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Novel electrocardiographic dyssynchrony criteria that may improve patient selection for cardiac resynchronization therapy

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Journal of geriatric Cardiology 2022年第1期19卷 31-43页

作者： gábor katona András Vereckei Department of Medicine and Hematology Semmelweis UniversityBudapestHungary

Cardiac resynchronization therapy(CRT)is an evidence-based effective therapy of symptomatic heart failure with reduced ejection fraction refractory to optimal medical treatment associated with intraventricular conduction disturbance,that results in electrical dyssynchrony and further deterioration of systolic ventricular ***,the non-response rate to CRT is still 20%−40%,which can be decreased by better patient *** main determinant of CRT outcome is the presence or absence of significant ventricular dyssynchrony and the ability of the applied CRT technique to eliminate *** current guidelines recommend the determination of QRS morphology and QRS duration and the measurement of left ventricular ejection fraction for patient selection for ***,QRS morphology and QRS duration are not perfect indicators of electrical dyssynchrony,which is the cause of the not negligible non-response rate to CRT and the missed CRT implantation in a significant number of patients who have the appropriate substrate for *** imaging modalities,many ventricular dyssynchrony criteria were devised for the detection of mechanical dyssynchrony,but their utility in patient selection for CRT is not yet proven,therefore their use is not recommended for this ***,CRT can eliminate only mechanical dyssynchrony due to underlying electrical dyssynchrony,for this reason ECg has a greater role in the detection of ventricular dyssynchrony than imaging *** improve assessment of electrical dyssynchrony,we devised two novel ECg dyssynchrony criteria,which can estimate interventricular and left ventricular intraventricular dyssynchrony in order to improve patient selection for *** we discuss the results achieved by the application of these new ECg dyssynchrony criteria,which proved to be useful in predicting the CRT response in patients with nonspecific intraventricular conduction disturbance pattern(the second greatest group of CRT candidates),an

关键词： patient synchronization eliminate

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A different cardiac resynchronization therapy technique might be needed in some patients with nonspecific intraventricular conduction disturbance pattern

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Journal of geriatric Cardiology 2021年第12期18卷 975-985页

作者： gábor katona Zsuzsanna Szelényi gábor Szénási Bálint Kozman Zsolt Rekvényi Luca Kópházi Zsolt Dobos Szilvia Vereckei András Vereckei Department of Medicine and Hematology Semmelweis UniversityBudapestHungary Heart and Vascular Center Semmelweis UniversityBudapestHungary Institute of Translational Medicine Semmelweis UniversityBudapestHungary Ardinsys Ltd. BudapestHungary Budapest University of Technology and Economics Faculty of ArchitectureBudapestHungary

BACKgROUND Current cardiac resynchronization therapy(CRT),devised to eliminate dyssynchrony in left bundle branch block(LBBB),works by pacing the latest activated left ventricular site(LALVS).We hypothesized that patients with nonspecific intraventricular conduction disturbance(NICD)pattern respond less favorably to CRT,because their LALVS is far away from that in *** By measuring the amplitude and polarity of secondary ST-segment alterations in two optional frontal and hori-zontal surface electrocardiogram(ECg)leads and using a software,we determined the resultant 3D spatial secondary ST vector,which is directed 180o away from the LALVS,in 110 patients with LBBB pattern and 77 patients with NICD pattern and heart *** validate the ECg method,we also estimated the LALVS by echocardiography using 3D parametric imaging and 2D speckle tracking in 22 LBBB patients and 20 NICD *** with NICD pattern were subdivided according to their non-overlapping frontal plane resultant secondary ST vector ranges to the NICD-1 subgroup(n=44)and the NICD-2 subgroup(n=33).RESULTS Based on the software determined coordinates of the resultant 3D spatial secondary ST vector directed 180o away from the LALVS,the LALVSs were located leftward,posterosuperior in the LBBB group,slightly left,superior in the NICD-1 sub-group,and slightly left,posteroinferior in the NICD-2 *** LALVS determined by ECg and echocardiography matched in all patients,except *** In the NICD-2 subgroup,a remote LALVS was found from that in LBBB pattern,which might explain the high non-response rate of the NICD pattern to the current CRT technique.

