2%) received second line chemotherapy. The median overall survival (OS) for these patients was 8.2 months (95% CI, 4.44 to 11.96 months). Multivariate analysis results indicated that female gender and having received second-line or more chemotherapy were independent prognostic factors for increased OS for all 48 patients. Charlson Index was not a significant independent prognostic factor for survival. There were 9 treatment related deaths due to infectious selleck inhibitor causes (18.8%).

Conclusion

Patients

75 years of age or older with advanced NSCLC may obtain clinical benefit from the administration of platinum-based doublet or single agent chemotherapy. However, oncologists must consider the aspect of safety in relation to the clinical benefits when managing this patient group.”
“BackgroundCurrent coronary heart disease (CHD) risk assessments inadequately assess intermediate-risk

patients, leaving many undertreated and vulnerable to heart attacks. A novel CHD risk-assessment (CHDRA) tool was developed for intermediate-risk https://www.selleckchem.com/products/mk-4827-niraparib-tosylate.html stratification using biomarkers and established risk factors to significantly improve CHD risk discrimination.

HypothesisPhysicians will change their treatment plan in response to more information about a patient’s CHD risk level provided by the CHDRA test.

MethodsA Web-based survey of cardiology, internal Vorinostat order medicine, family practice, and obstetrics/gynecology physicians (n=206) was conducted to assess the CHDRA clinical impact. Each physician was shown 3 clinical vignettes representing community-based cohort participants randomly selected from 8 total vignettes. For each, the physicians assessed the individual’s CHD risk and selected preferred therapies based on the individual’s comorbidities,

physical examination, and laboratory results. The individual’s CHDRA score was then provided and the physicians were queried for changes to their initial treatment plans.

ResultsAfter obtaining the CHDRA result, 70% of the physician responses indicated a change to the patient’s treatment plan. The revised lipid-management plans agreed more often (74.6% of the time) with the current Adult Treatment Panel III guidelines than did the original plans (57.6% of the time). Most physicians (71.3%) agreed with the statement that the CHDRA result provided information that would impact their current treatment decisions.

ConclusionsThe CHDRA test provided additional information to which physicians responded by more often applying appropriate therapy and actions aligned with guidelines, thus demonstrating the clinical utility of the test.

“
“Study Design. A retrospective observational study of healthy volunteers and patients with degenerative and infectious endplate abnormalities in the lumbar spine.

Objectives. Our purpose was to evaluate the usefulness of diffusion-weighted imaging (DWI) for the differentiation of degenerative and infectious endplate abnormalities using 1.5-T magnetic resonance imaging (MRI).

Summary of Background Data. DWI can provide valuable structural information about tissues that may be useful for clinical applications in differentiation find more between degenerative and infectious endplate abnormalities.

Methods. Sixteen consecutive patients with endplate abnormalities

that was detected by MRI of the lumbar spine, and 15 healthy volunteers were studied. DWI was performed using whole-body imaging with background body signal suppression with a b value of 1000 s/mm(2). Apparent diffusion coefficient values of normal and abnormal vertebral bone marrow were calculated.

Results. Twenty-nine vertebral

abnormalities were found in 16 patients. Nine vertebral abnormalities in 5 patients were because of infections and 20 vertebral abnormalities in 11 patients were because of degenerative changes; 7 levels were classified as Modic type 1, 7 levels as type 2, and 6 levels as type 3. DWI showed hyperintensity in all patients with infection, similar to that used in positron emission tomography, but not in the intervertebral spaces of any patients with degenerative disease. Apparent diffusion coefficient GW786034 values of infectious bone marrowwere significantly higher than normal and degenerative bone marrow.

Conclusion. DWI is useful for differentiation of degenerative and infectious endplate abnormalities. Moreover, MRI is widely used clinically because of the lack of ionizing radiation, low cost, and fast imaging time as compared with positron emission tomography. Therefore,

DWI has the potential to be used as a screening tool.”
“Temperature fluctuates rapidly and affects all developmental and metabolic processes. This often obscures the effects of developmental trends or of other environmental conditions when temperature fluctuates naturally. A method is proposed for modelling temperature-compensated rates, based on the coordination of temperature responses of developmental processes. In a data set comprising 41 experiments in the greenhouse, growth chamber, this website or the field, the temperature responses in the range of 6-36 degrees C for different processes were compared in three species, maize, rice, and Arabidopsis thaliana. Germination, cell division, expansive growth rate, leaf initiation, and phenology showed coordinated temperature responses and followed common laws within each species. The activities of 10 enzymes involved in carbon metabolism exhibited monotonous exponential responses across the whole range 10-40 degrees C. Hence, the temperature dependence of developmental processes is not explained by a simple relationship to central metabolism.

