A Web-based platform for interdisciplinary biomedical research.

The European Neuroblastoma Group of the International Society for Paediatric Oncology (SIOPEN) is dedicated to the research and treatment of neuroblastoma. The medical research network SIOPEN-R-NET is an extensive web-based European IT network for interdisciplinary biomedical research. The IT infrastructure has been built using state-of-the-art multi-tiered architecture principles. Basic features required for electronic data capture in clinical trials were implemented. Additionally, advanced tools were developed for registration, review, user management, communication and image management. Currently three clinical trials and eight supporting scientific studies are implemented. The medical research network is already in use by 345 active users from 240 institutions in 18 countries. More than 960 000 item entries and 7962 images from 1260 patients are stored. Challenges, which resulted from the fact that only 16 % of the centres had more than 2 patients per year, have been addressed by an intuitive user interface, hierarchical roles, user required features, and experienced support. The system has already been used extensively and has helped to make significant progress in the area of Neuroblastoma research.

The prognostic validity of the ventricular evoked response (VER) signals in cardiac transplantation.

INTRODUCTION: Computerized heart allograft rejection monitoring (CHARM) used for non-invasive rejection monitoring in heart transplant recipients is based on the analysis of ventricular evoked response (VER) signals. The aim of this study was to evaluate the prognostic validity of the Tslew(C), a parameter calculated from the VER. METHODS: During orthotopic heart transplantation, 2 unipolar fractally coated screw-in leads were implanted epimyocardially, one to the left and one to the right ventricle, and connected to a telemetric pacemaker. Recordings of intramyocardial electrograms were performed routinely at the hospital. Data processing was done, artifacts were eliminated, and trend curves of the patients were displayed. Tslew(C) was calculated from the tangent of VER and evaluated from 105 patients. The patients were divided into survivor and non-survivor groups. For statistical analysis, the 2-tailed t-test was performed. RESULTS: Patients in the non-survivors group compared with the control group showed a significantly lower Tslew(C) in the final follow-up (p < 0.001). The differences were even more impressive in patients with recorded intramyocardial electrograms 30 days before death or with a cardiac reason for death. Tests were performed to find an optimal prognostic threshold of the Tslew(C), and the value of 26 mV was finally found. CONCLUSION: Tslew(C) can function as prognostic factor after orthotopic heart transplantation. Further studies should be initiated to provide the prognostic threshold so that patients would not be forced to show up routinely every 4 weeks for follow-up visits. Patients would only have to be admitted to the hospital if the Tslew(C) were less than this prognostic threshold.