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1.
Acta Cardiol ; 76(3): 267-271, 2021 May.
Article in English | MEDLINE | ID: mdl-32208915

ABSTRACT

BACKGROUND: Cryoablation (CRYO) of cavotricuspid isthmus (CTI)-dependent atrial flutter (AFL) has been shown to be non-inferior to radiofrequency ablation (RF) in terms of ablation success and is associated with less pain. However, procedural time has been significantly longer with CRYO compared to RF. A possible explanation for this could be that operators had less experience with CRYO than with RF. The purpose of this study was to test the hypothesis that in the hands of experienced operators, cryoablation of CTI-dependent AFL is effective with procedure-time similar to what is reported for RF. METHODS: This prospective 2-center study included 184 patients with CTI-dependent AFL - median age 66 years (range 28-83), 159 men (86%). Cryoablation was performed using a 9 F, 8 mm tip catheter (Freezor MAX, Medtronic, Inc, MN, USA). Ablation endpoint was bidirectional CTI-block. Pain was evaluated with a visual analogue scale (VAS 0-10). All operators had experience of at least 25 previous CTI-ablations with CRYO. RESULTS: The acute success rate was 89%. Procedural time including an observation period of 30 min, was 115 ± 36 min which is similar to procedural times for RF in previous studies. Fluoroscopy time was 11 ± 9 min. Cryoablation was perceived as almost pain- free by the patients, VAS (mean) 1.8 ± 1.2. Success rate at 12-month follow-up (FU) was 88% in patients with primary success. No major adverse events occurred. CONCLUSIONS: Cryoablation of CTI-dependent AFL is effective, with a low level of procedure-related pain. In experienced hands, the procedure time in this prospective non-randomised trial seems to be in the level of reported procedure times for RF. The long-term relapse rate appears to be higher than for RF.


Subject(s)
Atrial Flutter , Catheter Ablation , Cryosurgery , Adult , Aged , Aged, 80 and over , Atrial Flutter/diagnosis , Atrial Flutter/surgery , Humans , Male , Middle Aged , Prospective Studies , Recurrence , Treatment Outcome
2.
J Chem Phys ; 148(13): 134708, 2018 Apr 07.
Article in English | MEDLINE | ID: mdl-29626858

ABSTRACT

We have performed a computational study to determine how the wetting of liquid deuterium to the walls of the material influences nucleation. We present the development of a pair-wise interatomic potential that includes zero-point motion of molecular deuterium. Deuterium is used in this study because of its importance to inertial confinement fusion and the potential to generate a superfluid state if the solidification can be suppressed. Our simulations show that wetting dominates undercooling compared to the pore geometries. We observe a transition from heterogeneous nucleation at the confining wall to homogeneous nucleation at the bulk of the liquid (and intermediate cases) as the interaction with the confining wall changes from perfect wetting to non-wetting. When nucleation is heterogeneous, the temperature needed for solidification changes by 4 K with decreasing deuterium-wall interaction, but it remains independent (and equal to the one from bulk samples) when homogeneous nucleation dominates. We find that growth and quality of the resulting microstructure also depends on the magnitude of liquid deuterium-wall interaction strength.

3.
J Chem Phys ; 147(19): 194704, 2017 Nov 21.
Article in English | MEDLINE | ID: mdl-29166088

ABSTRACT

Molecular dynamics simulations of an embedded atom copper system in the isobaric-isenthalpic ensemble are used to study the effective solid-liquid interfacial free energy of quasi-spherical solid crystals within a liquid. This is within the larger context of molecular dynamics simulations of this system undergoing solidification, where single individually prepared crystallites of different sizes grow until they reach a thermodynamically stable final state. The resulting equilibrium shapes possess the full structural details expected for solids with weakly anisotropic surface free energies (in these cases, ∼5% radial flattening and rounded [111] octahedral faces). The simplifying assumption of sphericity and perfect isotropy leads to an effective interfacial free energy as appearing in the Gibbs-Thomson equation, which we determine to be ∼177 erg/cm2, roughly independent of crystal size for radii in the 50-250 Šrange. This quantity may be used in atomistically informed models of solidification kinetics for this system.

4.
Phys Rev Lett ; 111(9): 095502, 2013 Aug 30.
Article in English | MEDLINE | ID: mdl-24033045

ABSTRACT

In body-centered-cubic (bcc) crystals, 1/2<111> screw dislocations exhibit high intrinsic lattice friction as a consequence of their nonplanar core structure, which results in a periodic energy landscape known as the Peierls potential U(P). The main features determining plastic flow, including its stress and temperature dependences, can be derived directly from this potential, hence its importance. In this Letter, we use thermodynamic integration to provide a full thermodynamic extension of U(P) for bcc Fe. We compute the Peierls free energy path as a function of stress and temperature and show that the critical stress vanishes at 700 K, supplying the qualitative elements that explain plastic behavior in the athermal limit.