Eight suggestive associations with P<1×10(-4) were carried through to in silico AZD7762 replication in 1292 AAA cases and 30503 controls. One single-nucleotide polymorphism associated with P<0.05 after Bonferroni correction in the in silico

study underwent further replication (706 AAA cases and 1063 controls from the United Kingdom, 507 AAA cases and 199 controls from Denmark, and 885 AAA cases and 1000 controls from New Zealand). Low-density lipoprotein receptor (LDLR) rs6511720 A was significantly associated overall and in 3 of 5 individual replication studies. The full study showed an association that reached genome-wide significance (odds ratio, 0.76; 95% confidence interval, 0.70-0.83; P=2.08×10(-10)).

Conclusions LDLR rs6511720 is associated with AAA. This finding is consistent with established

effects of this variant on coronary artery disease. Shared causal pathways with other cardiovascular diseases may present novel opportunities for preventative and therapeutic strategies for AAA.”
“Background: Iron deficiency (ID) can occur among exclusively breastfed infants before 6 mo of age.

Objective: The objective was to determine which subgroups of fully breastfed infants are at highest risk of ID.

Design: We assessed the prevalence of ID (ferritin < 12 mu g/L) and iron deficiency anemia (IDA; ferritin < 12 mu g/L and hemoglobin 105 g/L) and risk factors associated with ID and IDA at 6 mo among 404 fully breastfed VX-809 molecular weight infants with a birth weight >2500 g from 6 studies in Ghana, Honduras, Mexico, PD-1/PD-L1 Inhibitor 3 cell line and Sweden. Infants with an elevated C-reactive protein concentration (8%) were excluded.

Results: The percentages of infants with ID were 6% in Sweden, 17% in Mexico, 13-25% in Honduras, and 12-37% in Ghana. The percentages with IDA were 2% in Sweden, 4% in Mexico, 5-11% in Honduras, and 8-16% in Ghana. With data pooled, the key predictors of ID (20%) were male sex [adjusted odds ratio (AOR): 4.6; 95% CI: 2.5, 8.5] and birth weight 2500-2999 g (AOR: 2.4; 95% CI: 1.4, 4.3). The predictors of IDA (8%) were male sex (AOR: 7.6; 95% CI: 2.5, 23.0), birth weight of 2500-2999 g (AOR: 3.4; 1.5, 7.5), and weight gain above the

median since birth (AOR: 3.4; 95% CI: 1.3, 8.6). The combination of birth weight 2500-2999 g or male sex had a sensitivity of 91% for identifying ID and of 97% for identifying IDA.

Conclusions: Among fully breastfed infants with a birthweight. 2500 g, IDA is uncommon before 6 mo, but male infants and those with a birth weight of 2500-2999 g are at higher risk of ID and IDA. Am J Clin Nutr 2009;89:1433-40.”
“Dispersing conductive carbon black (CCB) particles into silicone rubber (SR), we studied the conductivity and piezoresistivity of particles filled polymer composite. The experimental results show that the conductive percolation threshold and shape exponent of composite are effected on by filler’s size and reduce with filler’s size decreasing.

Four patients (2.8%, 4/144) were diagnosed with N2 disease after systematic lymph node dissection. Total N2 involvement was 4.8% (7/147). As 9.5% (14/147) of study patients had N1 disease,

14.3% (21/147) of patients had occult nodal (N1 or N2) metastasis. In univariate analyses, larger tumour size and a higher primary tumour maximum standardized uptake value >7.3 (SUV(max)) were associated with occult nodal metastasis. Multivariate analysis demonstrated that a primary tumour SUV(max) >7.3 was an independent predictor of occult nodal metastasis (odds ratio: 7.574; P = GNS-1480 mouse 0.001).

