Out-of-hospital cardiac arrest and survival in a patient with Noonan syndrome and multiple lentigines: a case report

BACKGROUND: A 9-year-old Arabic boy attending middle school presented with an out-of-hospital cardiac arrest due to ventricular fibrillation recorded by Holter electrocardiographic monitoring. He had a background history of Noonan syndrome with multiple lentigines (also known as LEOPARD syndrome), a rare condition of autosomal dominant inheritance with approximately 200 cases reported worldwide. CASE PRESENTATION: Apart from characteristic features, the boy was known to have asymmetric septal hypertrophy with a maximum wall thickness of 24 mm measured by cardiovascular magnetic resonance imaging. A day prior to the event, he attended cardiology follow-up at our institution, and Holter monitoring was commenced. Following cardiopulmonary resuscitation by bystanders and paramedics, he reverted back into sinus rhythm after a total downtime of 24 min. He was initially treated in the intensive care unit and underwent implantable cardioverter defibrillator implantation. He has made a full recovery and remains at the top of his class. CONCLUSION: This case demonstrates that sudden cardiac arrest in patients with secondary forms of hypertrophic cardiomyopathy is not necessarily protected by apparently favorable phenotypes and that events may be preceded by non-sustained ventricular tachycardia observed by Holter monitoring. Implantable cardioverter defibrillator implantation plays a critical role in both primary and secondary prevention in patients at high risk of out-of-hospital cardiac arrest

On the Correlation between the Magnetic Activity Levels, the Metallicities and the Radii of Low-Mass Stars

The recent burst in the number of radii measurements of very low-mass stars from eclipsing binaries and interferometry of single stars has opened more questions about what can be causing the discrepancy between the observed radii and the ones predicted by the models. The two main explanations being proposed are a correlation between the radius of the stars and their activity levels or their metallicities. This paper presents a study of such correlations using all the data published to date. The study also investigates correlations between the radii deviation from the models and the masses of the stars. There is no clear correlation between activity level and radii for the single stars in the sample. Those single stars are slow rotators with typical velocities v_rot sini < 3.0 km s^-1. A clear correlation however exists in the case of the faster rotating members of binaries. This result is based on the of X-ray emission levels of the stars. There also appears to be an increase in the deviation of the radii of single stars from the models as a function of metallicity, as previously indicated by Berger et al. (2006). The stars in binaries do not seem to follow the same trend. Finally, the Baraffe et al. (1998) models reproduce well the radius observations below 0.30-0.35Msun, where the stars become fully convective, although this result is preliminary since almost all the sample stars in that mass range are slow rotators and metallicities have not been measured for most of them. The results in this paper indicate that stellar activity and metallicity play an important role on the determination of the radius of very low-mass stars, at least above 0.35Msun.Comment: 22 pages, 4 figures. Accepted for publication on Ap

Cluster Evolution in the ROSAT North Ecliptic Pole Survey

The deepest region of the ROSAT All-Sky Survey, at the North Ecliptic Pole, has been studied to produce a complete and unbiased X-ray selected sample of clusters of galaxies. This sample is used to investigate the nature of cluster evolution and explore potential implications for large-scale structure models. The survey is 99.6% optically identified. Spectroscopic redshifts have been measured for all the extragalactic identifications. In this Letter, first results on cluster evolution are presented based on a comparison between the number of the observed clusters in the North Ecliptic Pole survey and the number of expected clusters assuming no-evolution models. At z>0.3 there is a deficit of clusters with respect to the local universe which is significant at > 4.7sigma. The evolution appears to commence at L_{0.5-2.0} > 1.8x10^{44} erg s^{-1} in our data. The negative evolution goes in the same direction as the original EMSS result, the results from the 160 deg^{2} survey by Vikhlinin et al. (1998) and the recent results from the RDCS (Rosati et al. 2000). At lower redshifts there is no evidence for evolution, a result in agreement with these and other cluster surveys.Comment: 17 pages, 3 figures. Accepted for publication in ApJ Letter

The ROSAT North Ecliptic Pole Survey: The Optical Identifications

The X-ray data around the North Ecliptic Pole (NEP) of the ROSAT All Sky Survey have been used to construct a contiguous area survey consisting of a sample of 445 individual X-ray sources above a flux of ~2x10^-14 erg cm^-2 s^-1 in the 0.5-2.0 keV energy band. The NEP survey is centered at RA (2000) = 18h 00m, DEC(2000) = +66deg 33arcmin and covers a region of 80.7 sq. deg at a moderate Galactic latitude of b = 29.8deg. Hence, the NEP survey is as deep and covers a comparable solid angle to the ROSAT serendipitous surveys, but is also contiguous. We have identified 99.6% of the sources and determined redshifts for the extragalactic objects. In this paper we present the optical identifications of the NEP catalog of X-ray sources including basic X-ray data and properties of the sources. We also describe with some detail the optical identification procedure. The classification of the optical counterparts to the NEP sources is very similar to that of previous surveys, in particular the Einstein Extended Medium Sensitivity Survey (EMSS). The main constituents of the catalog are active galactic nuclei (~49%), either type 1 or type 2 according to the broadness of their permitted emission lines. Stellar counterparts are the second most common identification class (~34%). Clusters and groups of galaxies comprise 14%, and BL Lacertae objects 2%. One non-AGN galaxy, and one planetary nebula have also been found. The NEP catalog of X-ray sources is a homogeneous sample of astronomical objects featuring complete optical identification.Comment: Accepted for publication in the ApJS; 33 pages including 12 postscript figures and 3 tables; uses emulateapj.sty. On-line source catalog at http://www.eso.org/~cmullis/research/nep-catalog.htm

