A population study of the natural history of Wolff-Parkinson-White syndrome in Olmsted County, Minnesota, 1953-1989

BACKGROUND: Virtually all natural history studies of Wolff-Parkinson-White (WPW) syndrome have been case series and, as such, have been constrained by referral biases, skewed age and sex distributions, or brief follow-up periods. The purpose of our study was to examine the natural history, the development of arrhythmias, and the incidence of sudden death in an entire cohort of pediatric and adult WPW patients from a community-based local population. METHODS AND RESULTS: We identified 113 residents of Olmsted County, Minnesota, during the period 1953-1989 using the centralized records-linkage system provided by the Mayo Clinic and the Rochester Epidemiology Program Project. Medical records and ECGs were reviewed to confirm the diagnosis and to establish pathway location by ECG criteria. Follow-up, via record review and telephone interview, was complete in 95% of subjects through 1990. The incidence of newly diagnosed cases was approximately four per 100,000 per year. Preexcitation was not present on the initial ECG of 22% of the cohort. Approximately 50% of the population was asymptomatic at diagnosis, with 30% subsequently having symptoms related to arrhythmia at follow-up. Two sudden cardiac deaths (SCD) occurred over 1,338 patient-years of follow-up, yielding an overall SCD rate of 0.0015 (95% confidence interval, 0.0002-0.0054) per patient-year. No SCD occurred in patients asymptomatic at diagnosis. CONCLUSIONS: The incidence of sudden death in a local community-based population is low and suggests that electrophysiological testing should not be performed routinely in asymptomatic patients with WPW syndrome. Nevertheless, young, asymptomatic patients, particularly those < 40 years old, should return for medical follow-up should symptoms develop.     

A video DSP with a macroblock-level-pipeline and a SIMD typevector-pipeline architecture for MPEG2 CODEC

A video DSP with macroblock-level-pipeline and a SIMD type vector-pipeline architecture (VDSP2) has been developed, using 0.5 μm triple-layer-metal CMOS technology. This 17.00 mm×15.00 mm chip consists of 2.5 M transistors, and operates at 100 MHz. The real-time encoder and decoder specified in the MPEG2 main profile at the main level can be realized with two VDSP2's and a motion estimation (ME) unit, and one VDSP2 respectively, at an 80 MHz clock rate, with a total power dissipation of 4.2 W at 3.3 V     

Comparison of magnetic resonance volume flow rates, angiography, and carotid Dopplers. Preliminary results

BACKGROUND AND PURPOSE: We compared the results of conventional angiography, carotid Doppler, and magnetic resonance angiography volume flow rates to determine the clinical utility of volume flow rate assessment of blood flow to the anterior circulation in patients with carotid occlusive disease. METHODS: From 11 symptomatic patients, a total of 22 extracranial carotid arteries were studied with all three techniques. The studies were independently read, and regression analysis was used to compare the measurements. RESULTS: Carotid Doppler measurements of the distal extracranial carotid arteries were proportional to the inverse of the extracranial carotid volume flow rate (r = .53, R2 = 29%, P < .01), volume flow rates were proportional to the inverse of measured percent stenosis on angiography (r = .84, R2 = 71%, P < .01), and Dopplers were proportional to angiography (r = .94, R2 = 90%, P < .01). Symptomatic Doppler systolic velocity was significantly higher (P < .002), symptomatic measured stenosis was significantly higher (P < .002), and symptomatic volume flow rate was significantly lower (P < .01) than their respective asymptomatic-side values. These preliminary observations, however, may well change once a large data set, especially one in which more patients with high-grade carotid stenosis are included, is studied. CONCLUSIONS: Assessment of carotid volume flow rates by magnetic resonance angiography quantifies flow reduction secondary to atherosclerotic occlusive disease. The easily obtained flow data add both documentation of arterial flow characteristics related to internal carotid stenosis and information regarding the adequacy of collateral pathways.     

The relationship between preparation convergence and retention of extracoronal retainers

PURPOSE: Although traditional ideal convergence (the sum of taper of the opposite sides) for crown preparation has been arbitrarily set at 4 degrees to 10 degrees, some believe absolute parallelism yields the highest retention. This study examined the relationship between the degree of convergence of a machined metal die and the retention of its casting. MATERIALS AND METHODS: The method used was that of cementing cast metal crowns onto full crown preparations on brass dies with varying convergence angles, and then recording the force required to remove the crowns from the dies in a vertical direction using a Tate-Emery Testing Machine and Load Indicator. RESULTS: It was found that retention (i.e., the force needed to remove the cemented castings from the die in their common long axis) increases from 0 degree convergence to peak between 6 degrees to 12 degrees convergence. It also seems that a critical film thickness does exist for optimum retention, and that film thicknesses smaller than the critical thickness may be responsible for the phenomenon that we have observed and directly related to the convergence angle itself. CONCLUSIONS: There seems to be experimental data supporting the use of traditionally taught convergence. Our study found that convergence angles between 6 degrees and 12 degrees seem to be optimum for tooth crown preparation when one plans to use zinc phosphate cement. Convergence angles of less than 6 degrees may not be desirable even if they can be clinically achieved. The results of our study indicate that a relationship exists between the convergence angle and the critical cement thickness that is necessary to realize the maximum strength properties of zinc phosphate cement.     

ATM-based transport architecture for multiservices wirelesspersonal communication networks

This paper presents an ATM-based transport architecture for next-generation multiservices personal communication networks (PCN). Such “multimedia capable” integrated services wireless networks are motivated by an anticipated demand for wireless extensions to future broadband networks. An ATM compatible wireless network concept capable of supporting a mix of broadband ISDN services including constant bit-rate (CBR), variable bit-rate (VBR), and packet data transport is explored from an architectural viewpoint. The proposed system uses a hierarchical ATM switching network for interconnection of PCN microcells, each of which is serviced by high-speed, shared-access radio links based on ATM-compatible cell, relay principles. Design issues related to the physical (modulation), media access control (MAC), and data-link layers of the ATM-based radio link are discussed, and preliminary technical approaches are identified in each case. An example multiservice dynamic reservation (MDR) TDMA media access protocol is then considered in further detail, and simulation results are presented for an example voice/data scenario with a proportion of time-critical (i.e., multimedia) packet data. Time-of-expiry (TOE) based queue service disciplines are also investigated as a mechanism for improving the quality-of-service (QoS) in this scenario     

Cognitive treatments for eating disorders.

Cognitive-behavioral therapy (CBT) is applicable to all eating disorders but has been most intensively studied in the treatment of bulimia nervosa (BN). CBT is designed to alter abnormal attitudes about body shape and weight, replace dysfunctional dieting with normal eating habits, and develop coping skills for resisting binge eating and purging. CBT is effective in reducing all core features of BN and shows good maintenance of therapeutic improvement. Although superior to therapy with antidepressant drugs, CBT has not been shown to be consistently superior to alternative psychological treatments. Different hypotheses about CBT's mechanisms of action are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)