关键词： patients pattern ventricular

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The role of endoscopy in the management of hereditary diffuse gastric cancer syndrome

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World Journal of gastroenterology 2019年第23期25卷 2878-2886页

作者： Shria Kumar Jessica M Long gregory g ginsberg Bryson W katona Division of gastroenterology University of Pennsylvania Perelman School of MedicinePhiladelphiaPA 19104United States Division of Hematology and Oncology University of Pennsylvania Perelman School of MedicinePhiladelphiaPA 19104United States

Hereditary diffuse gastric cancer(HDgC) syndrome is an inherited cancer risk syndrome associated with path-ogenic germline CDH1 variants. given the high risk for developing diffuse gastric cancer, CDH1 carriers are recommended to undergo prophylactic total gastrectomy for cancer risk reduction. Current guidelines recommend upper endoscopy in CDH1 carriers prior to surgery and then annually for individuals deferring prophylactic total *** of individuals from HDgC families without CDH1 pathogenic variants remains less clear, and management of families with CDH1 pathogenic variants in the absence of a family history of gastric cancer is particularly problematic at present. Despite adherence to surveillance protocols, endoscopic detection of cancer foci in HDgC is suboptimal and imperfect for facilitating decision-making. Alternative endoscopic modalities, such as chromoendoscopy,endoscopic ultrasound, and other non-white light methods have been utilized,but are of limited utility to further improve cancer detection and risk stratification in HDgC. Herein, we review what is known and what remains unclear about endoscopic surveillance for HDgC, among individuals with and without germline CDH1 pathogenic variants. Ultimately, the use of endoscopy in the management of HDgC remains a challenging arena, but one in which further research to improve surveillance is crucial.

关键词： CDH1 gene Hereditary diffuse gastric cancer gastric cancer Endoscopic screening Endoscopy

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Long-term temporal patterns in flight activities of a migrant diurnal butterfly

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Insect Science 2021年第3期28卷 839-849页

作者： Edit Juhasz Adam gor Daniella Bali Fanni Kerekgyarto gergely katona Zsolt Vegvari Department of Evolutionary Zoology and Human Biology University of DebrecenDebrecenHungary Department of Ecology University of Veterinary MedicineBudapestHungary Centre for Ecological Research Danube Research InstituteBudapestHungary SDEI Entomology Information Centre Senckenberg Deutsches Entomologisches InstitutMOnchebergGermany

Recent studies demonstrated that the Painted Lady(Vanessa cardui),a cosmopolitan diurnal butterfly performs long-range migration between subtropical Africa and north-western Europe,covered by individuals belonging to up to six *** we analyze temporal patterns of complete annual migratory activity of the Painted Lady in Hungary,located in its Central European migratory route,almost completely unstudied *** do so,we used field occurrence data collected between 2000 and 2019 and estimated temporal patterns in migratory activity by fitting kernel density functions on the daily mean number of individuals and observation *** temporal distributions of kernel density estimates were analyzed as a function of time and key climatic predictors of the study *** found that(i)the timing of spring arrivals has been advancing;(ii)the relative intensity of the first and last migratory peaks of the Painted Lady significantly increased during the past decades;and(iii)intensity of the last migratory peak is related to the mean temperature of the previous month,inferring that the migration is shifting to earlier dates and their volume of the migration has substantially intensified,evoking mutually nonexclusive,competing *** study indicates the strengthening migration activities of a southerly distributed,long-distance migrant diurnal butterfly,most probably linked to the northward shift of wintering areas induced by warming trends of the southern parts of ***,the complexity of the likely processes leading to changing migratory strategies calls up for further research in both breeding and wintering areas.

