov, O.V.; Folkard, M.; Prise, K.M.; Michael, B.D.; Mothersill, C.

    2002-01-01

    According to the target theory of radiation induced effects (Lea, 1946), which forms a central core of radiation biology, DNA damage occurs during or very shortly after irradiation of the nuclei in targeted cells and the potential for biological consequences can be expressed within one or two cell generations. A range of evidence has now emerged that challenges the classical effects resulting from targeted damage to DNA. These effects have also been termed non-(DNA)-targeted (Ward, 1999) and include radiation-induced bystander effects (Iyer and Lehnert, 2000a), genomic instability (Wright, 2000), adaptive response (Wolff, 1998), low dose hyper-radiosensitivity (HRS) (Joiner, et al., 2001), delayed reproductive death (Seymour, et al., 1986) and induction of genes by radiation (Hickman, et al., 1994). An essential feature of non-targeted effects is that they do not require a direct nuclear exposure by irradiation to be expressed and they are particularly significant at low doses. This new evidence suggests a new paradigm for radiation biology that challenges the universality of target theory. In this paper we will concentrate on the radiation-induced bystander effects because of its particular importance for radiation protection

  14. Iodide-induced thyrotoxicosis in a thyroidectomized patient with metastatic thyroid carcinoma

    International Nuclear Information System (INIS)

    Yoshinari, M.; Tokuyama, T.; Okamura, K.; Sato, K.; Kusuda, K.; Fujishima, M.

    1988-01-01

    An unusual case of iodide-induced thyrotoxicosis is documented in this article. The patient was a 64-year-old euthyroid man with acromegaly. He also had multiple follicular and papillary thyroid carcinomas with a metastatic lesion in the lumbar vertebrae. After a total thyroidectomy, he became slightly hypothyroid, and the lumbar lesion began to incorporate 131 I by scintigraphy. When an iodine-containing contrast medium happened to be injected, a transient increase of serum thyroid hormone level was observed. After complete thyroid ablation with 83 mCi of 131 I, the oral administration of 100 mg of potassium iodide for 7 days induced a prominent increase of serum thyroid hormone level. These findings indicated that the metastatic thyroid carcinoma could produce excess thyroid hormone insofar as a sufficient amount of iodide was given. Although this is the first report of such a case, iodide-induced thyrotoxicosis may not be rare in patients with thyroid carcinomas because the Wolff-Chaikoff effect is thought to be lost, and the organic iodinating activity and lysosomal protease activity are well-preserved

  15. Working With Cultural-Historical Activity Theory

    Directory of Open Access Journals (Sweden)

    Wolff-Michael Roth

    2012-05-01

    Full Text Available This article focuses on the experiences of two researchers, Wolff-Michael ROTH and Luis RADFORD, using cultural-historical activity theory in mathematics education. The aim is to provide insights into the ways these researchers see and engage with activity theory, how they have come to adopt and expand it, and some of the challenges and concerns that they have had using it. These questions are not usually addressed within typical scientific papers. Yet, they are important for understanding both the dynamics of research and the practical use of cultural-historical activity theory. Since the format of research report papers is not necessarily well suited to convey personal experiences and thinking, the present article takes the form of a conversation, which provides an effective vehicle for exploring and articulating these matters. This provides a basis for understanding more deeply the underlying assumptions of this theory; its dynamics and how it is applied in research of mathematics practice, thinking, and learning; and insights into the manner in which experienced researchers grapple with the theoretical dimensions of their research. URN: http://nbn-resolving.de/urn:nbn:de:0114-fqs1202232

  16. Risk and responsibility: a complex and evolving relationship.

    Science.gov (United States)

    Kermisch, Céline

    2012-03-01

    This paper analyses the nature of the relationship between risk and responsibility. Since neither the concept of risk nor the concept of responsibility has an unequivocal definition, it is obvious that there is no single interpretation of their relationship. After introducing the different meanings of responsibility used in this paper, we analyse four conceptions of risk. This allows us to make their link with responsibility explicit and to determine if a shift in the connection between risk and responsibility can be outlined. (1) In the engineer's paradigm, the quantitative conception of risk does not include any concept of responsibility. Their relationship is indirect, the locus of responsibility being risk management. (2) In Mary Douglas' cultural theory, risks are constructed through the responsibilities they engage. (3) Rayner and (4) Wolff go further by integrating forms of responsibility in the definition of risk itself. Analysis of these four frameworks shows that the concepts of risk and responsibility are increasingly intertwined. This tendency is reinforced by increasing public awareness and a call for the integration of a moral dimension in risk management. Therefore, we suggest that a form of virtue-responsibility should also be integrated in the concept of risk. © Springer Science+Business Media B.V. 2010

  17. Modeling risk for child abuse and harsh parenting in families with depressed and substance-abusing parents.

    Science.gov (United States)

    Kelley, Michelle L; Lawrence, Hannah R; Milletich, Robert J; Hollis, Brittany F; Henson, James M

    2015-05-01

    Children with substance abusing parents are at considerable risk for child maltreatment. The current study applied an actor-partner interdependence model to examine how father only (n=52) and dual couple (n=33) substance use disorder, as well as their depressive symptomology influenced parents' own (actor effects) and the partner's (partner effects) overreactivity in disciplinary interactions with their children, as well as their risk for child maltreatment. Parents completed the Center for Epidemiologic Studies Depression Scale (CES-D; Radloff, 1977), the overreactivity subscale from the Parenting Scale (Arnold, O'Leary, Wolff, & Acker, 1993), and the Brief Child Abuse Potential Inventory (Ondersma, Chaffin, Mullins, & LeBreton, 2005). Results of multigroup structural equation models revealed that a parent's own report of depressive symptoms predicted their risk for child maltreatment in both father SUD and dual SUD couples. Similarly, a parent's report of their own depressive symptoms predicted their overreactivity in disciplinary encounters both in father SUD and dual SUD couples. In all models, partners' depressive symptoms did not predict their partner's risk for child maltreatment or overreactivity. Findings underscore the importance of a parent's own level of depressive symptoms in their risk for child maltreatment and for engaging in overreactivity during disciplinary episodes. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. Grundrechte der Staaten

    Directory of Open Access Journals (Sweden)

    Miloš Vec

    2011-01-01

    Full Text Available The so-called fundamental rights and duties of states were invented by natural law theory and exist in legal doctrine even today. They resulted from a transfer of the rights of the human individual to the state. What appeared in the middle of the 18th century in the works of Wolff and Vattel in a quite unsystematic and scattered way, was fully developed into a canon in the 19th century: Fundamental rights shifted into the centre of international law doctrine. They constituted the starting point of the international legal order as conceptualized by nearly all legal thinkers. Although an invention of natural law, they outlasted the 18th century and were even to be found in the works of some authors who considered themselves as positivists. Moreover, the general move towards »positivism« did not affect these rights, criticism of this view arising only at the end of the 19th century. Academic doctrine, therefore, was in conflict with the theory of the sources of international law. Their popularity resulted from the desire to have guiding principles in the international order. Most of these principles were materially attached to sovereignty: Fundamental rights emphasized the inviolable autonomy of the state as a legal subject no matter how international relations and international treaties developed.

  19. Adolescent sexual assault victims and the legal system: building community relationships to improve prosecution rates.

    Science.gov (United States)

    Campbell, Rebecca; Greeson, Megan R; Bybee, Deborah; Fehler-Cabral, Giannina

    2012-09-01

    Adolescents are at high risk for sexual assault, but few of these crimes are reported to the police and prosecuted by the criminal justice system. To address this problem, communities throughout the United States have implemented multidisciplinary interventions to improve post-assault care for victims and increase prosecution rates. The two most commonly implemented interventions are Sexual Assault Nurse Examiner (SANE) Programs and Sexual Assault Response Teams (SARTs). The purpose of this study was to determine whether community-level context (i.e., stakeholder engagement and collaboration) was predictive of adolescent legal case outcomes, after accounting for "standard" factors that affect prosecution success (i.e., victim, assault, and evidence characteristics). Overall, 40% of the adolescent cases from these two SANE-SART programs (over a 10-year period) were successfully prosecuted. Cases were more likely to be prosecuted for younger victims, those with disabilities, those who knew their offenders, and instances in which the rape evidence collection kit was submitted by police for analysis. After accounting for these influences, multi-level modeling results revealed that in one site decreased allocation of community resources to adolescent sexual assault cases had a significant negative effect on prosecution case outcomes. Results are explained in terms of Wolff's (Am J Community Psychol 29:173-191, 2001) concept of "over-coalitioned" communities and Kelly's (1968) ecological principles.

  20. “They do not know much, but then, you have to cover the syllabus”: The quality imperative – a dilemma for teachers’ in early grade multilingual classrooms in Kenyan primary schools

    Directory of Open Access Journals (Sweden)

    Susan Nyaga

    2015-12-01

    Full Text Available The centrality of language in any education system cannot be overemphasised. Wolff (2006: 50 sums this up by stating that “language is not everything in education, but without language everything is nothing in education”. As such, language mediates knowledge acquisition even when the content of education is not language. The question then arises as to which language is best to use in education. There are no straight answers to this, as education in most countries of the world takes place in multilingual contexts. In Kenya, the language-in-education policy supports the use of the learner’s first language as the language of instruction in the first three years of school. The policy, however, remains largely unimplemented for various reasons, among them the multiplicity of first languages that may be represented in one classroom. This article reports on some outcomes of a recently completed doctoral study that investigated teachers’ attitudes, skills and strategies in their management of linguistic diversity in multilingual classrooms. Specifically, the article reports on what informs teachers’ language choices and prioritisations beyond the policy rhetoric. The study disclosed that the language of examinations and textbooks, the pressure to cover the syllabus, and individual teachers’ language repertoires primarily determine which languages are prioritised and how they are used. The findings suggest that quality education for all may remain elusive in multilingual contexts until the language question has been adequately addressed.

  1. The effect of a parasite hybridizer on the magnetic behavior of partially delocalized transition shell systems (abstract)

    International Nuclear Information System (INIS)

    Sanchez-Castro, C.; Cooper, B.R.; Bedell, K.S.

    1991-01-01

    We have investigated how the behavior of a transition shell atomic species (species A) with orbital magnetism, driven by hybridization-mediated interactions via a sea of band electrons, is modified by the addition of a second parasite hybridizer (species B). Our approach involves a two-stage procedure. First, we calculate the modification of the band electron sea by hybridization with B by using a slave boson formalism. Second, the modifications in the A-A interionic interactions driving the orbital magnetic ordering are calculated by applying a Schrieffer--Wolff transformation on the renormalized Anderson lattice hamiltonian obtained from the first stage. The new A-A interactions have a different radial dependence (range factor) which depends in a nonlinear way on the band-B hybridization strength: and the consequences of this change on the magnetic ordering are studied using a mean-field approximation. This enables us to model the reduction in the magnetic ordering caused by competing parasite hybridization, and the dependence of this reduction on the relative hybridization strengths of the two species

  2. Pino ósseo homólogo conservado em glicerina a 98% e hemicerclagem com fio poliglactina 910 na osteossíntese umeral de pombos domésticos Homologous bone pin conserved in glycerin at 98% and hemicerclagem with a thread of poliglactina 910 in humerus osteosyntesis of domestic pigeons

    Directory of Open Access Journals (Sweden)

    Juliano Bolson

    2008-10-01

    Full Text Available O objetivo do presente estudo foi avaliar a utilização de um pino intramedular ósseo homólogo, conservado em glicerina a 98%, associado à hemicerclagem com fio poliglactina 910 na osteossíntese umeral transversa de pombos domésticos (Columba livia. Utilizou-se como pino ósseo a parte distal do tibiotarso, conservado com medula óssea. Foram operados 20 pombos domésticos, adultos, não-sexados e clinicamente sadios. Esses animais foram separados ao acaso em cinco grupos, com quatro indivíduos. O úmero foi seccionado cirurgicamente na sua diáfise, de forma transversa, e o pino ósseo foi devidamente implantado no seio do osso. Orifícios foram realizados e por eles procedeu-se hemicerclagem do tipo pontos de Wolff com poliglactina 910. Os animais foram avaliados clinicamente, por meio de radiografias semanais, e histologicamente após os períodos de 15, 30, 60, 90 e 120 dias. A conservação do pino ósseo em glicerina a 98% foi avaliada por meio de exames microbiológicos. Em todos os animais, pode-se notar, clinicamente, excelente adaptação à cirurgia e normalidade do uso do membro já radiologicamente pode-se observar formação de calo ósseo e cicatrização da fratura. Histologicamente pode-se observar que ocorreu formação de calo ósseo 15 dias após a cirurgia e cicatrização com remodelação completa a partir dos 90 dias. Nesse exame, além de leve a moderada reação inflamatória no período inicial de avaliação, nenhum outro evento foi notado nos períodos subseqüentes. Concluiu-se que a técnica e os materiais utilizados se tornam uma opção altamente viável na osteossíntese umeral transversa de pombos domésticos.The objective of the present study was to evaluate the use of a homologous bone intramedullary pin, conserved in glycerin at 98% associated to hemicerclage with a thread of polyglactina 910 in the transverse humerus osteosynthesis of domestic pigeon (Columba livia. The distal part of the

  3. Properties of a local dust storm on Mars' Atlantis Chaos by means of radiative transfer modeling.

    Science.gov (United States)

    Oliva, Fabrizio; Altieri, Francesca; Geminale, Anna; Bellucci, Giancarlo; D'Aversa, Emiliano; Carrozzo, Giacomo; Sindoni, Giuseppe; Grassi, Davide

    2017-04-01

    In this study we present the analysis of the dust properties in a local storm imaged in the Atlantis Chaos region on Mars by the OMEGA spectrometer (Bibring et al., 2004) on March 2nd 2005 (ORB1441_5). By means of an inverse radiative transfer code we study the dust properties across the region and try to infer the connection be-tween the local storm dynamics and the orography. OMEGA is a visible and near-IR mapping spectrometer, operating in the spectral range 0.38-5.1 μm with three separate channels with different spectral resolution. The instrument's IFOV is 1.2 mrad. To analyze the storm properties we have used the inverse radiative transfer model MITRA (Oliva et al., 2016; Sindoni et al., 2013) to retrieve the effective radius reff, the optical depth at 880 nm τ880 and the top pressure tp of the dust layer. We used the Mars Climate Database (MCD, Forget et al., 1999) to obtain the atmospheric properties of the studied region to be used as input in our model. Moreover we used the optical constants from Wolff et al. (2009) to describe the dust composition. The properties from the surface have been obtained by ap-plying the SAS method (Geminale et al., 2015) to observations of the same region relatively clear from dust. All retrievals have been performed in the spectral range 500 ÷ 2500 nm. Here we describe the result from our analysis carried out on selected regions of the storm and characterized by a different optical depth of the dust. Aknowledgements: This study has been performed within the UPWARDS project and funded in the context of the European Union's Horizon 2020 Programme (H2020-Compet-08-2014), grant agreement UPWARDS-633127. References: Bibring, J-P. et al., 2004. OMEGA: Observatoire pour la Minéralogie, l'Eau, les Glaces et l'Activité. Mars Express: the scientific payload, Ed. by Andrew Wilson, scientific coordination: Agustin Chicarro. ESA SP-1240, Noordwijk, Netherlands: ESA Publications Division, ISBN 92-9092-556-6, 2004, p. 37 - 49. Forget

  4. A multi-archive coherent chronology: from Greenland to the Mediterranean sea

    Science.gov (United States)

    Bazin, Lucie; Landais, Amaelle; Lemieux-Dudon, Bénédicte; Siani, Giuseppe; Michel, Elisabeth; Combourieu-Nebout, Nathalie; Blamart, Dominique; Genty, Dominique

    2015-04-01

    . & Wolff, E., An optimized multi-proxy, multi-site Antarctic ice and gas orbital chronology (AICC2012): 120-800 ka,Clim. Past 9, 1715-1731, 2013. Genty, D., Blamart, D., Ghaleb B., Plagnes, V., Causse, Ch., Bakalowicz, M., Zouari, K., Chkir, N., Hellstrom, J., Wainer, K., Bourges, F., Timing and dynamics of the last deglaciation from European and North African δ13C stalagmite profiles - comparison with Chinese ans South Hemisphere stalagmites, Quat. Sci. Rev. 25, 2118-2142, 2006. Lemieux-Dudon, B. ; Blayo, E. ; Petit, J.-R. ; Waelbroeck, C. ;Svensson, A. ; Ritz, C. ; Barnola, J.-M. ; Narcisi, B.M. ; Parrenin, F., Consitent dating for Antarctic and Greenland ice cores, Quat. Sci. Rev. 29(1-2), 2010. Veres, D. ; Bazin, L. ; Landais, A. ; Lemieux-Dudon, B. ; Parrenin, F. ; Martinerie, P. ; Toyé Mahamadou Kele, H. ; Capron, E. ; Chappellaz, J. ; Rasmussen, S. ; Severi, M. ; Svensson, A. ; Vinther, B. & Wolff, E., The Antarctic ice core chronology (AICC2012): an optimized multi-parameter and multi-site dating approach for the last 120 thousand years, Clim. Past, 9, 1733-1748, 2013.