Conclusions: Preoperative PET/CT scans contribute to reduce the frequency of occult nodal metastasis compared with those reported in the pre-PET/CT era. The higher SUV(max) in primary tumour was an independent predictor of occult nodal metastasis in patients with clinical stage IA NSCLC by PET/CT.”
“Contents

The present study was conducted to test different Sapitinib in vivo methods for porcine inner cell mass (ICM) and epiblast isolation and to evaluate the morphology and expression of pluripotency genes in ICM- and epiblast-derived outgrowth colonies (OCs) and passages thereof with particular attention

on the relationship between OCT4 expression and embryonic stem cell (ESC)-like morphology. A total of 104 zona pellucida-enclosed and 101 hatched blastocysts were subjected to four different methods of ICM and epiblast isolation,

Nepicastat respectively: Manual isolation, immunosurgery, immunosurgery with manual cleaning, or whole blastocyst culture. OCs were established on mouse embryonic fibroblast (MEF) cells and categorized according to morphology and OCT4 staining. Although all isolation methods resulted in ESC-like OCs, immunosurgery with manual cleaning yielded significantly higher rates of ICM/epiblast attachment and subsequent ESC-like morphology, whereas no significant difference was found between ICM and epiblasts with respect to these characteristics. All ESC-like OCs showed nuclear OCT4 staining and expression of OCT4, NANOG and SOX2 as evaluated by RT-PCR. Upon initial passages, the expression of pluripotency markers was, however, gradually lost in spite of maintained ESC-like morphology. In conclusion, we have established a robust system for derivation of ESC-like OCs from porcine ICM and epiblasts and we have shown that localization of OCT4 is associated with an ESC-like morphology although this relationship is lost during early passages.”
“Revalidation is a significant recent regulatory policy reform from the UK General Medical Council and being considered elsewhere around the world. The policy aims to regulate licensed doctors to ensure that they are ‘up-to-date and fit-to practise’. Fundamental to the policy is that the revalidation of doctors should benefit patients and improve doctor-patient relationships.

RSV was the most common coinfection virus and coinfection increased hospitalization rates. All HMPV subgroups except B2 cocirculated and there was no association found between HMPV genotypes and severity of disease.”
“The recent scale-up of malaria interventions, the ensuing reductions in the malaria burden, and reinvigorated discussions about global eradication have led many countries to consider malaria elimination as an alternative to maintaining control measures indefinitely. Evidence-based guidance to help countries weigh their options is thus urgently needed.

A quantitative feasibility assessment that balances the epidemiological situation in a region, the strength of the public health system, the resource constraints, and the status of malaria control in neighboring areas can serve as the basis for Kinase Inhibitor Library in vivo robust, long-term strategic planning. Such a malaria elimination feasibility assessment was recently prepared for the Minister of Health in Zanzibar. Based on the Zanzibar experience, a framework is proposed along three axes that assess the technical requirements to achieve and maintain elimination, the operational capacity of the malaria programme and the public

health system to meet those requirements, and the feasibility of funding the necessary programmes over time. Key quantitative and buy LGX818 qualitative metrics related to each component of the assessment are described here along with the process of collecting data and interpreting the results. Although further field testing, validation, and methodological improvements will be required to ensure applicability in different epidemiological settings, the result is a flexible, rational methodology for weighing different strategic options that can be applied in a variety

of contexts to establish data-driven strategic plans.”
“AIMS: To describe the involvement and input of physicians and nurses in cardiopulmonary resuscitation (CPR / do not attempt resuscitation (DNAR) decisions; to analyse decision patterns; and understand the practical implications.

DESIGN: A Qualitative Grounded Theory study using one-time open-ended interviews with 40 volunteer physicians and 52 nurses drawn from this website acute care wards with mixes of heterogeneous cases in seven different hospitals in German-speaking Switzerland.

RESULTS: Establishing DNAR orders in the best interests of patients was described as a challenging task requiring the leadership of senior physicians and nurses. Implicit decisions in favour of CPR predominated at the beginning of hospitalisation; depending on the context, they were relieved/superseded by explicit DNAR decisions. Explicit decisions were the result of hierarchical medical expertise, of multilateral interdisciplinary expertise, of patient autonomy and/or of negotiated patient autonomy. Each type of decision, implicit or explicit, potentially represented a team consensus.

To date, no study has investigated PLX3397 purchase the composition of tear proteins in tear samples of SM-intoxicated patients.