Discovery of 9 New Companions to Nearby Young M Stars with the Altair AO System

We present results of a high-resolution, near-infrared survey of 41 nearby, young (<~300 Myr) M0-M5.0 dwarfs using the Altair natural guide star adaptive optics system at the Gemini North telescope. Twelve of the objects appear to be binaries, 7 of which are reported here for the first time. One triple system was discovered. Statistical properties are studied and compared with earlier (F to K) and later (>= M6 very low-mass, VLM) populations. We find that the separation distribution of the binaries in this sample peaks at 13+14-9 AU, which is consistent with previous measurements of early-M binaries. Hence, early-M binaries seem to occur in--on average--tighter systems than G binaries. At the same time they are significantly wider than field VLM binary stars. The distribution of mass ratios q of primary and secondary stars was found to show an intermediate distribution between the strongly q-->1 peaked distribution of field VLM systems and the almost flat distribution of earlier-type stars. Consequently, we show evidence for relatively young, early-M binaries representing a transition between the well known earlier star distributions and the recently examined field VLM population characteristics. Despite the fact that this survey was dedicated to the search for faint brown dwarf and planetary mass companions, all planetary mass candidates were background objects. We exclude the existence of physical companions with masses greater than 10 Jupiter masses (M_Jup) at separations of >~40 AU and masses greater than 24 M_Jup for separations >~10 AU around 37 of the 41 observed objects.Comment: To appear in the January 1, 2007 issue of the Astrophysical Journal, 12 pages, 13 figures. Minor typographical and grammatical changes. Wrong round off in binary fraction correcte

The North Ecliptic Pole Supercluster

We have used the ROSAT All-Sky Survey to detect a known supercluster at z=0.087 in the North Ecliptic Pole region. The X-ray data greatly improve our understanding of this supercluster's characteristics, approximately doubling our knowledge of the structure's spatial extent and tripling the cluster/group membership compared to the optical discovery data. The supercluster is a rich structure consisting of at least 21 galaxy clusters and groups, 12 AGN, 61 IRAS galaxies, and various other objects. A majority of these components were discovered with the X-ray data, but the supercluster is also robustly detected in optical, IR, and UV wavebands. Extending 129 x 102 x 67 (1/h50 Mpc)^3, the North Ecliptic Pole Supercluster has a flattened shape oriented nearly edge-on to our line-of-sight. Owing to the softness of the ROSAT X-ray passband and the deep exposure over a large solid angle, we have detected for the first time a significant population of X-ray emitting galaxy groups in a supercluster. These results demonstrate the effectiveness of X-ray observations with contiguous coverage for studying structure in the Universe.Comment: Accepted for publication in The Astrophysical Journal; 5 pages with 2 embedded figures; uses emulateapj.sty; For associated animations, see http://www.ifa.hawaii.edu/~mullis/nep3d.html; A high-resolution color postscript version of the full paper is available at http://www.ifa.hawaii.edu/~mullis/papers/nepsc.ps.g

1ES 1927+654: Persistent and rapid X-ray variability in an AGN with low intrinsic neutral X-ray absorption and narrow optical emission lines

We present X-ray and optical observations of the X-ray bright AGN 1ES 1927+654. The X-ray observations obtained with ROSAT and Chandra reveal persistent, rapid and large scale variations, as well as steep 0.1-2.4 keV (Gamma = 2.6 +/- 0.3) and 0.3-7.0 keV (Gamma = 2.7 +/- 0.2) spectra. The measured intrinsic neutral X-ray column density is approximately 7e20cm^-2. The X-ray timing properties indicate that the strong variations originate from a region, a few hundred light seconds from the central black hole, typical for type 1 AGN. High quality optical spectroscopy reveals a typical Seyfert 2 spectrum with some host galaxy contamination and no evidence of Fe II multiplets or broad hydrogen Balmer wings. The intrinsic optical extinction derived from the BLR and NLR are A_V >= 3.7 and A_V=1.7, respectively. The X-ray observations give an A_V value of less than 0.58, in contrast to the optical extinction values. We discuss several ideas to explain this apparent difference in classification including partial covering, an underluminous BLR or a high dust to gas ratio.Comment: 8 pages including 10 figures. Accepted for publication in Astronomy and Astrophysic