Assessment of total and segmental body composition in spinal cord-injured athletes in okayama prefecture of Japan.

This study assessed total and segmental distribution of fat mass (FM) in athletes with spinal cord injury (SCI) and examined the relationships between segmental distribution of fat mass and age, injury level, athletic history, and training load in order to provide useful information for improvements in their physical strength and training. Twenty-five male athletes with SCI participated in the study. The whole bone composition was measured by a dual-energy X-ray absorptiometry (DXA) method for the calculation of bone minerals, FM, and fat-free mass. The percent fat of the trunk, arms, and legs was also calculated. The percent fat in the legs was highest in comparison with that in the trunk and arms (p &#60; 0.001), and the percent fat in the trunk was higher than that in the arms (p &#60; 0.001). The body fat (p &#60; 0.01), waist circumference (p &#60; 0.01), and waist-to-hip ratio (p &#60; 0.0001) were higher in the group aged 40 or older in comparison with that aged 39 or younger. Path analysis revealed that training load was a factor decreasing the percent fat on the arms and trunk (p &#60; 0.01), and athletic history was a factor reducing the percent fat on the arms (p &#60; 0.05). Our study suggests that exercise is effective in reducing the waist circumference, waist-to-hip ratio, and percent body fat of SCI individuals, and that such effects can help to enhance athletic performance and likely to protect against development of metabolic syndromes resulting from a sedentary lifestyle.</p

Assessment of total and segmental body composition in spinal cord-injured athletes in okayama prefecture of Japan.

This study assessed total and segmental distribution of fat mass (FM) in athletes with spinal cord injury (SCI) and examined the relationships between segmental distribution of fat mass and age, injury level, athletic history, and training load in order to provide useful information for improvements in their physical strength and training. Twenty-five male athletes with SCI participated in the study. The whole bone composition was measured by a dual-energy X-ray absorptiometry (DXA) method for the calculation of bone minerals, FM, and fat-free mass. The percent fat of the trunk, arms, and legs was also calculated. The percent fat in the legs was highest in comparison with that in the trunk and arms (p &#60; 0.001), and the percent fat in the trunk was higher than that in the arms (p &#60; 0.001). The body fat (p &#60; 0.01), waist circumference (p &#60; 0.01), and waist-to-hip ratio (p &#60; 0.0001) were higher in the group aged 40 or older in comparison with that aged 39 or younger. Path analysis revealed that training load was a factor decreasing the percent fat on the arms and trunk (p &#60; 0.01), and athletic history was a factor reducing the percent fat on the arms (p &#60; 0.05). Our study suggests that exercise is effective in reducing the waist circumference, waist-to-hip ratio, and percent body fat of SCI individuals, and that such effects can help to enhance athletic performance and likely to protect against development of metabolic syndromes resulting from a sedentary lifestyle.</p

An Approach to Catheter Ablation of Cavotricuspid Isthmus Dependent Atrial Flutter

Much of our understanding of the mechanisms of macro re-entrant atrial tachycardia comes from study of cavotricuspid isthmus (CTI) dependent atrial flutter. In the majority of cases, the diagnosis can be made from simple analysis of the surface ECG. Endocardial mapping during tachycardia allows confirmation of the macro re-entrant circuit within the right atrium while, at the same time, permitting curative catheter ablation targeting the critical isthmus of tissue located between the tricuspid annulus and the inferior vena cava. The procedure is short, safe and by demonstration of an electrophysiological endpoint - bidirectional conduction block across the CTI - is associated with an excellent outcome following ablation. It is now fair to say that catheter ablation should be considered as a first line therapy for patients with documented CTI-dependent atrial flutter

Calibration of imaging plate for high energy electron spectrometer

Copyright 2005 American Institute of Physics. This article may be downloaded for personal use only. Any other use requires prior permission of the author and the American Institute of Physics. The following article appeared in Review of Scientific Instruments, 76(1), 013507_1-013507_5, 2005 and may be found at http://dx.doi.org/10.1063/1.182437

Shortening of Fibrillatory Cycle Length in the Pulmonary Vein During Vagal Excitation

ObjectivesThe goal of the present prospective study is to evaluate the impact of vagal excitation on ongoing atrial fibrillation (AF) during pulmonary vein (PV) isolation.BackgroundThe role of vagal tone in maintenance of AF is controversial in humans.MethodsTwenty-five patients (18 with paroxysmal AF, 7 with chronic AF) were selected by occurrence of vagal excitation during AF (atrioventricular [AV] block: R-R interval >3 s) produced by PV isolation. Fibrillatory cycle length (CL) in the targeted PV and coronary sinus (CS) were determined before, during, and after vagal excitation. The CL was available at PV ostium during vagal excitation in 11 patients.ResultsForty-eight episodes of vagal excitation were observed. During vagal excitation, CL abruptly decreased both in CS and PV (CS, 164 ± 20 ms to 155 ± 23 ms, p < 0.0001; PV, 160 ± 22 ms to 143 ± 28 ms, p < 0.0001), and both returned to the baseline value with resumption of AV conduction. The decrease in PVCL occurred earlier (2.5 ± 1.5 s vs. 4.0 ± 2.6 s, p < 0.01) and was of greater magnitude than that in CSCL (16 ± 16 ms vs. 8 ± 9 ms, p < 0.01). A sequential gradient of CL was observed from PV to PV ostium and CS during vagal excitation (138 ± 29 ms, 149 ± 24 ms, and 159 ± 26 ms, respectively). The decrease in CL was significantly greater in paroxysmal than in chronic AF (CS, 11 ± 9 ms vs. 5 ± 7 ms, p < 0.05; PV, 23 ± 25 ms vs. 8 ± 14 ms, p < 0.05).ConclusionsVagal excitation is associated with shortening of fibrillatory CL. This occurs earlier in PV with a sequential gradient to PV ostium and CS, suggesting that vagal excitation enhances a driving role of PV

