Atrial fibrillation signal organization predicts sinus rhythm maintenance in patients undergoing cardioversion of atrial fibrillation.

AIMS: Electrical remodelling is believed to influence the outcome following cardioversion of patients with persistent atrial fibrillation (AF). However, the results in clinical studies are conflicting. We assessed the hypothesis that non-invasively obtained atrial fibrillatory organization can be used as a predictor of sinus rhythm (SR) maintenance. METHODS AND RESULTS: Fifty-four patients (37 men, age 67+/-11) with persistent AF (median duration 3 months, 1 day to 18 months), without anti-arrhythmic drug treatment, referred for cardioversion were studied. Assessment of the atrial harmonic decay was made by time-frequency analysis of the ECG. At 1-month follow-up, 30 patients had relapsed into AF. The mean harmonic decay at inclusion of those relapsing into AF was 1.5+/-0.3 compared with 1.1+/-0.3 among those maintaining SR (P=0.0004). Using a cut-off value of harmonic decay 相似文献   

Reactive oxygen species cause diabetes-induced decrease in renal oxygen tension

Aims/hypothesis Augmented formation of reactive oxygen species (ROS) induced by hyperglycaemia has been suggested to contribute to the development of diabetic nephropathy. This study was designed to evaluate the influence of streptozotocin (STZ)-induced diabetes mellitus, as well as the effects of preventing excessive ROS formation by -tocopherol treatment, on regional renal blood flow, oxygen tension and oxygen consumption in anaesthetized Wistar Furth rats.Methods Non-diabetic and STZ-diabetic rats were investigated after 4 weeks with or without dietary treatment with the radical scavenger DL--tocopherol (vitamin E, 5%). A laser-Doppler technique was used to measure regional renal blood flow, whilst oxygen tension and consumption were measured using Clark-type microelectrodes.Results Renal oxygen tension, but not renal blood flow, was lower throughout the renal parenchyma of diabetic rats when compared to non-diabetic control rats. The decrease in oxygen tension was most pronounced in the renal medulla. Renal cellular oxygen consumption was markedly increased in diabetic rats, predominantly in the medullary region. Diabetes increased lipid peroxidation and protein carbonylation in the renal medulla. Treatment with -tocopherol throughout the course of diabetes prevented diabetes-induced disturbances in oxidative stress, oxygen tension and consumption. The diabetic animals had a renal hypertrophy and a glomerular hyperfiltration, which were unaffected by -tocopherol treatment.Conclusions/interpretation We conclude that oxidative stress occurs in kidneys of diabetic rats predominantly in the medullary region and relates to augmented oxygen consumption and impaired oxygen tension in the tissue.Abbreviations ROS Reactive oxygen species - TBARS thiobarbituric acids reactive substances - NO nitric oxide - STZ streptozotocin     

Randomised controlled non-inferiority trial with 3-year follow-up of internet-delivered versus face-to-face group cognitive behavioural therapy for depression

Background

Guided internet-delivered cognitive behaviour therapy (ICBT) has been found to be effective in the treatment of mild to moderate depression, but there have been no direct comparisons with the more established group-based CBT with a long-term follow-up.

Method

Participants with mild to moderate depression were recruited from the general population and randomized to either guided ICBT (n=33) or to live group treatment (n=36). Measures were completed before and after the intervention to assess depression, anxiety, and quality of life. Follow-ups were conducted at one-year and three-year after the treatment had ended.

Results

Data were analysed on an intention-to-treat basis using linear mixed-effects regression analysis. Results on the self-rated version of the Montgomery–Åsberg Depression Scale showed significant improvements in both groups across time indicating non-inferiority of guided ICBT, and there was even a tendency for the guided ICBT group to be superior to group-based CBT at three year follow-up. Within-group effect sizes for the ICBT condition at post-treatment showed a Cohen′s d=1.46, with a similar large effect at 3-year follow-up, d=1.78. For the group CBT the corresponding within-group effects were d=0.99 and d=1.34, respectively.

Limitations

The study was small with two active treatments and there was no placebo or credible control condition.

Conclusions

Guided ICBT is at least as effective as group-based CBT and long-term effects can be sustained up to 3 years after treatment.     

Breakpoint characterization of the der(19)t(11;19)(q13;p13) in the ovarian cancer cell line SKOV‐3

About 20% of ovarian carcinomas show alterations of 19p13 and/or 19q13 in the form of added extra material whose origin often is from chromosome 11. Based on earlier spectral karyotype analysis of the ovarian cancer cell line SKOV‐3, which shows an unbalanced translocation der(19)t(11;19), the aim of this study was to determine the precise breakpoints of that derivative chromosome. After rough delimitation of the breakpoints of microdissected derivative chromosomes by array analysis, we designed a matrix of primers spanning 11q13.2 and 19p13.2 detecting multiple amplicons on genomic and cDNA. Sequencing the amplicons, accurate localization of both breakpoints on both chromosomes was possible and we found that exon 14 of HOOK2 from chromosome 19 and exon 2 of ACTN3 from chromosome 11 were fused in the derivative chromosome. The breakpoint in the HOOK2 gene was in an intrinsic triplet of nucleic acids leading to a shift in the ACTN3 reading frame in the derivative chromosome. This frameshift alteration should give rise to an early stop codon causing a loss of function of ACTN3. Signals in two‐dimensional Western blotting exactly match to calculated molecular mass and the isoelectric point of the fusion protein. © 2013 Wiley Periodicals, Inc.     