关键词： climatic responsiveness insect migration kernel density estimation Painted Lady

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Possibility of Use of Noise Analysis for Identification of Reactor Conditions during Accidents

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World Journal of Nuclear Science and Technology 2013年第3期3卷 96-105页

作者： Tamas Janos katona katona MVM Nuclear Power Plant Paks Ltd. Paks Hungary

Knowledge and control of the thermo-hydraulic conditions in the reactor is required for the effective accident management. Dedicated and qualified for harsh environment instrumentation has to be in place for this purpose. Experience of the Fukushima Dai-ichi plant and the lessons learned from the European stress tests demonstrated that alternative and divers tools and methods are needed for the identification of reactor condition in extreme situations. In the paper the feasibility of development of an alternative accident monitoring via well-known noise diagnostics methods is proposed and demonstrated. The possibility of identification of reactor accident conditions using temperature and pressure fluctuations, noise of the neutron and gamma field is considered on the basis of research achievements in reactor noise. As an example the use of pressure fluctuations for accident monitoring is presented.

关键词： Accident Management Nuclear Power Plant Post-Event Condition Noise Diagnostics Pressure Fluctuations

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Structure and Tone Change of the Press in View of the Reports of the Public Mood in the Era of Change of Regime(October 1988-January 1989)

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Cultural and Religious Studies 2018年第8期6卷 449-455页

作者： Csaba katona Hungarian Academy of Sciences BudapestHungary

1988 and 1989 was the dawn of Hungarian change of *** impact of the upcoming change is also well-documented in informers'reports of the public *** lecture examines the structure and tone of the press from this particular aspect from October 1988 to January *** the reports of the public mood were reflected on the free press?Membership of a state party is accustomed to the fact that the caring state determines what needs to be *** media products and their multi-faceted vision caused them serious *** reports of the public mood,it is not to be overlooked that their creators have been working on *** of informers recorded what readers of the reports of the public mood *** wrote what they really *** people were shocked to see more newspapers,magazines,and TV *** demanded their banning *** media activity was considered by many sources as self-directed and *** reported that many people agreed with the *** most people wrote that conflicting news is causing serious *** sudden freedom came to surprise most of the *** following quotation summarizes this:"The majority did not know what was right,what could be done,and what could not be *** variety of newspapers does not help clarity of vision but the difficulty of orientation".

关键词： change of regime Hungary reports of the public mood structure and tone change of the press

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The role of electrocardiography in the elaboration of a new paradigm in cardiac resynchronization therapy for patients with nonspecific intraventricular conduction disturbance

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Journal of geriatric Cardiology 2016年第2期13卷 118-125页

作者： Andras Vereckei gabor katona Zsuzsanna Szelenyi gabor Szenasi Balint Kozman Istvan Karadi The 3rd Department of Medicine School of Medicine Semmelweis University Budapest Hungary Institute of Pathophysiology Semmelweis University Budapest Hungary Ardinsys Ltd. Budapest Hungary

Cardiac resynchronization therapy （CRT） is associated with a favorable outcome only in patients with left bundle branch block （LBBB） pattern and in patients with a QRS duration 〉 150 ms, in patients with non-LBBB pattern with a QRS duration of 120-150 ms usually is not beneficial. After adjusting for QRS duration, QRS morphology was no longer a determinant of the clinical response to CRT. In contrast to the mainstream view, we hypothesized that the unfavorable CRT outcome in patients with non-LBBB and a QRS duration of 120-150 ms is not due to the QRS morphology itself, but to less dyssynchrony and unfavorable patient characteristics in this subgroup, such as more ischemic etiology and greater prevalence of male patients compared with patients with LBBB pattern. Further, the current CRT technique is devised to eliminate the dyssynchrony present in patients with LBBB pattern and inappropriate to eliminate the dyssynchrony in patients with non-LBBB pattern. We also hypothesized that electrocardiography may also provide information about the presence of interventricular and left intraventricular dyssynchrony and the approximate location of the latest activated left ventricular （LV） region. To this end, we devised new ECg criteria to estimate interventricular and LV intraventricular dyssynchrony and the approximate location of the latest activated LV region. Our preliminary data demonstrated that the latest activated LV region in patients with nonspecific intraventricular conduction disturbance （NICD） pattern might be at a remote site from that present in patients with LBBB pattern, which might necessitate the invention of a novel CRT technique for patients with NICD pattern. The application of the new interventricular and LV intraventricular dyssynchrony ECg criteria and a potential novel CRT technique might decrease the currently high nonresponder rate in patients with NICD pattern.

