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Haghjoo M Arya A Emkanjoo Z Sadr-Ameli MA 《Pacing and clinical electrophysiology : PACE》2005,28(5):384-390
BACKGROUND: Atrial undersensing occurs in a considerable number of patients with single-lead VDD pacing. This study tried to determine the role of implant side in maintenance of the VDD mode in patients with isolated atrioventricular (AV) block. METHODS: Eighty-two patients with isolated AV block (46 females; mean age, 58 +/- 17 years) received a single-lead VDD pacemaker (Medtronic Kappa, n = 70 and St. Jude Medical Affinity, n = 12). The patients were randomly assigned to one of two implantation groups (group I: right-sided VDD and group II: left-sided VDD). In each group, the P-wave amplitudes were determined at implantation, predischarge, 2-month, and 6-month follow-up. At each follow-up visit, stored event histograms of pacemaker were also retrieved. The atrial sensing measurements were compared between two groups. RESULTS: Implantation was easier from right side (1.7 +/- 1.0 vs 2.8 +/- 1.7 attempts, P = 0.001). Implant P-wave was higher in group I compared to group II (4.2 +/- 1.7 vs 2.7 +/- 1.0 mV, P < 0.0001). During follow-up, higher P-wave amplitudes were obtained in group I both at predischarge (2.6 +/- 1.3 vs 1.4 +/- 1.1 mV, P < 0.0001), 2-month (2.8 +/- 1.8 vs 1.3 +/- 1.0 mV, P < 0.0001), and 6-month (2.9 +/- 1.7 vs 1.3 +/- 0.9 mV, P < 0.0001) evaluations but remained stable throughout the 6 months in both groups. After implantation, VDD function was better maintained in group I than group II (100% vs 90%, P = 0.026). Incidence of atrial undersensing was lower in group I than group II (P = 0.026) in last follow-up visit. CONCLUSIONS: Implant side has a significant influence on atrial sensing performance in single-lead VDD pacing. Thus, right-side implantation should be the preferred approach for the implantation of VDD single-lead systems. 相似文献
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Arya G Schlick T 《Proceedings of the National Academy of Sciences of the United States of America》2006,103(44):16236-16241
The role of each histone tail in regulating chromatin structure is elucidated by using a coarse-grained model of an oligonucleosome incorporating flexible histone tails that reproduces the conformational and dynamical properties of chromatin. Specifically, a tailored configurational-bias Monte Carlo method that efficiently samples the possible conformational states of oligonucleosomes yields positional distributions of histone tails around nucleosomes and illuminates the nature of tail/core/DNA interactions at various salt milieus. Analyses indicate that the H4 histone tails are most important in terms of mediating internucleosomal interactions, especially in highly compact chromatin with linker histones, followed by H3, H2A, and H2B tails in decreasing order of importance. In addition to mediating internucleosomal interactions, the H3 histone tails crucially screen the electrostatic repulsion between the entering/exiting DNA linkers. The H2A and H2B tails distribute themselves along the periphery of chromatin fibers and are important for mediating fiber/fiber interactions. A delicate balance between tail-mediated internucleosomal attraction and repulsion among linker DNAs allows the entering/exiting linker DNAs to align perpendicular to each other in linker-histone deficient chromatin, leading to the formation of an irregular zigzag-folded fiber with dominant pair-wise interactions between nucleosomes i and i +/- 4. 相似文献
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C. Y. W. Tong C. Valentine O. P. Arya 《European journal of clinical microbiology & infectious diseases》1996,15(4):336-340
Endourethral swabs and first-pass urine (FPU) samples from 148 male patients were tested forChlamydia trachomatis by an automated enzyme immunoassay (EIA) (Vidas; bioMérieux, France), a direct fluorescent antibody (DFA) test (MicroTrak; Syva, USA) and two polymerase chain reaction (PCR) methods.Chlamydia trachomatis was considered present if a specimen was positive by at least two methods. This expanded criterion identified 27 patients (18%) as truly infected. One of the PCR methods was most sensitive for both types of specimen. When the recommended cut-off value of Vidas was reduced by 50%, its sensitivity on endourethral swabs was comparable to that of the DFA test, but the DFA test performed better with FPU. In general, FPU was suitable only for PCR. 相似文献
