WNT10A variants: following the pattern of inheritance in tooth agenesis and self-reported family history of cancer

Clinical Oral Investigations - The aim of this study was the analysis of WNT10A variants in seven families of probands with various forms of tooth agenesis and self-reported family history of...     

Pharmacological and ablative hybrid therapy of atrial fibrillation. Long-term effect on quality of life and arrhythmia-related symptoms

The pharmacological and ablative hybrid therapy of atrial fibrillation (AF) consists of radiofrequency catheter ablation of antiarrhythmic drug-induced typical atrial flutter (AFl) and continuation of drug therapy. The purpose of this study was to determine the effect of this therapy on AF symptoms and quality of life (QoL). Forty-six patients were monitored after isthmus-ablation of drug-induced typical AFl and continuation of their antiarrhythmic drug treatment over a mean follow-up of 22.4+/-11.6 months. AF characteristics, symptoms and QoL before and after ablation were evaluated by the SF-36 question- naire, the Symptoms Checklist-Frequency and Severity Scale and the analysis of ECG recordings. 63% of patients demonstrated recurrences of AF. However, the frequency and duration of symptomatic episodes significantly decreased in 82.6 and 76% of patients. All categories of the SF-36 improved significantly and the AF symptomatology showed a relevant attenuation in 65.8% of the study population. CONCLUSION: The pharmacological and ablative hybrid therapy significantly reduced the mean number and the duration of symptomatic AF episodes as well as AF-correlated symptoms and was associated with significant QoL improvement.     

Decremental Pulmonary Venous Pulse Propagation: Impact for Catheter Ablation in Focal Atrial Fibrillation

Background: Electrical isolation of pulmonary veins (PV's) is crucial to achieve success in catheter ablation for trigger elimination in focal atrial fibrillation (AF). To guide ostial PV radiofrequency (RF) delivery, it is necessary to identify the electrical breakthrough (EBT) between PV and left atrium. For this purpose, coronary sinus (CS) fixed rate pacing is commonly used. This study evaluated, whether CS extrastimulus pacing is superior in identifying the EBT area as compared to fixed rate pacing. Methods: In 9 patients (51 ± 10 years) undergoing a left sided electrophysiological study for AF ablation, 25 PV's (10 right and 15 left-sided PV's) were mapped using a 4 French fixed-wire catheter with eight 6 mm coiled Platinum electrodes in a distal looped configuration (Revelation Helix, Cardima Inc.). For mapping and ablation the electrode loop was positioned in the PV ostium rectangular to the longitudinal PV axis. EBT area was identified as those electrodes indicating the earliest PV signals during CS pacing. We measured number of EBT electrodes and time between EBT and the latest activated bipoles at the electrode loop during fixed rate and extrastimulus pacing. The reduction of two or more EBT electrodes was defined as a significant benefit in EBT identification. Results: In 22 of 25 PV's mapped PV potentials could be observed. Performing fixed rate pacing the EBT area was identified in a mean of 4.2 ± 1 electrodes, whereas using extrastimulus pacing, EBT area could be significantly reduced to 2.3 ± 0.8 electrodes. The time between EBT and latest electrode activated increased from 14 ± 7 ms to 22 ± 10 ms indicating an intrapulmonary conduction delay during extrastimulus pacing. In 13 of 22 PV's mapped (59%), extrastimulus pacing was beneficial in the identification of the EBT, as the primary target for RF delivery. Conclusions: CS extrastimulus pacing induces intra-PV decremental conduction properties allowing one to identify a more localised and smaller EBT area as the primary target for RF delivery. Performing PV ablation to treat focal AF, extrastimulus maneouvers allow to unmask the true EBT and thus may help to limit intrapulmonary RF delivery.     