  5. Pengaruh Iodium terhadap Perubahan Fungsi Tiroid dan Status Iodium

    Directory of Open Access Journals (Sweden)

    Suryati Kumorowulan

    2015-01-01

    Full Text Available ABSTRACT Iodine is an essential element that enables the thyroid gland to produce thyroid hormones. The source of iodine in the body comes from food, iodized salt and iodine capsules. Iodized salt and iodine capsules had been used by the government in Iodine Deficiency Disorders (IDD elimination program. However, iodine capsules prophylaxis program in the IDD endemic areas had caused symptoms of hyperthyroidism, subsequently the program was discontinued since 2009. The aim of this research to determine the effect of iodine supplementation on thyroid function and iodine status. This was quasi-experimental design, conducted in Pituruh Purworejo District. Sample of this study consisted of 85 women of childbearing age, divided into three intervention groups. Each group obtained iodized salt for one month, then continued with the provision of iodized salt and 200 mg iodine capsules in group I, iodized salt and 400 mg iodine capsules in group II, and iodized salt and shredded tuna fish 2 times a week in group III for 3 months. Thyroid status was measured by levels of TSH, FT4 analyzed with ELISA. Iodine status measured by UIE levels analyzed with spectrophotometer. Data was analyzed using General Linear Model Repeated Measure (GLM RM. After 3 months, in all three treatment groups the TSH changes were statistically significant. In FT4 hormone levels, after administration of the intervention occurred “Wolff-Chaikoff” mechanism. There were significant increase on Iodine status (UIE (p< 0.05 in all three treatment groups. There is a change in iodine status and thyroid function after administration of three forms of iodine intervention. Keywords: iodine, TSH, FT4, UIE. ABSTRAK Iodium merupakan bahan dasar untuk membentuk hormon tiroid. Sumber iodium tubuh berasal dari makanan, garam beriodium, dan kapsul iodium. Garam beriodium dan kapsul iodium telah digunakan oleh pemerintah dalam penanggulangan Gangguan Akibat Kekurangan Iodium (GAKI. Namun peng

  6. Transmisión y exclusión del conocimiento en la Ilustración: Filosofía para Damas y Querelle des femmes

    Directory of Open Access Journals (Sweden)

    Roldán Panadero, Concha

    2008-06-01

    Full Text Available At the beginning of Modernity there was an increasing process of spreading, access, and popularization of knowledge. In this context, this paper stands two points: On the one hand, “philosophies for ladies”, made by men, in spite of their purpose of spreading scientific knowledge, represent the typical contradiction in Enlightment while pursuing the emancipation of humanity and the oppression of women. On the other hand, different essays about that “philosophies for ladies”, many of them due to women, show a “dispute of women” (querelle des femmes along the European republic of letters. This is the outcome of an early Enlightment and a counterpoint to the contradiction between the diffusion of knowledge to all mankind and the exclusion of women in this process. Taking into account someone “representative” of Enlightment ethics (Wolff, Kant, we explain the contradiction between theoria and praxis by means of the confrontation between ethics and anthropology. These querelle des femmes represents - as stressed by Celia Amorós - “an enlightment inside the enlightment” that rebuilds the link between theory and praxis, between ethics and anthropology.En el origen de la modernidad asistimos a un proceso creciente de difusión, accesibilidad y popularización de los saberes. En este contexto, el presente trabajo desarrolla dos tesis: Una, que las “filosofías para damas” escritas por varones al comienzo de la modernidad, al margen de su intención de difundir los conocimientos científicos, representan un buen ejemplo de las inconsecuencias de una Ilustración que persigue al mismo tiempo la emancipación de la humanidad y el dominio de las mujeres. Otra, que hay ensayos coetáneos de esas “filosofías para damas”, muchos de ellos escritos por mujeres, que muestran que hubo una “disputa de las mujeres” (querelle des femmes que surgió a la par que la república europea de las letras como efecto de una ilustraci

  7. Catheter radiofrequency ablation for arrhythmias under the guidance of the Carto 3 three-dimensional mapping system in an operating room without digital subtraction angiography.

    Science.gov (United States)

    Huang, Xingfu; Chen, Yanjia; Huang, Zheng; He, Liwei; Liu, Shenrong; Deng, Xiaojiang; Wang, Yongsheng; Li, Rucheng; Xu, Dingli; Peng, Jian

    2018-06-01

    Several studies have reported the efficacy of a zero-fluoroscopy approach for catheter radiofrequency ablation of arrhythmias in a digital subtraction angiography (DSA) room. However, no reports are available on the ablation of arrhythmias in the absence of DSA in the operating room. To investigate the efficacy and safety of catheter radiofrequency ablation for arrhythmias under the guidance of a Carto 3 three-dimensional (3D) mapping system in an operating room without DSA. Patients were enrolled according to the type of arrhythmia. The Carto 3 mapping system was used to reconstruct heart models and guide the electrophysiologic examination, mapping, and ablation. The total procedure, reconstruction, electrophysiologic examination, and mapping times were recorded. Furthermore, immediate success rates and complications were also recorded. A total of 20 patients were enrolled, including 12 males. The average age was 51.3 ± 17.2 (19-76) years. Nine cases of atrioventricular nodal re-entrant tachycardia, 7 cases of frequent ventricular premature contractions, 3 cases of Wolff-Parkinson-White syndrome, and 1 case of typical atrial flutter were included. All arrhythmias were successfully ablated. The procedure time was 127.0 ± 21.0 (99-177) minutes, the reconstruction time was 6.5 ± 2.9 (3-14) minutes, the electrophysiologic study time was 10.4 ± 3.4 (6-20) minutes, and the mapping time was 11.7 ± 8.3 (3-36) minutes. No complications occurred. Radiofrequency ablation of arrhythmias without DSA is effective and feasible under the guidance of the Carto 3 mapping system. However, the electrophysiology physician must have sufficient experience, and related emergency measures must be present to ensure safety.

  8. Overactive bladder in the vulnerable elderly

    Directory of Open Access Journals (Sweden)

    Wolff GF

    2014-10-01

    Full Text Available Gillian F Wolff,1 George A Kuchel,2 Phillip P Smith1,21Division of Urology, Department of Surgery, 2UConn Center on Aging, University of Connecticut Health Center, Farmington, CT, USAAbstract: Overactive bladder (OAB is a common problem that may occur in individuals of all ages. It has a considerable impact on patient quality of life, and although moderately effective management strategies do exist, this condition often remains undiagnosed and untreated. OAB needs to be viewed as a symptom complex. Its presentation and management are complicated in the vulnerable elderly by the presence of baseline frailty and multiple coexisting chronic conditions. Furthermore, and beyond a simple understanding of symptomatology, providers must address patient goals and motivations as well as the expectations of caretakers. These multiple levels of perception, function, expectations, and treatment efficacy/risks must be tailored to the individual patient. While the vulnerable elderly patient may often have evidence of urinary tract dysfunction, OAB and urge urinary incontinence in this population must be understood as a multifactorial geriatric syndrome and viewed in the context of medical and functional baseline and precipitating risk factors. Expectations and goals must be tailored to the resources of vulnerable elderly patients and their caregivers, and care must be coordinated with other medical care providers. The management of OAB in the vulnerable elderly often poses significant management challenges. Nonetheless, with a thoughtful approach and an aim towards future research specifically for this population, significant reductions in morbidity and mortality long with enhancement in health-related quality of life are possible.Keywords: urinary incontinence, urgency, antispasmodics, aging, frailty

  9. Cardiovascular screening in adolescents and young adults: a prospective study comparing the Pre-participation Physical Evaluation Monograph 4th Edition and ECG.

    Science.gov (United States)

    Fudge, Jessie; Harmon, Kimberly G; Owens, David S; Prutkin, Jordan M; Salerno, Jack C; Asif, Irfan M; Haruta, Alison; Pelto, Hank; Rao, Ashwin L; Toresdahl, Brett G; Drezner, Jonathan A

    2014-08-01

    This study compares the accuracy of cardiovascular screening in active adolescents and young adults using a standardised history, physical examination and resting 12-lead ECG. Participants were prospectively screened using a standardised questionnaire based on the Pre-participation Physical Evaluation Monograph 4th Edition (PPE-4), physical examination and ECG interpreted using modern standards. Participants with abnormal findings had focused echocardiography and further evaluation. Primary outcomes included disorders associated with sudden cardiac arrest (SCA). From September 2010 to July 2011, 1339 participants underwent screening: age 13-24 (mean 16) years, 49% male, 68% Caucasian, 17% African-American and 1071 (80%) participating in organised sports. Abnormal history responses were reported on 916 (68%) questionnaires. After physician review, 495/916 (54%) participants with positive questionnaires were thought to have non-cardiac symptoms and/or a benign family history and did not warrant additional evaluation. Physical examination was abnormal in 124 (9.3%) participants, and 72 (5.4%) had ECG abnormalities. Echocardiograms were performed in 586 (44%) participants for abnormal history (31%), physical examination (8%) or ECG (5%). Five participants (0.4%) were identified with a disorder associated with SCA, all with ECG-detected Wolff-Parkinson-White. The false-positive rates for history, physical examination and ECG were 31.3%, 9.3% and 5%, respectively. A standardised history and physical examination using the PPE-4 yields a high false-positive rate in a young active population with limited sensitivity to identify those at risk for SCA. ECG screening has a low false-positive rate using modern interpretation standards and improves detection of primary electrical disease at risk of SCA. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  10. Efficiency in energy production and consumption

    Science.gov (United States)

    Kellogg, Ryan Mayer

    This dissertation deals with economic efficiency in the energy industry and consists of three parts. The first examines how joint experience between pairs of firms working together in oil and gas drilling improves productivity. Part two asks whether oil producers time their drilling optimally by taking real options effects into consideration. Finally, I investigate the efficiency with which energy is consumed, asking whether extending Daylight Saving Time (DST) reduces electricity use. The chapter "Learning by Drilling: Inter-Firm Learning and Relationship Persistence in the Texas Oilpatch" examines how oil production companies and the drilling rigs they hire improve drilling productivity by learning through joint experience. I find that the joint productivity of a lead firm and its drilling contractor is enhanced significantly as they accumulate experience working together. Moreover, this result is robust to other relationship specificities and standard firm-specific learning-by-doing effects. The second chapter, "Drill Now or Drill Later: The Effect of Expected Volatility on Investment," investigates the extent to which firms' drilling behavior accords with a key prescription of real options theory: irreversible investments such as drilling should be deferred when the expected volatility of the investments' payoffs increases. I combine detailed data on oil drilling with expectations of future oil price volatility that I derive from the NYMEX futures options market. Conditioning on expected price levels, I find that oil production companies significantly reduce the number of wells they drill when expected price volatility is high. I conclude with "Daylight Time and Energy: Evidence from an Australian Experiment," co-authored with Hendrik Wolff. This chapter assesses DST's impact on electricity demand using a quasi-experiment in which parts of Australia extended DST in 2000 to facilitate the Sydney Olympics. We show that the extension did not reduce overall

  11. Biomechanics of Posterior Dynamic Fusion Systems in the Lumbar Spine: Implications for Stabilization With Improved Arthrodesis.

    Science.gov (United States)

    Yu, Alexander K; Siegfried, Catherine M; Chew, Brandon; Hobbs, Joseph; Sabersky, Abraham; Jho, Diana J; Cook, Daniel J; Bellotte, Jonathan Brad; Whiting, Donald M; Cheng, Boyle C

    2016-08-01

    A comparative biomechanical human cadaveric spine study of a dynamic fusion rod and a traditional titanium rod. The purpose of this study was to measure and compare the biomechanical metrics associated with a dynamic fusion device, Isobar TTL Evolution, and a rigid rod. Dynamic fusion rods may enhance arthrodesis compared with a rigid rod. Wolff's law implies that bone remodeling and growth may be enhanced through anterior column loading (AL). This is important for dynamic fusion rods because their purpose is to increase AL. Six fresh-frozen lumbar cadaveric specimens were used. Each untreated specimen (Intact) underwent biomechanical testing. Next, each specimen had a unilateral transforaminal lumbar interbody fusion performed at L3-L4 using a cage with an integrated load cell. Pedicle screws were also placed at this time. Subsequently, the Isobar was implanted and tested, and finally, a rigid rod replaced the Isobar in the same pedicle screw arrangement. In terms of range of motion, the Isobar performed comparably to the rigid rod and there was no statistical difference found between Isobar and rigid rod. There was a significant difference between the intact and rigid rod and also between intact and Isobar conditions in flexion extension. For interpedicular displacement, there was a significant increase in flexion extension (P=0.017) for the Isobar compared with the rigid rod. Isobar showed increased AL under axial compression compared with the rigid rod (P=0.024). Isobar provided comparable stabilization to a rigid rod when using range of motion as the metric, however, AL was increased because of the greater interpedicular displacement of dynamic rod compared with a rigid rod. By increasing interpedicular displacement and AL, it potentially brings clinical benefit to procedures relying on arthrodesis.

  12. Conference 'onshore and offshore wind energy cost reduction: challenges and opportunities for the industry in France and in Germany'

    International Nuclear Information System (INIS)

    Abadie, Pierre-Marie; Hinsch, Thomas; Wallasch, Anna-Kathrin; Giese, Norbert; Guyet, Quentin; Lenhardt, Edouard; Beinke, Thies; Bodenstab, Marc; Wolff, Nicolas; Burkhardt, Claus; Lessmeister, Andreas L.

    2012-01-01

    The French-German office for Renewable energies (OFAEnR) organised a conference on cost reduction in onshore and offshore wind energy. In the framework of this French-German exchange of experience, about 140 participants exchanged views on the cost allocation in onshore wind energy projects, on their financing, and on the transport and logistics profitability challenges. Concrete examples of operating and maintenance cost reductions in offshore wind energy projects were presented as well. This document brings together the available presentations (slides) made during this event: 1 - Overview of France's onshore and offshore wind support policies (Pierre-Marie Abadie); 2 - Keynote: Framework conditions for cost reductions in the German wind energy sector (Thomas Hinsch); 3 - Cost of onshore wind energy projects in Germany - Status and experience feedback (Anna-Kathrin Wallasch); 4 - Crown estate's Offshore Wind Cost Reduction Pathways Study: how to transpose the conclusions to the German case (Norbert Giese); 5 - Combined Forces for Reliable Supply Chain - French-German Convergence of expertise: strategic partnerships for offshore projects implementation (Quentin Guyet, Edouard Lenhardt); 6 - Reducing costs of onshore and offshore wind energy. Mon2Sea research project - Real-time monitoring of transport and cargo handling of components for the offshore installation of wind turbines (Thies Beinke, Marc Bodenstab); 7 - expertise, Innovation and reduction of cost of energy: Vestas experience (Nicolas Wolff); 8 - Far-Offshore-Wind projects. Results of the First German Offshore Windpark alpha ventus (Claus Burkhardt); 9 - Maintenance for Offshore-Wind parks: examples and good practices for the future (Andreas L. Lessmeister)

  13. Book Reviews

    Directory of Open Access Journals (Sweden)

    Th. Heesterman-Visser

    1967-04-01

    Full Text Available - J. van Baal, P. Lawrence, Gods ghosts and men in Melanesia; Some religions of Australian New Guinea and the New Hebrides. Melbourne, Oxford University Press, London, Wellington, New York 1965. 298 pp., M.J. Meggitt (eds. - R.S. Wassing, V.F.P.M. van Amelsvoort, Culture, stone age and modern medicine. The early introduction of integrated rural health in a non-literate society. A New Guinea case study in medical anthropology. Van Gorcum & Comp. N.V., Assen 1964. 245 blz., ill., krtn. - P. van Emst, R.G. Crocombe, Land tenure in the Cook Islands. Oxford University Press, Melbourne 1964. 180 blz. - H.J.M. Claessen, N.J.B. Plomley, Friendly mission: The Tasmanian journals and papers of George Augustus Robinson, 1829-1834. Tasmanian Historical Research Association. 1966. 1074 pp., 17 plates, 36 maps. - J.C. Anceaux, John U. Wolff, Beginning Cebuano. Part I. (Yale Linguistic Series, 9. Yale University Press. New Haven & London 1966. 685 pp. - J.C. Anceaux, G.B. Milner, Samoan dictionary, Samoan-English, English-Samoan. Oxford University Press, London, 1966. 465 pp. - L. Sluimers, J.G. Keyes, A bibliography of western-language publications concerning North Vietnam in the Cornell University Library. (Supplement to Data Paper: No. 47, A bibliography of North-Vietnamese publications in the Cornell University Library, September 1962. Data Paper: No. 63, Southeast Asia Program. Department of Asian Studies. Ithaca, Cornell University, 1966. XII, 280 blz., XIV. - Th. Heesterman-Visser, H.A.P.C. Oomen, Eten om te leven. N.V. De Arbeiderspers voor N.O.V.I.B., Amsterdam 1965. 130 foto’s met tekst., B. Lawson (eds.

  14. Quest for steel quality: the role of metallurgical chemistry

    Energy Technology Data Exchange (ETDEWEB)

    McLean, A. [Toronto Univ., ON (Canada). Dept. of Metallurgy and Materials Science

    2000-10-01

    Improvements in the quality of steels and the role played by metallurgical chemistry to bring about those improvements are discussed. The particular emphasis is on the chemical behaviour of solutes in molten steel and the reaction between steel, slag and refractory materials and the manner in which they influence the physical properties and performance of the steel product. As an illustration of the contribution of chemistry to steel making the case of the steel plates used in the construction of the Titanic is cited. In 1911 when the Titanic was constructed by Harland and Wolff at their Belfast shipyard, the steel plates used in the hull met all then current specifications. In 1992 when a number of steel samples recovered from the Titanic were examined, it was found that the hull of the vessel was constructed of low carbon, semi-killed steel, produced in the open-hearth process. Microstructural analysis showed extensive carbon banding, typical of hot rolled 0.2 per cent carbon steel. Also found were long manganese sulphide inclusions elongated in the rolling direction, some of which exceeded 25 mm in length. It was determined that as a consequence of these inclusions, at a seawater temperature of 0 degree C, the hull plates of the Titanic had essentially no resistance to fracture. Today's high quality steels used in applications such as Arctic pipelines, offshore platforms, icebreakers and ships for the transportation of natural gas, oxygen and sulphur concentrations are frequently less than 10 ppm. These elements have a profound influence of the quality of the final steel products by virtue of their effect of hindering the formation of inclusions. 2 refs., 3 figs.

  15. The History of the Wolff–Parkinson–White Syndrome

    Science.gov (United States)

    Scheinman, Melvin M.