关键词： Cardiac resynchronization therapy Electrocardiography Heart failure

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Structural Mechanics Analysis Using an FE-Mesh Adaption to Real, 3D Surface Detected geometry Data

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Journal of Mechanics Engineering and Automation 2015年第7期5卷 387-394页

作者： Sebastian katona Michael Koch Tobias C. Spruegel Sandro Wartzack Department of Mechanical Engineering and Building Services Engineering Technische Hochschule Nuernberg Georg Simon OhmNuremberg 90489 Germany Chair of Engineering Design KTmfk Friedrich-A lexander- Universitaet Erlangen-Nuernberg Erlangen 91058 Germany

Within today＇s product development process, various FE-simulations （finite element） for the functional validation of the desired characteristics are made to avoid expensive testing with real components. Those simulations are performed with great effort for discretization, use of simulations conditions, like taking different non-linearities （i.e., material behavior, etc.） into account, to create meaningful results. Despite knowing the effects of deformations occurring during the production processes, always the non-deformed design model of a CAD-system （computer aided design） is used for the FE-simulations. It seems rather doubtful that further refinement of simulation methods makes sense, if the real manufactured geometry of the component is not considered for in the simulation. For an efficient exploit of the potential of simulation methods, an approach has been developed which offers a geometry model for simulation based on the existing CAD-model but with integrated production deviations as soon as a first prototype is at hand by adapting the FE-mesh to the real, 3D surface detected geometry.

关键词： FEA (finite element analysis) preprocessing simulation 3D surface detection RE (reverse engineering)

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采用原位包衣技术制备对乙酰氨基酚锭剂

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中国医药工业杂志 2016年第12期47卷 1581-1581页

作者： katona g 王盈

以2种糖醇（山梨醇和木糖醇）的共晶为原料，采用原位包衣技术制备儿科用对乙酰氨基酚（PCT）锭剂。与常规压片工艺相比，这种类型的熔融技术更具成本-效益效应，也更简单。该锭剂的成型和包衣发生在同一制造步骤中，再通过1个冷却步骤... 详细信息

以2种糖醇（山梨醇和木糖醇）的共晶为原料，采用原位包衣技术制备儿科用对乙酰氨基酚（PCT）锭剂。与常规压片工艺相比，这种类型的熔融技术更具成本-效益效应，也更简单。该锭剂的成型和包衣发生在同一制造步骤中，再通过1个冷却步骤使生产的锭剂具有较软的内芯和较硬且有抗性的外壳。

关键词：对乙酰氨基酚包衣技术锭剂制备原位成本-效益压片工艺熔融技术

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ECg stress test induced atrial ischemia in a patient with old inferior myocardial infarction due to a distal coronary artery lesion

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Journal of geriatric Cardiology 2017年第1期14卷 73-77页

作者： Andras Vereckei gabor katona Zsuzsanna Szelenyi Edit Takacs Pal Maurovich-Horvat David Becker 3rd Department of Medicine Budapest Hungary MTA-SE Cardiovascular lmaging Research group Heart and Vascular Center Budapest Hungary Center of Nuclear Medicine Semmelweis University Budapest Hungary

A 78-year-old man with a history of mitral valve prolapse underwent echocardiography during his cardiological check-up examination in 2011 in a symptom-free stage. Echocardiography revealed akinesis of the inferior septum and inferobasal free wall as a novel finding suggesting a distal right coronary artery （RCA） lesion （Figure 1）. The systolic left ventricular function was normal. Earlier echocardiographies did not show wall motion abnormalities.

关键词： Atrial infarction Atrial ischemia Electrocardiography

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