Methods: Total protein content as well as concentrations of vascular endothelial growth factor (VEGF), calcitonin gene related peptide (CGRP) and substance P were measured in unstimulated tears of chemically-injured patients who suffer from late ocular complications of SM. These levels were

compared to corresponding values obtained from tears of healthy control subjects. The concentration of total proteins was measured using the Bradford method and those of VEGF, CGRP and substance P by ELISA.

Results: Total protein concentration was significantly lower in tears of the SM compared to control group (p < 0.01). In contrast, tear samples of the SM group had significantly higher VEGF and VEGF/total protein compared to control group (p < 0.01). Tear CGRP concentration was found to be lower in the SM vs. control group (p < 0.05) but no significant difference in CGRP/total protein was observed (p > 0.05). Finally, tear substance P concentrations were not found to be significantly

different between the two groups (p > 0.05).

Conclusion: The results of this investigation indicated decreased total protein and Selisistat CGRP, and elevated VEGF concentration in tears of SM-intoxicated patients who suffer from chronic ocular complications.”
“Background: We present the first phase contrast (PC) cardiovascular magnetic resonance (CMR) measurements of the distribution of blood flow in twelve late gestation human fetuses. These were obtained using a retrospective gating technique known as

metric optimised gating (MOG).

Methods: A validation experiment was performed in five adult volunteers where conventional cardiac gating was compared with MOG. Linear regression and Bland Altman plots were used to compare MOG with the gold standard of conventional gating. Measurements using MOG were then made in twelve normal fetuses at a median gestational age of 37 weeks CYT387 research buy (range 30-39 weeks). Flow was measured in the major fetal vessels and indexed to the fetal weight.

Results: There was good correlation between the conventional gated and MOG measurements in the adult validation experiment (R=0.96). Mean flows in ml/min/kg with standard deviations in the major fetal vessels were as follows: combined ventricular output (CVO) 540 +/- 101, main pulmonary artery (MPA) 327 +/- 68, ascending aorta (AAo) 198 +/- 38, superior vena cava (SVC) 147 +/- 46, ductus arteriosus (DA) 220 +/- 39, pulmonary blood flow (PBF) 106 +/- 59, descending aorta (DAo) 273 +/- 85, umbilical vein (UV) 160 +/- 62, foramen ovale (FO) 107 +/- 54. Results expressed as mean percentages of the CVO with standard deviations were as follows: MPA 60 +/- 4, AAo37 +/- 4, SVC 28 +/- 7, DA 41 +/- 8, PBF 19 +/- 10, DAo50 +/- 12, UV 30 +/- 9, FO 21 +/- 12.

In this study, the blend films were hot-mixed at 180 degrees C by an internal find more batch mixer and then compression-molded to form test specimens. The results show that the addition of MDI as a compatibilizer led to in increase in the tensile properties compared with the uncompatibilized films.

Furthermore, the thermal properties indicated some improving interfacial adhesion between the two phases, as evidenced by the morphological results. These behaviors were observed in the blends with both gelatinized tapioca starch and gelatinized corn starch. The different types of starch had no effect on the glass-transition and melting-temperature Shifts, including water absorption of the blend films. On the other hand, the mechanical properties of the blends with gelatinized corn starch were higher than those of the others. (C) 2010 Wiley Periodicals, Inc. J Appl Polym Sci 116: 2305-2311, 2010″
“The EQ-5D-5L was developed to compensate for a selleck chemicals high ceiling effect and lack of descriptive richness of the EQ-5D-3L. We evaluated psychometric properties of EQ-5D-5L in the general population.

Six hundred of adults were sampled from the general population in South Korea using a multistage

stratified quota sampling method. Participants completed the EQ-5D-5L, EQ-5D-3L, and SF-36v2. One hundred participants were resurveyed for reliability evaluation. The ceiling effect, known-groups construct validity, convergent and discriminant validity, and reliability of EQ-5D-5L were evaluated.

A smaller proportion of participants answered ‘no problem’ to all dimensions of EQ-5D-5L (61.2 %) than EQ-5D-3L

(65.7 %, p < 0.01), indicating a reduced ceiling effect. Female, elderly, low-educated, and low-income participants reported health problems more frequently, indicating known-groups construct validity. The mobility dimension of EQ-5D-5L was better correlated with the physical component score (|r| = 0.48) than the mental Apoptosis inhibitor component score (|r| = 0.25) of the SF-36v2, and the anxiety/depression dimension was better correlated with mental component score (|r| = 0.45) than physical component score (|r| = 0.34), indicating convergent and discriminant validity. The intraclass correlation coefficient of EQ-5D-5L index was 0.75.