    2012-01-01

    While Drs Wolff, Parkinson, and White fully described the syndrome in 1930, prior case reports had described the essentials. Over the ensuing century this syndrome has captivated the interest of anatomists, clinical cardiologists, and cardiac surgeons. Stanley Kent described lateral muscular connections over the atrioventricular (AV) groove which he felt were the normal AV connections. The normal AV connections were, however, clearly described by His and Tawara. True right-sided AV connections were initially described by Wood et al., while Öhnell first described left free wall pathways. David Scherf is thought to be the first to describe our current understanding of the pathogenesis of the WPW syndrome in terms of a re-entrant circuit involving both the AV node–His axis as well as the accessory pathway. This hypothesis was not universally accepted, and many theories were applied to explain the clinical findings. The basics of our understanding were established by the brilliant work of Pick, Langendorf, and Katz who by using careful deductive analysis of ECGs were able to define the basic pathophysiological processes. Subsequently, Wellens and Durrer applied invasive electrical stimulation to the heart in order to confirm the pathophysiological processes. Sealy and his colleagues at Duke University Medical Center were the first to successfully surgically divide an accessory pathway and ushered in the modern era of therapy for these patients. Morady and Scheinman were the first to successfully ablate an accessory pathway (posteroseptal) using high-energy direct-current shocks. Subsequently Jackman, Kuck, Morady, and a number of groups proved the remarkable safety and efficiency of catheter ablation for pathways in all locations using radiofrequency energy. More recently, Gollob et al. first described the gene responsible for a familial form of WPW. The current ability to cure patients with WPW is due to the splendid contributions of individuals from diverse

  16. Paroxysmal supraventricular tachycardia: physiopathology and management

    Directory of Open Access Journals (Sweden)

    Paola Neroni

    2014-06-01

    Full Text Available Paroxysmal supraventricular tachycardia (PSVT is the most frequent arrhythmia in newborns and infants. Most supraventricular tachycardias affect structurally healthy hearts. Apart from occasional detection by parents, most tachycardias in this age group are revealed by heart failure signs, such as poor feeding, sweating and shortness of breath. The main symptom reported by school-age children is palpitations. The chronic tachycardia causes a secondary form of dilative cardiomyopathy. Treatment of acute episode usually has an excellent outcome. Vagal manoeuvres are effective in patients with atrioventricular reentrant tachycardia. Adenosine is the drug of choice at all ages for tachycardias involving the atrioventricular node. Its key advantage is its short half life and minimum or no negative inotropic effects. Verapamil is not indicated in newborns and children as it poses a high risk of electromechanical dissociation. Antiarrhythmic prophylaxis of PSVT recurrence is usually recommended in the first year of life, because the diagnosis of tachycardia may be delayed up to the appearance of symptoms. Digoxin can be administered in all forms of PSVT involving the atrioventricular node, except for patients with Wolff-Parkinson-White syndrome below one year of age. Patients with atrioventricular reentrant PSVT can be treated effectively by class Ic drugs, such as propaphenone and flecainide. Amiodarone has the greatest antiarrhythmic effect, but should be used with caution owing to the high incidence of side effects. Proceedings of the 10th International Workshop on Neonatology · Cagliari (Italy · October 22nd-25th, 2014 · The last ten years, the next ten years in Neonatology Guest Editors: Vassilios Fanos, Michele Mussap, Gavino Faa, Apostolos Papageorgiou

  17. Value of epicardial potential maps in localizing pre-excitation sites for radiofrequency ablation. A simulation study

    Science.gov (United States)

    Hren, Rok

    1998-06-01

    Using computer simulations, we systematically investigated the limitations of an inverse solution that employs the potential distribution on the epicardial surface as an equivalent source model in localizing pre-excitation sites in Wolff-Parkinson-White syndrome. A model of the human ventricular myocardium that features an anatomically accurate geometry, an intramural rotating anisotropy and a computational implementation of the excitation process based on electrotonic interactions among cells, was used to simulate body surface potential maps (BSPMs) for 35 pre-excitation sites positioned along the atrioventricular ring. Two individualized torso models were used to account for variations in torso boundaries. Epicardial potential maps (EPMs) were computed using the L-curve inverse solution. The measure for accuracy of the localization was the distance between a position of the minimum in the inverse EPMs and the actual site of pre-excitation in the ventricular model. When the volume conductor properties and lead positions of the torso were precisely known and the measurement noise was added to the simulated BSPMs, the minimum in the inverse EPMs was at 12 ms after the onset on average within cm of the pre-excitation site. When the standard torso model was used to localize the sites of onset of the pre-excitation sequence initiated in individualized male and female torso models, the mean distance between the minimum and the pre-excitation site was cm for the male torso and cm for the female torso. The findings of our study indicate that a location of the minimum in EPMs computed using the inverse solution can offer non-invasive means for pre-interventional planning of the ablative treatment.

  18. Exercise thallium testing in ventricular preexcitation

    Energy Technology Data Exchange (ETDEWEB)

    Archer, S.; Gornick, C.; Grund, F.; Shafer, R.; Weir, E.K.

    1987-05-01

    Ventricular preexcitation, as seen in Wolff-Parkinson-White syndrome, results in a high frequency of positive exercise electrocardiographic responses. Why this occurs is unknown but is not believed to reflect myocardial ischemia. Exercise thallium testing is often used for noninvasive assessment of coronary artery disease in patients with conditions known to result in false-positive electrocardiographic responses. To assess the effects of ventricular preexcitation on exercise thallium testing, 8 men (aged 42 +/- 4 years) with this finding were studied. No subject had signs or symptoms of coronary artery disease. Subjects exercised on a bicycle ergometer to a double product of 26,000 +/- 2,000 (+/- standard error of mean). All but one of the subjects had at least 1 mm of ST-segment depression. Tests were terminated because of fatigue or dyspnea and no patient had chest pain. Thallium test results were abnormal in 5 patients, 2 of whom had stress defects as well as abnormally delayed thallium washout. One of these subjects had normal coronary arteries on angiography with a negative ergonovine challenge, and both had normal exercise radionuclide ventriculographic studies. Delayed thallium washout was noted in 3 of the subjects with ventricular preexcitation and normal stress images. This study suggests that exercise thallium testing is frequently abnormal in subjects with ventricular preexcitation. Ventricular preexcitation may cause dyssynergy of ventricular activation, which could alter myocardial thallium handling, much as occurs with left bundle branch block. Exercise radionuclide ventriculography may be a better test for noninvasive assessment of coronary artery disease in patients with ventricular preexcitation.

  19. The occurrence of new arrhythmias after catheter-ablation of accessory pathway: Delayed arrhythmic side-effect of curative radiofrequency lesion?

    Directory of Open Access Journals (Sweden)

    Mujović Nebojša

    2011-01-01

    Full Text Available Introduction. New arrhythmias (NA may appear late after accessory pathway (AP ablation, but their relation to curative radiofrequency (RF lesion is unknown. Objective. The aim of this study was to determine the prevalence and predictors for NA occurrence after AP ablation and to investigate pro-arrhythmic effect of RF. Methods. Total of 124 patients (88 males, mean age 43±14 years with Wolff-Parkinson-White syndrome and single AP have been followed after successful RF ablation. Post-ablation finding of arrhythmia, not recorded before the procedure, was considered a NA. The origin of NA was assessed by analysis of P-wave and/or QRS-complex morphology, and, thereafter, it was compared with locations of previously ablated APs. Results. Over the follow-up of 4.3±3.9 years, NA was registered in 20 patients (16%. The prevalence of specific NAs was as follows: atrioventricular (AV block 0.8%, atrial premature beats 1.6%, atrial fibrillation 5.4%, atrial flutter 0.8%, sinus tachycardia 4.8%, ventricular premature beats (VPBs 7.3%. Multivariate Cox-regression analysis identified (1 pre-ablation history of pathway-mediated tachyarrhythmias >10 years (HR=3.54, p=0.016 and (2 septal AP location (HR=4.25, p=0.003, as the independent predictors for NA occurrence. In four NA cases (two cases of septal VPBs, one of typical AFL and one of AV-block presumed NA origin was identified in the vicinity of previous ablation target. Conclusion. NAs were found in 16% of patients after AP elimination. In few of these cases, late on-site arrhythmic effect of initially curative RF lesion might be possible. While earlier intervention could prevent NA occurrence, closer follow-up is advised after ablation of septal AP.

  20. Screening of Long Q-T Syndrome in Patients with Congenital Sensorineural Hearing Loss (Jervell and Lange Neilesen Syndrome: Prevention of Fatal Events

    Directory of Open Access Journals (Sweden)

    Farid Matin

    2001-01-01

    Full Text Available Objective:The idiopathic long Q-T syndrome is an infrequently occurring disorder in which affected individuals have an unusual electrocardiographic repolarization abnormality presenting as syncope or loss of consciousness related to ventricular tachycardia or fibrillation. Congenital long Q-T prolongation can be associated with congenital deafness in an autosomal recessive manner (Jervell and Lange-Nielsen syndrome. The purpose of this stuff was to screen this electrocardiographic abnormality in deaf-mute school children in our population, which has not been yet performed. Materials & Methods:  Of 1190 patients with hearing loss, 779 had congenital sensorineural deafness (CSD, aged 13±3.8 years (4-24, 63% female and 37% male. The family history of deafness was as follows: Cardiac axis deviation was found in 56 (7% patients. Electrical conduction abnormalities were found in 12 (15% patients, Wolff-Parkinson-White syndrome, sinus bradycardia, and sinus arrhythmia were found in 2 (0.25%, 4 (0.5%, and 3 (0.38% patients, respectively. The Q-T interval, and Q-Tc duration were 312.6±28.9 ms (200-500 ms, median 320 ms, and 383.6±29.3 ms (232-527 ms, median 413ms, respectively. Long Q-T syndrome was found in 4 (0.5% patients (3F and 1M. Results: Two of these 4 patients had total deafness and 2 had profound hearing loss. None of the patients with mild deafness had Q-T prolongation. Only one of these patients was symptomatic, and had been treated as a case of epilepsy for several years. Conclusion: This data supports the presence of long Q-T syndrome in patients with sensorineural hearing loss in our population, so routine electrocardiographic screening of anyone with congenital deafness is warranted to prevent subsequent associated cardiac arrhythmias and sudden cardiac death.

  1. Gated blood pool imaging in the diagnosis and management of arrhythmia

    International Nuclear Information System (INIS)

    Yamamoto, Shuhei; Kawai, Naoki; Okada, Mitsuhiro; Matsushima, Hideo; Kato, Rinya; Sotobata, Iwao; Tanahashi, Yoshibumi.

    1985-01-01

    The usefulness of multigated cardiac blood pool imaging in evaluating left ventricular function and ventricular activation was studied in patients with cardiac arrhythmias. Subjects consisted of 12 patients with the Wolff-Parkinson-White (WPW) syndrome; 20 with ventricular premature contractions (VPC); 21 with various modes of artificial pacemakers; and two normal controls. 1. Phase analysis was useful in localizing the bypass tract in patients with the WPW syndrome. In four patients with the WPW syndrome and five with VVI pacing, the phase difference between the posterolateral wall of the left ventricle (LV) and the right ventricular apex correlated significantly with the activation time difference between these two regions as assessed by endocardial electrograms (r = 0.94, p < 0.001). 2. Images of VPC were obtained using the bad beat rejection program in an ADAC computer system. The origin of VPCs evaluated by phase image coincided with results of standard 12-lead electrograms. 3. The LV ejection fraction (LVEF) decreased significantly (p < 0.001) after the injection of lidocaine (-3.7 %) or disopyramide (-6.2 %). The percent reduction in LVEF was significantly greater with disopyramide than with lidocaine (-15.1 vs -11.2 %). There was a significant correlation between the percent reduction in LVEF and the disopyramide plasma concentrations (r = -0.62, p < 0.001). 4. The influence of the pacing mode and exercise on LV function was studied in 21 patients with artificial pacemakers. In the VDD and DDD modes, end-diastolic volume (EDV) and cardiac output (CO) decreased after converting to VVI mode. CO increased markedly to approximately 250 % of the control value in the VDD and DDD, and moderately in the VVI and AAI modes during ergometer exercise. (J.P.N.)

  2. The History of the Wolff–Parkinson–White Syndrome

    Directory of Open Access Journals (Sweden)

    Melvin M. Scheinman

    2012-07-01

    Full Text Available While Drs Wolff, Parkinson, and White fully described the syndrome in 1930, prior case reports had described the essentials. Over the ensuing century this syndrome has captivated the interest of anatomists, clinical cardiologists, and cardiac surgeons. Stanley Kent described lateral muscular connections over the atrioventricular (AV groove which he felt were the normal AV connections. The normal AV connections were, however, clearly described by His and Tawara. True right-sided AV connections were initially described by Wood et al., while Öhnell first described left free wall pathways. David Scherf is thought to be the first to describe our current understanding of the pathogenesis of the WPW syndrome in terms of a re-entrant circuit involving both the AV node–His axis as well as the accessory pathway. This hypothesis was not universally accepted, and many theories were applied to explain the clinical findings. The basics of our understanding were established by the brilliant work of Pick, Langendorf, and Katz who by using careful deductive analysis of ECGs were able to define the basic pathophysiological processes. Subsequently, Wellens and Durrer applied invasive electrical stimulation to the heart in order to confirm the pathophysiological processes. Sealy and his colleagues at Duke University Medical Center were the first to successfully surgically divide an accessory pathway and ushered in the modern era of therapy for these patients. Morady and Scheinman were the first to successfully ablate an accessory pathway (posteroseptal using high-energy direct-current shocks. Subsequently Jackman, Kuck, Morady, and a number of groups proved the remarkable safety and efficiency of catheter ablation for pathways in all locations using radiofrequency energy. More recently, Gollob et al. first described the gene responsible for a familial form of WPW. The current ability to cure patients with WPW is due to the splendid contributions of individuals

  3. Markov random fields simulation: an introduction to the stochastic modelling of petroleum reservoirs; Simulacao de campos aleatorios markovianos: uma introducao voltada a modelagem estocastica de reservatorios de petroleo

    Energy Technology Data Exchange (ETDEWEB)

    Saldanha Filho, Paulo Carlos

    1998-02-01

    Stochastic simulation has been employed in petroleum reservoir characterization as a modeling tool able to reconcile information from several different sources. It has the ability to preserve the variability of the modeled phenomena and permits transference of geological knowledge to numerical models of flux, whose predictions on reservoir constitute the main basis for reservoir management decisions. Several stochastic models have been used and/or suggested, depending on the nature of the phenomena to be described. Markov Random Fields (MRFs) appear as an alternative for the modeling of discrete variables, mainly reservoirs with mosaic architecture of facies. In this dissertation, the reader is introduced to the stochastic modeling by MRFs in a generic sense. The main aspects of the technique are reviewed. MRF Conceptual Background is described: its characterization through the Markovian property and the equivalence to Gibbs distributions. The framework for generic modeling of MRFs is described. The classical models of Ising and Potts-Strauss are specific in this context and are related to models of Ising and Potts-Strauss are specific in this context and are related to models used in petroleum reservoir characterization. The problem of parameter estimation is discussed. The maximum pseudolikelihood estimators for some models are presented. Estimators for two models useful for reservoir characterization are developed, and represent a new contribution to the subject. Five algorithms for the Conditional Simulation of MRFs are described: the Metropolis algorithm, the algorithm of German and German (Gibbs sampler), the algorithm of Swendsen-Wang, the algorithm of Wolff, and the algorithm of Flinn. Finally, examples of simulation for some of the models discussed are presented, along with their implications on the modelling of petroleum reservoirs. (author)

  4. Analytical Solutions for the Surface States of Bi1-xSbx (0 ≤ x ≲ 0.1)

    Science.gov (United States)

    Fuseya, Yuki; Fukuyama, Hidetoshi

    2018-04-01

    Analytical solutions for the surface state (SS) of an extended Wolff Hamiltonian, which is a common Hamiltonian for strongly spin-orbit coupled systems, are obtained both for semi-infinite and finite-thickness boundary conditions. For the semi-infinite system, there are two types of SS solutions: (I-a) linearly crossing SSs in the direct bulk band gap, and (I-b) SSs with linear dispersions entering the bulk conduction or valence bands away from the band edge. For the finite-thickness system, a gap opens in the SS of solution I-a. Numerical solutions for the SS are also obtained based on the tight-binding model of Liu and Allen [https://doi.org/10.1103/PhysRevB.52.1566" xlink:type="simple">Phys. Rev. B 52, 1566 (1995)] for Bi1-xSbx (0 ≤ x ≤ 0.1). A perfect correspondence between the analytic and numerical solutions is obtained around the \\bar{M} point including their thickness dependence. This is the first time that the character of the SS numerically obtained is identified with the help of analytical solutions. The size of the gap for I-a SS can be larger than that of bulk band gap even for a "thick" films ( ≲ 200 bilayers ≃ 80 nm) of pure bismuth. Consequently, in such a film of Bi1-xSbx, there is no apparent change in the SSs through the band inversion at x ≃ 0.04, even though the nature of the SS is changed from solution I-a to I-b. Based on our theoretical results, the experimental results on the SS of Bi1-xSbx (0 ≤ x ≲ 0.1) are discussed.

  5. Exercise thallium testing in ventricular preexcitation

    International Nuclear Information System (INIS)

    Archer, S.; Gornick, C.; Grund, F.; Shafer, R.; Weir, E.K.

    1987-01-01

    Ventricular preexcitation, as seen in Wolff-Parkinson-White syndrome, results in a high frequency of positive exercise electrocardiographic responses. Why this occurs is unknown but is not believed to reflect myocardial ischemia. Exercise thallium testing is often used for noninvasive assessment of coronary artery disease in patients with conditions known to result in false-positive electrocardiographic responses. To assess the effects of ventricular preexcitation on exercise thallium testing, 8 men (aged 42 +/- 4 years) with this finding were studied. No subject had signs or symptoms of coronary artery disease. Subjects exercised on a bicycle ergometer to a double product of 26,000 +/- 2,000 (+/- standard error of mean). All but one of the subjects had at least 1 mm of ST-segment depression. Tests were terminated because of fatigue or dyspnea and no patient had chest pain. Thallium test results were abnormal in 5 patients, 2 of whom had stress defects as well as abnormally delayed thallium washout. One of these subjects had normal coronary arteries on angiography with a negative ergonovine challenge, and both had normal exercise radionuclide ventriculographic studies. Delayed thallium washout was noted in 3 of the subjects with ventricular preexcitation and normal stress images. This study suggests that exercise thallium testing is frequently abnormal in subjects with ventricular preexcitation. Ventricular preexcitation may cause dyssynergy of ventricular activation, which could alter myocardial thallium handling, much as occurs with left bundle branch block. Exercise radionuclide ventriculography may be a better test for noninvasive assessment of coronary artery disease in patients with ventricular preexcitation

  6. PHILOSOPHICAL-CULTURAL CONCEPTION OF TELEVISION AS A VISUAL PRACTICES OF XX-XXI CENTURY

    Directory of Open Access Journals (Sweden)

    A. M. Tormakhova

    2016-12-01

    Full Text Available Purpose of the article is to analyze the philosophical and cultural ideas about television, which is a leading visual practice of XX century. It does not lose its relevance in the beginning of the XXI. The role of television lies in visual presentation and formation of the basic norms of taste and traditions of different social groups. Television is the leading communicative practice, which consideration is represented differently in modern science. Research methodology involves an appeal to the philosophical and cultural concepts, representing different approaches to the understanding of television. The paper considers the views of Western scholars, such as R. Arnheim, M. Wolff, A. Kroker, G. Lipovetsky, M. McLuhan, D. Mulvin, J. Mittell, N. Postman, L. Saffhil, J. Sterne, E. Thompson, J. Fiske, S. Shapiro. During analysis of the issue of the specific nature of television content the works of Russian scientists – T. Savitskaya, N. Samutina and Polish contemporary author – R. Sapenko were used. Originality lies in the depiction of the main approaches to the study of television as a visual communicative practice. Deployment of the author's position within the designated issues is presented as a historical digression – from the first attempts at understanding the phenomenon of television to the newest scientific theories that have found expression in contemporary American philosophical and cultural thought. Results of the study can be used in the training course "Visual communication and practices." Conclusions indicated that the majority of contemporary visual practices based on certain patterns, embedded TV. Despite the emergence of new media practices, TV does not lose relevance, everywhere present in the culture, which means that his research will allow a better understanding of the specificity of cultural creativity process.