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Munita Meenu Bal M.D. Kedar Deodhar M.D. F.R.C.Path. Shailesh Shrikhande M.S. M.D. Parul Shukla M.S. F.R.C.S. Supreeta Arya M.D. Mukta Ramadwar M.D. F.R.C.Path. 《Diagnostic cytopathology》2013,41(7):599-606
Solid pseudopapillary tumor of the pancreas (SPT) is a rare and fascinating entity of elusive histogenesis and unpredictable biology. It has a peculiar proclivity to afflict young females and involve the pancreatic body‐tail region. Cytology diagnosis of these rare neoplasms remains a challenge. We analyzed the cytology features of all SPT cases diagnosed on fine needle aspiration cytology (FNAC) from 2003 to 2009 along with their histopathology slides. Nineteen consecutive cases were diagnosed as SPT on FNAC. Fifteen out of nineteen cases were confirmed as true SPT on histopathology. Amongst the true SPT, all except one occurred in females. Age ranged from 14 to 50 years. Pseudopapillae bearing stout branches terminating in bulbous tips and enclosing transgressing vessels, separated from a collar of tumor cells by a clear zone of myxohyaline coat were pathognomonic of SPT. Singly dispersed monomorphic tumor cells with bland chromatin formed the second diagnostic component of SPT. Nuclear grooves and hyaline globules were in addition helpful in segregating SPT from its close differentials. In four cases diagnosed as SPT on FNAC, histopathology revealed a different final diagnosis (one case each of paraganglioma, extragastrointestinal stromal tumor, metastatic papillary renal cell carcinoma and inflammatory myofibroblastic tumor). Conversely, one case of SPT had been erroneously diagnosed as neuroendocrine tumor on FNAC. Six cases (40%) developed metastasis; commonest site being liver. In conclusion, cytology in conjunction with clinico‐radiologic findings plays a key role in making a correct diagnosis. Awareness of unique cytomorphological features is important in distinguishing this tumor from its diverse mimics. Diagn. Cytopathol. 2013. © 2012 Wiley Periodicals, Inc. 相似文献
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Ramesh Kumar Vijay Kumar Rahul Arya Utpal Anand Rajeev Nayan Priyadarshi 《World Journal of Virology》2022,11(5):237-251
The coronavirus disease 2019 (COVID-19) pandemic continues to be a global problem with over 438 million cases reported so far. Although it mostly affects the respiratory system, the involvement of extrapulmonary organs, including the liver, is not uncommon. Since the beginning of the pandemic, metabolic com-orbidities, such as obesity, diabetes, hypertension, and dyslipidemia, have been identified as poor prognostic indicators. Subsequent metabolic and lipidomic studies have identified several metabolic dysfunctions in patients with COVID-19. The metabolic alterations appear to be linked to the course of the disease and inflammatory reaction in the body. The liver is an important organ with high metabolic activity, and a significant proportion of COVID-19 patients have metabolic comorbidities; thus, this factor could play a key role in orchestrating systemic metabolic changes during infection. Evidence suggests that metabolic dysregulation in COVID-19 has both short- and long-term metabolic implications. Furthermore, COVID-19 has adverse associations with metabolic-associated fatty liver disease. Due to the ensuing effects on the renin-angiotensin-aldosterone system and ammonia metabolism, COVID-19 can have significant implications in patients with advanced chronic liver disease. A thorough understanding of COVID-19-associated metabolic dysfunction could lead to the identification of important plasma biomarkers and novel treatment targets. In this review, we discuss the current understanding of metabolic dysfunction in COVID-19, focusing on the liver and exploring the underlying mechanistic pathogenesis and clinical implications. 相似文献