5.
Phys Rev Lett ; 106(2): 027401, 2011 Jan 14.
Article in English | MEDLINE | ID: mdl-21405249

ABSTRACT

We present density-functional theory calculations of the optical absorption spectra of silica glass for temperatures up to 2400 K. The calculated spectra exhibit exponential tails near the fundamental absorption edge that follow the Urbach rule in good agreement with experiments. We discuss the accuracy of our results by comparing to hybrid exchange correlation functionals. We show that the Urbach rule holds in a frequency interval where optical absorption is Poisson distributed with very large statistical fluctuations. In this regime, a direct relation between the optical absorption coefficient and electronic density of states is derived, which provides a link between photoemission and absorption spectra and is used to determine the lower bound to the Urbach frequency regime.

6.
Phys Rev Lett ; 93(19): 199601; author reply 199602, 2004 Nov 05.
Article in English | MEDLINE | ID: mdl-15600897
7.
Phys Rev Lett ; 85(3): 594-7, 2000 Jul 17.
Article in English | MEDLINE | ID: mdl-10991348

ABSTRACT

The recently proposed scaling law relating the diffusion coefficient and the excess entropy of a liquid [M. Dzugutov, Nature (London) 381, 137 (1996)] is tested for several metals using molecular dynamics simulations. Interatomic potentials derived from the embedded atom method are used to study Ag, Au, Cu, Ni, Pd, Pt, Ni(3)Al, and AuPt and the angular dependent Stillinger-Weber form is used to investigate Si.

8.
Clin Sci (Lond) ; 98(1): 15-20, 2000 Jan.
Article in English | MEDLINE | ID: mdl-10600654

ABSTRACT

It has been proposed that adenosine mediates ischaemic pain in humans. Patients with cardiac Syndrome X are hypersensitive to potential pain stimuli, including adenosine. On the other hand, recent findings suggest that low-dose adenosine infusion may have analgesic effects. Our aim was to test two hypotheses: (1) that the analgesic effect of adenosine is peripheral in origin, and (2) that part of the hypersensitivity to pain of patients with cardiac Syndrome X results from a disturbed mechanism of adenosine analgesia. A total of 12 female Syndrome X patients and eight healthy age-matched female controls were studied in a randomized, double-blind and placebo-controlled study. Adenosine (70 microg/min) or placebo was infused into the forearm via an intra-arterial catheter. After 15 min of infusion, a tourniquet on the upper arm was inflated to 225 mmHg to ensure arterial occlusion. The patient then carried out dynamic handgrip work at 60 Hz. Pain or discomfort in the forearm was estimated continuously according to the Borg CR-10 scale. After the first test, theophylline was infused for 10 min intravenously at a dose of 5 mg/kg body weight. The ischaemic forearm test was then repeated. On a second occasion, the procedure was repeated with the opposite treatment (adenosine/placebo). Only six of 12 Syndrome X patients completed the protocol because of pain during the catheterization procedure or an inability to establish an intra-arterial line. The time to onset of pain in the working, ischaemic forearm was greater for subjects treated with adenosine than for those treated with placebo, both in those Syndrome X patients who tolerated catheterization (49+/-27 s compared with 32+/-18 s; P<0.03) and in healthy controls (40+/-19 s compared with 16+/-8 s; P<0.02). The time to maximum pain, limiting ischaemic work, was also greater with adenosine pretreatment both in Syndrome X patients (137+/-28 s compared with 106+/-28 s; P<0.03) and in healthy controls (109+/-31 compared with 82+/-18 s; P<0.01). After infusion of theophylline there was no difference between adenosine and placebo in either group. Intra-arterially infused adenosine had similar peripheral analgesic effects on experimentally induced muscular ischaemia in those female Syndrome X patients who tolerated intra-arterial catheterization and in healthy controls. Thus adenosine analgesia is counteracted by theophylline, suggesting that the effect is mediated by membrane-bound peripheral adenosine receptors.


Subject(s)
Adenosine/antagonists & inhibitors , Analgesics/antagonists & inhibitors , Microvascular Angina/drug therapy , Purinergic P1 Receptor Antagonists , Theophylline/pharmacology , Adenosine/therapeutic use , Analgesics/therapeutic use , Analysis of Variance , Cross-Over Studies , Double-Blind Method , Exercise Test , Female , Forearm , Humans , Infusions, Intra-Arterial , Infusions, Intravenous , Ischemia/metabolism , Microvascular Angina/metabolism , Microvascular Angina/physiopathology , Middle Aged , Muscle, Skeletal/blood supply , Pain Measurement
9.
Phys Rev B Condens Matter ; 54(22): 15742-15746, 1996 Dec 01.
Article in English | MEDLINE | ID: mdl-9985641
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