  7. Etiology of Sudden Cardiac Arrest and Death in US Competitive Athletes: A 2-Year Prospective Surveillance Study.

    Science.gov (United States)

    Peterson, Danielle F; Siebert, David M; Kucera, Kristen L; Thomas, Leah Cox; Maleszewski, Joseph J; Lopez-Anderson, Martha; Suchsland, Monica Z; Harmon, Kimberly G; Drezner, Jonathan A

    2018-04-09

    To determine the etiology of sudden cardiac arrest and death (SCA/D) in competitive athletes through a prospective national surveillance program. Sudden cardiac arrest and death cases in middle school, high school, college, and professional athletes were identified from July 2014 to June 2016 through traditional and social media searches, reporting to the National Center for Catastrophic Sports Injury Research, communication with state and national high school associations, review of the Parent Heart Watch database, and search of student-athlete deaths on the NCAA Resolutions List. Autopsy reports and medical records were reviewed by a multidisciplinary panel to determine the underlying cause. US competitive athletes with SCA/D. Etiology of SCA/D. A total of 179 cases of SCA/D were identified (74 arrests with survival, 105 deaths): average age 16.6 years (range 11-29), 149 (83.2%) men, 94 (52.5%) whites, and 54 (30.2%) African American. One hundred seventeen (65.4%) had an adjudicated diagnosis, including 83 deaths and 34 survivors. The most common etiologies included hypertrophic cardiomyopathy (19, 16.2%), coronary artery anomalies (16, 13.7%), idiopathic left ventricular hypertrophy/possible cardiomyopathy (13, 11.1%), autopsy-negative sudden unexplained death (8, 6.8%), Wolff-Parkinson-White (8, 6.8%), and long QT syndrome (7, 6.0%). Hypertrophic cardiomyopathy was more common in male basketball (23.3%), football (25%), and African American athletes (30.3%). An estimated 56.4% of cases would likely demonstrate abnormalities on an electrocardiogram. The etiology of SCA/D in competitive athletes involves a wide range of clinical disorders. More robust reporting mechanisms, standardized autopsy protocols, and accurate etiology data are needed to better inform prevention strategies.

  8. Developing the Serious Games potential in nursing education.

    Science.gov (United States)

    Petit dit Dariel, Odessa J; Raby, Thibaud; Ravaut, Frédéric; Rothan-Tondeur, Monique

    2013-12-01

    Shortened hospital stays, high patient acuity and technological advances demand that nurses increasingly make decisions under conditions of uncertainty and risk (Ebright et al., 2003). With rising trends towards out-patient care, nurses will need to perform complex problem-solving within a dynamic and changing environment for which there is not one clear solution (Schofield et al., 2010; Wolff et al., 2009). The development of sharp clinical reasoning skills, as well as skills in detection, monitoring, investigation and evaluation are therefore essential (Aitken et al., 2002). Yet few nursing students have long-term exposure to home-care and community situations. This is primarily due to scarce human resources and the time-consuming requirements of student supervision (Duque et al., 2008). When students are given the opportunity to experience home-care or community visits these tend to be unstructured leading to wide variations in their competencies. New pedagogical tools are needed to adequately and consistently prepare nurses for the skills they will need to care for patients outside acute care settings. Advances in Information and Communications Technologies (ICT) offer an opportunity to explore innovative pedagogical solutions that could help students develop these skills in a safe environment. A three-phased project is underway that aims to create and test a Serious Game to improve nurses' clinical reasoning and detection skills in home-care and community settings. The first phase of this project involves the development of a scenario, the game engine and the graphic design and will be the focus of this paper. The second and third phases will test the Serious Game as an educational intervention and will be reported in subsequent papers. Copyright © 2012 Elsevier Ltd. All rights reserved.

  9. Financial audit of antitachycardia pacing for the control of recurrent supraventricular tachycardia.

    Science.gov (United States)

    Griffith, M J; Bexton, R S; McComb, J M

    1993-03-01

    To assess the financial implications of antitachycardia pacing in patients with frequent supraventricular tachycardia. Intertach pacemakers were implanted in 25 patients (mean age 47 years, five men): 22 had atrioventricular nodal reentry tachycardia. The patients had failed a mean of 4.9 (range zero to eight) drugs and had been admitted to hospital 3.7 (zero to 31) times over a symptomatic period of 13.9 years (two months to 54 years). The mean admission time for implantation was 2.8 (two to seven) days. One patient with Wolff-Parkinson-White syndrome subsequently underwent surgery. Infection occurred in two patients, and pain over the pacemaker required its resiting in two. Two patients have had one admission each for tachycardia. Six patients remain on anti-arrhythmic drugs. Costs were calculated including value added tax, capital charges, and allocated overheads. The cost a year before pacing was 1174 pounds including drug costs, clinic visits, and hospital admissions. The mean cost of pacemaker implantation was 3364.22 pounds, including the pacemaker and lead, admission and procedure, readmissions and first pacing check. Subsequent annual follow up cost was 73.72 pounds including annual clinic visits and drug costs. The cost of pacing is 4241 pounds whereas medical management costs 7044 pounds assuming pacemaker life of six years: with a 10 year life the cost is 4537 pounds compared with 11,740 pounds: with a 12 year life the cost is 4685 pounds compared with 14,088 pounds. The excess cost of implantation of an antitachycardia pacemaker is minimal in patients with frequent supraventricular tachycardia despite drug treatment and is justified by excellent control of symptoms and reduction of drug use and hospital admissions.

  10. VizieR Online Data Catalog: Optical & Spitzer photometry in IC 1805 (Sung+, 2017)

    Science.gov (United States)

    Sung, H.; Bessell, M. S.; Chun, M.-Y.; Yi, J.; Naze, Y.; Lim, B.; Karimov, R.; Rauw, G.; Park, B.-G.; Hur, H.

    2017-06-01

    For a study of the IMF and the star-formation history of the young open cluster IC 1805, we obtained deep wide-field VRI and Hα images of IC 1805 using the CFH12K mosaic CCD camera of the CFHT on 2002 January 6 and 7. We also observed several regions in IC 1805, for a study of the reddening and massive star content, using the SITe 2000x800 CCD (Maidanak 2k CCD) and standard UBVRI filters of the AZT-22 1.5m telescope at the Maidanak Astronomical Observatory in Uzbekistan on 2003 August 18 and 2004 december 25,30. Later, we obtained additional images of the central region of IC 1805 with the Fairchild 486 CCD (SNUCam) and UBVI and Hα filters of the AZT-22 telescope on 2007 October 7 and 2009 January 19. The Spitzer mapping observations were performed on 2006 September 20 under program ID 20052 (PI: S. Wolff). For complete photometry of stars in the CFH12K FOV in 3.6 and 4.5um, we also downloaded and reduced the GLIMPSE360 data (AOR: 38753280, 38763264, 38769408, 38799104, 38798592, 38784512, PI: B. A. Whitney). MIPS scans of IC 1805 were obtained on 2005 August 31 and 2005 September 2 (PID 3234, PI: J. S. Greeves). The Chandra X-ray Observatory Observations of IC 1805 (ObsID: 7033, PI: L. Townley) were made on 2006 November 25. The total exposure time was about 79ks. The properties of 647 X-ray sources were published in Townsley+ (2014,J/ApJS/213/1). We searched for the optical and MIR counterparts of these X-ray sources with a matching radius of up to 1.5". (4 data files).

  11. Symbolic Perfume Brands in Perception of Consumers

    Directory of Open Access Journals (Sweden)

    Andréa de Albuquerque de Lima

    2013-06-01

    Full Text Available Não é de hoje que o marketing discute que em um mercado competitivo as organizações precisam identificar e distinguir suas ofertas, diferenciação que é apresentada aos consumidores justamente na forma de uma marca. Nos últimos anos tem-se observado a crescente importância atribuída à marca como um ativo para as organizações. Trata-se de um componente do produto que vem recebendo atenção notória e se tornado, em muitos casos, o maior patrimônio da empresa. O que se vê é um grande esforço de pensar a importância das marcas para as organizações. O grande desafio para as empresas não é a criação de uma marca, mas sim a construção de uma marca que traga significado e proporcione benefícios aos consumidores. Esses benefícios são tanto funcionais quanto simbólicos. Com o objetivo de verificar a relação entre os benefícios simbólicos e as marcas de perfume na percepção das consumidoras, realizou-se uma pesquisa online com 200 consumidoras utilizando-se o software Survey Qualtrics, na qual foi aplicada uma escala de simbolismo e experiência de marca já testada por Wolff (2002. A análise fatorial resultou em 5 fatores de simbolismo, a saber: experiência, prestígio, exclusividade, confiança/superação das expectativas e status. Como resultado, as marcas percebidas como mais simbólicas foram O Boticário e Dior.

  12. Effects of thyroid hormones on the heart.

    Science.gov (United States)

    Vargas-Uricoechea, Hernando; Bonelo-Perdomo, Anilsa; Sierra-Torres, Carlos Hernán

    2014-01-01

    Thyroid hormones have a significant impact on heart function, mediated by genomic and non-genomic effects. Consequently, thyroid hormone deficiencies, as well as excesses, are expected to result in profound changes in cardiac function regulation and cardiovascular hemodynamics. Thyroid hormones upregulate the expression of the sarcoplasmic reticulum calcium-activated ATPase and downregulate the expression of phospholamban. Overall, hyperthyroidism is characterized by an increase in resting heart rate, blood volume, stroke volume, myocardial contractility, and ejection fraction. The development of "high-output heart failure" in hyperthyroidism may be due to "tachycardia-mediated cardiomyopathy". On the other hand, in a hypothyroid state, thyroid hormone deficiency results in lower heart rate and weakening of myocardial contraction and relaxation, with prolonged systolic and early diastolic times. Cardiac preload is decreased due to impaired diastolic function. Cardiac afterload is increased, and chronotropic and inotropic functions are reduced. Subclinical thyroid dysfunction is relatively common in patients over 65 years of age. In general, subclinical hypothyroidism increases the risk of coronary heart disease (CHD) mortality and CHD events, but not of total mortality. The risk of CHD mortality and atrial fibrillation (but not other outcomes) in subclinical hyperthyroidism is higher among patients with very low levels of thyrotropin. Finally, medications such as amiodarone may induce hypothyroidism (mediated by the Wolff-Chaikoff), as well as hyperthyroidism (mediated by the Jod-Basedow effect). In both instances, the underlying cause is the high concentration of iodine in this medication. Copyright © 2014 Sociedad Española de Arteriosclerosis. Published by Elsevier España. All rights reserved.

  13. Challenges in Bootstrapping a Start-Up Venture: Keenga Research Turning the Tables on Venture Capitalists

    Directory of Open Access Journals (Sweden)

    Prescott C. Ensign

    2016-01-01

    Full Text Available This case study chronicles the timeline of a new venture – Keenga Research. Keenga Research has a novel proposition that it is seeking to introduce to the market. The business concept is to ask entrepreneurs to review the venture capital (VC firm that funded them. Reviews of VC firms would then be developed and marketed to those interested (funds and perhaps enterprises seeking funding. What makes this case unique is that Keenga Research was a lean start-up. Bootstrapping is a situation in which the entrepreneur chooses to fund the venture with his/her own personal resources. It involves self-funding (family and friends, tight monitoring of expenses, and maintaining control of ownership and management (Winborg & Landstrom 2001; Perry, Chandler, Yao, & Wolff, 2011; Winborg, 2015. The lean start-up approach favors experimentation over elaborate planning, customer feedback over intuition and iterative design over traditional big upfront research and development. This case study requires the reader to consider a number of the basic challenges facing all entrepreneurs and new ventures. Is the concept marketable? Can the concept be developed and brought to market in a timely manner? Will the product generate revenue? How? When? What are the commitments of the entrepreneurs? Have they considered the major challenges to be faced? Since this venture involved gathering and developing research information and then creating an online platform, Keenga Research faced significant concept-to-market challenges. The research method used in this case study is first person participant observation and interviews. One of the authors was a team member so the contextual details come from direct observation and first-hand knowledge. This method of research is often used in anthropology, sociology, and social psychology where an investigator studies the group by sharing in its activities. The other author provided an objective and conceptual perspective for analyzing

  14. Numerical evaluation of bone remodelling and adaptation considering different hip prosthesis designs.

    Science.gov (United States)

    Levadnyi, Ievgen; Awrejcewicz, Jan; Gubaua, José Eduardo; Pereira, Jucélio Tomás

    2017-12-01

    The change in mechanical properties of femoral cortical bone tissue surrounding the stem of the hip endoprosthesis is one of the causes of implant instability. We present an analysis used to determine the best conditions for long-term functioning of the bone-implant system, which will lead to improvement of treatment results. In the present paper, a finite element method coupled with a bone remodelling model is used to evaluate how different three-dimensional prosthesis models influence distribution of the density of bone tissue. The remodelling process begins after the density field is obtained from a computed tomography scan. Then, an isotropic Stanford model is employed to solve the bone remodelling process and verify bone tissue adaptation in relation to different prosthesis models. The study results show that the long-stem models tend not to transmit loads to proximal regions of bone, which causes the stress-shielding effect. Short stems or application in the calcar region provide a favourable environment for transfer of loads to the proximal region, which allows for maintenance of bone density and, in some cases, for a positive variation, which causes absence of the aseptic loosening of an implant. In the case of hip resurfacing, bone mineral density changes slightly and is closest to an intact femur. Installation of an implant modifies density distribution and stress field in the bone. Thus, bone tissue is stimulated in a different way than before total hip replacement, which evidences Wolff's law, according to which bone tissue adapts itself to the loads imposed on it. The results suggest that potential stress shielding in the proximal femur and cortical hypertrophy in the distal femur may, in part, be reduced through the use of shorter stems, instead of long ones, provided stem fixation is adequate. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Prenatal Phthalate Exposures and Childhood Fat Mass in a New York City Cohort.

    Science.gov (United States)

    Buckley, Jessie P; Engel, Stephanie M; Mendez, Michelle A; Richardson, David B; Daniels, Julie L; Calafat, Antonia M; Wolff, Mary S; Herring, Amy H

    2016-04-01

    Experimental animal studies and limited epidemiologic evidence suggest that prenatal exposure to phthalates may be obesogenic, with potential sex-specific effects of phthalates having anti-androgenic activity. We aimed to assess associations between prenatal phthalate exposures and childhood fat mass in a prospective cohort study. We measured phthalate metabolite concentrations in third-trimester maternal urine in a cohort of women enrolled in New York City between 1998 and 2002 (n = 404). Among 180 children (82 girls and 98 boys), we evaluated body composition using a Tanita scale at multiple follow-up visits between ages 4 and 9 years (363 total visits). We estimated associations of standard deviation differences or tertiles of natural log phthalate metabolite concentrations with percent fat mass using linear mixed-effects regression models with random intercepts for repeated outcome measurements. We assessed associations in multiple metabolite models and adjusted for covariates including prepregnancy body mass index, gestational weight gain, maternal smoking during pregnancy, and breastfeeding. We did not observe associations between maternal urinary phthalate concentrations and percent body fat in models examining continuous exposures. Fat mass was 3.06% (95% CI: -5.99, -0.09%) lower among children in the highest tertile of maternal urinary concentrations of summed di(2-ethylhexyl) phthalate (ΣDEHP) metabolites than in children in the lowest tertile. Though estimates were imprecise, there was little evidence that associations between maternal urinary phthalate concentrations and percent fat mass were modified by child's sex. Prenatal phthalate exposures were not associated with increased body fat among children 4-9 years of age, though high prenatal DEHP exposure may be associated with lower fat mass in childhood. Buckley JP, Engel SM, Mendez MA, Richardson DB, Daniels JL, Calafat AM, Wolff MS, Herring AH. 2016. Prenatal phthalate exposures and childhood fat

  16. Predators and Parasitoids of Cacopsylla pyri (L. (Hemiptera: Psyllidae in Serbia

    Directory of Open Access Journals (Sweden)

    Dušanka Jerinić Prodanović

    2010-01-01

    Full Text Available The presence of C. pyri and its natural enemies was studied in both treated and untreated pear orchards in Serbia from 2005 to 2009. Five parasitoid and 21 predator species were identified as present on a considerable number of sites. The following parasitoid species were found: Prionomitus mitratus (Dalman,Psyllaephagus procerus Marcet,Syrphophagus ariantes (Walker,Syrphophagus taeniatus Förster and Tamarixia sp. In the study, the species Psyllaephagus procerus,Syrphophagus ariantes and Tamarixia sp. were forthe first time identified as parasitoids of C. pyri and as new species in the Serbian fauna.Among the parasitoids determined, Prionomitus mitratus predominated. Of the predators, the following species in four orders were registered: Dermaptera [Forficula auricularia Linnaeus (Forficulidae], Heteroptera [Anthocoris nemoralis(Fabricius, Anthocoris nemorum (Linnaeus, Orius (Heterorius minutus (Linnaeus, Orius (Heterorius nigerWolff (Anthocoridae, Campylomma verbasci (Mayer-Dür, Deraeocoris (Deraeocorisruber(Linnaeusand Deraeocoris(Knightocarsuslutescens (Schilling(Miridae],Neuroptera[Chrysopa pallens Rambur,Chrysoperla carnea(Stephens,Chrysopa sp.(Chrysopidae], and Coleoptera [Coccinella septempunctata Linnaeus, Adalia bipunctata Linnaeus, Adalia decempunctata(Linnaeus, Hippodamia tredecimpunctata (Linnaeus,Hippodamia variegata(Goeze,Propylea quatuordecimpunctata (Linnaeus, Calvia (Anisocalvia quatuordecimguttata(Linnaeus(Coccinellidae, Cantharis rustica Fallén, Rhagonycha fulva (Scopoli and Rh. testacea(Linnaeus (Cantharidae]. Of the predators determined, 12 species were registered for the first time as predators of C. pyri in Serbia, while C. rustica, Rhagonycha fulva and Rh.testacea have so far been known neither in Serbia nor in the world as predators of pear suckers.

