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The purpose of this study was to assess the efficacy of overdrive, single-site right atrial appendage pacing to reduce the burden of atrial fibrillation (AF) when compared with a standard lower rate limit of 60 bpm. This was verified by using the pacemaker's Holter. Eighteen subjects with a pre-implant history of paroxysmal AF and implanted DDDR mode-switching pacemakers were recruited. The pacemaker lower rate limit was programmed in random order to 60, 75 or 90 bpm for three 2-month periods and the amount of AF quantified. In addition, the exercise tolerance (ET), general well being (GWB), functional capacity (FC) and specific symptom prevalence (SSP) were assessed. The main finding of the study was that when ranked according to the amount of AF, there was no significant difference in the amount of AF according to the pacing rate. Six patients failed to tolerate pacing at 90 bpm. There were no differences in the ET, GWB, FC and SSP scores. It is concluded that those clinicians that manage patients with paroxysmal

HHT type 2 (HHT 2) is a multi-system vascular dysplasia caused by a mutation in the ALK-1 gene, but the phenotype has not been well defined. We report on 51 members of an HHT 2 kindred with an ALK-1 gene mutation shown to be associated with the disorder. This ALK-1 mutation was detected in 38 kindred members who were evaluated systematically for associated vascular abnormalities. Pulmonary arteriovenous malformations (AVMs) were found in 6% of those screened, cerebral AVM in 7%, hepatic AVM in 17%, and spinal AVM in 3%. We discuss these and other findings in the 38 affected kindred members, as well as findings in the 13 kindred members in whom the mutation was not detected. This study shows that pulmonary, cerebral, spinal, and hepatic AVMs can all occur in HHT 2. It also adds to the evidence suggesting that pulmonary AVMs are more common in HHT 1 than in HHT 2. We identify a higher prevalence of hepatic AVMs than previously reported in either HHT 1 or 2. This may be specific to the mutation in this kindred, but probably reflects the lack of routine screening for this manifestation. Even in this family in which all affected individuals have the same mutation, the clinical manifestations of HHT and their severity varied tremendously. Intrafamilial variation in expression of HHT is clearly significant, emphasizing the difficulty in establishing the diagnosis in individuals and in sub-typing families when DNA testing is not available.

Infrared micro-profiling is the combination of infrared microspectroscopy with precise microscope stage movements. It can provide molecular and spatial information for a variety of samples as small as 10 μn in diameter. To illustrate the technique, different contaminant materials, including a cellulose acetate fiber, oils deposited from a fingerprint, and a thin film of solder flux residue, were infrared micro-profiled. An integrated absorbance data reduction technique commonly used in gas chromatography/FT-IR applications was applied to the micro-profiling data. This technique organizes the vast amount of data generated, enabling the user to plot the results in 3-dimensional projections, allowing extraction of relevant spatial information. A method of coadding spectra from different pixel elements is presented, providing higher quality spectra without increasing data acquisition time. This procedure improves spectral signal-to-noise which aids in the identification of unknown contaminants.

La structure des reseaux obtenus par le procede sol-gel est derivee d'une serie de reactions de condensation. Les seules structures qui se degagent en solution sont celles qui sont stables dans l'entourage de synthese (alcool/eau). Des especes metastables formees lors de la consolidation sont stabilisees temporairement par la viscosite elevee de la matrice environnante. La reactibilite chimique des reseaux sol-gels permet de clarifier leur structure et vice versa

La structure des reseaux obtenus par le procede sol-gel est derivee d'une serie de reactions de condensation. Les seules structures qui se degagent en solution sont celles qui sont stables dans l'entourage de synthese (alcool/eau). Des especes metastables formees lors de la consolidation sont stabilisees temporairement par la viscosite elevee de la matrice environnante. La reactibilite chimique des reseaux sol-gels permet de clarifier leur structure et vice versa

Ultrasonic imaging of the cervical carotid arteries by ultrasonic arteriography and duplex scanning combined with pulsed Doppler spectrum analysis were investigated in a series of patients undergoing arteriography. By using the ultrasonic image as a guide for precise placement of the pulsed Doppler sample volume, the characteristics of blood flow at points of interest in the carotid arteries could be determined. Audible analysis of the Doppler signal permitted correct diagnosis of 23 of 26 (88%) high-grade stenoses or occlusions with ultrasonic arteriography and 24 of 26 (92%) with duplex scanning. Spectrum analysis of Doppler signals obtained with the duplex scanner detected all of the 22 high-grade stenoses. Spectral abnormalities of a lesser degree also were detected in 18 of 23 vessels (78%) with atherosclerotic plaques which should not have reduced cerebral blood flow. These techniques permit the accurate detection of and the distinction between high-grade stenoses and occlusion, as well as the identification of many plaques which are not large enough to affect intracranial hemodynamics.