The EQ-5D-5L has a smaller ceiling effect than the EQ-5D-3L and is a valid and reliable instrument to measure health-related quality of life in the general population.”
“We report theoretically and experimentally a dc magnetoelectric sensor consisting of a thickness-polarized 0.7Pb(Mg1/3Nb2/3)O-3-0.3PbTiO(3) (PMN-PT) piezoelectric single-crystal plate arranged along the longitudinal direction and sandwiched between a pair of electrically connected aluminum strips.

g. ostial encroachment and

previous mitral valve replacement). GDC-0973 purchase The aim of this study was to prove the feasibility and efficacy of this novel innovative off-pump apico-aortic conduit technique.

The bipartite conduit consists of an 18-mm prosthetic tube graft containing a stentless porcine aortic valve as well as a flexible semi-rigid and curved ventricular connector. Via left anterior lateral thoracotomy, the valved conduit is sutured to the descending aorta. The left ventricular connector is implanted with a gun-like applicator into the apex without cardiopulmonary bypass and with minimal blood loss.

Between March and December 2011, 7 patients (5 females/2 males) with a mean age of 82 (79-89 years) were operated on. The mean logistic EuroSCORE I was 36.4 +/- 23.7 (median 36.7%). The mean ejection fraction was 37 (25-65%) CUDC-907 manufacturer and the mean preoperative transaortic gradient was 38 (22-53 mmHg). Three patients had previous mechanical mitral valve replacement, 1 had a porcelain aorta and 3 had unfavourable distances between the aortic annulus and ostia (ostial

encroachment). Implantation was uneventful in all patients, with need for limited cardiopulmonary bypass in only 1 patient. Postoperative mean transaortic gradient was 14 (11-25 mmHg). Approximately 70% of stroke volume was bypassed as measured in postoperative magnetic resonance. One patient died in hospital due to respiratory failure. New York Heart Association class in the other patients diminished from 3.6 to 1.6. No rhythmic disturbances or heart block were encountered.

With this novel conduit, we observed excellent haemodynamic results. We feel that this additional surgical approach to aortic stenosis in elderly, high-risk patients can augment conventional on-pump and interventional treatments of aortic stenosis.”
“Background Gastric perforations are one of the intraoperative

complications of laparoscopic gastric banding (LAGB). Delayed diagnosis can increase the mortality and morbidity rates.

Methods Retrospective analysis of surgery outcome and long-term follow-up of the patients with gastric perforations during primary LAGB and revisional band procedures was performed.

Results BKM120 solubility dmso Twenty-four patients with gastric perforations were identified during 15 years of LAGB surgeries. Half of these had primary LAGB and half had revisional procedures (five emergent and seven elective). Gastric tear was found at surgery in 19 patients; the band was preserved and LAGB was completed in 18 of these. Five patients had delayed diagnosis and underwent re-exploration 24-72 h after surgery. During the surgery, 23 anterior, 8 posterior, 1 esophageal, and 1 small bowel tears were found. Laparoscopic repair was successful in 19 (83 %) cases. The mean surgery time and mean hospital stay were 56.3 min and 7.8 days, respectively. Morbidity and mortality rates were 25 and 4.1 %, respectively.

As a consequence, no association could be established between the serological condition and ELA-DRA. (c) 2012 Elsevier Ltd. All rights reserved.”
“Questions under study / principles: The Swiss Sentinel Surveillance Network (SSSN) has been used as selleck kinase inhibitor a monitoring system for asthma epidemiology. Three aspects of asthma were studied between 1989 and 2005: the seasonal pattern of asthma, practice incidence

and time trends for allergic and non-allergic asthma on the basis of the association of asthma with eczema and hay fever. The purpose of this report is to use the results from 17 years of asthma monitoring to show that the SSSN can be used as an instrument of research in practice.

Methods: Basically, monthly and yearly rates of episodes per 1000 consultations were calculated from weekly reports, and standard time series analysis methods were used to explore trends.