  17. Book Reviews

    Directory of Open Access Journals (Sweden)

    S. Husin Ali

    1977-04-01

    Full Text Available - G.A. Nagelkerke, Gerard J. Telkamp, Bouwstoffen voor de sociaal-economische geschiedenis van Indonesië van ca. 1900 tot 1940; een beschrijvende bibliografie; Koloniale studiën, 1916-1941; Koloniaal tijdschrift, 1912-1941. Amsterdam, Koninklijk Instituut voor de Tropen, 1977. 89 pp. - H.J. de Graaf, W.Ph. Coolhaas, Generale Missiven van Gouverneur-Generaal en Raden aan Heren XVII der Verenigde Oostindische Compagnie. Deel VI: 1698-1713. Uitgegeven door Dr. W.Ph. Coolhaas. Martinus Nijhoff, ‘s-Gravenhage 1976. XVI & 1000 blzn. Rijks Geschiedkundige Publicatiën. Grote Serie no. 159. - C.D. Grijns, John H. Wolff, Beginning Indonesian. Two parts, Southeast Asia Program, Cornell University, Ithaca, New York, 1971, 534 + 556 pp. tapes. - A. Ploeg, Fredrik Barth, Ritual and knowledge among the Baktaman of New Guinea. Universitetsforlaget, Oslo / Yale University Press, New Haven, 1975, 292 pp., maps, plates, figures, appendices, index. - A. Teeuw, Harry Aveling, Contemporary Indonesian poetry. Poems in Bahasa Indonesia and English by W.S. Rendra, Ajip Rosidi, Subagio Sastrowardojo, Toeti Heraty, Taufiq Ismail, Goenawan Mohamad, Sapardi Djoko Damono. Edited and translated by Harry Aveling. University of Queensland Press, Asian and Pacific Writing 5, St Lucia, Queensland 1975. 261 pp. - C. van Dijk, C. Smit, De dekolonisatie van Indonesië. H.D. Tjeenk (edition, Oxford University Press, 176 pp. - H.J.M. Claessen, S. Husin Ali, Malay peasant society and leadership. Kuala Lumpur: Oxford University Press, 1975. 192 pp. Bibliography, register, maps, tables, figures. - J.J. Romkes, Rodney Needham, Belief, language and experience. Basil Blackwell, Oxford 1972. XVII, 269 p. - J.B. Avé, Erik Jensen, The Iban and their Religion. Oxford Monographs on social anthropology. Oxford at the Clarendon Press, 1974, VIII, 242 pp.

  18. Acides gras polyinsaturés trans : aspects métaboliques

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    Sebedio Jean-Louis

    2000-01-01

    Full Text Available Les acides gras trans polyinsaturés sont formés à partir des acides gras indispensables (acides linoléique et a-linolénique au cours des traitements technologiques comme par exemple le raffinage des huiles ou la friture [1, 2]. L’acide linolénique est plus sensible à l’isomérisation que l’acide linoléique. En effet, comme l’a montré Wolff dans une revue récente [3], le degré d’isomérisation de l’acide linolénique peut atteindre 30 à 35 %. On retrouve également ces pourcentages dans les formules infantiles et le lait de femme [1]. Les principaux isomères formés sont les composés monotrans, à savoir les 18 :2-9trans,12cis, 18 :2-9cis,12trans, 18 :3-9trans,12cis,15cis, et le 18 :3-9cis,12cis,15-trans. Cependant, une température de désodorisation supérieure à 220 °C entraîne la formation d’isomères di-trans [4]. À titre d’exemple, nous avons représenté dans le tableau le contenu de quelques huiles végétales en isomères des acides linoléique et a-linolénique. Compte tenu de leur présence dans l’alimentation, on peut s’interroger sur les conséquences nutritionnelles et biochimiques de leur ingestion.

  19. Does the bipolar seesaw extend to the terrestrial southern mid-latitudes?

    Science.gov (United States)

    Newnham, Rewi M.; Vandergoes, Marcus J.; Sikes, Elisabeth; Carter, Lionel; Wilmshurst, Janet M.; Lowe, David J.; McGlone, Matt S.; Sandiford, Anna

    2012-03-01

    High precision comparison of Greenland and Antarctic ice cores, suggesting a pervasive antiphased temperature relationship between the polar hemispheres during the last glaciation, lends strong support to the bipolar seesaw model (EPICA, 2006). The extent to which reorganisation of ocean-heat transport during abrupt climate change events affected the southern mid-latitudes remains unclear, however, owing to a paucity of well-dated records with robust climate proxies, variability between some records, and varying interpretations of their significance. Here we present temperature reconstructions for three key pollen records recognised by the NZ-INTIMATE (NZ-I) group which, along with the preliminary NZ-I climate event stratigraphy (Alloway et al., 2007) and published marine records, are compared with polar ice core records for the interval 30-10 cal. ka. We focus on key events within the context of Dansgard Oeschger cycles 4-1 and The Antarctic Cold Reversal/Younger Dryas intervals. The New Zealand records are broadly consistent with an extended bipolar seesaw whereby the oceanic southern mid-latitudes are warmed at times of MOC weakening or cessation in the North Atlantic, and vice versa. Variability between records indicate that other factors must be involved, however, and nor do these records refute alternative models that predict an antiphased inter-hemispheric pattern. Nevertheless an extended bipolar model may explain an early onset of LGM conditions in New Zealand and elsewhere in the Southern Hemisphere at a time when interstadials GI3 and GI4 kept Greenland warm. Similar inter-hemispheric dynamics have been invoked to explain an earlier termination of the LGM in Antarctica than in Greenland (Wolff et al., 2009) which is also evident in the New Zealand records. A prominent mid-LGM interstadial complex observed in several New Zealand records, connected by tephrochronology may represent another antiphased event although stronger chronological control is needed

  20. Disfunción tiroidea inducida por amiodarona en la práctica clínica

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    José Luis Paz-Ibarra

    2011-01-01

    Full Text Available La amiodarona (AMD es una droga antiarrítmica potente (clase III usada en la práctica clínica para la profilaxis y el tratamiento de muchos disturbios del ritmo cardiaco, desde la fibrilación auricular paroxística hasta las taquiarritmias ventriculares que amenazan la vida. Frecuentemente causa cambios en las pruebas de función tiroidea principalmente relacionados a la inhibición de la actividad de la 5'-deiodinasa, resultando en una disminución de la generación de T3 desde T4 y el consecuente incremento en la producción de T3 reversa y una disminución de su aclaramiento. En 14 a 18% de pacientes tratados con AMD hay una disfunción tiroidea manifiesta, ya sea tirotoxicosis inducida por amiodarona (TIA o hipotiroidismo inducido por amiodarona (HIA. Tanto TIA como HIA pueden desarrollarse en glándulas aparentemente normales o en glándulas con anormalidades preexistentes clínicamente silentes. La TIA está primariamente relacionada a la síntesis de hormonas tiroideas inducida por el exceso de yodo en una glándula tiroidea anormal (TIA tipo 1 o a una tiroiditis destructiva relacionada a la amiodarona (TIA tipo 2, aunque frecuentemente ocurren formas mixtas. La tiroiditis de Hashimoto preexistente es un factor de riesgo definido para la ocurrencia de HIA. La patogenia del HIA es la falla para escapar del efecto agudo de Wolff-Chaikoff inducido por el yodo, debido a los defectos en la hormonogénesis tiroidea y, en pacientes con pruebas de autoanticuerpos tiroideos positivos, para tiroiditis de Hashimoto concomitante. La TIA es más común en zonas deficientes de yodo mientras que el HIA es usualmente visto en zonas suficientes en yodo. En contraste al HIA, la TIA es una condición difícil de diagnosticar y tratar, y usualmente se recomienda la descontinuación de la amiodarona. En esta revisión se analiza, de acuerdo a los datos actuales, las alteraciones en las pruebas de función tiroidea vistas en pacientes eutirodeos bajo

  1. Sudden cardiac death in athletes and its preventive strategies: review article

    Directory of Open Access Journals (Sweden)

    Farzin Halabchi

    2017-12-01

    Full Text Available Sudden cardiac death in sport, although rare, but is a tragic event, attracting the media and public attention. Sport and exercise may act as a trigger for sudden cardiac death. Risk of sudden death in young athletes with cardiovascular disease is 2.5 times more frequent than non-athlete individuals. More than 90% of cases of sudden death occur during or immediately after training or competition. Incidence of sudden cardiac death in any population, including athletes, is related to multiple factors such as gender, age, race, nationality, diagnostic screening methods and preventive measures for sudden cardiac death. Otherwise, incidence rate of sudden cardiac death is linked to the used definition and method of diagnosis. Different cardiovascular disorders may result in death of young athletes and hypertrophic cardiomyopathy, congenital coronary anomalies, arrhythmogenic right ventricular dysplasia and aortic rupture are among the most common causes. Marfan syndrome, dilated cardiomyopathy, viral myocarditis, Wolff-Parkinson-White (WPW syndrome, congenital long QT syndrome, Brugada syndrome and commotio cordis are reported as other etiologies. In older athletes (more than 35 years, ischemic coronary heart disease is responsible for majority of the cases similar to the general population. Because the outcome of sudden cardiac arrest in sports is very poor except in few cases, proper national strategies are needed to diminish the burden of sudden death in young athletes. It seems that there are two main strategies to achieve this goal: A Primary prevention with use of purposeful pre-participation evaluation programs. This evaluation should focuss on the proper history and physical examination. Nevertheless, there is significant debate between American and European countries regarding the use of paraclinical investigations (especially ECG. American heart association does not recommend ECG as an essential part of evaluation. In contrast, European

  2. How relevant is heterogeneous chemistry on Mars? Strong tests via global mapping of water and ozone (sampled via O2 dayglow)

    Science.gov (United States)

    Villanueva, Geronimo Luis; Mumma, Michael J.; Novak, Robert E.

    2015-11-01

    Ozone and water are powerful tracers of photochemical processes on Mars. Considering that water is a condensable with a multifaceted hydrological cycle and ozone is continuously being produced / destroyed on short-time scales, their maps can test the validity of current 3D photochemical and dynamical models. Comparisons of modern GCM models (e.g., Lefèvre et al. 2004) with certain datasets (e.g., Clancy et al. 2012; Bertaux et al. 2012) point to significant disagreement, which in some cases have been related to heterogeneous (gas-dust) chemistry beyond the classical gas-gas homogeneous reactions.We address these concerns by acquiring full 2D maps of water and ozone (via O2 dayglow) on Mars, employing high spectral infrared spectrometers at ground-based telescopes (CRIRES/VLT and CSHELL/NASA-IRTF). By performing a rotational analysis on the O2 lines, we derive molecular temperature maps that we use to derive the vertical level of the emission (e.g., Novak et al. 2002). Our maps sample the full observable disk of Mars on March/25/2008 (Ls=50°, northern winter) and on Jan/29/2014 (Ls=83°, northern spring). The maps reveal a strong dependence of the O2 emission and water burden on local orography, while the temperature maps are in strong disagreement with current models. Could this be the signature of heterogeneous chemistry? We will present the global maps and will discuss possible scenarios to explain the observations.This work was partially funded by grants from NASA's Planetary Astronomy Program (344-32-51-96), NASA’s Mars Fundamental Research Program (203959.02.02.20.29), NASA’s Astrobiology Program (344-53-51), and the NSF-RUI Program (AST-805540). We thank the administration and staff of the European Southern Observatory/VLT and NASA-IRTF for awarding observing time and coordinating our observations.Bertaux, J.-L., Gondet, B., Lefèvre, F., et al. 2012. J. Geophys. Res. Pl. 117. pp. 1-9.Clancy, R.T., Sandor, B.J., Wolff, M.J., et al. 2012. J. Geophys. Res

  3. Three-dimensional mapping of mechanical activation patterns, contractile dyssynchrony and dyscoordination by two-dimensional strain echocardiography: Rationale and design of a novel software toolbox

    Directory of Open Access Journals (Sweden)

    Cramer Maarten J

    2008-05-01

    Full Text Available Abstract Background Dyssynchrony of myocardial deformation is usually described in terms of variability only (e.g. standard deviations SD's. A description in terms of the spatio-temporal distribution pattern (vector-analysis of dyssynchrony or by indices estimating its impact by expressing dyscoordination of shortening in relation to the global ventricular shortening may be preferential. Strain echocardiography by speckle tracking is a new non-invasive, albeit 2-D imaging modality to study myocardial deformation. Methods A post-processing toolbox was designed to incorporate local, speckle tracking-derived deformation data into a 36 segment 3-D model of the left ventricle. Global left ventricular shortening, standard deviations and vectors of timing of shortening were calculated. The impact of dyssynchrony was estimated by comparing the end-systolic values with either early peak values only (early shortening reserve ESR or with all peak values (virtual shortening reserve VSR, and by the internal strain fraction (ISF expressing dyscoordination as the fraction of deformation lost internally due to simultaneous shortening and stretching. These dyssynchrony parameters were compared in 8 volunteers (NL, 8 patients with Wolff-Parkinson-White syndrome (WPW, and 7 patients before (LBBB and after cardiac resynchronization therapy (CRT. Results Dyssynchrony indices merely based on variability failed to detect differences between WPW and NL and failed to demonstrate the effect of CRT. Only the 3-D vector of onset of shortening could distinguish WPW from NL, while at peak shortening and by VSR, ESR and ISF no differences were found. All tested dyssynchrony parameters yielded higher values in LBBB compared to both NL and WPW. CRT reduced the spatial divergence of shortening (both vector magnitude and direction, and improved global ventricular shortening along with reductions in ESR and dyscoordination of shortening expressed by ISF. Conclusion Incorporation

  4. Diet and lifestyle factors associated with miRNA expression in colorectal tissue

    Directory of Open Access Journals (Sweden)

    Slattery ML

    2016-12-01

    Full Text Available Martha L Slattery,1 Jennifer S Herrick,1 Lila E Mullany,1 John R Stevens,2 Roger K Wolff1 1Department of Internal Medicine, The University of Utah, Salt Lake City, 2Department of Mathematics and Statistics, Utah State University, Logan, UT, USA Abstract: MicroRNAs (miRNAs are small non-protein-coding RNA molecules that regulate gene expression. Diet and lifestyle factors have been hypothesized to be involved in the regulation of miRNA expression. In this study it was hypothesized that diet and lifestyle factors are associated with miRNA expression. Data from 1,447 cases of colorectal cancer to evaluate 34 diet and lifestyle variables using miRNA expression in normal colorectal mucosa as well as for differential expression between paired carcinoma and normal tissue were used. miRNA data were obtained using an Agilent platform. Multiple comparisons were adjusted for using the false discovery rate q-value. There were 250 miRNAs differentially expressed between carcinoma and normal colonic tissue by level of carbohydrate intake and 198 miRNAs differentially expressed by the level of sucrose intake. Of these miRNAs, 166 miRNAs were differentially expressed for both carbohydrate intake and sucrose intake. Ninety-nine miRNAs were differentially expressed by the level of whole grain intake in normal colonic mucosa. Level of oxidative balance score was associated with 137 differentially expressed miRNAs between carcinoma and paired normal rectal mucosa. Additionally, 135 miRNAs were differentially expressed in colon tissue based on recent NSAID use. Other dietary factors, body mass index, waist and hip circumference, and long-term physical activity levels did not alter miRNA expression after adjustment for multiple comparisons. These results suggest that diet and lifestyle factors regulate miRNA level. They provide additional support for the influence of carbohydrate, sucrose, whole grains, NSAIDs, and oxidative balance score on colorectal cancer risk

  5. Clinical evaluation of a water-in-oil emulsion with protective and regenerative properties for the anogenital area

    Directory of Open Access Journals (Sweden)

    Küppers V

    2015-11-01

    Full Text Available Volkmar Küppers,1 Michael Kemper,2 Christoph Abels2 1Gynecological Practice, Dysplasia-Clinic, Düsseldorf, Germany; 2Dr August Wolff GmbH & Co KG Arzneimittel, Bielefeld, Germany Abstract: Inadequate hygiene, aggressive cleansing, and chafing skin folds, as well as urine, feces, and sweat may trigger irritative contact dermatitis in the anogenital area. Serious recommendations for protection of the skin toward irritants include hygienic aspects and the use of appropriate skin care. Furthermore, preventing an accumulation of irritants on unprotected skin is mandatory. An intraindividual comparison study with 30 participants (17 female, 13 male; age: 44.2±8.3 years was performed to evaluate the properties of a newly developed water-in-oil (W/O balm on artificial sodium dodecyl sulfate-damaged epidermal barrier. The balm was applied 14 days twice daily, and transepidermal water loss and erythema were investigated. A significant improvement of both parameters after 12 days and even after 21 days could be confirmed. Two major clinical trials were performed to evaluate the safety and efficacy regarding protective and regenerative properties of the W/O balm on irritated skin in the anogenital area. Therefore, 29 children were enrolled (14 male, 15 female, age: 15.5±7.8 months in an open-labeled 4-week clinical study. The balm was used in the area under disposable diapers at least after diaper change or if required. Furthermore, in a second open, multicenter study, 43 women (mean age: 46.2±16.9 with predisposition to skin irritation in the outer anogenital region were included. The product was applied for 4 weeks 1–2 times daily. In both studies, skin tolerability, applicability, scent, spreadability, and removability of the balm were evaluated by participants and practitioners predominantly as good or even very good, also skin hydration, protection, and regeneration were judged positively. The studies confirmed that the newly developed W/O balm

  6. Dos décadas de seguimiento exitoso de la primera ablación de arritmias por catéter de radiofrecuencia realizado en la historia de la medicina del Paraguay

    Directory of Open Access Journals (Sweden)

    Osmar Antonio Centurión

    2015-08-01

    Full Text Available La técnica de mapeo endocárdico durante el estudio electrofisiológico ha sido extensamente empleada en el análisis de las taquicardias paroxísticas supraventriculares (TPS. Mediante este mapeo endocárdico y el análisis meticuloso de los electrogramas endocárdicos y los respectivos intervalos de conducción, es posible localizar el sitio de origen de las arritmias y así facilitar su tratamiento ablativo por medio de catéteres de radiofrecuencia. Se describe el caso de un hombre de 29 años con síndrome de Wolff-Parkinson-White (WPW que manifiestó que presentaba varios episodios documentados de TPS con serio compromiso hemodinámico que motivaba su frecuente internación en terapia intensiva. El mapeo electrofisiológico endocárdico meticuloso demostró la presencia de un haz anómalo de Kent auriculoventricular izquierdo en posición posteroseptal. El período refractario absoluto del haz anómalo de Kent fue de 240 ms. La primera emisión de radiofrecuencia a través de un catéter adecuadamente posicionado previo terminó la taquicardia. La taquicardia permaneció no inducible a partir de entonces. En estas dos décadas de seguimiento clínico, el paciente no ha presentado ni un solo episodio de taquicardia. La curación definitiva generada por la ablación del haz anómalo de Kent ha proporcionado un cambio drástico, total y beneficioso en la calidad de vida al paciente. Los beneficios clínicos y socioeconómicos son mayores cuanto más temprano en la evolución se realice el procedimiento de ablación de arritmias.

