The results of the NASPE Prospective Voluntary Registry are reported. A total of 3,357 patients were entered. For those undergoing atrioventricular (AV) junctional ablation (646 patients), the success rate was 97.4% and significant complications occurred in 5 patients. A total of 1,197 patients underwent AV nodal modification for AV nodal reentrant tachycardia, which was successful in 96.1% and the only significant complication was development of AV block (1%). Accessory pathway ablation was performed in 654 patients and was successful in 94%. Major complications included cardiac tamponade (7 patients), acute myocardial infarction (1 patient), femoral artery pseudoaneurysm (1 patient), AV block (1 patient), pneumothorax (1 patient), and pericarditis (2 patients). A total of 447 patients underwent atrial flutter ablation and acute success was achieved in 86% of patients. Significant complications included inadvertent AV block (3 patients), significant tricuspid regurgitation (1 patient), cardiac tamponade (1 patient), and pneumothorax (1 patient). Atrial tachycardia was attempted for 216 patients and the success rate was higher for those with right atrial (80%) or left atrial (72%) compared to those with septal foci (52%). A total of 201 patients underwent ablation for ventricular tachycardia. The success rate was higher for those with idiopathic ventricular tachycardia compared to those with ventricular tachycardia due to ischemic heart disease or cardiomyopathy. While the number of AV junction ablation were higher for those > 60 years of age, there was no significant difference in the success rate or incidence of complication comparing patients > or = 60 to those < 60 years of age. In addition, we found no differences in incidence of success or complications comparing large volume centers (> 100 ablation/year) with lower volume centers or between teaching and non-teaching hospitals.

Background Ulcerative colitis (UC) patients have an increased risk for the development of colorectal cancer (CRC). Our aim was to assess the risk of CRC in UC patients compared with disease extent, disease duration, and geographic variation. Methods In this systematic review and meta-analysis, we searched PubMed, scientific meetings, and the bibliographies of identified articles, with English language restrictions for studies published from 1988 to 2018, and assessed the risk of CRC in UC patients. Patients with Crohn's disease, family history of CRC, and colorectal adenomatous polyp (CAP) were excluded from this research. The study was registered with PROSPERO, number CRD42018102213. Findings We included 58 studies that included 267566 UC patients. Extensive UC and left-sided UC had a higher risk of CRC than proctitis UC. Geography also played a role in UC-associated CRC development. The time of malignant transformation in Asian UC patients started after 10-20 years of this disease duration. North American UC-associated CRC patients significantly increased in more than 30 years of this disease duration. Conclusion In a systematic review of the literature, we found that disease extent, disease duration, and geography were strong, independent risk factors in UC-associated CRC development.

Catheter ablation of the atrioventricular junction with DC energy carries a significant, previously unrecognized risk of death (5.1%), particularly from lethal arrhythmias, when applied to patients with severe left ventricular dysfunction. Great care should be taken in these seriously ill patients to guard against postablation ventricular arrhythmias.

Objective To investigate alterations of neuronal structure an increase of lipofuscin and a decrease in both bNOScontaining neurons and fluorescent adrenergic neuand the mRNA expression of nitric oxide synthase (NOS) and adrenoceptor alpha 1 in young and old rat rons in the pelvic ganglia; (ii) significantly less expression of NOS mRNA than in young rat penile penile tissues, and assess the importance of these factors in erectile dysfunction (ED) associated with ageing.tissues; and (iii) no significant alteration in adrenoreceptor alpha 1 mRNA expression. Materials and methods NOS was determined in the pelvic ganglia of 32 rats using nicotinamide adenine Conclusions The fewer adrenergic and NOS-containing neurons and neurotransmitters in pelvic ganglia from dinucleotide phosphate (NADPH)-diaphorase staining. Adrenergic neurons were identified by histofluorescold rats may explain the enhanced penile smooth muscle tone previously reported in older impotent ence staining. The gene expression for NOS and for adrenoceptor alpha 1 was investigated in corporal men. Furthermore, lower mRNA expression of NOS may be associated with structural and functional tissue by diÂerential reverse transcriptase-polymerase chain reaction (RT-PCR) using specific oligonucleotide changes associated with ageing penile tissue. Keywords Pelvic ganglion, adrenergic staining, adrenoprimers. b-actin was used as an internal standard in each tube to quantify the baseline gene expression.ceptor, NADPH diaphorase staining, nitric oxide synthase, RT-PCR, gene expression Results The following changes occurred in old rats: (i) penile erection. In vitro studies of CSM from men diagIntroduction nosed with organic ED have suggested that the response to phenylephrine (PE) diÂers between young and old The mechanisms causing the decline of sexual function with age are not fully understood. Previous studies have men [9]. The CSM from older men undergoes significantly greater PE-induced contractions than that from shown that more than half of men have erectile dysfunction (ED) by the age of 75 years [1]. Although more the younger men [9,10] but the cellular and molecular mechanisms of this phenomenon remain unknown. frequent systemic disease and greater intake of medication are often associated with older men, the ageing Erectile dysfunction in older men may be a result of a global change in erectile tissue; as in other parts of the process undoubtedly plays a significant role in the development of ED.body, erectile tissue innervation and blood supply deteriorate with age. We have reported such changes in intracaPenile erection is maintained by a delicate balance between the contraction and relaxation of cavernosal vernosal nerves, smooth muscle, interstitial fibrous elements, and focal and diÂuse alterations in the tunica smooth muscle (CSM) in the penis. In the flaccid penis, noradrenaline from sympathetic nerve terminals and albuginea [11,12]. The activation of adrenoceptor alpha 1 induces the contraction of smooth muscle cells in the endothelin from end...