Evolutional transition of HBV genome during the persistent infection determined by single-molecule real-time sequencing

BACKGROUND: Although HBV infection is a serious health issue worldwide, the landscape of HBV genome dynamics in the host has not yet been clarified. This study aimed to determine the continuous genome sequence of each HBV clone using a single-molecule real-time sequencing platform, and clarify the dynamics of structural abnormalities during persistent HBV infection without antiviral therapy. PATIENTS AND METHODS: Twenty-five serum specimens were collected from 10 untreated HBV-infected patients. Continuous whole-genome sequencing of each clone was performed using a PacBio Sequel sequencer; the relationship between genomic variations and clinical information was analyzed. The diversity and phylogeny of the viral clones with structural variations were also analyzed. RESULTS: The whole-genome sequences of 797, 352 HBV clones were determined. The deletion was the most common structural abnormality and concentrated in the preS/S and C regions. Hepatitis B e antibody (anti-HBe)-negative samples or samples with high alanine aminotransferase levels have significantly diverse deletions than anti-HBe-positive samples or samples with low alanine aminotransferase levels. Phylogenetic analysis demonstrated that various defective and full-length clones evolve independently and form diverse viral populations. CONCLUSIONS: Single-molecule real-time long-read sequencing revealed the dynamics of genomic quasispecies during the natural course of chronic HBV infections. Defective viral clones are prone to emerge under the condition of active hepatitis, and several types of defective variants can evolve independently of the viral clones with the full-length genome

Outcomes after stepwise ablation for persistent atrial fibrillation in patients with heart failure

AbstractBackgroundThere is limited data regarding the outcomes after stepwise ablation for persistent atrial fibrillation (AF) in patients with heart failure (HF).Methods and resultsPatients without structural heart disease undergoing stepwise ablation for persistent AF (continuous AF≤1 year) were studied (n=108; age, 61±10 years) and 32 patients had a history of HF. The HF patients were further grouped on the basis of left ventricular ejection fraction (LVEF)≤45% (n=15) and >45% (n=17). During a median follow-up period of 2.2 years, repeated ablations were necessary in 65 patients. The proportion of patients that were arrhythmia free 1 year after the last ablation was 67% in patients with LVEF≤45%, 86% in LVEF>45%, and 91% in no HF (p=0.0009). In patients with LVEF≤45%, the AF burden was reduced to less than one paroxysmal episode per month, and patients with and without recurrences both showed significant increases in LVEF over the follow-up period (38±7% to 60±10% and 37±6% to 53±10%, respectively).ConclusionsHF patients with LVEF≤45% had lower chances to remain free from arrhythmias after stepwise ablation for persistent AF than those with LVEF>45%. Nevertheless, LVEF also improved in patients with recurrences, reflecting the observed reduction in AF burden and emphasizing the benefits of ablation

Prevention of long‐lasting atrial fibrillation through antitachycardia pacing in DDDR pacemakers

Objective The MINERVA trial showed that in pacemaker patients with atrial fibrillation (AF) history, DDDRP pacing combining three algorithms - (a) atrial antitachycardia pacing with Reactive ATP enabled, (b) atrial preventive pacing and (c) managed ventricular pacing (MVP)-may effectively delay progression to persistent/permanent AF compared with standard DDDR pacing. We performed a comparative non-randomised evaluation to evaluate if Reactive ATP can be the main driver of persistent/permanent AF reduction independently on preventive pacing. Methods Thirty-one centres included consecutive dual-chamber pacemaker patients with AF history. Reactive ATP was programmed in all patients while preventive atrial pacing was not enabled. These patients were compared with the three groups of MINERVA randomised trial (Control DDDR, MVP, and DDDRP). The main endpoint was the incidence of AF longer than 7 consecutive days. Results A total of 146 patients (73 years old, 54% male) were included and followed for a median observation period of 31 months. The 2-year incidence of AF > 7 days was 12% in the Reactive ATP group, very similar to that found in the DDDRP arm of the MINERVA trial (13.8%, P = .732) and significantly lower than AF incidence found in the MINERVA Control DDDR arm (25.8%, P = .012) and in the MINERVA MVP arm (25.9%, P = .025). Conclusions In a real-world population of dual-chamber pacemaker patients with AF history, the use of Reactive ATP is associated with a low incidence of persistent AF, highlighting that the positive results of the MINERVA trial were related to the effectiveness of Reactive ATP rather than to preventive pacing