  7. Teaching and Learning Astronomy

    Science.gov (United States)

    Pasachoff, Jay; Percy, John

    2009-07-01

    Preface; Part I. Astronomy in the Curriculum Around the World: Preface; 1. Why astronomy is useful and should be included in the school curriculum John R. Percy; 2. Astronomy and mathematics education Rosa M. Ros; 3. Astronomy in the curriculum around the world; 4. Engaging gifted science students through astronomy Robert Hollow; 5. Poster highlights: astronomy in the curriculum around the world; Part II. Astronomy Education Research: Preface; 6. Astronomy education research down under John M. Broadfoot and Ian S. Ginns; 7. A contemporary review of K-16 astronomy education research Janelle M. Bailey and Timothy F. Slater; 8. Implementing astronomy education research Leonarda Fucili; 9. The Astronomy Education Review: report on a new journal Sidney C. Wolff and Andrew Fraknoi; 10. Poster highlights: astronomy education research; Part III. Educating Students: Preface; 11. Textbooks for K-12 astronomy Jay M. Pasachoff; 12. Distance/internet astronomy education David H. McKinnon; 13. Educating students with robotic telescopes - open discussion; 14. Poster highlights - educating students; Part IV. Educating teachers: Preface; 15. Pre-service astronomy education of teachers Mary Kay Hemenway; 16. In-service education of teachers Michèle Gerbaldi; 17. Poster highlights: educating teachers; Part V. Astronomy and Pseudoscience: Preface; 18. Astronomy, pseudoscience and rational thinking Jayant V. Narlikar; 19. Astronomical pseudosciences in North America John R. Percy and Jay M. Pasachoff; Part VI. Astronomy and Culture: Preface; 20. Teaching astronomy in other cultures: archeoastronomy Julieta Fierro; 21. Poster highlights: astronomy and culture; Part VII. Astronomy in Developing Countries: Preface; 22. Astronomy Curriculum for developing countries Case Rijsdijk; 23. Science education resources for the developing countries James C. White II; Part VIII. Public Outreach in Astronomy: Preface; 24. What makes informal education programs successful? Nahide Craig and Isabel

  8. Varying Conditions for Hexanoic Acid Degradation with BioTigerTM

    International Nuclear Information System (INIS)

    Foreman, Koji; Milliken, Charles; Brigmon, Robin

    2016-01-01

    BioTiger TM (BT) is a consortium of 12 bacteria designed for petroleum waste biodegradation. BT is currently being studied and could be considered for bioremediation of the Athabasca oil sands refineries in Canada and elsewhere. The run-off ponds from the petroleum extraction processes, called tailings ponds, are a mixture of polycyclic aromatic hydrocarbons, naphthenic acids, hydrocarbons, toxic chemicals like heavy metals, water, and sand. Due to environmental regulations the oil industry would like to separate and degrade the hazardous chemical species from the tailings ponds while recycling the water. It has been shown that BT at 30 C° is able to completely degrade 10 mM hexanoic acid (HA) co-metabolically with 0.2% yeast extract (w/v) in 48 hours when starting at 0.4 OD 600nm. After establishing this stable degradation capability, variations were tested to explore the wider parameters of BT activity in temperature, pH, intermediate degradation, co-metabolic dependence, and transfer stability. Due to the vast differences in temperature at various points in the refineries, a wide range of temperatures were assessed. The results indicate that BT retains the ability to degrade HA, a model surrogate for tailings pond contaminants, at temperatures ranging from 15°C to 35°C. Hexanamide (HAM) was shown to be an intermediate generated during the degradation of HA in an earlier work and HAM is completely degraded after 48 hours, indicating that HAM is not the final product of HA degradation. Various replacements for yeast extract were attempted. Glucose, a carbon source; casein amino acids, a protein source; additional ammonia, mimicking known media; and additional phosphate with Wolffe's vitamins and minerals all showed no significant degradation of HA compared to control. Decreasing the yeast extract concentration (0.05%) demonstrated limited but significant degradation. Finally, serial inoculations of BT were performed to determine the stability of

  9. EL RETORNO A LA TRADUCCIÓN O NUEVAMENTE SOBRE LA HISTORIA DEL CONCEPTO DE HERMENÉUTICA

    Directory of Open Access Journals (Sweden)

    Elvia María González Agudelo

    2011-05-01

    Full Text Available La palabra hermenéutica como neologismo fue introducida en el lenguaje por el filósofo Dannhauer, en el año 1654, haciendo alusión a una ciencia general de la interpretación como propedéutica para todas las ciencias. Desde allí, en el horizonte del pasado, la palabra hermenéutica fue considerada por la mitología griega como enunciación del pensamiento, traducción, mandato o adivinación. Pero en Aristóteles la hermenéutica se empieza a concebir en tanto lenguaje, como análisis de los juicios, y en cuanto teoría jurídica, como comprensión, interpretación y creación. Así el uso del término hermeneia se extendió en el Medioevo, alrededor de lo teológico y lo jurídico. En lo teológico se aplicó un texto en particular, la Biblia, desarrollándose entre dos opuestos: lo alegórico expuesto por Filón de Alejandría, Orígenes y Augusto de Dacia y lo literal expuesto por Lutero, Philipp Melanchthon y Flacius Illyricus. En lo jurídico, la hermeneia se desarrolló entre la dogmática y la exégesis, consolidándose como una disciplina profesional. Ahora bien, la contemporaneidad del término hermenéutica como una ciencia general, al estilo de Dannhauer, fue seguida por Wolff, Chladenius y Meier y desde allí en su horizonte, la hermenéutica se constituye como concepto en Schleiermacher, Boeckh, Droysen, Dilthey y el jurista Betti; todos ellos le otorgan la posibilidad de método a la comprensión para postular verdades en las ciencias del espíritu, siguiendo el modelo de las ciencias naturales. Pero ya en el siglo XX, con Heidegger y Gadamer, la hermenéutica incurre de lleno en el problema del ser, es el giro de lo epistemológico a lo filosófico pues el concepto que sustenta las ciencias del espíritu es la formación. La hermenéutica, entonces, en tanto traducción de algo extraño en algo propio, posibilita permanentemente la formación del ser

  10. First-principle Simulations of Heavy Fermion Materials

    Science.gov (United States)

    Dong, Ruanchen

    Heavy fermion materials, one of the most challenging topics in condensed matter physics, pose a variety of interesting properties and have attracted extensive studies for decades. Although there has been great success in explaining many ground- state properties of solids, the well-known theoretical calculations based on density functional theory (DFT) in its popular local density approximation (LDA) fail to describe heavy fermion materials due to improper treatment of many-body correlation effects. Here with the implementations of dynamical mean-field theory (DMFT) and the Gutzwiller variational method, the computational simulation of the heavy fermion materials is explored further and better compared with experimental data. In this dissertation, first, the theoretical background of DMFT and LDA+G methods is described in detail. The rest is the application of these techniques and is basically divided into two parts. First, the continuous-time quantum Monte Carlo (CT-QMC) method combined with DMFT is used to calculate and compare both the periodic Anderson model (PAM) and the Kondo lattice model (KLM). Different parameter sets of both models are connected by the Schrieffer-Wolff transformation. For spin and orbital degeneracy N = 2 case, a special particle-hole symmetric case of PAM at half-filling which always fixes one electron per impurity site is compared with the results of the KLM. We find a good mapping between PAM and KLM in the limit of large on-site Hubbard interaction U for different properties like self-energy, quasiparticle residue and susceptibility. This allows us to extract quasiparticle mass renormalizations for the f-electrons directly from KLM. The method is further applied to higher degenerate cases and to the realistic heavy fermion system CeRhIn5 in which the estimate of the Sommerfeld coefficient is proven to be close to the experimental value. Second, a series of Cerium based heavy fermion materials is studied using a combination of local

  11. Measurements of {sup 131}I-Labelled Triiodothyronine Uptake by a Resin as a Means of Diagnosing Iodine-Basedow Produced by Intramuscular Administration of Iodized Oil in an Area of Endemic Goitre; Utilidad de la Prueba de la Captacion de Triyodotironina Marcada con {sup 131}I por Resina en el Diagnostico de Yod-Basedow Producido por la Administracion Intramuscular de Aceite Yodado, en una Area de Bocio Endemico

    Energy Technology Data Exchange (ETDEWEB)

    Fierro-Benitez, R.; Ramirez, I. [Instituto de Ciencias Nucleares, Escuela Politecnica Nacional y Facultad de Medicina, Universidad Central, Quito (Ecuador)

    1970-02-15

    The authors gave intramuscular injections of iodized oil with a view to studying its prophylactic effects on endemic goitre and related defects (such as endemic cretinism) in isolated areas where more traditional techniques have serious limitations. This system had been tried earlier in New Guinea, where the results showed a reduction in the prevalence of goitre and proved the technique to be both safe and practical. However, because of the remoteness of the population in question it was impossible to continue the observations and no information was obtained regarding the effectiveness of iodized oil in reducing the incidence of defects associated with endemic goitre, Ecuador's program, involving studies of the whole population of two rural communities in the Andes, was begun in March 1966. The final control check came three years later. Ethiodol (37% iodized oil, 450 mg iodine per cm{sup 3}, obtained from Fougera, Hicksville, Long Island, N.Y. United States of America) was injected intramuscularly, 2 cm{sup 3} being administered to subjects 12 years of age and older and proportionately smaller doses to younger children. The ethiodol produced extensive changes in the physiological behaviour of the thyroid. {sup 131}I uptake was depressed for six months and afterwards remained normal. Similarly, BEI and T{sub 4} returned to and stayed at normal levels from the very first control checks onwards, which indicated that even during the first few months the thyroid glands of these subjects were maintaining a normal capacity to secrete thyronines, i.e. that they were not exhibiting the effect described by Wolff and Chaikoff, PBI and BII maintained high livels in all the controls. Urinary excretion of iodine followed a double exponential path: calculations indicated that the subjects would still be excreting significant amounts five years after the injection. Six months after injection there was an unequivocal diagnosis of Iodine-Basedow in three older women with large

  12. Synthesis and reactions of cyclovalence isomers of azo-keto-carbenes

    International Nuclear Information System (INIS)

    Rettenbacher, A.S.

    2001-09-01

    Novel types of cycloaddition products with an azomethine imine functionality have been prepared from ω-azo-α'-diazo ketones with a carbon chain of variable length between the azo- and the keto-group; the reaction is induced by catalytical amounts of rhodium(II) acetate and occurs with the concomitant extrusion of dinitrogen. The synthesis of these cyclic azomethine imines succeeded in the course of the intramolecular reaction of the azo nitrogen atoms with a carbene/carbenoid carbon atom, in situ generated from the α-diazoketone functionality; this is a novel cyclization reaction. Some of the resulting cyclization products are stable and have been isolated, others could only be trapped with dipolarophiles as [3+2] cycloadducts. The ring-size of the heterocyclic products depends on the one hand on the length of the carbon-chain (for n = 0, 1, 2) between the carbonyl carbon atom and the quaternary aliphatic or aromatic carbon atom that blocks the tautomerization of the azo-group in the starting material. On the other hand, the ring size depends on which of the two nitrogen atoms of the azo-group undergoes the ring closure with the carbene/carbenoid carbon atom generated from the α-diazoketon functionality in the course of the reaction. By far the most serious problem in the preparation of the cyclic azomethine imines is the synthesis of the required ω-azo-α'-diazo ketones. A so far unknown property of the azo-group is its intramolecularly directed nucleophilicity toward ketenes, which emerge from acid chlorides and anhydrides, or from α-diazo ketones in the course of the Wolff rearrangement. This complicated the approach to the required ω-azo-α'-diazo ketones via these functionalities as precursors and with the desired chain length between the azo- and diazo-keto-groups. Nevertheless, these problems could be overcome by using alternative strategies. Utilizing ω-azo-α'-diazo ketones a largely commonly applicable approach to endocyclic and N

  13. Toward re-thinking science education in terms of affective practices: reflections from the field

    Science.gov (United States)

    Kayumova, Shakhnoza; Tippins, Deborah

    2016-09-01

    Rational and operationalized views of science and what it means for teachers and students to know and enact legitimate science practices have dominated science education research for many decades (Fusco and Barton in J Res Sci Teach 38(3):337-354, 2001. doi: 10.1002/1098-2736(200103)38:33.0.CO;2-0). Michalinos Zembylas challenges historically prevalent dichotomies of mind/body, reason/emotion, and emotion/affect, calling researchers and educators to move beyond the Cartesian dualisms, which have perpetuated a myth of scientific objectivity devoid of bias, subjectivity and emotions. Zembylas (Crit Stud Teach Learn 1(1):1-21, 2013. doi: 10.14426/cristal.v1i1.2) contends that the role of emotions and affect are best understood as relational and entangled in epistemological, cultural, and historical contexts of education, which represent contested sites of control and resistance. We argue that Zembylas' work is pivotal since "theoretical frames of reference for doing research in science education…[and] what constitutes knowledge and being within a particular frame" carry material bearings over the enactments of science teaching and learning (Kyle in J Res Sci Teach 31:695-696, 1994, p. 321. doi: 10.1002/tea.3660310703). In this paper, we hold cogen dialogue about how re-thinking notions of emotion and affect affords us, both science educators and researchers, to re-envision science education beyond cognitive and social frames. The framing of our dialogue as cogen builds on Wolff-Michael Roth and Kenneth Tobin's (At the elbows of another: learning to teach through coteaching. Peter Lang Publishing, New York, 2002) notion of cogenerative dialogue. Holding cogen is an invitation to an openly dialogic and safe area, which serves as a space for a dialogic inquiry that includes radical listening of situated knowledges and learning from similarities as well as differences of experiences (Tobin in Cult Stud Sci Educ, in review, 2015). From our situated experiences reforms

  14. The magmatic evolution and genesis of the Quaternary basanite-trachyphonolite suite of Itasy (Madagascar) as inferred by geochemistry, Sr-Nd-Pb isotopes and trace element distribution in coexisting phases

    Science.gov (United States)

    Melluso, L.; Tucker, R. D.; Cucciniello, C.; le Roex, A. P.; Morra, V.; Zanetti, A.; Rakotoson, R. L.

    2018-06-01

    feature also shown in the trace element composition of the phenocrysts in trachyphonolites. Supplementary Table S2: synopsis of the mineral assemblages of the main lithotypes of the Itasy complex. Supplementary Table S3: composition of olivine of the Itasy rocks. Supplementary Table S4: composition of oxides of the Itasy rocks. Supplementary Table S5: composition of pyroxene of the Itasy rocks. Supplementary Table S6: composition of amphibole, biotite and rhönite of the Itasy rocks. Supplementary Table S7: composition of feldspar and glass of the Itasy rocks. Supplementary Table S8: composition of feldspathoids of the Itasy rocks. Supplementary Table S9: composition of titanite, apatite, other accessories of the Itasy rocks. Supplementary Table S10: Recapitulation of mass balance calculations between rocks of different degree of magmatic evolution, and detailed results. The composition of the phases is reported in the supplementary tables. Supplementary Table S11: average REE mineral/bulk rock ratios for titanite, amphibole and clinopyroxene. The partition coefficients of titanite, clinopyroxene, apatite and amphibole are taken from Olin and Wolff (2012), Fedele et al. (2009, 2015) and Tiepolo et al. (2007). Note that amphibole of RT-06I-355 could not be considered in equilibrium with the host rock (cf. Supplementary Figs. S1a, S1b, S1c).