Results: The seasonal pattern shows distinct peaks of asthma attacks in June and November. Long-term trends show that consultations for first asthma

episodes increased up to 1999 and fell thereafter. Consultations for subsequent asthma episodes have fallen by a third since 1994. Shortterm trends indicate a plateau from 1997 to 2000 ARN-509 mw before a steep decline. The separate analysis of allergic and non-allergic asthma shows that the decrease in asthma consultations is chiefly due to the allergic component of asthma.

Conclusion: check details These findings are similar to those from other studies for the same time-period and show that the SSSN can generate valid scientific data.”
“Study Design. Retrospective review of prospectively collected data.

Objective. To identify the cause of failed open-door laminoplasty and to describe the surgical

strategies for revision surgery.

Summary of Background Data. Although laminoplasty has become popular, few articles have addressed the cause of failed cervical laminoplasty requiring revision surgery.

Methods. All patients who required revision surgery following open-door cervical laminoplasty were identified. Clinical data, method of surgical revision, time between surgeries, Nurick grade, radiologic parameters, and complications were analyzed. Laminoplasty failures were classified into 3 categories: “”technique related,”" “” inadequate symptomatic relief after treatment,”" or “” recurrence of symptoms due to disease progression.”"

Results. A total of 130 patients underwent cervical laminoplasty over a 10-year period (1996-2006), and 12 patients (9.2%) required revision surgery. The mean age was 50.7 years at the time of the index laminoplasty (range, 34-67 years) and 51.8 years (range, 35-70 years) at the time of the revision surgery. Mean duration of symptoms was 7.3 months before the index procedure (range, 2-17 months) and 5.6 months (range, 1-14 months) before revision surgery. The mean time interval between the index procedure and revision surgery was 16.6 months (range, 4-43 months).

5 %) and mitral valve regurgitations (22 %) are significantly correlated with aortic root dilation (p < 0.01) and mitral valve prolapse (p < 0.05) but without relevant progression during childhood. Prophylactic medication was initiated for 42 % of the patients (mean age, 8.0 +/- A 4.5 years) because of progressive aortic root dilation. Aortic dissection did not appear. Aortic root surgery was needed for 4 % of the patients. Gender-specific differences in cardiovascular findings, progression of disease, or treatment did not appear. Comparable with adults, aortic root dilation is the most frequent cardiovascular

finding in children and associated with relevant morbidity, whereas aortic and mitral valve regurgitation are of minor clinical relevance. Manifestation at an early age and slow progression of cardiovascular findings underscore the necessity of repeated echocardiographic examinations for early diagnosis LY2157299 chemical structure and start of prophylactic treatment.”
“Objective. Intrathecal baclofen (ITB) is effective in the treatment of dystonia

related to complex regional pain syndrome Selonsertib purchase (CRPS). In a previous study, we noted that the responsiveness to ITB declined in 30% of patients once drug delivery was switched from an external to an implanted device associated with a reduction of the infusion rate (IR).

Design. In a double-blind study, we investigated the effect of varying the IR at a fixed daily dose on the efficacy and safety of ITB in patients with CRPS-related dystonia. Patients were randomized to either slower infusion rate delivery (SIRD) or four-times faster infusion rate delivery (FIRD) for 2 weeks and were crossed over after a 1-week washout Selleckchem PD0325901 period.

Patients. Patients were eligible if they experienced no beneficial response to ITB on dystonia despite a minimum dose of 600 mu g/day, or because side effects limited dose escalation.

Outcome Measures. Primary outcome measures were changes in global dystonia and pain severity.

Results. There were no significant differences between the FIRD and the SIRD groups for the median change of numeric rating scale dystonia (-0.3 [interquartile range IQR -1.1-0.5]), pain (0.1 [IQR -0.8-1.3]), and

secondary outcomes, except for the frequency of adverse events, which was significantly higher during FIRD (12 vs 2). FIRD was preferred only by patients who were included because side effects to ITB prevented dose escalation.

Conclusions. Increasing the IR at a fixed daily dose is not associated with improvement of dystonia or pain but warrants further investigation in patients in whom side effects prevent further dose escalation.”
“Transient complete heart block (TCHB) is defined as complete interruption of atrioventricular conduction (AVC) after cardiac surgery followed by return of conduction. This study aimed to assess the risk for the development of late complete heart block (LCHB) after recovery of TCHB and to examine the electrocardiographic and electrophysiologic properties of the AVC system after TCHB.