The Moxus Modular metabolic system evaluated with two sensors for ventilation against the Douglas bag method

This study evaluated the Moxus metabolic system with the Douglas bag method (DBM) as criterion. Reliability and validity were investigated in a wide range of ventilation and oxygen uptake and two sensors for determining ventilation were included. Thirteen well-trained athletes participated in one pre-test and four tests for data collection, exercising on a cycle ergometer at five submaximal powers (50–263 W) and at $ V{\text{O}}_{{2{ \hbox{max} }}} $ . Gas exchange variables were measured simultaneously using a serial setup with data collected on different days in an order randomized between Moxus with pneumotachometer (MP) and turbine flowmeter (MT) sensors for ventilation. Reliability with both sensors was comparable to the DBM. Average CV (%) of all exercise intensities were with MP: 3.0 ± 1.3 for VO₂, 3.8 ± 1.5 for VCO₂, 3.1 ± 1.2 for the respiratory exchange ratio (RER) and 4.2 ± 0.8 for V _E. The corresponding values with MT were: 2.7 ± 0.3 for VO₂, 4.7 ± 0.4 for VCO₂, 3.3 ± 0.9 for RER and 4.8 ± 1.4 for V _E. Validity was acceptable except for small differences related to the determination of ventilation. The relative differences in relation to DBM at the powers including $ V{\text{O}}_{2\hbox{max} } $ were similar for both sensors with the ranges being: +4 to ?2 % for V _E, +5 to ?3 % for VO₂ and +5 to ?4 % for VCO₂ while RER did not differ at any power. The Moxus metabolic system shows high and adequate reliability and reasonable validity over a wide measurement range. At a few exercise levels, V _E differed slightly from DBM, resulting in concomitant changes in VO₂ and VCO₂.     

In Vivo Evaluation and Dosimetry Estimate for a High Affinity Affibody PET Tracer Targeting PD-L1

Molecular Imaging and Biology - In vivo imaging of programmed death ligand 1 (PD-L1) during immunotherapy could potentially monitor changing PD-L1 expression and PD-L1 expression heterogeneity...     

The effect of percutaneous dilatation of renal arterial stenosis on captopril renography in hypertension

BACKGROUND: The clinical effects of percutaneous transluminal renal artery angioplasty (PTRA) in patients with renal vascular stenosis and hypertension is controversial. METHODS: We consecutively recruited all 23 patients referred for evaluation of renovascular hypertension that eventually underwent unilateral PTRA, to be investigated with captopril MAG3 renography (CR), both before and after the endovascular procedure. Data were evaluated on an intention-to-treat basis. RESULTS: We found that the relative MAG3 clearance of the stenotic kidney increased (from 29.9+/-14% to 35.1+/-14%, p=0.01) and that the creatinine levels fell following the intervention (from 110+/-19 to 99+/-17 micromol/l, p=0.0003). Blood pressure levels were also lowered (from 173+/-32/93+/-17 to 158+/-31/86+/-15 mmHg, p<0.006) while the mean number of anti-hypertensive drugs was unchanged following PTRA (2.9+/-1.4 before and 2.8+/-1.3 drugs after the intervention, respectively, p=0.6). CONCLUSION: This prospective trial showed statistically significant improvements of individual kidney function as measured by CR and blood pressure in subjects with suspected renovascular hypertension treated with PTRA. Although the endovascular procedure was found to be safe, the magnitude of the absolute improvements was rather modest.     

Indirect CD4+ T‐cell‐mediated elimination of MHC IINEG tumor cells is spatially restricted and fails to prevent escape of antigen‐negative cells

Tumor‐specific Th1 cells can activate tumor‐infiltrating macrophages that eliminate MHC class II negative (MHC II^NEG) tumor cells. Activated M1‐like macrophages lack antigen (Ag) receptors, and are presumably unable to discriminate and thus kill both Ag‐positive (Ag^POS) and Ag‐negative (Ag^NEG) tumor cells (bystander killing). The lack of specificity of macrophage‐mediated cytotoxicity might be of clinical importance as it could provide a means of avoiding tumor escape. Here, we have tested this idea using mixed populations of Ag^POS and Ag^NEG tumor cells in a TCR‐transgenic model in which CD4⁺ T cells recognize a secreted tumor‐specific antigen. Surprisingly, while Ag^POS tumor cells were recognized and rejected, Ag^NEG cells grew unimpeded and formed tumors. We further demonstrated that macrophage‐mediated cytotoxicity was spatially restricted to areas dominated by Ag^POS tumor cells, sparing Ag^NEG tumor cells in the vicinity. As a consequence, macrophage tumoricidal activity did not confer bystander killing in vivo. The present results offer novel insight into the mechanisms of indirect Th1‐mediated elimination of MHC II^NEG tumor cells.