  15. Interglacial climate dynamics and advanced time series analysis

    Science.gov (United States)

    Mudelsee, Manfred; Bermejo, Miguel; Köhler, Peter; Lohmann, Gerrit

    2013-04-01

    Studying the climate dynamics of past interglacials (IGs) helps to better assess the anthropogenically influenced dynamics of the current IG, the Holocene. We select the IG portions from the EPICA Dome C ice core archive, which covers the past 800 ka, to apply methods of statistical time series analysis (Mudelsee 2010). The analysed variables are deuterium/H (indicating temperature) (Jouzel et al. 2007), greenhouse gases (Siegenthaler et al. 2005, Loulergue et al. 2008, L¨ü thi et al. 2008) and a model-co-derived climate radiative forcing (Köhler et al. 2010). We select additionally high-resolution sea-surface-temperature records from the marine sedimentary archive. The first statistical method, persistence time estimation (Mudelsee 2002) lets us infer the 'climate memory' property of IGs. Second, linear regression informs about long-term climate trends during IGs. Third, ramp function regression (Mudelsee 2000) is adapted to look on abrupt climate changes during IGs. We compare the Holocene with previous IGs in terms of these mathematical approaches, interprete results in a climate context, assess uncertainties and the requirements to data from old IGs for yielding results of 'acceptable' accuracy. This work receives financial support from the Deutsche Forschungsgemeinschaft (Project ClimSens within the DFG Research Priority Program INTERDYNAMIK) and the European Commission (Marie Curie Initial Training Network LINC, No. 289447, within the 7th Framework Programme). References Jouzel J, Masson-Delmotte V, Cattani O, Dreyfus G, Falourd S, Hoffmann G, Minster B, Nouet J, Barnola JM, Chappellaz J, Fischer H, Gallet JC, Johnsen S, Leuenberger M, Loulergue L, Luethi D, Oerter H, Parrenin F, Raisbeck G, Raynaud D, Schilt A, Schwander J, Selmo E, Souchez R, Spahni R, Stauffer B, Steffensen JP, Stenni B, Stocker TF, Tison JL, Werner M, Wolff EW (2007) Orbital and millennial Antarctic climate variability over the past 800,000 years. Science 317:793. Köhler P, Bintanja R

  16. Comparison of linoleic acid-containing water-in-oil emulsion with urea-containing water-in-oil emulsion in the treatment of atopic dermatitis: a randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Nasrohalli SA

    2018-01-01

    Full Text Available Saman Ahmad Nasrollahi,1 Azin Ayatollahi,1 Taraneh Yazdanparast,1,2 Aniseh Samadi,1 Hamed Hosseini,3 Mansour Shamsipour,4 Ali Asghar Akhlaghi,5 Somayeh Yadangi,1 Christoph Abels,6 Alireza Firooz1,2 1Center for Research and Training in Skin Diseases and Leprosy, 2Telemedicine Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD, Shahid Beheshti University of Medical Sciences, 3Clinical Trial Center, 4Department of Research Methodology and Data Analysis, Institute for Environmental Research, Tehran University of Medical Sciences, 5Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran; 6Dr. August Wolff GmbH & Co. KG Arzneimittel, Bielefeld, Germany Background: Application of topical moisturizers is an essential part of the management of atopic dermatitis (AD. Linoleic acid (LA, the most abundant fatty acid in the epidermis, and its derivatives have an essential role in the structure and function of the epidermal barrier, and their defects are prominent in AD. The aim of this study was to compare the efficacy and safety of two cosmetic products containing either LA or urea in patients with AD.Patients and methods: A total of 20 patients with AD who met the eligibility criteria and provided written informed consents were enrolled in this randomized, intra-individual split-body, single-center trial. Symmetrical lesions of patients were randomized for treatment with LA- or urea-containing water-in-oil (w/o emulsions applied two to three times daily for 4 weeks. The efficacy of the two products was evaluated by local Scoring Atopic Dermatitis (SCORAD of both lesions and also patient (or guardian satisfaction. In addition, trans-epidermal water loss (TEWL, stratum corneum (SC hydration, pH, sebum, temperature, erythema, melanin content, and ultrasonographic thickness and echo density of epidermis and dermis were

  17. Treatment and follow-up of patients suffering from the cutaneous radiation syndrome

    International Nuclear Information System (INIS)

    Peter, R.U.; Gottloeber, P.; Heckmann, M.; Braun-FaIco, O.; Plewig, G.

    1996-01-01

    The hazards of acute radiation exposure are commonly addressed with respect to total body gamma or neutron irradiation, resulting primarily in bone marrow failure as the main clinically relevant aspect of the acute radiation disease. Under conditions of inhomogeneous exposure, as they are characteristic for many accident scenarios, other organ systems, such as the skin may become more important in determining clinical prognosis. This became especially obvious in the two worst radiation accidents since 1945, the Chernobyl accident in April 1986 and the Goiania accident in September 1987. The characteristic chronic sequelae of accidental cutaneous radiation exposure and therapeutic results have been described based on own clinical experience with treating patients with acute and late cutaneous effects after therapeutic irradiation, and a distinct group of patients having survived the Chernobyl nuclear power plant accident of April 26, 1986. Apart from clinical examination, histological analysis and high-frequency (20 MHz) ultrasound as well as a variety of functional tests have been used to determine the extent of radiation fibrosis and to exclude malignant transformation of keratoses and ulcers. Treatment included, apart from dermatosurgical procedures and plastic surgery for disabling contractures or ulcers, argon laser treatment of telangiectasias, topical tretinoin 0,005% (Epi-Aberel R , Cilag, Frankfurt), etretinate and acitretin (Tigason R , Neotigason R , Hoffmann LaRoche, Grenzach) for radiation keratoses, partly combined with a novel, nonatrophogenic steroid, Mometasonefuroate (Elocon R , Schering-Plough, New Jersey) to antagonize inflammatory reactions, and low-dose interferon-gamma (Polyferon R , Rentschler, Laupheim) for extensive radiation fibrosis. Basic dermatotherapy was performed with an ointment containing linoleic acid (Linola R , Wolff, Bielefeld). With this combination treatment, transepidermal water loss could be sustained, progression of

  18. Transposição do músculo reto do abdome para correção de defeito iatrogênico no diafragma em cães Rectos abdominis muscle flap for repair of iatrogenic diaphragmatic defects in dogs

    Directory of Open Access Journals (Sweden)

    Renato Xavier Faria

    2000-08-01

    Full Text Available Neste experimento, foram utilizados 6 cães, com o objetivo de avaliar a viabilidade do músculo reto do abdome pediculado para correção de defeito no diafragma. O músculo foi dissecado até próximo sua inserção e deslizado para a cavidade abdominal através de uma incisão paracostal. Após a formação de um defeito no diafragma de aproximadamente 4 x l0cm, o músculo reto do abdome foi fixado com pontos de Wolff com fio de seda 2-0. Os animais foram observados por um período de tempo determinado de 15, 30 e 60 dias, quando foram operados novamente para observação macroscópica e microscópica. Tecido conetivo e áreas de hemorragia entre o retalho e diafragma, com tecido de granulação de maturidade média, foram observados no material das biópsias aos 15 dias. Aos 30 dias, foi notado pouco tecido de granulação que, aos 60 dias, era maduro. Na região do implante, foi verificada integração tecidual entre o músculo reto do abdome e diafragma com total oclusão do defeito diafragmático, formação de tecido de granulação, onde foram observadas aderências do fígado, lobo pulmonar caudal, estômago e omento. O músculo reto do abdome pediculado pode ser indicado para correção de defeitos no músculo diafragma, havendo uma completa integração tecidual na região do implante.With the objective of analyzing the use Rectus abdominis muscle flaps for repair of large diaphagmatic defects, when direct suture is impossible, six dogs underwent surgery. The Rectus ahdominis muscle was dissected up to its insertion and was introduced into the abdominal cavity through a paracostal incision. A defect of 4 x l0cm was created in the diaphragmatic muscle and the flap was sutured to the edges of the defect with horizontal mattres suture with 2-0 silk. Animais were clinically evaluated every day at the post-operative period. Biopsies and macroscopic observation were done at the 15th, 30th and 60th day. Connective tissue and hemorrhagic

  19. Concentrations and loads of nutrients in the tributaries of the Lake Okeechobee watershed, south-central Florida, water years 2004-2008

    Science.gov (United States)

    Byrne, Michael J.; Wood, Molly S.

    2011-01-01

    nitrogen plus ammonia ranged from 1.27 to 2.96 mg/L at the 16 tributaries during 2004–2008. Mean concentrations were highest at Fisheating Creek at Lake Placid (a non-priority site), and lowest at Wolff Creek, Taylor Creek near Grassy Island, and Otter Creek (three priority basin sites), and at Arbuckle Creek (a non-priority basin site). Mean concentrations of nitrite plus nitrate ranged from 0.01 to 0.55 mg/L at the 16 tributaries during 2004–2008. Mean concentrations measured in priority basins were significantly higher than those measured in non-priority basins. Nutrient concentrations were substantially lower in the non-priority basins; however, total loads were substantially higher due to discharge that was 5 to 6 times greater than from the priority basins. Total phosphorus, organic nitrogen plus ammonia, and nitrite plus nitrate loads from the non-priority basins were 1.5, 4.5, and 3.5 times greater, respectively, than were loads from the priority basins. In the non-priority basins, total phosphorus loads ranged from 35 metric tons (MT) in 2007 to 247 MT in 2005. In the priority basins, the loads ranged from 18 MT in 2007 to 136 MT in 2005. In the non-priority basins, organic nitrogen plus ammonia loads ranged from 337 MT in 2007 to 2,817 MT in 2005. In the priority basins, organic nitrogen plus ammonia loads ranged from 85 MT in 2007 to 503 MT in 2005. In the non-priority basins, nitrite plus nitrate loads ranged from 34 MT in 2007 to 143 MT in 2005. In the priority basins, nitrite plus nitrate loads ranged from 4 MT in 2007 to 27 MT in 2005.

  20. Use of regenerative energy sources and hydrogen technology. Proceedings; Nutzung regenerativer Energiequellen und Wasserstofftechnik 2008. Tagungsband

    Energy Technology Data Exchange (ETDEWEB)

    Luschtinetz, Thomas; Lehmann, Jochen (eds.)

    2008-07-01

    Within the 15th symposium 'Use of regenerative energy sources and hydrogen technology' at 6th to 8th November, 2008, in Stralsund (Federal Republic of Germany), the following lectures were held: (1) Processing of mine gas by means of membrane technology (T. Brinkmann, W. Clemens, A. Dengel, B. Hoting); (2) Energy storage in salt caverns / developments and concrete projects for adiabatic compressed air and for hydrogen storage (F. Crotogino, S. Huebner); (3) Application of an ORC plant in the area of a hybrid wind-hydrogen-plant (J. Eliasz, K. Rychlik); (4) Wind Farm Cluster Management Sysem (A.J. Gesino, C.A. Quintero Marrone, R. Mackensen, M. Wolff, B. Lange, K. Rohrig); (5) Results of a field test of a combination of a wood boiler and Stirling engine (B. Gross); (6) NANOSTIR - Optimisation of solid fuel operated Stirling CHP units by means of nano technological coatings (B. Gross); (7) Fundamental investigations of long-term behaviour / damage behaviour of big PEM stacks (September 2005 - October 2007) (M. Hinz, O. Luschtinetz, J. Lehmann); (8) HyFLEET:CUTE project: Results from the biggest hydrogen bus project in the world (T. Kampet); (9) Comparison of new chains of distribution for biogas and natural gas (M. Klamp); (10) Generation of hydrogen from formic acid at ambient temperature and its use in a H2/O2 fuel cell (B. Loges, A. Boddien, H. Junge, M. Beller); (11) PE membranes out of biological materials (E. Mendieta); (12) Offshore wind power affects generation, network and consumption (A. Miege, J. Lehmann, T. Luschtinetz, C. Sponholz, F. Gamallo); (13) Comparative investigations at fixed and tracking PV systems (R. Mueller, A. Rackwitz); (14) Energetic utilisation of biomass - boundary conditions, state of the art and perspectives (M. Nelles, D. Banemann, N. Engler, A. Schuech); (15) Supply networks - a new method of analysis for an optimized use of regenerative energy (R. Nieberle, A. Simroth); (16) Steam - vapour hybrid power plant supplied with

  1. MÚSCULO DIAFRAGMA HOMÓLOGO CONSERVADO EM SOLUÇÃO SUPERSATURADA DE AÇÚCAR PARA REPARAÇÃO DE GRANDE DEFEITO NO DIAFRAGMA DE CÃO HOMOLOGOUS DIAPHRAGM MUSCLE CONSERVED IN SUPERSATURATED SUGAR SOLUTION TO REPAR LARGE DEFECTS IN DIAPHRAGM OF DOGS

    Directory of Open Access Journals (Sweden)

    Alexandre Mazzanti

    2001-04-01

    Full Text Available O comportamento cicatricial de um segmento muscular homólogo, conservado em solução supersaturada de açúcar a 300%, foi pesquisado no músculo diafragma de cão. Foram utilizados nove cães, adultos, três machos, sem raça definida com peso variando de 10,4 a 21,0kg, separados em três grupos de igual número denominados de I, II e III. Foi criado um defeito no hemidiafragma direito na porção muscular de dimensões 9,0 x 6,0cm, através de toracotomia no 10º espaço intercostal direito para fixação do implante muscular com fio poliglactina 910 3-0, por meio de pontos de Wolff com sobreposição de bordas. Os cães foram observados por um período de 30 dias (grupo I, 75 dias (grupo II e 120 dias (grupo III de pós-operatório, quando foram reoperados para observação macroscópica e coleta de amostras para avaliação histológica. Foi verificado nos animais do grupo I, substituição parcial e nos grupos II e III, substituição total da porção muscular do diafragma enxertado por tecido fibrovascular, que ocluía o defeito diafragmático, sendo observado com a evolução pós-operatória, um tecido de menor espessura, quase transparente. O emprego de segmento de músculo diafragma, conservado em solução supersaturada de açúcar a 300%, em temperatura ambiente, para reparação de grande defeito no músculo diafragma de cão, é substituído por uma fina camada de tecido conjuntivo fibroso.The repair induced by an homologous muscular segment conserved in 300% supersaturated sugar solution on the diaphragmatic muscle of dogs was investigated. Nine adults mongrel dogs, three males, weights varying from 10.4 to 21.0kg, were used separated in three equally numbered denominated groups I, II and III. A defect was created, on the muscular portion of the right hemidiaphragm, with dimensions of 9.0 x 6.0cm, through thoracotomy in the 10th right intercostal space. The graft was sutured with thread poligalactin 910 3-0, by means of

  2. Mapping the entangled ontology of science teachers' lived experience

    Science.gov (United States)

    Daugbjerg, Peer S.; de Freitas, Elizabeth; Valero, Paola

    2015-09-01

    In this paper we investigate how the bodily activity of teaching, along with the embodied aspect of lived experience, relates to science teachers' ways of dealing with bodies as living organisms which are both the subject matter as well as the site or vehicle of learning. More precisely, the following questions are pursued: (1) In what ways do primary science teachers refer to the lived and living body in teaching and learning? (2) In what ways do primary science teachers tap into past experiences in which the body figured prominently in order to teach students about living organisms? We draw on the relational ontology and intra-action of Karen Barad (J Women Cult Soc 28(3): 801, 2003) as she argues for a "relational ontology" that sees a relation as a dynamic flowing entanglement of a matter and meaning. We combine this with the materialist phenomenological studies of embodiment by SungWon Hwang and Wolff-Michael Roth (Scientific and mathematical bodies, Sense Publishers, Rotterdam, 2011), as they address how the teachers and students are present in the classroom with/in their "living and lived bodies". Our aim is to use theoretical insights from these two different but complementary approaches to map the embodiment of teachers' experiences and actions. We build our understanding of experience on the work of John Dewey (Experience and education, Simon & Schuster, New York, 1938) and also Jean Clandinin and Michael Connelly (Handbook of qualitative research, Sage Publications, California, 2000), leading us to propose three dimensions: settings, relations and continuity. This means that bodies and settings are mutually entailed in the present relation, and furthermore that the past as well as the present of these bodies and settings—their continuity—is also part of the present relation. We analyse the entanglement of lived experience and embodied teaching using these three proposed dimensions of experience. Analysing interviews and observations of three Danish

  3. Facilitators and barriers to hypertension self-management in urban African Americans: perspectives of patients and family members

    Directory of Open Access Journals (Sweden)

    Flynn SJ

    2013-08-01

    Full Text Available Sarah J Flynn,1,2 Jessica M Ameling,1,2 Felicia Hill-Briggs,1–3 Jennifer L Wolff,4,5 Lee R Bone,1,3 David M Levine,1,4 Debra L Roter,3 LaPricia Lewis-Boyer,1,2 Annette R Fisher,6 Leon Purnell,6 Patti L Ephraim,2,7 Jeffrey Barbers,1,2 Stephanie L Fitzpatrick,1,2 Michael C Albert,1,8 Lisa A Cooper,1,2 Peter J Fagan,9,10 Destiny Martin,1 Hema C Ramamurthi,1,2 L Ebony Boulware1,2,7 1Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA; 2Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD, USA; 3Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; 4Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; 5Division of Geriatric Medicine and Gerontology, Johns Hopkins University School of Medicine, Baltimore, MD, USA; 6Community and Provider Advisory Board, Johns Hopkins Center to Eliminate Cardiovascular Health Disparities, Baltimore, MD, USA; 7Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; 8Johns Hopkins Community Physicians, Johns Hopkins Medical Institutions, Baltimore, MD, USA; 9Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA; 10Johns Hopkins HealthCare LLC, Glen Burnie, MD, USA Introduction: We aimed to inform the design of behavioral interventions by identifying patients’ and their family members’ perceived facilitators and barriers to hypertension self-management. Materials and methods: We conducted focus groups of African American patients with hypertension and their family members to elicit their views about factors influencing patients’ hypertension self-management. We recruited African American patients with hypertension (n = 18 and their family members (n = 12 from an urban, community-based clinical

  4. Comparison of the Impact of Wikipedia, UpToDate, and a Digital Textbook on Short-Term Knowledge Acquisition Among Medical Students: Randomized Controlled Trial of Three Web-Based Resources.

    Science.gov (United States)

    Scaffidi, Michael A; Khan, Rishad; Wang, Christopher; Keren, Daniela; Tsui, Cindy; Garg, Ankit; Brar, Simarjeet; Valoo, Kamesha; Bonert, Michael; de Wolff, Jacob F; Heilman, James; Grover, Samir C

    2017-10-31

    functions, and open-source editing were rated significantly higher by the Wikipedia group compared with the textbook group (P<.001). Additionally, the Wikipedia group rated open access editing significantly higher than the UpToDate group; expert editing and references were rated significantly higher by the UpToDate group compared with the Wikipedia group (P<.001). Medical students who used Wikipedia had superior short-term knowledge acquisition compared with those who used a digital textbook. Additionally, the Wikipedia group trended toward better posttest performance compared with the UpToDate group, though this difference was not significant. There were no significant differences between the UpToDate group and the digital textbook group. This study challenges the view that Wikipedia should be discouraged among medical students, instead suggesting a potential role in medical education. ©Michael A Scaffidi, Rishad Khan, Christopher Wang, Daniela Keren, Cindy Tsui, Ankit Garg, Simarjeet Brar, Kamesha Valoo, Michael Bonert, Jacob F de Wolff, James Heilman, Samir C Grover. Originally published in JMIR Medical Education (http://mededu.jmir.org), 31.10.2017.