An ultrasonographic picture of a growing pseudotumor in the abdominal cavity

The case history of patient is presented who was diagnosed a tumor in abdominal cavity in an ultrasonographic examination. In the following surgery the tumour was extirpated and histology verified a liposarcoma. The control ultrasonographic examination revealed a growing solid formation in the region of resection. For presumed relapse of liposarcoma the patient underwent laparotomy again. In the region of the original tumour there was a conglomerate of adhesions in a size of tangerine. The histological examination revealed fibrous and fatty tissue without the sign of malignity.     

fMLP-induced respiratory burst and the intracellular Ca2+ signal are not interrelated in neutrophils

Reactive oxygen intermediate (ROI) production and the development of the intracellular (IC) Ca2+ ([Ca2+]i) signal by formyl-Met-Leu-Phe (fMLP) stimuli were investigated in neutrophils. When the concentration was varied between 2.3 nM-2.3 microM, ROI production and the [Ca2+]i signal showed different fMLP concentration dependencies. ROI production increased continuously with increasing fMLP concentrations, while the [Ca2+]i signal responses reached a plateau around 230 nM fMLP. Moreover, when a consecutive, 2.3 microM fMLP stimulus was applied 10 min after the first fMLP stimulus, the intensity of the ROI production and that of the [Ca2+]i signal showed a variable dependence on the fMLP concentration of the first stimulus. An initial fMLP dose of 2.3 nM and 23 nM sensitized the cells regarding their ROI production and [Ca2+]i signals. After a first fMLP stimulus of 230 nM, the second stimulus produced an increased [Ca2+]i signal, while no ROI production could be activated. A strong fMLP stimulus of 2.3 microM desensitized the cells regarding both [Ca2+]i signal and ROI production. However, even in these desensitized cells, a high level of ROI production could be evoked by other stimuli like PMA or opsonized zymosan. The differences observed between the fMLP concentration dependence of ROI production and the [Ca2+]i signal strongly suggest that these two phenomena are not interrelated.     

PERG and spectral sensitivity in ocular hypertensive and chronic open-angle glaucoma patients

Pattern electroretrinography (PERG) was performed in 33 patients with chronic open-angle glaucoma (COAG), 18 ocular hypertensive (OH) patients, and 24 normal subjects. COAG patients exhibited significantly lower PERG amplitudes than did normal subjects (P _8rps = 0.025; P _16rps < 0.0001). The OH patients fell into two distinct groups: those with normal PERG scores and those with lower than normal scores. OH patients with PERG scores significantly lower than control values demonstrated significantly larger cup-to-disc ratios (P=0.002) and higher initial intraocular pressures (IOPs) than did OH patients with normal PERG scores (P=0.021). In the 11 OH patients in whom spectral sensitivity measurement was available, statistically significant correlations were found between the blue-cone sensitivity loss and the PERG amplitude (r _8rps )=0.772, P _8rps =0.0053 and r _16rps =0699, P _16rps =0.0167, respectively. our results demonstrate reduced PERG amplitude in high-risk OH patients and further illustrate the correlation between PERG amplitude and blue-cone spectral sensitivity in OH subjects. Confirmation of the roles of PERG and spectral sensitivity in the detection of early glaucoma requires longitudinal study.Offprint requests to: F. Zwas     

Complications of acute lesions of the digestive tract as a direct cause of mortality in patients with advanced forms of neoplasms in palliative and symptomatic treatment]

There were analyzed an autopsy protocols of 117 patients with oncological disease, in whom during performance of pathomorphological investigation an acute erosive-ulcerative affection (AEUA) of digestive channel (DCH) was revealed, of them in 69 patients palliative and/or symptomatic treatment for extended forms of cancer was conducted. Structure of principal complications as well as their significance in pathogenesis, localization of affection, influence of different methods of palliative treatment on AEUA DCH occurrence. The data obtained must be taken in account during planning of palliative therapy in such patients.     

History of atrial fibrillation

The authors review the history of atrial fibrillation, the most frequent clinically observed cardiac arrhythmia. A French "clinicopathologist", Jean Baptist de Sénac (1693-1770), was the first who assumed a correlation between "rebellious palpitation" and a stenosis of the mitral valve. From an analysis of simultaneously recorded arterial and venous pressure curves, the Scottish Sir James Mackenzie (1853-1925) demonstrated that a presystolic a wave cannot be seen on the jugular phlebogram during "pulsus irregularis perpetuus". The first human ECG depicting atrial fibrillation was published by Willem Einthoven (1860-1927) in 1906. The proof of a direct connection between absolute arrhythmia and auricular fibrillation was established by two Viennese physicians, Rothberger and Winterberg. The major discoveries relating to the pathomechanism and the clinical features of atrial fibrillation in the 20(th) century stemmed from the scientific activities of Karel Frederik Wenckebach, Sir Thomas Lewis, Gordon Moe, and Maurits Allessie.