  5. PREFACE: Nano- and microfluidics Nano- and microfluidics

    Science.gov (United States)

    Jacobs, Karin

    2011-05-01

    The field of nano- and microfluidics emerged at the end of the 1990s parallel to the demand for smaller and smaller containers and channels for chemical, biochemical and medical applications such as blood and DNS analysis [1], gene sequencing or proteomics [2, 3]. Since then, new journals and conferences have been launched and meanwhile, about two decades later, a variety of microfluidic applications are on the market. Briefly, 'the small flow becomes mainstream' [4]. Nevertheless, research in nano- and microfluidics is more than downsizing the spatial dimensions. For liquids on the nanoscale, surface and interface phenomena grow in importance and may even dominate the behavior in some systems. The studies collected in this special issue all concentrate on these type of systems and were part ot the priority programme SPP1164 'Nano- and Microfluidics' of the German Science Foundation (Deutsche Forschungsgemeinschaft, DFG). The priority programme was initiated in 2002 by Hendrik Kuhlmann and myself and was launched in 2004. Friction between a moving liquid and a solid wall may, for instance, play an important role so that the usual assumption of a no-slip boundary condition is no longer valid. Likewise, the dynamic deformations of soft objects like polymers, vesicles or capsules in flow arise from the subtle interplay between the (visco-)elasticity of the object and the viscous stresses in the surrounding fluid and, potentially, the presence of structures confining the flow like channels. Consequently, new theories were developed ( see articles in this issue by Münch and Wagner, Falk and Mecke, Bonthuis et al, Finken et al, Almenar and Rauscher, Straube) and experiments were set up to unambiguously demonstrate deviations from bulk, or 'macro', behavior (see articles in this issue by Wolff et al, Vinogradova and Belyaev, Hahn et al, Seemann et al, Grüner and Huber, Müller-Buschbaum et al, Gutsche et al, Braunmüller et al, Laube et al, Brücker, Nottebrock et al

  6. Enlightened Travelers and Their Mental Maps

    Directory of Open Access Journals (Sweden)

    Nikolay Aretov

    2015-07-01

    Full Text Available Enlightened Travelers and Their Mental Maps The issue of mental mapping of Eastern Europe (Wolff, posed during the Enlightenment, and the similar problem of the image of the Balkans (Todorova, are both multifaceted. This paper deals with three aspects of these processes and seeks to analyse them through the prism of the Orientalism-Occidentalism opposition. The article opens with a very general description of the Oriental mental maps on the part of 19th-century Bulgarian revolutionaries and modernisers. Most characteristic in this respect are the diaries of those convicted to exile in the Diarbekir fortress. I then turn my attention to texts by influential foreigners who arrived in Bulgaria immediately after 1878, including especially the publications by the Czech historian and Slavonic scholar Constantine Jireček and some of the reactions they provoked. The article reveals common elements in both the foreign perspective on the inhabitants of the Orient/the Balkans/Bulgaria and the Bulgarian perspective on the Occident/Western Europe. A hypothesis is proposed that what the analysed texts portray is not a general clash between traditionalism (patriarchal culture and modernity but rather a very particular conflict over which group should perform the role of the “civiliser” of Bulgarian society. Both sides of the conflict made instrumental use of existing discourses, be it modernist or patriarchal, Orientalist or Occidentalist. Oświeceni podróżnicy i ich mapy mentalne Problem mentalnego kartografowania Europy Wschodniej (L. Wolff, jak też Bałkanów (M. Todorowa, od czasów oświecenia jest wieloaspektowy. Artykuł charakteryzuje trzy spośród tych aspektów i poszukuje związków pomiędzy nimi, poprzez analizę opozycji orientalizm – okcydentalizm. Na początku prezentuję najogólniej mapy mentalne bułgarskich rewolucjonistów i przedstawicieli nowoczesności z XIX wieku na Bałkanach (Orient. Najbardziej charakterystyczne pod tym

  7. High resolution record of the Last Glacial Maximum in eastern Australia

    Science.gov (United States)

    Petherick, Lynda; Moss, Patrick; McGowan, Hamish

    2010-05-01

    time than traditionally accepted, and was not uniformly cool and dry. Alloway, B. V., D. J. Lowe, D. J. A. Barrell, R. M. Newnham, P. C. Almond, P. C. Augustinus, N. A. N. Bertler, L. Carter, N. J. Litchfield, M. S. McGlone, J. Shulmeister, M. J. Vandergoes, P. W. Williams and N.-I. members (2007). Towards a climate event stratigraphy for New Zealand over the past 30 000 years (NZ-INTIMATE project). Journal of Quaternary Science 22(1): 9-35. Denton, G. H., T. V. Lowell, C. J. Heusser, C. Schluchter, B. G. Andersen, L. E. Heusser, P. I. Moreno and D. R. Marchant (1999). Geomorrphology, stratigraphy, and radiocarbon chronology of Llanquihe Drift in the area of the Southern Lake District, Seno Reloncavi, and Isal Grande de Chiloe, Chile. Geografiska Annaler 81A: 167-229. EPICA (2006). One-to-one coupling of glacial climate variability in Greenland and Antarctica. Nature 444: 195-198. Kershaw, A. P., G. M. McKenzie, N. Porch, R. G. Roberts, J. Brown, H. Heijnis, M. L. Orr, G. Jacobsen and P. R. Newall (2007). A high-resolution record of vegetation and climate through the last glacial cycles from Caledonia Fen, southeastern highlands of Australia. Journal of Quaternary Science 22(5): 481-500. Newnham, R. M., D. J. Lowe, T. Giles and B. V. Alloway (2007). Vegetation and climate of Auckland, New Zealand, since ca. 32 000 cal. yr ago: support for an extended LGM Journal of Quaternary Science 22(5): 517-534. Petherick, L. M., H. A. McGowan and P. T. Moss (2008). Climate variability during the Last Glacial Maximum in eastern Australia: Evidence of two stadials? Journal of Quaternary Science 23(8): 787-802. Röthlisberger, R., R. Mulvaney, E. W. Wolff, M. A. Hutterli, M. Bigler, S. Sommer and J. Jouzel (2002). Dust and sea salt variability in central East Antarctica (Dome C) over the last 45 kyr and its implications for southern high latitude climate. Geophysical Research Letters 29(20): Art # 1963. Smith, M. A. (2009). Late Quaternary landscapes in Central Australia: sedimentary

  8. Les illusions perdues. Süssmilch, l’Académie de Berlin et Frédéric II : échec d’une politique de population

    Directory of Open Access Journals (Sweden)

    Jean-Marc Rohrbasser

    2011-08-01

    de Frédéric II paraissent en effet converger sur plusieurs points, et non des moins importants : d’abord en ceci que la politique est une affaire de proportion ; ensuite sur la question de la liberté politique ; enfin sur cette thèse que les aléas de la réalité politique ne remettent pas en cause le nécessitarisme métaphysique. Süssmilch, disciple du philosophe Christian Wolff, lui-même apprécié du souverain, prône une politique probabiliste qui n’a rien pour déplaire au roi. En outre, le bonheur des peuples passe par une bonne population, ce que reconnaissent et le pasteur et Frédéric.J’exposerai pour finir ce qui justifie le titre d’« illusions perdues » que j’ai donné à cette communication, en détaillant les points de désaccord existant entre le savant et le prince. La religion constitue le domaine fondamental : la méfiance de Frédéric II à l’égard des théologiens n’épargne certes pas Süssmilch. Dès lors, lorsque le pasteur se mêle de tenter de conseiller le prince, celui-ci lui rappelle qui exerce réellement le pouvoir : une étude de cas le montrera concrètement. On indiquera par là ce qu’il faut, dans ce cas, entendre par « despote éclairé », ce curieux concept de l’époque des Lumières.

  9. Book Reviews

    Directory of Open Access Journals (Sweden)

    Janet Rodenburg

    1992-04-01

    : Editions de la Maison des Sciences de l’Homme. 1991, xv 332 p. - Ger P. Reesink, H. Steinhauer, Papers on Austronesian linguistics No. 1. Canberra: Department of linguistics, Research school of Pacific studies, ANU. (Pacific linguistics series A- 81. 1991, vii 225 pp., - Janet Rodenburg, Peter J. Rimmer, The underside of Malaysian history; Pullers, prostitutes, plantation workers...Singapore: Singapore University Press, 1990, xiv 259 p., Lisa M. Allen (eds. - A.E.D. Schmidgall-Tellings, John M. Echols, An Indonesian-English Dictionary. Third edition. Revised and edited by John U.Wolff and James T. Collins in in cooperation with Hasan Shadily. Ithaca and London: Cornell University Press, 1989. xix + 618 pp., Hasan Shadily (eds. - Mary F. Somers Heidhues, Olaf H. Smedal, Order and difference: An ethnographic study of Orang Lom of Bangka, West Indonesia, Oslo: University of Oslo, Department of social anthropology, 1989. [Oslo Occasional Papers in Social Anthropology, Occasional Paper no. 19, 1989]. - E.Ch.L. van der Vliet, Henri J.M. Claessen, Early state economics. New Brunswick and London: Transaction Publishers, 1991 [Political and Anthropology Series volume 8]., Pieter van de Velde (eds. - G.M. Vuyk, J. Goody, The oriental, the ancient and the primitive; Systems of marriage and the family in the pre-industrial societies of Eurasia. New York, Cambridge University Press, (Studies in literacy, family, culture and the state, 1990, 562 pp. - E.P. Wieringa, Dorothée Buur, Inventaris collectie G.P. Rouffaer. Leiden: Koninklijk Instituut voor Taal-, Land- en Volkenkunde, 1990, vi 105 pp., 6 foto´s.

  10. NASA Names Premier X-Ray Observatory and Schedules Launch

    Science.gov (United States)

    1998-12-01

    Chicago until his death in 1995. The Chandra X-ray Observatory will help astronomers worldwide better understand the structure and evolution of the universe by studying powerful sources of X rays such as exploding stars, matter falling into black holes and other exotic celestial objects. X-radiation is an invisible form of light produced by multimillion degree gas. Chandra will provide X-ray images that are fifty times more detailed than previous missions. At more than 45 feet in length and weighing more than five tons, it will be one of the largest objects ever placed in Earth orbit by the Space Shuttle. Tyrel Johnson, a student at Priest River Lamanna High School in Priest River, Idaho, and Jatila van der Veen, a physics and astronomy teacher at Adolfo Camarillo High School in Camarillo, California, who submitted the winning name and essays, will receive a trip to the Kennedy Space Center in Florida to view the launch of the Chandra X-ray Observatory, a prize donated by TRW. Members of the contest's selection committee were Timothy Hannemann, executive vice president and general manager, TRW Space & Electronics Group; the late CNN correspondent John Holliman; former Secretary of the Air Force Sheila Widnall, professor of aeronautics at MIT; Charles Petit, senior writer for U.S. News & World Report; Sidney Wolff, Director, National Optical Astronomy Observatories; Martin Weisskopf, Advanced X-ray Astrophysics Facility project scientist, Marshall Space Flight Center, Huntsville, AL.; and Harvey Tananbaum, director of the Advanced X-ray Astrophysics Facility Science Center, Smithsonian Astrophysical Observatory, Cambridge, MA. The Chandra X-ray Observatory program is managed by the Marshall Center for the Office of Space Science, NASA Headquarters, Washington, DC. TRW Space and Electronics Group, Redondo Beach, CA, is NASA's prime contractor for the observatory. The Smithsonian Astrophysical Observatory controls science and flight operations of the observatory for NASA

  11. A developmental and psychoeducational approach to reducing conflict and abuse in little league and youth sports. The sport psychiatrist's role.

    Science.gov (United States)

    Kamm, R L

    1998-10-01

    To stress a point made earlier, whether backyard or Little League, the tone of the youth sports experience is greatly influenced by the player and team selection process. All possible steps should therefore be taken to ensure that the draft is held on high moral ground, and that the adult participants, even on the Major Little League level, behave cooperatively rather than competitively. If it is the community's hope that Little League will "build character, and not characters," it must embrace Shields and Bredemeier's work and flood the Draft Room with the four virtues of compassion, fairness, sportspersonship, and integrity. In one attempt to achieve fairness and balance, some leagues enter player evaluations into a data base and allow a properly programmed computer to project equal teams. It might be best, however, to borrow a page from backyard baseball, and make team selection a more cooperative venture. Wolff has proposed such a draft model. He recommends that each child's name be placed on a big blackboard at the beginning of the draft. All assembled give their assessment of each child's baseball ability, and a consensus skill-level number (one through five) is entered next to each player's name. If there are 72 names, and the league wishes to form six teams of 12 players each, dividing up the rated players so that the skill levels balance would assure everyone (coaches, parents, the league, and by extension, the community) that the teams were of relatively equal strength. No coach at this point would know to which team he or she was being assigned, so there would be no motive for "stacking" a given team. Each team would be designated by a letter of the alphabet, and the six letters would be thrown into a hat. The six coaches would then blindly pick a team from the hat. If a coach desired that his or her child play on his or her team, fair adjustments (trades) could be made subject to majority agreement. The three draft models can be summarized as follows

  12. Scientific Visualization for Atmospheric Data Analysis in Collaborative Virtual Environments

    Science.gov (United States)

    Engelke, Wito; Flatken, Markus; Garcia, Arturo S.; Bar, Christian; Gerndt, Andreas

    2016-04-01

    terabytes. The combination of different data sources (e.g., MOLA, HRSC, HiRISE) and selection of presented data (e.g., infrared, spectral, imagery) is also supported. Furthermore, the data is presented unchanged and with the highest possible resolution for the target setup (e.g., power-wall, workstation, laptop) and view distance. The visualization techniques for the volumetric data sets can handle VTK [6] based data sets and also support different grid types as well as a time component. In detail, the integrated volume rendering uses a GPU based ray casting algorithm which was adapted to work in spherical coordinate systems. This approach results in interactive frame-rates without compromising visual fidelity. Besides direct visualization via volume rendering the prototype supports interactive slicing, extraction of iso-surfaces and probing. The latter can also be used for side-by-side comparison and on-the-fly diagram generation within the application. Similarily to the surface data a combination of different data sources is supported as well. For example, the extracted iso-surface of a scalar pressure field can be used for the visualization of the temperature. The software development is supported by the ViSTA VR-toolkit [7] and supports different target systems as well as a wide range of VR-devices. Furthermore, the prototype is scalable to run on laptops, workstations and cluster setups. REFERENCES [1] A. S. Garcia, D. J. Roberts, T. Fernando, C. Bar, R. Wolff, J. Dodiya, W. Engelke, and A. Gerndt, "A collaborative workspace architecture for strengthening collaboration among space scientists," in IEEE Aerospace Conference, (Big Sky, Montana, USA), 7-14 March 2015. [2] W. Engelke, "Mars Cartography VR System 2/3." German Aerospace Center (DLR), 2015. Project Deliverable D4.2. [3] E. Hivon, F. K. Hansen, and A. J. Banday, "The healpix primer," arXivpreprint astro-ph/9905275, 1999. [4] K. M. Gorski, E. Hivon, A. Banday, B. D. Wandelt, F. K. Hansen, M. Reinecke, and M

  13. Book Reviews

    Directory of Open Access Journals (Sweden)

    Jerome Rousseau

    1984-04-01

    annotated translation by Virginia Matheson & Barbara Watson Andaya. Kuala Lumpur: Oxford University Press 1982, XIV + 476 pp., maps, ills. - Gerard A. Nagelkerke, J.A. de Moor, Indisch Militair Tijdschrift (1870-1942: A selective and annotated bibliography. The Hague: Sectie Militaire Geschiedenis van de Landmachtstaf; Leiden: Centre for the History of European Expansion. 1983. XIV + 237 pp. - Gert J. Oostindie, Albert Helman, De foltering van Eldorado. Een ecologische geschiedenis van de vijf Guyana’s. ‘s-Gravenhage, Nijgh & Van Ditmar, 1983. 495 pp. - Gerard Persoon, G. Adrian Horridge, 1 The Prahu, traditional sailing boat of Indonesia, Oxford, O.U.P.,1981. xv + 106 pp.'2 The lashed-lug boat of the Eastern Archipelagoes, Maritime Monographs and reports no. 54, National Maritime Museum, London, 1982, 75 pp. - Harry A. Poeze, H. Coerts, De A.R.P. en Nieuw-Guinea, Historische analyse van een partijcrisis. Franeker: Wever, 1983, 104 blz. - S.O. Robson, John U. Wolff, Communicative codes in central Java, Data Paper Number 116, Southeast Asia program, Department of Asian studies, Cornell University, Ithaca N.Y., June 1982. X + 188 pp., Soepomo Poedjosoedarmo (eds. - Jerome Rousseau, Harmut K. Hildebrand, Die Wildbeutergruppen Borneos. Müncher Ethnologische Abhandlungen, no. 2. München: Minerva Publikation, 1982. xxvii + 374 pp., 11 maps, 2 tables, bibliography, English summary - T.B. Simatupang, Jan Bank, Katholieken en de Indonesische Revolutie, Baarn: Ambo, 1983, 576 pp. - H. Steinhauer, Richard McGinn, Outline of Rejang syntax, NUSA Linguistic studies of Indonesian and other languages in Indonesia 14, Jakarta 1982, xvi + 76 pp. - Heather Sutherland, Yeo Kim Wah, The politics of decentralization. Colonial controversy in Malaya 1920-1929; Oxford University Press/Institute of Southeast Asian studies, Kuala Lumpur, 1982, xiv, 395 pp., map and photographs. - Rudolf van Zantwijk, Jerome A. Offner, Law and politics in Aztec Texcoco, Cambridge Latin American studies nr. 44